Josephine C. Aldrich

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WORCESTER

MAGAZINE

The Worcester ' Society for District Nursing By the Superintendent, Rosebelle Jacobus , R. N.

DISTRICT or visiting nursin g is not new; in fact, it dates back to the days of St. Paul. Between the pre­ Chr ist ian civilization and our own the histori cal link is brok en, but there is a record covering nearl y 2000 years to th e present t imo, The ear liest district nurse, visitor and social worker was Pheb e of Cenc hr ea, who lived ()O A . D ., the fri end and helper of Saint .Paul, who says of her, " She hath ".lES' ~I()TnE HI:\(j." been a succore r of man y and of myself also. " She was a woman of wealth, im­ portance and di gnity, an d took upon h erself the office of deaconess of th e Church of Cenchrea. From her day the work of th e district nurse has never been unkn own. In 1617, Vincent D e Paul went from Sp ain to Franc e. H e settled in th e hospital and assisted with the work of what would n ow be called the out- patien t dep art­ ment, meantime supervising th e work of th e visit ing sisters, and soon decided th at in order to obt ain bett er res ults ther e must be two distin ct departments, one for th e regular visiting and one for nu rsing' th e sick,-hence th e firs t society for district nursing, 1618, called th e "Ladies of Cha rity." Ver y quaint and pract ical were th e directions for the work of the members . '" Th e La­ di es of Char ity ' shall visit onl y thos e whose eases have

been examine d and passed upon by the presid ent, assist­ an t and treasurer. The lady who visits shall get th e nourishmeu t f'rom th e treasurer , cook it and bring it to th e in valids, chee rfully an d kindly sa lute t hem on en­ tering their ap artments. She shall arrange a tray all th e bed, spreading a napkin over it , an d pl acin g on it a glass, sp oon and br ead r oll. Next she sh all wash the sick per son 's hands, say grace, and th en , h avin g poured out the soup and put th e meat in a pla te, she sh all a r­ range all in th e tray. Sh e shall kindly in vite th e sick person to eat, doing all in a spirit of love as if dealin g with her own child. She shall t ry to cheer the invalid if downcast , cutting his f ood and pourin g ou t th e drink. Thus having set th in gs goin g, if th ere is anyone at hand she shall leave the rest to him and go on to the next sick person, whom she shall treat in the same way . She shall reme mber always to begin with those who hav e some one to help th em and fini sh wi th tho se who ha ve no one, so as to be able t o rem ain a long er tim e with th em. In the evening, she shall r eturn with the suppe r, and go through th e sa me ar range men t as before. Each patient sh all receive as mu ch bread as is necessary . with a qu arter of a pound of mutton or boiled veal for din­ n er an d as mu ch roast fo r supper, except on Sundays and f easts, when boiled chi cken shall be given and two or three t imes a week min ced p ie. Those who have no feve r may get a pint of wine every day, half in th e mornin g and half in the evening." In 1782 we fin d an attempt a t cottage nursing in Engl and. 'fhe R ev. Mr. Dolling, Vi car of Aldenham , raised subscr ip tions to send women for three month s '

THE };URSES RE ADY FOR TH EI R DAIL Y CALLS.

WOR CE STER t raining in midwifery that they m ight wo rk amon g t he village wo men. I n 1867 di s­ tr iet nursin g was well estab lis hed in E ng ­ land. I n th e U n ite d S ta t es, in 1813, Ch arlest on, S . C., was th e fir st t o take up di st rict n ursing. The N ew Y ork City Mis­ TH E SMILE TIIAT WON'T coxus OYF . sionary Society in 1877 was t he first to em ploy a regul a r tra ined nurse. Boston f oll owed in 1884, P hll aclrlphla in 1886, D ela ware in 1890, Chicago i n 1892, a nd W orcester in 1892. On .Iannary 1, 1909 , th ere were 500 asso cia tio ns i n t he United States emp loy ing ove r 1300 t rain ed nurses, Th e W or cester Societ y for Di at rict N ursing was organized in 1892, incorporated in 1899 , is snp p orted hy volu n ta r y contr ibut ions, empl oys six grad ua tes and three pupil n u rses. This inclndes th e n urse whose sal­ ar y is paid by t he Worcester 'I'uber cu losis R eli ef Asso­ ciati on. Tw o pup il nurses a re f urn ish ed by the City Hospi tal an d on e from th e Memor ial H ospital. Th e Society 's headqua r t ers is at 1 E lm Pl ace. Kin d f ri end s, chu rch a nd other societ ies have s uppli ed us wit h sheets, pillow-cases, ba by cloth es, luxu ri es a n d necessar ies f or the pati ents, and ex t ra pl easu r es at Chr-ist ma s a n d East er. Th e basi c princip les upon whi ch t he work is ad mi n ­ istered are that t he nursing of t he si ck in th eir hom es should be done seriously and adequa tely , in structi on being inciden t to it and not the prim ary mot ive. Since t h e addition to t he staff in D ecemb er , 1908, of the nurse for maternity cases, there have b een si xty pati ents u n der h er care . Visiting h ours are fro m 8.30 a.m. to 5.30 p .m. T he nu rse 's wor k is to v isi t. h er pa­ tient s once or t wice a d ay if n ecessary , seeing t hat the physician s ' orders a rc ca r ried out , an d to br ing to eac h

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pati ent all the care and comf or t that skilled and trained han ds can give. A visiting nurse is furn ished with out charge to those una bl e to pay. P atien ts in better eiren msta neos aloe expected to pay fr om fiv e cents up wards. When ahl e to pay th e r egular f ee of one dollar they arc r eferred to an hourly nurse. H possib le th e n urses will visit in th e mor-ning those cas es r epor ted the p r eviou s da y j those coming to the office bef ore twelve, th e af ter noon of th e sam e clay: Th e n urses are f or the public and it is desired that physicia ns and othe rs interested in th e sick shall send f or th em . Nu r ses are not ex pe cted to a tte nd mat ernity cases dur ing' labor , but after con­ finemen t will ca re for moth er and in fa n t u ntil re cove ry . One hu nd red a nd eigh tee n ph ys icians asked fo r our ser­ v ices i n 1908, an d $1 ,957 .45 was used f or the su pp or t of the S ocietv. In 1909 we n eed at least $2,000 more, if the opportun ities to increase an d im prove the work offer ­ ed th e S ociety are used. T he f ollowi ng' is from a nurse 's dai ly report : " i\f y first ca11 was a n ew cas e- -a child with pn eumo­ nia . I rea ched the house a nd IN THE T UBEKctl.O~ ! ~ 'l'E:-IT. fou nd t he occupants all Ital ia n . A man stood in th e door -way , and , as I came alon g, ca lled over his shoulder, 'The n u rse. ' Ont of another d oor -wa y ca me a woman who said, ' H er e, lady.' Inside t he ro om, ly ing' on two chairs, was a chi ld of two years, f ully d ressed even to his sho es. The temp era t u re was taken and regis tered ]()4%. A mor e u n comf ort able little cha p I h av e never seen. Whil e try in g to persu ade the mo th er- to let me re move some of t he cloth in g a nd bathe t h e littl e f ello w, just as 1

AFTER T HE N URSE H AS T ID IED UP T HE nooxr.

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was about to give up th e task ill despair, the father ~, .r.- •• ,; .. appeared, and npon learn­ ing' th e troubl e, pushed his wife asid e with no tender . I 1 touch, and said, ' Go on , sh e • I a woman , know nothing'. Me be ill hospital and know . Take everything off, and wash for fev er ; do him good. ' 1'1y heart ached for the mother, so sure her boy was about to be sacrificed, but I began my work , mean­ while askin g abou t the docON TH EIR DAT L Y ROl i:-;J)1' . tor 's order s, whi ch th e man gave in a seemingly in klligcnt manner. A sp onge bath of soap an d water, and alcohol rub, the mouth clean ed, a shee t put over th e old sofa (an improvement on the chair ) , the boy sleeping in his clean , fr esh bed , wi th only one garment on his now cool little bod y , and in walk ed th e doctor. I spoke of his order carri ed out for bathing, etc.; he looked at me, looked a t th e child, an d at the discarded clothing, laughed and said, 'This is my first visit here ; th e pati ents I ask ed you to see last night a re up stairs, two of them , in the same condition. ' So up stai rs I went, and began over again . It was t en o 'clock bef ore I left my Italian friends, after promising to call in th e late afternoon. " My second call was to a woman dying of tuber culo sis. A f ourteen-year-old girl is th e housekeeper and mother to the three young er child re n . The hou se was ne at and clean, the patient was as clea n as th e little gi rl cou ld keep her, but sh e was r estl ess and in much p ain from cons tan t coughing and th e bed sores on her back. After th e ba th, wh en her bed had heen freshly mad e, her hail' comb ed and teeth cleaned , and had taken some nourishm ent I hall brought fOI> her, she th ought she could sleep, and , after giving some advice to th e littl e housekeep er, I went on my way. "My thir-d, f ourth and fifth cases wer e very close together and all surgical dressing-women who had been operated on in th e hospitals, and permitted to come home on con dition that th e d istrict n urse giv e th e nee­ esssa ry care. " It was now 12.30, and I went home to lunch, " The first visit in th e af ter noon was to an old 111 a n with a. leg ul cer , whi ch is healin g slowly under con­ stan t car e and cleanlin ess. At fir st he did no thin g but grumbl e and f uss when he canght sight of a nurscs

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MAGAZINE uniform, as h e cons ide red all women 'a fool bunch,' a conclusion reach ed after he h ad wedded his third wife. Now he says he doesn't care whi ch nurse comes to him, as each one is 'a spot of sunshine, ' "The next call is to a bab y of three months, slowly st ar ving to death because n o f ood can be found to agree with him. .At birth a nd up to two mon th s he was st rong and well , but his mother one sad day, after weeks of temptation , went on a spree and poor baby was so neglected that his recovery is doubtful. A n eighbor called the nurse's attention to the pitiful cry ing of the child, and upon inv estigatin g she fou nd th e mother drunk on the floor and the p oor, little, dirty scrap of human ity on a bed almost in a state of exha ust ion . Th e mother is heart-broken, for she r eally loves her baby, and is now followin g instructi ons faithfully . The baby has an oil rub three tim es a day-twice by th e mother and once by the nurse, and the f ood is prepared daily by the nurse. "The next visit was to Mrs. B- , the pri ze p ati ent of the Society and a p et of us all . Daily h er kn ees must be steam ed and rubbed, her braces adj usted tha t she may walk around her room ; one year ago sh e walked f or th e first time in yea rs. Sh e usu ally has a mornin g visit, but is always glad t o wait her tum when more ser ious cases need us. "The ni nth visit was t o a little pneumonia conv ales­ cen t, a dear littl e gir l of eight. 'I'he evening t emper­ ature taken , a sp onge bath given, and inst ruc ti on as to 1ICr nou rish men t , then back to my Italian fri end s. All three te m per-at ures 'wer e ver y high . Th e two upstair's wer e at te nded fjrl:lt-th e usu al treat-men t of alcoho1 spong es, etc. Th e boy clown ­ stairs seemed a little better. and fa r more comfo r table than in th e momin g. This UOT II ,\ J{)IS rri.r .. tim e th ere was no re sistance from th e moth er, she rea 1­ ized what the mornin g tr eatment had done , and deeply appreciated it. Now she wanted t o help, so I explai ne d how sh e could spon ge th e boy during th e ni ght, and showed her how to prep ar e th e n ourishmen t. When I left her, sh e shook h ands a nd in her broken En gli sh said, by way of thanks, 'I lik a y ou too mu ch . ' " 'I'he averag e for the year is sixty-four visits a da y each workin g clay of 1908, Th e follo wing are th e offi cers of th e assoc iat ion ~ Board of D ire ctors: Presid en t. 'Miss Ira ri-iet g , Clarke, 9 Chestnut Street ; Vice-presid ent, Mr s. Edwin Brown. 70 Elm S t reet ; 'I'reasurcr, M 1'8 , H omer Gage, 8 Chest ­ nut S tre et; Clerk, Mr s. Henry J . Gross, 2:1 May Street. D i r entot-s : :i\fiss Josephine C, Aldrich , )\[rs. Frederi ck n . Baker, Miss Isabel 1\1. Cromp ton. Mr s. Ed gar A , Fi sh er , Mrs , '1'. H ovey Gage, .Ir ., Mr s. David H arrower , .Ir., Mrs. Geor ge M, Basse tt, Mrs. Ma tth ew J. Whittall , Advisory Board : Rev, B ernard S . Conaty, Mr. Ale x­ ander D e'\V' itt, Dr. Thomas H . Gage, Dr. 'Warren R. Gilman, Dr. L eonard P. Kinnicutt, Rt. R ev. Al exand er II , Vinton, Dr. Samu el B. Woodw ard .