Introduction
Lillian Wald lived between 1867 and 1940. She was born at Ohio in a place known as Cincinnati. Her family later moved Rochester York in 1878. She attended Cruuttenden’s school which offered English and French. She later joined New York‘s school of nursing in 1981. She started her nursing carrier by establishing foundation for providing health care to poor immigrants. She established a home nursing care during those times. There, after she established the Henry street settlement. All this work attracted many people from different region of the world (Luther, 1938).
According to (Buhler & Wilkerson, 1993) by 1906 Lillian Wald had 27 nurses working in the foundation to provide home based care. Foundation supporters and good wishers supported the foundation by volunteering contribute money to run the foundation activities. She wrote two books entailed, “The house on Henry Street” in 1911 and “Windows on the Henry Street” in 1934 (Buhler & Wilkerson, 1993).
She the basis of establishing of public health nursing which gave room for the nurses to give care not only to the people who are sick but also to those affected by social and economic short comings. She defined the responsibility of public health nurse as being concerned with the whole population health and being in a position to network with other social agencies in upgrading community’s living standards. She always emphasized on handling all groups of people with dignity and respect despite their poor social backgrounds as opposed to social commentators (Stanhope & Lancaster, 2010).
The role and implication for the community health nurse
Nurses apart from giving medication and patient record keeping they played other roles. They encompassed their remedies in treating patients. They also used botanical and herbs as therapy in treating diseases (Stanhope & Lancaster, 2010). Nurses acted like intermediaries between the professional physicians and the community people. Lavina Docks, she referred to this position as “middle place”.
They bridged the gap between the patient in terms of intelligence, poverty, and poor communication which could hinder them from acquiring quality health services. Their home visits enabled effective service provision in terms of providing medication and other and other required services. Nurses upgraded economic and social growth in the united state of America during this period. They helped change working environment among the communities affected by poverty, were mainly the people who had migrated to United States during the period of industrialization. Nurses were in front line in fighting and discouraging use of narcotic drugs. They rehabilitated those who were drug addicts and those fighting drug side effects. (Luther, 1938).
Nurses educate community so to increase awareness on the side effects of narcotics drugs. They educated community on health living how to prevent disease infection in the community. They were against the false advertisement which was misleading to the local people. They also fought misuse of community through forced labor and cheap labor. They provided nursing care to the community like administration of drugs such antipyretics and analgesics. Nurses were to evaluate health risks factors in the population and implement the required intervention (Buhler & Wilkerson, 1993).
Public health nursing
Lillian Wald invented the term public health nursing to refer to home based care offered by nurses to the community. She introduced three experiments on health sector which were aimed at improving health service provision to community. This Wald’s experiments were to solve health issues experienced in the past years in United States health care provision to the poor immigrant communities. These experimental strategies included the inventing public health nursing, establishing a country wide insurance payment for home-based care and the creation of a national public health nursing service (Goshen, 1995).
Invention of public health nursing
The increased outbreak of infectious diseases caused alarm and need for immediate attention. These infections were contributed to by dirty environment, high population leading overcrowding and over exhausting and poor facilities among the communities. Through health education on how infections are spread residents came to realize the need for concentrating in individual’s health to boost the community health general well being.
They also focused on cause of infections and how they are transmitted in all environments regardless of social class. With time visiting the home based care nurse organization did send visiting nurses all over the country to take care of those people who were sick at home hence controlling infections. There was difference in private and public sponsorship in health sector shown by both rich classes being afraid of infection related to “dangerous classes” and appreciating trained nurse obligation in resolving issue of upgrading the poor population of the immigrants. This triggered Lillian Wald to establish the Henry street nurses. She was focused on taking care of infected families to attain the required change in the health sector (Buhler & Wilkerson, 1993).
By 1915, nurses started orienting themselves in handling one particular infection to increase the proficient and efficiency of those infections. They choose to master on 0ne group of infection and limit their work on handling that particular group infections. Those group infections were tuberculosis, venereal diseases, and mental disorders. It also promoted professionalism in health sector (Goshen, 1995).
National insurance coverage for home based
She started this second experiment in 1909. She aimed to be sure home based nursing was cost economical and affordable to the poor communities. She introduced the Metropolitan Life Insurance Company as testing project. She convinced people on how nursing care saved poor peoples life. This national insurance benefited policy holder during illness. It was cheap and affordable. Cost per policy was cheap and affordable. She believed that by applying this policy death rate could be minimized. The Wald’s proposal was put into test by the insurance company; policy holders were visited by nurses from Henry Street policy (Buhler & Wilkerson, 1993).
Creation of national health nursing service
She encouraged Red Cross to extend its services to rural towns and districts and make their services more standard. She proposed for them work with isolated nurses and nursing organizations under a central body (Buhler & Wilkerson, 1993).
In Wald’s interest on Red Cross was due to its volunteer to support the organization financially.” It was a cause that “carried its appeal.” The Red Cross initially showed little interest, only sharing Wald’s zeal when her sponsor Jacob Schiff and Mrs. Whitelow Reid offered to provide the money necessary to begin the nursing service.” (Goshen, 1995).
Outcomes of Wald’s experimental strategies
Her vision that, the three experiments were to come to be of beneficiary to poor community in improving their health status was achieved. By the late 1920s, public health nursing proved its capability in to provide inclusive health care to the American people. This marked a major turning point in America health sector. This provoked nursing leaders to campaign for the creation of abroad, harmonized community-based nursing services. People criticized the separation of curative and preventive functions of the public health nursing. It was seen as bad decision, and many people called for merging of voluntary and publicly funded agencies (Luther, 1938)
National Insurance Coverage
It was integrated in the provision home based nursing. This out come influenced the of Metropolitan Life’s nursing service. People enrolled for this policies and by 1931 had enrolled number at 770 000 Icy holders receiving care leading to massive overstraining of the system (Goshen, 1995).
National Nursing Service
The Red Cross unlike the other Wald’s two experiments and vision was not adopted due to World War I. This put down her move to have Red Cross support since it shifted it attention toward the war casualties (Luther, 1938).
Conclusion
Lillian Wald brought major improvement in health care provision for poor communities in America. The outcome of her experimental strategies improving of communities health status, introduction of national insurance coverage and integration of national health services in to public health.
References
Buhler. K. & Wilkerson, R.N. (1993). Public Health: Then and Now Bringing Care to the People, Lillian Wald’s Legacy to Public Health Nursing, 83 (12), 1778-1786.
Goshen, D. D. (1995). Always a Sister: The Feminism of Lillian, D. Wald. New York: The Feminist Press at CUNY.
Luther, D. R. (1938). Lillian Wald: Neighbor and Crusader. New York. The Macmillan Company.
Stanhope, M. & Lancaster. (2010). Foundations of Nursing in the Community: Community Oriented Practice. St. Louis, Missouri. Mosby Elsevier Inc.