Convalescent Relief Work AT Bellevue Hospital NEW YORK JANUARY, 1908 CONVALESCENT RELIEF WORK AT BELLEVUE HOSPITAL NEW YORK JANUARY, 1908 PRESS OF J. J. O’BRIEN & SON 122 EAST 23RO STREET NEW YORK CONVALESCENT RELIEF WORK. In 1906 Dr. S. T. Armstrong, General Medical Supt. of Bellevue and Allied Hospitals called attention to cases of patients whose recovery was retarded either by anxiety concerning home conditions, or by mental depression because of their own outlook. He urged system- atic investigation and relief to supplement the medical and surgical treatment given, and advised that such work be under the charge of a Graduate Nurse because of her familiarity, both with Hospital discipline and the conditions of the patient. His proposal met with the warm co-opera- tion of Mrs. John L. Wilkie, one of the managers of the Bellevue Training School, and in July the experiment was authorized by the Trustees of Bellevue and Allied Hospitals. The salary of a Graduate Nurse, and later that of an Assist- ant, was granted, and an office provided in the Hospital. Results were immediate, as was the case in a some- what similar plan undertaken by Dr. Cabot in connection with the Dispensary of the Massachusetts General Hospital in Boston, and this new Social Service Work is rapidly becoming recognized as an integral part of Hospital develop- ment. The duties of these Relief Nurses at Bellevue are to visit in the wards to ascertain as far as possible the needs of each patient, and to act as the connecting link between such and the charitable associations and people caring for the indigent poor. HISTORY DUTIES OF RELIEF NURSES 3 The variety of the services rendered is too great to fully enumerate, for nothing is considered foreign to the work that will relieve mental anxiety and thus promote recovery. A man taken suddenly ill may have left a family destitute at home, or a mother may be anxious about small children left uncared for. Cases discharged may be in need of employment. Others may require only advice or to be put into communication with or sent to distant friends. Clothing may often be req- uisite or an escort to accompany to trains, etc. Admissions are secured to Homes for Incurables, Soldiers’ Homes or similar institutions which give permanent care. One of the most important features of the Relief Work is that of sending adults to convalescent homes, and of getting the convalescent babies and children to the seashore or country in the Summer. These homes are mainly supported by private charity and have been most hospitable to Bellevue patients. Those unfamiliar with convalescent work can form no idea of what a few weeks of rest, good food, fresh air and relief from anxiety means in uplift to such patients, who would otherwise take up the burden of life in a weak- ened condition, leading to another breakdown or chronic ill-health and who would in consequence often become public charges. An interesting feature of the work is the assistance given to country boys who have drifted to the City and who when discharged are helped to find positions and are often loaned money to provide the necessities of life until their first pay-day. Several men have been redeemed from the drink habit through the aid of institutions for the treatment of alcoholism SCOPE OF WORK 4 and have thus been enabled to re-enter the ranks of self- supporting citizens. Those of us whose lives are spent within the range of normal existence can little fathom how such patients as well as those in the prison wards, and others who have attempted suicide, are strengthened by the friendly hand clasp that gives assurance and help, or the renewal of hope that comes with the knowledge that some one cares and has faith in them and their future. Every one connected with the Hospital from the highest officials to the lowest employee has entered cordially into the spirit of the work, and many lay visitors also have contributed largely, of time and personal effort. Charitable Societies have co-operated cordially, and Miss Mary E. Wadley, the nurse in charge, has been untiring in her devotion to the work. It has been necessary to supply an Emer- gency Fund for use where the requirements were immediate or could not be met through the channels of the organized charitable societies. Till January 1 st, 1908, contributions have been received by Dr. Armstrong, General Medical Superintendent of the Hospital, but now that the work has ceased to be an experi- ment and has become permanent, it has been thought advisable to establish a Convalescent Relief Committee to meet these needs. Such a Committee has accordingly been appointed by the President of the Board of Managers of the Bellevue Training School for Nurses. Its duties are to collect and receive money for the Emergency Fund, to oversee the dis- bursal of said Fund, and to co-operate in every possible CO-OPERA- TION EMERGENCY FUND COMMITTEE 5 manner with the Department of Charities, the various organized charitable Societies and Institutions, and the Department of Bellevue and Allied Hospitals. Sub-joined to this brief statement of the work at Bellevue will be found extracts from the reports of the Nurse in charge. A perusal of these will lead, we trust, to money being sent to the Treasurer or to any Member of the Convalescent Relief Committee, or articles of clothing to the Office for Convalescent Relief at Bellevue Hospital. The history of these eighteen months has proved conclusively not only the need of such relief to the individual but the preventive value to City and State, in restoring to the wage earning ranks many who would otherwise become dependent charges on the municipal or state institutions. 1 he work so far has been confined to Bellevue, but it is hoped that it can soon be introduced into all of the City Hospitals. APPEAL PREVENTIVE WORK 6 EXTRACTS FROM REPORTS OF NURSE IN CHARGE OF CONVALESCENT RELIEF WORK, BELLEVUE HOSPITAL. EMERGENCY FUND. Total donations for 18 months from July, 1906, to January, 1908 - $731.07 Total expenditures for the same time - 711.22 LOANS. Of this $71 1.22, the sum of $305.28 was given out in loans (which includes an exceptional loan of $50 recently made to one individual). So far $130.38 has been returned. Of the 42 persons to whom loans have been made, 24, or 57%, have made payment in full 1 1, or 2V/2%, have paid in part; 9, or 22%, have as yet made no returns; but there is reason to believe that even this indebtedness will be reduced. Loans are made to tide a man over until pay-day; to help rehabilitate him and so improve his chances of finding employment; to redeem tools from pawn; to 7 enable patients to reach their friends in other cities, and to prevent any friendless boy or girl—possibly with no knowledge of the English language—from being turned into the streets without resources, and with thoughts natur- ally gravitating towards beggary or crime. All these are emergency needs. Where feasible, cases are referred to outside and co- operating societies, but it is not always possible or ad- visable, for reasons ably explained in the following quo- tation from Dr. Richard Cabot’s report for 1906 of Social Service Work at the Massachusetts General Hos- pital Dispensary: “To refer all cases to the Associated Charities has several objections. Firstly, that even the Associated Charities cannot keep track of all the minutiae of the suitability and adaptibility of the institutions or agencies needed by our patients. Secondly, the detailed estimate of the patient’s physical condition and outlook is easy for our workers to obtain through the physician close at hand, but not at all easy to pass on to another agency. Thirdly, as only a small portion of the cases which we refer to the Associated Charities could be directly dealt with by them, they must in turn pass the patient on to another society. This double reference, though often necessary, is undesirable. People grow discouraged, suspicious, restless or over-passive when passed along from person to person, and many drop out and are lost on the way. Fourthly, in a large proportion of our cases the needed reference is to another hospital, and in this work our agents are naturally more expert than those of any other society.’’ 8 TYPICAL ITEMS OF EXPENDITURE. Railroad, car and carriage fare for St. Eleanora’s Home, Tuckahoe, N. Y. - - $ .75 Railroad, car and carriage fare for Solomon and Betty Loeb Home, East View, N. Y. - .65 Mrs. M. R., to Sea Side Hospital to see sick baby ------- .25 M rs. McC., to Central Islip to see husband - 1.20 M. S., surgical abdominal belt - 3.00 J. B., carfare to Jamaica, L. I., for employment, .35 7 Olive Tree Inn tickets - 1.00 5 Mills Hotel meal tickets 1.00 Mrs. R. R., express and storage on baggage - 5.00 F. S. and four children, emergency aid - - 2.00 F. B., loan until pay-day - 2.00 Mrs. C. and baby, emergency aid - - - 1.00 M. L., stock of lemons for peddling - - - 3.00 Telegram to Rhinecliff ----- .25 J. L., accompanied to Seton Hospital - - .45 T. D., accompanied to Rosary Hill Cancer Hos- pital, Hawthorne, N. Y., including carriage 2.68 C. Z. (a crippled boy), brace - 3.00 M. C., case of neurastheria, board in country two weeks ------ 10.00 M. H., hot-water bag etc. - - - - 1.00 M. I., sick boy, transportation to Boston home - 2.00 M. J., underflannels, going to country - - 3.20 M. P., loan for repairing artificial leg - - 6.50 Expressage on clothing donated - .50 C. F., redeemed tools from pawn - - - 1.50 9 OF CASES. July, 1906, to Dec., 1907, inclusive. Number of new cases (for 18 months) - - 2530 Former cases receiving counsel or assistance (for 12 months) - - - - - 1 1 16 Visits to interview patients in wards (for 12 months) 3985 Visits from patients to Relief Office (for 12 months) 2031 Visits to office by physicians, social workers, etc., (for 12 months) ----- 1844 Visits to homes, institutions and offices on behalf of patients (for 12 months) - 468 Patients accompanied to trains country homes, etc., (for 12 months) - - - - 199 Number of cases referred to convalescent homes in 18 months - - - - - 812 Number of cases placed in permanent homes in private institutions (during 18 months) - 23 Number of institutions to whom patients have been referred in 18 months - 158 The above volume of work could not have been accomplished without the valuable assistance rendered by volunteer workers. Money, other than emergency funds, has been donated from time to time for typewriting or similar office expenses. *These figures are only approximately correct, owing to the fact that at the outset Miss Wadley carried on the work unassisted for several months, which made clerical exactness impossible. Figures are understated. 10 TYPICAL MONTHLY REPORT OF NURSE IN CHARGE. December, 1907. Visits to interview patients in wards - 669 Visits from patients to office - 247 Visits to office by physicians, social workers, etc. 203 Visits to institutions and offices 52 Visits to homes on behalf of patients 46 Patients accompanied to trains, country homes, etc. 12 Former cases receiving counsel or assistance - - 72 Number new cases - - 219 Cases pending - - - _ _ - 10 Emergency aid— Clothing Meals Temporary lodging R. R. Fare Etc. Aid 57 Referred to individuals, business houses, etc. for employment 23 Miscellaneous assistance: Letters written 72 Information ----- 45 Counsel ----- 46 11 Telephone Messages: Received - 246 Sent 289 Total 535 Referred to the Ass’n Imp. Cond. Poor: Aid 9 Hartsdale ----- ] State Board of Charities - - - - 10 Charity Organization Society 6 Joint Application Bureau 8 Dep’t of Charities - - - - - - 26 Seton Tuberculosis Hospital 4 Municipal Lodging House 3 Bureau for Dependent Children - 1 Dep’t of Health ------ 1 Otisville Tuberculosis Hospital - 1 Riverside Tuberculosis Hospital - 1 St. Vincent de Paul Society - - - - St. Elizabeth’s Home, Spring Valley - 23 St. Eleanora’s Home, Tuckahoe 35 Solomon and Betty Loeb Home 7 St. Andrew’s Convalescent Home 4 Guild of the Infant Saviour - - - - 4 Rosary Hill Home, Hawthorne, N. Y. - 1 New York State Institute 5 12 Italian Immigration Society I Brunswick Home ------ 1 Hadley Rescue Mission, Lodging - - - 1 Salvation Army ------ 1 Magdalen Home ------ 1 S. S. D. of Free Synagogue 50 St. Joseph’s Polish Home 2 Isabella Heimath Convalescent Home - - 17 St. Zita’s Home ------ 2 Isaac T. Hopper Home ----- 1 Council of Jewish Women 2 N. Y. Infant Asylum ----- 2 N. Y. Foundling Asylum 2 Chester Crest ------- 1 Bellevue Dispensary ----- 4 St. Mary’s Home ------ 1 Friendly Aid Society ----- j St. Joseph’s Hospital ----- | Legal Aid Society ------ 1 St. Barnabas’ House ----- | German Consul ------ 1i 13 CONVALESCENT RELIEF COMMITTEE. Dr. John \V. Brannan - Ex-officio President of the Board of Trustees of Bellevue and Allied Hospitals. Dr. Samuel Armstrong - - - Ex-officio General Medical Superintendent of Bellevue and Allied Hospitals. Miss Goodrich Ex-officio General Superintendent Training Schools of Bellevue and Allied Hospitals. Mr. Robert W. Hebberd - - - Ex-officio Commissioner of Public Charities. Mr. Homer Folks - Ex-officio President City Visiting Committee of the State Charities Aid Association. Mrs. William Church Osborn - 40 East 36th St. Chairman. Mrs. Elliot Benedict - - - 31 East 78th St. Treasurer. Mr. j. K. Paulding - - - 130 East 24th St. Mr. Sydney E. Goldstein - 600 West 134th St. Mrs. Walter Sands Mills - 324 West 89th St. Mrs. Grant La Farge - - 124 East 22d St. Miss Georgine Iselin - - New Rochelle, N. Y. Mrs. Leopold Stern - - 27 West 87th St. Mrs. T. C. T. Crain - - 121 West 73th St. Miss Ruth Morgan - - 26 Washington Sq. 14