Question

Identify a historical public health nurse who made significant contribution to the field of public health. Describe the event and the nurse’s intervention in response to the event. Discuss the outcome of the nurse’s intervention. How has this influenced the foundations of public health nursing today?

Answer 1

Lllian Wald was born into a comfortable Jewish family in 1867, but chose to work in the tenements of New York City. She coined the phrase “public health nursing” and is considered to be the founder of that profession.

Lillian was educated at a private boarding school. She had graduated from a two-year nursing program and was taking classes at the Women’s Medical College when she became involved in organizing a class in home nursing for poor immigrants on New York’s Lower East Side. Lillian, distressed by the conditions in the multi-story walk-up, cold-water flats, moved to the neighborhood and, along with her classmate and colleague Mary Brewster, volunteered her services as a visiting nurse. With the aid of a couple of wealthy patrons, the operation quickly grew in size. The Henry Street Settlement (otherwise known as the VNS, or Visiting Nurse Service) grew from 2 nurses in 1893 to 27 in 1906, and to 92 in 1913.

The nurses educated the tenement residents about infection control, disease transmission, and personal hygiene. They stressed the importance of preventative care, but also provided acute and long-term care for the ill. They received fees based on the patient’s ability to pay. The organization also eventually incorporated housing, employment, and educational assistance and recreational programs as well. In 1912, Wald helped found the National Organization for Public Health Nursing, which would set professional standards and share information. She served as its first president.

Her other accomplishments included:
•   Persuading President Theodore Roosevelt to create a Federal Children’s Bureau to protect children from abuse, especially exploitation such as improper child labor.
•   Lobbying for health inspections of the workplace to protect workers from unsafe conditions and encouraging employers to have nursing or medical professionals on-site.
•   Convincing the New York Board of Education to hire its first nurse, which lead to the standard practice within in the U.S. of having a nurse on duty at schools.
•   Persuading Columbia University to appoint the first professor of nursing in the country, and initiating a series of lectures for prospective nurses at Columbia’s Teachers College. This became the basis a few years later for the University’s Department of Nursing and Health and caused nursing education to shift away from solely hospital-taught training to university courses augmented by hospital fieldwork.

Wald wrote two books about her experiences, The House on Henry Street, and Windows on Henry Street. She died in Westport, Connecticut, on September 1, 1940. Wald’s legacy is seen in the lasting good of her many accomplishments in the areas of public health and social services, not the least of which is her founding of the VNS. The New York Visiting Nurse Service continued to grow and thrive, increasing to 3,000 employees, with the number of people served annually now totaling 700,000. The original VNS is still a model for the 13,000 visiting nurse groups which exist today.

Wald said, “Nursing is love in action, and there is no finer manifestation of it than the care of the poor and disabled in their own homes.”  

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