A < y wJG^ - A CELEBRATION OF PUBLIC HEALTH NURSING IN THE UNITED STATES 1893 -1993 A Century of Caring A CELEBRATION OF PUBLIC HEALTH NURSING IN THE UNITED STATES 1893 -1993 A Selection of Photos Reflecting Contributions of Public Health Nursing in the United States 1 Acknowledgments The idea for this photoessay originated at the Division of Nursing of the Bureau of Health Professions, within the Health Resources and Services Administration of the United States Public Health Service. It was a collaborative effort of many people. Dr. Audrey Davis of the Smithsonian Institution provided the major historical back- ground and most of the photos used. Her knowledge of the history of women in the United States, and especially of early public health nurses, provided the basis for this pictorial history. Dr. Moira Shannon and Captain Janet Horan, staff from the Division of Nursing, designed the final product and coordinated the related activities. Mr. James Walker and Mr. Francis Harding of the Health Resources and Services Admin- istration did the graphic design and layout of the publication. The American Public Health Association generously published the docu- ment. Among the many who contributed their support to this effort, the following are especially acknowledged: Dr. Maria Salmon and Dr. Thomas Phillips of the Division of Nursing; Dr. Fitzhugh Mullan of the Bureau of Health Professions; Dr. Susan Sparks, Ms. Lucinda Keister, and Mr. Peter Hirtle of the National Library of Medicine; and Dr. William McBeath and Mrs. Seiko Baba Brodbeck of the American Public Health Association. The cover photo was supplied through the courtesy of Mr. Lyle Churchill, Vice President for Development, Visiting Nurse Service of New York. 2 Dear Colleagues: We are delighted to be a part of this country's recognition of the special role public health nursing has played over its first century of service. One hundred years of meeting the health needs of the people of the United States; what a truly wonderful heritage for all of us! It is also our pleasure to be a part of the important process of looking forward and helping to shape public health nursing for the 21st century. The challenges of today and tomorrow are both similar and different from those of yesterday. Some plagues have been eliminated even as new ones emerge. The vision that guided public health nurses then will continue to serve us well: to preserve, protect and enhance the health of the people of this country. We in the U.S. Public Health Service, particularly those of us in the Division of Nursing and the Bureau of Health Professions, are honored to work in partnership with public health nurses every- where to bring this vision forward into the future. This photo essay brings together selected photos that reflect the rich and diverse history of public health nursing in the United States over the past 100 years. Maria E. Salmon, ScD, FAAN Fitzhugh Mullan, MD Director, Division of Nursing Director, Bureau of Health Professions 3 4 Introduction Public Health nursing in the United States traces its origins to those first graduate nurses who provided nursing services to poor people in their homes across the nation. These nurses provided care to those in need with little or no financial compensation, and they were frequently the only providers of care to these under- privileged people. These first public health nurses were courageous and caring women whose commitment to those they served was challenged daily by the overwhelming health problems they con- fronted and the social conventions that saw little place for women who operated outside of the haven of class and family. What truly remarkable and compassionate pioneers they were. The "official" event which marks the beginning of public health nursing in this country was the founding of the first organized public health nursing agency or settlement house in New York City in 1893. This agency went beyond the individual efforts of community nurses of previous times and began a large scale national movement to assure that "public health nurses" would be available to those in need. The vision of this movement came from Ms. Lillian Wald, a nurse, and the founder of the Henry Street Settlement in 1893 - the first district nursing agency in the United States. It was Ms. Wald, with her sense of calling, exceptional political and organizational skills, and tireless leadership, who brought together the people, resources and caring that became the phrase that she herself coined: the "public health nurse". While the words of historians can and in some cases have characterized the work of those early public health nurses in Henry Street and elsewhere, it is the images depicted in these photographs that truly chronicled the special work of public health nurses. These photo- graphs also portray the people they serve and the many settings in which they worked. Homes, workplaces, schools, street corners, clinics....anywhere people in need could be found; these were the settings captured on film. Each photo is different - each image unique. One of the major common themes is reaching out to care for the health of people in need. Another theme of the photographs of public health nurses is one of very independent and creative women forging a profession against great odds. Public health nursing agencies, those first settlement houses and district nursing agencies, were among the earliest major enterprises run by women in this country. Early public health nurses were competent administrators and managers who were able to mobilize community resources to support largely "unprofitable" businesses. How fortunate for this country that these business women saw human health as the greatest profit of all! For nursing and for women in general, the public health nurses who forged these impor- tant social organizations were truly inspirational models who still have much to teach us. An additional theme, especially in the photographs assembled for this essay, is the theme of one person making a difference. The history of public health nursing is one of individuals doing what was within their power to do - to make life better for others. The photographs here are generally not of the "great leaders", they are of those whose names are no longer connected to their images. In this way, they are each of us - or what each of us could be. They are timeless inspirations for public health nurses of today and tomorrow to do what they are able to do and leave their world a better place. This photo essay has been assembled, in part, to capture some of the unique history of public health nursing. It is also intended to share the spirit of public health nurses everywhere - a spirit of caring and personal courage. It is this spirit that made the first century of public health nursing a reality in the United States. It is our hope that this photo essay will help to kindle the spirit of those who carry this special legacy forward into the next century. Audrey Davis Moira Shannon Janet Horan 6 Public Health Nurses Public health nurses have worn many uniforms over the last century and their photographs were usedjor publicity and to encourage stajjmorale. VNA of Rochester, New York, ca 1940 8 Publichealthnurseswereresourcefulinraisingneededfundsandpoliticahupport,andinfilling social as wellasprofessional roles. Card' Signed' by7 'First'fiady' To Be Sold Nurses.'f afDay iVvW;*'/ the T tag Visiting Nurses to Sell Autographs Of Noted Persons •■<." ~*—~ ■ . ■ .•"'.' ',■-•;,,, Cards Bearing Such Signa- tures as Mrs. Warren Hard- . ing, Woodrow Wilson," \';. Herbert Hoover, Etc.,' '■,*.' ,. on Sale Tag Day. 'VISITING NURSE ^ASSOCIATION H> Ii (un( rad< and F Ma) H>, Nur Kog four ago; intei prcs prrs recti and toge Tl whii m-:- ,-\\WEDNESDAYSTAG DAY'^ Send [the Nurse o™e Contribute to the*50.000 fund for Vhe Instructive Visiting J^ NURSE SOCIETY OnlyK 'ill r sicv O'J u UuSfl utals Help se id thfeNuu n rn othi t9o; 1413V St Above left: The autographs offamous persons such as Florence King Harding, wife of the president, were sold or auctioned to encourage larger donations on Tag Days. VNA of Omaha, Nebraska, ca 1919 Above right: Public health nursing extra efforts, such as duringa flu epidemic, werepublicizedto urge larger donations. VNA of Omaha, Nebraska, ca 1919 Left: Patients were encouraged to raise funds. VNA of Washington, D. C. ca 1920 cjreai 9 VNA of Cleveland, Ohio. ca!919 Easter remembrancesforpatients. VNA of Brooklyn, New York, ca 1950 A RyiMD or ManyYeaB Guests such as Mrs. Calvin Coolidge, wife of the president, helped to celebrate public health nursing special events. J^ VNA of Washington, D. C. ca 1925 XtSjgk ^:-^i^-^'-- i'-.* 1 0 Below: Snowshoes enabledvisits to ruralfamilies. IVNA of Richmond, Virginia. cal920 Public health nurses have travelled by many modes oj transportation over they ears. Above right: When uniforms became shorter, bicycles were used. VNA of Brooklyn, New York, ca 1950 Left: Mary Breckinridge, founderojtheFrontier NursingService, on horseback. The Frontier NursingService, Wendover, Kentucky. cal930 (photoby Marvin Patterson) 1 1 The People Served by Public Health Nurses The U.S. Public Health Service, as the Federal agency responsible jor the health ojthe nation, has employedpublichealthnursestoprovideservicestomanypopulationsintheUnitedStates. Vac- cines to prevent disease as well as services topromote health and care jor illnesses have beenpro- vided through the Public Health Service. gl nv Top left: Public health nurse shows an lndianfamily the results of their tuberculosis x-rays. NationalArchives. ca 1955 Top right: Public health nurse screening new immigrants at Ellis Island in New York. National Library of Medicine, ca 1890-1920 Left: Public health service nurse weighing and measuring school children in a rural setting as part of a Ch ildren s Bu reauprogram. National Archives. cal920 1 2 Public health nurses have servedpeople across the lije span and havepracticed in a variety oj settings. They have addressed a continuum ojhealth needs including health promotion and disease prevention, treatment, andrehabilitation. Above right: Mother and child welcome the public health nurse. Cleveland, Ohio. cal950 Left: Public health nurse talks with elderly person. National Library of Medicine, ca 1930 1 3 Public health nurse teachingfootcare. VNA of Boston, Massachusetts. cal920 Public health nursegivingdemostration in bathingofan infant. I SA of Newark. Newfersey. cal912 Public health nurse teachingurine testing to diabetic woman. VNA ofRockford, Illinois. cal950 Public health nurse teaching rehabilitation techniques. VNA ofPhiladelphia, Pennsylvania. ca!980 1 4 Helpingpeople to re gain junction ajter illness or injury. Minnesota Historical Society, ca 1930 1 5 Places San Felipe Pueblo with outdoor adobe ovens inforeground. U.S. Indian Service, Albuquerque, New Mexico. Yardshowingproximity of well water supply and toilet facilities. \ NA ofMichiana, South Bend, Michigan. Public health nurse cares for a child in a tent after an earthquake. VNA of Santa Barbara, California. cal925 I 6 Home in rural area. VNA ofMichiana, South Bend, Michigan. Outdoorhome. VNA of Santa Barbara, California. I 7 Workplaces Gold miner receives foot care. VNA of Denver, Colorado. cal910 Belo w left: Employees receiving carein occupational health clinic American Association of Occupational Health Nurses. Below right: Implementing safety in the workplace. A merican Association ofOccupational Health Nurses. People Maternal death has long been a problem in the United States. VNA of Omaha, Nebraska. May 10,1920 THE THE 6.S UNITED STATES' M HIGHEST AfAOHG Z MOTHERS POREVtRY SAVE TH£ BABIES^ Public health nurses taught mothers how to keep their babies healthy. VNA of Portland, Oregon. ca!920 It is not the babies born, but the babies saved that count. Mothers, nurse your babies! The greatest good you can do your baby is to nurse it during the first year. When nursing is impossible cows milk is the only good sub- stitute for mother's milk. Do not use any milk that you do not KNOW to be clean and pure. If you cannot get pure milk we will help you. Another object of our milk station is to furnish milk modi- fied under the direction of a phy- sician to such babies as cannot take raw milk. Our first milk station wiB^ be opened at 270 Fourth $*«**. opposite the City Hall on or about June 15th. There will be a clinic daily from 11:00 to 12:00, with a physician in attendance. A graduate nurse will be in charge of the station to modify the milk and to advise the mothers in the care of their babies. Classes will be held and mothers will be taught how to bathe and care {or their babies. - 1 9 Healthy twins depict benefits of good diet and good care. VNA of Omaha, Nebraska. cal930 N. A. Now Testing Eyesight of Children and Foresight of Adult? Well baby clinic. VNA ofRockford, Illinois. cal949 School health clinic. VNA of Somerset Hills, Newfersey. ca 1940 2 0 7 Teaching parents about health at Swann's Creek School, Gray's Creek Township, Cumberland County, North Carolina. National Museum of American History. cal950 Teachingchildren proper nutrition. VNA of Greater Manchester, New Hampshire, ca 1930 Teachingmother and children how to prepare food. VNA of Omaha, Nebraska, ca 1910 2 1 Observinggrowth and development. VNA of Brooklyn, New York. cal950 Mother, brother, nurse andbaby share a smile. I ,\'4 of Brooklyn, New York. cal950 Monitoring infant health. VNA ofPhiladelphia, Pennsylvania. cal970 2 2 Communicable disease: a major threat to the health ojthe public and a challenge to public health nurses. Public health nurse giving medicine to tubercular patient. VNA of Omaha, Nebraska, ca 1920 Public health nurse cares)ror children with measles in room that serves as kitchen, bedroom and dining room. VNA of Newark, Newfersey. ca!916 2 3 Public health nurse provides immunization against commun icable disease. Indian Health Service. Public health nurse adjusts legbrace forchildwith infantile paralysis to m in im ize effects of paralysis. MinnesotaHistorical Society, ca 1930