Red Cross Nursing ServiceMiss Jane A. Delano,Chairman National Committee.
Miss Jane A. Delano,Chairman National Committee.
The rapid development of the Nursing Service of the Red Cross and the solidarity of its various activities are encouraging signs of future growth and more extended usefulness.
Our state and local committees of nurses, organized primarily for the enrollment of Red Cross nurses, have responded with enthusiasm whenever new demands have been made upon them. We now have more than five hundred representative nurses serving on these committees throughout the United States, and their co-operation and interest may be depended upon to further any work undertaken by the Red Cross. They have been most active in the sale of Christmas Seals and have co-operated with local tuberculosis agencies, often serving on special committees. In organizing our Rural Nursing Service we have sought their advice and assistance. They have suggested nurses for rural work and have given valuable information in regard to the needs of their own communities. Further details concerning this important service is given by Miss Clement, superintendent of rural nurses.
Our local committees are found ready to assist in relief work at celebrations and parades, and appreciate the opportunities for experience thus offered. The District of Columbia committee, of which Miss Anna J. Greenlees is chairman, secured the nurses required for relief stations established in Washington during inaugural week. A report of the work of these stations appears in this number of theMagazine.
The National Committee on Nursing Service, in co-operation with the First Aid Department, has been authorized by the Red Cross to organize classes of instruction for women in Home Nursing and First Aid. Once more we must appeal to our local committees of nurses for their assistance. The plan adopted requires that the instruction in Home Nursing shall be given by enrolled Red Cross nurses, who must, in a large measure, be secured through the local committees. As the work develops we hope that nurses especially qualified to instruct women in the principles of right living and the home care of the sick may be found willing to devote their whole time to this instruction. Even two classes a day would give a fair income and an opportunity to render valuable service to a community. Information concerning these classes for women is given in this issue by Miss Oliver, in charge of their organization.
Believing that the course in first aid adopted by the Red Cross would be valuable even to graduate nurses, arrangements have been made with the First Aid Department to allow enroled Red Cross nurses to take this course at home. The textbook written by Major Charles Lynch must be used, and nurses who so desire will be allowed to take an examination under the direction of a physician appointed by the Red Cross. To those who pass this examination a Red Cross First Aid Certificate will be issued.
Miss Fannie F. Clement,Superintendent of Rural Nurses.
Before the Red Cross entered the field of rural nursing several attempts were made to extend this work on a broad plan into the country districts. After the Peace Conference, held at Portsmouth, N. H., in 1905, the Russian and Japanese envoys made a gift of $20,000 to the State, to be used for charitable purposes. At this time several persons who realized that rural nursing was an important factor in the improvement of social conditions tried to have this sum used in establishing a state-wide system. It was not possible, however, to convince those in authority that this would be the best disposition of the gift. It was the aim of the Holman Association, incorporated in 1911, “for the promotion of rural nursing, hygiene and social service.” to expand as resources permitted to meet the needs of rural communities in the United States, but the society has recently been disbanded.
There are but few instances where rural nursing has been extended by a single organization to cover any considerable area. A pioneer work was started seventeen years ago in North Westchester county, New York, where the District Nursing Association now employ six nurses and covers about twenty villages. Gradually new districts in the surrounding territory are being opened up by the association.
There are, however, several individual nurses meeting the needs of rural communities, and often under trying conditions. In isolated regions they are cut off from helpful association with others doing similar work and the stimulus that comes from identification with an extensive organized effort. The Red Cross has planned a service of which these nurses may become a part, which will assist them to establish and maintain high standards.
Rural nursing as it now exists is generally carried on under the supervision of a committee which may include several sub-committees. These are responsible for various branches of the nurses’ work. Wherever such committees are able to arouse a general interest much has been accomplished not only in behalf of public health, but in many lines of public welfare work.
It is expected that in the development of Red Cross rural nursing, local committees will be created, meeting standards of salary and other regulations which are deemed necessary to insure the best interests of a community. The locality benefitted by the work of a nurse is expected to meet the expenses connected with it. Fees collected from patients are not sufficient for this, as all sick persons are not able to pay for the services of the nurse. As a rule, patients are expected to pay for professional visits, according to their means, but those unable to make any payments should not go uncared for. The responsibility for raising the necessary funds rests with the local committee, which also superintends the work of the nurse.
A general supervision by the Red Cross is maintained through occasional visits of the superintendent of rural nurses and through monthly reports of their work.
During the 1910 Red Cross Christmas Seal sale, the Anti-Tuberculosis Association of Wisconsin, offered the services of a visiting nurse for one month to twelve cities of a limited population, making the highest per capita sale. The Red Cross Seal Committee of Ohio, in 1912, sent a visiting nurse for one month to each of twelve small cities throughout the State as a prize in the seal-selling contest. Interest in visiting nursing was thus stimulated to a degree that several of these towns havesince been insisting upon a permanent nurse, and have raised funds necessary for her support.
Hospitals, dispensaries and medical attendance are seldom as accessible in the country as in cities. To have the rural nurse a resident in the community, her services for all regardless of any lines of distinction, to have intelligent nursing care for patients in their own homes, and instruction and demonstration given in the principles of hygiene, not only of person but as applied to home surroundings, are advantages which have been appreciated wherever the visiting nurse is established.
The best physicians have welcomed her assistance. No stronger testimony to the value of her services is needed than the present demand for public health workers in connection with industrial establishments, department stores, religious and civic institutions and health departments of city, town and county.
Women of the finest type are needed for this work and those who have had specialized training in public health activities. Several visiting nursing associations to be utilized as training centers for Red Cross nurses offer good opportunities for students to become familiar with social work of various kinds through lectures, study courses and affiliations with philanthropic societies in the city. Nurses may thus come in contact with milk stations, dispensaries, tuberculosis and charity organization societies, settlements and other social agencies.
Nurses eligible for appointment to the Rural Nursing Service, who have not already had experience or training in visiting nursing, after a minimum period of three months with a city nursing association will be placed one month with an association in the country, thus giving them actual experience in rural nursing and its problems before assignment to their post of duty. It is important that the rural nurse be informed upon the various branches of public health nursing and social service, as carried on in cities, in order that she may initiate work along these lines in country places where it is often wholly unorganized. She should be able to recognize contagious diseases and minor ailments among school children. By giving simple health talks in the schools, she is able to utilize one of the most advantageous avenues for influencing the home life of her people.
Local societies and clubs, the aim of which is to improve unfavorable conditions that exist in their communities can establish a no more fruitful source of helpfulness than by the employment of a visiting nurse. Red Cross Chapters will find in such an undertaking not only a means of creating interest in local work of the Red Cross, but opportunity of enlarging their field of usefulness to the community. The experience of the Red Cross Chapter in Islip, Long Island, in the employment of a rural nurse has long ago proven the value of this plan of work.
Miss Marion L. Oliver,In Charge of Organization of Classes.
Believing that the physical welfare of the race depends largely upon home conditions and that the women of the nation have a very definite responsibility in maintaining the health of the family, the American Red Cross has undertaken to organize on a national scale classes for women in home nursing and first aid. It is hoped that this instruction will make them better home makers, better mothers and better citizens. Before describing what has been accomplished in thisdirection, it is best to give details of the plan adopted. This can be done most briefly by quoting from the official circular relating to the same.
The American Red Cross has decided to organize classes of instruction for women in first aid, home nursing, hygiene and allied subjects, to be given under the supervision of the National Committee on Red Cross Nursing Service.
1. To afford women the opportunity to learn first aid to the injured, and to provide simple instruction in the home care of the sick.
2. To afford women the opportunity to learn how to prepare food for sick and well.
3. To afford women the opportunity to learn how to prepare rooms and other places for the reception of ill and injured.
4. To afford women the opportunity to learn how to protect their own health and that of their families.
It must be distinctly understood that this course of instruction for women is only intended to prepare them to render emergency assistance in case of accident, to give more intelligent care to their own families under competent direction, and, in exceptional cases, to assist in relief work under the supervision of the Nursing Service of the American Red Cross.
Much needless suffering is now caused the ill and injured on account of the ignorance of unskilled persons. It has been said that the fate of the injured is dependent on the care which their injuries first receive. It is therefore necessary for everybody to learn what to do first in an emergency, and what not to do. This is easy to learn, but the subject must be learned. Nobody can be expected to know this without instruction. The number of people injured in the United States is rapidly mounting and is now in the hundreds of thousands annually. Knowledge of first aid to the injured cannot, it is true, prevent the consequent suffering entirely, but it can be made an important factor in this result.
The health of the family depends largely upon the home maker, and it is most essential that she have a definite knowledge of personal and household hygiene and the proper preparation of food. Special diet for the sick is no less essential. Scarcely any woman is unacquainted with the sick room in her own family, and some simple instruction in the care of the sick should be a part of every woman’s education.
It is the purpose of the Red Cross to provide for this instruction.
This work is just being started in this country, so that great results cannot yet be reported. It has already been demonstrated here, however, that instruction in first aid will reduce deaths and serious results from injuries about one-half. On railroads and everywhere else that the American Red Cross has carried first aid instruction, all interested are enthusiastic in praise of the benefits derived. In other countries, such as Great Britain, France, Germany, Italy and Russia, work of a similar character to that contemplated for women has been done for many years and all testimony goes to show that the public has largely benefited therefrom.
Ten lessons in First Aid.
Fifteen lessons in Hygiene and Home Nursing.
Fifteen lessons in Dietetics and Household Economy.
All instruction will be very practical and pupils will, as far as possible, be required actually to do everything described in the teaching.Lessons in either First Aid or Home Nursing may be given first, but both these courses of lessons must be completed and certificates must be held in both by those desiring to take further instruction.
No two courses of instruction may be taken at the same time.
All first aid courses must be given by a physician and other instructions by a Red Cross nurse, unless otherwise authorized by the Red Cross.
Women desiring to form a class in either first aid or home nursing should secure a sufficient number of names—not less than ten or more than twenty-five—selecting one to act as president. The president so selected should then communicate with the Department of Instruction for Women, American Red Cross, Washington, D. C. A roll will be supplied on which the names of the members of the class will be inscribed and answers given in respect to certain essentials.
No one under sixteen years of age is eligible for these classes.
It will be necessary locally to obtain the services of a physician or a nurse to give the instruction, whose name and address should be forwarded to Washington with required roll of proposed class. All instructions must be approved, and a card of authorization issued, by the Red Cross before any course is begun.
The instructors’ fees, if any, must be paid locally, and arrangements for the same must be made by the class with the instructor selected.
It will also be necessary to provide a meeting place.
Books and charts will be supplied by the Red Cross. The cost of these will be $1 per member for each course of ten lessons, and $1.50 per member for each course of fifteen lessons. Payment for the same should be made in advance. The president will be responsible for collecting and forwarding this amount to Washington.
On the completion of each course of instruction an examiner will be appointed, to be paid by the Red Cross. Such examiner will be other than the instructor of the class.
No one will be allowed to take an examination in any course who has not attended at least three-fourths of the lessons of that course.
Certificates will be given successful candidates at the conclusion of each course of instruction.
After fulfilling the requirements for the organization of a class and the instructor has been formally appointed the class is free to begin work, and very interesting work it proves to be. The course of instruction in first aid begins with an introductory lesson in anatomy and physiology followed by nine lessons with practical demonstration in the care of emergencies and accidents most likely to be met with in the every-day walks of life. It is most desirable that each pupil be given an opportunity to practice on a model or manikin the various points covered in the lessons. After the ten lessons are over, those members of a class who have not been absent more than three times, are ready for examination. This is given by a physician other than the instructor of the class who is appointed direct from the first aid office. The examination is one-third oral, one-third written and one-third practical.
There are fifteen lessons in the Home Nursing course, and these should prove of absorbing interest and practical value to every one. The preliminary lessons deal with matters relating to the healthfulness of the home, such as contamination of food and its prevention, sources of impurities in water and air, personal hygiene and the preservation of health. Then follows simple instruction in the home care of the sick, how to make a sick bed, to transfer a patient from bed to chair, the general care of a patient, including baths and the use of ordinary sickroom appliances. For example, thetheory of bed-making was being taught in one of our classes the other day, and after the instructing nurse had finished her lecture, every member of the class had to make the bed with and without the patient, the patient in this case being a life-sized doll covered with oilcloth so that it could be bathed. Several members of the class did not make the beds satisfactorily and were told to practice at home so that at the next lesson they could do better. A special examination also follows this course.
After those Home Nursing lessons are over, it is planned to have a series of lectures on home economics and dietetics.
So much for the plans and organization, now for the actual classes. The records show that on March 30th almost six hundred women are taking this instruction.
Twenty-four classes in First Aid and three in Home Nursing have been formed in different localities. Both the Young Women’s Christian Association and the Girls’ Friendly Society have become interested in this work.
In Genesee, New York, the fox-hunting community has formed a large class for women to teach them to cope with the accidents of the hunting field.
In Manchester, Connecticut, where the Cheney Brothers have their big silk mills, classes in both First Aid and Home Nursing have been organized among the employes.
In Cincinnati a group of society women are taking the First Aid course.
In one of the suburbs of Washington, a group of young mothers have formed a class.
Other classes are active in Lexington, Ky., Providence, R. I., Detroit, Mich., North Attleboro, Milton and Manchester, Mass., Milwaukee, Wis., York, Pa., Philadelphia, Pa., and Washington, D. C.
Two classes have been formed by the wives of the officers of the Army and the Navy, and we hope that in time every Army post and Naval stations will have its regular classes in First Aid and Home Nursing, and that this work will not only be for the officers’ wives but for the wives of the enlisted men as well.
Al the end of each set of classes there is an examination and those who successfully pass receive a Red Cross certificate.
It is also planned that a field day will be held in each State that has enough classes to warrant it and at this field day First Aid teams of women will compete for a Bronze Medal. The rules for such a competition will be supplied upon request.