Nurse contribution to the construction of health policy in the state of Bahia (1925-1930).

OBJECTIVE: to analyze the contribution of nurses to the construction of health policy in the state of Bahia, from 1925 to 1930. METHODS: qualitative research, from a historical nature. Data were retrieved from five public archives, organized in a documentary corpus, and analyzed based on the health political analysis and the social control concepts, health policy and public health. RESULTS: from 1925 to 1930, the State seized the work of the woman/nurse and established it in public health. This fact enabled the nurse's contribution to the construction of the health policy of the state of Bahia, which took place by the implementation of sanitary education actions, home visits and hygienic surveillance. FINAL CONSIDERATIONS: the female nurse's work made the health policy of the state of Bahia viable and was an ideal instrument to access homes and instruct/advise people in their daily lives to adopt behaviors that prevent the occurrence and, above all, the spread of diseases.

Nurse contribution to the construction of health policy in the state of Bahia (1925-1930) / Participación de la enfermera en la construcción de la política de salud en Bahia (1925-1930) / Participação da enfermeira na construção da política de saúde na Bahia (1925-1930)

ABSTRACT Objective: to analyze the contribution of nurses to the construction of health policy in the state of Bahia, from 1925 to 1930. Methods: qualitative research, from a historical nature. Data were retrieved from five public archives, organized in a documentary corpus, and analyzed based on the health political analysis and the social control concepts, health policy and public health. Results: from 1925 to 1930, the State seized the work of the woman/nurse and established it in public health. This fact enabled the nurse's contribution to the construction of the health policy of the state of Bahia, which took place by the implementation of sanitary education actions, home visits and hygienic surveillance. Final considerations: the female nurse's work made the health policy of the state of Bahia viable and was an ideal instrument to access homes and instruct/advise people in their daily lives to adopt behaviors that prevent the occurrence and, above all, the spread of diseases.

RESUMEN Objetivos: analizar la participación de la enfermera en la construcción de la política de salud en Bahia entre 1925 y 1930. Métodos: investigación cualitativa de carácter histórico. Los datos fueron recolectados en cinco archivos públicos, organizados en un corpus documental y analizados a partir del análisis político en salud y los conceptos de control social, política de salud y salud pública. Resultados: entre 1925 y 1930, el Estado se apropió del trabajo de la mujer/enfermera y lo institucionalizó en el campo de la salud pública. Este hecho dio lugar a la participación de la enfermera en la construcción de la política de salud en Bahia, que se dio a través de la operacionalización de acciones de educación en salud, visitas domiciliarias y vigilancia higiénica. Consideraciones Finales: el trabajo de la enfermera hizo viable la política de salud en Bahia y fue un instrumento ideal para ingresar a los hogares y enseñar/asesorar a las personas en su vida diaria a adoptar comportamientos para prevenir la ocurrencia de enfermedades y, sobre todo, su propagación.

RESUMO Objetivos: analisar a participação da enfermeira na construção da política de saúde na Bahia entre 1925 e 1930. Métodos: pesquisa qualitativa de natureza histórica. Os dados foram coletados em cinco arquivos públicos, organizados em um corpus documental e analisados com base na análise política em saúde e nos conceitos de controle social, política de saúde e saúde pública. Resultados: entre 1925 e 1930, o Estado apropriou-se do trabalho da mulher/enfermeira e o institucionalizou no campo da saúde pública. Esse fato ensejou a participação da enfermeira na construção da política de saúde baiana, que ocorreu por meio da operacionalização das ações de educação sanitária, visita domiciliar e vigilância higiênica. Considerações Finais: o trabalho da enfermeira viabilizou a política de saúde baiana e foi um instrumento ideal para adentrar nos domicílios e ensinar/aconselhar as pessoas em seu cotidiano a adotarem condutas que evitassem a ocorrência e, sobretudo, a propagação das doenças.

"Something must be done!": public health nursing education in the United States from 1900 to 1950.

This article examines public health nursing (PHN) education in the United States from 1900 to 1950. Following establishment of district nursing and the Henry Street Settlement in the late 1800s, nurses worked with families and communities in schools, homes, and with immigrant populations in tenements of industrialized cities. By the early 1900s, PHN leaders recognized that graduates needed broader education than provided by hospital training schools to prepare nurses to address social conditions and promote health and hygiene for populations. Current themes in professional nursing, such as social determinants of health, have their roots in early discourse about PHN education.

Cultivating constituencies: the story of the East Harlem Nursing and Health Service, 1928-1941.

I examine the history of the East Harlem Nursing and Health Service in New York City from its beginnings as a demonstration project in 1922 to its closing in 1941. I explore the less tangible goals, needs, and ambitions of the many different constituents that paid for, delivered, and received health care services. I place these goals, needs, and ambitions as critically important drivers of ultimate success or failure. The East Harlem Nursing and Health Service gained international fame among public health leaders for its innovative and independent nursing practice and teaching. However, it ultimately failed because its commitment was to a particular disciplinary mission that did not meet the needs of the constituent communities it served. From 1928 to 1941, the service focused more on the educational advancement of public health nursing and less on addressing the real health care needs of those in East Harlem.

The nurse's first visit. 1918.

Home visiting was an important component of the Public Health Nurse's (PHN) role in the early twentieth century. In this reprint, originally published in 1918 and reprinted in 1926, Edna Foley discusses the significance of the first visit the PHN makes to a family. Critical themes in the paper include the importance of first impressions, communication and observation skills, obtaining the statistical data needed by the agency and collaboration with other community social service agencies. Many of the themes and strategies discussed by Foley are cogent to PHNs and visiting nurses in the contemporary health care arena.

Health insurance in California, its effect on public health nursing.

Health insurance coverage and the means by which it is paid have been topics of intense interest in recent years, but in the United States, creation of a uniform system for provision of medical care has been debated for nearly a century. During the Great Depression, before large group insurance plans, workers who formerly had been able to adequately support their families found themselves without employment or in low income jobs that barely put food on the table and a roof over their heads. Medical care was a luxury they could not afford. Health professionals suffered the effects of the economy too. Published in Public Health Nursing in 1936, this paper reflects a time period when the ravages of the Great Depression were manifest. California had received an influx of poor, migrant workers from other states hoping to provide for their families as pickers, canners, and manual laborers. The author, Marion E. Russell, described a 1935 health insurance proposal to cover all state residents. Selected excerpts illustrate differences in philosophy still evident in current considerations of national health care reform, particularly as related to mandated coverage. Russell worked in the State Relief Administration in San Francisco.

Nurses' role in the prevention of infant mortality in 1884-1925: health disparities then and now.

Nursing has a strong historical precedence in the treatment of health disparities. This article evaluates the public health nurses' (PHNs') role with infant mortality during 1884-1920, specifically how nursing care impacted on conditions of poverty, poor nutrition, poor living conditions, lack of education, and lack of governmental policies that contributed to the poor health of infants a century ago. The historical significance of the early PHNs' role can improve our understanding of nursing practice with childhood health issues today. Suggestions are made for nursing to focus on health disparities in childhood obesity, in areas of environmental and policy changes, and the development of social programs and education for families to support healthier living.

Public health nursing-indispensible and economical for everyone if organized.

In August 1930, the editors of the original Public Health Nursing published an article derived from a speech made by Dr. Haven Emerson, then professor of public health administration at Columbia University, on the topic of the distribution and use of public health nurses. The speech was made before an audience of lay board members from hospitals and public health nursing organizations in Chicago, February 17, 1930. Emerson reported the results of a data analysis in which the numbers and credentials of public health nurses in 24 cities across the United States were reported. Excerpts from this report and Dr. Emerson's conclusions are powerful reminders that while there were issues of labor supply and distribution, the power of nurses to effect social transformation was central to the role as conceived by those administering public health services.

[Community health and social action in the epidemiologic control of infantile trachoma, Spain (1932-1939)]. / Salud comunitaria y acción social en el control epidemiologíco del tracoma infantil, España (1932-1939).

Within the context of the endemic trachoma that affected different regions of Spain until the 1960s, this paper analyses the epidemiological determinants of child trachoma and its treatment, based on a preventive care model which incorporated the concept of community health that took shape during the interwar period. Early detection of cases, together with preventive measures, education, therapy and inspections, such as those carried out by visiting nurses, all helped to control the disease. Our results reaffirm the validity of the horizontal intervention strategies used for improving the sanitary conditions and environmental factors responsible for this prevalence of trachoma.

[The professionalization of nursing in Argentina: political and institutional disputes during Peronism.]. / La profesionalización de la enfermería en Argentina: disputas políticas e institucionales durante el Peronismo.

This paper discusses the professionalization of nurses in Argentina during Peron's administration (1946-1955). We will focus on two nursing schools during such period: Escuela de Engermas de la Secretaría de Salud Pública (1947) and Escuela de Enfermeras "7 de mayo" member of Fundación Eva Perón (1950). We will analyze the institutional disputes over budgetary positions in the context of greater government intervention in public health issues.

The best of public health nursing, circa 1941.

Public health nursing was the term Lillian Wald used to describe the work of nurses whose role it was to address both the immediate impact of sickness and the underlying relationship between poverty, social disadvantage, environmental hazards, and disease. The nature and content of American public health nursing of the 1930s are reflected in exemplars from Marguerite Wales's 1941 book, The Public Health Nurse in Action. Nurses' roles as educators, caregivers, and case managers overcoming barriers emerge from the tales. These vignettes illustrate the organic relationships that existed between nurses and communities. Nurses' understanding of the nature and influence of environmental, psychological and social factors on health behavior was essential to effective public health work. Their stories help us interpret the meaning of nursing at a moment in time. They also reflect the values of the founders of Henry Street Nursing Service and supervisors of public and voluntary agencies throughout the U.S. and Canada who selected and edited them for instructive purposes. Reading collections of such narratives also helps us to appreciate the difficulty of negotiating complex needs, and may provide greater appreciation for the work of our predecessors as well as our own.

Edna Dell Weinel, champion of public health nursing--excerpts from an oral history. Interview by Irene Kalnins.

Edna Dell Weinel is a former executive director (1980--1991) of the Family Care Center, a federally funded neighborhood health center in St. Louis, Missouri; this position capped her career as a county public health nurse, state maternal-child nursing consultant, and educator. In all her positions, Weinel lived her values: working at one's highest level of skill, social justice, and teamwork, and used political skills to build alliances for the improvement of community health. Her many contributions to public health and public health nursing were recognized by the Public Health Nursing Section of the American Public Health Association in 1993 with the Ruth B. Freeman Distinguished Career award. In interviews conducted early in 2007, Weinel spoke of her pride in being a public health nurse, her unchanging belief that health care can best be delivered by teams, and that public health nurses are an essential part of any effective team.

Learning to live with our children. 1949.

As the title suggests, being perplexed by one's children is not unique to the 21st century. In her paper, published in the original Public Health Nursing, Henrietta Fleck (1949), chair of Home Economics at New York University, addressed this persistent problem by providing advice on parent education methods for public health nurses. The materials-films, newspapers, cartoons, posters-are all within the nurse's arsenal today, supplemented by television, and the Internet. More interesting was Fleck's philosophy about parenting and family life. The excerpt omits the dated description of resources, focusing instead on her point of view. It reflects post-World War II optimism about the meaning and power of democracy in shaping familial behavior. The United States was readjusting to civilian life following World War II, fathers were returning home from military fields of action overseas, women were gradually being displaced from the industrial workplace-the country was expanding into suburbia and baby boomers were making their first appearances in the world. Fleck's assumptions include belief in the value of individualism, the importance of sharing both privilege and obligation, and the nature of maturity evidenced in an ability to make reasoned and reasonable choices and to hold oneself accountable for them. The limitations of her view are left to us to ponder.