An excellent system of district nursing is that developed by Miss Lillian Wald from her Nurses Settlement in New York City, and, according to Professor Winslow, it was due to her far-sightedness and organizing ability that the application of the educational force of district nursing was made to the problem of tuberculosis. Miss Wald’s belief that the hospitals can never cope with disease and that home treatment is better and more practicable is borne out by the figures given for the total number of patients treated last year by the district nurses which indicates that the number visited and cared for was larger than the number treated by three large city hospitals in the same space of time. Ten per cent. is the proportion usually cited as the ratio of the sick taken to hospitals. Miss Wald contends that the treatment of patients in their homes, especially where children are concerned, is preferable to hospital care in most cases, and can be carried on in a way that compares favorably with the treatment accorded in hospitals and by the private nurse in the homes of the well-to-do.
Miss Wald began her work for public nursing twenty-four years ago and has steadily pushed its importance into public recognition and changed the official attitude, as well as the attitude of doctors and laymen, from that of indifference or contempt to that of sympathy and understanding and public support.
In other cities, the idea has been taken up and developed in many ways. The Visiting Nurses’ Society of Philadelphia wants to increase its force to enter industrial nursing and here as elsewhere in the various aspects of nursing, the demand for training far exceeds the equipment. Here, too, just as the hospital nurse soon sees the necessity of economic backgrounds for cure and prevention of disease, so the industrial nurse is seeing and writing on the causes and prevention of ills among working men and women. They are greatly aided in this study by that splendid contribution by Miss Goldmark on “Fatigue and Efficiency.”
Los Angeles was the first city to municipalize the district nurse, and this bold step was taken at the instigation of Mrs. Maude Foster Weston and the College Settlement workers who furnished statistics and reports, which they themselves had gleaned from their own observations with private district nursing, to prove that such a step was municipally advantageous. The first school nurse was also secured in that city through the efforts of the same women. In 1909 a practical demonstration was given of the value of the district nurse in daily coöperation with the city physician in controlling an epidemic of measles.