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CHARITIES PUBLICATION COMMITTEE PUBLISHERS FOR THE RUSSELL SAGE FOUNDATION 105 EAST 22d STREET, NEW YORK i^ VISITING NURSING IN THE UNITED STATES Containing a Directory of the Organizations Employing Trained Visiting Nurses, with Chapters on the Principles, Organization and Methods of Administration of such Work By YSSABELLA WATERS Henry Street (Nurses') Settlement, New York City NEW YORK CHARITIES PUBLICATION COMMITTEE . . . MCMXII Copyright, 1909, by YSSABELLA WATERS Printed December, 1909 Reprinted February, 19 12 ^p PRESS OF WM. I\ FELL CO. PHILADELPHIA To LILLIAN D. WALD. Founder of the Nurses Settlement, New York City. Whose Work has been an In- spiration TO so MANY Nurses PREFACE This Directory is issued for the purpose of showing what is being done in this country through the services of the trained nurse in what has for many years been known as " District Nursing," and in the more recent extension of her activities in tuberculosis, school (medical in- spection), social welfare, and other more general social work. It is hoped also that the book may be an assistance to those who are plan- ning to establish new societies for service along similar lines. Every effort has been made to gather information regarding the various organizations throughout the United States that employ visit- ing nurses, and the statements contained in these pages are based upon facts gathered from annual reports, letters, and replies to a set of uni- form questions which were sent to each organization. Probably some have not been reported, and others may have been created since this* Directory was placed in the printer's hands. Revision in the near future will undoubtedly be necessary, and any omissions can then be inserted and mistakes corrected. Associations employing trained visiting nurses are therefore earnestly requested to report all errors or omissions, and to send to the writer their annual reports. By this means accurate information containing the latest developments of the movement may be included in the second edition. For obvious reasons, societies having nurses who are neither grad- uates of training schools nor pupil nurses are not included in this record, however admirable their service may be. Sincere thanks are extended to all whose cordial co-operation in furnishing information has made this book possible. NOTE TO THE SECOND EDITION This second printing of the original text furnishes an opportunity to state briefly that during the two years since the book was published many new organizations have been established, several old societies not formerly heard from have been reported, and several in the original text have been discontinued or absorbed by new associations. 7 PREFACE Data recently gathered from the old associations show that there has been a marked increase in their nursing staffs, and a decided upward tendency in the salaries. In 1909, there were reported 566 associations employing 1413 nurses, while on January ist, 191 2, there are 899 associations with 2442 nurses. At this time 15 of the previously recorded organiza- tions have been discontinued or merged in other societies, and 348 new (or not previously reported) associations have been formed, employ- ing 578 additional nurses. These figures include additions to the nursing staffs of the old associations made since the first publication of the Directory. Where the nursing service has been discon- tinued or been transferred to other organizations, the fact has been indicated by footnotes. Owing to lack of space it has been possible to add merely a condensed list of the new associations. This will be found at the back of the book. A new and thoroughly revised edition is in course of preparation, and the writer most earnestly requests that all errors or omissions be promptly reported to her at the Henry Street Settlement, 265 Henry Street, New York City. TABLE OF CONTENTS PART I History, Principles, Organization and Administration PAGE I. Brief History of Visiting Nursing 13 II. Principles 15 III. Methods of Organization and Administration 21 Articles of Association of the Visiting Nurse Association of Detroit, Michigan 23 By-laws of the Visiting Nurse Association of Chicago 25 Rules for Nurses of the Instructive Visiting Nurse Associa- tion of Baltimore, Md 27 Organization and Administration of the Nurses' Department of the Henry Street Settlement 29 PART II Directory and Statistical Tables Directory 41-312 Alabama 41 California 41 Colorado 52 Connecticut 54 Delaware 64 District of Columbia 65 Georgia 67 Illinois 70 Indiana 79 Iowa 82 Kansas 84 Kentucky 84 Louisiana 86 Maine 86 Maryland go Massachusetts 97 Michigan 1 38 Minnesota 147 9 TABLE OF CONTENTS PAGE Missouri 149 Nebraska 152 New Hampsiiire 153 New Jersey 159 New York 174 North Carolina 236 Ohio 238 Oklahoma 250 Oregon 250 Pennsylvania 251 Rhode Island 285 South Carolina 293 Tennessee 296 Texas 297 Utah 298 Vermont 299 Virginia 302 Washington 308 West Virginia 310 Wisconsin 310 Statistical Tables 313 Table I. List of Organizations, arranged alphabetically by states and cities or towns 315 Table II. Showing the growth of the visiting nursing move- ment in the United States, by years 365 Table III. Showing the number of associations and number of visiting nurses in each state 365 Table IV. Municipalities employing visiting nurses for tuber- culosis patients 366 Table V. Municipalities employing public school nurses. . . . 367 Second Edition, February, 191 2 List of New Organizations formed since July, 1909 368 10 PART I HISTORY, PRINCIPLES, ORGANIZATION, AND METHODS OF ADMINISTRATION BRIEF HISTORY OF VISITING NURSING The 50th anniversary of the estabhshment of Visiting Nursing was celebrated in May, 1909, in Liverpool, England, where the movement originated. Mr. William Rathbone put into practical operation in 1859 the idea of utilizing the services of the trained visiting nurse in the homes of the sick poor. Florence Nightingale had demonstrated to the world the im- portance of educating and organizing women for that large work pecu- liarly adapted to them — nursing the sick, and training the community in the essentials of hygiene, that sickness may be prevented. Until Mr. Rathbone started his memorable work in Liverpool, Miss Nightin- gale's efiforts had been directed to war, hospital, and institutional nurs- ing. The utilization in the homes of the people of nurses who at the same time became teachers and sought to remove the causes underlying much of the trouble, was astute and logical from the philanthropist's point of view, as well as from that of the generally good citizen. The adoption of district nursing in England was general from the beginning of the movement. Naturally, many experiments were made, some entirely futile, others important in establishing a system of home nurs- ing from which the present highly organized institutions have developed . Queen Victoria's Jubilee Institute for Nurses stands foremost in im- portance in the work in Europe. In America the movement did not take root until 1877, when the Women's Branch of the New York City Mission sent the first trained nurses into the homes of the poor. Two years later, the Society for Ethical Culture (New York City) placed a nurse for similar work in one of the city dispensaries. For a number of years extension of the movement was exceedinj^ly slow. In 13 VISITING NURSING IN THE UNITED STATES 1890 there were but 21 associations in all of the United States, the greater number of these employing but one nurse. It was not until 1894 that any real impetus was given to the work. From that time on the growth has been more rapid, and from 1905, remarkably so. In that year statistics show 171 associations in no different cities or towns, employing 445 nurses. There are today, August i, 1909, 566 associations with a stafif of 1413 nurses. In 1907, 67 new societies were organized. In 1908, 112 new ones were started, and in the first six months of 1909, 75 others were formed. The expansion of ideas of social betterment has been signifi- cant in this connection, and the visiting nurse has been recognized as an essential factor in carrying out many of its details. Thus, in America, there has been of late years a remarkable increase in the social welfare work entrusted to trained nurses, and the use of their services by munic- ipalities has been a most significant feature in the development of this movement. 14 II PRINCIPLES The requirements of the visiting nurse are not only practical and professional, but in a large measure spiritual. Purity of motives, in- tegrity of work, and broad social conceptions of duty to mankind, are for her not remote ideals, but necessary qualities in satisfactorily carrying out the daily routine. Confusion has prevailed, however, as to the exact functions of the visiting nurse, partly because of the eagerness to use her services for pvu-poses other than those definitely within her province, partly because of a more or less sentimental conception of her duties, and partly because she has frequently been employed as a missionary for special evangelical work. Understanding of her real work in the community has thus been delayed. While without doubt she has been valuable to these move- ments, this incidental use of her training and skill has made more difi5- cult the establishment of a thorough system of adequate care of the sick in their homes which would compare with the existing standards of nursing in institutions. The visiting nurse associations emphasize the importance of a work organized distinctly for the purpose of supplying trained nurses to give home care to the sick poor and to those of small means. Economy of Visiting Nursing. In addition to the humanitarian and social reasons for urging adequate nursing of people in their homes, is the important one of the economy to the community in thus caring for the sick. The available space in hospitals is entirely inadequate for meeting the demands of all who need nursing care. Certain acute and chronic cases do well at home under proper conditions, while many patients cannot or will not go to the hospitals. The costly hospital space may well be reserved, then, for those who need it urgently. 1.5 V7SITING NURSING IN THE UNITED STATES The Nurse. Her Qualifications. The physicians have not always given the visiting nurse immediate co-operation. In her ex- perience, she is repeating the history of the struggles of the women who first tried to gain recognition of their value and place in the hospitals. Some physicians have never been associated in their practice with the professional nurse; therefore, they are unaccustomed to her use; but the power to make home service most effective rests largely upon the doctors' readiness to recognize the value of the trained nurses' co-opera- tion, and to call freely upon her for assistance. Much of the responsibility for the success of the work also rests upon the nurse. The ability to keep up her district, and to be indefatigable in hunting out the sick who need her care, are important tests of the peculiar talents needed for this branch of the nursing service. Inasmuch as visiting nursing is largely among people who cannot afford a trained nurse all the time, the attendance of a physician is likely to be infrequent, and therefore, greater responsibility for detecting symptoms and re- porting them intelligently, falls upon the nurse. Often most delicate adjustment between doctor, family, and neighbors depends upon her discretion. For this reason, great care should be taken in the selection of the nurse, to ascertain her aptitude for the service, and to determine whether she is well equipped for it by her training. She should have had her professional education in a large general hospital, where the variety of experience would best prepare her for the emergencies of a district; and if possible, she should have had some additional training in visiting nursing where she could observe methods, and what is ex- tremely important, where she could gain some knowledge of the social forces and philanthropic resources operating within the circle of her ministrations. Calls for the Nurse. When visiting nursing associations were first organized, it was customary to prescribe stern rules as to the method of obtaining the service of the nurse. It was usual to forbid her to an- swer calls except upon the written request of a physician. Often she was assigned to a particular dispensary or physician, and her services being entirely under his direction, she became known as the visiting nurse of "Dr. So and So" or of "Dispensary Such and Such." Other [)hysicians were naturally not willing to request her help. Experience in the large societies has proved that it is unwise to have the nurse's 16 PRINCIPLES service at the disposal only of the doctors who are connected with chari- table institutions, thereby indirectly putting a premium on pauperism. It is now quite generally the rule that requests for visiting nurses may be sent by all physicians. In Baltimore, Boston, Chicago, Cleveland, and New York, the well known visiting nursing societies encourage calls from every source. Because of this the gain in acute service has been noteworthy, and the system works out as very practical in many ways. All societies rightly require the visiting nurse to obtain a physician for the patient when none is in attendance, and to act under his directions. There are, however, many seriously sick people who can reach her, for whom treatment might have been delayed or never given if she had been available only through the physician; this because of easier access to the nurse, and because she is often more generally known in a neigh- borhood than any other single person. Quality of Service. It should be understood by the nurse and the public that actual nursing is expected and shall be given. The condition of the patient and his circumstances should determine the length of the nurse's visit; it cannot, therefore, be arbitrarily limited without affecting the character (or quality) of the care. Education of the family should be incidental to this, and will be no less impressive because of the demonstration by the nurse through her skill in the giving of the daily bath, the careful handling of the patient, and the regularity of her visits, of the importance she plainly places upon the hygiene oi body and room. If the organization maintaining her desires to create a system of adequate nursing, provision should be made for permitting her to call more than once a day on patients with high temperatures, and upon those for whom the doctors have prescribed regular treatment requiring two or more visits. Thorough nursing which necessitates lengthy visits is done at the cost of a large numerical showing. In dis- trict nursing, as in other philanthropic work, the pressure of money needs often misleads people into efforts to make "a good statistical showing," whereas to one who can read the reports with intelligence, statements of enormous numbers of calls made in one day proclaim the fact that although many visits have been made and exhausting work done, there has been little real nursing as it is understood by those who treasure ideals of the care for the sick. Charwomen. In case of emergency a good nurse should be ready 2 17 VISITING NITRSING IN THE UNITED STATES to do any kind of service that bears relationship to the welfare of her patient. But it would be wasteful to use her time and strength for work that could be done by an unskilled person. It is good policy, therefore, to engage women to do cleaning or laundry work when there is no one in the family who can do it. Night Duty. To obtain the best results for the patients, the nurse should not be permitted to undertake night work in addition to day duty, and it is not wise to endanger the discipline and authority of clearly defined methods by permitting any irregularity in this rule, excepting under very unusual circumstances, or when the nurse has no other serious case under her care. Demoralization of the service is likely when the nurse's salary is in any measure dependent upon her privilege to take work (night or day) other than that paid for by the society en- gaging her. This would apply also to the question of fees. When a night nmse is necessary, one should be specially engaged for this pur- pose. Fees. It has been found through practical experience that pa- tients usually prefer to pay the nurse, and it is a good principle to es- tablish the custom from the beginning. Her salary should be entirely independent, and all money coming to her should be turned into the funds of the society, which fact should be understood by the patients as well as by the general public. Patients and physicians are more likely to engage a nurse upon a business basis when no stigma of charity is attached to her visits. It is true, however, that a large number of the patients in the visiting nurse's district cannot pay for her services and should not be urged to do so. The income of unskilled workers leaves but a narrow margin over and above the cost of living, for ex- penses incident to illness. The fees paid to a visiting nurse usually range from $.io to $.25, occasionally reaching as much as $.50 or $1.00 a visit. But though these sums are nominal from the point of view of the society, they represent, for one hour's service or less, a far greater percentage of the income of a workingman receiving $2.00 a day, than the $25 a week paid the private nurse for twelve hours' attendance, from an income of $5,000 a year. This suggestion is offered to encourage the acceptance of the small fee from the patient who may hesitate to call upon the visiting nurse because of the trifling sum he can offer. 18 PRINCIPLES Uniforms. The matter of uniforms is a debatable question and may properly be presented in a chapter on principles. Many societies cherish the picturesque costume that is reminiscent of ecclesiastical cus- tom, and prescribe such dress, cap, and veil for the nurses on their staff. Orderliness and beauty may be obtained through this usually becoming habit, and a certain amount of advertisement of the existence of the nurse is secured thereby. Unsuitable dress and the vexatious problem of regulating taste are thus obviated. It would seem sufficient, however^ and appropriate, to require the visiting nurses to be clothed suitably for their work, and to leave further choice to the individual. Cotton dresses, simple and easily laundered, aprons worn at the bedside, hats without ornamentation, and in cold weather outside garments long enough to cover the cotton gown, should be required while on duty. The Physician. The relationship of the visiting nurse to the phy- sician is of deep importance. Etiquette that is based upon coiu-tesy, loyalty, and respect to the patient, is a mutual obligation. It should be considered a grave breach of good training for the nurse to prescribe medicine, or to delay in calling a physician, if there be none; and her obligation to support the doctor against the doubtings of the family and the frequently intrusive neighbors is beyond argument. Disloyalty to the physician on the part of the family is frequent. Many people, ministered to by the visiting nurse, are highly emotional and, despite her protests, changes in physicians are made sometimes six, seven, or even more times during one illness. The nurse will often be perplexed as to her duty under such circumstances, but experience justifies the stand taken by the older societies that the visiting nurse is nowhere more needed than under such circumstances, and her duty is plainly to remain with the patient through all the vicissitudes of change. Relief. That it is unwise to have the nursing service complicated with the giving of financial relief, has been the universal experience. Nurses do not often have the training which enables them to handle such relief wisely, and when it is done the service may be seriously in- jured by a misunderstanding on the part of patients, doctors, and the community in general. There is every reason, however, for supplying a nurse with money that may be used at her discretion in emergencies, and she should have authority to purchase food, medicine, or fuel, if immediate aid is needed, but should report the case without delay to 19 VISITING NURSING IN THE UNITED STATES such societies as may be organized for that purpose. Authority for sending patients to hospitals, convalescent homes, dispensaries, sana- toria, special schools, etc., and enlisting the aid of other agencies, should be definitely placed with the individual nurse, or the supervising nurses, and should be included in the plan of administration. This also applies to the obligation of reporting violations of tenement house laws and de- partment of health regulations. 20 Ill METHODS OF ORGANIZATION AND ADMINISTRATION Individual Patron. The character of the organization of any visiting nurses' association must in great measure be influenced by the number of nurses employed, and also by the nature of the financial support. Ideal conditions exist in many places where an individual or a single family provide the money for the nurse's salary and all expenses incident to her service. If in addition the nurse has judgment and devotion to her work, no further organization is necessary. This arrangement is frequent in small towns and in country districts. The disadvantage lies in the fact that a service dependent upon the will or financial resources of an individual is not likely to be as permanent as that in which many people are interested. Committee Management. Organization and supervision by committee is a method most frequently adopted in America. The difficulty of collecting money in this way is greater than under individ- ual management, but there is advantage in interesting a larger circle of people in the work. Incorporated Societies. Societies that have been incorporated to enable them to hold property and to accept legacies, have constitu- tions and by-laws that are usual to other charitable societies. Some of these have endowments for single nurses, many of which have been given as memorials. Constitution and By-Laws. The constitutions, by-laws and rules for nurses found on pages 23-28 are typical of the larger visiting nurse associations in America. In addition to the committees ordina- 21 VISITING NURSING IN THE UNITED STATES rily appointed, active sub-committees should be given the responsibility of maintaining the supply closet, providing special diet and convalescent care and securing suitable employment for discharged patients. Service of Lay Workers. The possibility of appropriate social service for the patients that may be performed by members of the com- mittees, is largely dependent upon the ability of the nurse to indicate it. Valuable supplementary care can be given, and when this is done seri- ously, the advantage is two-fold: first through the benefit to the pa- tients themselves; second, through the deepening of interest in the lay worker through the opportunity to help in other ways than by merely providing money. Annual Report. The pubHc is interested in the annual report. It would be extremely interesting to have a uniform plan of report for all associations that should make possible a comparison of methods and results obtained similar to that suggested for the large hospitals. The statistical information gathered by accurate recording of work done by the nursing staff of an association could be made of great value to medical and social students in the community and to the general pubhc who desire reliable information upon the various measures established for human welfare and relief. As now published, many of the reports, though readable and interesting, do not always give important facts. Sometimes the figures are compiled in such a way that the numbers of patients treated, the diagnoses made, and the disposal of the cases, fail to show any relationship to each other. The points of general interest in a report are: Methods of administration, Cost of maintaining the service, The numbers of patients treated, Diagnosis and character of the illness. Results: (whether cured, sent to hospitals, died, etc.); Character of care given. In order to assist societies about to organize, a copy is given of the Constitution, By-Laws, and Rules for Nurses, of three associations which have been working successfully for a number of years. A de- tailed account of the administration of the Henry Street Settlement in New York is given also in the hope that it too may be of value in starting work on similar lines. 22 METHODS OF ORGANIZATION AND ADMINISTRATION ARTICLES OF ASSOCIATION OF THE VISITING NURSE ASSOCIATION OF DETROIT, MICHIGAN We, the undersigned, desiring to become incorporated under the provisions of Act i66 of the Public Acts of the State of Michigan of 1899, being an Act entitled "An Act for the Incorporation of Char- itable Societies," approved June 23rd, 1899, and acts amendatory thereof or supplementary thereto, do hereby make, execute, and adopt the following: ARTICLE I The names of the persons associating in the first instance and their respective places of residence, are as follows: See Article VI. ARTICLE II The name of such Corporation shall be "The Visiting Nurse Asso- ciation" and the location of its office for the transaction of business shall be Detroit, Wayne County, Michigan, and the period for which it is incorporated shall be thirty years. ARTICLE III The objects for which such Corporation is organized shall be the systematic management and gradual extension of District Nursing in the said City of Detroit, in the County of Wayne, and the giving of skillful and sympathetic relief to numbers of sick, poor, and needy persons within the limits of said city, and for such purposes to take and receive by gift, purchase, devise, or otherwise, such personal and real property as shall be allowed by law. ARTICLE IV The number of Trustees of such Corporation shall be eighteen, who shall hold office for a period of three years, except as hereinafter provided, and said Trustees shall be divided into three classes. The entire Board of Trustees shall be chosen in the first instance for the 23 VISITING NURSING IN THE UNITED STATES following terms. One-third shall hold office until the next annual meeting in 1902; one-third until the annual meeting in 1903, and one-third until the annual meeting in 1904; and thereafter one-third of the total nimiber of Trustees shall be elected annually, commencing at the annual meeting in 1902, for the full period of three years as hereinbefore provided. Said Board of Trustees shall choose from its members the following officers : A President, a Vice President, a Secretary and a Treasurer, each of whom shall hold office for a period of one year and until their suc- cessors shall be chosen. ARTICLE V The annual meeting of this Corporation shall be held at the office of the Corporation as established by its By-Laws on the second Thiu^s- day in March of each year, at such time as shall be prescribed in the notice therefor. ARTICLE VI The terms and conditions of membership in said Corporation shall be as follows: Any person may become a member by the pa>Tnent of an annual fee of One Dollar payable at such times as the By-Laws shall provide. All members of societies incorporated or unincor- porated which shall be recognized by a vote of the Trustees of this Corporation as contributing to the purposes for which this Corporation is formed shall be members, and such members shall not be required to pay the annual fee hereinbefore mentioned. All physicians shall be members and exempt from said fee. In witness whereof we have hereunto set our hands and seals this Foiu^h day of June, A. D. 1901, in duplicate. The names and addresses follow, and the signature of the Notary Public. 24 METHODS OF ORGANIZATION AND ADMINISTRATION BY-LAWS OF THE VISITING NURSE ASSOCIATION OF CHICAGO Section i. Any person may become a member of the Association upon payment of an annual fee of five dollars ($5.00), to be paid on or before the first day of January each year. Sec. 2. The officers of this Association shall consist of a president, two vice presidents, a secretary, a treasurer, and a board of directors, the membership of which shall be composed of the president, two vice presidents, secretary and treasurer of said Association, and twenty- seven (27) other members thereof. The president, vice presidents, secretary, and treasurer of said Association shall be elected by a vote of the members thereof at the annual meeting to be held in January in each year, for a term of one year each. Nine (9) directors shall be elected by a vote of members at such meeting to serve for one year, nine (9) for two years, and nine (9) for three years. Thereafter at each annual meeting nine (9) directors shall be elected to serve for three (3) years in place of those whose term of office shall have ex- pired. Honorary members may be elected at the discretion of the Board, who shall not be entitled to vote but may serve on the Advisory Committee. Sec. 3. The annual meeting of the Association shall be held on the first Wednesday after the first Monday in January. Special meet- ings of the Association may be called at any time by the directory, and shall be called upon the written request of any ten (10) members. A notice of every meeting of the Association shall be sent by mail by the secretary to each member at least foiu- (4) days prior to the date fixed for such meeting. Forty (40) members shall constitute a quorum for the transacting of business. Sec. 4. Regular monthly meetings of the board of directors shall be held on the first Thursday of each month, excepting July, August, and September. Special meetings of the directory may be called at any time by the president, and shall be called at the written request of any three (3) directors. 25 VISITING NURSING IN THE UNITED STATES The object of such special meeting shall be stated in the call, and no other business shall be considered at the meeting. Five (5) members of the directory shall constitute a quorum for the transaction of business. Sec. 5. It shall be the duty of each member of the directory to aid the Association by obtaining donations and subscriptions. Sec. 6. Absence of any member of the directory from three con- secutive regular meetings shall be deemed equivalent to resignation, and shall be acted upon as such, unless otherwise ordered by a two- thirds vote of the directors present at the meeting. Sec. 7. The president shall preside at all meetings of the Asso- ciation and of the directory, and shall, unless another order be made, appoint all committees thereof. In the absence of the president, or in any case of vacancy in the office, the powers and duties of the president devolve upon the vice president. Sec. 8. The secretary shall be recording and corresponding officer of the Association and directory, and shall perform any other duties assigned her by either the Association or the directory. Sec. 9. The treasurer shall receive all moneys of the Association and deposit them in such bank or banks as the directory may from time to time direct, and shall keep a true and accurate account of all moneys received and paid out. All vouchers shall be O. K.'d by the superintendent, and checks shall be signed by the treasurer, or in her absence by the president, or by some one of the other regular officers, or in the absence of all officers, by some one director appointed thereto by the president in writing. Sec. 10. As soon as may be after the annual meeting, there shall be appointed the following standing committees: (a) The Nurses Com- mittee, consisting of such number of persons as the directory may appoint, whose duty it shall be to take general charge of the nurses' work and to employ and direct the nurses, (b) Uniform Purchasing Office Needs Committee, consisting of such number of persons as the directory may appoint, whose duty it shall be to provide uniforms for the nurses and to purchase all supplies for the Association, (c) Fi- nance Committee, consisting of such number of persons as the direct- ory may appoint, whose duty it shall be to raise the necessary funds for the maintenance of the Association, (d) Printing Committee, 26 METHODS OF ORGANIZATION AND ADMINISTRATION consisting of such number of persons as the directory may appoint, whose duty it shall be to supervise and provide all current printing and the editing of the annual report, (e) Advisory Committee, consisting of such number of persons as the directory may appoint, whose duty it shall be to give suggestions or advice, as may occur to them, to any of the officers or committees upon the aflfairs of the Association, (f) Auditing Committee, consisting of such number of persons as the directory may appoint, whose duty it shall be to audit, at least once a year, the books of account of the Association. Sec. II. Resignation of officers or directors may be accepted by the directory, which shall fill all vacancies until the next annual meeting. Sec. 12. The order of business at all meetings of the Association shall be as follows: 1. Reading minutes of last meeting. 2. Communications. 3. Reports of officers. 4. Unfinished business. 5. New business. 6. Election of officers and directors. Sec. 13. The Charter of this Association may be modified, changed, or amended, and these by-laws altered, amended, or repealed at any regular meeting of the board of directors of this Association by the affirmative vote of two-thirds of the members of said board present at such meeting, due notice thereof having been given. RULES FOR NURSES FROM THE INSTRUCTIVE VISIT- ING NURSE ASSOCIATION OF BALTIMORE, MD, 1. Each nurse shall pledge herself to give at least six months' serv- ice to the Association, and if desiring to withdraw, shall give a month's notice. 2. Each nurse shall give eight hours' work daily, and shall be 27 VISITING NURSING IN THE UNITED STATES at the ofBce twice daily for calls, at the hours of 9 a. m. and i p. m.; but on Sundays and legal holidays no calls to new patients will be received, although visits to critical cases under her care may be required. 3. Each nurse shall be entitled to one month's vacation during the year, and, as her salary is continued during this time, it is required that she shall not exercise her profession. 4. Nurses shall answer all calls in their districts, excepting those from disorderly houses. 5. Nurses shall not nurse contagious diseases, but in all cases give instruction and every possible assistance to the families. 6. Nurses are not allowed to prescribe treatment or to continue to attend cases which are not under the care of a physician. 7. Nurses are not expected to attend cases of labor, but may after- wards visit mother and infant until recovery. 8. Nurses, in addition to their care of patients, shall give suitable instruction in each case to some member of the family, or other avail- able person, on ventilation, food, cleanliness, etc. 9. Nurses are not allowed to give material assistance, except in cases of real emergency, and then only until the need can be relieved by some other agency. They shall keep a record of all cases in which material assistance is given or which are referred to other agencies, and shall report them weekly to the Secretary. They are advised, in cases of doubtful emergency, to consult with the local agent of the Charity Organization Society. 10. Nurses shall not give or receive presents of any kind. 11. In lending articles to the sick, each nurse must keep a record of the date of loan and require all articles to be retiurned clean and in good order. 12. Nurses are instructed to collect at least ten cents for each pro- fessional visit, excepting when, in their judgment, the families are unable to make any payment. 13. There shall be no interference with the religious or political opinions of the patients. 28 METHODS OF ORGANIZATION AND ADMINISTRATION ORGANIZATION AND ADMINISTRATION OF THE NURSES' DEPARTMENT OF THE HENRY STREET SETTLEMENT The Henry Street Settlement is organized under the Membership Corporation Laws of the State of New York for the purpose of pro- viding and maintaining a system of free visiting nursing, to provide homes for nurses engaged therein, and generally to do all things proper to be done by said nurses in connection with said nursing; to conduct and maintain settlements as centers for the cultivation of higher civic and social life, including free libraries, reading and meeting rooms, and to maintain free homes for convalescents, and for recreative pur- poses. The administration of the various departments is controlled by the experienced workers themselves. The Head Worker is a nurse and works in close association with the superintendent of the nurses, the supervising nurses, and those whose experience and judgment are valuable in this direction. The method is given here in detail. Some features, particularly of the form of organization of the settlement as a whole may possibly be inapplicable to visiting nurses' associations, but the administration of the nursing department itself has proven to be simple, direct, and practical, permitting immediate action on any matter relating to the patients and to the staff. In small communities the problems involved in the nurses' duties are naturally less compli- cated than those in the large cities; conference with the committee or individuals in charge is likely to be informal and immediate. Where the staff is larger, a definite system of administration is essential. The one described here does not differ materially in this respect from other experienced associations. Appointment of the Staff. Following is a copy of the appli- cation blank given to each applicant for appointment to the nursing staff. Application must be made in person and only graduates of recog- nized training schools for nurses will be considered. 29 References : VISITING NURSING IN THE UNITED STATES HENRY STREET (NURSES') SETTLEMENT APPLICATION BLANK 190. . Name Age P. O. Address If in Greater New York give telephone number. Training School Graduate of class of Name Address Name Address Are you strong and well Have you ever had any tendency to flat-foot tubercular or cardiac trouble. Have you ever done district nursing Place Time, from to What other engagements since graduation Place Time, from to Probation. Except in emergencies, a new nurse becomes a resi- dent at the headquarters of the Henry Street (Nurses') Settlement and is assigned work in a nearby district. There is no established period of probation but a nurse is not considered a candidate for membership to the sta£f until she has been three months at least in the service. After a nurse has proved her aptitude for the work she is accepted as a reg- ular staff worker and may be retained at the Henry Street Settlement or sent to one of the outside districts in Manhattan or the Bronx. Hours of Duty. 9 a. m. to 6 p. m., with i^ to 2 hours at noon. One day for rest is allowed each week and may be taken on Sunday or a week day according to individual preference. At all other times the nurses remain in their districts ready to answer calls during the working hours of each day. There is no night work, but a nurse may be asked to take some share in the social activities of the settlement in which she is a resident. 30 METHODS OF ORGANIZATION AND ADMINISTRATION Salary. $6o first three months; $70 following nine months; $75 second and third years; $80 fourth year; $85 thereafter. One month's vacation is allowed each year with salary after the expiration of the first twelve months. Expenses. The board approximates $6 per week. Laundry is paid for by the individual nurse. Equipment. Nurses should come provided with the following: Four shirt waist suits of washable material, (when practicable the gingham of the school uniform is preferred) ; a plain hat and warm outer garment; a short woolen skirt for stormy weather, and strong, easy shoes; bandage scissors, small scissors, probe, forceps, and watch in good repair. (Aprons are supplied and laundered at the expense of the Settlement.) Bags are provided for each nurse. Character of the Work. Professionally, the nature of the work varies with the district. In the congested lower East Side, the service is acute, pneumonia predominating. The surgical work consists mainly of extensive burns, abscesses, and severe ulcers. The obstet- rical service is comparatively small, but several nurses at a time are detailed to specialize in this branch. The Department of Health has a staff of visiting nurses who care for diphtheria, scarlet fever and measles.* The settlement nurses are thus spared a complication from this source, and may retire from a case of contagion, knowing that the patient will receive attention. Post- Graduate Opportunity. Nurses who wish to study visiting nursing with a view of learning their fitness for this work, or other related social work to which nurses are now so frequently called, are admitted to the staff for a period of time for experience and instruction on the same terms as those who apply for definite positions. Nurses' Home. The nurses on the Settlement staff live in the dis- tricts in which they work, making their homes either in the houses of the Henry Street Settlement, other social settlements, or in small groups in tenement houses. This brings them in contact with people who are identified with the social and philanthropic movements of the city, and is of inestimable value as a stimulus to the nurse and opens every avenue of relief to their patients. Hours of Duty and Rest. The nurses are expected to be on duty * This work has been taken over by the settlement. 31 VISITING NURSING IN THE UNITED STATES from 9 a. m. to 6 p. m. with a suitable time for luncheon and rest at noon. The service is not interrupted on Sunday, the patient being cared for on that day as on any other. Because of the impossibility of securing the dispensary or charity doctor on Sundays and holidays, it is more important to have the nurse in attendance at such times. Chronic patients who are not seen daily, may at the discretion of the nurse be visited on Saturdays and Mondays, to enable her to attend church and lessen the working hours of Sundays. Each nurse is relieved from duty for 24 hours every week, and one whole month during the year. When she is off duty, her patients are visited by the nurses in the adjacent dis- tricts, or when the service is very severe, an extra nurse or "floater" is maintained on the staff for this purpose. During her month's holiday, a substitute is always placed in her district. Instruction and Supervision. The superintendent of nurses engages the staff and has general supervision of all the nursing. The city is separated into three large divisions, each having the oversight of a supervisor. These divisions are subdivided into districts with a staff niu-se in each, who has the immediate responsibility of her district. A new nurse is accompanied on her first days on duty by a supervising nurse, and is seen every day by the Superintendent that she may have instruction and help in adapting her training to the peculiar conditions in which she may find her patients. A conference of the entire nursing force with the Head Worker of the Settlement is held once a month, when subjects of general social importance as well as nursing matters are discussed. Calls for Nurses. Calls are accepted from all sources. When there is no physician the nurse requests the family to secure one. Fail- ing in this, she is responsible for getting either a private or public doc- tor, or obtaining hospital or dispensary treatment according to the needs of the patient. Daily Record. A daily record is kept by each nurse of the work that she has done. This is of great value not only as a history, but it gives also an opportunity for intelligent criticism and discussion of the day's work. Bedside Notes. Bedside notes of each case are kept by the nurse in attendance, primarily for the doctor's use. These remain in the pa- tient's room and are sent to the physician's office or to the dispensary 32 TO NURSES' SETTLEMENT ^^'^■ XAME ADDRESS TIME WORK DOXE X ursf Xo. flj I'i.si/s mtulc Pis/ rid Xa . Bedside Notes Xante. . A ddress . Dr. . . Xiirs Date Hours T P R Notes METHODS OF ORGANIZATION AND ADMINISTRATION once or twice a day, as he may desire. At the termination of the dis- ease, they are brought to the office of the Settlement. Case Cards. Case cards of all patients are kept at the headquarters of each district in card catalogues. These give the following items. Name Age. . . Address First Visit Last Visit Diagnosis Result Reported by Occupation. . M.D . Nurse. On the reverse side are notes for describing the treatment of the case, as to whether relief was given, night nurses engaged, and similar points of interest. Nurse's Bag and Contents. The following cuts show the bag now used by the nursing staff of the Henry Street Settlement, New York, and adopted by many other associations. It is made of leather and lined throughout with linen. It has long handles to permit of its being carried over the arm, and a soft leather flap to protect the contents from exposure to dust and rain. There is an adjustable lining that may be easily removed, scrubbed, disinfected and laundered. It is 14 inches long, 6 inches wide, and 7^ inches high. Contents of the Bag I Detachable lining. i Pencil. 1 Linen case for instruments. i Thermometer (mouth). 2 Small linen cases for dressings, i Thermometer (rectal). 3 33 VISITING NURSING IN THE UNITED STATES 3 Gauze bandages. 3 Thermometers. 3 Muslin bandages. I Glass syringe. 2 yards of gauze. I Glass catheter. I Package absorbent cotton. I Rubber catheter with glass con- I Roll adhesive plaster. necting tube, and rubber tub- i yard rubber tissue. ing. I Napkin for soiled dressings. I Medicine dropper. I Hand towel. I Caustic stick. I Apron. I Spatula. I Nail brush. I Agate funnel. I Doz. safety pins. I Agate bowl. I Box talcum powder. I 3-0Z. bottle. I Package bedside notes. 5 i-oz, bottles. 4 Large envelopes. 3 2-oz. jars. I Scratch pad. 2 i-oz. jars. I Vaseline jar. I Glass vial. Bottles and Jars are Filled as Follows: Bottles Jars I Alcohol 95 per cent. (In large I Acid Boric Powder. bottle). I Bichloride Tablets. I Tinct. Green Soap. I Vaseline. I Listerine. I Ichthyol Ung. 10 per cent. I Whiskey. I Acid Boric Ung. I Empty. I Empty. I Carbolic Acid 95 per cent. (Blue bottle). I Cascara tablets (Smallest bottle). Night Work. Nurses are not permitted to give night care. When the condition of patients requires it, nurses are engaged from reliable directories in the city. A list of nurses who understand tenement house conditions and who are willing to respond to such calls, is kept at the office. As in the day work, patients are expected to pay according to their means. In some directories the night nurses are willing to go for less than their usual fee of $4.00 a night, and arrangements for their 34 METHODS OF ORGANIZATION AND ADMINISTRATION payment are made according to the circumstances of the family by the Settlement nurse. Sometimes they pay all or part, the balance being made up from the funds at the disposal of the Settlement. It has been found impracticable to keep any number of nurses on the staff for night work exclusively, as the demands are likely to be very irregular. A requisition for the night nurse should come through the district nurse only. She is in a position to judge whether it is necessary to give this unusual service and whether the people can secure it themselves or not. Critical condition of the patient, exhaustion of the mother, of the mem- ber of the family who has carried the burden of the nursing, and financial conditions of the family, are factors that determine the decision. Obstetrical Service. The obstetrical service is kept distinct; the nurses assigned to this work answer no other calls. The dressings are sterilized in small canvas cyUnders, and a daily supply is taken to each patient, for use between the nurse's visits. The sterilizers are at the nurses' headquarters, except where a nurse works in connection with a lying-in dispensary; in this case the dressings are sterilized at the dis- pensary. Fees. Patients are encouraged to pay, and many greatly prefer to do so. The physicians also appreciate the desirability of the business basis, and are more ready to avail themselves of the nurses' service when this is understood. All the money received from this source is placed in the emergency fund, a part of which is used for the expenses incident to the nurses' service, such as carfares, supplies, etc. Supply Closets. Supply and loan closets are kept at each of the local headquarters. They are furnished with all kinds of medical supplies, disinfectants, sick-room appliances, bed linen, clothing, and delicacies for the sick. Purchases are made in large quantities and kept at the main office, where requisitions from the branches are filled. Financial Support. The money for the Nurses' Department of the Settlement is contributed distinctly for the service. Salaries in whole or in part are given usually for a year by individuals, members of a family, groups of people, societies and by other social settlements. The convalescent homes are supported almost entirely by individuals or members of a single family. Expenses incident to the care of the sick are met by irregular volun- 35 VISITING NURSING IN THE UNITED STATES tar)' contributions, special funds for which some person or persons hold themselves responsible, and from the fees paid by the patients. Relief. Each stafif nurse is authorized to give immediate relief in emergency, and she may use her judgment in providing nourishment and delicacies for her patients. If need 6f further aid is indicated, the appropriate relief societies are called upon. WTiere no organized society can supply the peculiar needs, the Settlement may assume the responsi- bility. Consultation with the Head Worker or superintendent of nurses upon such matters can be obtained immediately. Relief in this sense includes hiring of carriages, or private ambulance, securing special nurses, nourishment, eye glasses, bandages, elastic stockings, artificial limbs, railroad fare, sanatorium treatment, medicines, payment of board, and clothing. Charwomen. The nurses are authorized to engage women to clean the homes or do laundry for the patients where there is no one in the family able to do such work. Convalescent Homes and After-care. The Settlement main- tains two small convalescent homes in the country, each having a trained nurse in charge. The staff nurses are expected to make use of these for their patients, and of other convalescent homes in the community. Among other provisions for the cure of the patients, are rooms for minor surgical dressings. In these, nurses are in charge in neatly equipped offices, where ambulatory cases may come for their daily dressings. As none of these are bed patients, they can easily go to the office nurse, thus effecting a great economy of the visiting nurse's time. Patients are sent from private offices, dispensaries, and hospitals to these dressing rooms by physicians and surgeons, for the careful appli- cation of the treatment which they have prescribed, and which would be impossible for the people to carry out themselves in their own homes. This service is usually for chronic ulcers, empyema, burns, intestinal irrigations, insertion of eye drops, and recording temperatures. 36 methods of organization and administration Copy of the Monthly Report Submitted by Each Nurse MONTHLY REPORT 0} the Nursing 0} the HENRY STREET SETTLEMENT For the month of 190. . Nurse Dist Patients Nursing Visits Friendly Visits Dism. to Hospitals Dism. to Dispensaries Died Dismissed or Transferred Remaining under Care First-Aid Treatments Rec'd from Patients Expended These are sent to all who subscribe to the nursing service. Detailed financial reports of expenditures of special funds also are sent to those whose money has been given for such purposes. ANNUAL REPORT BLANK OF THE NURSES' WORK OF THE HENRY STREET SETTLEMENT Number of Patients, Diagnosis. Visits — Nursing 1 Abscesses, " Friendly and [ Alcoholism, Advisory J Burns, Office Dressings, Meningitis, Reported by Obstetrical Cases, Charitable Organizations, Pneumonia, Families and Neighbors, Rheumatism, Physicians, Typhoid, Total Tuberculosis, Disposition. Ulcers, Cured, Cardiac Diseases, Department of Health, Contagious Diseases, Died, Eye Diseases, Dismissed, (no illness) Gynecological Diseases, Dispensaries, Unclassified Medical, Hospitals, " Surgical, Special care, (other than trained nurse). No Illness, Special Nurse, Remaining under treatment Total Total 37 PART II DIRECTORY AND STATISTICAL TABLES DIRECTORY ALABAMA BIRMINGHAM The Graduate Nurses* Association, 20th Street and Avenue F. Established visiting nursing in December, 1907. Number of nurses: Two; one white and one colored. Salaries: $60 and $35. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. Plan of Work: The nurses work among the people of their own race. For contagious cases, a third nurse is engaged at the regular rates, $25 per week, and is retained as long as necessary. CALIFORNIA BERKELEY Board of Education, and the Charity Organization Society, 1910 Kittredge Street. Established school nursing April 4, 1909. Number of nurses: One. Salary: $100 per month. Hours: 9 a. m. to 5:30 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The nurse's salary is paid partly by the Board of Education, and partly by the Charity Organization Society. The work in the schools is followed up in the homes, and the mothers are instructed in the care of their children. If at any time the home visits make the work too heavy for the school 41 CALIFORNIA nurse, a pupil from one of the hospitals assists for a certain num- ber of hours each day. For contagious cases, a special nurse is provided, whose salary is paid by the Charity Organization Society. In connection with the home work, a supply closet is maintained, which furnishes bedding, gowns, and sick-room comforts for those who are unable to buy them. LOS ANGELES Board of Health, School Nursing Department. Established in 1903. Number of nurses: Four. Salary: $75 per month. Hours: 8:30 a. m. to 5 p. m. Plan of Work: In May, 1903, school nursing was started experi- mentally by one of the College Settlement nurses, under the supervision of the health officer. In 1904 a special school nurse was appointed by the city to take up the work systematically. There are now four on the staff, one of whom inspects the chil- dren in the day nurseries, children's hospitals, etc. Instructive District Nursing for the City of Los Angeles, College Settlement, 428 Alpine Street. Estaljlished in March, 1898. Number of nurses: Five. Salary: $75 per month and carfare. Hours: 8 a. m. to 5 p. m. Sundays and evenings are free. One half day off duty twice a month. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. History and Plan of Work: In December, 1897, the College Settle- ment appealed to the city council to appropriate a monthly allowance of $50 for the salary of a district nurse. The request was granted, and Los Angeles became the first city in America to establish municipal visiting nursing. A monthly allowance of $50 was made, which was in 1903 increased to $75. The city now supports five district nurses, all of whom work under the supervision of the College Settlement. 42 CALIFORNIA Work began in the public schools in 1903. In conjunction with the city health officer, the settlement furnished statistics and re- ports which led to the appointment of the first school nurse, in September, 1904. There are now four school nurses, who visit in all the schools of the city except three. These three schools are retained by the College Settlement nurses, who report to the city health board. Two settlement nurses have call stations at the Recreation Center, St. John and Holly Streets, and at Public Playground No. i. These stations were built especially for the nurses, and serve as oflSces and medical dispensaries. The tuberculosis service is very extensive. The nurses work in conjunction with the Helping Station of the Anti-Tuberculosis League, caring for all bedridden patients, and for those in the third stage of the disease. The ambulatory cases are referred to the Helping Station. The maternity work is well systematized, nearly all of the obstetrical cases among the poor of the city being cared for. The nurses give their services in three medical dispensaries, and care for all patients who attend the clinics. Calls are answered in all parts of the city, but the second, seventh, eighth, and ninth wards are considered the regular districts. Los Angeles Society for the Study and Prevention of Tubercu- losis, 737 Buena Vista Street. Established visiting nursing in 1907. Number of nurses: One. Salary: $35 per month. Hours : 8 to 1 1 : 30 four mornings of each week. Plan of Work: The nurse visits all the patients who attend the clinics, and when necessary, obtains relief for them from other societies. There are also lay visitors who assist in the social and educational part of the work. MONROVIA Visiting Nurse Association, Myrtle Avenue. Established May ist, 1908. Number of nurses: One. 43 CALIFORNIA Salary: $50 per month, with room, heat, light and conveyance. Hours: 8:30 a. m. to 6 p. m., with two hours' rest at noon. Plan of Work: At the nurse's home is a rest room for the public; also, an employment bureau carried on under the auspices of the churches. A relief committee takes charge of indigent cases and gives necessary help, OAKLAND Associated Charities, 808 Broadway. Established visiting nursing November 11, 1908. Number of nurses: One. Salary: $90 per month and carfare. Hours: About eight hours. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The nurse is a municipal employe, being appointed by the Municipal Board to work under the supervision of the Associated Charities. The work is extending so rapidly that the association is planning an arrangement by which pupil nurses from one of the hospitals may assist the city nurse. Sputum cups, clothing, nourishment, and medicines are provided for tuberculous patients when necessary. Fabiola Hospital Association, Broadway and Moss Avenue. Established visiting nursing in 1894. Number of nurses: One — pupil. Hours: 7 a. m. to 7 p. m. Classes of cases cared for: Surgical, medical obstetrical, and tu- berculous. Plan of Work: The senior pupils are assigned for a certain time to the district work as a part of their training. PASADENA Associated Charities of Pasadena, 65 N. Raymond Avenue. Established a visiting nurse department in April, 1906. Number of nurses: One — pupil. Salary: $75 per month. Hours: 8:30 a. m. to 4:30 p. m. 44 CALIFORNIA Classes of cases cared for: Surgical, medical, and tuberculous. Plan of Work: Senior pupils from the Pasadena Hospital are sent out in rotation for this service. A large part of the work con- sists of visiting and helping the many tuberculous patients who go to Pasadena from other states. A small health camp has been established with accommodations for three patients who are able to be up and take care of themselves. The Associated Charities provides food and laundry for the camp, and assists patients needing material aid. A loan closet is maintained, with bedding for patients living in tents. The pubHc schools are asked to supply eggs, one school after another contributing in turn. Each pupil brings one or more eggs, and in this way many dozens are received daily for the use of patients. SAN FRANCISCO Associated Charities of San Francisco, Visiting Nurse Depart- ment, 1500 Jackson Street. Established in 1899. Number of nurses: Three. Salary: $80 per month. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: Association for Prevention of Tuberculosis. Plan of Work: One nurse works in connection with two societies; the larger part of her salary is paid by the Associated Charities, the remainder by the Association for the Study and Prevention of Tuberculosis. All tuberculous cases are visited by one nurse; the other nurses care for the general medical, surgical, and ob- stetrical cases that may be brought to the attention of the Asso- ciated Charities. Adequate relief is given to all who need more than professional care. Cathedral Mission of the Good Samaritan, Visiting Nurse Department, 246 Second Street. Established in 1895. Number of nurses: One. 45 CALIFORNIA Salary: $50 per month. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. Affiliations: The Episcopal Chiirch. Plan of Work: A dispensary is maintained in charge of physicians, where minor operations are performed and eye and ear clinics are held. The nurse visits the kindergarten, Boys' Home, and day nursery in her district. She finds employment for people needing work, sends convalescents to country homes, and does fresh air work in the summer. Supplies of all kinds are kept on hand to loan or give away. Hale Brothers, 979-987 Market Street. Thb department store engaged a graduate nurse August 12, 1903. Number of nurses: One. Salary: $65 per month. Hours: 9 a. m. to 6 p. m. Classes of cases cared for: Surgical and medical. Plan of Work: The nurse cares for the health of the five hundred employes, and assists customers who may be taken ill in the store. The firm maintains an emergency hospital in the build- ing where cases of sudden illness may be cared for temporarily. Calls are often made upon employes in their homes, and in urgent cases, the nurse sometimes spends the night. Talks on personal hygiene are given to the girls and young women, and there are many opportunities for service on social lines. Nurses' Settlement, 19th and Iowa Streets. Established visiting nursing in 1898. Number of nurses: Two. Salary: $60 per month, with board, room, and carfare. Hours: Irregular. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Special nurses engaged for contagious patients. Plan of Work: This settlement was started by Miss Octavia Briggs, who acts as headworker. The residents are auxiliary inspectors 46 CALIFORNIA under the Board of Health. Aside from the regular nursing visits made in the neighborhood, first aid cases are cared for at the settlement dispensar>'. The settlement is used as a civic, educational and social centre. An active part is taken in the affairs of the community. Clubs and classes for boys, girls, and adults are held. The Potrero Woman's Club, composed of 60 members, was organized for civic improvement and mutual benefit. Laboring people from all parts of the city turn to the nurses for help in times of trouble and need. Homeless and deserted children are taken into the family until other homes may be found for them. The settle- ment is in close co-operation with the Juvenile Court, Associated Charities, public schools, and churches. The Superior Court recently placed a boy on three years' probation with the head- worker. The guest room is used for emergency cases, and for worn out mothers; also, young girls needing rest and care are taken in for short periods of convalescence. St. Francis Hospital, 2868 Cahfornia Street. Established visiting nursing for the senior pupils in July, 1906. Number of nurses : Three — pupils. Hours: Irregular; calls answered at night. Class of cases cared for: Obstetrical. Affiliations: University of California Medical School. History and Plan of, Work: In 1906 the pupil nurses were sent for one month to the St. Francis Maternity Hospital, where the work consisted entirely in attending district cases under the direction of the physician in charge. In 1907, the Maternity Hospital affiliated with the medical School of the University of California. Three pupils are now detailed in turn to the University Hospital, each serving for two months in the maternity wards and one month in the district work already mentioned, as a part of the training school course. St. Luke's Hospital, 1195 Valencia Street. Established visiting nursing in 1906. Hours: Irregular; calls are answered by night and day 47 CALIFORNIA Class of cases cared for: Obstetrical. Affiliations: The San Francisco Maternity Hospital. Plan of Work: This is a part of the obstetrical training given at the University of California Hospital, by which pupils from out- side hospitals have two months in ward work and one month in the districts. St. Luke's nurses have this service in rotation. San Francisco Association for the Prevention and Study of Tuberculosis, 1547 Jackson Street. Established visiting nursing January 18, 1909. Number of nurses: Two — a supervisor and an assistant nurse. Salaries: $100 and $75 per month. Hoiu^: 8 : 30 a. m. to 5 p. m. Class of cases cared for: Tuberculous. Affiliations: Associated Charities. History and Plan of Work: A tuberculosis clinic was opened on January 18, 1909, in temporary quarters at the Telegraph Hill Neighborhood Association. The nurses attend the clinics, visit the patients in their homes, and work along preventive lines, urging out-of-door living and sleeping. They enforce sanitary regulations which will protect the patient, family, and the com- munity at large. They co-operate with the Board of Health, report unsanitary houses or surroundings, new cases of tubercu- losis that they may find, and removals of patients to other lo- calities in order that the vacated premises may be disinfected. The nurses stimulate the patients to carry out the doctors' in- structions, and every effort is made to procure financial assis- tance for those who cannot otherwise follow their advice. Leaf- lets of instruction are distributed among the patients and their famines. In homes where pronounced cases of tuberculosis exist, the nurses frequently find new cases in the incipient stages of the disease. These they send to the physicians at the clinics, and the cure is begun, often before the patients realize that they have become infected with the disease. Sputum cups, paper nap- kins, disinfectants, milk and eggs, are given to people unable to buy them in proper quantities. Reclining chairs are loaned, 48 CAIJFORNIA and out-of-door life and rest are urged whenever it is possible for the patient to take them. San Francisco Maternity, 1195 Valencia Street. Established visiting nursing January 6, 1906. Number of niirses: Two — pupils. Class of cases cared for: Obstetrical. Plan of Work: This training is part of the obstetrical work given to the pupils of the California Hospital. San Francisco Medical Inspection of Schools, Department of Public Health, Butler Building. Established visiting nursing August i, 1908. Number of nurses: Four. Salary: $75 per month. Hours : 8 : 45 a. m. to 4 p. m. Classes of cases cared for: Surgical, medical, contagious, and tu- berculous. Plan of Work: The niirses report at specified schools at 8 : 45 a. m. They examine all pupils sent them by the principals, carry out whatever orders may be given by the school physicians for treat- ment in the school, and refer other cases to dispensaries or family physicians. Cultures are taken of suspected throats, and sent to the Board of Health. All contagious cases are excluded and referred to the Board of Health. Visits to the homes of the children needing care, and to those of truants, are made in the afternoons and on Saturday mornings. Cases of cruelty to children are reported to the Juvenile Court. Families in need of material assistance are referred to the charitable agencies. The nurses are supervised by the medical inspector. The Telegraph Hill Neighborhood House, 1736 Stockton Street. Established in 1890. Number of nurses: Two. Salary: $60 per month. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical medical, and tuberculous. 4 49 CALIFORNIA History and Plan of Work: The Neighborhood House, established by Miss EHzabeth Ashe, was at first intended for the benefit of the children of the neighborhood. In 1903, after Miss Ashe had taken a nurses' course in the Presbyterian Hospital in New York City, its scope was enlarged. A larger house was secured, visiting nursing was organized, and a dispensary was opened. The earthquake and devastating fire of 1906 checked the growth of the work, destroyed the house, and scattered the people in that part of the city. The settlement was soon re-opened, however, in Stockton Street, in more commodious quarters, with a dis- pensary, carpentry shop, gymnasium, club rooms for boys and girls, and two separate flats for resident workers. A loan closet, supplied by the Needlework Guild, fiu-nishes bed linen and clothing for the sick. The experiment of visiting nursing in the public schools was first made by the settlement, then taken over by the city. A nurse from the dispensary still visits the kinder- gartens regularly. A farm of 120 acres is an important adjunct of the settlement. It is used for a convalescent home where patients may be accom- modated, and also as a vacation camp. The farm is made partly self-supporting by the sale of its products. SAN JOSE The Good Cheer Club, Room 16, Letitia Building. Established visiting nursing May i, 1905. Number of nurses: One. Salary: $60 per month. Hours: 8 a. m. to 6 p. m. Two half days free from duty each month. Emergency calls are answered at night. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. A special nurse is sometimes engaged for contagious patients. Plan of Work: A loan closet enables the nurse to supply needed sick-room appliances. Sputum cups and nourishment are given when necessary. A charge of $.50 is made to all patients who can afford to pay for the nurse's services. 50 CALIFORNIA SANTA BARBARA Santa Barbara Visiting Nurse Association, Office at Neighbor- hood Club, 133 E. Haley Street. Established November i, 1908. Number of nurses: One. Salary: $75 per month and carriage expenses. Hours: Eight hours daily. Only very ill patients are visited on Sundays and holidays. Classes of cases cared for: Svugical, medical, obstetrical, and tu- berculous. History and Plan of Work: This association is closely allied with the St. Cecelia Club, which was started in 1892 for the purpose of providing hospital care for patients who were unable to pay the usual fee charged by the hospitals. The club also provided nursing care for patients in private homes. The visiting nurse now takes charge of all such patients, and follows up convales- cent cases discharged from the hospital. Emergency calls are answered at night. If more than an occasional night's work is required, the association provides a relief nurse. A loan closet supplies bed linen, clothing, and many sick-room appliances. Maternity outfits are provided for obstetrical cases; sputum cups, disinfectants and hammocks for tuberculous patients. The association has also undertaken nursing in connection with the public schools. The nurse visits certain schools each day, re- ceives the names of all pupils who may be absent on account of illness, visits them in their homes, and sees that they return to school at the earliest possible time. There is as yet no medical inspection of the pupils, therefore the nurse makes no attempt to examine or care for the children who remain in the class- rooms. SAN MATEO St. Matthew's Visiting Nurse, Red Cross Hospital, Established in April, 1907. Number of nurses: One. Salary: $75 per month. Hours: 9 a. m. to 5 p. m. Emergency calls are answered at night. 51 COLORADO Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Plan of Work: Funds were given by a philanthropic person to start visiting nursing in connection with the parish work of St. Matthew's Church, though not confined to parish cases. Calls are accepted from the sick and needy in all parts of the town, and in outlying districts. For long distances the nurse uses a wheel. A supply closet furnishes bed linen, clothing of all kinds, sick- room appUances, sputum cups, paper napkins, reclining chairs, etc. Nourishment is supplied to patients who are very ill and unable to purchase it. A small and perfectly equipped hospital has been built on the chvuch grounds, and patients requiring constant care, or surgical operations may be sent there. A second nurse is in charge of the hospital. COLORADO COLORADO SPRINGS The Colorado Springs Visiting Nurse Association. Established visiting nursing in January, 1902, Number of nurses: One. Salary: $85 per month and carfare. Hours: Irregular, Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Plan of Work: Tuberculous cases predominate, as patients are sent to Colorado Springs from all parts of the United States. DENVER Visiting Nurse Association of Denver, 1434 Glenarm Street. Established in the fall of 1892. Number of nurses: Four. Salary: $55 per month for the first year; $60 thereafter. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. 52 COLORADO Plan of Work: One nurse remains in the oflSce during the morning to receive calls and see patients. She attends the clinic at the Free Dispensary from 12 to i p, m., and in the afternoon visits patients in their homes. A supply closet furnishes bed linen and clothing, to loan or to give away. PUEBLO School District No. 20. Department of Education, Visiting Nurse Department. Established January 5, 1909. Number of nurses: One. Salary: $1200 per annum, and three months' vacation in summer. Hours: 9 a. m. to 4 p. m. Saturday afternoons and Sundays free from duty. Classes of cases cared for: Surgical, medical, contagious and tuberculous. Plan of Work: The nurse refers to the city or county physicians all children who show symptoms of illness or physical defects. She visits the homes after school hours, explains to the parents the necessity of having the children cared for by a doctor, and follows up such cases until they have received treatment and are ready to return to school. Talks are given in the school- room on general cleanliness and personal hygiene, care of teeth, skin, hair, etc. Children with symptoms of contagious disease are reported to the health officer, who takes charge of the case and gives the cer- tificate permitting the child to return to school after the quar- antine has been raised. An efficient truant officer looks after all absentees, and reports cases of illness to the school nurse, who visits the home on the same day. All cases of destitution found by the nurse among the school children are reported to the truant officer, who supplies clotliing at the expense of the school district. 53 CONNECTICUT CONNECTICUT ANSONIA See Derby. BIRMINGHAM See Derby. BRIDGEPORT Fairfield County Anti-Tuberculosis Association, Charities Building. Established visiting nursing in July, 1909. Number of nurses: Two. Salary: $60 per month. Hours: 8 a. m. to 6 p. m. Class of cases cared for: Tuberculous. Plan of Work: One nurse is in charge of the dispensary clinics which are held during the day, and in the evening to accom- modate patients who work. A second nurse visits the homes, gives nursing care to bed patients, and instructs the families in regard to the proper preventive measures to take. Gauze, sputum cups, disinfectants, milk, and eggs are supplied. A loan closet furnishes bed Unen and clothing. BRISTOL Bristol Visiting Nurse Association, 115 Maple Street. Established January 16, 1909. Number of nurses: One. Salary: $75 per month. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: A loan closet supplies sick-room appliances of all kinds, bed linen, and clothing. Infants' outfits, jellies and nourishing food are furnished when necessary. BUSHY HILL See Simsbury. 54 CONNECTICUT DERBY District Nurse Association of Derby, Ansonia, and Shelton. Established February i, 1904. Number of nurses: One. Salary: $60 per month. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. Plan of Work: Emergency and loan closets are supported in Derby and Ansonia. A directory of fifteen trained attendants is kept; these may be called upon to supplement the nurse's work where constant attention is needed. They work under the direction and supervision of the nurse. EAST WEATOGUE See Simsbury. ENFIELD Visiting Nurse Department of the Woman's Club, Enfield St. Established in March, 1908. Number of nurses: One. Salary: $80 per month. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The nurse's territory extends to Thompsonville and nearby villages. Emergency calls are answered at all times. Small fees are asked of patients who are able to pay for the nurse's services, the income received from this source being used for supplies, milk, eggs, etc. A loan closet furnishes bed Hnen and clothing. FARMINGTON The Gundy Nurse. Established April i, 1908. Number of nurses: One. 55 CONNECTICUT Salary: $80 per month. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: A loan closet furnishes bed linen, clothing, and infants' outfits. Small fees are charged for the nurse's services. HARTFORD The Visiting Nurse Association, 34 Charter Oak Avenue. Established April i, 1901. Number of nurses: Four. Salaries: $60 to $80 per month. Hours: 8:30 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: A nurse is sent by the association to the tubercu- losis clinics; she then visits the patients in their homes. Pa- tients discharged from the Hartford Hospital and Wildwood Sanitarium are followed up, home conditions investigated, and help given whenever possible. At 39 South Prospect Street is an apartment of three rooms which is used for a tuberculosis class and for social club work among young men, women, and children. The association hopes to have in the near future a day camp for summer service. HOP MEADOW See Simsbury. HOSKINS See Simsbury. LAKEVILLE Lakeville Visiting Nursing. Established in February, 1906. Number of nurses: Two. Salary: $75 and $80 per month. Hours: 9 a. m. to 6 p. m. 56 CONNECTICUT Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Contagious cases are sometimes visited at the end of the day's work, and, if unable to do more, the nurse gives the family verbal instruction as to the details of caring for the patient. Plan of Work: Calls are accepted from the people of the near-by villages of Ore Hill and SaHsbury as well as from the Lakeville region. A horse and carriage are provided for trips to distant points. A sliding scale of fees for the nurse's services is estab- lished, and the receipts from this source cover the expenses of carriage and medicines. Much friendly visiting is done to "shut-ins", — aged, infirm, and chronic patients. An emergency fund supplies eggs, and some- times milk; clothing, bed linen, and infants' outfits also have been suppUed on occasion. MEADOW PLAIN See Simsbury. MIDDLETOWN District Nurse Association, 260 Washington Street. Established in November, 1900. Number of nurses: Two. Salaries: $70 and $65 per month. Hours: Eight hours daily. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The nurses' districts extend to South Farms and Portland. Loan and supply closets are maintained at both Middletown and Portland. The use of a horse and carriage is given by the association for long distance calls, the owners of the livery stable reducing their prices for this purpose. A charge of $.50 an hour is the standard fee for the nurse's ser- vice, but patients may give less or nothing, according to their means. In contagious cases the nurse instructs the family, and gives all assistance possible without personal contact with the patient. 57 CONNECTICUT NAUGATUCK Naugatuck Visiting Nurse, 266 Church St, Established in September, 1905. Number of nurses : One. Salary: $60 per month. Hours: Irregular. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: A philanthropic woman entirely supports this work. NEW BRITAIN Visiting Nurse Association, 28 S. High Street. Established January 3, 1905. Number of nurses: Two. Salaries: $75 and $60 per month. Hours: 8 a. m. to 6 p. m. Emergency calls are answered at night. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: A well stocked supply closet supplements the work of the nurse. The articles are loaned or given away according to the needs of the case. Bed linen, clothing, blankets, toilet articles, babies' outfits, medical supplies, jellies, magazines, and toys are among the articles kept on hand. The income is de- rived from annual membership dues and patients' fees. The association supplies a furnished house for the nurses. A class in home nursing is held one evening each week during the winter. NEW HAVEN Trinity Parish Deaconess Work, 162 Temple Street. Established in 1895. Number of nurses: One. Salary: $50 per month and board. Hours: Irregular; calls answered at all times. Classes of cases cared for: Surgical, medical, obstetrical, [conta- gious, and tuberculous. 58 CONNECTICUT The Visiting Nurse Association, 200 Orange Street. Established in the summer of 1904. Number of nurses: Four, one of whom is a pupil. Salaries: $70 and $60 per month. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: The United Workers, Organized Charities, and Grace Hospital. Plan of Work: The nurses are assisted in the regular visiting work by pupils from the Connecticut Training School. A course of six weeks is given each senior pupil, under the supervision of the association. Regular visits are made to the kindergartens and day nurseries of the city. The United Workers and the Organized Charities furnish a room for supplies, and also the use of a telephone. The training school of Grace Hospital furnishes nurses for special service at very moderate rates. People interested in the work give money to the nurses to be used at their own discretion, for milk, eggs, and other neces- saries. In June, 1908, a nurse was detailed to the tuberculosis clinic of the New Haven Dispensary. Her entire time is given to tuberculosis work, visiting in the homes and keeping careful records of each case. NORWICH Norwich Hospital for the Insane. Established visiting nursing February i, 1908. Number of nurses: One — pupil. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: The United Workers. Plan of Work: The senior pupils of this hospital are sent into the homes of patients for general visiting nursing work, under the supervision of the United Workers. All the pupils of the hos- pital are detailed to this service in rotation. Whenever pos- sible, a fee of $.25 an hour is charged for general cases. In 59 CONNECTICUT obstetrical cases, the pupils attend the confinement, and for this service the fee is $i.oo. The United Workers, 9 Washington Street. Established visiting nursing in 1887. Number of nurses: One — pupil. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: Norwich Hospital for the Insane. History and Plan of Work: This charitable organization set apart as a "Visiting Nurse Fund," a legacy of $1500 that had been bequeathed to it, and a sum of $250 that had previously been given for the education of a trained nurse. As the latter sum was not needed for this purpose, a trained nurse was engaged to visit the sick poor in their homes. This work was carried on successfully until 1893, when the opening of the WiUiam M. Backus Hospital seemed to make the visiting nurse's service no longer necessary; it was therefore discontinued. In Feb- ruary, 1908, it was resumed under an arrangement with the Hospital for the Insane. The senior pupil nurses are given from one month to six weeks' training in this service under the direction of the physicians. Medicines are sometimes furnished by the association for very needy patients, and trained attendants are engaged for cases requiring constant care. If the patient be a man, requiring lifting, a man nurse is engaged for a limited time, A loan closet supplies bed linen, clothing and sick-room appliances. ORE HILL See Lakeville. PORTLAND See Middletown. SALISBURY See Lakeville. 60 CONNECTICUT SHELTON See Derby. SIMSBURY Simsbury Visiting Nursing Association. Established June 8, 1908. Number of nurses : One. Salary: $50 per month and expenses. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, tuber- culous, also contagious, exclusive of scarlet fever, smallpox, and diphtheria. History and Plan of Work: Simsbury is a rural district including twelve small villages: Tariffville, Hoskins, Terry's Plain, Hop Meadow, Center, East, and West Weatogue, Bushy Hill, New, Union, West Simsbury, and Meadow Plain. The nurse responds to calls from all these places, and travels by carriage — the only means of conveyance. Unless patients call for her, the associa- tion pays the cost of travel. Only calls of extreme urgency are answered at night. A charge of $.25 an hour is usually made for ordinary cases; in obstetrical cases, $2.00 at the time of confinement and $.25 for after calls. Massage, $1.00 per hour. For operations with ether, an extra charge of $.75 or $1.00 is made. Bed linen, clothing, and infants' outfits may be loaned or given to patients at the discretion of the nurse. A small fund has been established to purchase milk, eggs, and other nourishing food for special cases. SOUTH FARMS See Middletown. SOUTH NORWALK Tuberculosis Dispensary, 6 Pine Street. Established visiting nursing July 7, 1907. Number of nurses: One. Salary: $75 per month. Hours: 9 a. m. to 5 p. m. Class of cases cared for: Tuberculous. 61 CONNECTICUT Plan of Work: The nurse attends the clinic daily from 12 to i, and spends the rest of the time in visiting the homes. STAMFORD King's Daughters of the Presbyterian Church, 2 Rippowan PL Established visiting nursing in March, 1907. Number of nurses: One, Salary: $75 per month. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: This work is aflSliated with the Presbyterian Church, but it is non-sectarian, and patients who do not belong to the parish are visited. Special care is given to tuberculous cases. Sputum cups, milk and eggs, meat, etc. are supplied to patients unable to buy them in sufficient quantities. A small camp accommodating six people is maintained for tuberculous pa- tients. A loan closet furnishes bed linen and clothing. St. John's Episcopal Church, Woodland Avenue. Established visiting nursing in 1903. Number of nurses: One. Salary: $75 per month. Hours: Irregular. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. History and Plan of Work: The work is supported by the church, but the nurse's services are not limited to the parishioners. A small fee is charged, according to the patient's ability to pay. There is a church charitable society which assists in the care of needy patients, and provides a supply closet containing malted milk, soups, jellies, and other nutrients, and ordinary drugs. TARIFFVILLE See Simsbury. TERRY'S PLAIN See Simsbury. 62 CONNECTICUT THOMSONVILLE See Enfield. UNION See Simsbury. WATERBURY Waterbury Anti-Tuberculosis League, City Hall Annex. Established visiting nursing in December, 1907. Number of nurses: Two. Salary: $75 per month. Hours: 8:30 a, m. to 5:30 p. m. Class of cases cared for: Tuberculous. Plan of Work: Milk, eggs, medicines, and clothing are supplied when necessary. Beds are provided to enable patients to sleep alone. Financial help is given when needed. Patients are sent to sanatoria and supported while there either by the league or by other charitable agencies. Reclining chairs and sick- room appliances are loaned, and out-of-door sleeping accom- modations, curtains for porches, etc., are provided whenever possible. The Waterbury Visiting Nurse Association, 37 Central Avenue. Established in October, 1903. Number of nurses: Three in winter, and four in summer. In addition, there is one pupil nurse from the local hospital. Salary: $75 per month. Hours: 8:30 a. m. to 5:30 p. m. Classes of cases cared for: Surgical, medical, and obstetrical. Plan of Work: One nurse gives her entire time to teaching mothers how to care for their babies and young children. A milk station is to be established in connection with the settlement, and also a day camp for sick babies. A First Aid room is open from 2 to 4 p. m. where surgical dressings are attended to. One nurse remains in the settlement all day to receive the calls, attend the First Aid room, and see the neighbors who may need sym- 63 DELAWARE pathy or advice. They bring many problems and difficulties to be unravelled, and a very friendly personal relation, as well as a professional one, exists between the nurses and the neighbors. There is a well-stocked supply closet filled with bed linen, night- gowns, infants' outfits, and all kinds of sick-room appliances. Nourishment and delicacies may be provided for those who are very ill. Special nurses are occasionally supplied in critical cases. Convalescent patients needing building up are sent for two weeks or more to the vacation house of the association in the country. Mothers and babies are also sent for a two weeks' outing. DELAWARE WILMINGTON The Associated Charities, Visiting Nurse Department, Associated Charities Building, 602 West Street. Established in 1901. Number of nurses: Two. Salary: $40 per month. Hours: Irregular. Emergency calls are answered at night. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. History and Plan of Work: This work was started in 1901 by Bishop Leighton Coleman, the Babies' Hospital, St. Michael's Day Nursery, and the Associated Charities. In 1903 it was made a department of the Associated Charities, and a school for trained attendants was organized. The attendants are given a practical course of six months at the bedside, under the instruction of the head nurse, and they receive lectures from physicians. At the end of the course the pupils work for one year under the direction of the school. They are then given certificates as attendants fitted to care for pa- tients who do not require the services of a trained nurse. The school reserves the right to select for one year longer the cases that the attendants may go to, and stipulates that they shall not charge more than $7.00 per week. Bed linen, clothing, and sick-room appliances are loaned when necessary. Financial 64 DISTRICT OF COLUMBIA help, coal, and groceries are given to needy patients through the Associated Charities relief department. Delaware State Anti-Tuberculosis Society, 602 West Street. Established visiting nursing in 1907. Number of nurses: One. Salary: $75 per month. Hours: 9 a. m. to 5 p. m. Class of cases cared for: Tuberculous. Plan of Work: Milk, eggs, medicines, sputum cups, and paper napkins, are given to all patients who cannot obtain them in any other way. The Sunshine Society loans wheel chairs, and tents both for windows and for living out-of-doors. Patients needing hospital care are sent to the emergency sanitarium in the suburbs. A free dispensary started in April, 1907, is main- tained at 602 West Street. The work is supported by an ap- propriation from the state, and by the Anti-Tuberculosis Society. DISTRICT OF COLUMBIA WASHINGTON Committee on Prevention of Consumption, 923 H St., N. W. Established visiting nursing in March, 1908. Plan of Work: The nursing care of all tuberculous patients vmder the supervision and treatment of this committee and of the Free Dispensary, is given by two nurses on the staff of the In- structive Visiting Nurse Society. Their salaries are paid by the two societies equally. The Instructive Visiting Nurse Society, 2001- I Street, N. W. Established in February, 1900. Number of nurses: Twelve. Salary: $60 per month. Hours: 8 : 30 a. m. to 5 : 30 p. m. Only very ill patients are visited on Sundays. When possible, one half day off duty is given each week. 5 65 DISTRICT OF COLUMBIA Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous; advice is given for contagious cases. Plan of Work: The nurses work under the direction of the Visiting Physicians of the Poor, who are appointed by the health officer of the District of Columbia. They report at the police precinct of their district each morning and receive their orders from the doctors in charge. They also accept calls from other physicians, charitable agencies, and individuals. Books for registering calls are kept at the police stations, at the society's main office, and at the headquarters of each nurse. There are ten loan closets, one in each district, which furnish all necessary articles for the comfort of the patients. Milk tickets are given by the Washington Diet Kitchen. Ice tickets are also at the disposal of the nurses for all patients who cannot afford to buy their ice. This is made possible through the gen- erosity of a private citizen. On December i, 1906, one of the staff nurses was assigned to the Free Dispensary for Consumptives; now two nurses care for all the patients of the Committee for the Prevention and Cure of Tuberculosis. One-half the salary of these nurses is paid by this committee. The other half is paid by the Instructive Visiting Nurse Association. All patients are supplied with sputum cups, paper napkins, and disinfectants. Careful instructions are given as to the proper care of themselves and their families. The Citizen Relief Association supplies milk and eggs for in- cipient and hopeful cases. The Washington Diet Kitchen gives milk to more advanced patients. Records of all tuberculosis patients are kept on file at the central office, 2001- I St. N. W.; duplicate records are sent to the Free Dispensary for Consump- tives. Compulsory disinfection is enforced both after death and after change of residence. One of the staff nurses has been detailed to the Health Depart- ment to look up newly born infants. Each birth that is recorded at the health office is reported to the nurse who then visits the home. She explains a printed list of suggestions which are issued by the department, and which give simple rules in regard to the feeding and general care of infants. She examines the 66 GEORGIA babies' eyes, and if there is the slightest indication of ophthalmia neonatorum, the child is given prompt and effective treatment by an expert doctor. One nurse is sent to the South West Baby Dispensary for the summer months, to assist at the clinics and to visit the sick babies. The Red Cross Day Camp for Tuberculosis has a nurse from the Instructive Visiting Nurse Society. School nursing has been started experimentally, with the hope that the District of Columbia will take the matter up in the near future, and will appoint a special corps of nurses to enlarge and carry on the work. Woman's Home Missionary Society,* 917 O Street, N. W. Established visiting nursing July 15, 1907. Number of nurses: One. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. Affiliations: Methodist Episcopal Church and Deaconess Home. Plan of Work: The deaconess is a trained nurse, and is in residence at the Deaconess Home. Calls are answered whenever received, day or night. GEORGIA ATLANTA Atlanta City Public Schools, Ofiice of Supt. of City Schools. Established school nursing March i, 1909. Number of nurses: One. Salary: $75 per month. Hours: 8 a, m. to 5 p. m. Classes of cases cared for: Surgical, medical, contagious, and tu- berculous. Plan of Work: The nurse assists the medical inspectors in the physical examinations of the pupils, attends to minor surgical dressings in the schools, visits the homes to explain to the parents the physician's instructions and the necessity for following his advice. *Nursing service disconlinued. 67 GEORGIA City Mission Board, 74 South Boulevard. Established visiting nursing in October, 1905. Number of nurses: One. Salary: $40 per month. Hours: Irregular. Classes of cases cared for: Surgical, medical, and obstetrical. AflBliations: Fulton Bag Factory and Cotton Mills. History and Plan of Work: In 1903 the Woman's Methodist City Mission combined with the owners of the Fulton Bag Factory and Cotton Mills to estabUsh a settlement in the mill district. Shortly after, a dispensary was opened with the best children's specialist in Atlanta as attending physician. Later, other phy- sicians and specialists offered their services, and as the work grew, a visiting nurse was employed in October, 1905. The nurse lives at the settlement and attends the clinics which are held three afternoons each week. She also instructs her neighbors in the simple laws of hygiene, care of children, and other necessary subjects. During a part of the year lessons in home nursing, sanitation, and general hygiene are given to a class one afternoon a week. The necessity for vaccination is explained to parents, and the nurse sees that the children are vaccinated. Dispensary for the Home Treatment of Tuberculosis, 707 Gould Building. Established visiting nursing in April, 1907. Number of nurses: One. Salaries: $50 and $60 per month. Hours of duty: Irregular, whenever called. Class of cases cared for: Tuberculous. Affiliations: The Associated Charities provide necessary medicines and nourishment, and give financial help to destitute patients. Plan of Work: The nurse attends the clinics, assists the doctors, and takes the patients' histories. Later, visits of instruction and supervision are made in the homes. 68 GEORGIA First and Central Presbyterian Churches, Nurse's Headquarters, First Presbyterian Church. Established visiting nursing February i, 1909. Number of nurses: One. Salary: $50 per month. Hours: 9 a. m. to 5 p. m. Sundays 9 a. m. to 2 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Plan of work: There is a supply closet in both churches which enables the nurse to loan bed linen and clothing. Medicines, milk, and eggs are sometimes furnished, especially for tubercu- lous patients. AUGUSTA Home Comfort Society, Harrisberg District. Established June i, 1908. Number of nurses: One. Salary: $75 per month. Hours: 9 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Affiliations: The society is affiliated with the King's Daughters and Associated Charities. SAVANNAH Mary Maclean Circle of King's Daughters, St. Andrew's Mission, Cor. Zubly and Ann Sts. Established visiting nursing in February, 1904. Number of nurses: One. Salary: $7 5 per month and carfare. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Plan of Work: Bed linen, clothing, and food are supplied when necessary. Flowers and magazines are given to the bedridden or convalescent patients. There is a room at St. Andrew's 69 ILLINOIS Mission where the nurse attends to patients requiring minor surgical dressings. The city pays the association $25 per month for the nurse's services. THOMASVILLE, Grady County, Pebble Hill Plantation. Established visiting niursing March i, iqoo. Number of nurses: One. Hours: Irregular. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Plan of Work: This work was started by the owner of the planta- tion. The nurse is a colored graduate who cares for the sick and does preventive work among her own people on and near the Pebble Hill Plantation. She has a night school, principally for people who are too old to attend the regular day school. ILLINOIS BLOOMINGTON Brokaw Hospital. Established visiting nursing January i, 1904. Number of nurses: Two; a supervisor, and one senior pupil as assistant. Salary: $50 per month for the supervisor. Hours: 8 a. m. to 5 p. m.; Sundays excepted. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Plan of Work: The nurses are sent to obstetrical cases, and to those patients who cannot be admitted to the hospital or who may be awaiting admission. No calls are answered at night. CHICAGO Battle Creek Sanatorium,* 28 Thirty-third Place. Established visiting nursing in 1896. Number of nurses: Six. * This sanatorium has not replied to recent communications. 70 ILLINOIS Salaries: From $25 to $45 per month. Hours: 8 a. m. to 7 p. m. Emergency calb accepted at all hours. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. Plan of Work: The American Medical Missionary College supports the visiting nursing work. Carson, Pirie, Scott and Company, State and Madison Streets. Established a visiting nurse department in their store September 19, 1904. Number of nurses: Two. Hours: 8 a. m. to 5 : 30 p. m. Plan of Work: One nurse has charge of the accident room which is maintained for the benefit of the public; the other looks after the welfare of the employes, visits them in their homes when ill, or attends to minor ailments in the store. This nurse takes a special interest in the clerks who are strangers in the city and live in boarding houses; befriending, advising, and helping all who need a friend. Chicago Lying-in Hospital and Dispensary, 294 Ashland Avenue. Established visiting nursing in 1894. Number of nurses: Nine — pupils. Hours: Irregular. Class of cases cared for: Obstetrical. Plan of Work: The senior pupil nurses are sent out with a physician and student to care for obstetrical cases. Calls are accepted at all times. The nurses accompany the physicians and assist at the time of delivery. Postpartum visits are made with the phy- sician and students. Clothing for mothers and babies is supplied in destitute cases. There is an emergency fund which furnishes financial help when needed. In connection with this branch of their training the pupils spend one month in the Out-Patient Department. Chicago Municipal Sanatorium, 105 W. Monroe Street. Established visiting nursing November i6, 1907. Number of nurses: Nine; one supervisor and eight assistants. 71 ILLINOIS Salaries: $ioo, $75 and $60 per month. Hours: 8 :3o a. m. to 5 p. m. Class of cases cared for: Tuberculous. Plan of Work: The nurses assist the physicians during clinic hours, and later visit and instruct the patients in their homes. A uni- form system of records is kept, and a card catalogue of all the homes in the city where deaths from tuberculosis occur. The Department of Health has recently taken over this part of the work. In connection with the institute is the Edward Sana- torium at Naperville, Illinois, given by Mrs. Keith Spaulding in 1907. This is for the treatment of men and women with incipient pulmonary tuberculosis. Communication with dis- charged patients is maintained by means of letters every two months. The nurses also visit these patients in their homes to see that they do not forget the lessons taught them in the sana- torium, and to keep records of the results and permanency of the treatment. One nurse is assigned to each of the following dispensaries: Polyclinic, 174 E. Chicago Ave. Open Tues. and Fri., 2-3 p. m. Central Free (Rush Med. Coll.), 757 W. Harrison St. Wed. and Sat., 10 a. m.-i2 m. West Side (P. and S. Coll.), Congress and Honore Sts. Tues. and Fri., 10 a. m.-i2 m. West Side (Jewish Aid Society), Morgan and Maxwell Sts. Mon. and Thurs., 3-5 p. m. South Side (N. W. Univ. Med. School), 2431 Dearborn St. Mon. and Thurs., 10-12. Hahnemann Hospital Dispensary, 2811 Cottage Grove Ave. Mon. and Thurs., 2:30-4 p. m. Stock Yards Dispensary, 823 W. 47th, near Halsted Sts. Tues. and Sat., 9-10 a. m. Department of Health, SchooLNursing Department. Established in October, 1908. Number of nurses: 41; a supervisor and 40 assistants. Salary: $75 per month ten months in the year. Hours: 8:30 a. m. to 5:30 p. m. Classes of cases cared for: Surgical, medical, contagious, and tu- berculous. 72 ILLINOIS History and Plan of Work: In 1907, during an outbreak of scarlet fever, ten nurses of the Visiting Nurse Association staff were placed in the public schools to aid the medical inspectors in coping with the epidemic. The city council appropriated an emergency fund, $1800 of which was used for the nurses. In October, 1908, the Health Board created a temporary school nursing service which was continued and made permanent in March, 1909. This was accomplished with the aid of the Visit- ing Nurse Association, which gave up several of its most expe- rienced nurses for the school work. The school staff is now com- posed of civil service appointees; they work under the medical inspectors, assist them in the routine examinations in the schools, carry out their orders for the treatment of minor ailments of the pupils, visit the homes, instruct the mothers in the care of their children, and explain the necessity for operations or other sug- gestions made by the school physicians. They report home con- ditions to both teachers and doctors, insure the earliest possible return to school of all pupils who may have been excluded, and refer to the proper agencies all cases of destitution and want which they may find. Olivet House, 44 and 46 Vedder Street. Established visiting nursing September 10, 1904. Number of nurses: One. Salary: $75 per month. Hours: Irregular. Classes of cases cared for: Surgical, medical, and obstetrical. Plan of Work: This is a religious and social settlement, having a medical department and a corps of physicians. There is a small dispensary open daily except Sundays from 8 to 9 o'clock. The nurse assists the doctors during the dispensary hour, then visits the sick in their homes. Presbyterian Hospital School for Nurses, 430 Ashland Boulevard. Established visiting nursing in May, 1903. Number of nurses: One — pupil. Hours: Irregular; calls answered whenever received. 73 ILLINOIS Class of cases cared for: Obstetrical. Plan of Work: Senior pupils and nurses taking a post-graduate course accompany the physicians and attend the patients during labor. They also visit each patient for ten days following de- livery, and give nursing care to both mother and child. Provident Hospital and Training School, 36th and Dearborn Streets. Plan of Work: The senior pupils of this hospital have two months' service in district work under supervision of the Visiting Nurse Association. Two days of each week are spent with a graduate in caring for tuberculosis patients, attending clinics in the morning, and visiting in the homes in the afternoons. The remainder of the week is spent in general nursing work in the homes. University of Chicago Settlement, 4630 Gross Avenue. Established visiting nursing in June, 1906. Number of nurses: One. Salary: S70 per month. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Plan of Work: This settlement is situated in the quarter known as the stockyards district; the nurse is a resident, and her salary is paid by the owners of the stockyards. As infant mortality in that part of town has been great, the Department of Health sends daily lists of sick babies for the nurse to visit in their homes. A small day camp is maintained on the settlement grounds in summer, where mothers take their sick babies and remain through the day. The nurse pays especial attention to teaching of mothers, following up the cases, securing hospital care when necessary, or providing medical attention. A loan closet furnishes bed linen and sick-room appliances. When the families are able to pay, a small fee is charged for the nurse's services. 74 ILLINOIS The Visiting Nurse Association, 79 Dearborn Street. Established in 1890. Number of nurses: 37. Salaries: $50 for three probationary months; $60 the following nine months; $70 the second year, and an increase of $5 annually, until the maximum of $87 per month is reached. Hours: 8 a. m. to 5 p. m. Two half holidays are given each month. Only very ill patients are visited on Sunday. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. Plan of Work: This association is one of the largest in the country. The nurses are stationed in 25 different districts, and calls are answered in Chicago, South Chicago, Ravenswood, and Rogers Park. Emergency cases are cared for in Austin and Oak Park. A nurse is employed by the McCormick Reaper Works, and one by the Deering Reaper Works, to visit sick employes and their families. One nurse is in charge of the Social Service Department of the Children's Memorial Hospital. Two benefit associations have nurses visit and investigate members who report themselves as ill and unable to work. Weekly visits are made to every day nursery in the city; the children are examined and those who are ill are visited in the homes. In 1904, a Committee on the Prevention of Tuberculosis was formed and the sum of $2,000 was appropriated by the board of directors of the Visiting Nurse Association to help carry on the work. From that committee the Tuberculosis Institute grew, and it now has a staff of seven visiting nurses of its own. The Visiting Nurse Association has a special fund for its tu- berculosis patients from which milk and eggs, bed linen and cots may be supplied. Sick-room appliances, bed linen, and clothing are loaned to all patients needing such help. A colored nurse cares for colored patients exclusively. Following is a list of the sub-stations where the nurses have their headquarters, and where they may be found from 12 m. to 1 p. m.: Central Free Dispensary of Rush Medical College, Harrison and Wood Streets. 75 ILLINOIS McCormick's Works, Blue Island and Western Avenue. Children's Memorial Hospital, Out-Patient Department, 606 FuUerton Avenue. Deering Reaper Works, East Fullerton Avenue and the River. Haller's Drug Store, 474 W. North Avenue. Deering Pharmacy, 876 Clybourne Avenue. Martin's Drug Store, 92nd and Commercial Avenue. Metz's Drug Store, 562 N. Ashland Avenue. Meyer and Johnson's Drug Store, 1077 Lincoln Avenue. Pupils from the Provident Hospital (colored) are given six weeks' training in district nursing, under the supervision of the Visiting Nurse Association staff. One pupil at a time is detailed for this work. School nursing was the outcome of an epidemic of scarlet fever in February, March, and April of 1907, when the city coun- cil appropriated an emergency fund for the Department of Health, a part of which was used for nurses who supplemented the work of the medical inspectors. Ten nurses from the Visiting Nurse Association staff were assigned for this duty. This was the initial step taken toward the municipal school nursing ser- vice which was organized in October, 1908, by the Department of Health. To make the experiment as effective as possible, some of the most experienced visiting nurses were assigned to the school staff, and the newer nurses were taken on to the visit- ing staff. Supervision of this work was undertaken by the Visit- ing Nurse Association under the direction of the medical in- spectors. EVANSTON Visiting Nurse Committee, 1330 Church Street. Established in March, 1898. Number of nurses: One. Salary: $60 per month. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Plan of Work: The committee raises all necessary funds. The 76 ILLINOIS chairman acts as a supervisor of the nurse, receives her reports, and directs her in her work. Special nurses are engaged for cases of severe illness needing constant care. A loan closet furnishes bed linen and clothing. Milk and eggs, medicines, tents, and sputum cups are suppHed to tuberculous patients. FREEPORT Young Women Workers' Visiting Nurses* Association, King's Daughters Mission. Established December i, 1908. Number of nurses: One. Salary: $30 per month. Hours of duty: 8 a. m. to 5 p. m. Emergency calls answered at all hours. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Affiliations: Presbyterian Church. Plan of Work: Bed linen, milk and eggs are supplied by other charitable organizations of the city. GALESBURG Galesburg Visiting Nursing Association, City Hall. Established August 24, 1908. Number of nurses: One. Salary: $80 per month. Hours: Eight hours. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. Plan of Work: A well-stocked loan closet provides all necessary supplies for the sick and needy. MOLINE King's Daughters Union, Visiting Nurse Department, The Drury. Established October 19, 1903. Number of nurses: One. 77 ILLINOIS Salary: $ioo per month. Hours: 8 a. m. to 5 p, m. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Plan of Work: A supply closet furnishes sick-room appliances which may be loaned, and babies' outfits to be given away as needed. The Health Department requires the nurse to report typhoid cases if more than one case occurs in the same building. Emergency nurses are engaged when necessary, and they work under the personal supervision of the visiting nurse. All patients are expected to pay from $.10 to $1.00 per visit; those who are unable to do so, are attended free of charge. The manufacturers' and fraternal organizations of the city have presented the King's Daughters with a horse and buggy for the use of the nurse, and the city bears the expense of caring for them. PEORIA Associated Charities and Philanthropies, 301 City Hall. Established visiting nursing in May, 1902. Number of nurses: One. Salary: $75 per month. Hours: 8 :3o a. m. to 5 :3o p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Plan of Work: Supplies of bed linen, clothing, and sick-room neces- sities are maintained by the visiting nurse committee. Food, milk, and eggs are supplied by the nurse when necessary. A camp for sick babies is open during the summer months. Peoria Department of Health,* City Hall. Established visiting nursing May i, 1906. Number of nurses: One. Salary: $50 per month. Hours: 8 a. m. to 5 :3o p. m. Class of cases cared for: Tuberculous. *Nursing service discontinued. 78 INDIANA Plan of Work: Besides the tuberculosis work, the nurse instructs mothers in the proper methods of infant feeding. QUINCY Quincy Visiting Nurse Association. Established August i, 1909. Number of nurses: One. Salary: $85 per month.. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. Plan of Work: A loan closet fiumishes all necessary supplies. ROCK ISLAND Rock Island Visiting Nurse Association, 908 Twentieth Street. Established December 15, 1907. Number of nurses : One. Salary: $65 per month and transportation. Hours: 8 a. m. to 6 p. m. Only patients who are seriously ill are visited on Sunday. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Plan of Work: The nurse has sick-room appliances and bed linen to loan. Clothing and nourishment may be given in very urgent cases. INDIANA EVANSVILLE Associated Charities, 316 Sycamore Street. Established visiting nursing in 1903. Number of nurses: One. Salary: $60 per month. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Affiliations: The King's Daughters. 79 INDIANA Plan of Work: The nurse rides a wheel, and in this way easily covers the whole city. A well-stocked loan closet makes it possible to supply patients with clothing and other necessary and useful things. The Girls' Aid, a society of twelve young girls, furnishes nourishment, fruits, and delicacies, and provides money for medicines when necessary. The salary of the nurse is given by the King's Daughters. FORT WAYNE The Visiting Nurse League, 625 W. Wayne Street. Established March 19, 1900. Number of nurses: One. Salary: $60 per month. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Plan of Work: Special nurses are engaged for contagious and emer- gency cases when necessary. INDIANAPOLIS Department of Public Health. Established visiting nursing January i, 1908. Number of nurses: Two permanent; live others in summer. Salary: $20 per week. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Medical and tuberculous. Plan of Work: This service was originally intended -for tuberculosis patients only. Instruction and nursing care are given to all such cases. Milk and eggs are supplied when necessary. In the summer of 1908, a Pure Milk Commission was estab- lished for the distribution of pure and modified milk to infants and children under five years of age, and the Public Health nurses were given the supervision of all the children receiving the milk, and nursing care of all the children who were ill. In con- nection with this branch of the work an additional staff of five nurses is employed in the summer. They visit the homes and instruct the mothers in the care and proper feeding of their chil- 80 INDIANA dren. One milk station, supervised by the regular nurses, is open throughout the entire year. Indianapolis City Dispensary, Wabash and Pearl Streets. Established visiting nursing January i, 1908. Number of nurses: One. Salary: $60 and $65 per month. Hours: 9 a, m, to 6 p. m. and two hours' rest at noon. No visits are made on Sunday. Class of cases cared for: Tuberculous. Plan of Work : Milk and eggs are supplied when necessar}\ SOUTH BEND The Visiting Nurse Association, 221 W. Jefferson Street. Established September, 1902; incorporated, 1906; reorganized, 1908. Number of nurses : One. Salary: $70 per month. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. Affiliations: The Charity Organization. TERRE HAUTE The Terre Haute Social Settlement, Visiting Nurse Branch, 29 North First Street. Established September 3, 1906. Number of nurses : One. Salary: $60 per month. Hours: 8 a. m. to S'.^o p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Plan of Work: A loan closet furnishes bed linen and clothing, which may be loaned or given to all needy patients. Aside from the usual nursing cases, a good deal of work is done among tubercu- lous patients, for whom sputum cups and paper napkins are supplied. Nourishment also is given when necessary. 6 81 IOWA IOWA DAVENPORT Davenport Visiting Nurse Association, First National Bank Building. Established in 1901. Number of nurses: One. Salaries: $80 and $90 per month. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. An extra nurse is engaged for contagious cases. DES MOINES Bidwell Deaconess Home, 1155 East 9th Street. Established visiting nursing June 23, 1905. Number of nurses: One — a graduate nurse and deaconess. Salary: Deaconess' allowance. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical,- con- tagious, and tuberculous. Board of Education, School Nursing Department. Established in 1905. Number of nurses: Two. Salary: $75 per month. Hours: 9 a. m. to 3 :3o p. m. Classes of cases cared for: Surgical, medical, contagious, and tu- berculous. Plan of Work: The nurses visit all the schools, examine the chil- dren, exclude those who show any signs of contagious or infec- tious disease, and report such cases to the Board of Health. The Visiting Nurse Association of Des Moines. Established by the Registered Nurse Association of Des Moines, July 20, 1908. Number of nurses : Two. Salary: $75 per month. Hours: 8 a. m. to 5 p. m. 82 IOWA Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. FORT DODGE Visiting Nurse Association, 122 North 8th Street. Established in September, 1907. Number of nurses : One. Salary: $75 per month. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Affiliations: The Ingleside Club. History and Plan of Work: The Ingleside Club, a women's organ- ization, secured the co-operation of all the other organizations of women in the city in raising a fund of $600 to pay the salary of a visiting nurse for six months. An association was formed, whose board of directors is composed of members of the different clubs, representation being based upon the amount contributed by each. A small loan closet furnishes bed linen, clothing, and sick-room appliances. Malted milk, jellies, and other delicacies are kept on hand to be given as needed. SIOUX CITY Visiting Nurse Association of Sioux City, 608 Iowa Building. Established May 15, 1909. Number of nurses: One. Salary: $75 per month. Hours: 8 a. m. to 5 p. m.; Sunday excepted. Classes of cases cared for: Surgical, medical, obstetrical, contagious and tuberculous. Plan of Work: Night calls are answered only in cases of extreme emergency. The nurse attends free of charge all persons who are unable to pay for her services, but patients who can do so are expected to pay. 83 KANSAS, KENTUCKY KANSAS TOPEKA The Topeka Provident Association, 335 Jackson Street. Established visiting nursing in 1896. Number of nurses: One — pupil. Salary: $60 per month. Hours of duty: 9 a. m. to 5 : 30 p. m. Classes of cases cared for: Surgical, medical, obstetrical, conta- gious and tuberculous. Plan of Work: A special nurse is engaged for contagious cases. A loan closet furnishes bed linen, infants' outfits and sick-room appliances. Special diet, milk and eggs are provided when necessary. For tuberculous cases tents are provided, porches enclosed, etc., to enable patients to take the out-of-door rest cure. An endowment of $300 per year is devoted to special needs of the patients. KENTUCKY HINDMAN, Knott County Women's Christian Temperance Union Settlement. Established visiting nursing in August, 1902. Number of nurses: One. Salary: $60 per month. Hours: Irregular. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. History and Plan of Work: Hindman is a small village forty-five miles from the railroad, in one of the most isolated parts of the southern mountains. The settlement house is a large log cabin of eighteen rooms, occupied by the teachers, visiting nurse, and the pupils from the distant country districts, many of whom work their way through school. There is a school building, also a two-roomed log cabin built by the pupils for a manual training shop. The nurse takes part in some of the settlement activities and gives practical lessons in home making and home nursing when not away on her long rides or drives over the mountains, visiting and nursing her patients. 84 KENTUCKY There are many tuberculosis patients in the neighborhood, who are quite ignorant of the means they should take to combat the disease. To help these people the nurse will have a small tuberculosis camp and exhibit in the summer, using a two roomed cabin furnished only with things that may be bought in the village. She will live in the cabin, and with the aid of a window tent, and other simple devices which the people can easily copy, she will demonstrate what may be done in the mountains to prevent and cure tuberculosis. She has photographs and charts which she will explain, which show clearly the nature of the disease and how to prevent it. Many sick-room supplies have been fur- nished by the Hersey School of Boston, for the use of the patients. LOUISVILLE Board of Tuberculosis Hospital, 121 West Chestnut Street. Established visiting nursing June i, 1907. Number of nurses: One. Salary: $65 to $75 per month. Hours: 8 a. m. to 6 p. m. Class of cases cared for: Tuberculous. Affiliations: City and county. Histor}' and Plan of Work: The visiting nursing for tuberculous patients was begun by the Kentucky Anti-Tuberculosis Associa- tion on June i, 1907. On November 17, 1908, the work was turned over to the Board of Tuberculosis Hospital, and it is supported by city and county taxes. Milk and eggs, sputum cups, clothing, and financial aid are given when necessary by the Kentucky Anti-Tuberculosis Association. Prescriptions of the dispensary physicians are filled by the City Hospital. The King's Daughters and Sons, 512 Foxu-th Street. Established in 1891. Number of nurses: Three. Salaries: $75, $60 and $50 per month. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. 85 LOUISIANA, MAINE Plan of Work: Two of the nurses are white and one is a colored woman. Special nurses are engaged for contagious cases, and for others which need constant care. The nurses may furnish anything that in their judgment is needed for the patient's com- fort, including medicines, nourishment and bed linen. LOUISIANA NEW ORLEANS St. Marks Hall, 621 Esplanade Avenue. Established visiting nursing March i, 1909. Number of nurses: One. Salary: Deaconess' allowance. Hours: Irregular: calls answered when received. One rest day each week is given. Classes of cases cared for: Surgical, medical, and tuberculous. Plan of Work: St. Marks Hall is situated on the border of "Little Italy," and most of the nurse's patients are Sicilians. MAINE AUGUSTA The Augusta City Hospital, Comer E. Chestnut and Arsenal Streets. Established visiting nursing in May, 1903. Number of nurses: One — pupil. Hours: 7 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Affiliations: Ladies' Hospital Aid. Plan of Work: The senior pupils are given this service in rotation, and have two months' training in the district. The Ladies' Hospital Aid and other friends furnished a loan closet, and keep it supplied. One day each year is designated as " Hospital Day, " and friends from far and near donate money and useful articles for both the visiting nurse and the hospital. Babies' outfits, 86 MAINE men's night shirts, children's flannel robes, etc., are made for the patients by the pupils in the sewing classes of the public schools. Small fees are charged by the nurse, who bases the amount upon the patient's ability to pay. BIDDEFORD Trull Hospital Aid Association, Trull Hospital. Established visiting nursing in January, 1909. Number of nurses : One — senior pupil. Hours: 8 a. m. to 8 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. History and Plan of Work: In response to an appeal made by a committee of the Trull Hospital Aid Association, the state legis- lature granted the sum of $1000 each year for the next two years to establisli visiting in Biddeford and Saco. The senior pupil nurses are given three months' service in rotation in the districts* supervised by the superintendent of nurses. When the work is more than one nurse can attend to, a second or third pupil is sent out. The district extends to Saco. A loan closet furnishes bed linen, clothing, and sick-room appliances. EASTPORT Eastport District Nursing Association, Key Street. Established in December, 1904. Number of nurses: One. Salary: $55 per month with board and laundry. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Affiliation: Charity Organization Society. HOULTON Houlton Woman's Club. Established visiting nursing March 2, 1906. Number of nurses: One. 87 MAINE Salary: $70 per month. Hours: Irregular; emergency calls answered at all times. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Plan of Work: Sick-room appliances, bed linen, and clothing are loaned whenever necessary. PORTLAND Board of Health, 85 Market Street. Established visiting nursing June i, 1907. Number of nurses: One. Salary: $75 per month. Hours: Eight hoiu:?. Class of cases cared for: Tuberculous. Plan of Work: This work is largely educational. Patients are kept out-of-doors as much as possible, and in a few cases tents are furnished. Charts of the city are kept, showing where tuber- culous patients have lived. Tenants are not allowed to move into a house that has been occupied by a tuberculous person until the rooms have been disinfected. Most of the patients are now treated in their homes. In the near future it is planned to send advanced cases away for the safety of the family as well as for the benefit to the patients themselves. Sputum cups and paper napkins are given to those who cannot buy them. Milk and eggs are furnished by the Diet Mission of the city, at the request of the nurse. Steamer chairs and tents are loaned through the Tuberculosis Class of St. Luke's Church. District Nursing Association of Portland, Office at the Maine General Hospital. Established in March, 1904. Number of nurses: Three, two of whom are pupils of the hospital. Salary: $50 per month for the chief nurse, with room and board at the hospital. Hours: Eight hours. Classes of cases cared for: Surgical, medical, obstetrical, and tu- MAINE berculous other than pulmonary, which are referred to the Board of Health. Plan of Work: The work is largely under the management of the hospital, while the expenses of carrying it on are met by the asso- ciation. The association also pays the pupil nurses a small amount to cover the actual wear and tear of their uniforms in their dis- trict service. Small fees are collected from those patients who can pay. For special needs, cases are referred to the Associated Charities and Diet Mission. Unsanitary conditions are reported to the Board of Health. Milk and eggs are sometimes supplied for patients who need them, and tents loaned, even though the case be under the care of the Board of Health nurse. The visiting committee frequently furnishes clothing, infants' outfits, sheets, towels, etc. Portland Tuberculosis Class Association, 145 State Street. Established visiting nursing in March, 1908. Number of nurses: One. Salary: $1000 per year. Hours: 9 a. m. to 5 p. m. Affiliations: St. Luke's Episcopal Church. Plan of Work: The class meets in a room in St. Luke's Church which has model equipment for such work. The expense of maintaining it is met by private subscription and entertainments. The nurse visits the patients in their homes and instructs them in the general care of themselves and their families. The asso- ciation supports a day camp in the summer. Sputum cups, steamer chairs, tents, thermometers, and clothing are supplied, and sometimes balconies are built, to enable patients to sleep out- of-doors. Milk and eggs are furnished through other societies. SACO See Biddeford. 89 MARYLAND MARYLAND BALTIMORE The Babies' Milk Fund Association of Baltimore, 804 Cathedral Street. Established visiting nvirsing in 1904. Number of nurses: Three. Salaries: $50 per month for the iGLrst year; $55 second year, and $60 thereafter. Hours: 8:30 a. m. to 5 p. m. Class of cases cared for: Medical. Affiliations: The Thomas Wilson Sanitarium, the Federated Charities, and the Hebrew Benevolent Society. History and Plan of Work: This work was started by the Thomas Wilson Sanitarium in 1904. In 1906, a separate association was formed, which employs three nurses throughout the year; they are supervised by the head nurse of the Thomas Wilson Sanitarium. Each nurse has charge of two milk stations; this enables her to keep under observation every child, sick or well, that receives the milk. The nurses visit the homes of the sick children, and mothers are instructed in the proper care and feeding of their babies. A uniform charge of $.10 is made for a day's feeding; but mothers who are unable to pay this sum, may obtain it through the Federated Charities, the Hebrew Benevolent Society, or various charitable individuals. Department of Health, City Hall. Established April i, 1909. Number of nurses: Two. Salary: $1000 per year. Hours: 9 a. m. to 5 p. m. Class of cases cared for: Tuberculous. History and Plan of Work: The inspection of houses for fumi- gation after removal or death from tuberculosis was done for two years by the nurses of the Instructive Visiting Nurse Asso- ciation. The work increased so rapidly that a committee from the association appealed to the Board of Estimate for the ap- pointment of two municipal nurses to do this work. The 90 MARYLAND appropriation was granted and a nurse was placed in charge of this new department, with an office at City Hall. The nurses see that all houses from which tuberculous patients have moved or died are properly fumigated. They select the rooms to be fumigated, and see that the work is done thoroughly. Department of Health, School Nvursing Department. Established February i, 1905. Number of nurses: Five. Salary: $600 per year, payable semi-monthly. Hours: 9:30 a. m. to 5 p. m. History and Plan of Work: School nursing was established through the efforts of the Arundel Good Government Club, a well known women's club of Baltimore, which requested the school board to confer with the commissioner of health in regard to organiz- ing a school nursing service. The commissioner accepted the suggestion and the work was undertaken by the department of health. The city pays the salaries. After school hours, and on Saturday mornings, the nurses make visits to the homes of the pupils, explain to the parents the necessity of having their chil- dren looked after by a private doctor, or taken to a dispensary physician. They follow up each child, and in case of exclusion, insure his return to school at the earliest possible time. The Instructive Visiting Nurse Association, 11 23 Madison Avenue. Established in January, 1896. Number of nurses: One superintendent, an assistant superintend- ent, and 13 nurses. Salaries: $25 and $30 per month with board, laundry, and carfare. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: The Maryland Association for the Prevention and Relief of Tuberculosis. Plan of Work: The city is divided into districts, and each nurse has an office and loan closet in the district assigned to her. She 91 MARYLAND is at her office to receive calls at 9 a. m. and i p. m. every day except Sunday. Seven of the staff do general nursing; fovu: specialize in tuberculosis. This special work was started in March, 1904, by Mrs. Wm. Osier, who raised the salary for one nurse. Later the Maryland Association for the Prevention and Relief of Tuberculosis paid the salaries of three more nurses, all of whom are under the supervision of the Instructive Visit- ing Nurse Association. These four nurses attend the tuber- culosis clinics, visit the patients in their homes, and report a death or removal to the Board of Health, which provides for fumigation of the rooms or house left vacant. Sputum cups, paper napkins, and disinfectants are supplied by the State Board of Health, in exchange for registration and careful sta- tistics of each case. The Federated Charities and other agencies supply milk, ice, and eggs for patients who cannot afford to buy them. The nurses' offices are located as follows: Northern District, Falls Road and Third Avenue. Northeastern, Federated Charities Building, 1520 E. Eager Street. Eastern, Alaccabean Settlement House, 1204 E. Baltimore Street. Southeastern, Christ Church Mission House, 600 S. Bond Street. Southern, Federated Charities Building, 1418 Light Street. Southwestern, Lawrence House Settlement, 816 W. Lombard Street. Northwestern, Federated Charities Building, 2242 Pennsylvania Avenue. The nurses live in a central home. Classes in home nursing for working girls are held there. Talks are given to Mothers' Clubs on the care of the sick, general hygiene, and the feeding of children. Instruction is also given to caretakers, some of whom are trained to give efficient service in the homes, under the supervision of the nurses. The Johns Hopkins Hospital Alumnae Association, Hourly Nurs- ing, 219^ East North Avenue. Established in November, 1897. Number of nurses: One. Salary: $75 per month. Hours: Calls are answered at all hours. 92 MARYLAND Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: This work is intended to meet the demands of patients of moderate means. The usual fee is $.75 per hour or fraction thereof until 6 p. m. After that $1.00 per hour. Special rates may be made for operations and visits at night. Addi- tional nurses are engaged as the work requires. This work has been most successful and is largely self-supporting. Any deficit is covered by funds from the treasury of the Alumnae Association. Johns Hopkins Hospital, Out-Patient Obstetrical Department, North Broadway. Established in January, 1895. Number of nurses: Three — pupils. Hours: About eight hours. Class of cases cared for: Obstetrical. Plan of Work: This department provides free professional care for women in child-birth. The patients are examined when they apply at the Out-Patient Department, and given a card which they send to the hospital when the obstetrician's services are needed. A physician and nurse respond to the call, and give after care as long as it may be necessary. If it is found that the patient needs hospital treatment, arrangements are made for her admission to the maternity ward. The pupils who are given this service are those from the training schools of other hospitals which do not include obstetrics in their curriculum. These nurses are under the direct supervision of the head nurse of the maternity ward; they are given two weeks' training in the ward, and ten weeks in the districts. When assistance other than professional care is needed, patients are referred to the Social Service Department of the Hospital. Johns Hopkins Hospital, Out-Patient Orthopedic Department. Established in January, 1904. Number of nurses: One. Salary: $40 per month, carfare, and all living expenses at the hospital. 93 MARYLAND Hours: 8:30 a. m. to 5:30 p. m.; Sundays excepted Classes of cases cared for: Surgical and tuberculous. Plan of Work: The nurse attends the orthopedic clinics from 10 a. m. to I p. m. four mornings in the week, and visits the pa- tients in their homes the remaining time. She learns home conditions, refers cases to the Social Service Department when they require assistance which lies outside of her province, ex- plains to parents the necessity for operation, teaches the mothers how to adjust braces, and urges upon tliem the necessity for carrying out the doctor's orders. Johns Hopkins Hospital, The Phipps Dispensary. Established visiting nursing in February, 1902. Number of nurses: Two. Salaries: $60 per month and carfare. Supervisor, $75. Hours: 8:30 a. m. to 5:30 p. m. Class of cases cared for: Tuberculous. History and Plan of Work: Nursing care of tuberculous patients who attended the Johns Hopkins Hospital Dispensary was first made possible by a fund raised by private subscriptions. With the opening of the Phipps Dispensary in 1904, a second nurse was engaged, and the salaries of both nurses are now paid by Mr. Phipps. One nurse attends all clinics held at the dis- pensary, the other visits the homes, and teaches the patients how to care for themselves and prevent further contagion in their families. A special fund is given to supply the patients with street car tickets, enabling them to go to the dispensary for daily treatment. The Johns Hopkins Hospital, Social Service Department. Established visiting nursing in 1907. Number of nurses: Two. Salary: $65 per month. Hours: 9 a. m. to 5 p. m.; Sundays excepted. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. History and Plan of Work: In 1901, Dr. Charles P. Emerson or- 94 MARYLAND ganized the students of the Medical School into a student board for volunteer district work in connection with the Charity Or- ganization Society. Though the hospital patients received first attention, the service was not restricted to them. As far as can be ascertained, this was the first step toward the movement which plays such a prominent part in the development of hospital service in some of our large cities today. Student boards now meet regularly at several district offices vmder the chairmanship of members of the staff of the Johns Hopkins Hospital, who are also members of the board of managers of the Federated Charities composed of the A. I. C. P. and the Charity Organization Society. Cases from the Social Service Department of the hospital are assigned to the students. In September, 1907, the hospital authorities engaged a social worker of large experience, who should have daily office hours at the hospital, and to whom could be referred patients needing other than medical help. Upon her resignation, in the following spring, the social service work was undertaken by a nurse who had had experience in social work. Her hours at the hospital are from 10 a. m. to 3 p. m. The patients are sent from other departments to her and to her volunteer assistants; and they are visited in their homes. Each case is studied and treated accord- ing to its individual needs, and careful records are kept. The department aims to secure proper care for those who need it, and where possible to restore patients to a position of self support and independence. Sometimes the home conditions are bad and need readjustment; temporary financial assistance is given, employment is sought or changed, nourishing food or clothing is secured, and neglected children are cared for; aid is procured from existing charities, relatives, employers and others. This department is not a branch of the Federated Charities, but works in co-operation with it. It also co-operates with a board of young women especially interested in Jewish patients, who meet weekly at the hospital. Patients who may require assistance in preserv- ing the degree of health which they have attained in the wards are looked after upon their discharge from the hospital. 95 MARYLAND The Thomas Wilson Sanitarium, 303 N. Charles Street. Established visiting nursing in 1892. Number of nurses: One all the year; three others in summer. Salaries: Superintendent, $75 per month; assistants $50 for the first year, $55 the second year, and $60 thereafter. Hours: 8:30 a. m. to 5 p. m. Class of cases cared for: Medical. Affiliations: The Babies' Milk Dispensary. History and Plan of Work: The Thomas Wilson Sanitarium for children of Baltimore City was incorporated in 1897 for the purpose of " securing a summer retreat for sick children from the heat and unhealthfulness of the city, and such kindred sub- jects as may be hereafter determined upon by the corporation." The bequest was received by the trustees in 1880, and shortly after a site of 210 acres at Mt, Wilson, eleven miles from Balti- more, with an elevation of more than 500 feet, was purchased. Here, for a number of years, children were brought from the city each day and returned at night to their homes. In 1892, hospital buildings suitable for the care of about 40 mothers, 60 infants and a number of older well children were erected on the site and have been in use each summer since. From the beginning in connection with the work at Mt. Wilson, district work among sick children in Baltimore has been carried on by the sanitarium. In 1904, a number of milk stations were started, where modified milk might be obtained at minimum cost. This work is now done by a separate organ- ization — The Babies' Milk Fund Association.* Seven stations in various parts of the city are maintained throughout the year; in summer two additional stations are opened in the city parks. This work is under the immediate supervision of the sanitarium district nurse, who is assisted by three nurses in the employ of the Babies' Milk Fund Association. During the summer months when the work is increased, three additional nurses are employed by the sanitarium. The babies are taken to the milk stations once a week throughout the year to be weighed by the nurse, who also gives the mothers instruction in the proper *See page 90. 96 MASSACHUSETTS feeding, clothing, and general care of their children. The nurses visit in their homes all sick children under five years of age. When the children are convalescent and sent back to the city from Mt. Wilson, the milk mixture that was found suitable there is continued, through the help of the Milk Association. The nurses of the Babies' Milk Fund Association have charge of two stations each; the supervisor has one. The distributing centers and hours are: Station Hoors A 1520 E. Eager Street 12 to 1 p. m. B 117 Aisquity Street 9 to 10 a. m. C 1418 Light Street 9 to 10 a. m. D 824 W. Lombard Street 11 to 12 a. m. E 2242 Pennsylvania Avenue i to 2 p. m. F 600 S. Bond Street 12 to i p. m. G 3005 Fait Avenue 10 to 11 a. m. FREDERICK Frederick County Branch of the Maryland Association for the Prevention and Relief of Tuberculosis, 133 S. Market Street. Established visiting nursing June i, 1909. Number of nurses: One. Salary: $75 per month. Hours: 9 a, m. to 5 p. m. Class of cases cared for: Tuberculous. MASSACHUSETTS ARLINGTON Arlington District Nursing Association. Established in September, 1904. Number of nurses: One. Salary: $65 per month. Hours: 9 a. m. to 5 p. m.; Sundays excepted. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: All patients are expected to pay something for the service of the nurse, if only the minimum price of $.05 per visit. 7 97 MASSACHUSETTS The maximum fee is $.40 per hour. The work is maintained by annual subscriptions of $1.00 each, and by the patients' fees. BELMONT The Ladies' Aid Society. Plan of Work: When a resident of Belmont requires the services of a nurse for an hour or two a day, application is made to the president of the Ladies' Aid Society, who sends to the Waltham Training School for a visiting nurse. The patient generally pays the usual fee of $.25 an hour and carfare, but if not able to do so, the expense is borne by the Ladies' Aid Society. If the patient needs hospital care, application is made to the select- men for admission to the Waltham Hospital, as Belmont appro- priates $750 yearly for three free beds. The Ladies' Aid So- ciety supplies part of the hospital linen, supports one free bed, and pays out of its treasury the fees of the visiting nurse. BOSTON Boston Association for the Relief and Control of Tuberculosis,* 4 Joy Street. Established visiting nursing in January, 1906. Number of nurses: One. Salary: $75 per month and carfare. Hours: 8:30 a. m. to 5 p. m. Classes of cases cared for: Tuberculous. History and Plan of Work: This association started and main- tained for three years the first day camp in the United States, which was later taken over by the city and is now known as the Municipal Day Camp at Mattapan. The association supports one nurse on the staff of the Instructive District Nursing Asso- ciation who works under the supervision of this latter society. The Children's Hospital. Social Service Department, Huntington Avenue. Established visiting nursing in 1895. Number of nurses: Varies according to number to be visited. *Nursing service now controlled by Boston Consumptives' Hospital. 98 MASSACHUSETTS Hours: 9 a. m. to 5 p, m. Classes of cases cared for: Surgical, medical, orthopedic, and tuberculous. History and Plan of Work: The first visiting nursing undertaken by this hospital was made possible through funds raised by a philanthropic gentleman who was anxious to try the exper- iment of giving nursing care in the homes to certain patients who could not be admitted to the hospital. The work proved to be so valuable that it was adopted as a part of the regular activity of the hospital, and was made a branch of the training school curriculum for the third year. The nurses who are detailed to this department are given three months' service with the out-patients. The work is not limited to the city, but includes suburbs twelve or fifteen miles away. When special help is required, cases are reported to the Associated Charities and other 'philanthropic societies. Boston Consumptives' Hospital. Out-Patient Department, 13 Burroughs Place. Established visiting nursing September 11, 1907. Number of nurses: 13, one of whom is supervising nurse. Salary: $75 per month and carfare. Hours: 8:30 a. m. to 5 p. m. Classes of cases cared for: Tuberculous cases and their families. Plan of Work: Eleven nurses are assigned to districts and one acts as relieving nurse. They attend the clinics and visit the pa- tients in their homes. Sunday and evening visits are made when necessary. A record of all cases reported and visited is kept at the central oflBce. The Out-Patient Department works in connection with the Municipal Day Camp at Mattapan, and has developed a most thorough and comprehensive method of caring for tuberculous patients throughout the city. About 45 per cent of all the cases are children. Each nurse is a member of the conference of the Associated Charities of her district, and has access to its records. Ques- tions of relief are decided in conference with the organization best fitted to the needs of each case. 99 MASSACHUSETTS Milk is furnished to all who are unable to provide it in sufficient quantities, upon the recommendation of the nurse after her investigation of the home. The nurses hold fortnightly conferences for the discussion and study of social subjects. At these meetings they are detailed in turn to report on some one of Boston's charitable or philan- thropic organizations, such report covering the history and scope of the work done by the association under consideration. Two of the nurses are taking a special course in the Boston School for Social Workers, and it is hoped that this course may be extended to a larger number every year. Denison House, 93 Tyler Street. Established resident visiting nurse in 1904, Number of nurses: One Salary: $50 per month, with room and board. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The nurse visits in the homes, and attends a dis- pensary which is open one evening in the week; this is in charge of volunteer physicians. The nurse has charge of a Pasteurized milk station also, which is open at certain hours each day. Whenever the patients are able to do so, they pay $.10 for each visit. Department of Education. Division of School Hygiene, School Committee Building, Mason Street. Started experimentally December i, 1905; established perma- nently June 15, 1907. Number of nurses: 34; one supervisor and 33 assistants. Salaries: The minimum salary is $648 per year, with an annual increase of $48 until a maximum of $840 is reached. The superintendent's salary for the first year is $924, with an annual increase of $48 each year until the maximum of $1116 is reached. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Diseases of the eye, ear, nose, and 100 MASSACHUSETTS throat, mouth, skin, specific infections, minor surgical, and miscellaneous medical cases. History and Plan of Work: December i, 1905, a nurse was en- gaged to visit the schools in the Quincy district, her salary being assured by a member of the Hawthorne Club. In January, 1906, a second nurse began work in the Wells district, her salary having been promised by the Fathers' and Mothers' Club, Both worked under the medical inspectors of the Board of Health, treating in the school all such cases as could be attended to there, and visiting the homes to see that the medical orders were carried out. Later, in 1906, five nurses of the Instructive District Nursing Association staff were detailed to visit certain schools, and the Massachusetts Civic League introduced a bill in the legislature providing for medical inspection of public schools throughout the state, and authorizing school boards to employ nurses. The bill became a law and the legislature granted a sum of money sufficient to carry on the work. On June 15, 1907, an examination of candidates for the posi- tion of school nurse was held by the Board of Education, the subjects being: Principles and processes of nursing; anatomy and physiology; dietetics; arithmetic; English language and grammar. In September, 1907, 20 nurses under Dr. Margaret Carley as supervisor were introduced into the schools under the provision of the law, covering the entire elementary school popu- lation of Boston. In February, 1908, the number was increased to 34, giving each nurse the care of approximately 2,700 pupils. The nurses go on duty at 8 a. m. Each district is provided with a medicine room, equipped with necessary articles for emergencies, and for minor treatment advised by the medical inspectors. The nurses follow up excluded children in their homes and see that they receive proper medical attention either at home or in dispensaries and hospitals. The nurses also visit children who have been absent from school on account of minor illness or because of sickness in the family; by these visits they have reduced absenteeism to a minimum. During the summer a member of the regular school sta£E is assigned to each schoolyard playground. Her duties in the 101 MASSACHUSETTS playgrounds are to care for emergency cases, visit the pupils' homes to give suggestions and advice and demonstrate treatment that has been advised by the medical inspectors, escort pupils to family physicians or hospitals, follow up children needing special attention, and maintain an active interest in their behalf. Nurses also take pupils to the country or seashore for daily outings, and refer them to various " country week " agencies and asso- ciations. For special duties, talks are given to parents and pupils on general hygiene, sanitation of the home, care and function of the teeth, diet for young growing children in summer and winter. First Aid care is taught in cases of burn, poisoning, hemorrhage, injuries to the eye, etc., the use of emetics, stim- ulants, and the practice of artificial respiration and bandaging. Special talks on the care of babies are given to "Little Mothers.' Elizabeth Peabody House, 87 Poplar Street. Established visiting nursing in 1906. Number of nurses: One. Salary: $75 per month. Hours: Irregular; whenever called. Classes of cases cared for: Surgical, medical, and tuberculous. Plan of Work: The nurse is a resident of the settlement, and she gives special attention to the care of infants. She visits the babies in their homes and keeps at the settlement a record of each child, showing the weight, medical history, and home conditions. She instructs the mothers at home in regard to the feeding and general care of the children, and gives talks with supplementary instruction at the monthly Mothers' Meet- ings. She has charge of a modified milk station, examines each day the children in the settlement kindergarten, and has a Home Nursing club for girls. House of the Good Samaritan, Corner Francis and Binney Streets. Established visiting nursing in 1906. Number of nurses: One. Salary: $30 per month with board, lodging, and laundry at the hospital. 102 MASSACHUSETTS Hours: Twelve hours. Class of cases cared for: Tuberculous. Plan of Work: A day camp is maintained in the grounds of the Home, open on week days from 9 a. m. to 5 p. m. Women only are admitted. They are given nourishment, medical treatment if needed, and instruction in caring for themselves and their families. On Sundays, when the camp is not open, visits are made in the homes. Industrial School for Crippled and Deformed Children, 241 St. Botolph Street. Established visiting nursing March 3, 1906. Number of nurses : One. Salary: $55, increasing to $65 per month Hours: 9 a. m. to 4 p. m.; Sundays excepted. Classes of cases cared for: Surgical and orthopedic. AflSliations: There is a relief committee connected with the school, but financial aid is given mainly through other charities. Plan of Work: Only the children connected with the school are visited; these are chiefly surgical cases. Dinners are served to the children and extra nourishment is given to those who need it. Milk and eggs also are given to the children for home consumption, if the conditions there make this necessary. Instructive District Nursing Association, 561 Massachusetts Ave. Established in 1886. Number of nurses: 24; two superintendents, two assistant superin- tendents, sixteen nurses and four pupil nurses. Salaries: $50 per month for the first three probation months; $60 for the following nine months; $70 thereafter, with $5.00 per month for carfares. The nurses are supplied also with hats, coats, and skirts of uniforms. Hours: 8:30 a. m. to 5:30 p. m. Sundays, holidays and nights are generally free. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: The Society for the Relief and Control of Tubercu- 103 MASSACHUSETTS losis, the Lying-in Hospital, and the Massachusetts General Hospital. Plan of Work: The nurses have regular districts. Nine are appointed to work under the physicians in charge of certain municipal dispensaries, of which Boston has a complete system, founded in 1796. The nurses communicate daily with the physicians, receive their orders, and at times visit the patients with them. Calls are accepted from other medical men as well. One nurse on the district nursing staff is supported by the Tuberculosis Society. She is engaged entirely in supervising and instructing tuberculous patients. She teaches hygiene in the homes, secures the attendance of patients at clinics and day camps, and keeps histories and records. All bed patients are referred to the regular staff for nursing care. Four nurses specialize in obstetrical work; they are assisted by two pupils from the Lying-in Hospital. One nurse, who is supported by Mrs. Quincy A. Shaw, gives especial attention to children, visits four day nurseries which are connected with the Shaw Neighborhood Houses, and in the evening makes frequent visits to the homes in order to meet the mothers, who work during the day. One nurse inspects and attends to the em- ployes of the Lowney Candy Factory, which contributes $300 a year toward her salary. The Massachusetts General Hospital details two pupils each month for instruction in district work under the supervision of this association. Milk stations are maintained in the various districts, where there is on sale modified milk, put up by special milk dealers and prepared according to all the usual formulae for chil- dren of different ages. A bottle with one feeding costs two cents. Nurses are at the stations every morning at 8:30 to deliver the milk on orders signed by physicians. Later they visit all babies on the lists, and, if special modi- fications for sick children are required by the prescriptions of medical men, the nurses procure the milk and put it up themselves. 104 massachusetts The New Home and Training School for District Nurses A new Home which is also headquarters for the association was opened in 1906, and a training school in district nursing methods was established for the benefit of graduate nurses and senior pupils from well recognized hospitals. The course con- sists of four months' work in the homes of poor patients under the supervision of the superintendent, who is also head of the house. The pupils live in the home, and receive instruction, board, and lodging free. They have monthly lectures by well- known physicians, and are trained in making daily reports, keeping records, and in general household management. They are also encouraged in giving before Mothers' Clubs, practical talks on infant feeding, hygiene, and home nursing, examples of such talks being first given to them by the superintendent as part of their training. Massachusetts General Hospital, Social Service Department, Fruit Street. Established Social Service Work in October, 1905. Number of nurses: Three. Salaries: $1200 per year for headworker; $1000 for assistants. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, tubercu- lous, venereal, nervous, and pediatrics. History and Plan of Work: Dr. Richard C. Cabot started this work in order to provide for patients attending the Out-Patient Department further care than it is possible for the hospital staff to give. The department is financially separate from the hospi- tal, and is supported by private subscriptions. There are on the staff two graduate nurses who have had social training, one of whom is the superintendent of the department. Four salaried social workers, and sixteen volunteer helpers who are not nurses, are also included in the staff. Patients from many towns and cities in the state go to this hospital, and an endeavor is made to secure for each applicant the proper help, whether medical or other assistance. In all cases an effort is made to get at the cause of the difficulty; 105 MASSACHUSETTS this may lie in poverty, ignorance, or economic conditions, or it may have a psychological foundation. The patient is considered a social as well as a medical problem, and much of the treatment means long-continued work with the family as well as with the individual patient. As part of the equipment for meeting the patients' needs, the workers are in close touch with the various health and relief agencies in the state, such as hospitals, sanatoria, convalescent homes, visiting nursing associations, private and public charities, etc., and patients are guided to the one which will give the neces- sary help. For those troubled with nervous disorders there is on the staff a social worker trained especially to deal with such patients. In these cases, as in all others, the worker investigates the home, sees that the physician's orders are carried out, becomes ac- quainted with her patients, wins their friendship, gives encourage- ment, and in various ways leads them out of themselves along the path to recovery. Another trained social worker deals with the problems of unmarried, pregnant girls, and of those with venereal diseases. A large number of patients belong to the tuberculous group, and whenever it is possible, they are referred to anti-tuberculosis associations in tlieir own towns and cities. When this is not possible, arrangements are made for their care in hospitals or sanatoria, or they are referred to tuberculosis classes in connec- tion with the Social Service Department of this hospital. These classes care for ambulatory cases that can live at home. One trained, salaried worker visits them and sees that the necessary regulations are carried out, not only by the patient, but by the family. Children suspected of having tuberculosis are examined, visited in their homes, and kept under supervision in the clinic. Some are sent to convalescent homes, others to Mattapan Day Camp, and to sanatoria. Since July, 1908, the hospital has had under its direct juris- diction a nurse for social work in the wards of the hospital, where the need for such service is as great as in the Out-Patient Depart- 106 MASSACHUSETTS ment. Patients not able to work are sent to the Convalescent Home at Waverley, or they are referred to charitable agencies for help of various kinds. The services of district doctors and nurses are secured, letters are written to friends, work is found for discharged patients, and whatever a friend can do is done for all who need such help. Massachusetts Homeopathic Hospital Training School, East Concord Street. Established visiting nursing in April, 1906. Number of nurses: Two — pupils. Hours: 7:30 a. m. to 5:30 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Plan of Work: Senior pupils of the school are sent to the patients applying for aid at the Out-Patient Department of the hospital. Medical Mission Dispensary, Hull Street Settlement, 36 Hull Street. Established visiting nursing in 1895. Number of nurses: One superintending nurse and four pupils. Salary: $50 for the superintendent. Hours: 8 a. m. to 7 p. m. Classes of cases cared for: Surgical, medical, and obstetrical. Plan of Work: The work is carried on by the Methodist Woman's Home Missionary Society. Physicians, nurses, and lay-women form the resident staff. The nurses receive their training in the districts and the dispensary, and share in social work in Mothers' Meetings, Girls' Clubs and classes. They answer calls in rota- tion for obstetrical and emergency cases. A fee of $5.00 is charged for the former if the patients are able to pay; this in- cludes the services of both physician and nurse. Clothing and nourishment are provided when necessary. Mt. Sinai Tuberculosis Clinic, 17 Stamford Street. Established visiting nursing April i, 1907. Number of nurses: One. Salary: $70 per month. 107 MASSACHUSETTS Hours: 8:30 a. m, to 5 p. m. Class of cases cared for: Tuberculous. AflSliations: Jewish Federated Charities and Jewish Anti-Tuber- culosis Association. Plan of Work: The clinic is attended by Jewish physicians and the patients are visited by a Jewish nurse. The latter has organized a circle of young women under the name of the " Jewish Tuber- culosis Association" to help in the educational work, visit the patients in their homes, and aid in securing necessary outfits for taking the rest cure. Full directions are given each patient in regard to out-door life, diet, general hygiene, and how to live in order not to be a menace to the family and the public at large. The nurse visits each patient to see that the physician's instructions are carried out. Careful records are made, giving home conditions, number in the family, hygienic conditions of the house, and the presence of a piazza, yard or flat roof where the patient may live out-of- doors. The financial condition and occupation of the patient are gone into, and a record is made of other cases of illness in the family. Home visits are made every week, and reports given to the clinic physicians. Some incipient cases are sent to sana- toria, or to the country; some attend the Mattapan Day Camp. Milk and eggs are furnished for special cases by the North End Diet Kitchen. New England Baptist Hospital, Parker Hill Avenue. Established visiting nursing in 1895. Number of nurses: Two — pupils. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Plan of Work: Calls are answered from the physicians of the neighborhood, and free nursing care is given to the sick poor whenever a nurse can be spared from her hospital duty. These calls are rarely refused, and the nurse gives as much time as the individual case may require. This may include an emergency obstetrical case, or night duty for several nights to relieve a tired mother. The patients receive daily visits as long as necessary. 108 MASSACHUSETTS New England Hospital for Women and Children, Dimock Street, Roxbury District. Dispensary and Out-Patient Depart- ment, 29 Fayette Street. Established visiting nursing in July, 1884. Number of nurses: One — pupil. Hours: Irregular. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. History and Plan of Work: This hospital may claim the distinction of graduating the first trained nurse in the United States, Miss Linda Richards. The visiting nursing service is an adjunct of the hospital; senior pupil nurses are each appointed to two months of this service. They visit the patients who attend the dispensary and who live within a radius of half a mile. The nurse accompanies the doctor on the first visit, and makes as many visits thereafter as may be necessary. St. Stephen's House,* 2 Decatur Street. Plan of Work: This is a settlement having a free dispensary with trained nurse and physician in attendance. The work was started in 1903, and the nurse visits without charge the patients who apply to the dispensary. South End House, 43 East Canton Street. Established visiting nursing in 1906. Number of nurses : One. Salary: $65 per month. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Affiliations: There is close co-operation with the school nurses, who frequently refer to the settlement cases which they have no time to attend to. History and Plan of Work: This, the oldest settlement in Boston, has had a visiting nurse in residence since 1906. The nurse has * This settlement has not replied to late communications. 109 MASSACHUSETTS charge of the modified milk station, which is open every morn- ing, and there she advises the mothers in regard to the proper feeding of their babies. Once a week the babies are taken to the settlement to be weighed, and the mothers consult with the nurse. The settlement kindergarten has medical inspection; a careful examination of the children is made by the doctor and nurse. The nurse afterwards visits the mothers with reports made by the physician, and suggests the best way to carry out orders. There is also medical inspection of all children who go to the settlement farm for the summer outing, and the nurse visits these children in their homes. In 1907, the settlement nurse started social service work at the Boston Dispensary, attending two clinics a week in the neurology department. BRIDGEWATER The Bridgewater Visiting Nurse Association. Established in 1902. Number of nurses: One. Salary: $60 per month. Hours: 8 a. m. to 6 p. m. Emergency calls are answered at all times. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Affiliations: The Women's Club. BROCKTON Brockton Anti-Tuberculosis Association, 12 Cottage Street. Established visiting nursing in January, 1907. Affiliations: The Visiting Nurse Association. Plan of Work: The nurse of the Visiting Nurse Association cares for the patients referred to it by the Anti-Tuberculosis Associa- tion, and the latter pays for this service in proportion to the amount of work done. Brockton Visiting Nurse Association, 31 Centre Street. Established January i, 1905, by the Women's Club. Number of nurses: One. 110 MASSACHUSETTS Salaries: $60 per month. Supervisor, $80. Hours: 8 a. m. to 6 p. m., with two hours* rest at noon. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Plan of Work: Only calls from physicians are answered. The association is sustained by subscriptions and membership fees. BROOKLINE Brookline Friendly Society, District Nurse Committee, Union Building, High Street. Established in May, 1906. Number of nurses: One. Salary: $60 per month. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. History and Plan of Work: This work was started in May, 1906, by the Instructive District Nursing Association of Boston. In the following January, connection with the Boston association was severed, and the responsibility for the work was assumed by the Friendly Society. The churches furnish bed linen, infants' clothing, etc., to loan to needy patients. An emergency fund provides suitable food for those who cannot otherwise obtain it. Many women have pledged themselves to have special nourish- ment prepared in their own kitchens, in response to requests from the nurse by telephone. In special cases a generous supply of eggs may be furnished for tuberculous patients. The fees charged are $.40 an hour for general nursing, $1.00 for surgical cases requiring an anassthetic. Reductions from these charges may be made or the fee remitted altogether if patients are unable to pay. Department of Education, School Nursing Department, Lin- coln School. Established January i, 1909. Number of nurses: One. Salary: $850 per year. Ill MASSACHUSETTS Hours: 8:30 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, contagious, and tu- berculous. Plan of Work: The nurse visits six schools having an enrolment of about 2200 pupils. She is equipped with supplies for attending to minor surgical dressings. Each afternoon is spent in making calls in the homes. On Saturday mornings the nurse accom- panies children to the different dispensaries for treatment or- dered by the physicians. CAMBRIDGE Board of Health, School Nursing Department, City Hall. Established March 11, 1907. Number of nurses: One. Salary: $goo per annum. History and Plan of Work: The Visiting Nursing Association and the First Church of Cambridge initiated the work by detailing a nurse to the Board of Health to work experimentally in the schools of one district of the city. The experiment was so successful that the nurse was retained in the schools through the fall; and November 23, 1907, an appropriation was made by the city to continue the service. It is expected that the near future will find additional nurses in the field. At present the nurse spends one week in each school district, attending only the urgent cases in their homes. When the staff is increased entrance examinations will be held by the Board of Health and only nurses having a successful visiting nursing record will be eligible for positions. Cambridge Anti-Tuberculosis Association, 689 Massachusetts Ave. Established visiting nursing January i, 1907. Number of nurses: One. Salary: $40 per month and board. Hours: 8 a. m. to 5 p. m. Class of cases cared for: Tuberculous. Afiiliations: The Visiting Nursing Association, which pays the nurse's salary. 112 MASSACHUSETTS Plan of Work: The nurse does instructive work only. Patients needing nursing care are attended by the Visiting Nursing Asso- ciation. Whenever possible, advanced cases are sent by the Board of Health to the Holy Ghost Hospital as a preventive measure. For less advanced patients, out-door treatment is planned, and tents, steamer chairs, blankets, etc., are furnished when necessary. The sanitary conditions of the houses are investigated by the nurse, and improved when possible, or families are sometimes moved into better quarters. Milk and eggs are furnished if the patient is unable to procure them for himself. There is a tu- berculosis class where some patients are treated; other patients, women only, are sent to the Good Samaritan Day Camp. On Satiu-day morning the nurse attends a clinic which is held for the examination of children from families where there is tubercu- losis, or where there has been a history of tuberculosis in the past. Cambridge Visiting Nursing Association, 35 Bigelow Street. Established May 16, 1904. Number of nurses: Eight; three are pupils. Salaries: $45, $50, and $80 per month for the graduates. Hours: 8 a. m. to 6 p. m. Emergency and obstetrical calls are answered at night. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Plan of Work: One nurse cares for tuberculous patients only. She is supported jointly by the Visiting Nursing Association, and the Anti-Tuberculosis Association. Two nurses on the staff are school nurses. The Visiting Nursing Association gives a cer- tificate in visiting nursing to senior pupils from hospitals of near- by towns, the course covering a period of four months. The association pays the hospital a certain sum ])cr day for the ser- vice of each pupil. I^atients are expected to pay for the nurses' services when able to do so. For calls not exceeding one hour, $.40 is the fee. When possible, carfare, and time spent in going and coming is charged at the same rate. S[)ecial fees are: Surgical cases where s 118 MASSACHUSETTS ether is given, $i .00 to $3 .00 ; massage, $1 .00 per hour ; obstetrical cases, $2.00 for first call, $.40 for subsequent calls. The service of a nurse can be secured only at the request of the attending physician, or one of the directors. Sick-room appliances are kept on hand and loaned. Bed linen, clothing, infants' outfits and nourishment are given when necessary. CANTON Canton Nursing Association. Established in November, 1900. Number of nurses: One. Salary: $70 per month. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, conta- gious, and tuberculous. Special nurses are engaged for conta- gious patients, and for those needing constant care. Plan of Work: The association is largely self-supporting. A fee of $.25 per hour is charged whenever it is possible for the family to pay for the service. For an obstetrical case $5.00 is the usual fee. This includes two weeks' after care, two visits daily for the first week, and one daily for the second week. The balance of the expenses of the association is covered by subscription. CLINTON Lancaster Gingham Mills, 2 Green Street. Established visiting nursing in May, 1907. Number of nurses: One. Salary: $50 per month. Hours: 9 a. m. to 5:30 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The nurse has her office in one of the buildings, and in case of illness or accident the patient is attended to imme- diately. If the employe is ill at home, the nurse visits the patient there as often as her services are needed. 114 MASSACHUSETTS DAN VERS Danvers Visiting Nurse Association, 1 1 1 Locust Street. Established September i, 1908. Number of nurses : One. Salary: $70 per month. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, and tuberculous. Obstetrical calls are answered only in cases of emergency. Plan of Work: Calls for the nurse's services are received only through physicians, or some member of the board of managers of the association. Patients are expected to pay from $.10 to $.50 a visit. A "Comfort Fund" provides necessary delicacies. Bed linen, clothing, infants' outfits, and sick-room appliances may be loaned. EASTHAMPTON Visiting Nurse Department of the Helping Hand Society, Union Street. Established October i, 1906. Number of nurses: One. Salary: $75 per month. Hours: 8 a. m. to 5 p. m. Emergency calls are answered at night. When necessary, the nurse remains all night with a very ill patient, taking some time for rest the following day. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: An extra nurse is engaged to care for contagious cases. A loan closet supplies bed linen, sick-room appliances, wheel chairs, etc. The relief department supplies necessary food and fuel. FALL RIVER Union Hospital Training School for Nurses, 538 Prospect Street. Established visiting nursing in 1896. Number of nurses: Two — pupils. Hours: Irregular; calls answered whenever received. 115 MASSACHUSETTS Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The senior pupils take this service in rotation for six weeks at a time. FITCHBURG Fitchburg Society for the Control and Cure of Tuberculosis, 145 Main Street, Room 50. Established visiting nursing May 28, 1907. Number of niu-ses: One. Salary: $75 per month. Hours: g a. m. to 5 p. m. Class of cases cared for: Tuberculous. Plan of Work: The nurse supplies bed linen, milk and eggs when necessary. FRAMINGHAM Framingham District Nursing Association. Established in January, 1901; reorganized in January, 1908. Number of nurses: Two — one a pupil. Salar}': $50 per month, with room and board at the hospital for the graduate nurse. Hours: Irregular. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: All senior pupils receive instruction in district work under the supervision of the graduate nurse. A relief committee maintains a supply closet with all necessary equipment. A charge of $.25 an hour is made for patients who are able to pay. Special charges are: massage, $1.00; obstetrical cases, $1.00, with $.25 for after calls; operation with ether, $1.00. Service is free to all who cannot afford to pay. GARDNER District Nursing Association of Gardner, 61 Central Street. Established A})ril 5, 1906. Number of nurses: One. 116 MASSACHUSETTS Salary: $60 first year; $75 thereafter. Hours: 8:30 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The nurse has a supply of bed linen and clothing for her patients. GLOUCESTER Associated Charities,* 88 Middle Street. Established a visiting nurse department in connection with their other work in 1905. Plan of Work: A nurse is engaged whenever the occasion requires, and is paid according to the number of visits made. GREAT HARRINGTON Great Barrington Visiting Nurse Association. Established March i, 1908. Number of nurses: One. Salary: $100 per month. Hours: 9 a. m. to 5 p. m. Emergency calls are answered at night. Classes of cases cared for: Medical and tuberculous; obstetrical cases are taken after delivery. Plan of Work: Fees varying from $.05 to $1.00 are charged. In but few instances is it necessary for the nurse to remit the fee altogether. The association is giving the services of the nurse to visit the public schools, with the expectation that the Board of Education will later take up the work. The nurse has been placed on the regular list of teachers, and visits excluded chil- dren in their homes. Classes in home nursing and dietetic?. GROTON The Visiting Nurse Association of Groton. Established in 1897. Number of nurses: One. Salary: $60 per month. Hours: Calls arc answered at all hours. 'Nursing service discontinued. 117 MASSACHUSETTS Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: This work is maintained by contributions from the five churches of Groton, by individual subscriptions and by patients' fees. The nurse prepares for and assists at opera- tions in Groton and nearby villages. Bed linen, clothing, and sick-room appliances are kept on hand to loan when necessary. HAVERHILL Haverhill Association for the Relief and Control of Tubercu- losis, 112 Emerson Street. Established visiting nursing in 1907. Number of nurses : One. Salary: The nurse is paid $.25 for each call that she makes. Hours: Irregular. Classes of cases cared for: Medical, obstetrical, and tuberculous. Plan of Work: The nurse attends the tuberculosis clinic on Thurs- days from 4 p. m. to 5 p. m. and visits these patients in their homes. The association considers the use of the sleeping balcony the most successful means for providing out-of-door life, and it is prepared to build inexpensive balconies, and to loan tents. It also furnishes sputum cups, thermometers, steamer chairs, and blankets. HOLYOKE Holyoke District Nurse Association, 1235 Dwight Street. Established March 26, 1906. Number of nurses: One. Salary: $65 per month. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: One drug firm gives closet room for supplies, and others give medicines and various things necessary for the work. Friends of tlie association as well as the Holyoke Relief Asso- ciation furnish food and fuel when appealed to. Bed linen and medical supplies are loaned or given when necessary, also 118 MASSACHUSETTS underwear, blankets, and infants' clothing. The nurse attends to tuberculosis patients needing niursing care. Eggs, milk, window tents, etc., are furnished by the Tuberculosis Associa- tion, whose secretary attends the tuberculosis class and clinic and investigates the cases. Patients pay from $.15 to $.50 when able to do so. HUDSON Hudson District Nursing Association, 71 Washington Street. Established January 28, 1908. Number of nurses: One. Salary: $65 per month. Hovu^: 8 a. m. to 6 p. m.; Sundays and holidays excepted. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: Women's Club. Plan of Work: Bed linen, clothing, and sick-room appliances are loaned when necessary. LANCASTER Lancaster Visiting Nurse. Established July i, 1909. Number of nurses: One. Salary: $30 and all expenses. Hours: Irregular; emergency calls answered at night. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: Calls for the nurse are left at Dr. Beckley's office before 9 a. m. or between 2 and 3 p. m. Fees for visits of one hour or less are $.25; for each additional hour or part of hour, $.25; massage, $.50; for ten hours' duty by day — when the nurse is at liberty — $2.00. Confinement cases, $2.00; after- care, $.25 an hour. Calls made after 6 p. m. are double the above prices. Surgical dressings exceeding $.10 must be paid for by the patient or physician. The nurse is permitted to use discretion in collecting money from people who are unable to pay these charges. 119 MASSACHUSETTS LAWRENCE The Ladies' Union Charitable Association, Prospect Street. Established visiting nursing in May, 1908. Number of nurses : Two — one a senior pupil. Salary: $50 per month, board and lodging. Hours: 8 a. m. to 5 p. m. Emergency calls occasionally answered in the early part of the night. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: Besides the general visiting work a day camp is maintained for tuberculous patients. The nurses look after the patients there, taking their temperatures, pulse, and respiration, attend to the nourishment, and visit the patients in their homes. LEICESTER The Leicester Samaritan Association. Established visiting nursing February 15, 1907. Number of nurses: One. Salary: $70 per month. Hours: Irregular; emergency calls answered when received. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. History and Plan of Work: This work was started originally under the name of the Leicester Hourly Nurse Association. In Feb- ruan', 1909, it was incorporated with the Samaritan Association and is now known by that name. The latter society owned a large number of appliances necessary for the sick room and for the use of medical and surgical patients. These are at the service of the nurse or of any resident upon presenting the custodian with a physician's written order. The articles are kept in a room in the Public Library, which is given by the trustees, and the librarian is paid a small salary to act as cus- todian. A fee of $.25 or $.50 an hour is expected from all patients, as there are few really poor people in Leicester. When necessary the nurse's services are given without charge. 120 MASSACHUSETTS LEXINGTON Lexington Fellowship of Charities, Leslie House. Established visiting nursing in 1901. Number of nurses: One. Salary: $65 per montli. Hours: Irregular. Calls are answered day or night. One after- noon free from duty is allowed each week. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: Calls from the town and vicinity are answered. The nurse has the use of a horse and carriage when her patients live at a distance. LINCOLN The Ladies' Aid Society. Plan of Work: This society has no resident nurse, but when calls are received a visiting nurse from the Waltham Training School is sent to the patient as often as necessary. Twenty-five cents per hour and carfare is the usual fee charged. When possible the patients pay this; otherwise, the expense is borne by the Ladies' Aid Society. All hospital patients are sent to the hos- pital in W^altham. LOWELL Middlesex Women's Club, Visiting Nursing Department. Established November i, 1908. Number of nurses : One. Salary: $75 per month. Hours: 8 a. m. to 6 p. m.; Sundays excepted. Classes of cases cared for: Surgical, medical, obstelricul, and tuberculous. Plan of Work: A well-equipped supply closet is maintained, witli bed linen and clothing which may be loaned or given away. Surgical supplies are furnished, and many articles for use in the sick room may be loaned. Milk and eggs are supplied for needy patients. A relief committee investigates needy families, and furnishes aid of various kinds when necessary. 121 MASSACHUSETTS LYNN Associated Charities,* Lee Hall, lo City Hall Square. Established visiting nursing in November, 1896. Number of nurses : One — pupil. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The senior pupils of the Lynn Hospital have two months of district work during the course of their training. The Associated Charities pays $12.50 per month for the nurse's service, and furnishes clothing or other necessary supplies. The Lynn Tuberculosis Committee, Office of Associated Charities, 2 Lee Hall. Established visiting nursing June i, 1907. Number of nurses : One. Salary: $780 per year. Hours: Dependent upon the amount of work to be done. Plan of Work: Eggs and milk may be supplied when necessary. Aid is given to enable patients to go out of town to more desir- able localities. Outfits for living out-of-doors also furnished. MALDEN Maiden Industrial Aid Association, 21 Ferry Street. Established visiting nursing in 1899. Number of nurses: One. Salary: $60 per month. Hours: 8 a. m. to 6 p. m., with two hours' rest at noon. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work : The society also maintains a day nursery. MARBLEHEAD Marblehead Visiting Nurse Association, 69 Pleasant Street. Established in 1896. Number of nurses: One. *Nursing service now carried on by the District Nursing Association. 122 MASSACHUSETTS Salary: $65 per month. Hovirs: 8 a. m. to 6 p. m. Night duty and Sunday calls are ex- ceptional. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work : A call for the nurse must be by written order signed by the patient's physician. She cannot respond to any other. When the nurse attends contagious cases, she is subject to special limitations respecting her visits to other patients. These limitations are prescribed by the attending physician. At such times, the nurse is required to use thorough means of dis- infection, and to change her clothing throughout before going to another case. A loan closet furnishes all necessary supplies for the sick room. MARLBORO Marlboro Woman's Club. Established visiting nursing November i, igo6. Number of nurses: One. Salary: $65 per month, carfare, and telephone. Hours: 8 a. m. to 8 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: Bed linen, clothing, sick-room appliances, and medicines are provided when necessary. MEDFORD Medford Visiting Nurse Association, Howard's Drug Store, Medford Square. Established in June, 1900. Number of nurses: One. Salary: $63 per month. Hours: 8 a. m. to 6 p. m., with two hours' rest at noon. Emer- gency calls answered at night. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: In May, 1907, this association undertook special 123 MASSACHUSETTS tuberculosis work in addition to the general visiting nursing. Sputum cups, paper napkins, and bags are supplied. Milk and eggs are given when necessary. Bed linen, clothing, and sick-room supplies are loaned. The nurse's district is a large one, and she uses a bicycle to enable her to cover the many miles she is obliged to travel each day. A class in home nursing is held on Saturday afternoon. MELROSE Melrose Hospital. Visiting Nurse Department. Established in 1905. Number of nurses: One; sometimes two senior pupils. Hours: Irregular. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: The city pays the hospital $1000 annually for this service to the city poor. Plan of Work: This work is supervised only by physicians. The municipal appropriation partly maintains it, the hospital sup- plying sheets, nightgowns, surgical dressings, and nourishing food when necessary. A large proportion of the calls come from patients who are unable to pay; for others a small fee is charged. Each senior nurse has from one to three months of this service as a part of her training. MILTON Milton Visiting Nurse. Established in July, 1903. Number of nurses: One. Salary: $60 per month. Hours: Irregular; calls answered when received. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: This work is supported by the generosity of one woman and the fees collected from the patients. 124 MASSACHUSETTS NATICK Natick Visiting Nurse Association. Established April 12, 1899. Number of nurses: One. Salary: $75 per month. Hours: About nine hours. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: A relief committee and a club of young ladies, the " Sunshine Band," are helpful in securing supplies of bed linen, clothing, delicacies and medicines for the nurse's use. NEW BEDFORD The Instructive Nursing Association, 298 Union Street. Established in 1887. Number of nurses : Two. Salary: $70 per month. Hours: 8 a. m. to 6 p. m. Employment on Sundays and holidays is exceptional; night calls are rarely answered. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: A supply committee provides all necessary comforts for the patients and the sick room. Once a month, at the regular meeting of the board of managers, one of its members reads the nurses' journal, which keeps the board in touch with the work of the two nurses, and the results of the care of the patients. The fees are $.75 per hour, and $.50 per half hour. Smaller sums are charged according to the patient's ability to pay. NEWTON Newton District Nursing Association, Newton Hospital, Wash- ington Street. I^stablished in 1898. Number of nurses: Three; a supervising graduate nurse and two or more pupils, according to the number of patients to be visited. Salary: S40 per month and board for supervisor. 125 MASSACHUSETTS Hours: 8 a. m. to 6 p. m. Night calls are always answered. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: A supply committee furnishes necessary bed linen, clothing, and sick-room appliances. NORTHAMPTON The Northampton Association for the Prevention and Control of Tuberculosis. Established November 22, 1907. Plan of Work: The nurse of the Northampton District Nursing Association visits all tuberculous cases needing professional care. There are also several lay visitors who assist in the educational work, distributing literature, etc. Northampton District Nursing Association, 49 Elm Street. Established in January, 1907. Number of nurses: One. Salary: $70 per month. Hours: 9 a. m. to 5 p. m. No calls are answered at night. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: The Association for the Prevention and Control of Tuberculosis. Plan of Work: The association furnishes bed linen and garments for the patients; these the nurse may give or loan. The Tuber- culosis Association refers all its cases to the visiting nurse of this society. NORTH EASTON North Easton Visiting Nurse. Established in 1896. Number of nurses: One. Salary: $70 per month. Hours: Irregular; emergency calls are answered at night. Classes of cases cared for: Surgical, medical, obstetrical, ; and tuberculous. 126 MASSACHUSETTS History and Plan of Work: The work was established by the owners of a large shovel factory, and the nurse's services were at first intended only for the benefit of the very poor who could not have skilled care in any other way. Later the work was placed upon a paying basis, and all who can do so are asked to pay for their nursing, while the factory owners make up any deficit that may arise. There is no organization or board of managers. A treasurer holds and disburses the funds. The nurse carries on some educational work on the subject of tuberculosis, and in the summer when the work is light she holds classes in home nursing. For long-distance calls, she has a horse and carriage. A supply closet provides for bed linen, clothing and sick-room appHances, and there is a fund which enables her to buy food, fruit and other necessities for her pa- tients. When continuous care is required for those who are seriously ill, an extra nurse is engaged for as long a time as may be necessary. NORTH PLYMOUTH Plymouth Cordage Company. Established visiting nursing in February, 1901. Number of nurses: Two. Hours: Irregular; calls answered night and day. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The company has established an emergency hos- pital which is fitted up with cots, and all appliances for per- forming minor surgical operations, attending to surgical dress- ings, etc. A room in the nurses' house has been fitted up as a dispensary, and on Sundays and holidays when the mill is closed patients are cared for there. The nurses visit the patients in their homes, supply nourishment, medicine and clothing when necessary, and loan sick-room appliances. A part of their duty when calling upon the employes is to note the condition of the houses. Should the plumbing be out of order, or a house need repair in any way, they report the fact at the office of the company. 127 MASSACHUSETTS NORWOOD Norwood Visiting Nurse Committee. Established in March, 1906. Number of nurses: One. Salary: $75 per month. Hours: 8 a. m. to 5 p. m. Emergency calls answered at night. Only very ill patients visited on Sundays and holidays. Classes of cases cared for: Siu"gical, medical, obstetrical, and tuberculous. Affiliations: Norwood Woman's Club. Plan of Work: A loan closet is maintained for furnishing bed linen, clothing, and sick-room appliances. Broths, eggs, meat, coal, etc. are supplied when necessary. A fee of $.25 an hour is charged for general medical and surgical cases; surgical cases when ether is given, $.75 or $1.00; obstetrical calls, $1.00 or $2.00 for the first call, $.25 for subsequent visits. Reductions from these charges are made when necessary. PEPPERELL The Pepperell District Nurse Association. Established March 2, 1908. Number of nurses: One. Salary: $65 per month. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: A supply closet is furnished with bed linen, cloth- ing and sick-room appHances to loan. The usual charges are: $.50 per hour for general medical and surgical cases; $1.00 for obstetrical visits at the time of confinement, and $.25 for the after oills. For surgical cases, where ether is given, the charge is S.75. No charges are made to tliose who are unable to pay for the nurse's services. PITTSFIELD Pittsfield Visiting Nurse, House of Mercy Hospital. Kstablished in 1901. 128 MASSACHUSETTS Number of nurses: One. Sa]ar>': $75 per month and carfare. Hours: Irregular. Classes of cases cared for: Surgical, medical, and obstetrical. History and Plan of Work: In 1901, the graduate nurses of the Bishop's Training School agreed to give two weeks each year for the care of the sick poor in their homes; they were under super- vision of the superintendent of the Training School, who re- ceived the calls and maintained an unbroken succession in the service. This arrangement continued for five years. A fund was given to buy whatever supplies might be needed. The electric railway companies helped; one by a free pass over its road for several years; the other by a gift of money. In 1906, a gentleman undertook to finance the work, and for over a year he and his friends contributed enough money to pay a nurse $65 per month, different nurses taking the service for one month at a time. In 1907, another gentleman inter- ested himself in the work, an association was formed, and a nurse engaged to do the work continuously, at a salary of $75 per month and carfare. A small fee is charged, but the service is largely free. Clothing, milk and eggs, medicine and food are given when necessary. The city often works in co-operation with the nurse, and in cases of great need furnishes coal and other necessities. QUmCY Women's Club, Visiting Nurse Committee, Women's Club House. Established July i, 1905. Number of nurses: One. Salary: $500 per year, with suite of rooms, heat, light and use of laundry at the club house. Hours: 8 a. m. to 5 p. m. Emergency calls are answered at all hours. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: Needy patients are referred to the pliilanthropic committee of the club. Only calls from physicians are accepted. 'J 129 MASSACHCrSETTS SALEM The Woman's Friend Society. District Nurse Committee. Established visiting nursing in 1896. Number of nvirses: One. Salary: $70 per month. Classes of cases cared for: Surgical, medical, and obstetrical. Plan of Work: The loan closet contains bed linen, clothing, babies' outfits, etc. When able to do so, patients are expected to pay a fee of $.50 an hour. SOMERVILLE Somerville Visiting Nurse Association, i Webster Street. Established August 12, 1906, Number of nurses: Two. Salaries: $70 and $60 per month. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: Calls are answered only at the request of physi- cians, the president of the association, or agent of the Associated Charities. Carfare and a fee of $.25 are charged when patients are able to pay. For surgical and obstetrical calls, the charge varies from $1.00 to $3.00. Bed linen, clothing, and sick-room appliances are loaned when necessary. An anti-tuberculosis department has recently been established and a special clinic and open-air camp are hoped for in the near future. SOUTHBRIDGE Southbridge Visiting Nurse Association, 36 Chapin Street. Established February 19, 1909. Number of nurses: One. Salary: $75 per month. Hours: Eight hours. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. 130 MASSACHUSETTS SPENCER Spencer District Nursing Association. Established February lo, 1908. Number of nurses : One. Salary: $70 per month. Hours: 8 a, m. to 6 p. m. Emergency calls are answered at night. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. A fee of $.50 an hour is charged to all patients who are able to pay that sum. Gratuitous service is given when necessary. SPRINGFIELD Springfield Association for the Prevention of Tuberculosis,* 613^^ Main Street. Established visiting nursing November 24, 1908. Number of nurses : One. Salary: $70 per month. Hours: 8 a. m. to 5 p. m. Class of cases cared for: Tuberculous. History and Plan of Work: The first special undertaking of this association was to hold weekly classes. Later, a day camp was opened, which the members of the classes were invited to attend. This was so successful that it soon developed into a night and day camp, with accommodations for men to remain continuously. It is expected that the near future will see furtner extensions which will enable the women patients also to stay at night. Day patients arrive at 9 a. m. and all have a luncheon of bread and milk at 9:30. A substantial hot dinner, with a glass of milk, is served at noon; at three o'clock an egg-nog is given them, and at half-past five all have milk before going home. The day patients are admitted free of charge, carfare being provided for those unable to pay it. Patients who remain all the time in camp are charged $2.50 a week. This is sometimes paid by their friends. During the winter a room is maintained at headquarters where the physi- cians and nurse meet the members of the classes, and the educa- *A trained nurse no longer emploved. 131 MASSACHUSETTS tional part of the work is kept up as well as the oversight of patients themselves. Sputum cups, paper napkins and bags are given; milk and eggs, and warm clothing also are furnished for those who cannot obtain them for themselves. Reclining chairs, window tents, etc, are loaned. The Union Relief Association, lo Court House Place. Established visiting nursing in 1906. Number of nurses : One — pupil. Classes of cases cared for: Surgical, medical, and obstetrical. Plan of Work: The Union Relief Association pays $7.00 a week to the Springfield Hospital for the services of a senior pupil nurse to visit patients in their homes. All tuberculosis cases are referred to the Association for the Prevention of Tuber- culosis. WALPOLE Walpole Visiting Nurse Association. Established June 14, 1909. Number of nurses: One. Salary: $65 per month. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The Lend-a-Hand Club is responsible for the loan closet which furnishes bed linen and sick-room appliances. WALTHAM The American Waltham Watch Company. Established a social service department October 10, 1907. Number of nurses: One. Salary: $70 per month. Hours: Irregular; whenever called. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. Plan of Work: The nurse has one office at the factory and an- other at the company's boarding house. She visits in the homes 132 MASSACHUSETTS and gives nursing caxe whenever called upon. A supply closet furnishes linen, clothing, sick-room appliances, milk, eggs, etc. The work is quite as largely preventive as curative. Tuber- culosis patients are given home treatment, or are sent to the state sanitarium at Rutland. Waltham District Nursing Association, 249 Bacon Street. Established in 1900. Number of nurses: Two, usually; more if necessary. All are senior pupils from the Waltham Training School. Hoiurs: 7:30 a. m. to 9 p. m., with two hours off duty daily. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The W^altham pupils are given this service under a supervising nurse as a part of their training. Calls are answered from the surrounding towns. A schedule of fees is maintained: $.25 an hour is the usual charge for medical and siurgical cases, $1.00 for the first call on obstetrical patients, and the same charge for an hour's massage. Carfares are added when calls are more than half a mile distant from the hospital. Reduc- tions may be made when necessary. There is a loan closet at the training school for the visiting nvu-ses' use. Special nour- ishment is supplied when needed. WARE District Nurse Committee, Social Science Club. Established July i, 1903. Number of nurses : One. Salary: S800 a year and carfare. Hours: Eight. Office hours 7:30 to 8 a. m. and 12:30 noon to I p. m. Only in exceptional cases are calls answered at night and on holidays. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The nurse has at her disposal bed linen and cloth- ing, and when necessary provides nourishment and sputum cups. 133 MASSACHUSETTS WATERTOWN Society for Relief of the Sick and Poor. Established visiting nursing in 1902. Number of nurses: One. Salary: $897.25 per year. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, and obstetrical. Affiliations: Unitarian Church. History and Plan of Work: This society is one of the oldest in the coimtry. It was organized in 181 6 at the beginning of the Unitarian movement by the members of the only church at that time in Watertown, The society has been carried on all these years by the women of the church, not restricting its ministrations to any creed, color or nationality. It unites with all the other churches in sustaining the District Nvirsing Association of the town, giving $25 a year from its treasury, but the Society for Relief of the Sick and Poor is maintained entirely by the Unitarian church. Watertown District Nursing Association, 28 Main Street. Established December 22, 1902. Number of nurses: One. Salary: $70 per month. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: The Women's Club. Plan of Work: Emergency calls are answered at night. A loan closet supplies bed linen, clothing, and sick-room appliances; when necessary, old linen, cloth, materials for bandages and dressings may be furnished. In a few exceptional cases nour- ishment is supplied by individual members of the board. The schedule of prices is as follows: ordinary nursing visits, $.25 an hour; first call in obstetrical case, $2.00; massage, $1.00 per hour; assisting the physician in minor surgical cases, $1.00; emergency night calls, $.50 per hour. Patients are expected to pay all necessary carfares. 134 MASSACHUSETTS WEBSTER S. Slater and Son, Incorporated. April I, 1907, a nurse was engaged to look after the employes of the mills owned by this company, and to visit the sick in their families. Salary: $75 per month. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: In each mill there is an emergency room where the patients are received and treated, and where minor accidents and sometimes major cases are attended to. The nurse has supplies of all kinds to loan or to give when necessary. Sputum cups and paper napkins are supplied to tuberculous patients. WESTON The Ladies' Aid Society. In this village all patients requiring visiting nursing care are looked after by the Ladies' Aid Society, which pays for the visits of a Waltham Training School pupil whenever the neces- sity arises. The patients pay for the service when able to do so. The usual fee is $.25 per hour and carfare. WHITINSVILLE The King's Daughters. Established visiting nursing in January, 1901. Number of nurses: One. Salary: $18 per week. Hours: Irregular. Emergency calls are answered at night. Classes of cases cared for: Surgical, mediaal, obstetrical, and tuberculous. Plan of Work: Charity calls are answered only on an order from the attending physician. For other patients, a uniform charge of $.50 is made for the whole or part of the first hour. Night nursing may be undertaken in cases of need if the day's work has not been too heavy; a fee of $3.00 is asked for such service. For general massage, $2.00 is charged. Local massage is 135 MASSACHUSETTS considered a part of regular nursing. Aside from the fees, the expenses of the work are covered by membership dues of $.25 yearly; $.15 for members vmder the age of sixteen, and $.50 for associate members. All necessary appliances for the sick room are owned by the Samaritan Society of Whitinsville, and may be borrowed by the nurse or by any citizen who presents to the custodian a written order from the attending physician. Payment is required only when needless damage is done to the article borrowed. This society began with an outfit valued at $221. The outfit is now worth nearly $1,000, and contains various sick-room appliances, from a rubber ring to adjustable fracture beds, sterilizers, and electrical fans. The society also sells oxygen tanks and band- ages when necessary. There is a "Care Fund" of $1000, the interest of which goes to keep the supplies in repair. If cloth- ing and nourishment are needed the nurse reports the case to the committee. WINCHESTER The Winchester Visiting Nurse Association. Established February i, 1899. Number of nurses: Two. Salary: $60 per month, and a house to live in. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: Charity Organization Society. Plan of Work: The nurses respond only to the calls of an author- ized physician. A bed for the use of free patients is maintained by the association at the Winchester Hospital. Clothing and nourishment are furnished when necessary. Sputum cups, milk and eggs are given to tuberculosis patients; window tents also are provided. A special nurse is engaged for very ill pa- tients who need constant care. Occasionally, patients are sent at the expense of the association to the state sanatorium at Rutland. Fees of from $.05 to $.50 are charged when patients are able to pay. 136 MASSACHUSETTS WOBURN Wobum Visiting Nurse Association. Established in 1904. Number of nurses: One. Salary: $60 per montli. Hours: Eight hours. Classes of cases cared for: Surgical, medical, and obstetrical. WORCESTER The Worcester Society for District Nursing, i Elm Place. Established in 1893. Number of nurses: Six, and three pupils, one from the Memorial Hospital, and two from the City Hospital. Salaries: $55 per month first year, $60 second year, $65 thereafter. Hours: 8:30 a. m. to 5:30 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: The Society for the Relief of Tuberculosis. Plan of Work: The pupil nurses receive six weeks' training in dis- trict work under the supervision of the society. The hospitals give their services, and the society pays then: carfare. Sys- tematic work was at first taken up with the tuberculosis clinic; the tuberculosis society then engaged its own nurse, but placed her under the supervision of the superintendent of the District Nursing Society. She, in turn, refers any tuberculous patients who are very ill and need special attention to the regular staff of nurses for care. Some work has been done in the public schools, looking up the excluded children, treating them under the doctor's orders, giving practical instruction to the mothers in the homes, and notifying the physicians when children were ready to be returned to school. This was given up, owing to the pressure of nursing calls and the limited number of nurses. Talks are frequently given, however, to mothers of the children in the kindergarten classes of the public schools. 137 MICHIGAN Worcester Society for Relief of Tuberculosis, 37 Pearl Street. Established visiting nursing February i, 1908. Number of nurses: One. Salary: $60 per montli. Hours: 8:30 a. m. to 5:30 p. m. Class of cases cared for: Tuberculous. Afl&liations: Worcester Society for District Nursing. Plan of Work: The nurse works under the supervision of the Worcester Society for District Nursing; her salary is paid by the Tuberculosis Society. Tents, reclining chairs, and warm clothing are loaned or given by the District Nursing Society. Milk and eggs are supplied for incipient cases, and sputum cups and disinfectants are provided when needed. MICHIGAN ANN ARBOR Hospital and Visiting Nurse Circle of King's Daughters, 1530 Hill Street. Established May 9, 1909. Number of nurses: One. Salary: $70 per month. Hours: 8:30 a. m. to 5:30 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: A loan closet furnishes bed linen and sick-room appliances. BATTLE CREEK The Battle Creek Sanatorium. Established visiting nursing in 1891. Number of nurses: Six — graduates and pupils. Salary: $30 per month for the graduates, board, room, and laundry. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. 138 MICHIGAN Plan of Work: The visiting nursing is maintained as a means of supplementing the training of the nurses who receive their diplomas from the Sanatorium. A graduate nurse supervises the work, and senior pupils are given two months' training in this department. There is a dispensary connected with the Sanatorium in Battle Creek, and a branch sanatorium in Chicago* where tu-o pupil nurses are sent each month in rotation. BAY CITY The Civic League Free Dispensary and Visiting Nurse Com- mittee, 1009 Washington Street. Established March 14, 1908. Number of nurses : One. Salary: $70 per month. Hours: 8 a. m. to 6 p. m. Sundays are free, and one day each week the nurse is allowed three hours off duty. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. DETROIT Board of Health, School Nursing Department. Established March 26, 1906. Number of nurses: Two. Salary: $75 per month. Hours: Eight hours. History and Plan of Work: The school nursing service was started by the Visiting Nurses' Association, which detailed one of its nurses to work under the medical inspectors of the Board of Health in several public schools. This work was experi- mental and intended to show the great need that existed for such a service. The results were most satisfactory. The experiment, fostered for two years by the Visiting Nurses' Association, resulted in April, 1908, in a municipal appropria- tion of $1500, to be used for the support of two school nurses. They began their work under the direction of the Board of * Sec page 70. 139 MICHIGAN Health in September, 1908. The staff will be increased as the work demands it. Society for the Study and Prevention of Tuberculosis, Board of Health. Established visiting nursing in 1890. Number of nurses: Four. Salary: $75 per month. Hours: 8:30 a. m. to 5:30 p. m. Class of cases cared for: Tuberculous. ^\ffiliations: The Visiting Nurse Association. History and Plan of Work: The Visiting Nurse Association insti- tuted the care of tuberculous patients when the society was first organized. For some time they detailed one of their staff to attend the tuberculosis clinics at the Board of Health, and this nurse visited in the homes and instructed all the patients who were being treated by the city physicians. In June, 1908, Detroit organized a Charity Day, or Tuberculosis Tag Day, when $11,000 were realized; this enabled the city to enlarge and carry on the work far more efficiently than ever before. The fund is under the management and control of the Society for the Study and Prevention of Tuberculosis. A committee on "applications, social work, and niusing," consisting of seven members, has been appointed. Mrs. Lystra E. Gretter, super- intendent of the Visiting Nurse Association, was made chair- man of the committee, and four other members are also on the Visiting Nurse Association board. The nurses attend the clinic at the Board of Health, visit the patients in their homes, gi\'e nursing care to those who need it, instruct all patients and their families on the nature of tuberculosis and how to prevent further infection. They also see that the milk and eggs fur- nished by the health department are properly used by the pa- tients to whom they are given, and that the rules and regula- tions of the Board of Health are carried out in regard to dis- infection. 140 MICHIGAN Visiting Nurse Association, 69 Lafayette Boulevard. Established in 1894. Number of nurses : Eight. Salary: $50 to $70 per month and imiforms. Hours: Eight hours. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: Board of Health, and Society for Study and Preven- tion of Tuberculosis, History and Plan of Work: In 1894, Miss Alice Bow en, a graduate of the Farrand Training School, began on her own initiative, visiting nursing among the poor families of the city. In 1897, the Visiting Nurse Association was organized, and in 1901 it was incorporated. The work is centralized in the Nurses' Home, where the nurses live, receiving their board, laundry, and room as part of their salary. A loan closet is maintained for bed linen, clothing and sick-room supplies. There is also a dispensary, and a disinfecting room to safeguard both nurses and patients when contagious diseases are met with. The association started public school nursing in March, 1906, and carried it on for two years, under the direction of the health officer and the medical inspectors. In April, 1908, an appropriation was made by the municipality, and in September, 1908, two municipal nurses began their work.* In 1906, the care of tuberculous patients was commenced by this association in connection with the health board and the Post Graduate clinics. Milk and eggs were furnished for needy patients, and the services were continued for two years. In 1908, the Society for the Study and Prevention of Tuberculosis employed four nurses, and they are supervised by the Visiting Nurse Associa- tion. Each summer the nurses do considerable Fresh Air work. During the year several churches sent, in rotation, weekly supplies of fruit, cereals, malted milk, jellies, etc. for the sick and needy patients. Members of a school alumnje make soft and fluid diets twice a week and distribute them where needed. * See page 139. 141 MICHIGAN FLINT The Opportunity Circle of the King's Daughters, 415 Stevens Street. Established visiting nursing in February, 1904. Number of nurses : One. Salary: $80 per month, board, and room. Hours: 7 :;^o a. m. to 5 p. m. with two hours' rest at noon. Classes of cases cared for: Svugical, medical, obstetrical, and tuberculous. Plan of Work: A loan closet is maintained for all necessary sick- room supplies, bed linen, infants' outfits, clothing, etc., and milk, eggs, medicines, groceries, jellies, and fruits, are fur- nished when needed. A small fee is charged where patients are able to pay. There is an emergency room in lieu of a hospital, in which emergency cases are cared for, or patients who cannot properly be treated at home. An assistant nurse is employed when the work demands it. GRAND RAPIDS The Anti-Tuberculosis Society, Nurse's Office, 23 Park Street. Established visiting nursing November 27, 1906. Number of niu-ses : One. Salary: $60 per month and uniforms. Hours: 8 a. m. to 5 p. m. Class of cases cared for: Tuberculous. Plan of Work: This society pays the salary of one nurse who is a member of the District Nursing Association staff and de- votes her entire time to tuberculosis patients. The nurse attends the clinics at the Free Dispensary, visits the patients in their homes, gives nursing care to the bed patients, instructs the families in sanitary laws, and helps them to adjust the home conditions in a way that will be favorable to the patient's re- covery, and to their own protection. Sputum cups are supplied by the dispensary. Board of Education, School Nursing Department, Nurses' Office, 23 Park Street. Established in May, 1905. 142 MICHIGAN Number of nurses : Three. Salary: $55 per month. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, contagious, and tuberculous. Plan of Work: This service was started experimentally by the District Nursing Association with one nurse, who continued the work for seven months. In that time the necessity for medical and nursing care of school children was so well demonstrated, that medical inspection was started on January 2, 1906, by volunteer physicians under the supervision of the Board of Health. On January 22, 1906, two visiting nurses were ap- pointed on the nursing staff. The salaries are paid by the Board of Education to the District Nursing Association, and the latter supervises the work. Diu-ing school hours the nurses are busy in the schools, and later they visit the parents of the excluded pupils to explain the necessity of following the advice of the medical inspectors. District Nursing Association, 23 Park Street. Established in 1893. Number of nurses : Six. Salary: $55 per month. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. History and Plan of Work: Visiting nursing in Grand Rapids was first started by a committee of the Charity Organization Society. It is now carried on as an independent association which intro- duced nursing into the public schools, started the care of tubercu- lous patients, and now supervises all three departments, — general nursing, school, and tuberculosis work. A supply closet fur- nishes bed linen, clothing, maternity outfits, and sick-room appliances, which are loaned; milk and eggs are given when necessary, also infants' outfits and new and old clothing for children. A Neighborhood Basket is sent into different neigh- borhoods each week, the papers advertising the address and 143 MICHIGAN asking friends of the District Nursing Association to contribute. Each Friday the basket is returned to the office, and on Saturday the nurses distribute the supplies received. HOUGHTON Houghton County Anti-Tuberculosis Society, Calumet. Established visiting nursing June i, 1909. Number of nurses : One. Salary: $100 per month. Hours: 9 a. m. to 5 p. m. Class of cases cared for: Tuberculous. ISHPEMING The Cleveland-Cliffs Iron Company, Sociological Department. Established visiting nursing May 6, 1908. Number of nurses: One. Salary: $80 per month. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The nurse looks after the employes and their families. There is a Rest Farm where women in need of rest or recreation may be sent, and remain as long as necessary. A benefit association provides for the injured and aged employes, and cares for the widows and orphans of men who have been killed while at work. JACKSON The Town Improvement Society, Young Women's Christian Association Rooms, Main Street. EstabHshed visiting nursing March 17, 1907. Number of nurses: One. Salary: $20 per week. Hours: Irregular; whenever called. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous, 144 MICHIGAN Plan of Work: Bed linen and clothing may be loaned or given away. Jellies and nourishment are supplied to very ill patients. KALAMAZOO Women's Civic Improvement League, 320 West Kalamazoo Avenue. Established visiting nursing in February, 1904. Number of nurses : Two. Salary: $70 per month. Hours: 8:30 a. m. to 5 : 30 p. m., with one free afternoon each week. Only emergency calls are made on Sunday. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The Nurses' Supply Club of the First Methodist Church furnishes bed linen, clothing, and sick-room appliances. The league has five wheel chairs in constant use by patients. Special diets are provided when necessary. LANSING The Visiting Nurse Association, Care of Y. W, C. A. Established May i, 1907. Number of nurses : One. Salary: $75 per month and carfare. Hours: 8 a. m. to 6 p. m.; Sundays and one afternoon of each week excepted. Emergency cases are answered at all times. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: A fee varying from $.10 to $.50 per visit is charged when the patient is able to pay. MARQUETTE The Visiting Nurse Association, Room 26, Harlow Block. Established December 7, 1908. Number of nurses: One. Salary: $80 per month. Hours: 8 a. m. to 5 p. m. 10 145 MICHIGAN Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: This association supplies food and clothing when necessary, also work for those who need it. MUSKEGON The Visiting Nurse Association, Forest Avenue. Established in February, 1905. Number of nurses : One. Salary: $40 per month, board, laundry, and carfare. Hours: 8 a. m. to 5 p. m.; Sundays excepted. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: A loan closet supplies bed linen, clothing, infants' outfits, sick-room appliances, and wheel chairs. The Neighbor- hood Basket is taken in rotation by the members of the asso- ciation, kept for a month, and filled with all sorts of necessaries and delicacies by their friends. Some of the public school teachers interest their pupils in bringing fresh eggs, jellies, fruit, etc. During the canning season in the fall, "Fruit Show- ers" are held, when large supplies of all kinds of home-canned things are received for the nurse's patients. owosso Visiting Nurse Association, 408 Park Street. Established November 2, 1908. Number of nurses : One. Salary: $60 per month. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: Anti-Tuberculosis Society. Plan of Work: A loan closet is maintained, and a Neighborhood Basket furnishes food and delicacies. SAGINAW Saginaw General Hospital. Established visiting nursing in January, 1904. 146 MINNESOTA Number of nurses : One. Salary: $50 per month, with room, board, and laundry at the hospital. Hotirs: 8 a. m. to 5 p. m. Class of cases cared for: Tuberculous. Plan of Work: Paper napkins, bags, milk, eggs, meat, and other noiurishment are supplied to patients. Bed linen, sick-room appliances, and beds are loaned when necessary. MINNESOTA MINNEAPOLIS Instructive Visiting Nurse Committee of the Associated Chari- ties, City and County Building. Established in 1903. Number of nurses : Seven. Salaries: From $50 to $65 per month and uniforms. Hours: 8:30 a. m. to 5:30 p. m. On Sundays the nurses alternate in visiting only very ill patients. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: One niurse specializes in obstetrical cases; one has charge of inciuable patients, not including tuberculosis, and three do general nursing and tuberculosis work. A day camp is maintained for tuberculous children. Milk, eggs, cots, bedding, warm clothing, window tents, and large tents are supplied for the patients. Bed linen, infants' outfits, and gen- eral supplies are furnished for the use of all. In summer sick babies are sent to the City Hospital Camp, which is maintained in a large tent erected on the hospital grounds. The senior pupil nurses from St. Barnabas Hospital are given a course of visiting nursing imder the supervision of the graduate nurses. ST. PAUL Anti-Tuberculosis Committee, 401 New York Life Building, Sixth Street. Established visiting nursing November 7, 1908. 147 MINNESOTA Number of nurses : Three. Salary: $75 per month. Hours: 8:30 a. m. to 5 p. m. Sundays are free and each nurse has one half day a week off duty. Class of cases cared for: Tuberculous. Plan of Work: Funds for the work were raised by a Tag Day, and a gift of $2500. Sputum cups, paper napkins, nourishment, and any necessary relief may be furnished. A loan closet pro- vides reclining chairs and necessary sick-room appliances. The Associated Charities of St. Paul, 609 Baltimore Building. Established a visiting nurse department November i, 1902. Number of nurses: One. Salary: $60 per month. Hours: 8:30 a. m. to 5:30 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. History and Plan of Work: This visiting nursing department was the first work of the kind in St. Paul. The nurse has had training in Charity Organization methods and principles besides her professional training. Two churches and a group of be- nevolent individuals maintain a fund for milk and eggs. Two women's associations frequently fvunish noiu-ishing food for patients who are very ill. Instructive Visiting Nurse Department of the Amherst H. Wilder Charity, 246 Endicott Building. Established November 15, 1906. Number of nurses : Two. Salary: $75 per month. Hours: Eight hours. Classes of cases cared for: Surgical, medical, and obstetrical. Plan of Work: The nurses have a loan closet, and furnish milk and eggs when necessary. 148 MISSOURI MISSOURI KANSAS CITY The Visiting Nurse Association, 1115 Charlotte Street. Established visiting nursing in 1889; Association formed in 1891. Number of nurses : Three. Salaries: Supervisor, $60 first year, $70 thereafter; assistants, $50 first year, $60 thereafter, and uniforms. Hours: 8:30 a. m. to 5:30 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. History and Plan of Work: This service is the outgrowth of work started by the First Congregational Church of Kansas City. In 1 89 1, this association was organized and took over the work of the church. A well-stocked loan closet furnishes bed linen, clothing, and sick-room appliances. A diet committee supplies milk, eggs, broths, medicines, and delicacies of various kinds. A small fee is usually charged. The nurses visit the tuberculosis clinic of the Post-Graduate Medical College, follow up the patients in their homes, provide them v>'ith instructive literature, nourishment and medicines. A special sum of money is given to the association to provide car-rides for tuberculosis patients. ST. LOUIS Epworth District Nursing Association, 3019 Bell Avenue. Estabhshed visiting nursing in September, 1902. Number of nurses: One. Salary: Deaconess' allowance. Hours: Irregular; whenever called. Classes of cases cared for: Surgical, medical, and obstetrical. Affiliations: The Methodist Episcopal Church. Plan of Work: The nurses are trained nurse-deaconesses, and have no salaries save the usual deaconess' allowance and all living expenses. Small fees are expected whenever the family can pay. A loan closet is supplied with all kinds of necessary appliances for the sick room, besides bed linen, clothing, surgical dress- ings, etc. Special provisions are made for operations and 149 MISSOURI obstetrical cases in private homes. Sterilized dressings and all appliances are loaned when necessary. Kingdom House, 803 Hickory Street. Established visiting nursing in October, 1896. Number of nurses: One, permanently; two during the summer months. Salary: $25 per month with board and laundry. Hours: 8 a. m. to 6 p. m. Emergency calls answered at night. Classes of cases cared for: Surgical, medical, and obstetrical. Contagious cases are visited once and sent to a hospital as soon as possible. Tuberculous cases are referred to the Society for the Relief and Prevention of Tuberculosis, Plan of Work: Kingdom House is a social settlement, and the nursing is one of its activities. There is a Babies' Clinic at the settlement in charge of the nurse and the district physician. The nurse also has charge of a pure milk station at the house, which is open daily from 8 to 9 a. m. She has a linen closet provided with bed linen, gowns, and maternity bags to give or loan, a closet of clothing for the needy, and a fund with which to buy milk and necessary medicines. She may use this fund also for paying the insurance of patients for a limited time. Much of the nurse's time is spent in caring for the sick babies brought to the settlement dispensary. St. Louis Provident Association,* 1623 Washington Avenue. Established visiting nursing in 1894. Number of nurses : Three. Salaries: From $40 to $65 per month. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, and obstetrical. Plan of Work: Tuberculous patients are referred to the Tuberculosis Society. Every morning the nurses inspect the children who at- tend the association's day nursery and on the physicians' orders, supply free milk for any who need such help. Medicine and nour- ishment are furnished when patients are unable to procure them in any other way. Needlework guilds give bed linen and clothing. *This work has been taken over by the Visiting Nurse Association. 150 MISSOURI Under the supervision of the nurses, women are trained as attendants to care for patients. They receive a special course of lectures at the Young Women's Christian Association, after which they are admitted to the nursing staff as pupils, two at a time, and given one month's practical experience in the homes. St. Louis Society for the Relief and Prevention of Tubercu- losis, 625 Locust Street. Established visiting nursing January 10, 1907. Number of nurses: Three. Salaries: $50 and $90 per month. Hours: 8:30 a. m. to 5:30 p. m. ; Sundays excepted. Class of cases cared for: Tuberculous. Plan of Work: The nurses attend all the tuberculosis clinics in the city, receiving from them, from the churches, and from all charitable associations the addresses of patients to be visited. They also visit the discharged patients of Mt. St. Rose Hospital and the city hospitals, teaching them how to care for themselves and prevent the spread of the disease in their families. Washington University Hospital, 611 North Jefferson Street. Established visiting nursing by the pupil nurses February i, 1908. Number of nurses : Two — one a pupil. Salary: $60 per month for supervisor. Hours: 7 a. m. to 7 p. m. The pupils are on duty from 7 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, and obstetrical. Plan of Work: On March i, 1909, a supervising nurse was en- gaged to take charge of the work. The nurses accompany the physician of the Lying-in Department in obstetrical cases, assist him during the confinement, utilizing to the best advan- tage whatever they may find in the house to work with, and make a daily call upon each patient for ten days. While on rounds they keep in touch with the hospital by telephone, and thus learn of new cases. No night calls are made. 151 NEBRASKA. NEBRASKA LmCOLN Charity Organization Society, Visiting Nurse Department. Established October i, 1904. Plan of Work: This work is carried on by a graduate nurse, who does hourly niu-sing also on her own responsibility. The gen- eral district work comes through the Charity Organization Society, the latter paying $.50 per visit for the nurse's services. OMAHA Immanuel Lutheran Church, 19th and Cass Streets. A graduate deaconess nurse began visiting nursing in connection with her other church duties in 1905. Salary: Deaconess' allowance and all expenses. Hours: Irregular. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. Plan of Work : Clothing and food are supplied when necessary. Visiting Nurse Association, 3305 Burt Street. Established in 1896. Number of nurses : Two. Salaries: $50 and $70 per month. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: Special nurses are engaged for contagious cases when necessary. There are also a number of caretakers who may be engaged to stay with patients needing constant care. The nurses have bed linen and clothing to give or lend, also infants' outfits and sick-room necessities, nourishment for the very sick, and medicine. For tuberculous patients they supply sputum cups, and loan window tents, reclining chairs, etc. 152 NEW HAMPSHIRE NEW HAMPSHIRE BERLIN Berlin Instructive District Nursing Fund, 95 High Street. Established in 1903. Number of nurses: One. Salary: $75 per month. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The work is supported by the Berlin Mills Com- pany, largely for the benefit of the employes. Emergency calls are answered at all times; but only patients who are very ill are visited on Sundays and holidays. A horse and carriage is at the nurse's disposal. CONCORD Concord District Nursing Association, 234 North Main Street. Established December i, 1899. Number of nurses: Four; two are senior pupils from the Nevv Hampshire State Hospital Training School. Salaries: $50 and $35, with all expenses, for the two graduate muses. Hours: 8 a. m. to 6 p. m. Obstetrical calls are answered at night. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: The State Hospital. Plan of Work: All the pupils from the hospital receive three months' visiting nursing work in the districts under the super- vision of the association. The nurses' services may be obtained through a physician only. A small fee, from $.10 to $.50, is charged for ordinary cases; night visits, $1.00 to $2.00; as- sistance at surgical operations, $1.00 to $3.00; obstetrical cases, $1.00 to $5.00. No fees are collected from the very poor. Sick- room appliances are kept on hand. Bed linen, clothing, and infants' outfits may be loaned or given away. The Concord Diet Kitchen, a separate organization, supplies 153 NEW HAMPSHIRE nourishing broths to all patients recommended by the nurses. Free transportation over the street railways has been given to the nurses for eight years past. The association has given the services of its head nurse to the department of education for three months' public school nursing. This has been so success- ful that it is probable the work will be permanently assumed by the city. DANBURY Church Settlement Association. Established visiting nursing in January, 1905. Number of nurses: Two. Salary: Supervisor, $50; assistant, $40 per month. Hours: Irregular. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. Plan of Work: This is a scattered rural district including several villages with long distances between each. Aside from their professional duties, the nurses give lessons in home nursing, first aid to the injured, cooking, dressmaking, and rugmaking. They also have charge of a small and complete cottage hospital, which has recently been built by private subscription. This is the only hospital within a radius of forty miles. In connec- tion with the hospital is a dispensary, which ministers to a large number of people. DERRY Derry Nursing Association, 62 E. Broadway. Established in February, 1908. Number of nurses: One. Salary: $15 per week. Hours: Eight hours. Class of cases cared for: Surgical, medical, obstetrical, and tuber- culous. Affiliations: The Women's Club. Plan of Work: This is a manufacturing town, composed largely of shoe factories, and the nurse finds very few families too poor to 154 NEW HAMPSHIRE pay her the schedule price per visit. General charges are $.25 per hour; $2.00 for confinement cases, and $.25 cents for each after visit. Massage, $1.00. DOVER Dover District Nursing Association. Established January 11, 1909. Number of nurses: One. Salary: $15 per week. Hours: 8:30 a. m. to 5:30 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: A loan closet provides bed linen, clothing, and necessary sick-room supplies. Dover has a large manufacturing population, and few patients 'are unable to pay the nominal fee charged for the nurse's services, FRANKLIN The Ladies' Hospital Aid Society. Established visiting nursing in January, 1901. Number of nurses: One. Salary: $50 per month. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: Charity Organization Society. History and Plan of Work : The society had its inception in January, 1900, when a small group of women met with the purpose of arranging a public meeting to discuss building a hospital. A bequest of $5000 for hospital purposes had been left by Mrs. Sally Proctor in the hands of trustees, but in consideration of the cost of building and maintenance, it was decided to organize the Hospital Aid Society; its objects were to provide nursing care, clothing, bedding, and sanitary supplies for the indigent sick, and emergency supplies for accidents, and to encourage the establishment of a hospital as soon as the funds would war- rant it. Other charitable work may also be undertaken. 155 NEW HAMPSHIRE The women retain entire control by limiting the privilege of voting in the society to women. Men may become honorary members by the payment of annual dues of $2.00, but have no vote. Women and children become members by the payment of $1.00 and $.25 dues respectively. For assistance in case of accident, emergency boxes containing all necessary supplies have been placed in the manufacturing establishments and the railroad stations of the city. An operating table owned by the society and available to all physicians is kept at the City Hall. The nurses answer calls from physicians only. KEENE Elliott City Hospital. Established visiting nursing in 1903. Number of nurses: One — pupil. Hours: 7 a. m. to 7 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The senior pupils are sent to patients who pay for their services at the full price, or in such sums as their means allow. A Charity Nursing Fund reimburses the hospital in cases where patients cannot afford to pay any fee. Since igo6, the student niu-ses have had a four months' course under the Instructive District Nursing Association of Boston, receiving a certificate at the close of their course there. LISBON The Lisbon District Nursing Association. Established February 22, 1909, Number of nurses: One. Salary: $60 per month. Hours: Calls are answered at all hours, day or night. Classes of cases cared for: Surgical, medical, and obstetrical. MANCHESTER Manchester District Nursing Association, City Mission, Cor. Bush and Merrimack Streets. Established November 10, 1898. 156 NEW HAMPSHIRE Number of nurses: Three — one graduate and two pupils. Salary: $50 per month for supervisor. Hours: Nine hours. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: City Mission. NASHUA Good Cheer Society. Established visiting niursing in 1901. Number of nurses : One. Salary: $60 per month and transportation. Hours: 8 a. m. to 7 p. m. with two hours of rest at noon. Sim- days and holidays 8-10 a. m. and 1-3 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: Charity Organization and Woman's Club. Plan of Work: The object of the society is to carry cheer and help to the sick and poor of the city of Nashua in any form except that of money. The membership is limited to 25 women who may not be less than 21 years old, and who must be im- married when admitted. These rules do not apply to honorary members, of whom there are a number. A supply closet is maintained which enables the nurse to furnish bed linen and clothing. She also gives provisions, and milk and eggs in limited quantities. The members of the society make friendly calls and carry flowers, fruit, broth, and jellies with them. Patients are expected to pay the nurse from $.05 to $.40 a visit according to their circumstances, but free visits are also made. PETERBORO Visiting Nurse Association. Established in January, 1907. Number of nurses: One. Salary: $50 per month with board, room, and laundry. Hours: About nine. 157 NEW HAMPSHIRE Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. History and Plan of Work: In January, 1907, a graduate nurse was engaged for three months experimentally, the expenses being borne by a philanthropic resident. At the end of that time an association was formed, and the work is now supported by annual subscriptions of $1.00, and by contributions from friends. Night calls are made when necessary. The scale of fees is: one hour's visit, $.30; one day, $3.00; one night, $2.00; twenty-four hours, $4; assisting the physician in obstetrical cases, $2.00; preparing for operation and assisting, from $.50 to $3.00. PLYMOUTH Emily Balch Cottage Hospital Association.* Established visiting nursing in 1900. Number of nurses : One. Salary: $50 per month, and living expenses at hospital. Hours: Irregular. Classes of cases cared for: Surgical, medical, and obstetrical. WALPOLE Walpole District Nurse. Established in May, 1904. Number of nurses : One. Salary: $65 per month. Hours: Irregular; emergency calls answered at night. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: This work is supported by a philanthropic resident of Walpole. It is conducted and supervised by a committee of ladies representing the various churches, members of which donate all necessary articles for the loan closet. A fee of $.25 an hour is charged to all who are able to pay. This money goes towards the nurse's salary. Nourishment is furnished for very ill and needy patients. *This association has not replied to late communications. 158 NEW JERSEY NEW JERSEY BERNARDSVILLE The Visiting Nurse Association of Bemardsville. Established November i, 1903; incorporated in June, 1907. Number of nvu-ses: One. Salary: $100 per month. The association also gives the nurse a furnished house, light and fuel, a stable, horse, carriage, and driver. Hours: Irregular. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. History and Plan of Work : The work was founded by the rector of St. Bernards Episcopal Church and was originally intended as a parish activity. The inevitable broadening of the work made it necessary to form an association, which was incorporated in June, 1907. The nurse's visits cover an area of some tw'enty square miles and include several small villages. Calls are ac- cepted only upon the orders of physicians. Two rooms in the Nurse's Home are reserved for emergency cases and for an extra nurse. There is also a well-equipped First Aid Room, where minor operations and dressings may be performed for patients who are able to go there. Supplies of all sorts both to give and to loan are kept on hand. Once a year the association meets at the nurse's home for a public conference. The residents of the villages are invited to attend, and the house is open for inspection. The following schedule of fees is maintained: for single visits, from $.05 to $1.00; operations including preparation of room and patient, from $1.00 to $5.00; confinements, including eight subsequent visits, from $2.00 upwards. Extra charges are made for night calls, and special rates for chronic cases. The nurse is in her office at certain hours to take new calls or to loan articles from the supply closet. A small charge is made for the use of these. BLOOMFIELD Westinghouse Lamp Company. Established a social service department in July, 1907. 159 NEW JERSEY Classes of cases cared for: Surgical, medical, and tuberculous. Plan of Work: A nurse was at first engaged for this work, but later it was given over to a physician who was also a graduate of the Bellevue Training School. A hospital for the care of emergency cases is maintained, and a polyclinic open every after- noon, where medical, surgical, nose, throat, eye, ear, and skin cases are prescribed for and treated. The physician takes an interest in the social welfare of the employes, and is doctor, nurse, and friend to all. BOUND BROOK The Woman's Literary Club and Library Association, 211 West Second Street. Established visiting nursing November 9, igo8. Number of nurses : One. Salary: $60 per month and lodging. Hours: 8 a. m. to 5 p. m.; Sundays excepted. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: All patients are expected to pay a fee for the nurse's services according to their means. For operations, including the preparation of the room and the patient, $2.00 is charged; for confinements, including daily calls for nine days, $3.00; for ordinary nursing visits to medical cases, $.35 per hour. The collection of fees is left to the discretion of the nurse. A loan closet supplies all necessary appliances for the sick room, and comforts for the patients. BURLINGTON The Friendly Institution. Charitable society organized in 1796; established a district nursing department in 1901. Number of nurses: One. Salary: $40 per month, board and room. Hours: 8 a. m. to 7 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. 160 NEW JERSEY CHATHAM See Milbum. EAST ORANGE East Orange Aid to the Sick. Established visiting nursing April 20, 1903. Number of nurses : Two — head nurse and assistant. Salaries: $100 and $60 respectively. Hours: Irregular. Classes of cases cared for: Surgical, medical, and obstetrical. Plan of Work: Emergency or maternity calls are accepted at all hours. The regular fee for hourly visits during the day is $.50; after 8 p. m., $1.00 per hour. Charges for visits to the poor are made at the discretion of the head nurse. A fee of $3.50 is asked for attendance at operations with preparation of the patient and room. Minor operations are at lower rates. For maternity cases, including the time of delivery and visits for nine days afterward, $5.00. ELIZABETH Visiting Nurse Association, 30 South Second Street. Established a visiting nursing department January 15, 1909. Number of nurses : One. Salary: From $60 to $70 per month. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: A supply closet furnishes bed linen, clothing, and sick-room appliances. Through the interest of friends of the work, the nurse may give necessary nourishment in special cases when the patients are unable to procure it themselves. HACKENSACK Children's Relief Society, and General Welfare Society. Established visiting nursing July 26, 1909. Number of nurses: One. Salary: $1000 per year. 11 161 NEW JERSEY Hours: 9 a. m. to 5 p, m. daily; Satiirday afternoons and Simdays excepted. Classes of cases cared for: Surgical, medical, and tuberculous. HILTON See South Orange. JERSEY CITY Board of Health, School Nursing Department. Established in April, 1907. Number of nurses : Two. Salary: $60 per month. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, contagious, tuber- culous. Plan of Work: The nurses treat the children in the schools, fol- lowing out the physician's orders, and visit excluded pupils to see that they are receiving proper treatment, or to explain the doctor's orders, and show the mothers how to carry them out. Board of Health, Visiting Nurse Department. Established in January, 1905. Number of nurses: Two. Salary: $60 per month. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. Plan of Work: Calls are received from the City Hospital, Free Dispensary, and all the city physicians. LAKEWOOD Visiting Nurse Association of Lakewood, Fourth Street. Established September 25, 1906. Number of nurses: One. Salary: $85 per month; horse and carriage, and furnished house. Hours: 8 a. m. to 6 p. m. Emergency calls are answered when- ever received. 162 NEW JERSEY Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: An unofficial committee of men and women carry on this work. It is sustained by contributions, the fees of patients, and by money received from entertainments given for this purpose. Milk, eggs, and other nourishment are supplied when the patients are unable to procure them in sufficient quantities. Bed linen, clothing, and other supplies are fur- nished when necessary. MADISON The Town Improvement Department of the Thursday Morn- ing Club, Visiting Nurse Committee, 67 Green Avenue. Established October 15, 1906. Number of nurses: One. Salar}': $75 per month. Hours: 9 a. m. to 8 p. m. Only emergency calls answered at night. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The nurse is assisted in her work by one of the committee who has had some experience in the Bureau of Char- ities of a nearby city. The aim of the friendly visitor is to help the patients or their families to help themselves. Medical treatment, food, clothing, and work have been secured through the co-operation of interested people. MAPLEWOOD (Old Short Hills) See Milburn. MILBURN The Neighborhood Association of Milburn Township. Established visiting nursing in March, 1904. Number of nurses: One. Salary: $800 per year and lodging. Hours: Irregular. One half holiday each week is given. 163 NEW JERSEY Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The township includes Wyoming, Short Hills, Chatham, White Oak Ridge, Springfield, Maplewood, and Old Short Hills. The nurse instructs a class of Italian and Polish women in the care of babies and in simple home nursing. A "Delicacies Committee" furnishes nourishment and delicacies for the sick and feeble. In the summer, ice and milk for sick babies are provided for needy families. A loan closet con- tains articles which may be borrowed only on the written order of a physician. Duplicate lists are made out, one of which is given to the doctor, and he is held responsible for the return of the articles in good condition. The nurse is allowed to make visits in the neighboring towns of Springfield and Maple- wood, upon payment of the usual fee. No free calls are made outside the township. MONTCLAIR The Montclair Colony of New England Women, 47 Park Street. Established visiting nursing January 5, 1905. Number of nurses: One. Salary-: From $65 to $80. Hours: Irregular. Emergency calls answered at night. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: Maternity bags are supplied for obstetrical cases. MOORESTOWN The Visiting Nurse Association. Established January 15, 1906. Number of nurses: One. Salary: $25 per month, with board, laundry, and one-half the amount of fees collected. Hours: 8 a. m. to 7 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. History and Plan of Work: June 15, 1906, the Current Events 164 NEW JERSEY Club formed a Visiting Nurse Department and engaged the Mt. Holly nurse for a part of the time, to carry on the work in Moores- town. In September, 1907, an independent association was formed with the approval of the Ciurent Events Club, and a nurse was engaged who could devote her entire time to the Moorestown district. The township has appropriated money on two occasions for surgical supplies, and gave $50 towards running expenses for 1909. The association loans sick-room appliances, bed linen, etc. when necessary. MT. HOLLY The Woman's League, 12 Union Street. Established visiting nm-sing January 9, 1905. Number of nurses: One. Salary: $50 per month, and one-half the fees collected after neces- sary expenditures for medicines, etc. are deducted. All fees collected at night belong to the nurse. Hours: 8 a. m. to 7 p. m. Only emergency calls from physicians answered at night. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: A charge of $.10 a visit is usually made for ordi- nary cases; $5.00 for obstetrical cases for the nurse's services with the physician at time of birth, and as many subsequent calls as necessary. A loan closet is maintained for necessary supplies, and nourishment is given when needed. NEWARK Joint Committee for the Better Care and Feeding of Infants, 12 Academy Street. Established visiting nursing in July, 1908. Number of nurses: Two. Salary: $60 per month. Hours: About eight hours. Classes of cases cared for: Improperly fed and sick infants only. Affiliations: The Babies' Hospital; Associated Charities; Visiting Nurse Association ; Newark Social Settlement. 1G5 NEW JERSEY History and Plan of Work: In 1893, Dr. Henry L. Coit organized the first "Pure Milk Movement," and through his efforts the Babies' Hospital Milk Dispensary modifies milk for sick babies. Later, the Joint Committee was formed. There are now five milk stations in Newark, at the Babies' Hospital, The Bethany Dispensary, The Canal Street Playgrovmd, The Newark Social Settlement, and the Newton Street Playground. These sta- tions are in charge of two trained nurses. The nurses distribute the milk at the stations, visit and instruct the mothers in the homes, and keep statistics. When possible, a small price is charged for the milk. Ladies' Benevolent and Missionary Society of the North Re- formed Church. Established visiting nursing December 8, 1906. Number of nurses : One. Salary: $55 per month. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, and tuberculous. Plan of Work: The nurse's services are given almost wholly to the sick poor in the parish. Clothing and food are supplied when necessary. The Visiting Nurse Association, Charities Building, 10 Academy Street. Established November 15, 1902. Number of nurses : Five. Salaries: $65 to $80 per month. Hours: Eight daily. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: The State Society for the Prevention of Tuberculosis and the Mutual Aid Association of a large department store. Plan of Work: In addition to the regular visiting nursing, special interest is taken in the tuberculosis work. Circulars of in- struction have been published by the association and distrib- uted among the patients. The State Society for the Preven- 166 NEW JERSEY tion of Tuberculosis refers all patients to the Visiting Nurse Association. The nurses report to the Board of Health all houses requiring disinfection after death or removal of patients, and the board supplies all disinfectants needed for daily use. A day camp was started in the summer of 1908 at Arsdale Terrace in the Vailsborough district. This is under the super- vision of the Visiting Nurse Association, and one of the staff is in charge. Milk and eggs may be supplied, also drugs, sick-room appli- ances, invalid chairs, cots, paper napkins, and many luxuries that would otherwise be beyond the patients' means. Two of the day nurseries are visited by the nurses three times a week, and in 1905 arrangements were made with a large department store to care for their employes when ill. The Mutual Aid Association of the store pays the visiting nurse association $.25 a visit. NEW BRUNSWICK The Visiting Nurse Association of New Brunswick, 147 Bay- ard Street. Established in July, 1907. Number of nurses : One. Salary: From $40 to $60 per month. Hours: 8 a. m. to 6 p. m. Emergency calls answered whenever received. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. Affiliations: The Jersey Blue Chapter of the Daughters of the American Revolution. Plan of Work: Ten tents are available for tuberculosis patients. Sputum cups and warm clothing are provided for very needy cases. The medical inspector of the public schools refers all sick pupils to the visiting nurse. The Board of Health has supplied a thoroughly equipped bag for the care of contagious patients. A "lending outfit" is maintained for the use of those in extreme need. An arrangement has been made with the firm of Johnson and Johnson, manufacturers of Red Cross 167 NEW JERSEY supplies, whereby all cases of illness among their employes or their families are reported to the nurse and cared for by her. There is a dispensary fully equipped with surgical instruments and supplies, where the nurse is in attendance certain hours several days in the week, and a physician is always on call. The association expects to have in the near futiure a modified milk station, and a day camp for sick babies. ORANGE Anti-Tuberculosis Committee, 124 Essex Avenue. Established visiting nursing in 1905. Number of nurses : One. Salary: $75 per month. Hours: 9 a. m. to 5 p. m. Plan of Work: The nurse attends the tuberculosis clinics at the Orange Memorial Hospital and Dispensary, follows up the patients in their homes, and visits the patients referred to her by private practitioners. The committee gives no relief, but refers all cases needing aid to the proper agencies. The bed patients are cared for by the Nurses' Settlement; extra nour- ishment is given by the Diet Kitchen; the Bureau of Charities gives financial assistance; while patients who cannot be cared for at home are transferred to the tuberculosis pavilion of the Orange Memorial Hospital. Patients living at home are instructed, and, if necessary, they are provided with outfits for living out-of-doors. These outfits may be loaned or given away. The nurse distributes paper bags and napkins, sputum cups, and printed instruc- tions; she helps the patient to carry out the treatment ordered by the physician, and to improvise arrangements for sleeping out-of-doors. Both porches and tents are used for this purpose. Notification of removal or death is sent to the health depart- ment, and disinfection is carried out by that body. Public lectures have been given by the committee, and its general educational work has been supplemented by the state tubercu- losis exhibit which was held for a week in Association Hall. A day camp is hoped for in the near future. 168 NEW JERSEY Board of Education, School Nursing Department. Started experimentally April 24, 1906; established as a department of the Board of Education, Sept. i, 1906. Number of nurses : Two. Salaries: Supervisor, $775 per year; assistant, $650 per year. Hours: 9 a. m. to 3:15 p. m. Classes of cases cared for: Surgical, medical, contagious, and tuberculous. History and Plan of Work: April 24, 1906, the Board of Educa- tion offered to pay a member of the Nurses' Settlement $25 per month during the remaining part of the school year to spend three half days each week in visiting the public schools. The experiment was so successful, that the work was taken over by the Board of Education, and at the beginning of the fall term the same nurse was appointed to the official position of school nurse, under the administration of the Board of Education. In September, 1908, an assistant was appointed. There is no regular medical inspection in the schools. The nurses in- spect the children of the kindergartens and higher grades, attending to minor surgical dressings, and finding eye and skin diseases which need attention. After school hours the nurses visit the homes, recommend medical care, and instruct the mothers; or, if necessary, they accompany the children to dis- pensaries or specialists for treatment of eyes, or throat, fitting of glasses, removal of adenoids, enlarged tonsils, etc. Visiting Nurses' Settlement, 24 Valley Street. Established September i, 1900. Number of nurses: Three. Salaries: $50 and all living expenses for head worker; $20 and all living expenses for the students. Hours: 9 a. m. to 5 p. m. Emergency calls answered at night. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: Pupil nurses from the Orange Memorial Hospital started this work, each pupil having two months' training under supervision of the trained nurses of the settlement. In 1906, 109 NEW JERSEY graduate nurses were substituted for undergraduates, and the settlement was ready to furnish hourly nursing for non-con- tagious cases to those who could afford to pay the regular schedule prices, or the best trained assistance was at the com- mand of those who could pay but little or nothing. There are also resident nurses who take private cases at regular prices. The nurse employed by the Anti-Tuberculosis Committee is a member of the household, and gives much of her valuable time to the work of the settlement. During the year 1906 the public school teachers sent so many children to the settlement's First Aid room that the head worker was led to call the attention of the Board of Health to the fact, and she offered to permit one of the settlement nurses to visit the pupils in a small number of schools. The work was so successful that the nurse received the appointment as school nurse for the following year. A Simmons College graduate dietitian is the housekeeper of the settlement; salary $40 per month, and all living expenses. She conducts private classes in the diet kitchen of the settle- ment, the fees from which go to the settlement. She also has classes in tv\^o hospitals. She modifies milk and has charge of the milk dispensary. A loan closet provides clothing and supplies for the sick and needy. St. Barnabas' Guild rents one room in the settlement which is devoted to the use of tired nurses needing rest and freedom from care. A late development of the settlement work is the course in visiting nursing which is open to graduates of recognized schools. There are four terms of three months each: the spring term, lasting from March to June; the summer term, from June to September; the fall term, from September to December; the winter term, from December to March. The training consists of practical nursing in the homes under supervision of the head worker. Experience is given in medical, surgical, and obstet- rical cases and care of chronic invalids; preparation for and attendance at operations in private homes; home care of tuber- culosis patients, which includes the planning for the out-door 170 NEW JERSEY life of the patients on roofs, piazzas, and in tents. A course of six lessons in dietetics is given by the dietitian, and lectures on visiting nursing are given in all but the summer term. PATERSON The Visiting Nurse Settlement, 85 Prospect Street. Established June 20, 1907. Number of nurses : One. Salary: $70 per month. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. History and Plan of Work: Visiting nursing was started under the auspices of the Visiting Nurse Committee of the Charity Organ- ization Society. In October, 1908, this committee raised sufficient money to open the present settlement house, and in December of that year the work was withdrawn from the Charity Organization Society. A First Aid room is maintained; sick diets, bed linen, surgical and medical supplies are furnished when necessary. The nurse also cares for the patients of the Tuberculosis Society. Volimteer help is given by the Guild of St. Barnabas nurses, and friendly visiting is done by lay visitors on the nursing com- mittee. Families visited by the nurse are given preference for admission to clubs and classes at the settlement. PLAmriELD City Union of King's Daughters, 104 Madison Avenue. Established visiting nursing in 1895. Number of nurses: One. Salary: $15 per week. Hours: Irregular. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: Milk, eggs, and medicines are provided when necessary. A supply closet furnishes clothing, bed linen, infants' outfits, and sick-room appliances. A camp for sick 171 NEW JERSEY babies is maintained in summer, and when vacancies occur, yoimg children are taken in. The nurse makes daily visits to the King's Daughters' day nursery, and investigates all appli- cants before they may be admitted. PRINCETON Princeton Village Improvement Society, Visiting Nurse Com- mittee, 25 Bayard Lane. Established in 1901. Number of nurses: One. Salary: $75 with room, light, and fuel in the nurse's house. Hours: Irregular; calls answered at all times. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work : The society provides a small house for the nurse, one room in which is fitted up for emergency patients. They are cared for by the housekeeper during the nurse's absence. A charge of $4.00 a week is made for the use of the emergency room. The nurse answers calls only on the order of a physician. She visits the Model School once in two weeks to examine the school children. A supply closet is maintained with clothing, bed linen, and sick-room appliances which may be loaned, rented, sold or given to patients, at the discretion of the nurse. Nourishment and medicine are supplied to needy patients. Fees of $.10, $.25, or $.50 are charged for visits of an hour, at the discretion of the attending physician. Other charges are: operations including preparation of patient and room, $2.00; confinement cases including eight subsequent visits, $3.00; massage, $1.50 for each treatment. For loaned articles, $.05 or $.10 a week is charged; sheets, $.25 per dozen; towels, $.10 per dozen. RIDGEWOOD Ridgewood Relief Association. Established May 10, 1909. Number of nurses: One. Salary: $50 per month. 172 NEW JERSEY Hours: 9 a. m. to 5 p, m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. SOUTH ORANGE Society for Lending Comforts to the Sick, 7 South Orange Street. Established visiting nursing in 1895. Number of nurses : One. Salary: $75 per month and house rent. Hours: Irregular: emergency calls answered at night. Wednes- day afternoons and one Sunday each month free. Classes of cases cared for: Surgical, medical, and obstetrical. Plan of Work: A loan closet is maintained, with all kinds of appliances for the sick room, medical supplies, bed linen, cloth- ing, etc. Linen and clothing may be given away when needed. A special "delicacies committee" furnishes broths and nourish- ing food. The nurse does a great deal of "follow-up" work, and keeps in touch with her patients long after her nursing visits have ceased, finding work for them and helping them in many ways. Calls are made to neighboring villages. West Orange, Maplewood, Springfield, Union, Hilton, Wyoming, and Irvington. A minimum fee of $10 is charged for obstetrical cases, with daily calls for nine days following; $2.00 for operations, includ- ing preparation of the room and patient. Daily visits are $1.00 per hour, or patients who are unable to pay these prices may be charged $.10 an hour, but the collection of fees is left to the dis- cretion of the nurse. SUMMIT Visiting Nurse Association. Established in December, 1904, by the Fortnightly Club. Number of nurses: One. Salary: $7 5 per month. Hours: 9 a. m. to 5 p. m. Emergency calls are answered at night. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The nurse has bed linen, clothing, and infants' outfits to lend. 173 NEW YORK TRENTON Pi Gamma Epsilon Society, 138 Allen Street. Established visiting nursing in May, 1907. Number of nurses: One. Salary: $40 per month and all expenses. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: A loan closet furnishes bed linen, clothing and sick-room appliances. The nurse has a small fund at her dis- posal, with which she buys medicine and nourishment for very needy patients. Sputum cups and paper napkins are given to the tuberculosis patients who cannot buy them in sufficient quan- tities. The nurse gives talks to mothers' clubs on hygiene and infant feeding. A small fee is charged all patients who can pay. UNION See South Orange. WEST ORANGE See South Orange. WHITE OAK RIDGE See Milbum. WYOMING See Milburn. NEW YORK ALBANY The Albany Guild for the Care of the Sick, 390 Madison Avenue. Established a visiting nursing service in 1896. Number of nurses: Seven. Salaries: $40 per month for three probationary months, and $50 per month thereafter. After two years' continuous service from the end of the probationary term, the nurses receive $60; at the end of the fourth year the salary is raised to $65 and $70 per month. Five dollars monthly is allowed for carfare. The 174 NEW YORK nurses' home is provided, but board and laundry are paid for individually. Hours : Irregular. Calls are answered day and night. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. History and Plan of Work: This association was organized in 1880 as a Fruit and Flower Mission. In 1896 the name was changed to the present one, and a visiting nurse was assigned to the Albany Hospital Dispensary. As the work grew, other nurses were detailed to the South End and Faith Mission dis- pensaries. In 1897, the nursing part of the work was made a separate department of the guild, and more nurses were added. In 1900, an obstetrical service was started experimentally in connection with the Medical College; the college faculty desired to provide instruction for students of medicine and nursing, and the guild wished to check untrained midwifery by providing skilled care for the sick. In 1903, the entire responsibility of this department was assumed by the guild. In the same year a diet kitchen was opened experimentally, which a year later gave the nurses an opportunity to board at the Guild House; this was the beginning of a central home for the nurses and the diet kitchen staff. The latter provide delicacies for the sick, conduct cooking classes for nurses in hospital training, and for the Girl's Friendly societies. The guild has developed a course for trained attendants or "domestic nurses" which offers the applicants two and one-half years of work in the care of the sick under a capable graduate nurse. The training consists in lectures from physicians, studies from text-books, and helping with minor surgical cases at one of the dispensaries and in the obstetrical clinic. At the end of the time, if the pupil's practical work has been good, and she has passed the required standard in her examinations, she is given a certificate which declares her to be a certified guild nurse. This allows a maximum charge of $15 a week. When a patient needs constant care, an attendant is sent to work under the supervision of the visiting nurse. The services of one nurse are given to patients who are re- 175 NEW YORK ferred to the guild by the Tuberculosis Dispensary. Milk, eggs, and sputum cups are provided for those who cannot buy them. The patients and their families are carefully instructed by the nurses, and a tuberculosis class is held weekly at the Guild House. A sliding scale of fees permits the head nurse to adapt prices to the ability of the patients to pay. No charge is made to the very poor. To others, calls may be made for $i.oo per day, if the time does not exceed two hours. From $2.00 upwards may be charged for operations, and from $5.00 to $10 for ma- ternity cases. Charges are made for baths, surgical dressings, etc., at the rate of $.50 or $1 per hour. AUBURN The Fanny G. Aderson Visiting Nurse, Auburn City Hospital, 3 Lansing Street. Established in 1903. Number of nurses: One — pupil. Salary: None. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. History: A trustee of the hospital gave a memorial fvmd to start the visiting nursing work. It is carried on by the pupil nurses. BREWSTER District Nursing Association of Southeast. Established November 17, 1907. Number of nurses: One. Salary: $65 per month. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The town of Southeast includes a number of vil- lages, of which Brewster is the principal one. Patients who are able to do so are asked to pay a fee for the nurse's services. The charges are from $.10 to $.50 an hour; for night duty 176 NEW YORK $2.00; and for operations, $5.00. The nurse has charge of a supply chest, and a small sum is asked for each article loaned. BROOKLYN Abraham and Straus, Fulton Street. A Social Welfare Department was organized in January, 1905. Number of nurses: One. Salary: $15 per week. Hours: 9 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, contagious, and tuberculous. Plan of Work: A superintendent has charge of the various social branches; a nurse cares for the sick, and a physician makes daily rounds. A simny rest room, where temporarily ill employes may be cared for, is furnished with couches and easy chairs, a medicine closet containing simple remedies, and a library of good books. Hot nourishing lunches are served at a minimum cost. Much thought is given to helping the employes in every way. When incipient tuberculosis patients are found among them, they are sent away by the firm to regain their health. Upon their return some light employment compatible with their strength is given them. Committee on the Prevention of Tuberculosis, 69 Schermerhorn Street. Plan of Work: Three tuberculosis classes are held under the super- vision of this committee. The patients of these classes are visited either by the nurses of the District Nursing Committee, or by volunteer visitors, according to the condition of the patient. District Nursing Committee of the Bureau of Charities, 67 Schermerhorn Street. Established in 1890. Number of nurses: Thirteen. Salary: $75 per month. 12' 177 NEW YORK Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: Four nurses on the staff live in the neighborhood of their work and are in residence at the following settlements: Asacog House, 52 Sands St. Greenpoint Settlement, 85 Java St. City Park Chapel, 209 Concord St. Lincoln Settlement, 105 Fleet St. The last is a colored ntirse working among her own people. Other nurses have headquarters as follows: School Settlement Association, 148 Northern Office of Bureau of Chari- Jackson St. ties, 255 Division Ave. Little Italy Neighborhood House, Bedford Office of Bureau of Chari- 146 Union St. ties, 1660 Fulton St. Willow Place Chapel, 27 Columbia South District, 18 Fourth St. Place. Central Office, 67 Schermerhorn St. (three nurses). ■ Each nurse is at her office daily — Sundays excepted — from 12 m. to I p. m., for receiving new calls, for consultation, and for First Aid dressings. During the summer, extra nurses are taken on for work among babies under two years of age. These nurses supplement the regular work in connection with the milk stations established by the Brookl)Ti Children's Aid Society. Friendly House Association, 49 Warren Street. Established visiting nursing in December, 1905. Number of nurses : One. Salary: $65 per month. Hoxu"s: Irregular. Classes of cases cared for: Surgical and medical. Plan of Work: Friendly House is a settlement which aims to de- velop the social, intellectual, artistic and physical side of the neighborhood. Those who desire the privilege of any depart- ment must become members of the settlement as a whole. Indi- vidual dues are $.50 a month. Family dues are $.75 for two members and $1.00 for three or more. This gives admission 178 NEW YORK to class work and social activities, according to the age of the member, that may be carried on daily throughout each week. It also entitles each member to the services of a doctor, den- tist, or trained nurse. The nurse is a resident of the house and may be seen at all times. The doctor has office hours at the settlement two evenings and one afternoon each week; he is paid a salary to insure regular attendance. When the doctor's services are needed outside of office hours, he responds to calls. He does not answer calls from people who are not members of the house, unless a regvdar fee is paid. The dentist has office hours at the settlement one afternoon and one evening during the week. A diet kitchen is maintained by the house; also a First Aid room where the nurse assists physicians in minor operations, such as the removal of tonsils, adenoids, etc., and attends to surgical dressings for patients able to be up and about. Frederick Loeser and Company, 482 Fulton Street. Established a social service niu-se in 1899. Number of nurses: One. Hours of duty: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The nurse cares for the employes in the store and visits in the homes those who are ill. Methodist Episcopal (Seney) Hospital, Social Service Out- patient Department,* 6th Street and 7th Avenue. Established May i, 1909. Number of nurses: One. Salary: $45 and all living expenses at the hospital. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The nurse visits tb.e patients in their homes from 9 to 12 a. m., and is in attendance at the dispensary from i to 5. *Work discontinued. 179 NEW YORK St. Phoebe's Mission House, 125 De Kalb Avenue. Established visiting nursing in 1883. Number of nurses : One. Salary: $4.0 per month and maintenance. Hours: 9 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: Episcopal chiurches of Brooklyn. Plan of Work: A physician is in attendance at the house two after- noons each week for free consultation. The house is supported by the Episcopal churches of Brooklyn, and maintains a con- valescent department for women and girls, where patients dis- charged from the hospitals but still in need of a trained nurse are cared for until ready to take up their regular occupations. BUFFALO District Nursing Association of Buffalo, 631 White Building. EstabHshed in 1892. Number of nurses: Six. Salaries: From $50 to $60 per month and uniforms. Hours: 9 a. ra. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. Plan of Work: An endowment fund pays part of the salaries. One nurse devotes her entire time to tuberculosis work. She is assigned to the tuberculosis dispensary' at 165 Swan Street, and visits all patients who apply there for treatment. A second nurse specializes on contagious diseases. She receives $75 per month and uniforms. A diet kitchen is maintained which fur- nishes milk and eggs to patients unable to get them elsewhere. Tuberculosis Dispensary of the Charity Organization Society, 165 Swan Street. Established visiting nursing in December, 1907. Plan of Work: The District Nursing Association gives the ser- vices of a trained nurse who attends the dispensary clinics, and 180 NEW YORK visits the patients in their homes. Milk, eggs, sputum cups, etc. are furnished to all who need them. Welcome Hall, 404 Seneca Street. Established in November, 1894. Number of nurses : One. Salary: $60 per month, with an annual sum of $50 for uniforms. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: First Presbyterian Church. History and Plan of Work: Welcome Hall is a settlement founded by the First Presbyterian Church; a nuise has been in residence from the beginning. Office hours at the settlement are from four to five daily, Sundays excepted. Milk, eggs, meat, fruit, drugs, and garments are furnished to those in need. A small fee is charged when patients are able to pay. The nurse keeps in touch with the probation and truant officers, sees that children report at court, or return to school after illness, and explains the Child Labor law and other laws to the parents. Through her influence the Syrian women of the neighborhood have largely given up the custom of strapping their babies to a board for the first six months of life. Westminster House, 424 Adams Street. Established visiting nursing in 1896. Number of nurses : One. Salary: $60 per month. Hours: Irregular; emergency calls answered at all times. Sundays are free from duty and one half day each week. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Pkm of Work: The expenses of the nurse and of the diet kitchen are defrayed by the Women's Parish Society of Westminster Church. The diet kitchen furnishes milk, eggs, soups, jellies, and fruits for patients who need them. ISl NEW YORK CASCADESVILLE See Lake Placid. EAST IRVmGTON See Irvington. ELMIRA Visiting Nurse Association. Established in 1901. Number of nurses : One. Salaty: $50 per month. Hours: 5 a. m. to 9 p. m. Classes of cases cared for: Surgical, medical, contagious, and tuberculous. Plan of Work: The nurse has bed linen, clothing, and sick-room appliances to loan. GENEVA Geneva Committee for the Prevention of Tuberculosis,* 502 Main Street. Established September i, 1908. Number of nurses: One. Salary: $60 per month. Hours: 9 a. m. to 5 p. m. Plan of Work: The nurse's work is largely among tuberculous patients, but medical cases also are cared for. GLOVERSVILLE Gloversville District Nurse Association. Established June i, 1908. Number of nurses: One. Salary: $40 per month and all expenses. Hours: 12 m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. * This committee has not replied to late communications. 182 NEW YORK Plan of Work : The nurse lives at the Nurses' Home of the Nathan Littauer Hospital. All patients needing other than professional care are referred to the churches. GRAND VIEW See Nyack. IRVINGTON Irvington Visiting Nurse, 6 Home Place. Established July i, 1909. Number of nurses: One. Salary-: $75 per month. Hours: 9 a. m. to 4 p. m. Night calls answered only in emer- gencies. Classes of cases cared for: Surgical, medical, and obstetrical. Plan of Work: A loan closet furnishes sick-room appliances, bed linen and clothing. Milk and eggs are supplied when necessary. A small fee is asked of all who are able to pay for the nurse's services. JAMESTOWN Woman's Christian Association Hospital, Visiting Nurse Department. Established in 1892. Number of nvurses: One — pupil. Hours: Irregular. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: A philanthropic resident of Jamestown pays the hospital $350 annually to have a pupil nurse on call whenever needed to visit patients outside the hospital, LAKE PLACID The Visiting Nurse Fund. Established November 26, 1902. Number of nurses: One. Salary: $60 per month. 183 NEW YORK Hours: Irregular, as the territory covered is a large one. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. Plan of Work: This work is under the auspices of the Moun- taineer Circle of King's Daughters. There are five villages in the district: Averyville, Cascadeville, Lake Placid, Newman, and North Elba. The fees for the nurse's ser\-ices are: For non-residents, for 24 hours $3.00 " residents, " 24 " 1.50 "12 " 75 " 6 " SO Short visits are made for fees varying from $.05 to $.25. MOUNT KISCO The District Nursing Association of Northern Westchester County. Established in 1896. Number of nurses: Four. Salaries: $65 and $70 per month. Hours: Irregular. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: The association has the use of endowed beds in the following hospitals in New York City: Presbyterian Hospital, 3 beds; St. Luke's Hospital, 3 beds; Woman's Hospital, i bed; Seney Hospital, Brooklyn, i bed. Through the kindness of friends, patients may also be admitted to free beds in the Hahne- mann, German, and St. Mary's Childs' Hospitals, St. Andrew's Convalescent Home, and the Loomis Sanatorium. History and Plan of Work: In 1896, Miss Ellen Morris Wood, a graduate of Johns Hopkins Hospital, started visiting nursing in the vicinity of her home at Mt. Kisco. Upon the outbreak of the Spanish-American War a Red Cross auxiliary was formed, which gave good service during the war, and on November 15th. 1898, it was reorganized as a District Nursing Association^ In addition to the central committee, sub-committees in the 184 NEW YORK neighboring villages were formed to deal with "Hospitals and Nursing, Instruction, Supplies, Ways and Means." Nurses were at first engaged individually whenever calls were received for their services. Lectures were given by Miss Wood in the public schools and to the townspeople on home nursing, first aid to the injured, hygiene, physiolog}-, etc. In July, 1899, Miss Wood gave up the work on accovmt of impaired health, and sailed soon after for Europe. She con- tracted typhoid fever while caring for a sick sailor on the vessel, and died from the disease. In 1900, the association started a fund called the Ellen Morris Wood ^Memorial Fund, the interest of which was to be applied to the maintenance of one or more resident visiting nurses in villages of Northern Westchester County. There are now four of these nurses. One has her headquarters at Mt. Kisco, her district comprising the villages of Mt. Kisco, Bedford Station, and Bedford Village. Another, located at Pleasantville, visits Chappaqua, Hawthorne, Sherman Park, and Valhalla. A third, with headquarters at Golden's Bridge, visits Katonah, Purdy's Station, Croton Falls, Somers, Lake Waccabuc, Cross River, and South Salem. The fourth nurse started in October, 1908, at Yorktown Heights. Her district covers the villages of Crumpond, Croton Lake, and Amawalk. For long distances the nurses use the railroad. Carriage hire is paid either by the family of the patient or by a subcommittee. The subcommittee of each village has charge of all local relief work, and maintains a supply closet stocked with bed linen, clothing, and sick-room appliances, which may be loaned or rented to the patients. Special nurses are engaged by the committees when permanent nursing care is needed. Families able to pay for untrained helpers may obtain them through the registry kept by the visiting nurse of their district. These women receive from $7.00 to $15 a week, according to their ability and experience. The Mt. Kisco committee takes up various matters of public hygiene, and' the one at Pleasantville conducts a Girls' Evening Club and a Children's Afternoon Sewing Class. 185 NEW YORK NEWBURGH Visiting Nurse Society, 109 Johnson Street. Established in 1897. Number of nurses : One. Salarj': $60 per month, house and board. Homrs: Irregular. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: A special effort is made to look after school chil- dren requiring attention for adenoids, eye, ear, and nose troubles. The work is afiSliated with all the churches of New- burgh. A supply closet is maintained, and bed linen and cloth- ing are loaned or given to needy patients. Nourishment, med- icines, and sputum cups are provided. NEWMAN See Lake Placid. NORTH ELBA See Lake Placid. NEW ROCHELLE New Rochelle Visiting Nurse, New Rochelle Hospital. Established December i, 1907. Number of nurses: One. Salary: $75 per month. Hovirs: Irregular. Classes of cases cared for: Surgical, medical, and obstetrical. NEW YORK The Association of Tuberculosis Clinics of the City of New York. The Association is the outgrowth of an experiment undertaken by the Committee on the Prevention of Tuberculosis of the New York Charity Organization Society, to demonstrate the possi- bility of effective home treatment of tuberculosis in New York City. Later a separate organization was formed, composed of 186 NEW YORK the representatives of ten special tuberculosis clinics, having as its purpose the ultimate dispensary control of the disease. The city has been districted, and patients are required to attend the clinic in tlie district in which they live. When application is made to the wrong clinic, the patient is referred by card to the right one. Patients receive free medical treatment and advice, and are visited in their homes by trained nurses. When neces- sary, milk and eggs are provided by some clinics as part of the treatment; clothing, payment of rent, and other relief is either provided by special fvmds administered by the dispensary nurse, or through charitable organizations. Hospital and sanatorium care is secured for those who need such treatment. Bellevue, Gouvemeur, Vanderbilt, and the Health Department clinics have women's auxiliaries which raise funds for the relief of needy patients attending their clinics, and maintain day camps on ierry boats in connection with Bellevue, Gouverneur, and the health department. The Red Cross Society maintains a day camp on the roof of Vanderbilt Clinic. Following is a list of the dispensaries, their addresses, the hours they are open, and the number of tuberculosis nvurses connected with each: Bellevue Hospital Clinic, Foot of East 26lh Street; weekdays, i to 3 p. m.; 5 visiting nurses. Flower Hospital Clinic, E. Boulevard and 63d Street; Monday, Wed- nesday, Saturday, 2:30 to 3:30 p. m.; i visiting nurse. German Hospital Clinic, 76th Street and Park Avenue; weekdays, 3:30 to 4:30 p. m.; Tuesday, Friday, 8 p. m.; i visiting nurse. Good Samaritan Clinic, 75 Essex Street; weekdays, 2:30 to 4:30 p.m.; 1 visiting nurse. Gouverneur Hospital Clinic, Gouverneur Slip; Monday, Wednesday, Friday, 2 to 4 p. m.; i visiting nurse. Harlem Hospital Clinic, 136th Street and Lenox Avenue; weekdays, 2:30 to 3:30 p. m.; I visiting nurse. Health Department Clinic, 55th Street and 6th .Avenue, weekdays, q a. m. to 12 m., 2 to 4 p. m.; Thursday, 8 to 9 p. m.; 7 visiting nurses. Morgagni Clinic, 173 W. Houston Street; Tuesday, Thursday, Saturday, 3 to 4 p. m.; I visiting nurse. Mt. Sinai Hospital Clinic, Madison Ave. and looth St.; weekdays, 10 to II a. m.; 3 visiting nurses. New York Dis[)ensary, 180 Grand Street; weekdays, 11 a.m. to 12:30 p. m.; I visiting nurse. New York Hospital Clinic, 8 West 16th Street; weekdays, 2 to 3:30 p. m.; 2 visiting nurses. 187 NEW YORK New York Throat, Nose & Lung Hospital Clinic, 229-231 E. 57th Street; weekdays, 3 p. m. and 8 p. m.; i visiting nurse. Presbyterian Hospital Clinic, 70th St. and Madison Avenue; weekdays, 1:30 to 3 p. m.; 3 visiting nurses. St. Bartholomew's Clinic, 215-217 E. 42nd Street; Tuesday, Thursday, Saturday, 1 130 to 2 130 p.m.; 4 visiting nurses. St. Luke's Hospital Clinic, Amsterdam Ave. and 113th Street; Monday, Friday, 2 to 3 p. m.; 2 visiting nurses. St. Vincent's Hospital Clinic, 153 W. nth Street; Monday, Wednesday, Friday, 10 to 11 a. m.; i visiting nurse. Vanderbilt Clinic, 60th St. and Amsterdam Avenue; weekdays, i to 2:30 p. m.; Monday, Wednesday, Friday, 9 to 10:30 a. m.; 4 visiting nurses. The Babies' Hospital of the City of New York, Lexington Avenue and 55th Street. Established visiting nursing in January, 1907. Number of nurses: One. Salary: $75 per month. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, and tuberculous. Plan of Work: The nurse assists in the dispensary, follows up pa- tients who have been discharged from the hospital, and visits in the homes the children who attend the Out-Patient Depart- ment. She teaches the mothers how to care for their children, and arranges to send patients to the country and to convalescent homes. Baptist Deaconess' Society of the City of New York. Head- quarters, Amity Church Settlement, 312 West 54th Street. Established visiting nursing November 8, 1S95. Number of nurses: Six. Hours: Ten. Calls answered at night. Classes of cases cared for: Surgical, medical, obstetrical, conta- gious, and tuberculous. Plan of Work: This is an auxiliary of Amity Baptist Church. The work is carried on in connection with the Dispensary. The deaconesses receive their training as nurses in one of the regular hospitals of the city. Their work is voluntary, and they are given their support in the home, with a small allowance, suflicient to cover incidental expenses. A supply closet fur- 188 NEW YORK nishes bed linen, clothing and sick-room appliances, which may be loaned or given away. A small hospital is also maintained at Amity House. Bellevue Hospital, Social Service Bureau, East 26th Street. Established July 9, 1906. Number of nurses: Four. Salaries: $100 per month for executive secretary; $75 without main- tenance, or $50 and maintenance for assistant nurses. Hours: 9 a. m. to 5 p. m. daily; Saturday afternoons and Smidays excepted. History and Plan of Work: In 1906, an experiment was inaugurated by the trustees of this hospital, in which a graduate nurse, Miss Mary E. Wadley, was appointed to supplement the treatment of the medical and surgical patients, by making a systematic investigation of their needs beyond the ti'eatment given in the wards or dispensary. Other nurses were added from time to time, and in May, 1909, the social service work was re-organized. The Social Service Bureau was created, to include the tubercu- losis as well as all other similar divisions of the work. The work is under the general direction of the hospital au- thorities. The support of the relief fund is undertaken by an executive committee, which acts also in an advisory capacity. It is composed of two trustees of the hospital, two members of the board of managers of the Bellevue Training School for Nurses, the general medical superintendent of the hospital, the general superintendent of the training schools, and the chairman of each sub-committee which may be formed for special work in the future. The Social Service Bureau is under the management of Miss Wadley, who has full direction of all the practical work of the bureau; she is knov/n as the executive secretary. Three assist- ant nurses do general work, one nurse specializes on babies' diseases, and seven are on the tuberculosis staff. The Ladies' Auxiliary of Bellevue Hospital furnishes one nurse who cares for tuberculous patients in the wards and in the dispensary. The Red Cross Association gives the salary of one nurse for the lu- 189 NEW YORK berculosis clinic. The social service section of the Free Syna- gogue cares for the Jewish patients who are treated at the hos- pital. The duties of the nurses are to visit the wards, to learn the needs of each patient, and then, using the various channels of relief in the city, endeavor to meet those needs as far as possible. The assistance rendered is almost as varied as the causes of sick- ness and incapacity. It may be only good advice, or a communi- cation v/ith distant friends that is necessary; or it may be the securing of admission to convalescent or inciurables' homes, and taking the patients there when ready to go. This is one of the largest fields of the nurses' labors so far. Clothing, which is often a necessity, is supplied. Convalescent babies and children are sent to the seashore and country. Country boys and young men are carefully looked after upon discharge, and positions are found for them; if necessary, money is loaned to them until their first pay-day comes. An emergency fund may be drawn upon when the need is iu"gent, or when the charitable societies fail to respond. There are many problems connected with immigrants. Their friends are communicated with, steamship tickets are exchanged, assistance is sometimes secured through their consuls, work is found for them, etc. Some of the most difficult problems of all are those connected with the alcoholic, psychopathic, and prison wards, as the co- operation of the patient must first be won. Then follows the need of help such as the other patients require. In short, no kind of assistance is foreign to this department that is within the bounds of possibility to render, or that will promote recovery and insure permanent health. A post-graduate course has been open to a limited number of students in this department since January, 1909. Bellevue and Allied Hospitals, Out-Patient Department, Tuber- culosis Clinics, East 26th Street. Established visiting nursing in December, 1903. Number of nurses : Eleven. 190 NEW YORK Salaries: $90 per month for supervisor and head nurse of day camp; $75 without maintenance or $50 with maintenance for assistant nurses. Hours: 9 a. m. to 5 p. m. Class of cases cared for: Tuberculous. History and Plan of Work: The visiting of tuberculosis patients who were attending the special clinics of the Out-Patient depart- ments was begun by the pupil nurses under the supervision of a graduate nurse. Later this work was given up to graduate nurses. There are seven graduate nurses in the work at Bellevue, three at Gouverneur Hospital, and one at the Harlem Hospital. The clinics are held at Bellevue Hospital every week day from I to 4 p. m.; Children's Clinic, Tuesdays and Saturdays at 2 p. m. ; Gouverneur Hospital, Mondays, Wednesda3^s and Fridays at 2 p. m. At each hospital these patients have a separate room, with attending physicians and trained nurses. The latter assist at the clinics and visit the patients in their homes. Printed slips are distributed which explain the nature of the disease, method of infection, and general treatment. Milk and eggs are given, on the physician's prescription, to all who are unable to pay for suflScient quantities. Sputum cups and paper napkins are supplied; clothing, tents, and reclining chairs are furnished. All patients who can go are sent to day camps which are main- tained on two ferry boats, one moored at the foot of East 26th Street, and the other at the foot of Jackson Street. They are fitted up to accommodate both sexes and all ages, and are open from 9 a. m. to 5 p. m. Hot dinners are served at noon, and lunches of milk and eggs at 10 a. m. and 4 p. m. The Department of Education supplies a public school teacher for the children who attend the day camp at 26th Street, and regular school sessions are held, enabling the pupils to keep up their studies and at the same time take the open-air rest cure. Bethany Church Mission of Broadway Tabernacle, 455 Tenth Avenue. Established visiting nursing in March, 1907. Number of nurses: One. 191 NEW YORK Salary: $85 per month. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: This work was started through the interest of a parishioner, who bears the entire expense, and confides the direc- tion of it to the Broadway Tabernacle. Bed linen, clothing, food, and supplies of all kinds are either loaned or given to patients. Bethlehem Chapel, 196 and 198 Bleecker Street. A City Mission nurse has her headquarters at the chapel, visits the sick members of the parish, and also answers calls that may come to her from the neighborhood. Bloomingdale District Nurse Association, Bloomingdale Clinic of St. Michael's Protestant Episcopal Church, 225 West 99th Street. Established visiting nursing May i, 1905. Number of nurses: One. Salary: $75 per month. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, and tuberculous. Afl&liations: There is close co-operation with the Charity Organiza- tion office of the district. Plan of Work: The headquarters of the nurse are in the parish house of St. Michael's Church, but the organization which employs her is not parochial; it represents the neighborhood. Calls are received from other churches in the vicinity. When necessary, trained attendants are engaged to stay with patients who require care at night, and all kinds of supplies are furnished for the nurse to use at her discretion. Money is given for eye- glasses and medicines, clothing and sick-room appliances, while nourishment, flowers, etc. are freely given. Tlie nurse does a great deal of Fresh Air work in summer, and is able to send her patients to convalescent homes throughout the year. Tubercu- losis patients are sent to Liberty, and women and children need- ing special care to Sea Breeze. 192 NEW YORK Caroline Rest Fund, Under the auspices of the New York Associa- tion for Improving the Condition of the Poor, 105 East 22nd Street. Established visiting nursing in 1907. Number of nurses: Three. Salary: $75 per month. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Medical and obstetrical. Plan of Work: A sum of money given by Mr. George H. F. Schrader in memory. of his mother, and called the Caroline Rest Fund, supports three visiting nurses whose special work is to instruct mothers, before and after their confinement, in the proper care of themselves and their babies. Daily lessons are given in bathing the baby, in the preparation of its food, in sterilizing milk bottles, and in the care of the ice-chest where the milk is kept. The mothers are taught to sterilize water for the baby to drink, to make barley water, to prepare boracic water with which to cleanse the child's mouth after feeding, and bathe the eyes. They are taught how to irrigate the infant's bowels when necessary, and to wash the baby's clothing and their own. Later, all mothers who can leave home are sent to Caroline Rest at Hartsdale, New York, for convalescent care and further education. Daily instruction is given by a trained nurse in all the subjects which the mothers have been taught by the nurse in the city, and the lessons are repeated day after day as long as the mother remains at the Rest. Cooking teachers go up from the city twice a week to give them cooking lessons. The kitchen, bed-rooms, and laundry, are used for giving instruction. The visiting nurses in the city visit the mothers upon their return from Caroline Rest, and give further instruction if it is needed. Charity Organization Society, United Charities Building, 105 East 22nd Street. Established a visiting nurse department in 1895. Number of nurses: Seven. Salaries: $7 5 and $60 per month. Hours: 9 a. m. to 5 [). m. 13 193 NEW YORK Classes of cases cared for: Surgical, medical, obstetrical, contagious, and tuberculous. Plan of Work: The nurses are assigned to the district offices of the Charity Organization Society, and attend to all cases of illness that may be reported to the office or found in the course of the work of the districts. The offices are situated as follows: 369 East 145th St. Bronx District 316 West 42nd St. Chelsea District 127 Chrystie St. Corlears District 105 East 22nd St. Gramercy District 59 Morton St. Greenwich District 15 East 125th St. Harlem District 1947 Broadway Hudson District 68 Manhattan St. Riverside District Through the affiliation with the district offices, the nurses are enabled to obtain any relief needed for the patients luider their care, provide clothing and nourishment, and secure entrance for them into convalescent homes. Children's Aid Society, School Nursing Department, 105 East 22nd Street. Number of nurses: Three. Hours: 8 :3o a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, contagious, and tuberculous. Plan of Work : This society employs three nurses for the following three schools which are under its supervision: 224 W. 63rd Street; 350 East 88th Street, and 630 Sixth Street. They visit and give professional care to the pupils. The Delineator Company started May i, 1909, a special Hne of work which is called the "Delineator Mothers' Conference," which sends visiting nurses to the following six schools: Jones Memorial, 407 East 73rd Street; Henrietta, 224 West 63rd Street; West Side, 417 West 38th Street; Italian, 156 Leonard Street; Phelps, 314 East 35th Street, and Pike Street, 28 Pike Street. The remaining schools under the auspices of the Children's 194 NEW YORK Aid Society have City Mission nurses, or are visited by the regular school staflf under the Board of Health. Minor dressings are attended to and treatments given in the school buildings under the direction of the medical inspectors. Visits are made in the homes, and nursing care is given to any member of the family who may be ill. Christ Church (Presbyterian) affiliated with the Brick Church, 334 W. 36th Street. Established a visiting nursing department in July, 1901. Number of nurses: One. Salary: $100 per month. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The nursing service is intended primarily for the congregation of Christ Church and the famiUes represented in the Sunday School and clubs, but cases reported from the neighbor- hood are also attended to. A tuberculosis class organized in November, 1906, was the first to be formed in New York City. Each patient keeps careful records of his daily life, the number of hours spent out of doors, amount of sleep taken, how many eggs are eaten, how much milk is taken, etc. For the out-of-door life, patients utilize roofs and balconies whenever possible. In 1908, a part of the roof of Christ Church was fitted up for a small day camp for those living nearby and not having access to suitable roofs. Nourishment is provided for these patients, outfits for taking the open-air treat- ment are loaned or given away as the case demands, and milk and eggs are supplied when necessary. Sewing has been given several of the patients to do, for which they receive compensation. It is hoped to extend this method of helping them. Christ Lutheran Church, 406 E. 19th Street. Established visiting nursing in connection witli its parish work in November, 1897. Number of nurses: One. 195 NEW YORK Salary: Deaconess' allowance and all expenses. Hours: Irregular. Classes of cases cared for: Surgical, medical, obstetrical, and tuber- culous. Church of the Incarnation, 240 East 31st Street. Established visiting nursing in October, 1894. Number of nurses: One. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The nurse assists the parish physician at his dis- pensary clinic three times a week. The remaining time is spent in caring for the sick people belonging to the chapel, the children of the day nursery, and such other cases in the neighborhood as may be called to her attention. Church of the Sea and Land, Henry and Market Streets. Established visiting nursing in 1893. Number of nurses: One. Salary: $60 per month. Hours: Irregular. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. History and Plan of Work: Visiting nursing was started in connec- tion with this church by a New York City Mission nurse. At first the service was limited to members of the parish. In January, 1898, a nurse was taken into residence at the church settlement, 52 Henry St., and general visiting nursing among the sick of the neighborhood was begun. The work grew so rapidly that in the spring of 1899 an affiliation with the Nurses Settlement was effected, the latter taking all calls east of Rutgers Street. In March, 1900, the work was wholly given over to the supervi- sion of the latter organization, and two nurses were maintained at the Church House, the church paying the salary of one nurse, and the Nurses Settlement the other. All calls were answered whether from parishioners or otherwise. 196 NEW YORK In the fall of 1905 the Church House was given up, and the parish resumed control of its own nurse, who now combines the work of nurse with that of parish visitor. There is a First Aid room in the church building, open daily from 3:00 to 4:30 p. m. Bed linen, clothing, and sick-room appliances are kept on hand to loan or give away as needed. The Delineator's Mothers' Conference,* Butterick Building. Established visiting nursing April i, 1909. Number of nurses: Eight. Salaries: Superintendent, $125 per month; assistants, $50. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, contagious, and tuberculous. History and Plan of Work: At the Congress of Mothers held in New Orleans in February, 1909, a National Department of Child Hygiene was instituted to deal with infant mortality, the birth-rate, the dependent child, the physical welfare of the school child, other problems of child life, and the education of mothers in child hygiene to prevent disease. Through the efforts of The Delineator, it is hoped that mothers' conferences on the care of babies will be organized in every city in the United States. The work has been started in New York, Philadelphia, Chicago, New Orleans, Providence and thirty other smaller cities. In New York, The Delineator has engaged eight nurses who work in connection with the Children's Aid Society schools and the New York Diet Kitchen. Visits are made in the homes and classes for mothers are held in the following school buildings: Jones Memorial 407 E. 73rd St. Madison Square Church House ..Cor. 3rd Ave. and 30th St. Pike Street 28 Pike St. Italian 156 Leonard St. 63rd St 224 W. 63rd St. West Side Vi9 W. 38th St. Riverside 259 \V. 6qth St. Physicians are present to weigh and examine children and to lecture on the proper care and feeding of infants and young •This work was carried on one year only. 197 NEW YORK children. The nurses interest themselves in all members of the families they visit, send people to convalescent homes, or put them in touch with other organizations which might benefit them. Careful records of all cases are kept. The records in- clude the social factors affecting families, the physical progress of mothers and babies, daily and weekly reports of the nurses' work and records of institutions assisting. Department of Health, Contagious Nursing,* 55th St. and 6th Ave. Established May 26, 1903. Number of niu-ses: Two. Salary: $75 per month. Hours: 9 a. m. to 4 p. m. Class of cases cared for: Contagious. Plan of Work: The nurses live in their own homes and go each morning to a house near the Contagious Hospital that has been fitted up for their use. There they change their street dresses for uniforms, go out on their rounds, and returning in the late afternoon again, leave at the house all external clothing, dress, boots, wraps, and nursing bags. These are taken to the disin- fecting plant of the hospital, and are sterilized during the night and returned in the morning. The nurses visit patients having scarlet fever, diphtheria, measles, whooping cough, etc. Nursing care is given each patient, and the parents are instructed in the care of the eyes, nose, and skin, the proper method of isolation and disinfection, the dangers of complications, and the manner in which contagion may be spread. The nurses carry in their bags white cotton gowns which they put on before caring for the patient, and remove before leaving the house. These gowns are disinfected with the other articles each night at the hospital. Department of Health, Division of Child Hygiene (School Nursing), Sixth Avenue and 55th Street. Established visiting nursing October i, 1902. Number of nurses: 141. *This service discontinued. 198 NEW YORK Salaries: Superintendent, $i2cx3 per year; assistants, $900. Hours: 9 a. m. to 5 p. m.; Saturday afternoons and Sundays excepted. Classes of cases cared for: Surgical, medical, contagious, and tuberculous. History and Plan of Work: The system of public school nursing in New York City was started October i, 1902, at the instigation of the Henry Street Settlement (Nurses' Settlement), which made the experiment for the city, then turned it over to the Department of Health. The settlement gave the services of one of its nurses. Miss Lina L. Rogers, to visit daily for a month four of the large schools in the crowded East Side. At the end of that time the results of the experiment were so satisfactory that the Department of Health assumed charge of the work. Miss Rogers was en- gaged as supervisor, having at first a staff of twelve nurses visiting in forty-eight schools. This was the first system of school nursing established in America under municipal control. The work grew rapidly, more nurses were added to the staff, and in 1908 it reached the number of 206. Four hundred and sixty- two public schools with an enrolment of 606,325 pupils are visited by the nurses, who in addition visit parochial schools, American Female Guardian Society schools, Children's Aid Society schools, and kindergartens. Each nurse is assigned to a certain district in which the number of schools varies according to the density of the population. She reports at each school daily at a specified time. In a room set apart for the purpose, she receives all children who have been ordered to go to her for treatment. WTien possible they are assembled in groups and instructed orally or by means of cir- culars which explain methods of home treatment, particularly for pediculosis. The nurses carry out in the schools certain treatments ordered by the medical inspectors, and after school hours they take children to dispensaries, visit the homes of those who have been excluded, instruct the mothers when necessary, and explain the medical inspector's advice. At the weekly routine inspection the nurse visits the classrooms, and examines the eyelids, skin, and throat of each pupil. If 199 NEW YORK cases are found showing symptoms of diphtheria, scarlet fever, measles, whooping cough, chicken pox, or mumps, the nurse on her own responsibility excludes the child, if the inspector is not in the school to confirm the diagnosis, and telephones to the central office the name and address of the pupil. A medical inspector is then sent to the home and takes entire charge of the case. The nurses send to the supervising nurse daily and weekly reports. During the summer months, while the schools are closed, the nurses are assigned to "Summer Corps" work. They visit systematically the mothers of all newly-born children whose births have been reported by midwives. They investigate in each case the condition of the mother during and after labor, and note any abnormality in either mother or child, particularly the occurrence of abnormal labor, the use of instruments by the midwife, etc. As regards the child, the nurse notes the presence of malformations or other abnormalities and of ophthalmia neonatorum. Whenever unusual conditions are found to exist, the nurse reports the facts to the office, and the conduct of the midwife in the case is investigated. The mothers are instructed as to the proper care, feeding, bathing, and clothing of the children. After July ist, the nurses begin a systematic canvass of all tenements in their districts, for the purpose of visiting the mothers of all children under two years of age and instructing them in the general care and hygiene of their children. When there are older children in the families, the mothers are instructed in the care of their scalps and teeth. The work of the nurses is pre- ventive and educational. When a sick baby is found and there is no physician in attendance, the case is reported to the office and a medical inspector is detailed to treat the baby, while the nurse continues her care. The Department of Health maintains one hospital and two dispensaries for the treatment of trachoma. A dispensary is situated at Gouverneur Slip and a hospital and dispensary at the corner of ii8th Street and Pleasant Avenue. All cases of 200 NEW YORK trachoma not under the care of a private physician, are referred by the medical inspector or school nurse to these hospitals and dispensaries. All applicants for positions on the school nursing stafiE of the Department of Health must be registered nurses, and must have passed the Civil Service examinations. Department of Health, Division of Communicable Diseases. Established visiting nursing in September, 1904. Number of nurses: 24. Salary: $75 per month. Hours: 9 a. m, to 4 p. m.; Sundays excepted. Class of cases cared for: Tuberculous. Plan of Work: The staff is divided into district and clinic nurses; under the latter head there are 14 nurses — six in Manhattan, six in Brooklyn, and two in the Bronx. Some are on duty in the tuberculosis clinics of the Department of Health from 9 a. m. until 4 p. m,; others visit these patients in their homes, and submit full reports to the clinic physicians. These nurses visit also the applicants for admission to the Sanatorium at Otisville, Orange County, New York, which can be gained only through the Department of Health. The railroad fares of all accepted patients are paid, and clothing is supplied when necessary. In the district division there are 10 nurses who are assigned to each borough office, four in both Manhattan and Brooklyn, and one each in the smaller boroughs. Their duties are to visit and advise tuberculosis patients who are not under the care of private physicians or attending tuberculosis clinics having nursing staffs. Sputum cups and paper napkins are supplied to all who need them. Fumigation of the rooms upon the termination of a case, is ordered by the nurse. Complaints from citizens are investi- gated and if necessary forcible removal to a hospital is recom- mended. Emanuel Chapel, 737 E. 6th Street. EstabUshed visiting nursing in 1901. Number of nurses: One. Salary: $75 per month. 201 NEW YORK Hours: Irregular. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The nurse's work is largely confined to the parish- ioners of the chapel, many of whom live at a great distance from it. The nurse's territory therefore extends to Harlem, the Bronx, and Brooklyn. Bed linen and clothing are given when necessary. Nourishment of milk and broths is sometimes given to indi- vidual cases. The soups and broths are made by the nurse, who has also a small emergency fund to use for patients who are in great need. Flower Hospital, 63rd Street and Avenue A. Established a Social Service Department March 8, 1909; estab- lished visiting nursing for the senior pupils June i, 1909. Number of nurses: Two; one a pupil. Salary: $25 per month and all living expenses for the Social Service nurse. Classes of cases cared for: Surgical, medical, and tuberculous. Plan of Work: Sputum cups are suppHed for the tuberculous patients, and tickets for milk from the Diet Kitchen. German Hospital and Dispensary, Park Ave. cor. 76th Street. Established visiting nursing April, 1908. Number of nurses: One. Salary: $80 per month. Hours: 8 a. m. to 4 p. m. Class of cases cared for: Tuberculous. Plan of Work: The nurse attends day clinics, and evening classes on Tuesday and Friday from 7 to 8 p. m. for patients who work during the day. Special diet is given to patients in need of extra nourishment; those too ill to attend the clinics are given nursing care at their homes. Suitable cases are sent to country and sanatoria, and instruction is given in open-air treatment. Patients are urged to utilize tents on the roofs of tenements, and to live out of doors. 202 NEW YORK Good Samaritan Dispensary, Tuberculosis Clinic, 75 Essex St. Established visiting nursing April 19, 1909. Number of nurses : One. Salary: $75 per month. Hours: 9 a. m. to 5 p. m. Class of cases cared for: Tuberculous. Plan of Work : Many patients who attend this clinic are sent to the day camp which is maintained on a ferry boat moored at the foot of Jackson Street. All these patients are given a hot dinner at noon, and lunches in the morning and afternoon. Patients unable to go to the day camp are given free milk tickets. Halsey Day Nursery, 227 East 59th Street. Plan of Work: The visiting nurse connected witli St. Thomas's House, 229 East 59th Street, visits the day nursery every day, and gives professional care to the children. Harlem Hospital,* Visiting Nurse Department, 136th St. and Lenox Avenue. Established July, 1905. Number of nurses: One. Salary: $75 per month. Hours: 8 a. m. to 5:30 p. m. Class of cases cared for: Tuberculous. Plan of Work: The nurse attends dispensary clinics and visits patients in their homes. Milk and eggs are supplied to poor patients when necessary, by the hospital. Henry Street Settlement (Nurses Settlement), 265 Henry Street — Main Office. ^Established July i, 1893. Number of nurses: 50. Salaries: $60, first 3 months; $70, following 9 months; $75, second and third years; $80, fourth year; $85, fifth year. Hours: 9 a. m. to 6 p. m. No calls are made after 6 p. m. Each nurse has one entire day free every week, and one month's vacation with full salary after each year of service. *This hospital has not replied to late communications. 203 NEW YORK Classes of cases cared for: Surgical, medical, obstetrical, minor contagious, and tuberculous. History and Plan of Work: The nurses' ser^ace is one department of a general social settlement that was founded by a trained nurse, Miss Lillian D. Wald. The plan of the settlement was from the first based upon a belief in the value of district nursing in conjunction with other social work as a means of increasing the knowledge of real conditions in the poorer sections of the city, and for providing first hand information with which to stimulate efforts for further improvement of social conditions. An independent, non-sectarian visiting nursing service has been established by the settlement for the people of New York. The nurses live in the districts in which they work, in order that their identification with the neighborhood and its problems may be complete. The founder and her associate lived for two years in a tenement; at the expiration of that time a house was taken, and other nurses and social workers, men and women, joined them. From time to time as the settlement activities have expanded, other houses or parts of houses have been acquired for the accommodation of the residents, and for the organizations and other social features of the settlement. The nurses live in the houses owned by the settlement in Henry Street and in East 79th Street, and in branches in other parts of the city. Some of them maintain small households of their own in tenement houses, or are in residence in other social settlements in the districts in which they work. In connection with the nursing service. First Aid rooms are maintained, where a nurse is in attendance during the daytime to perform minor surgical dressings and give much needed advice. Several convalescent homes belonging to the settlement are in charge of nurses on the staff; three of these are open all the year, one in the summer only. Special funds have been established for engaging night nurses for extremely ill patients where the family can pay in part only or not at all, and for buying extra nourishment or other necessary supplies. Loan closets furnished with sick-room appliances, bed linen, clothing, sputum cups, paper napkins, disinfectants, 204 NEW YORK etc., are maintained in each district. Charwomen may be employed at the discretion of the nurse for cleaning the rooms of their patients and for laundry work. There is a special staff for the obstetrical service, and steril- ized dressings are supplied for each case. A branch house is maintained in East 79tli Street. In the colored section of tlie city, nurses belonging to the general staff have their headquarters, and work among their own people professionally. They also help other workers to develop social activities in the neighborhood through clubs and classes. The system of public school nursing in New York City, the first established by any municipality in America, was begun in 1902 at the instigation of the settlement, which made the experi- ment for a month for the city. The initial steps in the nursing of contagious diseases in the homes were also taken by the settle- ment for the Department of Health, which now maintains a small staff of nurses for that branch of work. The more experienced nurses in the settlement take part in public duties to a large extent. Two are on the New York State Board of Nurse Examiners under the State Department of Education, for registration of hospital graduates. Others are on the lecturing staffs of the School of Philanthropy, the Hospital Economics Course at Teachers' College, and act on Tuberculosis Committees and the Department of Health " Committee on the Summer Care of Children." The head worker and founder of the settlement is a member of both national and state Child Labor committees, and participates in many other movements which deal with large social interests. Each nurse on the staff is assigned to a given district. Some of these are quite small, particularly in the congested quarters of the city, making it possible to give more time to the individual case. Two or more visits a day are made to all patients who need frequent attention. Calls are accepted from all sources. When one comes from a family where there is no physician in attendance the nurse secures one through private or public charities. The patients pay from S.io to $.25 a visit when able to do so. The nurses do not wear a formal uniform, but they have 205 NEW YORK garments suitable to their work, — plain washable dresses, simple hats and coats, and in bad weather, a short woolen skirt. A milk station is maintained in Henry Street, where a high grade of milk is sold. This is sent to the settlement from a gentleman's private dairy, and is intended only for patients who are in special need of pure, rich milk. The price charged is the same as that paid for ordinary bottled milk in the neighborhood. Those who are unable to pay for it have tickets given them by the visiting nurses or by agents connected with philanthropic societies. No bottles are given without tickets. Dr. Hill's Maternity Clinic, 216 East 76th Street. Established visiting nursing November i, 1908. Number of nurses: Three. Hours: 9 a. m. to 6 p. m. Class of cases cared for: Obstetrical. House of Aquila, 130 Stanton Street. Established visiting nursing in September, 1908. Number of nurses: One. Salary: $25 per month and expenses. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical and medical. Affiliations: Protestant Episcopal City Mission Society. Plan of Work: The nurse looks after the children in the day nursery connected with the house. They are examined daily, and when absent or ill the nurse visits and cares for them in their homes. Junior Sea Breeze — Open Air Camp, Under the Auspices of the New York Association for Improving the Condition of the Poor, 64th Street and East River. Established visiting nursing in June, 1906. Number of nurses: Four. Salary: $65 per month, laundry and carfare. Hours: 9 a. m. to 5 p. m. Class of cases cared for: Medical. History and Plan of Work: This is an activity which is carried on onlv during the summer months. It was started in the summer 206 NEW YORK of 1906, when the association erected five vvooden shacks each equipped for tv\'elve sick babies, who were given regular hospital care, and also two large tents overlooking the river where mothers could take their babies, and where the older children also were made welcome. The Department of Education maintained a vacation school near the tents for the children who were old enough and well enough to attend. A physician was there daily from g a. m. to 5 p. m. to give personal attention to the sick children. A visiting nurse followed up all cases that were brought to the association, and urged mothers of sick babies to take them for advice and care to Junior Sea Breeze, or to a hospital. The babies were taken in for the day or were kept for continuous hospital treatment. In the following summer, the 19th ward, which lies between 39th and 90th Streets, Fifth Avenue and the East River, was selected as a field for an active campaign among the babies and young children. Twenty-three nurses were engaged to make house-to-house visitations, to give advice and instruction to mothers, and to urge them to take their sick children for treat- ment to Junior Sea Breeze, or to a hospital. In some instances convalescent babies needing further professional care were sent with their tired mothers from Junior Sea Breeze to the Fresh Air Home at Coney Island, thus completing their cure. Since 1908, a physician has been in residence each summer subject to call both day and night, and in 1909 the visiting nurs- ing force was enlarged. This camp was planned primarily as an instrument to prevent disease and each year works toward this end, with an evergrowing effectiveness. R. H. Macy's Mutual Aid Association, 34th Street and Broadway. Established social welfare nurses in September, 1904. Number of nurses: Three. Hours: 8:30 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. Plan of Work: The nurses care for employes, or for patrons wlio may be taken ill in tlie store. They also visit sick emj)loyes in 207 NEW YORK their homes. A physician is in attendance at the store three days in the week from 9 to 11:30 a. m., and is subject to call by telephone whenever he may be needed, Madison Square Church House, Third Avenue and 30th Street. Established visiting nursing in connection with the religious and social work of the church in 1900. Number of nurses : One. Salary: $60 per month. Hours: Eight hours. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: Clinics are held on Mondays and Thursdays at the Church House. A physician is in charge, assisted by the nurse. The latter also has a class in home nursing on Tuesday evenings during the winter. Manhattan Maternity and Dispensary, 327 East 60th Street. Established visiting nursing February 16, 1905. Number of nurses: Three; sometimes four — pupils. Hours: 7 a. m. to 7 p. m. with two hours off daily, and half of Sunday. Class of cases cared for: Obstetrical. Plan of Work: A free nursing service was established in 1905 in connection with the Out-Patient Department. The stafif is composed of pupils from several hospitals, who receive their obstetrical training here. Uniforms for tenement house service are supplied by the hospital. The pupil nurses work in the homes of the patients under the direction of a supervising nurse. Clothing for mothers and babies, food and fuel, may be given in emergency cases only. When necessary, charitable societies are called upon to give relief. Manhattan Visiting and Instructive Nurses' Association, 239 East 14th Street. Established in February, 1906. Number of nurses: Two. 208 NEW YORK Salary: From $50 to $75 per month. Hours: 7 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. Plan of Work: Mothers' meetings are sometimes held, and instruc- tion given in the details of ordinary nursing care. Clothing and bed linen kept on hand to loan or give away. Milk tickets, malted milk, and other nourishment given to needy patients. Margaret Bottome Memorial,* The King's Daughters' House in Harlem, 216 East 128th Street. Established visiting nursing on July i, 1902. Number of nurses: One. Salary: $50 and room. Hours: 10 a. m. to 5 p. m. Emergency calls answered at night. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. History and Plan of Work: This is a settlement named for the founder of "The King's Daughters and Sons." The nurse is a resident of the house; her district extends from looth Street to 135th Street, and from Fifth Avenue to the East River. Office hours are kept by her daily from i to 2 p. m., when patients able to be about, go for dressings and aid of all kinds. Nourishment, clothing, and sick-room appliances are supplied when necessary. The work is largely among women and children, obstetrical calls predominating. Ministering Guild, 515 Lexington Avenue. Established in 1895. Number of nurses: One. Hours: Eight hours. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: This work is a private philanthropy oirried on by a small number of women, who supply all necessary funds. * A visiting nurse no longer in residence. 14 209 NEW YORK Morgagni Clinic, 173 West Houston Street. Established visiting nursing in November, 1908. Number of nurses : One. Salary: $60 per month. Hovirs: 7 a. m. to 7 p. m. Class of cases cared for: Tuberculous. Plan of Work: The nurse attends clinic on Tuesday, Thursday, and Saturday mornings from 10 to 12; the remaining time is spent in visiting the patients in their homes. Sputum cups, gauze handkerchiefs, and disinfectants are furnished to all who are unable to buy them. Mt. Sinai Hospital, Social Welfare Department, Fifth Avenue and looth Street. Established visiting nursing in 1890. The Social Welfare Depart- ment was organized in July, 1907. Number of nurses: Five; one a senior pupil. Salaries: Supervisor, $80 per month; assistant, $65 per month and board. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. History and Plan of Work: For several years the senior pupils of this hospital have had training in visiting nursing, one pupil at a time being detailed for the service. In 1907, a Social Welfare Department was started with a graduate nurse in charge. The work grew rapidly, and in 1909 assistant nurses were added to the staff. Supervision of the visiting pupil nurses was trans- ferred to this department, and the instruction adds greatly to the value of the training given to the undergraduates. The nurses visit the wards, learn the needs of the patients who are about to be discharged, then visit the families to ascer- tain home conditions and what chance there may be for conva- lescent care. They send patients to convalescent homes and tuberculosis sanatoria. Arrangements are made with the var- ious relief societies for help of all kinds, and employment may be found for those needing work. 210 NEW YORK Patients awaiting admission to the hospital are visited also, and nursing care is given until they can be admitted to the wards. When necessary, temporary financial assistance, rail- road transportation, and clothing are furnished. Braces and surgical appliances are supplied, which may be paid for wholly or in part. All bottle-fed babies discharged from the hospital are visited in the homes, and instructions are given to the mothers regarding the preparation of food and the proper care of the child. National Biscuit Company,* 15th Street, 9th and loth Avenues. This factory has had a Social Service nurse for some time. There is an emergency room where she attends to minor surgical dressings, and slight illnesses. She also gives the employes lessons in general hygiene. The New York Association for Improving the Condition of the Poor, 105 East 22nd Street. Established visiting nursing in 1906. Number of nurses: Five. Salary: $75 per month. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. Plan of Work: Two of the nurses visit the people who have applied for aid, and who are reported by the district visitor to be ill. General nursing care is given to all who need it. Mothers are instructed in child feeding and simple hygiene. Patients are sent to convalescent and country homes. A supply closet furnishes bed linen, clothing, and sick-room appliances. These may be loaned or given away, according to the needs of the patients. In 1908, a system of home visiting was organized, in connec- tion with various children's dispensaries. This was the result of the educational movement which was started at Junior Sea Breeze, and it was intended to prevent the repeated recurrence of diseases among children who had been once cured. This * No answers received to late communications. 211 NEW YORK was especially necessary in cases due to improper feeding, and the need had been long felt of following the after course of patients whose illness was due to bad home conditions. A visiting nurse was engaged, therefore, to attend the Children's Department at BeUevue. She assisted the physicians in the dispensary, visited the babies in the wards, and followed them to their homes to continue the treatment and to correct unfavorable home conditions as far as possible. The association now has three nurses engaged in this work, and has inaugurated a similar service at the University and Bellevue Medical Clinic, at New York Hospital, at Roosevelt Hospital, and at the Vanderbilt Clinic. The New York Colored Mission, 225 West 30th Street. Established visiting nursing in 1899. Number of nurses: One. Salary: $25 per month. Hours: Four daily; Sundays excepted. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. Affiliations: Friends' Church. Plan of Work: Food, clothing and other supplies are given when needed. New York Dispensary, 145 Worth Street. Number of nurses: Two. Hours: 9 a. m. to 4 p. m. Salaries: $75 per month. Classes of cases cared for: Surgical, medical, and tuberculous. Plan of Work: Milk is sometimes given to needy patients. The New York Hospital, West 15th Street. Established visiting nursing in March, 1907. Number of nurses: Two. Salary: $75 per month, lunches, and carfare. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, and tuberculous. Plan of Work: One nurse attends the tuberculosis cUnics and visits 212 NEW YORK the patients in their homes. She teaches the families the neces- sary precautions in guarding against infection, and instructs the patients how best to effect their cure. Special diet is pro- vided and sputum cups are given to all who cannot afford to buy them in sufficient quantities. The second nurse attends the children's clinics, visits these patients, and follows up those who have been discharged from the hospital wards. She sends patients to convalescent homes, supplies necessary clothing, crutches, etc., and sees that all necessary surgical appliances are obtained through other channels. New York Infirmary for Women and Children, 321 East 15th Street. Established visiting nursing in connection with the Out-Patient Department, in 1902. Number of nurses: One — pupil. Classes of cases cared for: Surgical, medical, contagious, and tuberculous. Plan of Work: Each pupil nurse has two months' training in this work, under supervision of the women physicians connected with the Department. Social Service Department November i, 1908, a graduate nurse was engaged to follow up patients discharged from the hospital, or those attending the Out-Patient Department who needed other than professional care. Patients are sent to convalescent homes, children are placed in institutions, sent to the country, etc., and employment is found for those needing work. New York Milk Committee, Under the Auspices of the New York Association for Improving the Condition of the Poor, 105 East 22 nd Street. Established visiting nursing June i, 1908. Number of nurses: Nine. Salary: $75 per month. Hours: 9:00 a. m. to 5:00 p. m. Classes of cases cared for: Infants under two years of age. 213 NEW YORK Plan of Work: June 17, igo8, the New York Milk Committee opened seven milk depots to supply milk for infants. They were under the supervision of trained nurses and volunteer physicians who instructed the mothers in classes. Special stress was laid upon the desirability of giving the babies mothers' milk rather than bottled milk, and no mother was permitted to buy bottled milk until a physician had determined that she was unable to nurse her baby. From ^ cent to 2^ cents were charged for each bottle. People who could not afford to pay for the milk were given financial assistance by the New York Association for Improving the Condition of the Poor, or by other relief societies. Seven of the nurses were assigned to certain districts; they began by interesting the physicians of the neighborhood in the work, and securing their services for conducting the consulta- tions. The nurses were given the names and addresses of all babies in their districts whose births had been recorded within the three previous months; the babies were visited and the mothers invited to attend the mothers' classes at the milk depots, where physicians were present to examine the children and give talks on the proper care and feeding of infants. The work was more largely preventive than curative, and it has been continued up to the present time. Systematic records are kept of each child; it is weighed each time it is taken to the depot, and notes are made of intestinal disturbance or other illness, and of the kind of milk used. Facts showing medical and social conditions affecting the life of the child are kept also, and a strong hold has been secured upon the mothers by the careful follow-up work of the nurses. There are two nurses not connected with depots who give most of their time to home visiting, and instructional work. The addresses of the milk depots in charge of visiting nurses are: 202 Henry Street 246 East 82nd Street 244 Mulberry Street 146 West looth Street 73 Cannon Street 412 West 47th Street 434 East 73d Street 214 NEW YORK New York Orthopedic Dispensary and Hospital, 126 East 59th Street. Established visiting nursing March 21, 1899. Number of nurses: Four, tliree of whom are pupils. Salary: $35 per month and all expenses. Hours: 8:30 a. m. to 5:30 p. m. Classes of cases cared for: Tuberculous and orthopedic. Plan of Work: The nurses' visits are confined to the patients who are under the care of the dispensary surgeons. Only ortho- pedic cases, and children with tubercular joints are cared for. The mothers are instructed in the general care of the children, and they are taught how to adjust the braces and to do what- ever else may be necessary. No fees are charged; dressings are supplied by the dispensary. WTien special relief is neces- sary, the family is referred to the proper agency. New York Throat, Nose, and Lung Hospital, 229 E. 57th Street. Established visiting nursing in November, 1908. Number of nurses: One. Hours: i p. m. to 5:30 p. m. Plan of Work: The nurse visits her patients before and after clinic hours. Milk is supplied to needy patients through the New York Diet Kitchen. The Presbyterian Hospital, Visiting Nurse Department, 70th Street and Madison Avenue. Established in 1904. Number of nurses: Six — three are senior pupils. Salary: $75 per month for the graduate nurses. Hours: 8:30 a. m. to 5 p. m. Every third Sunday free from duty. Classes of cases cared for: Siugical, medical, and tuberculous. Plan of Work: The Presbyterian Hospital was one of the first in New York City to establish a visiting nurses' service. A grad- uate nurse supervises this department, and directs the work of the pupils. The course is elective during the third year, and lasts for two months; only those students who have special 215 NEW YORK interest in this branch of nursing take it up. One afternoon each week is allowed for classes and lectiires. A special uniform and a fully equipped bag are supplied by the hospital. Each nurse has a district assigned to her and also a part of the office work, keeping of records, etc. The patients visited are those who attend the dispensary, and those who are dismissed from the wards at an early stage of convalescence in order that room may be made for patients more in need of hospital care. A loan closet supplies bed linen, and sick-room appliances. Several physicians and surgeons volunteer to visit patients who are not able to go to the dispensary, and cannot afford a private doctor. Tuberculosis work was done in the beginning by the pupils, but after several months' trial the students were found inade- quate for this service, largely because of the frequent changes in the staff, and a graduate nurse was engaged in December, 1905, to carry on this part of the work. Milk and eggs are supplied to needy patients by the Katie Geitz Kitchen at 519 East 76th Street, a branch of the Visiting Nursing Department. In May, 1907, a third graduate nurse was engaged to specialize on social service work, as had been done from the beginning by the instructor. Occasional visits are made at the request of outside physicians or social workers; the service, however, is almost wholly for the hospital patients. A fee of $.10 to $.25 is asked of those who can afford to pay. The money received in this way forms the Patients' Fund, and supplies nourishment, flowers, and fruit for very ill or needy patients. St. Bartholomew's Clinic, 217 East 42nd Street. Established a visiting nursing department February i, 1908, Number of nurses: Four. Salary: $35 per month, board and laundry. Hours: 9 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, and tuberculous. Plan of Work: This work is carried on under the auspices of St. Bartholomew's Church. 216 NEW YORK St. George's Church, Stuyvesant Square, East i6th Street. Established visiting nursing in connection with other activities of the Church in 1884. Number of nurses : One. Salary: $400 a year and all living expense at St. George's Deacon- ess' Home, 208 East i6th Street. Hours: Irregular. Emergency calls answered at night. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The nurse visits and gives nursing care to all parishioners who need her services. The top floor of the Deacon- ess' Home is fitted up for convalescent patients, and used by women and girls of the parish who have been in hospitals and who need a period of rest to enable them to return to their work. The nurse cares for these patients and helps to make their stay a pleasant one. When her professional duties permit, she has also certain social responsibilities in connection with the clubs and classes. St. Luke's Association of Grace Parish, Broadway and loth Street. Established visiting nursing in 1877. Number of nurses: One. Salary : $400 a year with board. Hours: Irregular. Classes of cases cared for: Surgical, medical, and tuberculous. Plan of Work: Grace Dispensary, 414 E. 14th Street, has a physician in charge and a nurse is in attendance during clinic hours, who visits these and other patients in their homes. St. Luke's Hospital, Cathedral Heights, 113th Street. Established visiting nursing December 18, 1908. Number of nurses: One. Hours: Irregular. Classes of cases cared for: Surgical, medical, and tuberculous. Plan of Work: Convalescent relief work is carried on in connection with the Out-Patient Department of the hospital. 217 NEW YORK St. Thomas' Chapel of St. Thomas' Church, 230 East 6oih Street. Headquarters of the nurse, St. Thomas' House, 229 East 59th Street. Established visiting nursing December 12, 1896. Number of nurses: One. Salary: $50 per month. Hours: About ten. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. Plan of Work: The nurse visits only the very poor of the parish who are not able to pay for her services. There are three parish doctors with whom she co-operates, and from whom she receives many of the calls. The Halsey Day Nursery, 227 East 59th Street, is also under her care. This she visits every day, and each child who enters the Industrial School and Kitchen Garden classes is examined. Society of the Lying-in Hospital of the City of New York, Second Ave., 17th and i8th Streets. Established visiting nursing in 1895. Number of nurses: Ten — pupils. Hours: Irregular. Calls are answered whenever received. Class of cases cared for: Obstetrical. Plan of Work: Nurses from many of the large hospitals of New York City, Brooklyn, Boston, Cleveland, Jersey City, Philadel- phia, Scranton, Pennsylvania, Norfolk, Virginia, Yonkers and Middletown, in New York, receive their obstetrical training at this hospital. They are given a certain part of the three months' service in visiting the patients in their homes. The pupils accompany the physician at the time of delivery, and give the mother and child ten days' after care. The Out-door Depart- ment of the Ladies' Auxiliary employs a visiting agent and seven cleaning women; and upon recjuest of the nurse or physician, the visitor will see that the patient's rooms are sys- tematically looked after and cared for during her illness. When necessary, clothing is supplied for mother and child. Milk, 218 NEW YORK coal, and groceries are given for two weeks, or longer, according to the condition of tlie mother and the family. Sunny-side Day Nursery, 221 East 104th Street. Established visiting nursing in connection with this work on March i, 1903. Number of nurses: One. Salary: $60 per month, and $5.00 for carfare. Hours: About eight hours. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. Plan of Work: The nurse cares for the sick children in their homes, takes those needing hospital care to the appropriate hospitals, and, upon their recovery, sends the patients to convalescent homes. She also attends to having glasses fitted for children who need them, and takes others to the Orthopedic Hospital for braces or special treatment. Nourishment, fuel and cloth- ing are supplied when necessary. United Relief Works, Society for Ethical Culture, 33 Central Park West. Established visiting nursing in April, 1879. Number of nurses: Three. Salary: $70 per month. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, contagious, and tuberculous. History and Plan of Work: This was the second society in the United States to undertake visiting nursing, and the first to organize it in a purely secular way. This was also the first visiting nursing work that was done in connection with public dispensaries. Miss Eflie R. Benedict, a graduate of the Belle- vue Training School, started the work at the German Dispen- sary in 8th Street, and later took it up at the Demilt Dispensary, 245 E. 23rd Street, corner 2nd Avenue. In 1883 she was "loaned" to the Chicago Ethical Society to aid it in organizing the work in that city, and remained there for six months. At 219 NEW YORK the end of that time she returned, leaving two nurses, one in the south side dispensary, and one in the west side, to carry on the work there. The New York Ethical Society now supports three nurses with headquarters at the Demilt Dispensary, 245 East 23rd Street, The Good Samaritan Dispensary, corner Essex and Broome Streets, and the Northern Dispensary, corner Christo- pher Street and Waverly Place. The nurses attend the clinics during certain hours of each day, and visit the patients in their homes. Each nurse has a loan closet furnished with bed linen, clothing, and sick-room appliances. They also have $5.00 a month each to use as an emergency fund for buying extra nourishment for their patients or whatever may be needed in special cases. Surgical dressings are supplied by the dispen- saries. Vanderbilt Clinic, Department of Visiting Nursing, 60th Street and Amsterdam Avenue. Established in 1902. Number of nurses: Five. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, tuberculous, and pediatrics. History and Plan of Work: The Presbyterian Hospital Training School Alumnae gave the first money to be used for starting visiting nursing among tuberculous patients attending this clinic. Later the nurse was maintained by a fund given by Mrs. W. K. Vanderbilt. There are now four nurses working in three departments, devoting their energies to the care of tuber- culosis patients, to the instruction of mothers and the care and feeding of babies and children, to the nursing of severely acute cases, and treatment of various chronic disorders. Aside from the regular tuberculosis work, there are several tuberculosis clinics which meet three mornings and four after- noons each week, and a children's clinic, all of which are at- tended by the tuberculosis nurses. In the children's clinic, cases of pulmonary tuberculosis only are treated, and the chil- 220 NEW YORK dren of tuberculous parents are regularly examined. A day camp was opened December 9, 1908, on the roof, for men, women, and children. A hot dinner is served at noon and two lunches, one in the morning, the other at 4 p. m., consisting of a glass of milk and an egg. The expense for maintaining the camp is borne for one year by the New York County branch of the National Red Cross. A Social Service branch, with a physician in charge, was started January 30, 1907. A few months later, the work was assumed by a trained nurse. Patients who are not in need of medical attention are referred to her by the various physi- cians; she also interviews many of the patients while waiting, before they are seen by the physicians. Alany need to have work found for them, some need dental care, others are re- ferred to various associations for financial relief; some are admitted to hospitals, and some are sent to convalescent homes or to the country. Very many are instructed in hygiene, and others need friendly advice, eyeglasses, or surgical appliances of various kinds. During the summer months, Fresh Air work is an important feature. Children from the children's depart- ment who need convalescent care, especially those who have tuberculous parents, are sent to the country, where they remain from one week to several months if necessary. Day excur- sions are planned for those who cannot leave home for a longer period. John Wanamaker, Beneficial Association. Established a visiting nursing service in February, 1897. Number of nurses: Three. Salaries: $100 and $80 per month. Hours: 8:30 a. m. to 5:30 p. m. Classes of cases cared for: Surgical, medical, and tuberculous. Plan of Work: All employes of this department store become members of the Beneficial Association as one of the conditions of their employment. A small monthly assessment is deducted from their salaries, and the association pays weekly benefits in case of sickness, and a burial benefit in case of death. The 221 NEW YORK Beneficial Association pays the salary of the secretary, who is a nurse, and the firm pays that of the other two nurses. In cases of illness or accident an employe immediately notifies the secretary, and she or one of her assistants visits the employe to learn the character of the illness, and to see that proper care is given the patient. Visits are made and repeated from day to day, or week to week, as the case requires. Nursing care is given, and in some instances in a critical illness, a night is spent at the patient's bedside. Special nurses are engaged for very ill patients who need continuous care. In long cases of illness, where the families are powerless to bear the necessary expense and the patient cannot be transferred to a hospital, arrange- ments have been made whereby the nurses of the Henry Street Settlement may be called upon for hourly service at a nominal fee. There are two First Aid rooms in the store, one containing four beds, the other two, where the nurses treat simple ailments and slight injuries. An emergency fund raised by the associa- tion is used to supplement the regular fund, and enables the association to send an incipient tuberculosis case away to take the rest cure, or to meet any other emergency which may arise. The discovery of such needs, and recommendations befitting each case, are made by the nurse. Wilkes' Dispensary, Out-Patient Department of St. Mary's Free Hospital for Children, 435 Ninth Avenue. Established visiting nursing in 1901. Number of nurses : One. Salary: $35 per month, and all expenses. Hours: 9 a. m. to 4 p. m. Classes of cases cared for: Surgical and medical. Plan of Work: The service is limited to patients who apply for treatment at the dispensary, the nurse visiting them in their homes as long as necessary. A loan closet furnishes bed linen and clothing; surgical dressings also are supplied. Woman's Branch of the New York City Mission and Tract Society, 105 East 22nd Street. Established visiting nursing in 1877. 222 NEW YORK Number of nurses: Ten. Salary : $60 per month and carfare. Hours: Eight, either day or night. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. History and Plan of Work: This was the first society in the United States, so far as can be ascertained, to give trained nursing care in the homes of the sick poor. Miss Frances Root, one of the early Bellevue graduates, began the work. The field of this service lies below 14th Street, and it is carried on in con- nection with kindergartens, day nurseries, several of the Chil- dren's Aid schools, The City Mission churches, and the American Guardian schools. The nurses' headquarters are at the following addresses: Olivet Memorial Church, 63 Sec- Bethlehem Chapel, 196 Bleecker ond St. St. De Witt Memorial Church, 280 Virginia Day Nursery, 632 East Rivington St. 5th St. Broome Street Tabernacle, 395 Children's Aid Schools: 256 Mott Broome St. St., 156 Leonard St., 295 E. Italian Mission House, 34 Charl- 8th St., 24 Sullivan St., and ton St. 287 E. Broadway. Spring Street Church Settlement, 246 Spring St. In the schools the nurses carry out the medical inspectors' orders; they visit the pupils' homes, instruct the mothers in general hygiene and the care of their babies, and take children to dispensaries. Daily visits are made at the Virginia Day Nursery, and treatments are given the children in the emergency room. Aside from their professional duties, the nurses take an active part in the religious work of the society, both in the homes of the patients, and in the Christian Workers' Home, 129 East loth St., where the nurses live. Instruction is given in Bible study, and in general missionary work of all kinds. NYACK Rockland County District Nursing Association,* First Avenue. Established July i, 1909. * Nursing service discontinued. 223 NEW YORK Number of nurses: Two. Salary: $60 per month. Hours: Irregular. Calls answered when received. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The nurses answer calls in Nyack, South Nyack, Grand View, and Piermont. All classes of patients are cared for. Fees from $.10 upward are charged; patients who are unable to pay are cared for free of charge. ossnoNG District Nurse Association, Ann Street. Established in April, 1905. Number of nurses : One. Salary: $50 per month. Hours: 8:30 a. m. to 6 p. m., with two hours' rest at noon. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The nurse also has general charge of the health of the children in the Christ Child Day Nursery, and of the old women in Bethany Home. PIERMONT See Nyack. RHINEBECK Thompson House District Nursing, Thompson House Hospital. Established July 14, 1902. Number of nurses : One. Salary: $50 per month and living expenses. Hours: 7 a. m. to 7 p. m. Emergency calls answered at night. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. History and Plan of Work: This work receives its name from Thomas Thompson, who left over a million dollars in trust for the relief of poor seamstresses and shop girls in the towns of Brattleboro, Vermont, and Rhinebeck. The donor provided 224 NEW YORK that if the whole income should not be needed for this purpose, it could be used for kindred purposes. By a decree of the Supreme Court of Massachusetts, the trustees were authorized to build hospitals in Brattleboro and Rhinebeck, and the visit- ing nurses in both places are supported by this fund. Bed linen and supplies of all kinds are furnished for the use of the nurse. Nourishment also is supplied when needed. ROCHESTER Bausch and Lomb. Established a graduate nurse for professional work June 2, igo6. Salary: $20 per week, or $1040 per year. Hours: About nine. Sundays are always free, and Saturday afternoons from May till October, inclusive. The nurse is on duty only when the factory is running; she therefore has ten days' vacation at Christmas time when the inventory is being taken, and all holidays. Plan of Work: There is a well-equipped hospital room with one bed always ready for emergency cases and slight illnesses. Serious accident cases are removed to a hospital as soon as possible. A mutual benefit association among the employes receives large contributions from the company, and its funds are available for the members in case of sickness or death. The nurse has many opportunities for close personal con- tact with the employes, making the rounds of the factory fre- quently to see that hygienic conditions are maintained and to advise with foremen as well as individual workers regarding matters pertaining to health. When the new factory building now in process of erection is completed, two rooms will be avail- able for hospital purposes, one for men, and one for women. With additional facilities, greater opportunities will be afforded the nurse for social welfare work, which then will be vigorously entered upon. Hahnemann Hospital. Established visiting nursing in 1904. 15 225 NEW YORK Number of nurses: One — pupil. Hours: Irregular, Classes of cases cared for: Surgical, medical, and obstetrical. Plan of Work: The senior pupils are given one month in district nursing as a part of their training. Rochester Homeopathic Hospital, 224 Alexander Street. Established visiting nursing in 1891. Number of nurses: Two — pupils. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The senior pupils are sent into the districts for a certain period during their training. Calls are received from all sources. The hospital is given $600 annually towards carry- ing on this work. Social Service Department Established February 15, 1909. Number of nurses: One. Salary: $70 per month and carfare. Hours: 8 a. m. to 5 p. m. ; Sundays excepted. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The nurse visits all patients who are dismissed from the wards and who need convalescent care; also post- operative cases, and those who attend the hospital dispensary. She learns the home conditions, and gives the patients such assistance as may be needed. Northfield Visiting Nurse of the Female Charitable Society, 36 Poplar Street. Established December 14, 1908. Number of nurses: One. Salary: $70 per month. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, and obstetrical. 226 NEW YORK Plan of Work: This work is supported by the Northfield girls for the benefit of the Female Charitable Society, which furnishes volunteer visitors. Each visitor is detailed to a small district to look up and relieve the needy sick. Those needing nursing care are reported to the visiting nurse. Bed linen, clothing, and nourishment are supplied when necessary. Rochester Public Health Association, Tuberculosis Department, 32 S. Washington Street. Established visiting nursing September i, 1904. Number of nurses : Two. Salaries: $60 per month with carfare. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, and tuberculous. Plan of Work: One nurse gives general nursing care to tuberculous patients; the other investigates the homes of all patients attend- ing the various free clinics, to see if they are worthy of free treat- ment, and also looks up new patients. All tuberculosis cases are registered in the tuberculosis clinic, and they are then cared for by the tuberculosis nurse. The bed patients receive sputum cups, paper napkins, milk and eggs, literature upon the subject of tuberculosis, and printed instructions for the care of themselves and their families. Outfits for living out-of-doors may be loaned or given as the case demands. Those able to attend the clinics, obtain their own supplies. Public School Work The nurses of the Public Health Association investigate and follow up cases reported by the Medical School inspectors, and many others are cared for through their connection with the Free Disjicnsary. Special effort is made to reach the school children through the general clinics, in order to treat them for necessary ailments. Twice a week one nurse prepares for and assists at operations for the removal of tonsils and adenoids. Rochester State Hospital, South Avenue. Established visiting nursing in Sei)teniher, 1907. 227 NEW YORK Number of nurses: One — senior pupil. Hours: Irregular. Class of cases cared for: Obstetrical. Plan of Work: All the senior pupils of the hospital are given this service in rotation. The nurse works under the supervision of a physician, and gives daily care to each patient for ten days following the birth of the infant. ROME Department of Health. Established visiting nursing January i, 1909. Number of nurses : One. Salary: $65 per month. Hours: 8:30 a. m. to 5:30 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Local Committee of the State Charities Aid Association, 206 North James Street. Established visiting nursing May i, 1908. Number of nurses: Two — pupils. Hours: 7 a. m. to 7 p. m. Classes of cases cared for: INIedical, obstetrical, and tuberculous. Plan of Work: A senior pupil nurse of the Rome Hospital visits tuberculous patients in their homes and attends the dispensary clinics on Tuesdays, Thursdays, and Saturdays from 8 to 9 p. m. Special diets are furnished to needy patients and free examinations of sputum are made. A second pupil nurse visits medical and obstetrical patients in their homes and gives them nursing care. The cost of maintaining the tuberculosis dispensary is provided by the city. The expense of the nursing service is defrayed by private subscriptions. Rome Hospital, East Garden Street. Established visiting nursing May i, 1908. Number of nurses: Two — pupils. 99.R NEW YORK Plan of Work: This work is largely in connection with the State Charities Aid Association. SARANAC LAKE Saranac Lake Society for the Control of Tuberculosis, Main Street. Established visiting nursing August 24, 1900. Number of nurses : One. Salary: $1100 per year. Hovus : 8 a. m. to 8 p. m. ; Sundays excepted. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. History and Plan of Work : This society was started as the Saranac Lake District Nursing Association. In 1907 it became a part of the Society for the Control of Tuberculosis and is now known by that name. After-care only is given in obstetrical cases. Advice and instruction are given in contagious cases, but no nursing care. An eflFort is made to educate tuberculous patients and their families to carry out stringent sanitary regulations concerning the disposal of sputum. The society distributes educational literature upon the subject and aids the Board of Health to enforce sanitary measures in hotels and boarding houses. It endeavors to discourage the practice of sending hopeless patients, who are without means of support, to the Adirondacks. The society maintains a free bureau to disseminate reliable information concerning good boarding places, and the cost of living in the vicinity. A loan closet provides fur coats, reclining chairs, and sick-room appliances for patients who are unable to buy them. The nurse has also a supply of clothing which is always more or less in demand. Investigation of needy cases is made and temporary aid given when necessary. A second nurse is engaged to care for patients needing attention on Sundays, and also for those who require constant nursing during acute illness. 229 NEW YORK SCHENECTADY Municipal Dispensary, Jay Street. Established visiting nursing in June, 1908. Number of nurses : One. Salary: $75 per month. Hours: 9 a. m. to 5 p. m. Class of cases cared for: Tuberculous. Affiliations: City. Plan of Work: Sputum cups are furnished by the dispensary. Milk and eggs are given to needy patients by the Commissioner of Charities, SOUTHEAST See Brewster. SOUTH NYACK See Nyack. SYRACUSE Bureau of Health, Department of Medical Inspection of Public Schools. Established visiting nursing for the pubhc schools April 22, 1908. Number of nurses: Two. Salary: $50 per month. Hours: 9 a. m. to 4 p. m. Plan of Work : The nurse works under the supervision of the medical inspector, and after school hours visits excluded children in their homes to see that they are following the physicians' advice, and to insure the children's return to school at the earliest possible time. Department of Health Clinic for Treatment of Pulmonary Disease, 508 E. Fayette Street. Established visiting nursing April i, 1908. Number of nurses: One. Salary: $800 per year. Hours: Irregular. Class of cases cared for: Tul^erculous. 230 NEW YORK Plan of Work : The nurse attends the clinics, and visits all patients in their homes. Sputum cups, disinfectants, milk and eggs are supplied when necessary. Reclining chairs, window tents, etc. may be loaned. TROY Instructive District Nursing Association. Established May i, 1908. Number of nurses: One. Salary: From $65 to $75 per month. Hours: Eight. No night calls are accepted. Classes of cases cared for: Surgical, medical, obstetrical, contagious, and tuberculous. Affiliations: Leonard Hospital. Plan of Work: The supply committee maintains a closet at the home of the chairman, and everything needed for the sick room is kept on hand. When necessary, the assistance of other nurses is secured. The superintendent of Leonard Hospital receives all telephone calls for the district nurse. St. John's Protestant Episcopal Church, First Street. Established visiting nursing in February, 1908. Number of nurses: One. Salary: $70 per month. Hours: 9 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The nurse cares for the sick and needy poor of the parish. Bed linen, clothing, and sick-room appliances may be loaned or given to the patients. Medicines and delicacies are supplied when the families are unable to provide them. Troy Tuberculosis Relief Committee,* 2 Hill Street. Established visiting nursing June i, 1907. Number of nurses: One. Salary: $60 per month. * The District Nursing Association cares for the tuberculous patients. 231 NEW YORK Hours: About eight. Sundays and Fridays are free. Class of cases cared for: Tuberculous. Affiliations: Charity Organization. Plan of Work: On Friday night the nurse attends the evening clinic. Sputum cups and paper napkins are supplied. Milk tickets and eggs are given when necessary. Sleeping bags, reclining chairs, cot beds and tents are loaned. In some in- stances porches are built to enable patients to live out of doors. Overcoats, capes, sweaters, and all kinds of clothing may be loaned or given away. UTICA The Faxton Hospital Visiting Nurse. Established visiting nursing in May, 1903. Number of nurses : One — pupil. Hours: 7 a. m. to 7 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuber- culous. Plan of Work: The senior pupils take the service in rotation, or, if necessary, two go out at a time. Night calls are answered only in emergencies. The physician calling for the nurse must send his own carriage or see that she is escorted to her desti- nation. A fund of $30 per month is contributed for carfare, medicine, nourishment, and supplies. Bed linen and clothing are given to destitute patients. WESTCHESTER Westchester Visiting Nurse, 2610 St. Raymond's Avenue. Established in April, 1898. Number of nurses: One. Salary: $75 per month. Hours: Irregular. Classes of cases cared for: Surgical, medical, obstetrical, contagious, and tuberculous. Plan of Work: The nurse has charge of a dispensary in conjunction with the various physicians of Westchester. Calls are answered at all times. The district is a rural one. Aside from her pro- 232 NEW YORK fessional duties the nurse acts in the friendly capacity of general adviser to her neighbors upon all subjects. She has a supply closet of clothing which she loans or gives away at her discretion. WHITE PLAINS White Plains Nursing Association, Miles Building, 15 Court Street. Established visiting nursing in 1906. Number of nurses: One. Salary: $75 per month and carfare. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Medical, obstetrical, and tuberculous. History and Plan of Work: A nursing committee was formed in 1904 as the preliminary step toward establishing a district nursing association. This committee furnished a supply closet, made out a list of nurses who could be called upon in time of need, and acted as an agent in securing nurses for patients, but it did not assume the financial responsibility. The work was carried on in this way for over a year. May 17, 1905, a constitution and by-laws were adopted, and July 1, 1906, a permanent nurse was engaged. Special nurses are employed for patients needing constant attention, and a colored nurse is engaged to care for her own people. A supply closet is maintained at the home of Mrs. Henry Ungrich, Jr., Prospect Hill Avenue. Articles can be borrowed only upon the signed order of the attending physician, the nurse, or a member of the association. A small rental fee is usually charged for the more expensive articles. YONKERS Board of Health, 9 Dock Street. Established visiting nursing in 1905. Number of nurses: One. Salary: Sioo per month for the permanent nurse. Hours: Irregular. Class of cases cared for: Contagious. Plan of Work: In addition to the usual duties, the nurse acts as a sanitary inspector. She visits quarantined cases, and sees that 233 NEW YORK the regulations are being carried out. During the summer, three or four other nurses are engaged to look after sick infants. St. John's Riverside Hospital, District Nursing Department. Established in 1901. Number of nurses : Two — pupils. Salary: $85 per month and carfare, with laimdering of uniforms. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical and medical. Plan of Work: The senior pupils of the training school are given this service in rotation as part of Uieir training. Each nvurse has every alternate Sunday free and one half day each week. Calls are received principally through the hospital physicians, but those from other physicians also are accepted. Bed linen, clothing, and nourishment are supplied when necessary. Cards stating that a fee of from $.10 to $.50 is customary are pre- sented to all patients, but the nurse uses her judgment as to charging the maximum or minimum price. All patients discharged from the hospital are followed up and visited in their homes; those needing other than nursing care are referred to the hospital committee, or to the Commissioner of Charities. Reports to physicians on the progress or termination of cases are made by postal card. The Sanitary League of Yonkers, 291 Nepperhan Avenue. Established visiting nursing October 8, 1906. Number of nurses : One. Salary: $1200 per year. Hours: Irregular. Class of cases cared for: Tuberculous. Affiliations: City Departments. Plan of Work: The nurse attends the dispensary clinics, which are held every day from 12 to i p. m. and on Monday, Wednesday and Friday evenings from 8 to 9 p. m. She visits all the patients in their homes, and keeps a full history of the family as long as she has it in her care. She reports bad housing conditions, keeps a record of the births that occur in the families of her patients, and 234 NEW YORK copies certificates of all deaths from tuberculosis. She keeps a list of all the cases of tuberculosis that are reported in the city, and calls on those who do not attend the dispensary clinics, advising and helping them; and she records the names of all who are not under treatment by a physician. Milk and eggs are supplied to those who are unable to buy them. The Woman's Institute of Yonkers, Department for Phil- anthropic Work, 38 Palisade Avenue. Established visiting nursing in May, 1899. Number of nurses : One. Salar}- : $80 per month. Hours: 9 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, and tuberculous. Plan of Work: Classes in home nursing are held. Clothing, food and nourishment are supplied when necessary. Yonkers Homeopathic and Maternity Hospital.* Since 1896, the hospital has sent out its senior pupils to care for obstetrical patients in the homes. Hours: 8 a. m. to 7 p. m. YORK The Nursing Society for the Township of York. Established December i, 1907. Number of nurses: One. Salary: $20 per week, with room. Classes of cases cared for: Surgical, medical, obstetrical, tuber- culous, and contagious. Plan of Work: York is situated in a rural community and the nurses' district includes some dozen villages, among which are Greigsville, Rebsof, Piffard, Fowlerville, Wadsworth, Craigs, and Linwood. She is taken back and forth from her home to the different villages either by the physicians or the families of her patients. Necessary sick-room appliances are loaned; also clothing when necessary. * 'Ihis hospital has not replied to late communications. 235 NORTH CAROLINA NORTH CAROLINA ASHEVILLE Flower Mission and Associated Charities, Visiting Nurse De- partment,* College Street. Established in January, 1908. Number of nurses: Two — one a senior pupil. Salary: The supervising ninse receives $20 per month for four hours of work daily. Plan of Work: The pupil does general visiting nursing for half of each day. She is supervised by the graduate nurse, who keeps the records and sends in the monthly reports. The nurse also attends the weekly meetings of a tuberculosis class, and visits all the patients who belong to it. Calls are received from all sources. If a patient is found without medical attendance, the case is reported to the physician for the Associated Charities. Small fees are charged whenever possible, and are added to the funds of the association for medical supplies. A steam laundry of Asheville launders gratuitously the nurses' uniforms, and bed linen from the supply closet. Street car company furnishes carfare; Associated Charities, bed linen and requisite supplies. DURHAM Durham Clinic for Pulmonary Diseases, 301 Morris Street. Established visiting nursing April i, 1909. Number of nurses: One. Salary: $75 per month. Hours: 9 a. m. to 5 p. m. Class of cases cared for: Tuberculous. Plan of Work: Clinics are held four days during the week, two for white patients, and two for colored people. The nurse employs the remaining time in visiting the patients in their homes. The town and county pay $100 per month toward the expense of this work, including the nurse's salary. The King's Daughters furnish the supply closet with bed linen, blankets, and clothing, which are loaned to the patients. * Nursing service discontinued. 236 NORTH CAROLINA ALLAPASS The Mountain Visiting Nurse. Established in December, 1902. Number of nurses : One. Hours : Irregular. Calls answered whenever received. Classes of cases cared for: Surgical, medical, obstetrical, contagious and tuberculous. History and Plan of Work: This is a mountainous district in the northwestern part of North Carolina, many miles from the nearest reliable physician. The work was started and has been continued by Miss Lydia Holman, whose first visit was made in response to a call to nurse a severe case of typhoid fever. Upon the recovery of the patient, Miss Holman resolved to make her home in the district and take up visiting nurse's work. She rides from cabin to cabin, carrying needful supplies strapped to her saddle. The ordinary cabin scattered through the mountains is built of logs, chinked with clay, and consists of one or two rooms and sometimes a loft. Only the open fireplaces, and the cracks left by the imperfect chinking save the family from suffocation; there are rarely any windows, the only real opening being the door. The altitude is high, the air pure and bracing, and all the natural conditions should insure perfect health, but unhygienic homes and a deeprooted aversion to air and water have allowed tuberculosis and typhoid to creep in and claim many victims. The nurse usually limits her calls to acute illnesses, and to ob- stetrical cases; it is in the latter branch that enlightenment and help are most needed, as the methods in general use are crude and primitive. The district is large and the distances are great, often from five to twenty miles between cases, and the work of necessity sometimes exceeds that which is usually considered within a nurse's province. Minor surgical operations, obstetrical work, general medical and skin cases, and extracting of teeth, fall within her regular line of work. She frequently remains with one patient long enough to give the family minute instructions and demonstrations regarding the care of the patient, lest she should not be able to repeat the journey for several days. 237 OHIO For remuneration the nurse accepts whatever may be offered. For obstetrical cases among well-to-do people, the regular charge is $io; for others, $5.00, sometimes $2.00, and often her services are given gratis. Visits are paid for according to distance and number, with no regard to the time spent, or to work that may be done. Frequently farm products are given in lieu of money — chickens, potatoes, com, oats, hay, and wood, or whatever there may be an oversupply of. In this way the niu-se pays for her cabin, her horse and her food. WILMINGTON Wilmington Visiting Nurse,* 322 South 5th Street. Established October 8, 1904. Number of nurses: One. Salary: $50 per month, laundry, and carfare. Hours: 8:30 a. m. to 4:30 p. m.; Sundays and legal holidays excepted. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: This work is mainly supported by members of St. James Episcopal Church, and is in close co-operation with the Associated Charities. OHIO CANTON Children's Aid Society, Eagle Block. Established visiting nursing in December, 1905. Number of nurses: Two — one a pupil. Salary: $60 per month. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, contagious, and tuberculous. Affiliations: Altman Hospital. Plan of Work : The graduate nurse is also a probation officer con- nected with the Juvenile Court. The nurses take pupils of the *This association has not replied to late communications. 238 OHIO public schools to physicians for examination and treatment. During the six winter months, from January to May, they have the use of a horse and carriage on their rounds. cmcmNATi Board of Health, Bureau of School Hygiene. Established school nursing January 5, 1909. Number of nurses: Two. Salary: S60 per month. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical and medical. Plan of Work: There is a central clinic to which the nurses urge all pupils who cannot pay a private doctor to go. This dispensary cares for general medical and skin diseases, and the school children are carefully looked after. All pupils who can afford to pay, are sent with cards for their own physician to fill out. Eight schools and 6,000 children are now under supervision. The Christ Hospital, 2139 Auburn Avenue. Established visiting nursing in 1890. Number of nurses: Two — one a pupil. Salary: Deaconess' allowance. Hours: Irregular. Classes of cases cared for: Surgical, medical, obstetrical, contagious, and tuberculous. Affiliations: The Methodist Episcopal Church, and the University Settlement. Plan of Work: During their training, the senior pupil nurses have a period of visiting nursing under supervision of a graduate deacon- ess nurse. Besides their general work, they attend the University Settlement clinic, and visit the patients in their homes. Bed linen and clothing may be loaned or given to needy patients; nourishment may be supplied for very sick people. The Maternity Society of the Protestant Episcopal Church. Established visiting nursing in 1881. Numljer of nurses: One. 2:-59 OHIO Salary: $65 per month. Hours: 9 a. m. to 5 p. m. Class of cases cared for: Obstetrical, Plan of Work: The society was formed with the object of providing the services of a physician and a nurse, and supplying necessary aid and comfort to destitute women in child-bed, regardless of creed. This aid was Ip be limited to the woman's necessity, and to be given at the discretion of the visitor. A medical staff was organized of physicians who offered their services, one of whom acted as physician-in-chief. Committees were formed for purchasing material and making necessary garments; others for furnishing invalid supplies and supervising the nurse. All applicants are provided with the services of a physician and nurse, when desired. Outfits of infant clothing with comforts for the mother are given when needed. A chest committee sees that a large supply of maternity bundles is kept in readiness for the nurse. Each bundle contains thirty-four articles necessary for mother and infant. There are garments for the use of both, a toilet bag with soap, powder, and old linen, a card with printed instructions on the care of the eyes and how to feed a.nd clothe babies properly. Through the Invalid's Supply Shelf, the nurse is enabled to give her patients tea, cocoa, jeUies, groceries, and other nourishing food. A supply of second-hand bed linen, blankets, gowns, and clothing is kept to be given to patients whenever they may be needed. Tuberculosis Dispensary, Department of Health, 508 W. 9th Street. Established visiting nursing September i, 1907. Number of nurses: Two. Salary: $60 per month. Hours: Eight hours. Class of cases cared for: Tuberculous. Plan of Work: The nurses give lectures on tuberculosis, look after the general condition of the patients' homes, inquire into their means of support, teach the patients how to care for themselves 240 OHIO and to guard their families from infection. From June 15 to September 15 they have charge of two milk stations. Milk and eggs and other necessary things are supplied through affiliation with various charitable organizations. Union Bethel Settlement, 501 E. Third Street. Established visiting nursing in 1904. Salary: $50 per month. Hours: Irregular. Calls are responded to at all hours. Classes of cases cared for: Surgical, medical, and obstetrical. Plan of Work: The settlement has connected with it a medical staff of several doctors, a well-equipped dispensary, and a large day nursery. For certain hours of each day, the nurse is in attendance at the dispensary. She also examines the children in the day nursery, and visits patients in their homes. Tuberculosis patients are reported to the dispensary of the Department of Health. University Settlement Association, 224 West Liberty Street. Established a visiting nursing department March i, 1909, The nurses are from the Christ Hospital.* They attend the cHnic connected with this settlement and visit the patients in their homes. CLEVELAND Board of Education, School Nursing Department. Established in September, 1908. Number of nurses: Two. Salaries: $500 to $900 per year with uniforms, bags, and carfare. Hours: 8 a. m. to 5 p. m.; Sundays excepted. One month's vacation with full pay is given during the year. Classes of cases cared for: Surgical, medical, contagious, and tuberculous. Plan of Work: The nurses work under the supervision of the Visiting Nurse Association.! Their salaries are paid by the Board of Education; they are employed as teachers, and have Ijeen placed on the teachers' salary schedule, the amount received being based upon experience and efficiency. The nurses work in *ScL' page 239. t^^'C next [)age. 10 241 OHIO the school dispensaries, under the district physicians, caring for minor ailments which might otherwise necessitate the children's remaining away from school. They visit the homes, see that the physician's instructions are carried out, and that excluded children return to school at the earliest possible moment. Deaconess Home, Visiting Nurse Department. Established in 1895. Number of nurses: Two. Salary: Deaconess' allowance, board, laundry, and carfare fur- nished. Hours: Irregular. Calls answered when required. Classes of cases cared for: Surgical, medical, obstetrical, and tuber- culous. Affiliations: Methodist Episcopal Church, The Visiting Nurse Association of Cleveland, 501 St. Clair Avenue. Established April 19, 1902. Number of nurses: 29. Salaries: $50 first three months; $60 following nine months; $70 second year; $75 third year; $80 fourth year, and one month's vacation with full salary each year. Hours: 8 a. m. to 5 p. m. Only very ill patients are visited on Sunday, and one half day each week is given free from duty. Classes of cases cared for: Surgical, medical, obstetrical, conta- gious, and tuberculous. History and Plan of Work: This association began its work with a staff of four nurses: one superintendent, and three assistants in the districts. It was supported entirely by private benevolence. The three district nurses had their stations at three of the settle- ments and became m.embers of the family in each. At present, all the trained nurses in Cleveland who are visit- ing in the homes of the poor and giving professional care or in- struction, are on the staff of this association and under its super- vision. They participate in nearly all of the charitable activities in the city that have to do with the care of the sick or with the instruction and help of the needy. 242 OHIO Ten nurses are assigned to districts. They have call stations in different parts of the city at pharmacies, settlement houses, etc. One nurse is a graduate of the Tuskegee Training School and works among the colored people, helping them in many ways other than professional. Each district has its loan closet which is kept well stocked with medical and surgical supplies, and bed linen from the main oflSce. Four nurses are employed by the Babies' Dispensary and Hos- pital, 2500 East 35th Street. One nurse remains on duty at the dispensary, and the others visit in the homes. Careful records of the children's history, weight, and general physical condition, with home conditions and sanitation, financial circumstances, etc., are kept by each nurse, and filed with the physician's report. There is a milk laboratory where modified milk may be obtained; or the nurse teaches the mother how to prepare it at home. Two nurses are engaged in the obstetrical service, one having headquarters at the Cleveland Maternity Dispensary, St. Clair Hospital, 4422 St. Clair Avenue, the other being employed by the Western Reserve Maternity Dispensary, Lakeside Hospital. These nurses visit the patients in their homes, instruct them how to prepare for maternity, and give nursing care after confinement. Later, the babies with their mothers are turned over to the Babies' Dispensary. Four nurses who look after tuberculosis patients have their headquarters at the Tuberculosis Dispensary, Western Reserve Medical College, St. Clair Avenue and East 9th Street. These nurses work under a group of dispensary physicians, and visit the patients in their homes, giving nursing care and detailed in- struction as to rest, fresh air, disposal of sputum, etc. They also report conditions found in the homes, and bring other members of the families to the dispensary for examination. Four nurses are supported by the city. Two of them work in the schools, while two investigate and report to the Board of Health cases of contagious disease. The school nurses work in two school dispensaries, and visit in their homes the children attending these schools. One nurse is employed by Rainbow Cottage for the care of 243 OHIO crippled children. This cottage is the convalescent home for children who have been discharged from Lakeside Hospital, or who attend the clinics for crippled children. The nurse investi- gates the home conditions, sees that the treatment prescribed by the physician is carried out, instructs the family in the care necessary for the patients, and sees that braces, wheel-chairs, etc., are procured when needed. Two nurses are engaged in the summer to take charge of fresh air outing work in connection with the Fresh Air Camp. These nurses investigate the home conditions of each candidate for an outing, and see that there is no contagious illness in the family or neighborhood. They are responsible also for the physical condition and perfect cleanliness of each child before it is sent to the Fresh Air Camp or country home. Lakeside Hospital employs a visiting nurse for its Social Service department. She works in connection with the dis- pensary and discharged ward patients, visits them in their homes, gives nursing care when necessary, sends convalescents to coun- try homes, refers families needing financial help to the proper authorities, and follows up cases until they can be satisfactorily terminated. The Cleveland Hardware Company has maintained a visiting nurse since November i, 1907. She has complete charge of the factory dispensary, and general supervision of hygienic condi- tions in all the buildings. Each department foreman sends the name and address of an absent employe to the nurse, and she visits the home, making a report by telephone as to the condi- tion found there. This is done with office employes also, on the same basis as with the factory employes. Full and comprehen- sive records are kept of each person visited in the home, these records embracing a detailed account of the various members of the family, general home conditions, etc. Aid is given through the benefit association or through existing agencies in the city, and each case is followed up till all has been done that can be done. One nurse is engaged at the central office of the association to keep cliarge of the nurses' records, and to relieve the superin- tendent in training new nurses in district work. 244 OHIO All of these nurses are on the staff of the Visiting Nurse Asso- ciation and wear a common uniform. A staff physician has recently been appointed who makes a thorough physical examination of each nurse before she is ac- cepted on the staff, and is consulted in all cases of serious illness among the nurses. Before a nurse is permitted to undertake the tuberculosis work, she is given an additional examination by a specialist. This association publishes a Quarterly Magazine which is devoted entirely to visiting nurse work, and to charities with which the visiting nurse is especially affiliated. Following is a list of these affiliated charities: Alta House Babies' Hospital Board of Education Cleveland Hardware Company Cripple School Deaconess Home Fresh Air Camp Goodrich Social Settlement Hiram House Lakeside Hospital Maternity Dispensary Tuberculosis Dispensary COLUMBUS Columbus Society for the Prevention and Cure of Tubercu- losis, Dispensary, 40 S. Third Street. Established January 27, 1906. Number of nurses: Three. Salaries: Supervisor, $75 per month; assistant nurses, $60. Hours: 8 a. m. to 5 p. m. Class of cases cared for: Tuberculous. Affiliations: City. History and Plan of Work: Caring for tuberculous {)alients was started l)y the District Nursing Association committee. De- cember 5th, J905, the two societies sejxiraled, the 'tuberculosis 245 OHIO Society engaging its own nurses. The head nurse works under the direction of the medical director, has charge of the dis- pensary, and keeps records of all dispensary and house patients. Sputum cups are furnished free to all dispensary patients, and medicines also when prescribed by the dispensary physicians. Milk and eggs are furnished to those who are able to attend the clinic. The nurses visit all the patients in their homes and aid them in carrying out preventive measures. Bed patients are referred to the District Nursing Association. The nurses make careful inquiry regarding sickness among other members of the family, and endeavor to send to the dispensary for examination any that may not be in good health. Special attention is given to school children. Saturday morning is the children's hour at the dispensary, and a Fresh Air school is planned for them in the near future. This society has a Children's Educational Committee in charge of a nurse. During the past year she has interested i,ooo boys in the fight against disease and dirt, through membership in the Clean City League. Eight hundred and forty-nine girls also belong to it. The boys and girls have been formed into eight clubs, meeting in different parts of the city. Lessons are given in the care of the home and of the body; ventilation ; simple home nursing lessons; care of the backyard, and its relation to disease; disposal of garbage; clothing, and its relation to good health; symptoms of tuberculosis, and what to do for it, out-door treatment, and what everybody must do to help. The society has a summer camp situated on land belonging to the county, and patients are sent there during the day. Bed linen, clothing, steamer chairs, tents, cots, nourishment of all kinds, and carfare are given to all who need them. Instructive District Nursing Association, 276 E. State Street. Established June 15, 1898. Number of nurses: Five. Salaries: From $60 to $100 per month. Hours: 8 a. m. to 5:30 p. m. 246 OHIO Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Plan of Work: An extra nurse is engaged to visit the acute cases on Sundays, thereby relieving the staff nurses for one whole day in the week. They also have one afternoon free in the middle of the week. Emergency nurses are employed whenever necessary. After-care only is given in obstetrical cases. Modified milk is prepared and furnished for babies. A loan closet fiu^ishes necessary bed linen, clothing, and sick-room appliances. DAYTON Flower and Fruit Mission, 213 Arcade. Established visiting nursing in 1903. Number of nurses : Two. Salaries: $60 per month. Hours: 8 a. m. to 5:30 p. m. and a half holiday each week. Only very ill patients are visited on Sunday. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. Plan of Work: There is a diet kitchen under the direction of the mission, where the nurses may secure broths, jellies, and other needed nourishment; fresh eggs, malted milk, etc. may also be obtained. A loan closet supplies bed linen, clothing, infants' outfits, and tents and complete camping outfits for tuberculosis patients. There is a Fresh Air farm for children and mothers. National Cash Register Co., Hygiene Department. Established in 1901. Number of nurses: Two. Salary: $20 per week. Hours: During factory hours. Saturday afternoons are usually free. Classes of cases cared for: Surgical and medical. Plan of Work: The nurses' work among the men is confined to First Aid treatment in cases of accident or serious illness, and to the administering of simple remedies for minor ailments. In the care of llie girls and women, there are no restrictions what- 247 OHIO ever. The women employes are at liberty at all times to consult the nurses. The latter make regular rounds through the factory, meeting the girls and winning their confidence in regard not only to matters of health, but to other problems as well. A physician visits the factory every day for one hour, during which time the nurses consult him concerning patients for whom a physician's advice is necessary. In case of serious accident or sudden ill- ness, the doctor is immediately summoned by telephone. An emergency room where accident cases may be cared for, is fully equipped with surgical appliances and dressings. There are also three rest rooms in the women's departments. If the women are ill or indisposed, they are always at liberty to go to the rest rooms on the company's time. TOLEDO Thalian Tuberculosis Dispensary, ii8 Michigan Street. Estabhshed May i, 1907. Number of nurses : Two. Salary: $60 per month and carfare. Hours: 8 a. m. to 5:30 p. m. Class of cases cared for: Pulmonary tuberculosis. Affiliation: Charity Organization Society. Plan of Work: This society is one of the three separate branches of the Toledo Visiting Nurses. The tuberculosis nurses are super- vised by the general superintendent and paid by the Thalian Society. Toledo District Nursing Association, 1517 Monroe Street. Established in 1900. Number of nurses: Six. Salaries: From $50 to $75 per month. Classes of cases cared for: Surgical, medical, and obstetrical. History and Plan of Work: The King's Daughters instituted this work, and later it was enlarged by the formation of a Visiting Nurses' Aid Society, which added two nurses to the staflf. These two societies now constitute the District Nurse Association of 248 OHIO Toledo. Close relations are maintained with the Charity Or- ganization Society. A loan closet furnishes all necessary sup- plies, — bed linen, clothing, maternity outfits, medical supplies, and delicacies for the patients. Each nurse has a monthly allow- ance for the purchase of milk and eggs or other necessaries at her discretion. When time permits, visits are made to patients who are able to pay $.50 an hour. Each nurse is expected to do her share of emergency work, but in special cases, extra nurses may be em- ployed for not more than three days. At the end of this time the supervising nurse reports the case to the executive board for further action. YOUNGSTOWN The Visiting Nurse Association, Baldwin Memorial Kinder- garten. Established in December, 1904. Number of nurses: Four; a superintendent and three assistants. Salaries: $75 per month for the former; for the latter, S40 for the first three months, and $50 thereafter. Hours: 9 a. m. to 5 p. m. Only the seriously ill patients are visited on Sundays. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Plan of Work: Besides the regular visiting nursing, special summer work is carried on for sick babies, two e.xtra nurses being taken on the staff for this purpose. Milk is modified and taken to the homes, and careful instruction is given to the mothers. Public school work also has been started by the regular stuff nurses. The principals notify them of children needing atten- tion, and the nurses then take the children to physicians for diag- nosis and treatment. If necessary to exclude a child from school, it is cared for and returned at the earliest possible time. Slight local infections and cases of eye and skin diseases are treated in the school by the nurse, under the physician'> orders. 249 1 OKLAHOMA, OREGON OKLAHOMA OKLAHOMA CITY Department of Health, Corner Maine and Harvey Streets. Established visiting nursing September 25, 1908. Number of nurses: One. Salary: $75 per month. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Tuberculous and contagious. Plan of Work: Sputum cups are furnished by the department. Rooms are disinfected in case of removal or death of such pa- tients. Milk and eggs and other foods are supplied by the Provident Association, which receives some support from the city. OREGON PORTLAND City of Portland School Nursing Department. Established visiting nursing October 5, 1908. Number of nurses: One. Salary: $75 per month. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, contagious, and tu- berculous. Plan of Work: This nurse has forty- five schools under her care. The Visiting Nurse Association, 601 Medical Building. Established June i, 1902. Number of nurses: Three. Salaries: From $60 to $80 per month. Hours: 9:30 a. m. to 5:30 p. m. Only emergency calls made on Sunday. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Plan of Work: Special nurses are engaged for night work and con- tagious cases when necessary. Mothers' helpers are sent into 250 PE2SrNSYLVANIA homes where the mothers are ill and there are small children to be cared for. Bed linen and nourishment are furnished for needy cases. Invalid chairs, tents, and paper napkins are provided for tuber- culosis patients. This association was instrumental in having school nursing introduced into the public schoob. PENNSYLVANIA ALLEGHENY The Farmington Society. Established in December, 1894. Number of nurses : One. Salary: $75 per month. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tu- bercular. Plan of Work: This Society was organized and is wholly supported by graduates of the Farmington School. It has one nurse who works among the poor, principally those of Allegheny. Small fees are charged to patients who are able to pay. Clothing and other necessaries are donated by the society when needed. Several hundred children are given a Christmas treat each year, and dinners and groceries are sent out to many families. The Visiting Nurse Association of Allegheny County, 812 Arch Street. Established in January, 1894. Number of nurses: One. Salary: $50 per month. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tu- berculous. Affiliations: City, and the Women's Christian Associations of Pittsljurgh and Allegheny. Plan of Work: This association is under the direction of the 251 PENNSYLVANIA Women's Christian Associations of Pittsburgh and Allegheny. Clothing and food are provided when necessary. The work is divided into two classes, public and private nursing. The former is the service rendered to city patients and paid for by the city. The latter is that given to persons who apply directly to the society for a nurse, and pay the association whatever their financial condition permits. The society is maintained by the city, private donations, and membership dues. ALLENTOWN SeeHarrisburg, Pennsylvania Department of Health. ALTOONA See Harrisburg, Pennsylvania Department of Health. BANGOR See Harrisburg, Pennsylvania Department of Health. BEAVER FALLS See Harrisburg, Pennsylvania Department of Health. BELLEFONTE See Harrisburg, Pennsylvania Department of Health. BERWICK See Harrisburg, Pennsylvania Department of Health. BETHLEHEM Moravian Union of King's Daughters and Sons, 24 Church Street. Established visiting nursing October i, 1898. Number of nurses : One. Salary: $30 per month and board and laundry. Hours: Irregular. Calls answered at all times. Classes of cases cared for: Surgical, medical, and tuberculous. Afiiliations: Tuberculous patients are usually referred to the tu- berculosis ntu-se of South Bethlehem, who is employed by the State Department of Health. History and Plan of Work: In 1888 the first circle of King's Daugh- PENNSYLVANIA ters, called the "Silent Ten," was formed in the Moravian Church. In 1895, there were thirteen such circles, which then united under the name " Moravian Union of King's Daughters and Sons." From the beginning it had been one of their duties to furnish the infirmary of the Theological Seminary, and to provide and pay for necessary nursing of the patients taken there. October i, 1898, the union engaged a nurse to minister perma- nently to all those of the congrf^^ation who were unable to pay for such services, and the t'^astees gave a small house for the nvirse's residence. This is called the "King's Daughters' Cottage." The entire support of the nurse is borne by the union. A permanent fund has been started, which will in time cover her salary. If the nurse's time is not fully occupied with free patients, others of the congregation may engage her at regu- lar rates. A large supply closet is maintained in the cottage, and bed linen, blankets, clothing and babies' outfits may be loaned or given away, as the case demands. Air cushions, ice coils, hot-water bags, bed-room refrigerators, etc., are loaned. Six wheel chairs have been given, each bearing the name of the donor. Nourishment and ice are provided when necessary. BLOOMSBURG See Harrisburg, Pennsylvania Department of Health. BRADDOCK See Harrisburg, Pennsylvania Department of Health. BRISTOL See Harrisburg, Pennsylvania Department of Health. BURKVILLE See Harrisburg, Pennsylvania Department of Health. BUTLER See Harrisburg, Pennsylvania Department of Health. CARLISLE Carlisle Visiting Nursing Association, 9 N. Hanover Street. Established March 16, 1905. Number of nurses: One. 253 PENNSYLVANIA Salary: $25 per month, a furnished room, and 50 per cent, of the fees received from patients. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: City, and the Civic Club. Plan of Work: The town pays the salary of the nurse, and the Civic Club furnishes her room. Pennsylvania Department of Health. See Harrisburg. CARNEGIE See Harrisburg, Pennsylvania Department of Health. CHESTER See Harrisburg, Pennsylvania Department of Health. CLARION See Harrisburg, Pennsylvania Department of Health. CLEARFIELD See Harrisburg, Pennsylvania Department of Health. COATESVILLE See Harrisburg, Pennsylvania Department of Health. CORRY See Harrisburg, Pennsylvania Department of Health. DANVILLE See Harrisburg, Pennsylvania Department of Health. DOYLSTON See Harrisburg, Pennsylvania Department of Health. DRIFTON Visiting Nurse of Drifton, Freeland, and Eckley. Established in 1898. Number of nurses : One. Salary: $50 per month and traveling expenses. 254 PENNSYLVANIA Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: When necessary, another nurse is engaged to visit contagious patients. A philanthropic woman pays all expenses of this work. DU BOIS See Harrisburg, Pennsylvania Department of Health. DUSHORE See Harrisburg, Pennsylvania Department of Health. EASTON See Harrisburg, Pennsylvania Department of Health. ECKLEY See Drifton. ERIE Pennsylvania Department of Health. See Harrisburg. Woman's Club, Philanthropic Department, 128 W. 7th Street. Organized visiting nursing in December, 1905. Number of nurses: One. Salary: $70 per month. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, and obstetrical. Plan of Work: A supply closet furnishes bed linen and sick-room appliances which may be loaned or given away. All tubercu- lous cases are referred to the State Tuberculosis Dispensary. EVERETT See Huntington. FRANKFORD See Harrisburg, Pennsylvania Department of Health. FRANKLIN See Harrisburg, Pennsylvania Department of Health. 255 PENNSYLVANIA FREELAND See Drifton. GERMANTOWN General Hospital of Germantown. Established visiting nursing May i6, 1908. Number of nurses: One. Salar)': $60 per month. Hours: Eight or ten hours. Class of cases cared for: Tuberculous. Plan of Work: The nurse visits only those patients who go to the hospital dispensary, instructs them how to care for themselves and their famihes, and how to avoid spreading the disease. She sees that the patients carry out the doctor's orders, take the proper diet, and live out of doors as much as possible. She learns the financial conditions of the families, and helps them to obtain aid when needed. In many cases she has interested church societies in providing milk [and eggs. All patients are supplied with sputum cups, paper napkins, and bags. The dis- pensary is held in a tent, erected in a large open lot. Reclining chairs, blankets, and all necessary supplies are kept there. GETTYSBURG See Harrisburg, Pennsylvania Department of Health. GREENSBURG See Harrisburg, Pennsylvania Department of Health. HANOVER See Harrisburg, Pennsylvania Department of Health. HARRISBURG Board of School Directors, 121 Chestnut Street. Established visiting nursing in the public schools in September, 1908. Number of nurses: One. Salary: $60 per month. 256 PENNSYLVANIA Hours: 9 a. m. to 4 p. m. Classes of cases cared for: Surgical, medical, contagious, and tuberculous. Plan of Work: Medical inspection was instituted with one physi- cian and one nurse. The salary of the physician is $40 per month for two hours' work each day. The nurse gives her entire time to caring for the pupils in the schools, and visiting in the homes. The Harrisburg Visiting Nurse Association, 410 Patriot Building. Established in 1899; incorporated, 1908. Number of nurses: Three; a supervising nurse and two assistants. Salaries: $75 and $60 per month. Hours: 8.30 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. History and Plan of Work: Prior to the organization of this asso- ciation, a philanthropic woman supported a visiting nurse in Harrisburg. The work retained this individual character for some years, gradually increasing, until three nurses were em- ployed. Owing to the larger demands made upon the service, this association was formed and incorporated in 1908, and a board of managers undertook the direction of the work. In 1906, the visiting nurse was made the agent of the Benevo- lent Association; in this capacity she was enabled to enter the public schools and bring to the superintendent's attention the needs of the school children. Upon the request of the associa- tion, the school board granted permission to the nurses to visit two schools, one in Sibletown, a poor quarter, and the other a special school for delinquents. As a result of this work, public school nursing has been undertaken by the Board of Education, with the nurse who first developed it in charge. The nurses have their office in the building occupied by the Charity Organ- ization Society, and work in co-operation with that and all other agencies of relief. They also have experience in probation work. There is a Nurses' House, managed l)y the association, in which they live, paying $25 a month for their expenses. 17 ' 257 PENNSYLVANIA State Department of Health, 202 Locust Street. In the General Appropriations Act of 1907, the legislature of Pennsylvania granted to the State Department of Health, in addition to its regular budget, the sum of $400,000, " to establish and maintain, at such places in the state as may be deemed necessar}% dispensaries for the free treatment of indigent persons affected with tuberculosis, for the study of social and occupa- tional conditions that predispose to its development, and for continuing research experiments for the establishment of pos- sible immunity and cure of said disease." This appropriation was to be for two years. The State Department of Health began at once to establish dispensaries all over the state, with one or more in each county. The staff of each dispensary con- sists of a chief, who is also county medical inspector, and a corps of assistant physicians and visiting nurses. There are also a chief visiting nurse and one assistant, who inspect the work of the staff nurses. July I, 1909, there were 11 1 state dispensaries in operation, in 77 of which there were 91 visiting nurses. The nurses attend the clinics and visit in the homes to give instruction to patients and their families. Milk and eggs are supplied when needed, and other aid is sometimes furnished. Each patient is liberally supplied with sputum cups. In many of the dispensaries, tuberculosis class methods have been adopted, and day camps established. The dispensaries are under the direct control of Dr. Samuel G. Dixon, Com- missioner of Health. Following is a list of the dispensaries having visiting nurses, their addresses, and other data: Allentown, Lehigh County, Pennsylvania Department of Health, Dispensary No. 51, 719 Linden Street. Established visiting nursing March i, 1908. Number of nurses: One, who is also a physician. Altoona, Blair County, Pennsylvania Department of Health, Dis- pensary No. 14, 17 16 Union Avenue. Established visiting nursing January i, 1908. Number of nurses: One. Hours: 9 a. m. to 6 p. m. 258 PENNSYLVANIA Bangor, Northampton County, Pennsylvania Department of Health, Dispensary No. 87. Established visiting nursing December 7, 1908. Number of nurses: One. Hours: 9 a. m. to 6 p. m. Beaver Falls, Beaver Cotmty, Pennsylvania Department of Health, Dispensary No. 103. Nurse from Rochester visits these patients. Bellefonte, Center County, Pennsylvania Department of Health, Dispensary No. 15, 129 E. Diamond Street. Established visiting nursing January 5, 1909. Number of nurses: One. Hours: 9 a. m. to 6 p. m. Berwick, Columbia County, Pennsylvania Department of Health, Dispensary No. 16, 108 West 2nd Street. Established visiting nursing April i, 1908. Number of nurses: One. Hours: 9 a. m. to 6 p. m. Bloomsburg, Montour County, Pennsylvania Department of Health, Dispensary No. 93. Nurse from Berwick visits these patients. Braddock, Allegheny County, Pennsylvania Department of Health, Dispensary No. 101, 812 Braddock Avenue. Established visiting nursing April 3, 1909. Number of nurses: One. Hours: 9 a. m. to 6 p. m. Bristol, Bucks County, Pennsylvania Department of Health, Dis- pensary No. 82, Lawrence Building. Established visiting nursing April 17, 1909. Number of nurses: One. Hours: 9 a. m. to 6 p. m. Brookville, Jefferson County, Pennsylvania Department of Health, Dispensary No. 102, 205 Main Street. Established visiting nursing .\pril 17, 1909. Number of nurses: One. Hours: 9 a. m. to 6 p. m. Butler, Butler County, Pennsylvania Department of Health, Dis- pensary No. 15. Established visiting nursing January i, 1908. Number of nurses: One. Salar}': Paid according to number of visits made. Hours: Irregular. Carlisle, Cumberland County, Pennsylvania Department of Healthi Dispensary No. 4, 511 East High Street. Established visiting nursing November 25, 1907. Number of nurses: One. Hours: As required. The salary of this nurse is paid by the town, and her time is shared with the Carlisle Visiting Xurse Association. 2.59 PENNSYLVANIA Carnegie, Allegheny County, Pennsylvania Department of Health, Dispensary No. 83, 4th Avenue. Established visiting nursing April 17, 1909. Number of nurses : One. Hours: 9 a. m. to 6 p. m. Chester, Delaware County, Pennsylvania Department of Health, Dispensary No. 12, 516 Market Street. Established visiting nursing November 12, 1907. Number of nurses : Two. Hours: 9 a. m. to 6 p. m. Clarion, Clarion County, Pennsylvania Department of Health, Dispensary No. 43. Established visiting nursing January 21, 1908. Number of nurses : One. Salary: Paid according to the number of visits made. Hours: Irregular. Clearfield, Clearfield County, Pennsylvania Department of Health, Dispensary No. 62, 237 E. Market Street. Established visiting nursing April 17, 1907. Number of nurses: One. Hours: 9 a. m. to 6 p. m. Coatesville, Chester County, Pennsylvania Department of Health, Dispensary No. 75, 307 Chestnut Street. Established visiting nursing April 17, 1909. Number of nurses: One. Hours: 9 a. m. to 6 p. m. Corry, Erie County, Pennsylvania Department of Health, Dispen- sary No. 99, 45 North Center Street. Established visiting nursing January 4, 1909. Number of nurses: One. Hours: 9 a. m. to 6 p. m. Danville, Montour County, Pennsylvania Department of Health, Dispensary No. 28. Established visiting nursing June 20, 1908. Number of nurses: One. Hours: Irregular. Doylestown, Bucks County, Pennsylvania Department of Health, Dispensary No. 23. Nurse from Bristol visits these patients. Du Bois, Clearfield County, Pennsylvania Department of Health, Dispensary No. 95, 244 South Main Street. Established visiting nursing April 17, 1909. Number of nurses: One. Hours: 9 a. m. to 6 p. m. Dushore, Sullivan County, Pennsylvania Department of Health, Dispensary No. 59, Kline's Opera House. Number of nurses: One. Hours: 9 a. in. to 6 p. m. 260 PENNSYLVANIA Easton, Northampton County, Pennsylvania Department of Health, Dispensary No. 52, 207 Ferry Street. Established visiting nursing May i, 1908. Number of nurses : One. Hours: 9 a. m. to 6 p. m. Erie, Erie County, Pennsylvania Department of Health, Dispensary No. 3, 510 State Street. Established visiting nursing March i, 1908. Number of nurses: One. Hours: 9 a. m. to 6 p. m. Everett. See Huntington. Frankford, Philadelphia County, Pennsylvania Department of Health, Dispensary No. 107, 1731 Orthodox Street. Established visiting nursing May 10, 1909. Number of nurses: One. Hours: 9 a. m. to 6 p. m. Franklin, Venango County, Pennsylvania Department of Health, Dispensary No. 72, 11 15 Elk Street. Established visiting nursing May 10, 1909. Number of nurses: One. Hours: 9 a. m. to 6 p. m. Gettysburg, Adams County, Pennsylvania Department of Health, Dispensary No. 60. Established visiting nursing June 20, 1908. Number of nurses: One. Hours: Irregular. Greensburg, Westmoreland County, Pennsylvania Department of Health, Dispensary No. 57, Coulter Bldg. Established visiting nursing April 17, 1909. Number of nurses: One. Hours: 9 a. m. to 6 p. m. Hanover, York County, Pennsylvania Department of Health, Dis- pensary No. 86, 328 Franklin Street. Number of nurses: One. Hours: 9 a. m. to 6 p. m. Harrisburg, Dauphin County, Pennsylvania Department of Health, Dispensary No. 13, 202 Locust Street. Established visiting nursing March 28, 1908. Number of nurses: Two. Hours: 9 a. m. to 6 p. m. Hastings, Cambria County, Pennsylvania Department of Health, Dispensary No. 69, Fourth Avenue. Established visiting nursing January 26, 1909. Number of nurses: One. Hours: 9 a. m. to 6 p. m. 261 PENNSYLVANIA Hazelton, Luzerne County, Pennsylvania Department of Health, Dispensary No. 68, Associated Charities Building. Established visiting nursing February i8, 1909. Number of nurses: One. Hours: 9 a. m. to 6 p. m. The nurse's district includes Everett. Homestead, Allegheny County, Pennsylvania Department of Health, Dispensary No. 100, 318 Eighth Avenue. Established visiting nursing February 13, 1909. Number of nurses: One. Hours : 9 a. m. to 6 p. m. Huntington and Everett, Huntington County, Pennsylvania De- partment of Health, Dispensary No. 47. Established visiting nursing July i, 1908. Number of nurses: One. Hours: 9 a. m. to 6 p. m. Johnstown, Cambria County, Pennsylvania Department of Health, Dispensary No. 9, 440 Lincoln Street. Established visiting nursing May i, 1908. Number of nurses: One. Hours: 9 a. m. to 6 p. m. Lancaster, Lancaster County, Pennsylvania Department of Health, Dispensary No. 39, 22J East Orange Street. Established visiting nursing February i, 1908. Number of nurses: One. Hours: 9 a. m. to 6 p. m. Lebanon, Lebanon County, Pennsylvania Department of Health, Dispensary No. 5. Established visiting nursing March i, 1908. Number of nurses: One. Salary: Paid according to number of visits made. Hours: Irregular. Lewiston, Mifflin County, Pennsylvania Department of Health, Dispensary No. 10. Established visiting nursing April i, 1908. Number of nurses: One. Salary: Paid according to number of visits made. Hours: Irregular; as required. Lock Haven, Clinton County, Pennsylvania Department of Health, Dispensary No. 46. Established visiting nursing May 14, 1908. Number of nurses: One. Salary: Paid according to number of visits made. Hours: As required. Lykens, Dauphin County, Pennsylvania Department of Health, Dispensary No. 78, 262 Main Street. Established visiting nursing April 17, 1909. Number of nurses: One. Hours: 9 a. m. to 6 p. m. 262 PENNSYLVANIA McKeesport, Westmoreland County, Pennsylvania Department of Health, Dispensary No. 81, 412 Grand Street. Established November 18, 1908. Number of nurses: One. Hours: 9 a. m. to 5 p. m. Meadville, Crawford County, Pennsylvania Department of Health, Dispensary No. 41. Established visiting nursing February 13, 1908. Number of nurses: Orte. Salary: S75 per month. Hours: As required. The salary of this nurse is given by two philanthropic residents of Meadville. The nurse visits the patients of the Instructive Visiting Nurse Association and gives as much time as may be necessary to the tuberculous patients. Mercer, Mercer County, Pennsylvania Department of Health, Dis- pensary No. 61, 419^ East State Street. Established visiting nursing February 18, 1908. Number of nurses: One. Salary : Paid according to number of visits made. Hours: As required. Meyersdale, Somerset County, Pennsylvania Department of Health, Dispensary No. 30. Number of nurses: One. Hours: 9 a. m. to 6 p. m. Mifflintown, Juniata County, Pennsylvania Department of Health, Dispensary No. 26. Established visiting nursing January i, 1908. Number of nurses: One. Salary: Paid according to number of visits made. Hours: As required. Monessen, Westmoreland County, Pennsylvania Department of Health, Dispensary No. 88, People's National Bank Building. Number of nurses: One. Hours: 9 a. m. to 6 p. m. Monongahela, Washington County, Pennsylvania Department of Health, Dispensary No. 55, 127 South Main Street. Number of nurses: One. Hours: 9 a. m. to 6 p. m. Montrose, Susquehanna County, Pennsylvania Department of Health, Dispensary No. 49, Chestnut Street. Estal)lishcd visiting nursing May 9, 1909. Number of nurses: One. Hours: 9 a. m. to 6 p. m. Mt. Carmel, Northumberland County, Pennsylvania Department of Health, Dispensary No. 71, Syndicate Building Established visiting nursing March 14, 1909. Number of nurses: One. Hours: 9 a. m. to 6 p. m. 263 PENNSYLVANIA Mt. Pleasant, Westmoreland County, Pennsylvania Department of Health, Dispensary No. 77, Braddock Building. Established visiting nursing April 17, 1909. Number of nurses: One. Hours: 9 a. m. to 6 p. m. New Castle, Lawrence County, Pennsylvania Department of Health, Dispensary No. 35, 20 E. North Street. Established visiting nursing Februar}' 20, 1908. Number of nurses: One. Salary: Paid according to number of visits made. Hours: As required. Norristown, Montgomery County, Pennsylvania Department of Health, Dispensary No. 31, Bean Building. Established visiting nursing January 20, 1908. Number of nurses: One. Hours: 9 a. m. to 6 p. m. Oil City, Venango County, Pennsylvania Department of Health, Dispensary No. 32, First Street. Established visiting nursing June 20, 1908. Number of nurses: One. Salary: Paid according to number of visits made. Hours: 9 a. m. to 6 p. m. Philadelphia, Pennsylvania Department of Health, Dispensary No. 21, 12 South 17th Street. Established visiting nursing January 12, 1908. Number of nurses: Four. Hours: 9 a. m. to 6 p. m. Philipsburg, Center County, Pennsylvania Department of Health, Dispensary No. 80, Potter Arcade. Established visiting nursing January 5, 1909. Number of nurses: One. Hours: 9 a. m. to 6 p. m. Phoenixville, Chester County, Pennsylvania Department of Health, Dispensary No. 76, Church Street. Established visiting nursing April 12, 1909. Pittsburgh, Allegheny County, Pennsylvania Department of Health, Dispensary No. 20, 412 Grand Street. Established visiting nursing February 20, 1908. Number of nurses: Five. Hours: 9 a. m. to 6 p. m. In addition to medical care this dispensary provides extra nourisli- ment for those patients who cannot afford to buy it for themselves. Pittston, Luzerne County, Pennsylvania Department of Health, Dispensary No. 94, 80 North Main Street. Established visiting nursing February i, 1909. Number of nurses: One. Hours: 9 a. m. to 6 p. m. 264 PENNSYLVANIA Pottstown, Montgomery County, Pennsylvania Department of Health, Dispensary No. 106, 304 York Road. Established visiting nursing June 19, 1909. Hours: 9 a. m. to 6 p. m. Pottsville, Schuylkill County, Pennsylvania Department of Health, Dispensary No. 66, 115 So. Centre Street. Established visiting nursing May 20, 1908. Number of nurses: One. Hours: 9 a. m. to 6 p. m. Punxsutawney, Jefferson County, Pennsylvania Department of Health, Dispensary No, 64, Weber Building. Established visiting nursing April 17, 1909. Number of nurses : One. Hours: 9 a. m. to 6 p. m. Reading, Berks County, Pennsylvania Department of Health, Dis- pensary No. 37. Established visiting nursing January 15, 1908. Number of nurses : One; a Bellevue graduate who is also a physician. Salary: Paid according to number of visits made. Hours: Irregular. Ridgway, Elk County, Pennsylvania Department of Health, Dis- pensary No. 42. Established visiting nursing April 17, 1909. Number of nurses : One. Hours: 9 a. m. to 6 p. m. Rochester, Beaver County, Pennsylvania Department of Health, Dispensary No. 22, Rochester Trust Company Building. Established visiting nursing July i, 1908. Number of nurses: One. Hours: 9 a. m. to 6 p. m. Scranton, Lackawanna County, Pennsylvania Department of Health, Dispensary No. 40. Established visiting nursing February 25, 1908. Number of nurses: One. Shamokin, Northumberland County, Pennsylvania Department of Health, Dispensary No. 53. Number of nurses: One. Sharon, Mercer County, Pennsylvania Department of Health, Dis- pensary No. 36. Established visiting nursing, 1908. Number of nurses: One. Salary: Paid according to number of visits made. Shenandoah, Schuylkill County, Pennsylvania Department of Health, Dispensary No. 85, 31 South Jardan Street. Established visiting nursing February 2, 1909. Number of nurses: One. Hours: 9 a. m. to 6 p. m. 26r) PENNSYLVANIA South Bethlehem, Northampton County, Pennsylvania Department of Health, Dispensary No. 98, 6 West 4th Street. Established visiting nursing April 17, 1909. Number of nurses : One. Hours: 9 a. m. to 6 p. m. Stroudsburg, Monroe County, Pennsylvania Department of Health, Dispensary No. 65. Established visiting nursing April 20, 1908. Number of nurses: One, w^ho is also a physician. Salary: Paid according to number of visits made. Tyrone, Blair County, Pennsylvania Department of Health, Dis- pensary No. 79. The nurse from Bellefonte visits these patients. Uniontown, Fayette County, Pennsylvania Department of Health, Dispensary No. 67, 57 West Main Street. Established visiting nursing June 20, 1908. Number of nurses: One Hours: 9 a. m. to 6 p. m. Washington, Washington County, Pennsylvania Department of Health, Dispensary No. 105, 127 South Main Street. Established visiting nursing April 17, 1909. Number of nurses: One. Hours: 9 a. m. to 6 p. m. West Chester, Chester County, Pennsylvania Department of Health, Dispensary No. 6. Established visiting nursing December 5, 1907. Number of nurses: One. Salary: Paid according to number of visits made. Hours: Irregular. West Fairview, Cumberland County, Pennsylvania Department of Health, Dispensary No. 96. The nurse from Carlisle visits these patients. Wilkes-Barre, Luzerne County, Pennsylvania Department of Health, Dispensary No. 1, 239 South Washington Street. Established visiting nursing July 22, 1907. Number of nurses: Three. Williamsport, Lycoming County, Pennsylvania Department of Health, Dispensary No. 33, 242 Pine Street. EstaVjlished visiting nursing March i, 1908. NumV)er of nurses: One. Hours: 9 a. m. to 6 p. m. York, York County, Pennsylvania Department of Health, Dis- pensary No. 2, 25 North Duke Street. Established visiting nursing November i, 1907. Number of nurses: Two. Hours: 9 a. m. to 6 p. m. 266 PENNSYLVANIA HASTINGS See Harrisburg, Pennsylvania Department of Health. HAZELTON See Harrisburg, Pennsylvania Department of Health. HOMESTEAD See Harrisburg, Pennsylvania Department of Health. HUNTINGTON See Harrisburg, Pennsylvania Department of Health. JOHNSTOWN See Harrisburg, Pennsylvania Department of Health. LANCASTER See Harrisburg, Pennsylvania Department of Health. LEBANON See Harrisburg, Pennsylvania Department of Health. LEWISTON See Harrisburg, Pennsylvania Department of Health. LOCK HAVEN See Harrisburg, Pennsylvania Department of Health. LYKENS See Harrisburg, Pennsylvania Department of Health. McKEESPORT McKeesport Hospital. Established visiting nursing in August, 1899. Number of pupils: Two senior pupils at a time have this service. Hours: Irregular. Class of cases cared for: Obstetrical. Plan of Work: The nurses accompany the doctors for the confine- ment, and make three subsequent visits to the mother and child. Pennsylvania Department of Health. See Harrisburg. 267 PENNSYLVANIA MEADVILLE The Meadville Visiting Nurse, 553 East Arch Street. Established January i, 1907. Number of nvu:ses: One. Salary: $75 per month. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: This work was made possible through the interest of two philanthropic women. The nurse has bed linen, cloth- ing, and sick-room appliances, which she may loan, donate or rent. She also furnishes antiseptic dressings. Pennsylvania Department of Health. See Harrisburg. MERCER See Harrisburg, Pennsylvania Department of Health. MEYERSDALE See Harrisburg, Pennsylvania Department of Health. MHi'FLINTOWN See Harrisburg, Pennsylvania Department of Health. MONESSEN See Harrisburg, Pennsylvania Department of Health. MONONGAHELA See Harrisburg, Pennsylvania Department of Health. MONTROSE See Harrisburg, Pennsylvania Department of Health. MT. CARMEL See Harrisburg, Pennsylvania Department of Health. MT. PLEASANT See Harrisburg, Pennsylvania Department of Health. 268 PENNSYLVANIA NEW CASTLE See Harrisburg, Pennsylvania Department of Health. NORRISTOWN See Harrisburg, Pennsylvania Department of Health. OAKMONT Oakmont District Nursing Association. Established in 1901. Number of nxirses: One. Salary: $60 per month. Hours: Irregular. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The nurse's territory also includes Verona. She has bed linen and clothing to give or loan to her patients as the case demands, and supplies nourishment for very ill people OIL CITY See Harrisburg, Pennsylvania Department of Health, PHILADELPHLA Board of Public Education, Department of School Nursing. Randall School Annex, Bainbridge Street above Ninth. Started experimentally by the Visiting Nurse Society November 2, 1903. Established by the city in January, 1908. Number of nurses: Six. Salary: Superintendent, $75 per month; assistants, $62.50 per month . Hours: 9 a. m. to 5 p. m. Saturdays 9 a. m. to 12 m. Classes of cases cared for: Surgical and medical; contagious and tuberculous cases are referred to proper authorities. History and Plan of Work: November 2, 1903, the Visiting Nurse Society received permission to start school nursing as an experi- ment, and the full time of one nu^se was given for four years. During the last three months, the society maintained four nurses 269 PENNSYLVANIA in the schools. The city then took the matter up and appro- priated sufficient money to maintain six nurses. The nurses assist the physicians in their examinations of the pupils in the schools, carry out the treatment ordered, and visit the homes to give instruction and explain the physicians' recom- mendations. In urgent cases the nurses may carry out pre- scribed treatment in the homes. They accompany the children to dispensaries and to specialists. The city has made an appro- priation for eyeglasses, and several of the leading opticians offer to supply pupils at very low rates. The nurses see that all children who need glasses have them properly fitted. Gimbel Brothers, Market, Eighth and Ninth Streets, Established a Social Service Department December 6, 1902. Number of nurses: One. Hours: 8 a. m. to 5:30 p. m. Classes of cases cared for: Surgical, medical, and tuberculous. Plan of Work: A well-equipped emergency hospital is main- tained in the store for employes or patrons who are taken ill, and a physician is always on call. There is a mutual aid society which pays the usual sick and death benefits, and provides special nurses when necessary; also clothing, provisions, rent, coal, delicacies for the sick, milk and eggs, medical attention, and board in the country for two or more weeks at a time, etc. In all cases where such help is needed, the nurse recommends what action shall be taken. Jewish Maternity Association, 532 Spruce Street. Established visiting nursing in 1897. Number of nurses: One — pupil. Hours: Eleven hours. Class of cases cared for: Obstetrical. Affiliations: The Jewish Charities. Plan of Work: All supplies necessary for the comfort of the pa- tients are furnished; also clothing for mothers and infants. Nourishment is given when necessary. 270 PENNSYLVANIA Pennsylvania Department of Health. See Harrisburg. Philadelphia Deaconess' Home, 6ii Vine Street. Established visiting nursing in June, 1899. Number of nurses: One. Salary: Deaconess' allowance, and all expenses. Hours: Irregular. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. Plan of Work: Bed linen is supplied when necessary, and some- times sick diet is furnished. The Philadelphia Dispensary, 127 South 5th Street. Established visiting nursing in 1884. Number of nurses: One. Salary: $40 per month. Hours: 8 a. m. to 6 p. m. No night calls are made. Class of cases cared for: Largely obstetrical. Plan of Work: The nurse visits all patients once or twice before confinement to teach the mother how to care for herself and how to prepare for labor. After delivery, nursing visits are made for nine days, or longer if necessary. The nurse also prepares for minor gj-necological operations that may be performed in the homes by the dispensary physician, and attends sucli patients daily as long as her care is needed. The Henry Phipps Institute, 238 Pine Street. Established visiting nursing in February, 1903. Hours: 9 a. m. to 5 p. m. Class of cases cared for: Tuberculous. Plan of Work: The pupil nurses who are trained in the institute are those who have had tuberculosis and have become cured of the disease. At the end of the two-year course, they are given certificates from the directors of the institute which testify to their ability to nurse patients suffering from tuberculosis, and they receive appointments to positions in sanatoria, and other places where tujjerculosis work is being done. Two pupils at a 271 PENNSYLVANIA time are on the visiting nursing staff. The patients visited are those who go to the dispensary for treatment. Sputum cups, paper napkins, and bags are supplied; milk is furnished daily. In the southern district it is given out directly from the insti- tute; in the northern, southeastern and western districts, milk- men deliver it at the patients' homes. Presbyterian Hospital, Tuberculosis Class, 39th Street and Powelton Avenue. Established visiting nursing on November 11, 1908. ' Number of nurses : One. Salary: $75 per month. Hours: About eight. Some visits are made in the evening. Class of cases cared for: Tuberculous. Plan of Work: Through the interest and support of the Ladies' Aid Society of this hospital, a nurse is engaged to care for the patients of the tuberculosis class. This work is largely with ambulatory cases, and it is instructive rather than purely pro- fessional, as many of the patients are at work away from home during the day, or do light work at home. The nurse arranges proper sleeping quarters for them, and sees that they have places for taking the rest cure out of doors. She procures adequate clothing when necessary, gives instructions in regard to the disposal of sputum, and inspects the sanitary conditions of the homes. Sputum cups, paper bags, and napkins are supplied. Nourisliment and clothing are obtained through other agencies. When proper home treatment is not possible for the incipient cases, they are sent to sanatoria. No fees are charged for the nurse's visits. St. Martha's House, 2029 S. Eighth Street. Establislied visiting nursing in February, 1903. Number of nurses: One. Salary: $35 per month, with board, laundry, and room. Hours: 9 a. m. to 5 p. m. Classes of cases aired for: Surgical, medical, obstetrical, and tuberculous. 272 PENNSYLVANIA Affiliations: St. Martha's House is a church settlement affiliated with the Episcopal Church. Plan of Work: No night calls are accepted. When her profes- sional duties permit, the nurse takes part in the social activi- ties of the house. She has a daily supply of Pasteurized milk which she sells to her patients at cost, or gives at her discretion to mothers who are vmable to buy it. She has also a loan closet with supplies of old linen, bedding, clothing, sick-room appliances, and other useful articles for the comfort of the sick. St. Stephen's Church Tuberculosis Class, 9 South loth Street. This class was started February 11, 1908, by the Pennsylvania Society for the Prevention of Tuberculosis, and the Visiting Nurse Society, in co-operation with St. Stephen's Church. The tuberculosis nvurse of the Visiting Nvurse Society attends to the patients connected with the class. Starr Center Association, 725 Lombard Street. Established visiting nursing in December, 1905. Number of nurses : One. Salary: $75 per month. Hours: 8 a. m. to 5:30 p. m. ; Emergency calls answered at night. Classes of cases cared for: Medical, contagious, and tuberculous. History and Plan of Work: This work was organized by the Visit- ing Nurse Society, but in October, 1908, the society's nurse was withdrawn, and the service is now under the control of the Starr Center. The greater part of the nurse's work is to care for the babies who are supplied with milk from the milk depots. The Visiting Nurse Society of Philadelphia, 1340 Lombard Street. Established in February, 1886. Number of nurses: 19; one a senior pupil. Salary: $55 first two years; $60 thereafter. Hours: 8 a. m. to 7 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. 18 273 PENNSYLVANIA History and Plan of Work: This is one of the oldest visiting nursing societies in America. It was organized in the same year as the Boston Instructive District Nursing Association.* Eight of the nurses are assigned to districts near the central office; three nurses and the pupil are in the Manayunk Branch, two are in the Kensington District, and one is at West Philadelphia. Special tuberculosis work was started August i, 1907, and two nurses are in charge. Both incipient and advanced cases are cared for. The nurses teach preventive measures to pa- tients and families, and give nursing care to bed patients. Nour- ishment, groceries, and coal are supplied when needed. Efforts are made to induce patients to go to hospitals or sanatoria. Out-door treatment is insisted upon for those who cannot leave home. Roofs, fire-escapes, balconies, and porches are used for this purpose. Tents are put up in back yards, and steamer chairs are loaned. Sputum cups, paper bags, and napkins are provided for all patients. In February, 1908, the society was asked to co-operate with St. Stephen's Chiirch in forming a class for the instruction of tuberculosis patients. The class was established and has been most successful. Special obstetrical work is carried on in connection with St. Timothy's Hospital. Senior pupil nurses are given two months of this service under supervision of the Visiting Nurse Society. Special nurses are engaged for the care of critical cases at night. This society successfully demonstrated the need of public school nursing, and gave the services of one nurse for four years, from November 2, 1903, to December, 1907. The last three months of this time it maintained four nurses in the schools, withdrawing them only when the city took up the work and placed six nurses in the schools. In summer, the Visiting Nurse Society undertakes Fresh Air and vacation work; babies, children, and mothers are sent to the country, seashore, and convalescent homes. Free ice is furnished by the Bureau of Health, and the Needle Work Guild of America provides clothing and bed linen for the loan closets. *See page 103. 274 PENNSYLVANIA The addresses of ihe various branch offices are: 1340 Lombard St., Central office, McNeil's Drug Store, Front & York Sts. Kensington Branch, 476 Martin St. Roxborough, Manayunk, and Germantown Branch, Jenks' Drug Store, Cor. Market and Preston Sts., West Philadelphia. PITTSBURGH Bureau of Health. Established visiting nursing March 14, 1907. Number of nurses : Five, Salary: $80 per month. Hours: 8 a. m. to 4 p, m. Class of cases cared for: Tuberculous. History and Plan of Work: The nurse was first appointed for the purpose of visiting indigent patients who attended the tuber- culosis dispensary. In March, 1909, a city ordinance was passed providing for the creation of a tuberculosis commission with five nurses. The commission was organized in order to correlate the tuberculosis work of the various organizations of the city, including the Bureau of Health, the Tuberculosis League, and the State Dispensary. These three organizations employ twelve visiting nurses, who devote their entire time to tuberculosis work. Through the commission, they are assigned certain districts, thus avoiding duplication of work. An appro- priation has been made for the appointment of six summer nurses also. Their work will be confined chiefly to the care of babies, instructing the mothers in regard to feeding their chil- dren, and in spreading a pure milk propaganda. Calvary Protestant Episcopal Church,* 6026 Station Street. Established visiting nursing July i, 1902. Hours: Irregular. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Irene Kaufman Settlement, 1835 Centre Avenue. Established visiting nursing in April, 1902. ,* This church has not replied to late communications. . 275 PENNSYLVANIA Number of nurses: Three; one a pupil. Salaries: From $60 to $85 per month, with room and laundry. Hours: 8 a. m. to 5 p. m.; one half day each week, and every other Sunday excepted. Classes of cases cared for: Surgical, medical, and obstetrical. History and Plan of Work: This work was organized by the Pitts- burgh section of the Council of Jewish Women. All tubercu- losis patients are referred to the League for the Prevention of Tuberculosis. Patients needing material relief are referred to the proper agencies. No money is given, but nourishment and delicacies are furnished. Clothing and bed linen may be loaned or given to needy patients. A fee of $.10 or $.15 is charged for the nurse's services if the family can pay. Patients unable to secure a physician are recom- mended to one of several who have volunteered their services for such cases. East End Visiting Nurse's Aid Association, 5820 Alder Street. Established in the spring of 1895. Number of nurses: One. Salary: $60 per month. Hours: Irregular. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: Untrained assistants are employed to remain with patients when necessary, and to carry out the nurse's direc- tions during her absence. Bed linen, clothing, and sick-room appliances are kept on hand. First Presbyterian Church, Sixth Avenue. Established visiting nursing December i, 1904. Number of nurses: One. Salary: $60 per month. Hours: 8 a. m. to 5 p. m. In cases of extreme illness the nurse remains all night. 276 PENNSYLVANIA Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The work is chiefly for people belonging to the church, but patients who are not members of the parish are visited also. The church has an endowed bed in the General Hospital where free patients may be sent. It maintains in the country a Convalescent Home for children. This is open during June, July, and August, and is superintended by the nurse, who selects the children to be sent, arranges for their transportation, etc. A fund for medicines, milk and eggs is at her disposal. Bed linen, babies' clothing, etc., may be loaned or given away. Fruit and Flower Mission, 43 Federal Street. Established visiting nursing May i, 1898. Number of nurses: One. Salary: $50 per month. Hours : Eight hours. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. History and Plan of Work: This mission was started many years ago. The object was "to provide a nurse, food, clothing and delicacies for the sick, to visit the hospitals, and to do a neigh- borly work among the poor." The nurse answers calls from all parts of the city. She provides medicines, bandages, food, clothing, and coal. Kingsley House Association, Fullerton and Bedford Streets. Established visiting nursing June i, 1906. Number of nurses: One. Salary: $65 per month. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The work is under the direction of physicians and is carried on in co-operation with the Board of Health. The nurse has a well-equipped dispensary at Kingsley House, where she 277 PENNSYLVANIA has office hours every day from 3 to 5 p. m. A part of her time is given daily to the pubhc schools in the neighborhood, for the care of the children in attendance there. She has sup- plies of bed linen and clothing, and gives nourishment when necessary. McCreery and Company, Wood Street and Sixth Avenue. This department store has had a trained nurse in its employ since September i, 1904. It employs also a social secretary for welfare work. Hours: 8:30 a. m. to 5:30 p. m. Plan of Work: Emergency cases only are cared for by the nurse. Hospital rooms for employes and for patrons are maintained, where cases of accident or sudden illness are taken, and where, if necessary, they may remain even for several weeks. In such cases a second nurse is engaged to care for the patient. A list is kept of the absent employes, and these are visited by the social secretary. It is one of her duties to render any needed assist- ance, financial or otherwise, and to provide needed comforts for the sick room. Methodist Episcopal Deaconess Home, 2000 Fifth Avenue. Established visiting nursing by the trained deaconess-nurses in October, 1890. Number of nurses: One. Salary: Customary deaconess' allowance. Hours: Whenever called. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. Plan of Work: Nourishing food, and clothing both old and new, are given ^\hen necessary. Pennsylvania Department of Health. See Harrisburg. School Nursing. The resident nurse of Kingsley House visits the Public Schools whicli are located in the neighborhood. She works in co-opera- tion with the examining physicians, teachers, and the Board of 278 PENNSYLVANIA Health. Simple treatment is given in the schools and visits are made in the homes. Soho Baths Settlement House, 2404 Fifth Ave. Established January i, 1909. Number of nurses : One. Salary: $60 per month. Hours : Four daily. No work on Sunday. Classes of cases cared for: Surgical, medical, and obstetrical. Tuberculosis League of Pittsburg, 2851 Bedford Avenue. Established visiting nursing in April, 1907. Number of nurses : Two ; one a pupil. Salary: $75 per month. Hours: 7:30 a. m. to 5 p. m. Class of cases cared for: Tuberculous. History and Plan of Work: The first nurse was supported by the city. She visited and instructed all cases reported to the city authorities, as well as those attending the Pittsburg Sanatorium clinics. In May, 1908, she was transferred by the Board of Health to another department to look after sick babies, and the League has since then supported its own nurses. At present there is a graduate assisted by one pupil from the Western Pennsylvania Hospital. One visits in the mornings, attends the dispensary clinics in the afternoons, and looks after the welfare of discharged patients. The other spends all her time in home visits. The nurses distribute sputum cups and paper napkins, and have a fund from which needy patients are supplied with milk and eggs. Woods Run Industrial House. Estiiblishcd visiting nursing December 21, 1908. Number of nurses: One. Salary: S60 per month, room and board. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. 279 PENNSYLVANIA Plan of Work: The nurse is a resident of the settlement, and she visits the sick in their homes. A medical dispensary is open on Monday, Wednesday, and Friday from lo a. m. to ii a. m. A competent physician and the nurse are in charge. On Satur- day afternoons a tuberculosis clinic is held in the dispensary from 2 to 4. PITTSTON See Harrisburg, Pennsylvania Department of Health. POTTSTOWN See Harrisburg, Pennsylvania Department of Health. POTTSVILLE See Harrisburg, Pennsylvania Department of Health. PUNXSUTAWNEY See Harrisburg, Pennsylvania Department of Health. READING See Harrisburg, Pennsylvania Department of Health. RIDGEWAY See Harrisburg, Pennsylvania Department of Health. ROCHESTER See Harrisburg, Pennsylvania Department of Health. SCRANTON Associated Charities, Visiting Nurse Department, 334 North Washington Avenue. Established visiting nursing April i, 1909. Number of nurses: Three. Salary: $65 per month for the supervisor. Hours: 8 a. m. to 5:30 p. m. Classes of cases cared for: Surgical, medical obstetrical, and tuberculous. 280 PENNSYLVANL^ History and Plan of Work : Visiting nursing was started in Scranton under the auspices of the Hahneman Hospital in 1901 the salary of a graduate nurse being paid by a philanthropic resident. In April, 1909, the general direction of the work was assumed by the Associated Charities, the financial support remaining the same. The senior pupils from the Hahneman and State hospitals receive a month's training in the districts, under the supervision of the graduate nurse. Bed linen, clothing, sick-room appliances, surgical supplies, and special nourishment are furnished by the twelve churches of the city, each church having charge of the supply basket one month during the year. Pennsylvania Department of Health. See Harrisburg. SEWICKLY Woman's Club, Philanthropic Department. Established visiting nursing in 1899. Number of nurses: One. Salary : $60 per month. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: Church societies and needlework guilds. Plan of Work: Obstetrical calls are always answered at night. It is optional with the nurse whether she shall attend other cases after 6 p. m. All fees received for night duty are turned over to the nurse as extra salary. When she is not busy with charity work she takes cases at $.50 an hour, and uses these fees for medical supplies, nourishment, etc. for those who cannot procure them for themselves. Supplies of bed linen, blankets, nightgowns, and warm underwear, are donated by the churches and needlework guilds. These may be loaned or given away as the case demands. Every winter the churches and clubs contribute an emergency fund to buy coal and provisions for destitute patients. SHAMOKIN See Harrisburg, Pennsylvania Department of Health. 281 PENNSYLVANIA SHARON See Harrisburg, Pennsylvania Department of Health. SHENANDOAH See Harrisburg, Pennsylvania Department of Health. SOUTH BETHLEHEM Church of the Nativity, Parish House. Established visiting nursing in 1897. Number of nurses : One. Salary: $60 per month, with room in the Parish House. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. History and Plan of Work: In 1897, a graduate nurse from St. Luke's Hospital, South Bethlehem, started visiting nursing work among the poor people of the parish, and induced other nurses to serve for one or two months after graduation, for the sake of the experience. A permanent nurse is now in charge of the work, which is supported and directed by the Episcopal Church. The work is non -sectarian, and a large foreign population in the toNs n brings many calls from people of other parishes. Emergency calls are answered at night. With but few exceptions, the patients pay a fee of $.10 an hour for general nursing, $.25 for an obstetrical case, and $1.00 for all-night service. If the nurse has time to answer calls from well-to-do patients, regular prices are charged. There is in the Parish House, a supply closet which furnishes sick-room appli- ances. All necessary clothing is distributed by the parish visi- tor. The nurse pays especial attention to the instruction of mothers in the care and proper feeding of children. Pennsylvania Department of Health. See Harrisburg. STROUDSBURG See Harrisburg, Pennsylvania Department of Health. 282 PENNSYLVANIA TYRONE See Harrisburg, Pennsylvania Department of Health. UNIONTOWN See Harrisburg, Pennsylvania Department of Health. VERONA See Oakmont. WASHINGTON See Harrisburg, Pennsylvania Department of Health. WEST CHESTER See Harrisburg, Permsylvania Department of Health WEST FAIRVIEW See Harrisburg, Pennsylvania Department of Health. WILKES-BARRE See Harrisburg, Pennsylvania Department of Health. The Visiting Nurse Association of Wilkes-Barre, 15 W. North- ampton Street. Established November 2nd, 1908. Number of nurses: One. Salary: $50 and $70 per month. Hours: 8 a. m. to 5 p. m. Only very ill patients visited on Sunday. Classes of cases cared for: Surgical, medical, and obstetrical. Plan of Work: Calls are accepted from all sources. Office hours are held daily from 8 to 9 a. m. and i to 2 p. m. A small fee is charged for each visit, the amount being left to the discretion of the nurse. Dressings are charged for at cost. A loan closet is fully equipped with all necessary supplies. Milk and eggs may be furnished by the Associated Charities for very needy patients. The nurse gives weekly talks on home nursing to young women's clubs. She also gives talks to the various relief associations connected with the large factories in Wilkes-Barre. 283 PENNSYLVANIA The Wyoming Valley Society for the Prevention and Treatment of Tuberculosis, 56 South Pennsylvania Avenue. Established visiting nursing July 13, 1906. Number of nurses: One. Salary: $60 per month. Class of cases cared for: Tuberculous. Affiliations: The State Department of Health. History and Plan of Work: The society was organized with the view of caring for the poor consumptives of this valley. A dis- pensary was opened at 173 South Main Street, and a visiting nxu"se was engaged. The dispensary was in constant operation until it was taken over by the State Department of Health July 22, 1907, and became the State Dispensary No. i. The Wyoming Valley Society continues in existence, and works in co-operation with the State Department of Health. It furnishes cots, blankets, tents, reclining chairs, attendants, etc., and pays the fares of destitute patients going to the State Sana- torium at Mont Alto. In the summer a milk station is main- tained for pasteurizing and modifying milk for babies. The nurse visits in the patients' homes scattered all over the valley, teaches them how to care for themselves and prevent further contagion in their families, reports all urgent cases to one of the physicians of the society, and sends patients to sanatoria. WILKINSBURG Anti-Tuberculosis League, 616 Penn Avenue. Established visiting nursing January 11, 1909. Number of nurses: One. Salary: $60 per month. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, con- tagious, and tuberculous. Plan of Work: Sputum cups, paper napkins, nourishment and clothing are supplied when necessary. WILLIAMSPORT See Harrisburg, Pennsylvania Department of Health. 284 RHODE ISLAND YORK Pennsylvania Department of Health. See Harrisburg. The Visiting Nurse Association, 524 E. Philadelphia Street. Established January 8, 1909. Number of nurses: One. Salary: $65 to $75 per month. Hours: 8:30 a. m. to 6 p. m. Sundays and ^ day each week free from duty. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. History and Plan of Work: This association is the outgrowth of a sewing club, the members of which made garments for the patients in the maternity ward of York Hospital. A supply closet is maintained furnishing bed linen, blankets, gowns, sick-room apphances, and nourishment. RHODE ISLAND ANTHONY ARCTIC ARKWRIGHT CENTERVILLE CLYDE CROMPTON FISKEVILLE HARRIS HOPE Visiting Nurse Association of the Pawtuxet Valley. Established December 28, 1908. Number of nurses: Three. Salary: $60 to $75 per month. Hours: 9 a. m. to 5 p. m.; Sundays excepted. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The Pawtuxet Valley is made up of a number of small manufacturing villages: Hope, Jackson, P'iskeville, Ark- wright, Harris, Phenix, Clyde, Crompton, Anthony, Lippett, 285 - See Hope. RHODE ISLAND • : Riverpoint, Arctic, Quidnick, Washington, and Centerville, The population is largely employed in the mills, and the patients are usually able to pay the nurse's fees. The nurses' work has had a phenomenally rapid growth. Three weeks after the first nurse began her duties, the demand was so great that a second nurse was engaged. Four months later a third nurse was needed to specialize on tubercular cases, as 33 per cent, of all the patients belonged to that class. A loan closet is maintained with bed linen, cots and sickroom appliances. JACKSON See Hope. NEWPORT The Newport Association for the Relief and Prevention of Tuberculosis, Over 201 Thames Street. Established visiting nursing in September, 1904. Number of nurses: Three — pupils. Salary: $50 per month and all living expenses at the hospital. Class of cases cared for: Tuberculous. Plan of Work: All visiting nursing in Newport is under the direction of the Newport Hospital. The tuberculosis department is supervised by a senior pupil who is assisted by the pupils in the Training School. The expense of this work is met by the Ladies' Aid Society of Newport Hospital, and by the Tuberculosis Association, the latter paying the hospital $.50 for each visit made to its patients. The secretary of this society co-operates with the nurses in all matters relating to the famihes of the tul)erculosis patients. Careful records of such cases are kept at the hospital dispensary. Maps have been made showing the location of houses where tuberculosis has been found. The Board of Health disinfects homes when death has occurred or removal has taken place. Provision is made for a special diet of milk and eggs for those who cannot buy them. Steamer chairs and tents are loaned for out-door treatment, and sputum cups, with instructions for the care and disposal of sputum, are freely supplied. Special 286 RHODE ISLAND leaflets are distributed to the school children through the public schools, and to mothers through the Mothers' Meetings which are conducted by the Civic League. Whenever possible, children are examined where the family history shows that other members have had tuberculosis, and the nurses keep a careful supervision over all patients who remain in their homes. The Newport Hospital. Established visiting nursing in the spring of 1884. Number of nurses: Three — two pupils. Hours: 7 a. m. to 5 p. m. Emergency calls are answered day and night. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: Association for the Relief and Prevention of Tuber- culosis. History and Plan of Work: Visiting nursing in Newport was first established under the supervision of the superintendent of nurses of the hospital, and so continued until 188 1, the nursing being done by the senior pupils. It was then for five years placed under the auspices of the Charity Organization Society, and separated from hospital management, though the pupil nurses still consti- tuted the nursing staff. In the fall of 1896, at the request of the Charity Organization Society the direction was resumed by the hospital. The department is in charge of a senior nurse who is selected for her adaptability to this line of work. The length of the supervising service is three or four months. One pupil cares for obstetrical patients only, and one is assigned to medical and surgical cases, including care of tuberculous patients. The length of service of each pupil is two months. Emergency calls are answered day or night by extra nurses. Sick-room appliances, bed linen, clothing, and nourishment are furnished from the District Nursing Fund. The Association for the Relief and Prevention of Tuberculosis pays the hospital $.50 for every nursing visit made to its patients. Visits requiring observation only are made gratuitously. ' 287 RHODE ISLAND PAWTUCKET Associated Charities,* 55 High Street. Established a visiting nursing department June 14, 1907. Number of nurses: Two. Salary: $60 per month. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, and obstetrical. Plan of Work: The nurse is empowered to draw upon the Associated Charities for supplies, and to furnish material relief when neces- sar}'. Clothing may be given, but bed linen may only be loaned. Society for the Relief and Control of Tuberculosis,* 55 High Street. Headquarters of visiting nurse. Associated Charities Ofl&ce. Established visiting nursing May 25, 1908. Number of nurses: Two. Salary: $60 per month. Hours: 8 a. m. to 5 p. m.; Sundays excepted. Class of cases cared for: Tuberculous. Plan of Work: Clothing, milk, and eggs are supplied for needy patients. PEACE DALE Neighborhood Guild. Established visiting nursing in October, 1905. Number of nurses: One. Salary: $65 per month. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: This is a rural district, and the work is carried on along settlement lines, the nurse doing her share of the social work, as well as of nursing. She has commodious quarters in the new Hazard Memorial Building, with a living room, sterilizing room, bathroom, and a large office fitted up so that it may be easily turned into an emergency operating room. * Nursing service of both has been combined, and is now known as the District Nursing Association. 288 RHODE ISLAND PROVIDENCE Providence District Nursing Association, 55 Eddy Street. Established in April, 1900. Number of nurses: 17, four of whom are pupils. Salaries: The nurses receive $50 per month for the first six months, $60 the following eighteen months, and $70 thereafter. Hoiu^: Eight. No visits are made by the nurses on Sunday; all necessary calls on this day are taken by the pupils. The nurses also have one afternoon each week free from duty. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: Providence League for the Suppression of Tuberculosis. Plan of Work: A superintendent, one assistant superintendent, eleven graduate nurses, and four senior pupils constitute the nursing staff. Two of the latter are from the Butler Hospital, and two from the Rhode Island Hospital. The city is divided into four districts, each of which has a supervising graduate nurse and one pupil. Four nurses specialize on tuberculosis work, two on children, and one is placed where the work is heaviest. The Providence League for the Suppression of Tuberculosis pays the salaries of the tuberculosis nurses, who confine themselves to the educational side of the work. Patients needing nursing care are referred to the District Nursing Association staff. During the summer, four special nurses visit in families where there are babies and small children, giving instruction and pro- fessional care. Two day camps for babies are maintained on private grounds; they are limited to ten beds each, and are kept filled by the special nurses. One object of the camps is to teach the mothers by example what they themselves may do for their children. Nurses who have had much experience with babies are in charge, and assistants work under their direction. Physi- cians of Providence have the medical supervision of the patients, visit the babies in their homes when necessary, and give talks to the mothers. The babies are broifght to camp at 8:30 every morning, Sundays included. The milk is modified each day, according to the physician's orders, and at night the mothers 19 289 RHODE ISLAND take their babies home with enough milk to last through the night; they pay $.05 a day for the entire care at the camp. The articles used for each child are kept separate. Bottles, nipples, night- gowns, and sheets are boiled daily. On the recovery of a baby it is sent home and visited by a nurse to see that instructions are carried out as long as necessary. A nurse also takes charge of the children who are sent away for summer outings. The supply bureau keeps all necessary articles on hand for the use of the nurses. Usually these articles are loaned. An emergency fund makes it possible to engage special nurses for critically ill patients who need constant care. There is also a fund for medicine, when it is impossible for the patients to pro- vide them. All such things may be bought at the Rhode Island Hospital at nominal prices. Through the kindness of a well- known dentist, free dental treatment may be given to patients in their homes. Owing to the close co-operation with the Society for Organizing Charity, it is not necessary for the nurses to give material assistance, except in rare emergencies, when the associa- tion is usually reimbursed by the Society for Organizing Charity. The League for the Suppression of Tuberculosis furnishes all relief for tuberculous patients. The Providence League for the Suppression of Tuberculosis, 332 Butler Exchange. Established its connection with the District Nursing Association in 1907. Number of nurses : Four. Class of cases cared for : Tuberculous. Affiliations: The District Nursing Association. History and Plan of Work: In April, 1906, the care of tuberculosis patients was undertaken by the District Nursing Association. The following year, the League for the Suppression of Tubercu- losis assumed the financial part of the work and pays the salaries of four nurses. The nurses do instrwctional work under the supervision of the superintendent of the District Nursing As.sociation ; they give no nursing care to their patients, except for purposes of 290 RHODE ISLAND demonstration. All bed patients are referred to the general nursing staff of the District Nursing Association. The Tuberculosis League is a committee of the Charity Or- ganization Society, and furnishes medical attendance, milk, eggs, clothing, reclining chairs, sputum cups, and cots. In some cases it has been possible to give adequate financial assistance which enabled patients to cease work and take the rest cure. Fam- ilies are sometimes cared for while the wage-earner is under treatment in the State Sanatorium. During the summer of 1907, a day camp was conducted for children who were in the incipient stages of tuberculosis, or who were considered especially susceptible to the disease. One nurse visited the camp, took temperatures, gave baths, etc. In the autumn the parents withdrew the children to send them to school, and this led to the opening of the first Fresh Air School in America. One entire wall of a classroom was removed, and great glass windows were put in which are fastened to the ceiling, leaving the space three feet from the floor quite open. The desks are movable, and the children generally sit with their backs to the sun. They wear hats and wraps, and, in cold weather, mittens. Foot muffs are supplied to keep their feet warm. A fire in a small stove in the centre of the room tempers the air, and enables the pupils to warm their hands. Hot nourishing broth is served at recess both morning and afternoon. The children are care- fully watched by a physician, and records are kept of their weight and general condition. In May, a day camp under the joint management of the hos- pital and Tuberculosis League was opened on the grounds of the Rhode Island Hospital. The hospital provides provisions, the league the equipment and a nurse. The camp has a large dining tent with two smaller ones for emergency use. Places are held for the pupils of the Fresh Air school during vacation time. The patients of the camp are those whom the nurses find in their visits to the homes, and whom they think may be benefited by the camp treatment. In 1907, the league held a tuberculosis exhibit at the Outlet, a department store. This was instrumental in calling the nurses' 291 RHODE ISLAND attention to many new cases, and a large number of new patients applied at the tuberculosis clinic of the Rhode Island Hospital, where a nurse is present three mornings a week. LIPPETT QUIDNECK RIVERPOmX WASHINGTON See Hope. WOONSOCKET Woonsocket Anti-Tuberculosis Association, i66 Main Street. Established visiting nursing November 9, 1908. Number of nurses: One. Salary: $70 per month. Horn's: 9 a. m. to 5 p. m. ; Sundays and one half day each week excepted. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: The State Board of Health. Plan of Work: Calls are accepted from all sources. Aside from her professional duties, the nurse does much educational work by giving talks and demonstrations to the patients and their families, to women's clubs, and in the public schools. Patients needing relief are referred to the association's relief com- mittee, which meets every two weeks. In case of emergency the nurse gives relief directly. Reclining chairs, tents, cots, blankets, etc., are loaned by the society. Milk and eggs are supplied when necessary. Trans- portation to sanatoria is sometimes given, with extra wraps and out-door outfits to use there. The State Board of Health supplies sputum cups, paper bags, and napkins. All cases attended by the nurse or found by her, are registered at the offices of the Board of Health. Houses where death has occurred or a patient has been removed, are reported to the Health Office for fumigation. 292 SOUTH CAROLINA SOUTH CAROLINA CHARLESTON The Ladies' Benevolent Society. Founded in 1813. Established a graduate nurse in 1902. Number of nurses: One. Salary: $50 per month. Hours: 8 a. m. to 9 p. m. Classes of cases cared for: Surgical, medical, obstetrical, contagious, and tuberculous. History and Plan of Work: This was the first secular association in America, so far as can be ascertained, to send nurses to the homes of the sick poor. Its constitution and by-laws, which we quote freely in this account of its work, contain much interesting reading, and show that many of the methods of the society, adopted at that early date, are in accordance with the most approved ideas of the present day. The society was the outgrowth of a severe epidemic of yellow fever which had left many families in a pitiful condition. Its object was "The nursing of the poor while sick and incapacitated to perform their usual labor." The principles of the society were thus expressed: "To relieve the distress of the poor, and the sufferings of the sick, is the duty of all. Charity is more blessed to those who give, than to those who receive, but by doing too much, the independence and energies of the object are destroyed." Sixteen ladies were elected annually as a visiting committee. Each visitor, for three months, had to visit " The sick poor within the four lower wards of the city, who are proper objects; visit them, if they can with propriety, and relieve them as prescribed by the regulations of the board." "There may be eight aged infirm persons retained as pensioners by the Board. The sum of 37^ cents weekly shall be allowed to these pensioners, but no money shall be given to patients." "No medicine is to be bought or paid for, the dispensary being open to the poor, and the physician the most competent judge of the constitution and 293 SOUTH CAROLINA diseases under which the patient is laboring." "Patients shall receive weekly one pound of brown sugar (unless the complaint be such as to render white sugar proper, in which case the white shall be substituted), one pound of coffee or a quarter of a pound of tea, a pint of lamp-oil or one pound of tallow candles, three quarts of grits or two quarts of middling rice, one pound or six and one-quarter cents worth of meat (fresh or salt), or a chicken every day, when meat is ordered by the physician. If milk be ordered in preference to meat, a pint may be allowed. Arrow- root or barley according to the state of the patient may be given, and one-quarter of a cord of wood, carting and sawing included, to last two weeks in winter; half the quantity in summer; one pound, or six and one-quarter cents worth of soap. Flannel and a blanket may be given when necessary." "Visitors may continue their visits and supplies for a week after the patient is left by the physician, or until the patient is quite convalescent. In cases of illness, or sickness where persons are subject to afflictions which though painful at the time are relieved, having intervals of health, and of ability of being out, they are to be left to their own efforts and family when once restored to their usual health. Chronic diseases, rheumatism, etc., are not subjects for this society. Such sufferers must be assisted to the Poor House, or the Hospital, and if they refuse to go, they must be left to do as they please, but they are not to be continued on the Society. "The poor are never so well supplied with comforts as to render aid unnecessary, therefore the visitors are requested to have the bed linen belonging to the society used in all cases of illness." "When patients are ill, nurses must be supplied by the visitors, and paid according to the services required. Any neglect of duty on the part of the nurse will meet with immediate dismissal." The sociei.y was undenominational in character, and its funds came from Protestants, Catholics, and jews. One clergyman gave $50, the proceeds of the sale of his sermon on the " Character of Eve." Up to 1865, fifty-two years after the society was founded, no changes had been made, and the plan worked very well. 294 SOUTH CAROLINA The war scattered the members and dissipated the funds, so that • no regular meetings were held for twenty years, but the society's ministrations never really ceased. In 1902, it showed its pro- gressive character by employing a trained nurse, and the work is now being carried on in the most approved way. Colored trained nurses and pupil nurses from hospitals are engaged to care for patients who need constant attention and are employed for days or even weeks at a time, working imder the supervision of the society's nurse. FROGMORE, St. Helena Island, Beaufort County. Penn Normal Industrial and Agricultural School. Established visiting nursing in October, 1906. Number of nurses: One. Salary : $30 per month and living expenses. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. History and Plan of Work: This is an agricultural district on one of the largest islands off the coast of South Carolina, and about half way between Charleston and Savannah. The population consists of about 7,000 colored people, and 50 whites. The Eustis family, as a memorial to their parents, engaged a graduate nurse from the Dixie Hospital, Hampton, Virginia, to take up the work in this community. The nurse lives at the Penn School and cares for both white and colored residents. She visits not only in the homes on St. Helena Island, but she also visits families living on the neighboring islands, of which there are a number. She cares for cases of illness which may occur among the day scholars, and student boarders. She has a weekly mothers' meeting at the school, where questions of hygiene, and problems that arise in the homes are discussed. She has a weekly mothers' meeting at the Eustis Plantation on Ladies' Island, and she also has two classes in hygiene among the advanced students. The nurse has an oftice in Cope Cottage, where patients go for advice, dressings and treatments of various kinds. 205 TENNESSEE GREENVILLE Monaghan Mills Visiting Nurse. Established visiting nvirsing February i, 1908. Number of nurses: One. Salary: $50 per month, board and laundry. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, contagious, and tuberculous. Plan of Work: This work was established for the benefit of the employes in the mills, and the people living in the village. There is a dispensary where the nurse assists the physicians during clinic hours; the remaining time is spent in visiting her patients in their homes. TENNESSEE NASHVILLE Methodist Training School. Visiting Nurse Department, 422 Park Place. Established September 18, 1907. Number of nurses : Two, and two pupils. Salary: $50 per month for the graduate nurses. Hovirs: Irregular. Classes of cases cared for: Surgical, medical, obstetrical, contagious, and tuberculous. Plan of Work: The school is primarily for the piu*pose of training missionaries and deaconesses for home and foreign fields. The Nurse-Deaconess training extends over a period of three years, two of which are given to the technical nursing work, including the care and feeding of children, and nursing in the homes of the poor. A trained nurse is employed to reside in the school, supervise its sanitary conditions, attend to the food of the pupils, and care for any who may be ill. The Nurse Circle, First Presbyterian Church, 154 Fifth Ave., N. Established visiting nursing in 1898. Number of nurses: One. Salary: $50 per month. 296 TEXAS Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. TEXAS EL PASO El Paso United Tuberculosis Relief Association,* Court House Building. Established visiting nursing February 15, 1909. Number of nurses : One. Salary: $75 per month. Hours: 8 a. m. to 5 p. m. Class of cases cared for: Tuberculous. Affiliations: The Women's Associated Charities. History and Plan of Work: Miss A. Louise Dietrich, superintendent of St. Mark's Maternity Hospital, gave her services for one month in order to demonstrate the need of visiting nursing work among the tuberculosis patients. At the end of that time the necessity had been shown to be so great that twenty men pledged them- selves to be responsible for the nurse's salary. She attends the free tuberculosis clinic, and visits the patients in their homes. The larger number of them live in tents, and are people who have gone to Texas from other states hoping to regain their health. Clinics are held every afternoon from 3 to 4, and on four mornings during the week. In cases of necessity the Women's Associated Charities furnish eggs, milk, clothing, reclining chairs, etc. FORT WORTH Medical College Hospital, 1003 Throckmorton Street. Established visiting nursing May 10, 1909. Number of nurses : Five — pupils. Classes of cases cared for: Medical, obstetrical, and tuberculous. Plan of Work: The pupils visit in the homes a certain number of hours each day. It is expected that the work will demand a salaried nurse in the near future. * Nursing service discontinued. 297 UTAH HOUSTON Maple Street Settlement Association, 1701 Maple Street. Established visiting nursing March i, 1909. Number of nurses: One. Salary: $75 per month. Hours: 8 a. m. to 6 p. m. Emergency calls answered at night. Classes of cases cared for: Surgical, medical, obstetrical, contagious, and tuberculous. Affiliations: Christ Church. Plan of Work: The nurse is in residence at the settlement, where she has an office and First Aid room. Contagious cases are visited once and instruction for the care of the patient is given. The nurse visits the Rusk School, one of the public schools in the most crowded district. The children are examined by a physi- cian, and the names of the sick or needy pupils are given to the nurse for care and investigation. Through the school children the entire family is reached. The nurse has an office in the school building, where she may be seen at certain hours for advice and minor surgical dressings. She is also connected with the Salva- tion Army Dispensary, which is the only free dispensary in Houston. UTAH SALT LAKE CITY The Relief Society Nurse Class of the Mormon Church. Established visiting nursing in 1899. Plan of Work: The Mormon Church cares for its sick poor in the following way: Each nurse, in consideration of her training, which is free, agrees to do charity work among the very poor for fifty days, during a period of two years after her graduation. This is done in answer to calls from the superintendent. The superintendent supervises the work, and the officers of the ward associations co-operate with her, in supplying food and clothing when necessary. 298 VERMONT VERMONT BELLOWS FALLS The Women's Club, Visiting Nurse Department. Established visiting nursing January i, 1904. Number of nurses: One. Salary: $75 per month. Hours: 9 a. m. to 6 p. m. Emergency calls are answered at night. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: Nourishing food and clothing are furnished to those who need such help; and many cases of financial distress are relieved with funds given by the churches and the town. BRATTLEBORO Brattleboro Memorial Hospital,* Canal Street. Established visiting nursing in March, 1902. Number of nurses: One. Salary: $50 and all living expenses at the hospital. Hours: Irregular. Calls answered at night. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. History and Plan of Work: Visiting nursing was begun under the auspices of the Thompson Trust, more than two years before the hospital was opened. The trust was created by the will of Thomas Thompson, who left a sum of over one million dollars for the relief of poor seamstresses, needle women, and shop girls in the tc^nc of Brattleboro, Vermont, and Rhinebeck, New York, who might be in temporary need. The will provided that if the whole income was not needed for this purpose it should be applied to kindred charities. By a decree of the Supreme Court of Massachusetts, the trustees were authorized to build, equi[> and carry on hospitals in Brattleboro and Rhinebeck. In order to supply the need of nursing for many poor patients before the hospitals could be finished, a visiting nursing service was started and is still being carried on, in both places. There is one graduate nurse in Brattleboro who gives her entire time * Visiting nursing service disconlinucd. 299 VERMONT to the work ; she is assisted by a pupil from the hospital when the service is heavy enough to require it. Calls from patients unable to pay the nurse's fee are given first consideration. The follow- ing schedule is maintained for other patients. Obstetrical visits, first call, $i.oo; subsequent calls, $.50; twelve hour duty night or day, $3.00. Major surgical dressings, $1.00, minor dressings, $.50. Massage per hour, $1.00. The income received from pay patients largely sustained the free work during the year of 1908. Clothing or bed linen may be supplied to needy patients. Through the co-operation of the Mutual Aid Association, housekeepers or helpers are sent to patients needing constant care, and they work under the direction of the nurse; they are also sent to homes where the household and children must be cared for when the mother is ill. BURLINGTON The Visiting Nurse Association, 114 Pearl St. Established February 4th, 1907. Number of nurses: One. Salary: $60 per month. Hours : 8 a. m. to 5 :3o p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: Calls of extreme emergency answered at night. The nurse has supplies of bed linen, clothing, and sick room appli- ances. Nourishment is given when necessary. PROCTOR Proctor Hospital, Visiting Nursing Department, Ormsbee Avenue. Visiting nursing established in 1895. Number of nurses: Two; sometimes three — pupils. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. History and Plan of Work: The Vermont Marble Company started the visiting nursing service in Proctor and West Rutland, before the hospital was built; the service being instituted for the benefit of the employes and their families. The work proved so 300 VERMONT successful that the company built a hospital in Proctor in 1896, and the visiting' work was continued imder the supervision of the training school. The graduate nurses were replaced in time by senior pupils, one of whom was assigned to West Rutland, and one or two, as the work required, to Proctor. The hospital is maintained largely for the workmen of the company and their families, but others in the community are admitted as pay patients. The income so received goes toward the expenses of the hospital, and all further costs are borne by the company. No fees are paid for the nurses' service. ST. ALBAN'S St. Alban's Visiting Nurse Association, 17 Bank Street. Established Jime i, 1907. Number of nurses: One. Salary : $50 and expenses. Hours: 8 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: This work was started and is carried on by the Women's Club. WEST RUTLAND See Proctor. WINDSOR The Windsor Visiting Nurse Association. Established March i, 1907. Number of nurses: One. Salary: $65 per month. Hours: Irregular. Calls answered whenever received. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: Calls are accepted only from physicians or some member of the committee on nursing of the club. 301 VIRGINIA VIRGINIA ALEXANDRIA The Anti-Tuberculosis Society, Alexandria Hospital. Established visiting nxirsing in January, 1898. Number of nurses: One. Classes of cases cared for: Surgical, medical, obstetrical, and tuberoilar. Plan of Work: Bed linen and clothing are loaned when necessary. BEAVER DAM, Hanover County Beaver Dam Visiting Nurse, Pinecote. Established December 15, 1908. Number of nurses: One. Salary: $60 per month and fiunished house to live in. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work : This is a rural district, and the nurse cares for both white and colored people. She has a horse and carriage for traveling long distances, and a loan closet which contains bed linen, clothing, and sick-room appliances. DANVHLE Ministering Circle of King's Daughters. Main Street. Established visiting nvursing in May, 1904. Number of nurses: One. Salary : $50 per month. Hours: 9 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, contagious, and tuberculous. Plan of Work : The nurse has the use of a horse and carriage when necessary. HAMPTON Hampton Training School for Nurses.* EstabHshed visiting nursing in 1891. * This Training School has not replied to late communications. 302 VIRGINIA Number of nurses: One — pupil. Hours: Irregular. Calls are answered at all hours. Classes of cases cared for: Surgical, medical, and obstetrical. Plan of Work: This service is a part of the regular training given to the pupils in their senior year. LEESBURG The L. M. Memorial Nurse. Established October 15, 1904. Number of nurses: One. Salary: $70 per month. Hours: Irregular. Emergency calls are answered at all hours, and special private duty is sometimes taken. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: The nurse visits in their homes both white and colored patients, and no one is allowed to pay for her services. Only such presents as are suitable for the replenishment of the loan closet are accepted. In addition to visiting, and giving instruction in the homes, the nurse conducts classes in elementary nursing for trained attendants, who are thus enabled to take a certain class of patients at moderate fees. LYDIA, Greene County St. James Mission. Established visiting nursing in 1906. Number of nurses : One. Hours: Irregular. Plan of Work: This is a mountainous district, and the nurse makes her calls on horseback, sometimes riding eighteen miles to a case. There is a small hospital of five beds of which the nurse has charge, and as the nearest physicians are seven miles away all the hospital beds are frequently full. LYNCHBURG Van Dyke League, Church St. Established a visiting nurse department in April 15, 1908. Number of nurses: One. 303 VIRGINIA Salary: $75 per month. Hours: 9 a, m. to 5 p. m. Classes of cases cared for: Surgical, medical, and tuberculous. Plan of Work: Food, clothing, medicine, and bandages are sup- plied, when they cannot be obtained elsewhere, MISSION HOME, Albemarle County The Protestant Episcopal Church. Established visiting nursing in 1906. Number of nurses: One. Salary: $25 per month and expenses. Hours: Irregular. Calls answered whenever received. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: Mission Home is the headquarters of a large moun- tain mission work, which is divided into three departments: medical, educational, and evangelistic. For the former there is a hospital consisting of one small ward, a nurse's room, and a dispensary. The work of the nurse is almost wholly that of visiting in the homes; only patients needing close attention for a short time — operative cases — are taken into the hospital. During the nurse's absence on her rounds these are cared for by a deaconess who has also had hospital training. The work is supported by members of the diocese and people interested in the cause. It is under the direction of the Archdeacon of the Blue Ridge and of the Rev. Geo. P. Mayo, resident rector of Mission Home. NORFOLK Anti-Tuberculosis League, loi Freemason Street. At present financial arrangements have been made with the City Union of King's Daughters nurses to care for their tuberculous patients^ both white and colored. City Union of the King's Daughters, 90 Charlotte Street. Established visiting nursing January i, 1897. Number of nurses: Three; one supervising nurse, one assistant, and one pupil from the Norfolk Protestant Hospital. 304 VIRGINIA Hours: 9 a. m. to 6 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Affiliations: The Protestant Hospital and the Anti-Tuberculosis League. Plan of Work: The work is carried on in connection with the Board of Health, city physicians, and private practitioners. Through arrangement with the Anti- Tuberculosis League, the superintendent of the King's Daughters' nurses cares for all tuberculous patients. The pupil nurses have one month in the district work as a part of their regular training. The King's Daughters employ a visiting housekeeper who is sent into the homes when the mother is ill, to look after the children, attend to the housework, and carry out the nurse's directions in her absence. The society has a sterilizer for pre- paring surgical dressings and maternity outfits. Bed linen, clothing, and sick-room appliances are furnished when needed, also milk and medicines for patients who cannot afford to pay for them. A seaside camp is planned for the near future with a special view to caring for the children of tuberculous patients. Norfolk Protestant Hospital. The pupil nurses have each one month's training in district work. This is supervised by the superintendent of the City Union of King's Daughters, 90 Charlotte Street. Southern Industrial Classes, Visiting Nurse Department,* Cumberland Street. Established November 15, 1905. Number of nurses: One. Salary: $550 per year. Hours: 9 a. m. to 6 p. m.; Sundays and Friday afternoons excepted. Classes of cases cared for: Surgical, medical, and tuberculous. Plan of Work: The object of this society is to care for the sick, and to introduce industrial work into the public schools for colored students in Norfolk and its vicinity. The nurse is a colored woman, visiting only among her own people. A part * Visiting nursing service carried on by King's Daughters. 20 305 VIRGINIA of her time is given to the regular class work for girls attending the school. This course comprises first aid to the injured, hygiene, bed-making, and the care of chronic invalids, and the lessons are supplemented by lectures from physicians. The nurse also has classes for older women and mothers. A supply closet furnishes sick-room appliances and bed linen; old clothing is kept on hand to be loaned or given to the patients when needed. A relief fund is contributed by the colored people to provide fuel and nourishment for the sick in cases of great need. PETERSBURG King's Daughters and Sons, 25 North Union Street. Established July 4, 1906. Number of nurses: One. Salary: $50 per month. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: Nourishment, clothing, coal, and medical appliances are furnished when necessary. RICHMOND Instructive Visiting Nurse Association, 223 South Cherry Street. Established in October, 1900. Number of nurses: Six. Salaries: From $40 to $60 per month and carfare. Hours: 9 a. m. to 5 p. m. One afternoon free from duty is allowed each week. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Attendants and special nurses are employed for contagious cases. History and Plan of Work: The settlement was founded by a group of self-supporting graduate nurses under the leadership of Miss Cabaniss, with the intention of carrying on charitable nursing in intervals of spare time. The work became so absorbing and the demands so extensive that, after sixteen months of the ex- 306 VIRGINIA perimentai undertaking, they decided to appeal to the public for funds to enable them to devote their entire time to visiting nursing and social settlement work. A house had been rented and fur- nished, and up to the time the appeal was made, all their personal expenses and those incidental to the work had been met by the nurses. All the churches of the city and many individual friends responded to the call. An association was formed on a non- sectarian basis, and the regular staff of nurses was provided for. The settlement has been an active force in civic and municipal affairs, and has promoted the development of the Charity Or- ganization Society, reformed the arrangements for nursing in the city almshouse, and developed active working relations with the Board of Health, which has now placed its two tuberculosis nurses in the settlement under the direction of the head worker. The nurses are doing experimental work in the public schools, and they hope that this will later be taken up by the city as a regular service. There is a loan closet supplied with bed linen, clothing, and sick-room appliances. Special diet for patients is sometimes prepared at the settlement. Richmond Department of Health, 1408 E. Franklin St. Established visiting nursing November 25, 1907. This clinic is for white patients only. The nurses of the In- structive Visiting Nurses Association attend the clinics and visit the patients in their homes. Richmond Dispensary for Tubercular Communicable Diseases of the Nose, Throat and Lungs, 412 North Third Street. Established visiting nursing November 25, 1907. Class of cases cared for: Tuberculous. Affiliations: City, and Instructive Visiting Nurse Association. Plan of Work: The nurses of the Instructive Visiting Nurse Asso- ciation attend the clinics and visit the patients in their homes. When necessary, milk and eggs are furnished by the city in a limited amount. This dispensary is attended by colored patients only. 307 WASHINGTON Richmond Tuberculosis Institute, 210 North 23d Street. Established visiting nursing November i, 1905, in connection v^^ith a charitable dispensary, which is in a specially constructed build- ing in the rear of the institute. Number of nurses : Three. Salaries: $40 per month, with board and lodging. Hours: Irregular. Class of cases: Tuberculous. Plan of Work : The nvuses attend the dispensary, which is open every day from 7 a. m. to 9 a. m, and 7 p. m. to 9 p. m. Financial aid is given in cases of extreme need. WASHINGTON SEATTLE Board of Education, Seventh and Marion Streets. Established school nursing January 13, 1908. Number of muses : Two. Salaries: $85 per month. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, contagious, and tuberculous. Plan of Work: Salaries are paid and control and supervision exercised by the Board of Education. The nurses carry out the instructions of the medical inspectors, who are under the Health Board. Each muse visits thirty schools, or one-half of all in the city, representing an enrolment of 12,500 pupils. Routine in- spection of hair, eyes, ears, nose, throat, teeth, and skin is made periodically. Cultures taken from suspicious looking sore throats are sent to the Health Board. The nurses keep records of all the cases, visit the homes of pupils who are excluded, and impress upon the parents the necessity of carrying out the physicians' orders. As there are no free clinics in Seattle, the nurses enlist the services of private practitioners in cases where the family is unable to pay the customary fee. In the visits to the homes, the nurses find many 308 WASHINGTON opportunities for detecting and correcting causes responsible for the troubles for which the children are under treatment. Charity Organization Society, 312 Collins Block. Established visiting nurse department July i, 1905. Number of nurses : One. Salary: $70 per month. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: A special effort is made to care for tuberculous patients. Paper napkins are fiunished by the society, and milk and eggs are supplied by the Fruit and Flower Mission. A supply closet fvimishes bed linen, which may be loaned to general patients, and occasionally given away to needy cases. SPOKANE The Associated Charities of Spokane, 415 Lindell Building. Established visiting nursing February i, 1908. Number of nurses: One. Salary: $80 to $100 per month. Hours: 8 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: A loan closet provides bed linen and clothing. Sputum cups, milk and eggs are supplied to tuberculous patients when they are not able to buy them in sufficient quantities. TACOMA Board of Education. Established school nursing December 25, 1908. Number of nurses: One. Salary: $65 per month and carfare. Hours: 8 a. m. to 6 p. m. ; Saturday afternoons and Sundays excepted. Classes of cases cared for: Surgical, medical, contagious, and tuberculous. 309 WEST VIRGINIA, WISCONSIN WEST VIRGINIA MOUNDSVILLE Reynolds Memorial Hospital Training School for Nurses.* Established visiting nursing in 1905. Number of nurses: One. Salary: $40 per month. Hours: Irregular. Calls answered whenever received. Classes of cases cared for: Surgical, medical, obstetrical, contagious, and tuberculous, WISCONSIN EAU CLAIRE Eau Claire Visiting Nurse Association, 3o8>^ Barstow Street. Established April 15, 1903. Number of nurses: One. Salary: $60 per month. Hours: 9 a. m. to 5 p. m. Classes of cases cared for: Surgical, medical, obstetrical, contagious, and tuberculous. Plan of Work: When necessary, an emergency nurse is employed for contagious diseases. The association co-operates with all the charity organizations of the city. There is a loan closet, which supplies necessary furnishings for the sick room. Medicines, malted milk, fruit, and food are given to patients when necessary. Tents are also supplied for the out-door treatment of tuberculous patients. MENASHA See Neenah. MILWAUKEE The Ladies' Sanitary and Benevolent Association, 7th and Vliet Streets. Established visiting nursing on June 24, 1906. Number of nurses : One. Salary: $40 per month. * This hospital has not replied to lute communications. 310 WISCONSIN Hours: 8:30 a. m. to 5:30 p. m. Classes of cases cared for: Surgical, medical, obstetrical, contagious and tuberculous. Milwaukee Visiting Nurse Association, 624 Caswell Building. Established July i, 1906. Number of nurses : Seven, Salaries: $60 for three probationary months; $70 the following nine months, and $85 thereafter. A large part of the uniform is provided by the Association. Hours: 8:30 a. m. to 5:30 p. m. Classes of cases cared for: Surgical, medical, obstetrical, and tuberculous. Plan of Work: There is in each district a loan closet containing bed linen, clothing, and sick-room appliances. A fund given by the Alpha Zeta Pi Society furnishes nourishment, milk, eggs, and medicines for needy patients; food and fuel are supplied for emergency cases. One nurse specializes in tuberculosis work, and attends the clinics at the South Side Free Dispensary, 331 Grove Street. She visits these patients in their homes, instructs them how to carry out the treatment prescribed at the dispehsary, and how to avoid further contagion for themselves and their families. One nurse attends the Children's Clinic, and gives nursing care to those patients who are too ill to go to the dispensary. A day camp for sick babies is maintained throughout the summer months. In 1908, a "Tag Day" was held for the benefit of the association, and $11,000 was realized. In the fall of that year the nurses began experimental work in the public schools, and there are now three nurses detailed to that work. NEENAH The Visiting Nurse Association. Established October i, 1908. Number of nurses: One. Salary: $60 per month. Hours: 8 a. m. to 6 p. m. ; Sundays excepted. 311 WISCONSIN Classes of cases cared for: Surgical, medical, obstetrical, contagious, and tuberculous. Plan of Work: Patients living in Menasha are cared for also. RACINE Instructive Visiting Nurse of the Associated Charities, 212 Fifth Street. Established December i, 1908. Number of nurses: One. Salary: $50 per month and carfare; limches also are provided. Hours : Eight hours. Classes of cases cared for: Svirgical, medical, obstetrical, and tu- berculous. Plan of Work: There is a supply closet with bed linen and clothing to lend. 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III JJ_ 1 s snojnojtqnx 2^2 u t s £ S s t >-><>- >< > > > >< > > ^ snotgvtuoj S : SB i : u O > > > jvjtJfttsqo 0/ u 1 s « ^ ^ : 8 > > > > >> > >< pnpgjf S £ 8 s 2 jQ » ss d U >. >< >i >< > >, >4 >- >< jDnijng s s : s £ ^ s iS 8 >H >H >< >< >, >H tH >4 a >< C" xo V) <3 vO vO vO m H 1 1 1 1 1 1 1 1 1 1 S S 1 1 1 1 1 1 1 1 1 1 a X .00 00 OC < o. 00 00 00 00 Oi 00 g H}4»d : : s 5 h3 tffvnpv^Q M M t~ " " " M H " « sasanM io om w « r. - " M M H « « en IMSy Jtiito i2 § ^-^ ; ; U S Q o . ; X H M u ■< i{Jjnijj • 3 s s ^d < uotfvztuvSuQ 'KitlivtiJ __ 00 > M <: tr, w 00 as iHsnavxsg 8> 1 8. S 8. 8> 1 ^ 8, & jl i| a-- g ^ « ^ c "■ c 1 ^ > 5 ? age i !^ ^ s > .2 £ K, „ i« ■^ X < 7 1— > «- 3 w f B Q ^ wl " S:|g •s 5 .2 -^ ^J 1 *- rt tJ *" C/5 tAl JS < < t-i c h h r-i Q ca CQ H ; < i Id z ■ < < < : 4; .i tJ in gi 1 1 c 1 a ^ a -s ^1 ? 1 -^ ^ c c t- c rt c o B K a 3 O .2 (73 > .2 "1 ^ J^ be H 8 ^1 ^ ^ < -a ^1 H H a B c c bo &K •S - Q 2 3 «J "s "S I .a a' ** tJ o j3 ^ ,. E S K U X •« (T. a ^ be "* -J ^ ^ A ospita t Xur St. •sClu Dept. 1th, S 3 £ ti i pita 11 H stric man urse Hea [/3 s 25 ^>y< ^ W - W h „ S ^ 60 o 'E < Trull Asso. Eastpo ing A Houlto \isiti Board ri X ^ :^2:{ § t l-i U) a .. . 2 T3 Si V 51 2 ^ OSS! .s "2 s a fc «» ^ o ^ 8 ;c S g. snopiodsqnx >5 1 >< >> > i snotStfiuoj : > fa o tn U p)jtu}»tsqo > i i p^pm > S > > > i > pnSMs 1 > i > i « 3 nii^d s»ivttpv*f) sasaa^ so "0>i 1U3%Y J3t{t0 City. City. o H < fa fa < H^-inHD 1 : 3 : : : : : : : 1 ^ uotjvxtuvSjQ ....... . , iCluvi{j !■.....■ . . a3Hsnavxs3 •^00 ■i^>o r» lot ii << 'A District Nursing Asso. of Portland, Maine General Hospital. Tuberculosis Class Asso.. I4S State St. The Babies' Milk Fund Asso., 804 Cathedral St. Department of Health, City Hall. Department of Health, School Nursing, City Hall. The Instructive Visit- ing Nurse Asso., 1123 MadLson Ave. The Johns Hopkins Hospital Alumna; As- so., Hourly Nursing, 2i9i E. North Ave. The Johns Hopkins Hospital Out-Patient Obstetrical Dept. The Johns Hopkins Hospital Out-Patient Orthopedic Dept. l-l Portland (.Continued) Maryland R,iltimore. 324 a K § S O B. ^ Si t S.fi 5 d S cil 2 E = S ^ O T3 >> "^ <» =^ g c b ih *^ b c ^ -a >2 3 ^" 3 ^ S, § t: E-S E ^ ;^ >^ 8 . > > S > 1 1 $ Yes. > >^ >J >J i > s >< 1 > a. 2 ■-3 Q ■o -3 ^ K „ ^ „ 2" t^ in vO «. 8. 00 1 S R 00 a H. ^ 8> ^ w M •3 -a 1 S $50 first year, $70 thereafter; $5 per month, carfare and part of uniforms. $1200 per year super- intendent, $1000 assistants. Pupils. $70 per month. Pupils. Pupils. < tn W •< tk snmSviuoj : : : : : : >I $ JV3tp»ff >- £ SS SG : ss jvnSjns > > t Hours of Duty at •< 1 00 1 i 1 1 1 1 CO O^ t^ 06 t— t 3 at o 2 ■< M sjidnj si}vnpv4Q « 10 H. ■>«• • « • « ro . M • S3san>j io "OM M 0. ■<»• fO « M « - 5 < ]u»Sy 431110 d : : : i-". : UOtlDZtlwS^Q onliiiued) House of the Good Sa- 1906 niaritan, Francis & Binney Sts. Hull St. Settlement, 1805 Medical Mis.sion Disp.. 36 Hull St. : uaHsnavis'.i i J-. Q £ C H •< < -0 U-. t^ 'O ce Q 000. 00 5 & 00 00 00 Ind'l School for Crippled & Deformed Children, 241 St. Bot- olph St. Instructive District Nursing Asso., 561 Massachusetts .'\ve. Massachusetts Genrl. Hospital, Social Ser- vice Dcpt. Ma.ssachusetts Homeo- pathic Hospital. .\It. Sinai Tuberculo.sis Clinic. .\ew England Baptist Hospital, Parker Hill Ave. N'ew England Hosp. for Women & Chil- dren, 20 Fayette St. ;j2(j — ■5 5"= c c a- c o o „ c S & 1 > > >* 3 J3 !-* f J= III S e c o o o^^ !: S E b« t. **S Si a s. S. :? s g. o o w «» *» J s. I— r 00 00 00 00 I I I I I 3 ^ s 2 -a - -p = - O •£ j: ^ j= c j:* '2 •:; -i a ^ - •- s.- Q !2 ^ a c s ^ .s ' '5 t ^ -^ -; Q > "3 >- _ 2 O r<^ ^ .^ .■5 -^ U 5° ■3= -g :i27 1 "O 3 lO g ■3 •2 -o «» 3 V ^ ^ . ^a M < §1 1. j: . - 8 •s ■s a o o S. 11 < u^^ E V a E Eg s « S W 1- 0, «» c '5 § R snoptOMqnx £ s s d t s w oJ 2 i £ > >< >, >H > >l > > > > > snotSvtuoj • U . • ■ . ■ ■ ■ O pot^fipqO 4^ QJ a> o £ o a o u V M >' >H > > >H >< >H >H >< >< JVStpfff d « t s Si s £ sj i M iJ >1 > tH >. > >< >. > >< > u p)n8jns « fi £ : s 3 s s s i >< >< >H >H >H >^ >* >< > U ^ i3 ^ o i ^ i ss 3 be i ttf u 3 M 3 1 1 a 1° a b fc t; h t- fc: fc t K ■< 00 *^ *"* g mfnd " " 2 2 H S3tvnpvJf) sassn^ 10 'o^j 1^ lusgy Jiiffo E 2. : S o H S iio.mtij 1 ti »< < uouvziuvSjq £ &tU^D tH > „ o >fl 00 t^ r^ -c 00 o. 00 t^ aaHsnavxsg S 8, a & 00 §> g g & g & si u •1-2 il 1 i 3 ^ o < ' • be .« < t^ -9 & ^ 5 mU o -^ 3 3 i;.' c c« S q8 o C M 3 S c/o .E f '3! g -3 O o H 3 W S2 s< 1^ 1 5= X be II 2 Z ^1 •c O .2 "S 2 5 • - S 00 Ol m 00 • 1^ ^S2 < ^ u 2 t M *C bw Q < O H a K K ^ H H H c o O E S C •< 4. c 1 « 3 el c c 2 L^ 1 %. c 1 v. c L> u. C c O C K K X 328 •i Q, • E ■" o ■« E GO O *'* 1/1 rt fo »N. \Q ^ *C *~ 'C E " 5"e s > 1 1 ^ >^ 1 > >J >• s > > ■ >i • • 1 > > s >* 8 > >< s > t > >< > I T T 00 J2 I 5 " " " - " - " " " - - M fO " « : : 5 1 . o V3 : : : : : : : : ; : : : : : : : > 1 00 00 1 a 00 1 1 o CO 00 00 00 00 2 '-S E .e o rt ^ rt d w 2; ube Lee stria H " 3 «j "S n c E c f= E « > "7 o ^ '-* u .^. d i^' •c cr t) m 11 !X n, S!< c« J3 -a ja < J3 < H H H § t1=^ ^ ^ £f i2 Q "«; bo 3 •3 < H h H H H — • < 3 -^ r. E .S X .5 3 -, !>^ H -a < 329 a, rt - g i ^ S o § ° o c 2i ^ :5 s o C -• ■= CD ■S J« «»o;n3i»^X ^1 > i > > i > i > > u tntngvptoj : : : : : : : : : : : : o p>3tjpisqo > i i > > t t > i > > > 2 > >< < U V>^P»H t t i > > t t i > t > t > 1 1 pnSuns > t t > > i > t > > > P^ W ^ XT) XTi Xfi tUiSy J»H10 11 H'^ntiD a3Hsnavxs3 u as - ^^ be J3 .5 3 — o 5 o -A g ■5 K ^- E "2 js o « ^ a i? S « jn •2 -5 •- o Q . -^ 4* .— 'is- :- f- =- /^ H ^ SUj=^-'. ^>-c:t/3UJ= O w o w J3 = 3 i ^ t^ CJ ; .2" _g o •5 -S s O CO y. y. y. 330 >>•"♦; 21 E a ^ o> o ■Si <» 1 s -d" . rt ^ o Ta ^ S - 3 . •£ J3 •£ c ~ c C i o E i E §1 i S. Yes. Yes. Yes. Yes. Yes. Yes. Yes. Yes. Yes. Yes. Yes. Yes. Yes. Yes. : : : Yes. Yes. Yes. Yes. Yes. Yes. Yes. Yes. Yes. Yes. Yes. Yes. Yes. Yes. t t t tttttttt 8 SB SB > > > Yes. Yes. !Yes. Yes. Yes. Yes. Yes. Yes. JYes. Yes. jYes. t S SB E 2 ■2 .2 QZ^ .• Z a O K -C ii .53 E • •£ ^ M ^ ^ :s g I =" c^ .. |l?!^li^5l1li§-i 8 E bo _■" a i 2 c^ U — " ^ ^ « p .b C ^ § ^ °y o - O £ K 'C .y U "^ ^ 3 a ., S ,, .'^ ~ <^ ;j;ii .i 13 ■§ 3 g Id •o -^ >< J3 J3 cS ^ S •«' J3 J3 JS 1 s i ^ei g E g I t-l IT S 5 >- 8 i O o snojn3Mqnx s >.^ t i 4J i s S S « s M >H > >H >H > > tH >H pH tH >H snotSvtuoj « t s u O >< >■ >< jvn^msqo i :§ t S £ ^ Id > > > >H tH >^ tonpsyi £ t i : £ i U « t >< >1 fH >H > >< >^ > pnSjng 2 £ S s i « « t Ix > >i >l > >< > > o o " w " « sasaQ>i JO -oisi •<1- 00 M « . >o " H " " lUiSy Mtno 8 "• "^ ■ s^ o >« U z g H s t(3^nijj 1 J d (« < iwiivziuvSjo KfidtntJ o -o "u ^„ ■a - t: •- Sf 2 J ^ >.Q -• 1 ^ § ill! ^ ^ ? 31 ?: i! j:l t/5 o S, 8 P < bo ho c a 3 3 II •3 U 11 CO ^ 1^1 Q pd S U ^ ft PC (^ > H H CQ w K H H fS M O •c < P4 XI c c M c c 8 s c S 3 O J3 -3 "3 u. C a HH 1- W 332 K S3 I month, boa y and carf ar month. s. ^|R o 1-1 >< i i S >< o A 5 .i J w ™ (3 O ^ u. t:? .2 o c to O X O 2 , 11 ^ > > > > > >< > >H > > 2 > i > : s > ^ I I 1 1 8, a 1 1 •o 00 00 < S( ^ g > E 3 2 :5 8 .2 d s u a o rl _« u! < CO rt P £ o •3 U bi j^' n 3 fr V— . 'A < > ^ is 0- 2 f a w •-~i ^) u i" ■.n p 2 d 'n E < "o fci C :< £ tj 1) 3 J3 9. 2 < ^ r! 1—1 333 1 C ■g :5 ^ t; o .^ ^ te c "• o. *'■? § c O 3 o > < "3 1 £ E < XT. c 1 ^^ 1 . s ■J jn R 1 s > 3 nl O ""a >o rt lo OP "S 3 c E o a- Q 2 S. snt^3J9qtiX 4) ■ £ ^ t 2 Sfi in H < >H ■ >< > > >H >< snotSviuoj . '■ ^ . u >i O pnxi»pqo t 2 8: ss S3 2 SB SB < > >H >H >. > >, >H >. P^V»H i t i \ t £ 2 SB SB .J > >< > >H > > > > fvnS^ns t sj SB : ^ £ £ SB t > > >H >. >H >H >< > N a . o u ij iJ X p<'iS >0 lO "^ ^ J2 i2 ^ - sas an>i iO ■o>i " M >0 W) W M M n M /Ms^l/ ^3?/;o >> u : : S5 O , ,• -d 2 H K ^ T3 s iioumij • 3 O • • ^5 < ■ ■^' ^ tunivzuwSuQ 'Kiuviij > 4j ■> aaHsriavxsa 8, \0 ^ r^ M 00 CO O- & i 1 1 i " M S c8 |- _^ CO g^ 11 1:2 »5 !i 'A .y o (5 6 ^< a.s 1 J 'oL i^ E £^ o .2 .S -g ^ ^ ^ «| ^ < .B X ^ < ^ ^-^i^ yi .'^X •3 3 <« g ■§ ^ i i g S J2 t/2 U C U 1 m > t^ * < OS 3 •A in U ■a; p. < (^ *^, ^ C. n ffi c t7 ^^1 C c E C 334 KZ •» 73 ■= «» C I. 5 ■£ c8 •:: •- a fe i I i :^ I a 9" <- Z " g J- O £ w tH > > >" > > > > > >< >< > > > 8 >< > > > >< >< > > > > > 1 >< s > > > > >< > > > > >• >< rt ^ n : : : : " : « ' '■ : : : " - " - " : " M HI W „ - " M •» « - " - n M « M " H « .s w i2 „ .5 ,•/^ C 2 _; a H al. trict on. Dis- K-ia- So- g n 'i-i ^^ a S * ^ S .2 fe z 5 ^ E Society, tt City H Lisbon rsing Asso Manchest t Nursing , City Mi Good Ch >. > 1 .2 1 ?i C :i "s > 6 ^i£^?.M-S 1 ^ ■g J= < -c 3 12; ^< U E ^ " E 2 ^ — o 335 "• a o o B a o •5 -S a a o o B e §■3 B .2 £ ^•ol R o 6 >< > > > > > > >^ snotSvptoj > > ; : fvytJtitsqo V > i > > i > 1 > p>np?ff > > > > i > i 1 i 1 i jvJiBJtts > > > > > i 2 >< i > i»fvnpvJQ sasan^.^ io 'o^j tusSy usmo 1i3M1{J UOtfVZtUvSjQ 'KftJni{j aaHsnsrvxs3 3 -t: i. Po •/-. .Sf 9 IT, O s >< s > > £ > 1 > S > : ; s >* S >> : : ; ' ■ >« ; 5h si >< > >< 1 1 1 > > s >- 33 > >i 2 > 8 > 8 > : d >* s > >< s > > 2 >< >< >. « M m w » « « H H, M » - « - VI M M « m M - - W " 3 •« C/3 • t > 1 % 1 1 1 8, 1 1 t^ ^ 1 1 00 2 e'- M rri %/ ^ E Z'E g ^ I < i -i 35 •3 < 2^ W C/3 -- n o « Sf - jz _ j3 « .5 < ja S8 « w -s _ C s o 0, o »; u U J3 -3 Q XI ;3 ■< g K '^ I 2 « I H I > „ i § E "S u ^ rt O S rt M E '^ c3 *: 'i-e< .- J, w M o o 337 "3 1 T3 TS "3 •o TJ § jj •o 2 § £ >< ^ ^ tt •* >. j: ^ ^ -= % a: •< c o o . > « S 1 ^ 1 c §1 < S E S 1/ >i 5 E !« £ E £ E tfj 21 &I ■a I a R i.l «» i« 1 «> snopiJutqnX S $. S3 s t S M < >< >< > > >< > > >« snotSvtuoj s . i O >* > ^VMjpisqO <: 8 "^ s J ^^ t t 1 >H > >i >< > > > >H potptpj S~ S £ s s s i SG > >* > > > >< > >- > > pmSung s 2 I £ ~s >« > > > >H > >< > > bi a °>. bI >^ -o J „ >o lO !3 T 1/1 1 1 3 be 1 1 1 1 1 1 go a £ £ w . » 00 00 00 a » 00 o. < 2 n}4nj : 5 < Qg H s3tvnpt>xQ H M t^ H " h? '^ H4 " sasMn^ io -oa^ K - - H - H ;? M H M P-. 11133 V j3ttio fj O ir 1* z c p < < 1{3JII11J uottvttuvSjQ '/Ctf'jv^J > TT ,^ <£ «, r. lo^ I m "oT 9* a: iHsnavxsg s g S & 8. s s g, 1 - " h 5 P 2 1 2 c < 3 < s 12 i 3 3 St Si 3 vO in ^ 3 << Ml •r c > .2 5° < O r .-1 ^•^ g < u ^. C c c n bC > u E 3 U3 c 3 . < E n Cn c c "3 5 "c E E o E i 2 = 1 >. ^ £ in -c c (A -J •n Q 1 r- C- h f- < H b Il< ^ < O U. c c c c iS X ^ c s ^k> u (r r- < < — — 338 ^1 ague S ° § -f ■ •» 'c -i .iz x: J .= E ^ ^. E KR Ji =• £. £. " tii E ^H to —; ^ c w « Z < - £ S ^ I 5 *? »^ cfi v; 3 1^ rt o o ?l 11 ■s ^ 6C = •s J= "C f< „ ;2 s is i' in Jo > « H H 339 ■< < to $75 per month. $ioo per month super- intendent, $75 with- out maintenance, $50 with maintenance assistants. $90 per month super- intendent, $75 with- out maintenance.Sso with maintenance assistants. $85 per month. $75 per month. < U O rn<»/»3^»9«^ i ^ t s s se SB >* > >< >i >< > >( snotsvptoj t t '. : : : : p>3j.<;<>;j(?0 t t t : s 2 : > > > >. > • ivnptjs: Yes. Yes. Yes. Yes. Yes. Yes. pnSuns Yes. Yes. Yes. Yes. Yes. Yes. Hours of Duty A. M. P. M. 9 —5 Irregular. 9 —5 9 —5 8 —6 Irregular. 9 —5 3 stf4nd : : : : : : : sitonpou;) H >0 ■* " M M 1-1 sasHn>i ao "0^ •1 VO ■* M W M 1-1 1 B < -J h < 1 iu33y J3H10 , : : : : : ; : : : : : : : : umfvziuvSuQ 'xiuvijj : : : : : : : aiHsnavxsji .§> IS S g s , c/: j= ^ " 2 ^ g-c^ J2 ciO C/i 3 :5i() u ^ .Si" 1^ i E B 60 < (It > j= i r-' < 03 ■^ 5 4 i la ^^ ■s -s JL.f >< > > > > i > i 1 > i > > Yes. : >i > > >< > i >< > > > Yes. i > i > > i > i > > i X >< > i > •C o u — ' .J. *^ (^ o >; c >. .^ ^ ;:j •c j= c y u e lo 's u >• 8 --c 25 2 3 "^ t/5 t/) j: XI t/2 J3 u .^ (4 ^"^ !3 (1 ts s k5 w C ^ ^ -a -s S fc) ■£ >. J= "o ^-s W 3 U t/3 J3 o 5 Ho 5 -5 O cj -S ■S •§ 2 ci -T! J3 3 -"'us; 3 < a ^ S 3 «« " "^ S. "3 •r ■ § C ■" E .2 Z ^ fc ii s-u OSIS man E. 6t Q W w < 341 E *J o g S ^ bfl I- -a I ° "^ w: ^ t3 jg CJ « ^ « ^ ca o C e »- lags snopi3J9qnx > > & t $. > < snotSvptoj i X pndpjsqo i > : i > t > < u pnpijf 1 1 > ^ > i 5h i > \v3t3xns 1 > > : i >< sjt^nj ; sifonpodQ " « - " fo " ■* CO " inji io "O^ - - « - « « ^ .0 - P. E. City Miss. Soc. A. I. C. P. /jwa^' iiHiio • : . I : s < < uoiivmivSuQ • 'wo- • : : aaiisnaviS3 Q <; Q Sri ^ S^. S 3 - . > = 1^ M -3 < :^ ^ 3J P S .a to ■ -1 ' K u^ - Ji ~ ' o e < ■£ <= j3 oa 2 oa d 5 o 341 R .2 Si 1 .c >< ja „• j= jd fc: C f ii £ c •" 1 s s s a • § E sl s e s S i^ E s ^ 8 ^s' 1 ^R 1- R u C R a B l-^ 5 m N ui S jc: «» •» «» «» <» «» «» s S 8 s s ?3 ?! » ?! Si s > > > > tH >< > > tH Ix t- s . S S . . > > > s SE S SG « «; . t > » — >< >> > >< > > SB ^ f> sfi ?i i t 2 tH > > > > >- JH >* > > s i t £ f, si SB i t > > > > > > > > > r r r 0. 1 10 1 1 fa t 1 0. r r 0. " " « M « ■* " - « " - « " Oi (1 M « ^ - - 10 " « « " 0. a; . . . . . . u >-; < : : : ; : ; : — -- - — -— — - — - — — — — b - -- — — -- - . vO — — — ^- _... - '^^ -— — — — .„ — r^ — — 00 5i ^ c^ R 0. 0. 00 R 8. 8. - " •" - " " w C >• c 2 g 2 3 d (55 d < )-• u 'a c c?5 3 6 C < c c M t. Sinai Hospital, Social Welfare Dept., 5lh .Ave. & looth St. u 'a « in § 3 d '3 a "3 c 15th St., Qth & 10th Aves. he N. Y. .'\sso. for Im- proving the Condition W u." 8 a. "0 c "c U t?5 s 5 p 8 w5 'a. ^ g .5 St. he Xew York Milk Committee, 105 E. 22nd St. -'• ''- ''■ ''■ ''• >". •^ ■— r- f" 343 snoptJMqnx a o . a- w :& C >- ™ E o -a ^ S. 53 o snotSvtuoj p3tJ)»}sqo pnptpi jvJtS^ng S o B.' >o o z 2 < sjt4nj to <*) ; : s»ivnpDJ{) - « to t " " - - : sasan*^ jo "ox •» - ■o * - M - M o >tt»a^ jniio i{34nt{j — .2 aaHsnavisg .« 6 Sc}^ f n ^ B 1: 3 t;5-f, M Addre CIATION C o K c 3 i o •W 3 ^1 Q 2 s ■a ^ s Z^ C t/3 ^ m 5S z ^ ■* ■^ z ■3^ II •50 ■ S ag ea - g " O J3 .So' — " M >> i! 3 c .:; J= '"-' '" ^ _ - h-1 „ I ° :^ -g - 1 i ^ - 5 y:i c/; t/5 z 1: S-5 z 344 b o ^ S ^ i' ^ ^* a. cd u a R |2 i C. . gj >- u 2 = R S o «» 0< o» «» s >< :^ 1 > > 2 > s : 8 > > > >< : : : > : : 5H 1 >< >> > 1 > > > > > 2 S 8 > tH >< > > 1 > >< > s > >i > 8 s s >> > >! I I A 00 s las. 3ffi . o !(< < 3^ W g- §• 1^ istrict elation bomps S'ursin House ausch ahnem he Ho /, < Q H ss K H ".2; j: 3 (J JS ' E - } 34.-5 1 !L V) JS £ < § f a J3 j: C o e § >► e e ** < t/3 a 3 E H us, . & -2 o ■S. 2 3 " a. «» E E 1-1 o R E 1 2 E [X4 snopijxiqnx s t t I s £ ,S £ ^ > > > >< > > > tH W en snotSvfUoj • • • • 8 ^ O O > >< jvotJtmqO t 8 t £ £ . 8 £S > >, > >. >< >< < pnvpi s • s s £ S 8 £ U >< > >< > >< > > p>otS.ins s 8 : : 8 8 £ > >< > >- >* a o 1h 1.4 ^ >* ». lO ^ iri t^ t^ 00 >n •. 00 c o o sji4nj : M : " " : ; : : 2 3 H s»pmpv^ " " ' • " " " IH •1 sasi laa ao -ON " " M « C4 (-• - « W HI ;Mi>a{/ i»i/;o >• . >. >. >> . y. u U O u c M < it3uni{j ■ • • • • < uotp)ZtuvSjQ 'IHnD aaHsnavxsg t l^OOO °°S OOOO 00 CO Name and .Vddress OF Association The R. Public Health Asso., Tuberculosis Dept., 32 S. Washing- ton St. Rochester Slate Hos- pital, South Ave. Department of Health. The Local Comm. of the State Charities' Aid Asso., 206 N. James St. Rome Hospital. The S. L. Soc. for the Control of Tubercu- losis, Main St. Municipal Dispensary, Jay St. Bureau of Health Dep. of Med. Inspec. of Schools. Dept. of Health CHnic for Pulmonary Disease, 508 E. Fay- ette St. The Instructive Dis- trict Nursing As.so- ciation. Place Rochester {Continued) c 'J- c C C Syracuse Trov 346 K K d ° i. I «» «» o< •5 js t - ^ ~ 8 Z^ 21 = Yes. Yes. Yes. Yes. Yes. Yes. Yes. Yes. Yes. Yes. : 8 : 8 : Yes. > Yes. Yes. Yes. Yes. Yes. Yes. > Yes. Yes. Yes. Yes. Yes. Yes. Yes. 8 > 8 8 : : 8 > > > i Yes. Yes. Yes. i 1 W r. A Zm ^ U •i E o ^- . 2 ?Y^ U - -S .c = ^ o i- h H ::= 2^ ffl •£ •i -^ -i a . ^ o 55 ■< O S 5 o Q *rf u ._ u . bO 0. 'f" m J= rt c J= a 1-) 5J < 1 c a S 'c L4 3 3 "5 ■5. Q c 3 /5 ■a J! E g ,0 a >• < rt fc a hp s J "o i< £ w ■5 3 =y J= > .§ S u — vi s ;- oi rt (U — .i , ; D ^.ii « C/^ u s 0^ = >^ U : O -7 31: 0! 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C/3 i! 3 > < •2 5 2.e^> 1 >^ . c c ; . 1 . g < ! il E E : E £ • ^ "" £ B. 21 S5 ^ 1- w o s 12 «» itKtjnyMqnx £ £ S 2 S S £ S S 2 2 to ■< U If > > > >i > Sh > > > >H > SlUflSvfUOJ >< o ]V3}J}»isqo * 2 a ' £ : • > >< > tvnpajf S £ 2 t : £ >. > > > >H U jvnSuns b c; £ t : £ > s- >, >. > ^ a o ^ > & >0 U-. o o o >c vO ^ '{i ^ 1 1 1 = 1 1 1 1 1 — 1 1 1 M ti c-^ a '? ac < a 00 M o. O. Oi o. o ^ o a: sfi^nj g 5 H s»ttfnpvJQ M « ^ M l-t " " " S3S snjsj JO -0^ t3< • § u ■"■ Q ]ii3Sy J9t[io u .- ? Ol U • J5 to 2 > 2 H < ipjniij ; ; rt •J fe < s uottmtuvSiQ ^n^'DHJ 00 N 3 ■* °° 00 00 00 o> 00 00 ar Hsi'iavxs3 8> a 00 00 & 8, 8, & & & « — 1) "- . J= o ^" — ' j: ■Z > = tr. t =■ B — "^ ^ ^ -^ ■^ = -^ :/ = ^ « P-) C3 J^ rt « c rt a S ^ ■^.j Z C/3 >S O X K K tr £1 ^3 e i- < < B "5 "3 '^ -o Z " 1^ . " :?"^o c a c 2 "^ '^ 'O c 2 . c Is .■= ^ .= < « X 5- 4, iS t, -i .a J= < j: Q n'2 S- ■§ ^ 5 i:S (i£ d(? -c — - o t-' f- !-> r* r" H H t- — t- < Z z < ;5; o > < K > — EC w » ^ c c o-g 5 c £ ^ ^ J= r C $ rt o «. E < < < £S £ c: £ 350 ^ a Yes. Yes. : : : ; : « : : : : : : i I a s 8, a ■Si -B <$ :B v_ _ O nj _ ' jr -; a »; ^00 _; •.^.^C;|c^^tG:^iC^i^Q I- > 1 ^ •5 w ■£ •= o. _• o. d ^ ^ J, c^ 2 o A .0- 'y^ ^ ° ^^ T1 hH •- H HO H H H h' h Z. 6 ^ Q '^ 3 a ^ 5 U 351 o2 O ij pjtjttpqo IPfVH foytSdns i-l C> l-l ijf4nj ntDiipo-'D sasaQN io -OM JM*^^' *>i//0 Homnj UOtf-DZtUOgjQ aaHSiisvxs^ a ^ Q H <2 2 b 2 •S" ii rt ;^ ^ « *J M Q Z j3Q'OJ30j3Qj3 ;2o 3 :^ -s a . o o 3 • -3 -= Q* H O. -A -A (-1 H r- H H r 2 S- "1 ^"^ Q ^ 2 Q 352 iC s S 3 /^ o c a x; -' o f^ >* Q. X .Is K o ^ U i' o ° S 8 I « Q .5 '== .= g a ^ - ^ 2 .— .£ "^ T3 £ =- -c 2 o o Z ." 'S O •5 6 ■£ ■£ K o K u- '° ^ '° S .2 - .2 - .£ 3 a; S j= S j= S a ^ K u c/2 3- n 00 Ma-; ^' a "5 2 IE o S ^ 5 23 ^5:i S" j= < O ; ; ; C tn 1 I snofnjJiqnx s t £ V v ; S S S 8 ?i ss i > > > > > ■ >H > > > >- > > u < snotSviuoj U o poijpjsqo '• '■ ^ '• 3 '• fcj > > < tVJtpiff • • u ij > U jDJiSms > • • ... ^ a ■^S p; vo s _rt y-1 rt y^ in ^ rt o _* (o u bc §Q s ^ t: s < H-4 hH o g ^tf^^'d : : « : ; ; : : Z; < H sifynpoiQ M M " " *^ " " sasanj^ ao -o^ lUiSy -t^HIO d rt c! rt rt ! rt ; rt a Kl cj ti z w t/2 w tn m m w m Ol C/2 C« o H 3 HOitiHj . . •< UOtfVitUvgJO &n.ivtij 00 00 00 CO O. 00 o. aansnavxs^ & a 8 * 5- o» 00 c> o- c> 8. 1 ^ ^ •£ w ■£ ^ ^ .c*j J3« ta^jj; ^(4 ^ Ji -C in ;S .iiw.^" coiii Q 2 2 -e. 2 If K a ft < 2 "o cj; "o m"3 ^ ■t *j ^s •s O a . rn a. a a . a . a |o I°|o=r|«^^1^o o " d ,^o l«lo (£ 5- 1<2 ?• (2 a (S d S £ a .£ ^ e (2 a(2 a S^ _• o! ^ ci aon o. CU So .a (5 C ^ 5 .r Q^3.So§^Qt^^2x 5 X (5 5 t 5^5^ H H H h H S h H H h H H h * c 1. «. c ^ I-i > a ^ S c "5 -3 Ji '-d 1 S !C C :: ^ ^ s s S ^ *5 «^ 354 ^ g I S c- Q > >< S >• i > > > > £ > i > > i i > ;a > > t > >< > ■k ■£ ;j5 c" M K c .r ^ ;§ ~' c ^ = u^ = S^ 8 "^ Q > ■5 E c :^ ^ := ■<= H H a \c K 3.5.-) ^ a s. j: . 11" .S snofn}J»qnx > > snofSvtuoj fvMjpfsqo pmp9jf pjfgjng 2 ! J/* > > > > >< >< >< > >. >< >H ^ . £ t > >< > t i ^ T, n S . £ £ >* > >< > >* > > >* ?\ s t t t « £ £ £ £ > > > > > >< > > > >< t K t t i £ £ S £ £ > > > > > >< >< > > >< o i- U \n »/> ^ \n V) J2 ui -J ifl ■o 1 3 1 ^ 1 1 3 1 1 3 1, 1 1 1 ^ X " 00 00 '"' "^ 00 0. - - : " - « - " M " ^ - M - " " " m M - - - - - V) - " " - - M , . ■3 ii a Asso. emen hAve losis burgh ve. ustria ^2; 1^%. . 357 •! & s >< •5 ^ X < < ; : Ib i 1 ; ; snofnidtqnx i d 2 I £ S SS S J i t Sh >i > > >< > >( >i >. > > tnotSvfuoj S pytuUtsqO : ^ : ^ •2 >* tH ■< pnpspi : ^ : ^ > > fvotgjn^ : i : i > > a i^ 1 1 a 1 1 1 T 1 1 T T go a K o 0>0> 00 0>000v00> < § ini JO "oj^ - H ». Cr> M M H M Ht iu38y Jiipo cj M r ■3 ', rt ; n a ci S Ol t/3 y a t^ Vi V CO C/3 o H < ^■"11(0 : : : h < uoi)vzitwSuQ iCjuviiJ >c 00 o. X O.00 Ov OOCOiOOO. aHHSi'iavxsa & ^ &^& & ^^S-S'^ - i -c !r ^ -c J, ^' r j3 ^ J ■£ -S cr; - J •rt^-Sg".* -^"rt a ■S c rt a ^ o £ a :S ^ - a a ^. -s 6 -- u ^ !^ ^ ^ d -3 3 -5 ^ ■* c -s ^ a: a ''- << ° -c i' -^ ^ o c s I [^ ° ^ =! =^- Q o c . ..0. c."U«>>-S— .5~o. o..a. . c| la leJii ^^c|||a ^a^Q^^^ 2 (2 a ^3 1^ g- a X. ^ «• rt *• rt . C3 f-. r- f- H h r H H H >. 0. :S 13 I > - C " 1 5 >, c ^ c 1 a ^ i- So ^ C q: a! e; c> c^ V 358 Yes. 1 Yes. >* Yes. > Yes. > T 1 T ►H 1-1 O S :s ^ ^ ■S •£ •£ ^ -c 2. . 4) ■> o -jr -5 j3 -S x Q -r S •5 6 =^ ■^ 2 K ' .■= Q .S - Q ,0 w ■5 StA H h H H H H h in }tj)»isqo ; >i > > : 8 i > > pntpfjf 8 8 : £ i : s s >* > > > >< >< fonSins : S S : s t : 8 8 >i > >< > >. > b a ° >< fc -o vO u^ lO lO XT, lo •« »; |S 1 1 1 1 1 1 1 -a oQ a w ffi • = 00 o r* t^ 00 00 o> in4nj fo « ; ; ■<>■ z < H s91vnpviQ " M n • M e« "^ ^ S!isan>i ao -0^ " " m t«) to « -^ ;;<»?{/ ^t/;o ■; ! ■■ Jl t/ 3 "3 "^ o < < i{3jmtj ■ utntvzuivSxo Ktfjvttj 1 . a 00 ■ •!-• ta S i^ "-^ u t3 "rt U ^5Q^ ac 5! b c 360 ■5 ■£ •T3 w "2 S c s S o J= 1I .£ >■ .c J j= •s si 1 c E « 1 -c = 3 c c § -i " £ i E c ll s 1 B k ail a:; ! R Si's c a-s 0. 3 «» •» «» «» «» •» *S M b » S £ £ 8 £ d IG £ £ « >< > > >H > >H > > > tH a . s s oi > > >i £ £ a £ s ~s' £ > > >< > > >< >- >H C S t. £ s t £ > > > > > > > a t 8 t S - > > > > > > > u U ^ w 0. _rt •c _rt 10 Jl j; 1 1 3 1 "3 1 1 1 .3 1 1 t-i 1 u 1 1 5c 1 Oi 00 t-H OC *^ 00 « 00 « : ^ : * H •H " - M n - M H ■- 1/5 M II t. DC *?s o 3 i; (/■ a u : £ > „ OC rO IM « r^ 00 o. 1 §■ « §> s 1 s 00 a & & " - P. League for Sup- ssion of Tubercu- s, 333 Butler Ex ■s i c < '3 d < c a cs i •S ^ ll c £ "S 1 CO ■a 1 ^ B II 0. 2 1 b U 3 3 U i 2; < f 'c 0. < "3 "■a ►2 "S - r -^^ -a 3 wl g 1 " ■a< (75 in .2 3 3 .a 3 • £ X j: 1 4, E X E I?, ^ r- f- r- r" H f- ~ y. - • ^ ■*^ ^ t/; !/) <; -75 t !A < ■5 ^ = J 1^ y. w 1 **^ y "f V. ^ H s u c t I-' -r £ "rt c h > s^ ^ 1 -c 1 a t 3 c C 3 f C/^tj C >* b. ~ 361 1 a snojniufqnx & = s g- snotSvptoQ ]vytj)3lsqO fvytptjf jvnSuns « a s]t4nj stjvnpvjQ sasaax ^o 'o^ /IWjfl;' ^»l/»0 .9 U i{3Jni{j UOftPZtUvSdQ aaHsnavxsa m 2 c i 3 E rt s S E _c Q a '^ U 1> Q ^ u s; S« V -J D H <• u ffi J;^ ,• << o -^ f^ o M /^-' ^ a o Si "§ J 3 c Xl r ■3. K cTj "3 ' .s "S < r7 o < C < ji u J3 > JJ is ."^o 3 2 W ;= 3 H u r • *!• H M >< 14 y. (J r 1 n ^ U> i« ■A ^ ^ 'S o II Q «=- 'g Ca <^ -e5 H H c c! X E ra O <- u « c: 1 ^ 362 ^ 2=3 = p '6. a giu « B o ^ fl — • i> * 21 2 E O. J3 o ^ l-l HI H4 0> l-l Yes. Yes. Yes. Yes. Yes Yes. Yes. Yes. Yes. Yes. Yes. Yes. : : s : : : : ; ; : > Yes. Yes. Yes. Yes. Yes. Yes. Yes. Yes. > Yes. Yes. Yes. Yes. Yes. Yes. Yes. Yes. Yes. > 2: ■a ^ •a 2 "5 E c 3 f ;| 1 3 E •B 1 a U a Q ii c X .2 1 > 1 3 2; 3 r- 'E 3 E £ •t C .2 (3? S 5 3 'E T, 3 ■0 d -a J5 ■J E ~ rt "0 J3 C/2 i 1 C ,c3 'JO 3 c 3 X a 3 c < 3 (J? i ^ be ^ 3 -n •!-^ c E 3 3 c s 3 3 C J3 < 3 1 c7; c. a as u "3 ijfi -3 "3 a: i5 3 tr. C/5 r< r- ;~ H X c-i t- H r- oa O 2 X - ^ HVA V}i**d sflvnpvM) sasan^ io •o>i JU33V i3^10 % % ^ ^ e - O ^ g s" « ^ ^t «» < u O < u snojn^aqnx > >> >i >! S > ^ >- snmSviuoj ; s > > > > : ^ jvoixmsqO > > d > > > 8 > > > jvnptff i S > Yes. > > > >< > > jv3t8ms t > Yes. > > > i >< ip^nifj uofjvztuvSJO aaHSnavxsg & g K.= •a" O " § w S >. 1^ . cj 5 1 &> o c V Oi ^ j= -S :3 ja t/3 3 H H (33 ■^ ■£ = < .2 ^ 2 >5 =g .5 c y ^ ^ M S -s .2 S "S I 1 cj "y £ ^ ^ 3 a: 364 STATISTICAL TABLES TABLE II.— SHOWING THE GROWTH OF THE VISITING NURSING MOVEMENT IN THE UNITED STATES. NUMBER OF NEW ASSOCIATIONS FORMED— BY YEARS (TO JULY, 1909) 1877. 1878. 1879. 1880. 1881. 1882. 1883. 1884. 1885. 1886. 1887. 1888. 1889. 1890. 1891. 1892. 1893. 1894. 1895. 1896. 1897. 1900. 1901. 1902. 1903. 1904. 1905. 1906. 1907. 8 i6 13 10 19 24 24 35 • 37 49 67 , 112 1909 75 (First 6 months) Unknown 7 TABLE III.— SHOWING THE NUMBER OF ASSOCIATIONS AND NUMBER OF VISITING NURSES IN EACH STATE (TO JULY, 1909) States Alabama Arizona Arkansas California Colorado Connecticut Delaware Dist. of Columbia Florida Georgia Idaho Illinois Indiana Indian Terriiur\-.. Iowa Kansas Kentucky Louisiana Maine Maryland Massachusc-ti> Michigan Minnesota Mississipjji Missouri No. OF I No. OF AssociA- 1 Visiting TioNS I Nurses States 19 4 21 39 3 6 20 33 2 3 3 15 7 7 iQ 118 6 12 6 8 I I 3 5 39 179 42 13 o 13 No. of Associa- tions Montana o Nebraska 3 New Hampshire I 12 New Jersey 29 New Mexico o New York | 108 No. Carolina ] 4 No. Dakota ; o Ohio ■ 18 Oklahoma ' i Oregon '< 2 Pennsylvania • 119 Rhode Island. So. Carolina.. So. Dakota... Tennessee Texas Utah Vermont Virginia Washington. . . West Virginia. Wisconsin Wyoming 6 15 No. OF Visiting Nurses 41 o 458 5 o 72 35 3 7 24 4 365 VISITING NURSING IN THE UNITED STATES TABLE IV.— MUNICIPALITIES EMPLOYING VISITING NURSES FOR TUBERCULOSIS PATIENTS Estab- lished No. OF Nurses California, Los Angeles, Instructive District Nursing for the City of Los Angeles " Oakland, Associated Charities Georgia, Savannah, The King's Daughters Illinois, Peoria, Department of Health Indiana, Indianapolis, The Department of Public Health " " The Indianapolis City Dispensary Kentucky, Louisville, The Board of Tuberculosis Hospital Maine, Biddeford, The Trull Hospital Aid Association (State Aid) " Portland, Board of Health Massachusetts, Boston, Boston Asso. for Relief and Control of Tuberculosis " Melrose, The Melrose Hospital Michigan, Detroit, Department of Health New Jersey, Jersey City, Board of Health " Newark, The Visiting Nurse Association (State Aid) New York, New York, The Department of Health " Rome, " " " Rochester, Rochester Public Health Association... " Schenectady, Municipal Dispensary " Syracuse, Board of Health " Yonkers, The Sanitary League North Carolina, Durham, Durham Clinic for Pulmonary Dis- Ohio, Cincinnati, Department of Health " Columbus, The Society for the Prevention of Tuberculosis Oklahoma, Oklahoma City, Department of Health Pennsylvania, Allegheny, The Visiting Nurse Association " Carlisle, The Carlisle Visiting Nurse Association . " Harrisburg, State Department of Health " Pittsburgh, Board of Health Rhode Island, Woonsockct, The Anti-Tuberculosis Associa- tion Virginia, Richmond, The Dispensary for Tubercular Diseases . . 1908 I 1904 I 1906 I 1908 2 1908 I 1907 I 1907 2 1907 I 1906 I 1905 I 1890 4 1905 2 1902 5 1904 24 1909 I 1904 2 1906 1909 I 1907 2 1906 3 1908 I 1894 I 1905 I 1907 91 1907 5 1907 366 STATISTICAL TABLES TABLE v.— MUNICIPALITIES EMPLOYING PUBLIC SCHOOL NURSES California, Berkeley, Board of Education " Los Angeles, Board of Health " San Francisco, Department of Health Colorado, Pueblo, Department of Education Georgia, Atlanta, Department of Education Illinois, Chicago, Department of Health Iowa, Des Moines, Board of Education Maryland, Baltimore, Department of Health Massachusetts, Boston, Department of Education " Brookline, Department of Education " Cambridge, Department of Health . . Michigan, Detroit, Board of Health " Grand Rapids, Board of Education New Jersey, Jersey City, Board of Health " Orange, Board of Education New York, New York, Department of Health " Syracuse, Board of Health Ohio, Cincinnati, Board of Health " Cleveland, Board of Education Oregon, Portland, City of Portland Pennsylvania, Harrisburg, Board of Education " Philadelphia, " " " Washington, Seattle, " " " " Tacoma, " " " 367 Estab- lished No. OP Nurses 1909 I 1903 4 1908 4 1909 I 1909 I 1908 41 1905 2 1905 5 1905 34 1909 I 1907 I 1906 2 1905 3 1907 2 1906 2 1902 141 1908 2 1909 2 1908 2 1908 I 1908 I 1908 6 VISITING NURSING IN THE UNITED STATES A List of Organizations not in the Original Text, with the Number of Nurses and their Salaries Place Alabama. Mobile Montgomery . Association California. Oakland Metropolitan Life Ins. Co. Anti-Tuberculosis League. Alameda Co. Tuberculosis Soc. Dept. of Health, School Division. Sierra Madre I Board of Health. Connecticut. Branford Bridgeport Meriden Middletown . New Britain . New London . Stamford. . . , W^aterbury . . Delaware. Dover Lewes Wilmington . District of Columbia. Washington. . . . Georgia. .Atlanta. . . Augusta . Macon . Illinois. Decatur. . . Galesburg. . Springfield . Visiting Nurse. Metropolitan Life Ins. Co. Meriden Tuberculosis Re- lief Asso. Metropolitan Life Ins. Co. Middletown Milk Comm. Tuberculosis Relief Soc. Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. School Nurse. Delaware State Tuberculo- sis Commission. Delaware State Tuberculo- sis Commission. Metropolitan Life Ins. Co. Milk laboratory. Anti-Tuberculosis & Visit- ing Nurse Asso. Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Woman's Civic League. Board of Education. Tuberculosis Asso. Address ID N. Julia St. 503 Bell Building. 525 Seventh St. 1358 Broadway. 19s Sherman Ave. i7>^ West Main St. 195 Sherman Ave. 232 Main St. Children's Hospital. Grant Building. 130 W. Eldorado St. 7i7>^ E. Washing- ton St. No. OF Nitrses Salary $75 per mo. $80 to $8s per mo. $65 per mo. $70 per mo. $50 per mo. $65 per mo. $80 per mo. $40 & all expenses. $100 mo. per $45 per mo. S75 per mo. $75 per mo. 36S STATISTICAL TABLES Pl.*ce Association Address No. ojf Nurses Salary Indiana. .Anderson St. John's Hospital. Metropolitan Life Ins. Co. Vanderburg Anti-Tubercu- losis Soc. The Children's Aid Asso. & Pure Milk Com. Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Dr. Mix's Hospital. Graduate Nurses' Asso. Visiting Nurse Asso. 219 Read St. Odd Fellows' Bldg. 404 S. Fourth St. 308 B. & T. Building. I I 2 I I I I I 2 Evansville Indianapolis Marion $50 per mo. $60 per mo. Muncie Richmond Iowa. Dubuque $100 per Kansas. Topeka Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. I I Kentucky. Henderson Lexington Ix)uisville Anti-Tuberculosis Asso. Metropolitan Life Ins. Co. Fayette Tuberculosis Asso. Metropolitan Life Ins. Co. Anti-Tuberculosis Asso. Metropolitan Life Ins. Co. Metropolitan Life Ins. Co 618 W. Main St. 922 S. 6th St. I I 3 I I I 2 $75 per mo. ,$100, $75, & $55 per mo. Owensboro Louisiana. New Orleans $50 per mo. Maine. Bath Biddeford Brewer Fairfield Kennebunk Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Central Maine Tuberculo- sis Asso. Visiting nurse. I I I 2 I $60 & $75 per mo. $100 per Lewiston Portland Waterville Westbrook Androscoggin Anti-Tub. Assoc. Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Barrett Hospital. .... 537 Main St. I I I I I $50 per mo. Massachusetts. Adams Anti-Tuberculosis Asso. Metroix)Iitan Life Ins. Co. .... .... 2 I .$50 per mo. / i 24 m) VISITING NURSING IN THE UNITED STATES A List of Organizations not in the Original Text (Continued) TiACt: Association Andover Anti-Tuberculosis Comm. Smith Dove Mfg. Co. Beverly Beverly Hospital. United Shoe Machinery Co. Boston W. L. Douglas Shoe Co. Health Dept. Filene Co-operative Asso. W. H. McElwain Co. Milk & Baby Hygiene Asso. H. Siegel Co.'s Employee's Benefit Asso. Brighton ' Brighthelmstone Club. Canton School Department. Chelsea Board of Health. Frost Hospital. Clinton Asso. for Relief & Cure of Tuberculosis. \ Metropolitan Life Ins. Co. Deadham j Emergency Nursing Asso. Fall River Anti-Tuberculosis Soc. Metropolitan Life Ins. Co. Fitchburg Metropolitan Life Ins. Co. Foxboro Visiting nurse. Gardner ^ Anti-Tuberculosis Asso. Gloucester Gloucester Hospital. Greenfield Visiting Nurse Asso. Haverhill Board of Health. Metropolitan Life Ins. Co. HoUiston Metropolitan Life Ins. Co. Hopkington Metropolitan Life Ins. Co. Ipswich Coburn Charitable Soc. Lawrence Lawrence General Dist. Nursing .Asso. Metropolitan Life Ins. Co. Lowell The Lowell Guild. Lynn Board of Health, School j Nursing Dept. ! Metropolitan Life Ins. Co. I V'isiting Nursing Asso. Maiden Board of Health. Metropolitan Life Ins. Co. Manchester Woman's Club. No. OP ; _ Norses ' oalary $20 per wk. $45 per mo. $50 per mo. $122 per mo. Spark St. 100 Summer St. 441 Washington St. 348 Congress St. 8 Beaver St. 600 Washington St. 410 Market St. 205 Globe Bldg. Board of Office. Health T74 Chestnut St. City Hall. Lawrence Hospital. 17 Decatur City Hall. 22 Lincoln St. General St. per $100 mo. $75 per mo. $25 per wk. $21 per wk. $60 to $80 per mo. $20 per wk. $75 per mo. $70 per mo. $60 & $80 per mo. $60 per mo. $65 per mo. $75 per mo. $50 & uni- forms. $50 per mo. $60 per mo. $50 per mo. $70 per mo. $18 per wk. ;570 STATISTICAL TABLES Place Association Address No. OF Nurses Salary Mansfield Visiting Nurse Asso. Maynard Metropolitan Life Ins. Co. I Milford Metropolitan Life Ins. Co. Alillbury Soc. for Dist. Nursing. $65 per mo. Miller's Falls Metropolitan Life Ins. Co. Monson Metropolitan Life Ins. Co. Natick Metropolitan Life Ins. Co. .... Needham Visiting Nurse Asso. New Bedford Med. Dept. Charity Org. Soc. 12 Market St. $60 per mo. New Bedford School Dept. i66 William St. 2 $800 per year. New Britain Visiting Nurse Asso. 6s S. High St. I Newburyport Anti-Tuberculosis Asso. Metropolitan Life Ins. Co. Essex St. I $60 per mo. Newton Metropolitan Life Ins. Co. North Adams Metropolitan Life Ins. Co. Palmer Society for District Nursing Pittsfield Anti-Tuberculosis Asso. Eaton Crane & Pike Co. General Electric Co. Metropolitan Life Ins. Co. 290 South St. $75 per mo. Revere The Dist. Nursing Asso. Inc. 119 Proctor .\ve. $70 per mo. Rockland The Visiting Nurse Asso. 55 Pacific Si. Rockport Metropolitan Life Ins. Co. Salem Board of Health. City Hall. $15 per wk. So. Braintree Metropolitan Life Ins. Co. So. Framingham . . . Dennison Mfg. Co. 2 So. Framingham Relief & Framingham Hospi- 3 $50 per mo. Anti-Tuberculosis Asso. tal. & all ex- penses. Springfield Metropolitan Life Ins. Co. The Salvation Army. I $700 per Stoughton The Stoughton Dist. Nurse I 1 $65 per mo. Asso. Taunton The Visiting Nurse Asso. $70 per mo. Waltham The Charity Comm. $50 & all ex- penses. The Waltham Public Schools. Watertown The Hood Rubber Co. $78 per mo. Webster Metropohtan Life Ins. Co. Westfield Metropolitan Life Ins. Co. Whitman Whitman Nursing Asso. Worcester Royal Worcester Corset Co. Michigan. Gwinn Cleveland-Cliffs Iron Co. I ! $80 per mo. 1 371 VISITING NURSING IN THE UNITED STATES A List of Organizations not in the Original Text (Continued) Place Address Holland j Metropolitan Ijfe Ins. Co. Kalamazoo Metropolitan Life Ins. Co. Muskegon Hackley Hospital. Negaumee Cleveland- Cliffs Iron Co. Minnesota. Brainerd Duluth Fairbault. . . Minneapolis . St. Paul Missouri. Excelsior Springs Kansas City .... Visiting nurse. Associated Charities. Anti-Tuberculosis Comm. Visiting Nurse Asso. University Free Dispensary Metropolitan Life Ins. Co. 306 Court House. City Hall. 1800 Washington .\v. Metropolitan Life Ins. Co. I .... Tuberculosis Soc. & Board 1115 Charlotte St. i of Health. | St. Joseph's Buchanan Co. Soc. to Pre- | .... vent Tuberculosis. [ Metropolitan Life Ins. Co. ' .... New Hampshire. I Nashua | Metropolitan Life Ins. Co. ' .... Portsmouth ! District Nursing Asso. Congress Block. New Jersey Atlantic City . . Bayonne Boonton Burlington . Camden. . . Elizabeth . . Englewood . Jersey City Jersey City Heights Lambertville Newark Orange Passaic Paterson Phillipsburg . Plainfield . . . Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Visiting Nurse & Boonton Improv. Soc. Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Visiting Nurse Soc. Board of Education. Metropolitan Life Ins. Co. Visiting Nurse Asso. of Presbyterian Church. Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Associated Charities. Comm. on Infant Mortality.' Metropolitan Life Ins. C6. j Passaic Diet Kitchen. j Comm. on Prevention of j Tuberculosis. I Anti-Tuberculosis Soc. ' Charity Organization Society Nursing Committee. j 531 Federal St. City Hall. 13 Central Ave. 227 Main St. 155 Passaic St. City Hall. Main & Jersey Sis. 5 Ravine Road. $80 per mo. $75 per mo. $75 per mo. $100 per mo. $75 per mo. $75 per mo. $75 per mo. $100 per mo. $75 per mo. $65 per mo. $60 per mo. $960 per yr. $75 per mo. $75 per mo. $75 per mo. 3: STATISTICAL TABLES Place ASSOdATION Address No. OF Nurses Salary New York Amsterdam Metropolitan Life Ins. Co. Tuberculosis Dispensary. 38 E. Main St. $100 per Astoria Metropolitan Life Ins. Co. Auburn Metropolitan Life Ins. Co. Birmingham Metropolitan Life Ins. Co. Camden Metropolitan Life Ins. Co. Canajoharie Metropolitan Life Ins. Co. Canandaigua Health Asso. 41 South Main St. $75 per mo. Canastota Metropolitan Life Ins. Co. Cazenovia Metropolitan Life Ins. Co. Chadwicks Metropolitan Life Ins. Co. ClarksMiUs Metropolitan Life Ins. Co. Cleveland Metropolitan Life Ins. Co. Cohoes State Char. Aid. Tub. Com. City Hail. $780 per yr. Cold Springs Metropolitan Life Ins. Co. Coming Metropolitan Life Ins. Co. Cortland Metropolitan Life Ins. Co. Fayetteville Metropolitan Life Ins. Co. Flushing Metropolitan Life Ins. Co. Fulton Metropolitan Life Ins. Co. School nurse. Geneva Glens Falls Metropolitan Life Ins. Co. Woman's Club. $70 per mo. Herkimer Metropolitan Life Ins. Co. Ithaca Metropolitan Life Ins. Co. Visiting Nurse Asso. Jamaica Metropolitan Life Ins. Co. Jamestown Visiting Nurse Asso. City Hail. $55 per mo. Kingston Federation of Women's Clubs. $75 per mo. Little Falls Metropolitan Life Ins. Co. Lockport Metropolitan Life Ins. Co. Long Island City . . . Metropolitan Life Ins. Co. Long Island. Maspeth, L. I Metropolitan Life Ins. Co. Long Island. Mt. Vernon District Nursing Asso. 136 Cottage Ave. New Brighton Metropolitan Life Ins. Co. Port Richmond. New York City Grace Settlement & Disp. Manhattan Hospital. National Cloak & Suit Co. 414 E. 14th St. Wards Island. 207 W. 24th St. Post Graduate Hospital, 303 E. 20th St. $75 per mo. Babies' Wards. New Rochelle Metropolitan Life Ins. Co. Niagara Falls Com. for Prevention of Tu- berculosis. Metropolitan Life Ins. Co. 44 Falls St. $60 per mo. North Kingston ... Visiting Nurse & Anti-Tu- $70 per mo. berculosis Asso. S7;j VISITING NURSING IN THE UNITED STATES A List of Organizations not in the Original Text (Continued) Place Association Address No. OP Nurses Salary Norwich Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Visiting Nurse Asso. Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Anti-Tuberculosis Soc. Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Riverdale Health League. Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Visiting Nurse Asso. State Char. Aid Tub. Comm. Metropolitan Life Ins. Co. State Char. Aid Tub. Comm. Metropolitan Life Ins. Co. Metropolitan Life Ins. Co. Board of Education. Anti-Tuberculosis Com- mittee of One Hundred. Associated Charities. Diamond Rubber Co. The Firestone Tire & Rub- ber Co. B. F. Goodrich Rubber Factory. The Mary Day Nursery. Visiting Nurse Asso. Metropolitan Life Ins. Co. I I I I I I I I I I I I I I I I I I I I I 7 1 I I I I I I 1 2 I I 3 2 I Nyack 46 Marga 511 So. \V ret St. arren St. Ogdensburg Olean Oneida Oriskany Falls Ossining Oswego Peekskill Plattsburg Port Jervis Poughkeepsie Richfield Springs . . . Riverdale $100 per mo. $75 per mo. Rochester Rome St. Johnsvillf Schenectady Schuylervilic Seneca Falls Syracuse $50-$75 per Utica 124 May St. mo. $75 per mo. Waterford Watkins .... is8th St. South. Watertown Yonkers North Carolina Winston-Salem .... North Dakota Fargo $70 per mo. $100 per Ohio. .\kron So. Main St. 58 Central OflBce Bldg. mo. $90 per mo. Ashtabula $60 per mo. $80 per mo. $70 per mo. $70 per mo. 374 STATISTICAL TABLES Place Association Address No. OF NUKSES Salary Chillicothe Metropolitan Life Ins. Co. I Ross Co. Anti-Tub. Soc. 57 W. 2d St. I $75 per mo. Cincinnati Anti-Tuberculosis League. 209 W. 12th St. 3 $70 per mo. Visiting Nurse Asso. '' $5ci-$6o per Cleveland The Babies Dispensary. 17 Board of Health. 25 $6o-$75 per Daj^on Tuberculosis Soc. of Dayton I $50 per mo. Newark Metropolitan Life Ins. Co. Newark Sanatorium. I Zanesville Metropolitan Life Ins. Co, I Pennsylvania. Allentown Metropolitan Life Ins. Co. Braddock Metropolitan Life Ins. Co. Bradford Pa. Dept. of Health. Brownsville Pa. Dept. of Health. Butler Metropolitan Life Ins. Co. Carbondale Metropolitan Life Ins. Co. Pa. Dept. of Health. Chambersburji Pa. Dept. of Health. Chester Metropolitan Life Ins. Co. Coatesville Metropolitan Life Ins. Co. Columbia Pa. Dept. of Health. Connellsville Pa. Dept. of Health. Coudersporl Pa. Dept. of Health. Darby Visiting Nurse Fund of Darby & Vicinity. Emporium Pa. Dept. of Health. J Erie Metropolitan Life Ins. Co. Honesvillc Pa. Dept. of Health. Indiana Pa. Dept. of Health. Irwin Metropolitan Life Ins. Co. Jenkintown Pa. Dept. of Health. Kane Pa. Dept. of Health. Kingston West Side Visiting Nurse 143 S. Maple Ave. Asso. Kittanning Pa. Dept. of Health. Lancaster Visiting Nurse Asso. Farmers Trust Co. Lansford Pa. Dept. of Health. Lebanon Lillian Light Memorial Asso. $60 per mo. McConnellsburj^ . . . Pa. Dept. of Health. Mauch Chunk Pa. Dept. of Health. Mifflinburp Pa. Dept. of Health. Milford Pa. Dept. of Health. Milton Pa. Dept. of Health. New Bloomfield . , Pa. Dept. of Health. Nanticoke Pa. Dept. of Health. . . New Castle Visiting Nurse Asso. 302 N. M ercer St. 375 VISITING NURSING IN THE UNITED STATES A List of Organizations not in the Original Text (Concluded) Place Association Address No. OF Nurses Salary Norristown Metropolitan Life Ins. Co. .... I Philadelphia Kensington Dispensary for .... Tuberculous Diseases. I $50 per mo. Philipsburg Pa. Dept. of Health. I Phoenixville Pa. Dept. of Health. | I Pittsburgh Public Schools, Medical Inspection Division. Dept. of Public Health. 10 $75 per mo. Visiting Nurse Asso. 504 Webster Ave. 1 2 $60 per mo. Pittston District Nursing Asso. 106 York Ave. I 1 Pottstown Metropolitan Life Ins. Co. 1 Pottsville Metropolitan Life Ins. Co. .... I Reading Visiting Nursing Asso. 223 N. Fourth St. 3 $40-$6o per mo. Renova Pa. Dept. of Health. . . I Sajnre People's Co-operative Hos- .... pital. I Selinsgrove Pa. Dept. of Health. I Steelton . . . .' Civic Club. Trust Bldg. I Sunbury Pa. Dept. of Health. I $35, board, room, & laundry. Susquehanna Pa. Dept. of Health. ; Tamaqua Pa. Dept. of Health. Tarentiun ^Metropolitan Life Ins. Co. | Pa. Dept. of Health. Tioga Pa. Dept. of Health. Tionesta Pa. Dept. of Health. Titusville Pa. Dept. of Health. Towanda Pa. Dept. of Health. Tunkhannock Pa. Dept. of Health. . . Uniontown Metropolitan Life Ins. Co. Waynesboro Pa. Dept. of Health. Waynesburg Pa. Dept. of Health. Wellsboro Pa. Dept. of Health. Wilkinsburg Pa. Dept. of Health. Williamsport Pa. Dept. of Health. 3 Rhode Island. Bristol Fortnightly Club. I Cranston Cranston Nursing Asso. 49 Nichols St. I East Greenwich ... Visiting Nurse & Anti-Tu- berculosis Asso. Main St. I East Providence . . . District Nursing Asso. I Pascoag Burrellville Anti-Tubercu- losis Asso. Main St. I I70 per mo. Pawtucket District Nursing Asso. 6 t Westerly Visiting Nurse Asso. I 1 Wickford Anti-Tuberculosis Asso. I i 376 STATISTICAL TABLES Place Association Address South Carolina. | i Aiken The Relief Society. j Columbia Olympia Cotton Mills. j Sumter : Civic League, Nurse Comm. ' I Tennessee. \ Chattanooga Metropolitan Life Ins. Co. Jackson Metropolitan Life Ins. Co. Knoxville i Metropolitan Life Ins. Co. Nashville \ Anti-Tuberculosis League. City Health Dept. City Health Bldg. Texas. | El Paso i W. C. A. School for Mothers.; Court House. Utah. Salt Lake . St. Mark's Hospital. Charitv Comm. Virginia. j Charlottesville | Public Health & District Nurse Asso. Richmond Health Dept. ; Richmond Public Schools, ! Med. Inspec. Div. Roanoke Free Medical Dispensary. Winchester Memorial Hospital. Washington. Aberdeen School Nurse. Everett School Nurse. | .... Olympia City Schools. i .... Seattle Dept. of Health. I i West Virginia. j Charleston Anti-Tuberculosis League. 512 Broad St. Clarksburg MetropoHtan Life Ins. Co. \ .... No. OF Nurses Salary $75 per mo. $iooo per year. $60 per mo. $85 per mo. $1800 per year; $900 per year. $40 per mo. $60 per mo. $60 to $75 per mo. $70 per mo. $85 per mo. S60 per mo. Wisconsin. .Madison Anti-Tuberculosis Asso. Milwaukee Anti-Tuberculosis Asso. Child Welfare Comm. 314 Goldsmith Bldg. City Hall. $75 per mo. $75 & ex- penses. $80 per mo. THE SURVEY SOCIAL CHARITABLE CIVIC A JOURNAL OF CONSTRUCTIVE PHILANTHROPY THE SURVEY is a weekly magazine for all those who believe that progress in this country hinges on social service: that legislation, city government, the care of the unfortunate, the cure of the sick, the education of children, the work of men and the homes of women, must pass muster in their relation to the common welfare. As Critic, The Survey examines conditions of life and labor, and points where they fail: how long hours, low pay, insanitary housing, disease, intemperance, indiscriminate charity, and lack of recreation, break down character and efficiency. As Student, The Survey examines immigration, industry, congestion, unemployment, to furnish a solid basis of fact for mtelligent and permanent betterment. As Program, The Survey stands for Prevention: Pre- vention of Poverty through wider opportunity and adequate charity; Prevention of Disease through long-range systems of sanitation, of hospitals and sanatoriums, of good homes, pure food and water, a chance for play out-of-doors; Pre- vention of Crime, through fair laws, juvenile courts, real reformatories, indeterminate sentence, segregation, discip- line and probation; Prevention of Inefficiency, both industrial and civic, through practice in democracy, restriction of child labor, fair hours, fair wages, enough leisure for reading and recreation, compulsory school laws and schools that fit for life and labor, for the earning of income and for rational spending. EDWARD T. DEVINE graham TAYLOR ) PAUL U. KELLOGG / ' ' i05 EAST 22D STREET NEW YORK - - - EDITOR ASSOCIATE EDITORS ?2.oQ YEARLY OUR SLAVIC FELLOW CITIZENS By EMILY GREENE BALCH Associate Professor of Economics at Wellesley College Few recent books of seriotis purpose have made so great an im- pression on the reviewers. The New York Sun, widely known for its critical discrimination, devoted over five columns to a review. "Miss Balch," said the Sun, "is richly gifted with the qualities and training demanded for the complicated and important task which she has accomplished in this volume. The literary charm, the well-balanced proportion of fact, description and analysis (both intellectual and moral), and the remarkable self-restraint and fair- mindedness wliich she exhibits, raise her work above the level of mere sociological investigation, and establish it in the category of books wliich the ordinary reader should not pass by.** The London Spectator, one of the leading literary journals of England, gave it over a page review, finding it "a remarkable exam- ple of the thoroughness with which the work of economic investiga- tion is carried on in the United States.** The second part, studying the Slav in industry and in his home after he has landed in America, is of particular interest to the Spectator, The review sums up with this sentence: "We can warmly recommend Our Slavic Fellow Citi- zens to every one who is interested either in the future of the Slavs, with which the future of Europe promises to be more and more bound up, or in the conditions and prospects of European immi- grants in the New World.** FROM OTHER REVIEWERS A book that exhausts the subject. — Baltimore "Sun." An important contribution to the literature of immigration. — Boston ** Transcript." Miss Balch has been studying this question for years and her work is regarded as a very important achievement. — "Review of Reviews." The author covers a wide range of topics, ethical, social and economic; and her book deserves a wide circulation and careful study. — Springfield "Republican." Miss Balch has given ms one of the most valuable books on immigration that we know of, a work full of guidance, of truth, of understanding. — Chicago "Record-Herald." Prof. Balch may well dispute with Miss Tarbell for the American laurel dm womanhood for patient investigation and consummate skill in marshalling her accumulations. — Pittsburgh "Post." Prof. Balch brought to her task an insight into the history, the grouping and the race psychology of these people which made one believe that she was a Slav herself. . . . To this she adds a statistician's eye for detail, a socialist's discernment of causes and the facile pen of a ready writer. — Prof. Edward A. Steiner in "The Survey." 48 full-page*IllustrattJns; Tables. -t^^^Ce, FoStpaiO, $2.50 CHARITIES PUBLICATION COMMITTEE 105 East 22d Street, New York RUSSELL SAGE FOUNDATION PUBLICATIONS HOUSING REFORM A Handbook for Use in American Cities By LAWRENCE VEILLER Secretary Tenement House Commission of J 9 00; Deputy Commissioner New York Tenement House Department under Mayor Seth Low ; Director Department for the Improvement of Social Conditions of the New York Charity Organization Society; Joint Author The Tenement Problem ; Director National Housing Association. As Hr. de Forest points otrt in the introduction, this book is written by ** the person most competent by knowledge and experi- ence to deal with the subject/' Mr. Veiller is qualified as a reformer, as **a lobbyist in behalf of the common welfare/* as a ptiblic official, to treat housing reform in a practical way. He tells not only the need but the remedy, and how to secure it. CONTENTS FOREWORD. BY ROBERT W. dc FOREST I. Housing Evils and Their Significance. II. Some Popular Fallacies. III. Congestion and Overcrowding. IV. The Housing Problem a Three-fold One. V. How to Start a Movement for Housing Reform. VI. The Essentials of a Housing Investigation. VII. Model Tenements and Their Limitations. VIII. Municipal Tenements and Municipal Regulation. IX. Essential Principles of a Housing Law. X. "What a Housing Law Should Contain. XI. The Enforcement of Housing Laws. XII. How to Secure Legislative Reforms. XIII. The Field of Private Effort. XIV. A Chapter of "Don'ts." Sample Schedules for Housing Investigations. Index. 220 Pages; Price, Postpaid, $1.25 "No housing evils are necessary j none need be tolerated. Where they exist they are always a reflection upon the intelligence, rightmindedness and moral tone of the community." — Lawrence Veiller. A MODEL TENEMENT HOUSE LAW By LAWRENCE VEILLER A companion volume to "Housing Reform." Specific sections cover every essential of a model housing law. 148 pages; Price, postpaid, $(.25 SPECIAL WORKING EDTTION Printed on one side of the paper, widely leaded, unbound but wire- stitched at the top. Price, postpaid, $1.25 CHARITIES PUBLICATION COMMITTEE PUBLISHERS FOR THE RUSSELL SAGE FOUNDATION 105 EAST 22d STREET, NEW YORK is v)= o i University of California SOUTHERN REGIONAL LIBRARY FACILITY 405 Hilgard Avenue, Los Angeles, CA 90024-1388 Return ttiis material to the library from which it was borrowed. T] J8L15«8? Series 9482 iff if liiiiiiiii m I !!l