The Universalist. [volume] (Chicago [Ill.]) 1884-1897, 1897-09-04
OUR CONTRIBUTORS.
LIFE AND WORK OF TRAINED
NURSES.
BY MISS LILLIAN D. VALID.
Head of the Nurses Settlement, Henry Street
New York.
III.-Dist,ict Nursing.

lll.-D1SU1cU Nursing.
Something like forty years ago 1850
an English Philanthropist sent a woman
to work among the sick poor of Liver
pool in their own homes. -Four years
later the same gentleman had divided
the city into eighteen districts, assign
ing nurse to each. This seems to have
been the origin OF what is now known as
District Nursing" an elastic term,
which to day includes many methods Of
utilizing among the straitened and the
very poor the nursing skill and educa-
tive possibilities Of hospital graduates.
1t is work which has appealed to all,
from many standpoints, until now a
number of cities have forces of trained
nurses, some scattered, others we'll or
ganized, but all doing district nursing
in the crowded quarters of the poor or
in the outlaying separated homes of
great cities.
The methods of reaching this class of
patients and the minute details of the
work must vary according to the special
conditions and needs of the neighbor-
hood in which the nurse is at work
Probably no two are identical, particu-
larly in our more cosmopolitan cities,
but generally speaking, district nurse
gives the day to her various charges, di-
viding the hours according to the num-
bsr and needs of her patients, not living
in the house with any one OF them, as
does the private nurse. but going from
one to another. Thus she economies
her steps and each day regulates her
work 30 that the patients most i'll or
least cared for by their companions
shall have the greater share of her time
and skill. Going from one to another
she will perform many and varied SER
vices, not always nursing in the narrow
est sense of the word, but everything
done for the comfort and we'll being of
the sick one or the family is naturally
of such practical character that none
can measure the almost unlimited possi-
bilities of this true missionary to the
people.
She must be alert and deft in many
kinds of service, quick to detect and
ready to act, for in this work the doctor
is remote and often never seen, the re-
sources few, and the patients life may
depend on the nurses ability to meet
emergencies and avert the consequences
of ignorant mistakes. She may have
to clean the room or stop hemorrhage;
teach child how to sweep without rails
ing dust. or instruct mother how to
care for the tracheotomy tube; she may
improvise appliances or give cooking
lesson.
She will generally be obliged to teach.
often to enforce, laws of hygiene and
cleanliness, which are household words
even among children of the better edu-
Gated. She must be tactful enough to
give her lessons despite the forbidding
barriers of ignorance and prejudice, and
yet win respect and love. and welcome
to the homes Of her district She may
find the best nurse can do is not suffi-
cient, and that the patients condition
and circumstances require hospital
treatment. In this event. her difficult
ties will probably be augmented by his
aversion to the transfer. until persua-
sion and arguments influence him to
accept what alone can save him. Often,
however. what is really hospital case"
will be cared for at the poor home. that
removal of the patient tthe mother. per-
haps) may not break up the family. In
such case, the most intelligent member
of the family, or friend, must be en-
listed in service and put in charge until
the next visit of the nurse.
The "loan closet" without which no
district nurse can work, should be with.
in easy reach. In it she keeps atomizers,
bed-pans, blankets, head-rest nigh
gowns. sheets Cotton and rubber), ster-
ilizers, syringes, toys, picture books, etc.,
in word, all such appliances as will
conduce to the comfort and cleanliness
of patients whose resources are too linn
tied to procure them. These things
may be given outright, but are generally
loaned, record Of the loan kept in the
closet acd cancelled when the articles
are return ed to it. From the closet the
nurse fills her bag, empties. replenishes,
again and again. In the bag she carries
with her, she will have the antiseptic
solutions. bandages, instrument case,
syringes, thermometer. ETC., and will add
to these things such things as she has
found wanting and which the people can
not supply. Though she is careful not to
be considered an almoner, she will often
find it necessary to carry beef extract,
eggs, iellies, milk tickets. and various
tempting dishes, and as often brings in
other agencies to correct or help.
In cities already distrcted by dispen-
saries, the nurse often works only with
the visiting physician of her district.
Beginning her rounds in the early morn
ing, she will meet him at stated hour
to report on the cases visited that morn
ing and the previous afternoon, receive
orders and instructions for them or the
new cases he desires her to see, replen-
ish her bag with the needed supplies,
and re-commence her rounds. In the
"Nurses' Settlement" the reouests for