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220 WORCESTER MAGAZ INEThe Worcester ' Society for District Nursing

By the Superintendent, Rosebelle Jacobus , R. N.

".lES' ~ I ( ) T n E H I : \ ( j . "

DISTRICT or visitingnursing is not new; in fact ,it da tes back to the days ofSt. Paul. Between the preChristian civilization andour own the histori cal linkis broken, but there is arecord covering nearly 2000years to the presen t t imo,The earliest district nurse,visitor and social worker wasPhebe of Cenchrea, wholived (O A. D., the fr iendand helper of Saint .Paul,who says of her, " She hathbeen a succorer of manyand of myself also. " She was a woman of wealth, importance an d dignity, and took upon herself the officeof deaconess of the Church of Cenchrea. From her daythe work of th e district nu rse has never been unknown.In 1617, Vincen t De Paul went fr om Sp ain to France.H e settled in th e hospital and assisted with the work

of what would now be called the out- patient depar tmen t, meantime supervisin g the work of the visit ingsisters, and soon decided that in order to obtain betterresults ther e must be two distinct departments, one forth e regular visiting and one for nu rsing' th e sick,-henceth e firs t society for district nursing, 1618, called the"Ladies of Cha rity." Ver y quaint and practical wereth e di rections for the work of the members. '" Th e Ladies of Char ity ' shall visit only thos e whose eases hav e

been examined and passed upon by the presid ent, an t and tr easurer. The lady who visits shall gnourishmeu t f'rom th e treasu rer, cook it and bringth e invalids, cheerfully an d kindly salute them otering th eir ap artments. She shall ar range a trthe bed, sp reading a napkin over it , and pl acin ga glass, spoon and bread r oll. Next she shall wasick person 's hands, say grace, and th en, having pout the soup and pu t th e mea t in a pla te, she shrange all in th e tray . She shall kindly invite thperson to eat, doing all in a spir it of love as if dwith her own child. She shall t ry to cheer the iif downcast, cut ting his food and pouring out th eThus hav ing set th ings going, if th ere is any ohand she shall leave the rest to him and go onnext sick person, whom she shall treat in th e sameShe shall reme mber always to begin with those whsome one to help th em and finish with those whono one, so as to be able to rem ain a longer timth em. In the evening, she shall r eturn with the sand go th rough the same ar rangement as before.patient shall receive as much br ead as is necessarya quarter of a pound of mutton or boiled veal foner and as mu ch roas t for supper, excep t on Suand feasts, when boiled chicken shall be given anor th ree t imes a week min ced p ie. Those who hafeve r may get a pint of wine every day, halfmorning and half in the evening."In 1782 we find an attempt at cottage nursEngland. 'fhe Rev. Mr. Dolling, Vicar of Alderaised subscriptions to send women fo r th ree m

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

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221

TH E SMILE TIIAT WON'T coxus OYF .

W O R CE STERt ra in in g in midwiferythat they might workamong the villagewomen. I n 1867 distr iet nursin g was wellestab lished in E ngla nd . I n th e U nitedS ta t es, in 1813,Ch ar leston, S . C., wasth e fir st to take updi str ict nur sing. TheNew York Cit y Missionary Society in1877 was t he first to employ a regula r tr a ined nurse.Boston followed in 1884, P hllaclrlphla in 1886, Dela warein 1890 , Chicago i n 1892 , and W orcester in 1892. On.Iannary 1, 1909 , th er e were 500 associa tio ns in theUnited States employing ove r 1300 t rain ed nurses,The W or cester Society fo r Di atrict N ur sing wasorganized in 1892, incorporated in 1899 , is snpportedhy volu ntary cont ributions, empl oys six gra duates an d

three pupil n u rses. This inclndes the n ur se whose salary is paid by the Worcester 'I'uberculosis R elief Associati on. Tw o pu p il nurses a re f urn ished by the CityHospital an d one from th e Memorial H ospi tal. Th eSociety 's headquarters is at 1 E lm Pl ace. Kin d f ri ends,church a nd other societies have s upp li ed us wit h sheets,pillow-cases, ba by clothes, luxu ri es and necessaries f orthe pati ents , an d ex tra pl easu r es at Chr-istmas andEast er.The basi c principles upon whi ch the work is administered ar e that t he nursing of the sick in th ei r hom esshould be done seriously an d ad equa tely, in struc tionbeing inciden t to it and not the primar y mot ive.Since t he add ition to t he staff in December , 1908, ofthe nu rse fo r maternity cases, th er e have been sixtypati ents u nder her care . Visiting hours are from 8.30a.m. to 5.30 p .m. T he nu rse's wor k is to visit. her patients once or t wice a day if necessary , seeing tha t thephysicians' or ders arc carried out , and to bring to eac h

MAGAZ INEpatient all the care and comfort that skilled and trainedhan ds can give.A visiting nurse is furn ished with ou t charge to thoseunable to pay .P atien ts in better eirenmstaneos aloe expected to payfrom five cen ts upwards. Wh en ahle to pay th e r egularf ee of one do llar they arc refer red to an hourly nurse .H possib le the nurses will visit in th e mor-ning th osecas es r eported th e previous day j those coming to theoffice befor e twelve, th e af ternoon of the same clay:

Th e nurses ar e f or the public and it is desired thatph ysicians and others interested in the sick shall sendf or th em.Nu rses are no t expected to a tte nd mat ernity casesdur ing' labor , bu t after confinemen t will ca re fo r moth eran d in fant u nt il re cove ry .One hu nd red and eighteenph ys icians asked fo r our serv ices in 1908, an d $1,957.45was used f or the support ofth e Societv. In 1909 weneed at least $2,000 more, ifth e opportun ities to increasean d im prove th e work offer ed th e Society are used.The f ollowi ng' is from anurse 's dai ly repor t :" i\fy first ca11 was a n ewcase- -a child with pn eumonia . I reached the house and IN THE U B E K c t l . O 'l'E:-IT.fou nd t he occupants all Ital ian . A man stood in thedoor-way , and , as I came along, called over his shoulder,'T he nu rse. ' On t of another door-way came a womanwho said, ' H ere, lady.' Inside the room, ly ing' on twochairs, was a child of two years, f ul ly d ressed even to hisshoes. Th e temperature was taken and regis tered ]()4%.A mor e uncomfortable little cha p I h ave never seen.Wh il e tr y ing to persuade the mo th er- to let me re movesome of t he clot h ing and bathe the littl e fellow, just as 1

AFTER T HE NURSE H AS T IDIED UP T HE nooxr.

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~ ~ MAGAZ INEwas about to give up th e.i ; . task ill despair, the father .r.- ,; . . ap peared, and npon learning' the tr ouble, pushed hist J : . :'./i '( I wife asid e with no tender. I 1 touch, and said, ' Go on, she I a woman , know nothing'. Mebe ill hospital and know .

1.Take everything off, andwash for fever ; do himgood. ' 1'1y heart ached fo rthe mother, so sure her boywas about to be sacrificed,bu t I began my work , meanwhile asking abou t the doc-ON TH EIR DATL Y RO l i:-;J)1' . to r 's orders, whi ch th e man

gave in a seemingly in klligcnt manner . A sp onge bathof soap and wa ter, and alcohol rub, the mouth cleaned, asheet put over the old sofa (an improvement on thechai r ) , the boy sleeping in his clean, fr esh bed , wi thonly one garment on his now cool little body, an d inwalk ed the doctor. I spoke of his order carried out forbathing, etc.; he looked at me, looked a t th e child, an dat the discarded clothing, laughed and said, 'This is myfirst visit here ; the patients I asked you to see las tnight are up stairs, two of them , in the same condition. 'So up stairs I went, an d began over again . I t was teno 'clock before I lef t my I talian friends, af ter promisingto call in th e la te afternoon." My second call was to a woman dying of tuberculosis.A fourteen-year-old girl is th e housekeeper and motherto the three younger children. The house was neat andclean, the patient was as clean as th e little gi rl couldkeep her, but she was restl ess an d in much pain fromconstant coughing and the bed sores on her back. Af te rth e ba th, when her bed had heen freshly mad e, herhail' combed and teeth cleaned, and had taken somenourishm ent I hall brought fOI> her, she th ought shecould sleep, and , aft er giving some advice to the littlehousekeeper, I went on my way."My thir-d, fourth an d fifth cases wer e very closetogether an d all su rgical dressing-w omen who had beenope rated on in th e hospitals, and permitted to comehome on condition that the d istrict nurse give th e neeesssary care." I t was now 12.30, and I wen t home to lunch ," The first visit in the af ternoon was to an old 111 anwith a. leg ul cer, which is healing slowly under constant care an d cleanliness. At fir st he did no thing butgrumbl e an d f uss when he canght sight of a nurscs

wxn -rx FOR TH E NURSE.

uniform, as he considered all women 'a fool bu nch,conclusion reached after he had wedded his third wNow he says he doesn't care whi ch nurse comes to has each one is 'a spot of sunshine , '"The next call is to a baby of three months, slowstarving to death because no f ood can be found to agwith him. .At birth and up to two mon ths he was stroand well, but his mother one sad day, after weekstemptation , went on a spree and poor baby was neglected that his recovery is doubtful. A neighcalled the nurse's attention to the pitiful cry ing of child, and upon investigating she fou nd the motdrunk on the floor and the p oor, little, dirty scraphuman ity on a bed almost in a state of exhaustion . Tmother is heart-broken, for she r eally loves her baand is now followin g instructions faithfully . The bhas an oil rub th ree tim es a day-twice by th e motand once by the nurse, and th e food is prepared daby the nurse."The next visit was to Mrs. B- , the pr ize pati enthe Society an d a pet of us all . Daily her kn ees mbe steamed and rubbed, her bra ces adj usted tha tmay walk around her room ; one year ago she walfor th e first time in years. She usu ally has a mornvisit, but is always glad to wait her tu m when mserious cases need us."Th e ni nth visit was to alittle pneumonia convalescent, a dear littl e girl ofeight. 'I'he evening temperature taken , a sp onge bathgiven, and instruction as to1ICr nou rish ment , then backto my Italian fri ends. Allthree te mper-at ur es 'wer every high . Th e two upstair'swer e attended fjr l:lt-theusual treat-ment of alcoho1sponges, etc. Th e boy clownstai rs seemed a little better .and fa r more comfortablethan in the moming. This UOTII ,\ J{) IS rr i.r ..tim e th ere was no resistance fr om the moth er, she rized what the morning treatment had done, and deeappreciated it. Now she wan ted t o help, so I explai how she could sponge th e boy during th e ni ght,showed her how to prep ar e th e nourishment. Whelef t her , she shook h ands and in her broken En gsaid, by way of thanks, ' I lika you too mu ch. ' "'I'he average for the year is sixty-four visits a each workin g clay of 1908,Th e following ar e the offi cers of th e assoc iat iBoard of D irectors: Pre siden t. 'Miss Ira ri-iet g , Clar9 Chestnut Street ; Vice-presid ent, Mrs. Edwin Bro70 Elm St reet ; 'I'reasurcr, M 1'8 , H omer Gage, 8 Chnut Stre et; Clerk, Mrs. Henry J . Gross, 2:1 May StrDirentot-s : :i\fiss Josephine C, Aldrich , )\[rs. Fredern . Baker , Miss Isabel 1\1. Crompton. Mrs. Ed garFi sher, Mrs , '1'. H ovey Gage, .Ir ., Mrs. David H arrow.Ir ., Mrs. George M, Bassett, Mrs. Ma tthew J. WhittAdvisory Board : Rev, Bernard S. Conaty, Mr. Alander D e'\V' it t, Dr . Thomas H . Gage, Dr . 'Warren Gilman, Dr . Leonard P. Kinnicutt , Rt . Rev. Al exanII , Vinton, Dr. Samu el B. Woodward .