Spring 2002 by PennNursing

Spring 2002 Vol. 16

lSSN 1049-2259

No PLACE LIKE HOME: A HISTORY OF NURING AND HOME CARE IN THE US By KAREN BUHLER-WILKERSON,RN

PHD, FAAN

For nearly two centuries. variou organizations have struggled to care for the sick at home. The history of organized home care in the United States reflects many of our fundamental ocial relationships and values. The intriguing question about this history is why, despite the fact that home care is a preferred choice by many palien and familic ,and perhaps a cost-effective alternative to in tituuonai care. it nevertheless remain. a marginalized experiment in caregiving.

Center for The Study of The History of Nursing UNIVERsm' U . PEN 'SY VANIA

The earlie t eff&rt to care for the ic" at home in the United States were mo A HI. TORY tivated by a tradition of religiou benevolence Of NUR INC among wealthy ladie of AND Charleston. Sc. By the end HOMI ARE of Ule 19th cent ury, urban ization. indu trializalion, IN THF immigration, and the con UNIT 0 stant threat of infectiou disease were transfonning TAH most large urban cities into increasingly unhealthy place to live. The relation ship between poverty and illness was indisputable aDd popuJarization of lhe germ theory of disease pro vided furlh r motivation to protect society from Ullcon trolled disease. The grow ing avai lability of trained nur. es provided a pra tical s lullon to thi urban thr at of disease and disor der. Acr s the country, wealthy ladies began to hire nurses to care for the sick poor in their homes. By 1909, nearly 600 organizations across the country were spon oring tbe work of the e v i ~ i Ling nur . Thal same year, public health nw·sing

Sc IIOUL OF N URSINO This artie/e is based on the lecture which Dr. Buhler-Wilkerson presented to The New York Academy of Medicine ill November 2001.

(Collt il/lled Oil page 8)

CENTER FOR THE STUDY

THE HISTORY OF

NURSING Tbe Center jiJr The Study afThe His tory of ursing was established in 1985 to encourage and fac il itate hislori aJ scholar ~hi p on health care history and nu rs ing in th United States. ow in i L~ seventeenth year of existencc. the Center continues to d eate and main l in a resource for such re earc h; to improve the quali ty and scope of histo rical scholarshi p on nursing; nod to disseminate new knowledge on nursing his tory through ed ucation, conferences, publi cati ns, and inter-di c ipl inary ctlllabo ration .

NEWS FROM THE CENTER

AWARDS, HONORS AND O THER TmNGS The 2001 American JownaL of Nursing Book of the Year winner for History and Hcalth)'olicy is Enduring Issues in American Nursing edi ted by Ellen Baer, Patricia D' Antoni o, Sylv ia Rinker, and Joan Lyna ugh. This book is intended for use in teaching 3tlhe univ rsi ty I vel and was published by pringer Publllihi ng Company _

Current projects at the Center range from s tudies of international nursing, home based nursing, and research on carc of the critically ill to the twentieth-century rela ti onship between nurs ing and American phil[,nth ropy. We also continue to collect, pl'()cess, and catalogue an outstanding col lect ion of primary histurical ma t riab . Feel free LO vi , it thc Center Monday through Friday, 9:00 a.m. to 5:00 p.m. cholllrs planning to condu ct rese reh at the CeJlIer hould con tact Ih Ce nter 'S curator at 2 15-898-4502 . Our curator will respond with a descrip tion of the sco pe and content of rele vant mate ri als in the various collec tions.

IC,.",

Ad""", 8."d

Ann P. Knight. Chai r M. Loui e Fitzpa tri ck, Vice Chair Li llian S h()lt i ~ Brunner Will iam H. Helfand Hann ah Hender:on Jeanne Kiefner Nadin Landi s Mark Frazie r Lloyd Charl es E. Rosenberg Stephanie A. Stachni wicz Ann Percy Stroud Cenler Staff Karen Buh ler-Wilkerson, PhD, FAAN Directo r Ell n D. Baer, PhD, AAN Associate Di rector Joan E. Lynaugh, PhD, FAAN Ass oc-iate Din:ctor Gai l E. Farr, MA, CA C urato r Betsy Weiss Ad ministrative Assistant Rita Beatty V,l un leer

Pafrid a D ' AlllOnio (Ieji ) and Karen Buhler-Wilkerson , winners of

Lavinia L. Dock Award for 2()()!

Karen Buhler-Wilkerson and Patrici a D'Antonio both received 'Lavinia L. Dock Award for Exemplary Historical Research and Writing 200 I" from rhe American A so ciation for the History of Nurs ing; Karen for her book No Place LIke flome .· A His/or ' of Nursing and Home Care in the United Slales, and Pal for her artic le "Revi iting and Rethinking the Rewriting of Nursing History," Bulielill of the History ofMedicine, Summerl 999, Vol. 73,No.2.

EXPERT PANEL ON NURSING AND lli, TORY Spearheaded by Nettie Birnba h, a proposal to form an expert panel on nur ing history has been accepted by the American Academy of Nu rsing. Expert panels pro vide a flexible means for add res ing issu es of the nursing profession and concerns for the heahll of Ihe public. The mis. ion of thi s panel will be to analyze relationships be twe n curren l events and larger historica l lhemes, between the past and the present, and will place some of the mor controver ial and compelling politic I and social issues in nursing in their historical context. The panel 's main project wi!] be the creation of a Nursing and History web site linked to national and international nursing centers and repositories . The purpose of the website is threefold: It will provide broa access to the historical ev idence needed to make effective health pol icy deci.sions; it will provide a forum that can be used by researchers, educators, and pohcymakers to look at the historical context of practical issues in nursing; and it will increase nur, ing's visibility in the national and int malionalcommunities. Karen Buhler-Wilker on is Chair of the Panel. The members include: Ellen Baer, Susan Benedict, Neltie Bim bach, Barbara Brodie, Signe Cooper, Patricia Donahue, Julie Fai nnan , LOld se Fitzpatrick, LaurieGlass, Joan Lynaugh, Elizabeth Norman, and Trish S ifen . (co ntinued 011 paRe 8)

THE UNIVERSITY OF PENNSYLVANIA SCHOOL OF NURSlNG WELCOMES

NEW DEAN r.

Afaf Meleis, PhD, F AAN, RN, an inlernation lly acclaimed nurse and medical sociologist, is now the fi fth dean of the School of Nursing of the Univer -ity of Penn ·ylvania. Meleis has been a professor of nursing in the Departm nt of Community Health Sy tems at the Uni ersity of California, San Francisco School of Nurs ing since 197 1, where she served as assistant dean for acad mic programs from 1971 -75. She was on the faculty of the Uni versity f Californ ia, Los Ange les from 1968 to 1971. "We are delighted that an acade mician, researcher and women's advocQte of Dr. Mele is' cal iber has chosen to take the helm at Penn's cha o I of Nursing," said Uni versity of Penn ylvania President judi th Rod in. ' Her experience and credentials rei nforce the r Ie nursing plays on the wo rld . tage as she joins a staff of cons idera ble national and international repute." Considered a "c ultur al bridge buil der" both narionally and internationally, M leis i accl aimed for he r focus on international research in women and h alth i sues. She curre ntly serves as president of the International Council on Women's Health, and has been an invi t d v i iting profi ssor, symposium presenter, keynote speaker, board m mber and consultant on international nursing, heal th and women 's issue in the MiddleEa t, Europe, A ia and South America. She has been honored fo r he r achievements by a number of universities and professional organizations worldwide. In 1990. Egyptian President Hosni Mubarak presented her iLh that country's Medal of Excellence for her p rofessiona l and scholarly work . She is also the recipient of lye mentorin g awards. including a regional one. Most rece ntly, in Ap ril, he received the Chancellor' Award for the Advancement of Faculty Women at UCSF, where in 2000 he al 0 organized and chaired the lntemational Congre , on Women 's Health L'lsues. "Afaf Meleis brings her con. iderable expertise in theoreti aJ nursing, international h al th and women' hea lth i sues to the University," Penn Provo t Ro bert Barchi sai d. "Her reputation as a pioneer in women's hea lth issues and culturally competent care worldwide is truly im pressive. We believe she will lead Penn' School f N UT ing to even higher prominence both nationally and intemati na lly."

THE PGH CLOSURE: AN

ORAL HISTORY This Oil going study was made pns. ible by support from the Alice Fisher Society' Summer Fellowship aI /he Ulliversity of PenllSylvanio's Center for The Study ofThe History of Nursing

Mrs. Belly Conll er. surgical supervisor o/th e Philadelphia Gene ral Hospiral Police and Firemen's Ward, accepts an award fr om City a/ Ph iladelphia f ire cOlllmi ioner Joseph Rizzo, 1972 . Joseph's broth er. Philadelphia mayor Frank Rizzo, closed Philadelphia General in 1977. P hoto: Alumni Association o/the PGH Training School for Nll rses Coliection, CSHN.

On June 30tlJ, 1977 , the Phila delphia General Hospital (PGH) c losed its doors. In its heyday of th - early \920 ,the PGH covered the townsltip of Blockley, which was more than 100 acres. The most prominent physicians of the City's hospitals . taffed and su perv ised it. And it boasted the best in organ ized nursing care, established by Mis Alice Fi her. protege of Aorence Nightingale, and carried forward by her suc cessor. chief nurse Marion Smith. and the first nurse to sit for a civil service exam. Theeiife of Phil a delphia soc iety served in appoint me nts by the Mayor, and a the (co ntinued on page 7)

COLLECTIONS NEWS

MANAGING ARCIllVES AND RECORDS OF TIIE PENN SCHOOL OF NURSING

A a repo. itory of material!> relating to the history of nursing, the Center is naturally interested in the documentary hi tory of its own institutional home, the University of Pennsylvania School of Nursing (UP SON). This is not 10 say dIat dIe UP nursing school's records are 100 percenl complete and in p rfect order. Record. accumulate in file cabinets and on hard drives here ju t as they do at other insti tutions. Over the past several years, however, the Center ha made genuine progre s toward furthering sound records manage·· men! practices at the school and ensuring the preservation of his torically valuable portions of the school' history in archive . The Center would like to share some r the details with readers because our experiences i1lu ·trate the im portance of archives and record management programs in institu tional etlings such as nursing school which provide education and employment for a large number f the Chronicle's readers. The Center has a facilitative rather than dire ,t role to play in regard to record management Ilt the UP SON. Al thouah the Center does collect personal papers of individual UP SON faculty, we do not attempt to be the repository for the SON' administrative records. The records of the school. its depanments, committees. boards, and officers, are in stimtional records and are administered under the "Protocols" of the University of Penn ylvania Archives and Record Center ( ARC). The Protocols are Unj versity-wide policy, adopted by Ule President and Trustees of the University in June 1990. The Protocols established archival and records management stan dards at Penn, under which UARC man ages both the Ilistorically sign ificant records f the University as well a the inactive records of individual academic and administrative offices within the Uni ver iry. The distinction between tbe two

University oj Pennsylvania School or Nursing dean Claire M . Fagin speaks 0 111 at the President's Forum on 'he Environment during her lenure as Interim President u(t he University . 199 Pharo : Claire Fagin Papers. CSHN .

is Lhat tho e records designated hi. tori cally significan t are housed at the Un i ver ity Archives and made available for research and teaching; those designated inactive remain under the control ( f the office that created them; and the Univer sity Records Center act simply a an extension of each office's own filing y rem. The Record Center works clo ely with each ofti ce of origin to impose re tention schedules on its records, that is, a period of time after which the records are scheduled for destruction. For the reader int rested in learning more about this unified archival and records man agement program, a fu ll description may be found at the UARC web site: hltp:Uwww.archives.upenn.edu Bolh the Center and UARC face a real challenge in managing the peed and volume at which SON administrative records are created and tored. Without

a systematic program in place for han dling inactive records, both permanent and non-perman nt records run the ri k of being lost or de troyed. During the year 2000, Center staff became aware of two rooms in the basement of the Nurs ing Education Building ftlled with boxes and filing cabinets. The Center obtained Ule Sello l' pcmlisSion to examine the files . The material con i ted mainly of administrative tiles ofule SON from the 1980s to the present. Included were pur chasing invoice , travel vouchers, and ther routine bu ·ine. records, but there were al 0 more unu 'ual item. such as architecturdl plans. What concerned us most was that the lime period of the records coincided with Claire Fagin's tenure as dean. Not only was Dr. Fagin the guiding force of the sch 01 for many years. but she i ' stiU an active person age and an emeritu memb r of the fac

ulty. In fact he had just transferred an additional increment of hcr personal and profes ional papers to the Center to add to the Claire Fagin papers which she had donated to the Center in 1991, c nlinu ing a proce s that began when she des ignated the Center as the offi cial repo i tory of her papers. Her gift arrived in mid-year 2000, about the same time as the Center staff began to assess the records fou nd in the basement storer om .It immediat Iy becarneapparent that there were more of Dr. Fagin ' s pa pers in the two storerooms. In the summer and faU of2000, Cen te r taff surveyed the records in the ba ement and fo und that they were, in deed, admi nistrative records oflhe SON during the Fagin years. The Center' s survey learn did idenlify omeofClaire Fagin ' personal papers in the store rooms; tho 'e relating to her deanship of the SON and to her interim presidency of the University were sent to the Un iver sity Archives. The surveyors al 0 iden titied record ' of assistant dean wh bad carried out many of Fagin's initia ti ves for improving the quality of nurs ing education at th university and the e, too, were sent ro UARC. They included records pertaining to linance, fWldraising, strategic planning, survey', and task forces administered by the Dean's office from th late J970, through 1991. Why the records drifted into store rooms is really nOl so mysterious . People who work in organizations are often perplexed about what to do with records, despite the presenc f archi vists and records manager to provide gui dance. What the chool should have done was to sort and label the boxes and send the inactive fil es to the university records center and those identified for permanent preservation to the unive r ity arc hi ves . Because these procedures were not follow d, it took many mor month· to sort thi ngs oul than it would have otherwise , and the records could have been lost. The Center was fo rtunate to have a supportive collaborator in Mark Frazier Lloyd , DirectorofUARC and a member

of the Center's advi ory board ince 1988. Mark offered resources from hi program to box and mov the SON records fro m the storerooms to UARC. Those identified for permanent preserva tion have since been processed al UARe. Technical Services Archivist Kaiyi Chen has prepared a de 'criptive inventory enti tled "Guide to the Univer ity of Penn ylvania School of Nursing Records , 1908-1998." UARClypical ly publishes its guides in dual formal: on line, althe UARC web ite, and in tradi lional, printed fomlat. The Protocol , however, stipulate that admJni trative paper ' of the University remain closed to research for twenty-five years from the date of their creation. An appeal mechanism is available to qualified scholars conducting . ub tanliv re eareh, but because of the twenty-five year rule, the full text and inventory of Dr. Chen ' s has not been made available on-line. A copy of the printed edition has been made available to the Nursing History Cenler and is available there upon request. The Center thank all who partici pated in tillS effort LO preserve and pro mote acces to documentation of the University of Pennsylvania during the Fagin years, PENN SCHOOL OF NURSING DEANS PAPERS PROJECT Perhaps the most exciting aspect of the Center ' s collaboration with the Uni versity of Pennsylv ania Archives and Records Center (see precedi ng article) is that Mark Lloyd and the University Ar chives and Records Center donated $10,000 to Lhe Center to enable u to sort, rehou 'e, and produce finding aids to the papers of two University Scb 01 of Nursing deans. One of the e co llec tions is a '!fOUp of papers which Claire M. Fagin. RN. PhD, FAAN. donated to the Center in 2000. T his addition (261in ear feel, 1978-2000) to the Fagin personal paper · i ' of imerest for several reason . The papers received fro m Dr. Fagin in J991 contained documentation of the research and publication of two of the

Dean's most important -cholarly works, Family Centered Nursing in Community Psychiatry : Trearmenl in the Home , (1970) and Nursing in Child Psychiatry ( 1972). The installment received in 2000 documents Dean Fagin's professional interests and activities since her retire ment from the School ofNursing in 1991 , includ ing, most notably, her year as In terim Presidenl of the University. 1993-94 (and first woman CEO of an Ivy League univer ity). The Fagi n collection IS a rich ource of insight into nursing and health care in the 1990s. Project archi vist Rita T. Beatty processed the papers and prepared a finding aid for research ers. The finding aid is currently avail able in traditional printed format in the Center's reading room. An on-line edi tion will be posted to the Center' s web ite later this pring. The other material which will be pr cessed under the UARC grant is a col lection of personal papers donated by NormaM .Lang,RN,PhD, FAAN, FRCN, dean orlhe School from 1992 to 2000. Dr. Lang pioneered the nursing profession's first quality assurance ef forts in tbe 19705. Her work to identify standards and measures to evaluate the quality of nursing care is now used to guide nursing policy throughout tb world and her model-known as the Lang Model-is widely regarded for its role in enhancing knowledge and en couraging the use of performance mea surement to improve the quality of health care. Among her many accom pli hments, Dr. Lang has been named the recipient f the Jessie M. SCOlt Award for 2002. The award i given by the American Nurses A. sociation for the demonstration of the interdependent re lationships among nursing du alion, nursing practice, and nurs ing research. Dr. Lang is also the first woman and first nurse to receive the Ernest A. Codman Award (200 I ) for he r pioneering role in nursing informatics. The Center looks forward to processing the Lang paper, which do umenl her leadersh ip in creat i.ng a uniform language for nursing. l)

Gail E. FaIT MA, CA Curator

DONORS TO

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JANUARY

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THE STUDY

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HISTORY OF NURSING

1, 2001 THROUGH DECETvlBER 31, 2001

Alumni Association of the Hospital of th e University of Pe nnsyl va ni a Sc hoo l of Nursing Al umni Asso iation of the Training Schoo l fo r Nurses Philadelphi a Ge ne ral H ospital Virginia A . Aaron L inda H. A iken Lauren S A rnold E llen Dav idson Bae r Henry P Baer Jr S us an B Daird M r. and Mrs . J. Mark Baiada An ne M Banas N ira Bartal B arbara Bates E lizabeth M. Bear Susan Wei ss Be hrend Jeanne Quint Benoliel Eve lyn Rose Benson Palsy J Berlet Lela Rick s Bethel Ne ttie Birnbach Ruth M. Blea kley D o lore s T . B o nsall Geertje Bosch ma Nancy N . Boyer Ann M arie W alsh B rcnna n Barbara B rodie F rance s Brouse Li llian Sholti :' B runner SUSll/1 Brunoli-S tille r Karen B uhl er- W il ke r~ on Mr. and Mrs. John C. Burnham Judith Caesar Caroline CaJ11una s Bar a ra Cham berlain M r. and M rs. Ke ith A. Chan ey Alice Lee Ch un Marl ene H. C ianci Pll mel a F. C ipriano Lydi a E. C lark Be ry l Board man C lca ry Timothy P. C lo ugherty Thomas W . C onne ll y l r Nich las Co nno lly Cynthia Co nn o ll y S igneCoo per G race K . Coulso n Deborah R C o x Mary F. Cra ford Patrici a 0 ' Alltonio Elcanor L. Dav is Lynore Desilets loanne Disch Irene D issinger Flo rence Downs H clcn Edw ards Karen Egcnes Mary E lling

Ruth pp inge r Jonathan Erlen Julie Sc hauer Faimlan Jane A. Farrell-Beck Suzanne L. Feetham lane t L. Ficke isscn Patricia I. Fi scher M. Loui se Fit zpatrick Mari lyn E . Flood Catherin e Freeman JearulC F rye Palmer H. F utchcr G ale G amer Florence R. Ga rtland Carol P. Gemlain Laur ie Glass lane t Golden Em aG ou ld ing L ydia M G rch Marga ret G rey Phyllis Harrington Isabella S Harrison C arol Hayes-C hristianse n La ura Lucia Hayman Patricia A. Heffner W illia m H . Helfand Carol S . Hc lmstadter Loretta Ashley Helt on Be th Helw ig W an da Hies tand Hannah L. He nde rso n C onst ance L. Hi ll Ki n N. H ol bek W illiam L. Hol.zemer Ch ri sty Nye Hoover Jacq ueli ne R ose Holt L o ui e ah l Hoy Jacqu eline L. Kahn Doroth y G . Ka pens tein Ursula M Karau E lizabeth A Katona Ida H. Ka ufm an AI da E. Kerschner Jeanne Kie fner N o rma Pedcn Killebrew M ar il yn G. K ing Ann P. K night Ire ne Kuhar Anne W Lauer E loi eR. Lee Jan Lee Charle s Letocha H lene B. Kerritz Levy Sandra Lewenson Edi th P. Lewis Ma ry Ann Le wis Martha Libs ter Lippincott W illiams & Wilkins C nstance L it willer

Eliz abeth P . L osa A rl ene Lo vej oy-B luem Ruth Watson L u bic Barbara Vra bel Lund Joan E. L ynaugh Margue ri te L. Ma nfreda Ba rbara Ba rd en Mason Diana J Mason Jo an Daly M ason E. Ann Ma tter Nadina M, tt es M ary M cBride Ma rgarct Mc C lure Gloria 1. McNeal Esther l ean Mc Neil Kathryn M Mc rshon Math y Me zey E li zabeth A. Miller Harvey S . Shipley M illcr Lana M ille r Lois A , Monteiro Ann C. Motte M ary Alic e Musse r Will iam Nace Ma ry Duffin Nay lor 1anne ke Ne ilson E li zabe th M . Norm an Veronica C . O ' Day T homas Craig OLson Mara l Palanjian John L. Paras ca ndola Sleve n 1. Pe itzrnan Sharon Peterson Annette M arie Petti nco D OI"ol11y Phillips R o be rt V . Pie monte La ura Randar Joan S Rando lph ldabellc Ream E li zabeth Reedy S usan Reve rby Robert H . Richardson Natali N R iegler Sylvia RiJlker T heodore R Robb Brooke Robe rts Dori' Ro berts Carol Halsted Robinson Clara Shaefer R oe Charles E. Rose nbe rg Amy LOll i 'e Ruesc h La urie Russe ll Debo rah A Sam pso n L uc ille M Savacool A lice Savastio C arln Schissel Barbara Sc hnu r Thelma M . Sc horr

7 Norma Rohrbough Shue Mary Jane E. Sieke rt G race S iotterback Suzanne C. Smeltzer Nancy T . Snyder Theresa R. Snyder Annetlc C. Squire Stephanie A. Stachniew ic z Beverl y Peril Stern Mi riam Stern Lucy E. Stette r Rosemary A. Stevens Dr. and Mr ~ . Bayard Storey Ann Percy Stroud Mr. and Mrs. Herbert Strumpf Neville Sirumpf Beth Ann Swan Mary Tarbox Carole Torok Deborah L. Torres Lorrai ne Tulman Un iversity of Pennsylvania Arc hi ves and Records Center Nancy M. Va lentine Mr. and Mrs. D. W . Van Duscn An n M . Van Hoff Elizabeth Vickers Linda V. Walsh Ellen Drace Warner Rosalyn Wa tts Mary Jessica Welfare M artha Wertheim Jean C. Whe lan Fa W. Whitney Jane Wiest Ethel K. Wishart Za ne Robinson Wolf Alm a Woolley Ma ry Ann Wu yscik Cara Zeidman

THE PGH CLOSURE: AN ORAL HISTORY

guardians of the hospital. The hospi tal , expanded dramatically in 1925 , was the fi rs t institution to offer radiologi cal therapy for cancer (with M adame Marie C urie), and led the development f OT 'pecialization in med icine. orga nized nursing. and the development of state-of-the-art laboratory services. It had its own linen service, food ser vice, housing for staff, and even its own fi.re department. It was, as some of its loyalists said, " a city unto it self." This noble legacy became history on that sunny June day. And while there has been much speculation about the causes, circumstances, and phenomena that led to that landmark dec is ion, the lived experiences of those who were party to, and subject to, that decision have yet to be re corded . The oral hi story clo. ure p roject incl udes the peopL who made the decis ion; who supported the deci sion; who opp sed the decisi n; who implemented the decision; who fought the deci ion; who suffe red with [he dec ision; who negotiated the deci sion; who lived with the deci ion. The Alice Fi her Fellowship set the stage for unde rtaking this important work. T he oral histories of many of those who were center stage are being re corded and transcribed. T he early in tervi ws included Dr. L ui Polk, act

iog heal th commissioner at the time of the cl osure (who also offered his exten sive personal archive to complement this study); Stephanie Stachniewicz, director of nursin g s evice and nurs ing educa tion (who co-authored a book on the nursing school); Tina Weintraub, the deputy managing di rector for the City of Philadelphia, nd the exec utive director of the PGH until 1976; H illel Levenson. Managing Director of the City of Phila delphia, the chief operating officer for the City ; Martin Wein berg, City Solic i tor, and poli tical confidant of Mayor Frank Rizzo, d uring whose administrd tion the PGH closed; Frank Rizzo Jr.. now a city councilman , and son of the late Mayor Rizzo; Tom Leonard, City Con trolle r, and keeper of the City's books; and Barry Savitz, the health center direc tor charged with faci litati ng patient tran fer. As with much re ·earch. lhis inquiry has led LO another series of inquiries and another Ii t of potential informants. W ith time, pat ience, and persistence, the lived experiences of these witnesses, combined with other research tech nique ,may give rise to a more fulsome pictuTe of the cl osure of an hi. toric Phila de lphia institution . Donna Gentile O ' Donnell Doct ral Student University of Pennsylvania School of Nursing

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No PLACE LIKE HOl\1E (continued/rom page 1 )

leader Lillian Wald had even convinced the Metrop liLan Life Insurance Com pany to e. tablish insurance cove rage for home care for its po licyholders. Between 1909 and 1952, Metropol itan paid for over LOO million home visi ts to its policy holde durin g sickne s. By the 1920 . ho pitaLs were recast lng themselves a an accepted center of medica l care whi le care at home was be coming the preferred alternative forear ing for the chronically ill. By the 1930 , hronic illness was the focus of home care. Unfortunately , the longstanding nature of this vexing problem held li ttle mean ing in the world of f undraising and most home care organiza ions struggled to survive throughout the 1940 and 1950 . Deeply committed to the commu nities they served and believing in the services ti1ey offered, agencies cross the country they searched f r u tainabl strategies fo r thei r traditio nal m ission o f caring for the sick. The answer would come with the passage of the Medicare legislation in 1965. Ironically, it was home care's perceived capacity to empty hospital beds that res ulted in its inclu sion in this legislation. Med icare home care was t r the acutely il l, not for those with long te rm ill nesses. T hroughout this hi tory, a lac k o f consensus on the mission and objec tives of home care has made establishing its place within the ontin uum of health care an ongoi ng chalJe nge. Even after a century of experimentation, hom care ambiguities have allowed us as a society to avoid addressi ng home care's really tough i sues: was caring fo r the sick at home a private family obligation or a re sponsibility hared wi th a caring oci ety; should home care be provided o nly under the most restrictive of circum stances or whenever it can help; or should we simply not dec ide andjust keep muddling along? Simply put, the U.S. bas no realistic system of support for the families of tho,e who need extensive or long term care. Today. a significant but largely in visible group of " informal caregivers" provide most care for the sick at home-

managing on their own as best they can. Such care is challenging. exhausting , inconvenient and interrupts daily pat terns of living and work. Prov iding care and the essentials of daily living (food, sh Iter, housekeeping services) req uires tremendous effort. For those living alone, illne s is even more challenging. As a ociety, we are enamored with self-reliance, independence, and self help. We are suspiciou . of dependency and look down on tho e who require as sistance. While in times of eri is we reach out to needy neighbors or victim of terrorism, we hesita.te to institutiona l ize ordinary everyday caring. The cur rent debate over assuring the appropri ate distribution and lise of th one bi l lion dollars raised to help the victims of September 11th underscores daily the intensity of our conflicts. Sickness and injury, and especially chr nic illness, are incongruent with a production-oriented and worker-depen dent society. A istance from benevo lent volunteers or paid caregivers i gen erally required (although not always avai lable) and this need transcends class, race. ethnic ity, age , gender, place, and time. W ho de erves to ~et care and who pays for that care are fWldamenta l and unresolved problems after years of inconclusive debate. The open -ended nature of home care spawns endless worry and, ul timately, an unwillingness to pay for the home care of others. The patient's "failure to die or get well" remain a cen tral concern in any discu ion of home care. Whatever the configuration of serv ice, chronic care, stretchin g out over time, i a particularly dreaded cu rse.

For nearly two cent urie ,organized ho me care has survived at the margins of our health sy tern. The inability of the public to visualize tile e lement, out comes, or val ue of home care only make more difficult the task of de id ing whether care of tile sick at h me is a 0 cietal responsibi lity or a private family concern . As a matter of fact. we are left to this day with the unanswered ques tion, "Who pays, for whom, for what, and how m uch'!"

Copies f No Place Like Ho me may be ordered from The John, Hopkin Unive rsity Press ($45.00, cloth).

NEWS FROM THE CENTER

(continlled/rampage 2)

No Place Like Home continues to generate nation wide attention . It re ceived tile 2001 . Professional and Scholarly Publishing Award for Nursing and Allied Health" from the As ociation of American Publi hers. It was very fa vorably and thoughtfully rev iewed by Suzanne Gordon in tbe March 4 issue of The Nation . And it was the subject of a recent interview Wilh Karen by the Los Angeles radio station KPCC/PBS on April 10. The American Academy of Nursing Honorable Mention for the 200 I Media Award was presented to William Helfand and John Ittmann for The Nightingale 's Song: Nurses and Nursing in the Ars Medica Collection of !lIe Philadelphia Museum ofArt.

CENTER FELLOWS SELECTED The Center is proud to announce the 'election of this years Brunner and Fisher Fellow . Deborah Sampson, a doctoral student in nurslng at the Uni versity of Pennsylvania, will use the Lillian Sholtis Brunner Fellowship to pur sue her research goal f inve ligating the legislative history of advanced prac tice nursing. She is in the proc s of in terviewing Jesse M. Scott, MEd, RN, former United States SUTgeon General. on her J6-year government career. Ms. Scott was a pivotal leader in tbe expan sion of nur es' education, practice, and fund ing during the 1970s. M . Sampson' research on nursing leaders is also supported by Sigma Theta Tau, Xi Chapter. Joy B uck, the Alice Fisher Scholarhip award winner, is a doctoral student at the Universit y ofVirgjnia tudying the American bo pice movement in the latter half of the 20th century. Her research fo cuses on the Connecticut Rospicc and the role of nursing in its transformation

N EWS FROM THE CENTER (conlifllledjrom pret:eeding paRe )

NADINE LANDIS IS RECOGNIZED FOR A

LIFETIME

OF SERVICE

from conception to bureaucratization (1965 - 1985 ). The research isaimed at enhancing our under, tand ing of the evo lution of community-based models of term ina! care, the impact of that care on the terminally ill and their famil ies, and the translation of these int nursing practice, research, and national health care policy. INTERNATIONAL NEWS Nira BartaJ , PhD received the doctor ate last spring from Hebrew University. Israel. She presented the Center with a copy of her dissertati n: "Theoretical and Practical Training of Jewish Nur es in Mandatory Pale tine 1918-1948, Through U1e Prism of the Hadassah School of Nursing Jeru alem." Nira will be accompanying her husband Israel, to the Uni ted States for the fall 2002 semes ter at Penn where he will be a visiting fellow at the Center for Juda ic Studie . I rael Bartal is also affi liated with He brew Uni ver ity. [( was on one of these visits tb t we first met Nira and her two sons, Avishai and Uriya. In the preface to her dissertation,. ira describ d the Center as "a unjque place lhat served a' source of reinforcement and information ab ut the pecilic di cipJjn of the his tory of nursing ...and exposed me to new and sign iticant lines of thought. "

GRANTS The National Library of Medic inc has awarded a fello wship to Julie Fairman, RN, PhD, FAAN, for her work on "The History of the Nurse Practitio ner Movement , 1960 to the P r sent." Dr. Fainnan's work wi ll al '0 be supported by a National Endowment for the Humani ties Fellowship entitled "Gendered Do main: Medici ne and the Nurse Praclili ner Movement, 1960 to the present," which wi ll start in 2003.

Nadine La ndis (left) p resents a Nig hlinga/c Medal to LQis Marlin at Class Night , 1958 . Photo . From Pictorial Treasures from Our Past School of Nursing, Hospital of the University of Pennsylvania, 1886-1978 .

Center for the Study of the History of Nursing Advi 'ory Board member Nadine Landis was the recipient of the Special Recognition Award from the Alumni Associa tion of the School of Nur jng of the Hospital of the Univer ity of Pennsylvania (HUP) in 2001 , This award has been presented every five year ' since 197 1 as a means to honor and bring recognition to th se HUP gradu tes who have made outstanding and igoi ficant contributions t nursing, health care, and mankind through practice, teach ing. research, writing , patient recovery, community involvement, and polilical and so cial activity. Nadine Landis he lped create the tide tape/video, "Our Legacy," docu menting the history of the HUP Sch 01of Nursing. She was also re ~ponsible for as sembling the excellent publication, Pictorial Treasuresfrom Our Past (1996), which captures this story decade by decade from 1886 to 1978. Her commitment to collecting and preserving this history has made it possible for historians to better represent HUP's tory in books and TV docu mentaries .

PASSING The Center for The Study o/The History of' Nursing mo urns the passing of Audrey Real Helfand, beloved wife of Advis ry Board MemberWilllam H. Helfand. Mrs. Helfand died on March 15.2002. Contributions in her memory may be made to The National Jewish Hospital and Research Center, Denver, Colorado.

BOOK NEWS

As WE SEE OURSELVES: JEWISH WOMEN IN NURSING

accu rately it reflects the mores and as sumptions of cul ture and re ligion. Au thor Benson includes social and bio graphical sketches which allow the reader to gain some insi ght into famiJy and religious life. In the last par t of this sec tion she introduces us to nurses like Johanne Moritzen, ho studied nurs ing and practiced in the late 191h cent ury. But, he also reminds us of s cially prominent and affl uent women like

Evelyn Rose Benson, As We Se Ourselves: Jewish Women in Nursing (Ind ianapolis, Indiana: Center Nursing Publ ishing, 200 1). 196 pp.

As We See Ourselves offers three di stinct perspecti ves on Jewi h li nk ages with nursing. First, Evelyn Benson pro ides an overv iew, fro m biblical to modem time, of the his tory of nursing from the Jew ish pe r spective. She follows this with a con te mporary depic tion of the Jew ish presence in nu rsi1lg using first hand material gathered fr m her ow n pains taki ng survey on the experiences of Jew ish women in nursi n . And, finally, she closes with a chapter reviewing the world w ide involvement f Jewish women in wartime. Thi s is a book wilh a mission, as aulhor Bens n make clt:at in her preface. She makes a convincing ar gument that, not only does n ursin need to recogn ize and pay attention to the conlri bu ti ons of all ethnic and re ligious groups, but the domina nce of Christian ideology tended, hi tori cally, to ubsume the r Ie f Jew ish women in nursing. She reminds us that for centuries women's history was ex cluded from general history; moreover, nursi ng history was left out of women's history . Fi nally, she argues that Jew ish women, with few exceptions, were ex eluded from nursing hist ry . Based on my knowledbe of th literature, not onl y is this a book with a mission. it is unique and fills an informational and hi torical void. Part One is an overview of the his tory of how and where Jewi 'h women involved themselves in nu rsing and pro vides a rev iew of the over aJI.Jewish ex perience. We are remi nded again of how imbedded nursing is in cul ture and how

Ph iladelphia' Rebecca Gratz who worked to c reate general welfare assis tan e in rapidly growing American cities. Not surprisingl y, Lil li an Wald, the re nowned soci al reformer and nurse of Henry treet fame, is given considerable space here. Bu t Benson ah o draws our attention to the connection between Henrietta Szold, the famo us Zionist leader, and Wald oSzold is best know n as the fo under of Hadassah , which lawlched public health and nursing re forms in Palesti ne. Other his to ric figure recal led in this s ction help the reader to recognize tilat, al though nur ing may not have been granted the 'yichu 'or prestige of medicine, there were memo

rable Jew ish women who did ch ose nu r. i1lg. In Part T wo we are introduced to a sample of Jewish women who selected nursing as their career. The idea that Jewi sh girl. don 't go into nu r. ing i e plored thro ugh their experiences, s is the reaction of Jewish parents when nu r ing is the child ' . choi . Experi ences of both anti-semitism and accep tance are re ported in the voices of these interviewees. Thi is a rich section - the nurse" acco unts ri ng true and better ex pr s the sense of the message tha n a more ab tract ap proach might do. Next we read of the relatively new Hadassall Nur es Councils fonned to e tab li sh an international partnership with the Nursing D ivision of the Hadas 'ah Medical Organization in lsrael and address the educa tion al, so iaI and professional con ems of Jewi hand Zioni t nurse in the United Stale: and IsraeL Author Benson sees the Hadassah Nliise Council as a I ng awaited opportunity "to join together as Jews, as women, and as n urses" (p. 20 I). The last sect ion chronicles the w rk f Jew i h women and nurses in wartime. The author ar gues that there i a pecial con n ction between nursing as an organ ized work and the demands f war. Here she documents tbe long standing in volvement of Jewi h women in thi s lradition. Among the les ' known stories i the role of Jewish women in the Spani h Civil War. Perhap the most poignant is that of Massachusetts nurse Frances Slanger, who was killed in an artillery barrage in Ocrober, 1944. Hereagain,lheaulhormem riali ze women who wou ld the rw ise remain un known. Thi s i , as [ indicated at the outset, a unique book. It reca lls and describes in an easy to read and well documented way, the origins, involve ment and contri bution of Jewish women in nursing. I think it wil l fi nd an appreciative audi ence. Joan E. Lynaugh P rofessor Emeri tu s University of Pennsylvan ia Schoo l of Nursing

F ELLOWSHIPS

lNMEMORY

ALICE FISHER SOCIETY Helen Barbara Dopsovic died on September 30, 200 t . A 1939 graduate ofPhiladel phia Generall-lospitaJ School o f Nursing (PGH SoN), . he was di linguished by a keen and perceptive nature, the thoroughnes and cali ber of her nursing work, and her swe tness and generosity . Ms. Dopsovic was born and rai ed in Cala. auqua, Pennsylvania, and grad uated from Catasauqua High Scbool. Her fam ily background was Russian . She became nuent in Lhe language and cul ti vated her heritage rouring Rus ia and collecting art. She was a mem ber of the Russian Ortho dox church th roughout h r life. She enjoyed sharing her hobbies wiLh friend s whether it was teaching Lhem to cook spec ial dishes or to decorate Ea te r eggs in Lhe traditional Slav ic method. Helen Dop ovic entered PGH SoN, at the ad ice of her family phy ician and graduated in 1939. She re ceived a BSN rom the Universi ty of Pennsylvania in the 1960s.

HISTORICAL FELLOWSHIP LILLIAN SHOLTIS BRUNNER HISTORICAL F ELLOWSHIP

The Center for The Study of The History of Nursing offer two fellow ship of $2,500 to support residential study usi ng the Center' collections.

Helen Dopso vic. 1939. Photo: PGH ColleClian . CSHN.

Her nursing career began as surgical head nu rse in the men 's surgical ward at PGH but wa cuI short by a two year bou t with tuberculosis which necess ita ted complete bed-rest. T his wa not uncomm n for nurs ing students at large institutions at the ti me. Although they took precautions when treating tho e with TB , the scope of interaction with und iagnosed patients on other wards afforded many opportun it ies of contacting the disease. Undaunted, Dobbie (as her friends called her) mastered the arts o f knitti ng, fi ne embroidery and crewel. In I 44, as an American Red Cross disaster nurse, M . Dopsovic was sent among eastem coa t states, gaining experience in noods. fires. accidents, and med ica l emer gencie . She also spent time work ing wi th iron lung patients. Even her summer vaca · tion were pent nur ing: as a camp nurse te chin n arts and crafts and rganizing in firmarie . Sh remain d with the Red Cross for a lmost 20 years. From 196110 1977 Helen returned to POR as Supervisor of the Neurology Depart ment and Assistant Director of Nursing Service. After the close f PGH in 1977 'he became Patient Care Coordinator at the Philadel phia ursing Home. The Center for T h Study of T he History of Nursing bears the impri nt of Helen Dopsovi c b th from ber gene ro us donations and initial work on the large and valuable Alumni Association of the Training Sch 01for Nurses Philad Iphia Genera l Hospital collection. Helen 's close frie nd, Stephanie Stachn iewicz, the fina l d irector of the PGH School of Nursing and Nur ing Serv ice had this to say about her, "Her astuteness and orga nizing abi lity made her a wei ome member of committees and project of all types. She was a hard worker and a great friend to have. She had (l lifetime int rest in people, places, and things. I' m sorry I can ' t do justice to an amazing woman, co-worker, and friend ."

The Ali ce Fi her Society Hislori cal Fellow hip. which is made po. sible by the genero ity of the Alumni Asso ciation of the Pili ladelphia General Hospita l Training School for Nurses, is open to nur es at the master's or doctoral leve l who are eeking a i lance with research and writing as part of their study of history. Each scholar wi ll be expected to spend four to six weeks in residence al the Center. Selection of the Brunner Scholar will be ba ed o n evidence of prepara tion and/or productivity in historical r . earch related to nursing. Although doctorally prepared candidates are preferred. the fellowships are open to tho e with pre-doctora l preparat ion. Brunner scholars typically six to eight week! under the general direction of nurse hi torian associated with the Center. Research completed by the fel low will help insure the growth of cholarly work in nursing history. Ap plicants for the $2.500 Brunner Fe!low ship should contact Center Director Karen Buhl r-Wilker on at Lhe Center for The Study of The History of Nurs ing, University of Pennsylvania, School of Nursin o , 420 Guardian Dri ve,Pllilade lphia,PA 19 104-6096 or call 2 15-898-4502. The appticati n deadl ine i ' December 3 I , 2002.

CALENDAR

American Association for the History of' Nursing 191h Annual Conference September 27 -29. 2002, Sull LukeCity. Utah. The American Association for the Hislory of ursing and Brigham Young University College of Nursing are co spon oring thi s annual conference that provides a forum for sharing historical research in nursing. The keynote speaker will be Margarete Sandelowski, PhD, RN, FAA . The pre-conference workshop, Thursday September 26. foc uses Ort "0 ing I-Listory: Fam ily History/Geneal ogy." More information about the pro gram is found on the AAHN website: hUp:ljwww.aahn .org.

The American Association for the History of Medicine 75th Annual Meeting April 25-2R, 2002. Kan as City, Missouri. Several Center affiliates will be present ing their rese'ircb: Jean Whelan: 'The Eight-Hour Day: The Campaign to Re duce the Working Hour of Nurses, 1930-1950"; C)'llthia Connolly:" 'Not Just Poor and Pitiable but Physically in Need'; New York Hospital's Campbell Convalescent Cottages for Children. 1907- 1936" ; and Karen BuhlerWilker on: "Sick at Home: Who Pays, Who CaresT The AAHM Web address is http://www.histmed.org

C~nterfor

The Canadian As ociation for the History of Nursing May 24-262002. University ofToronto. Being held jOintly with Lhe Canadian So I.!iety f r the History or Medicine. The theme will be Boundari s: Geographies, Genrcs. Gender. Karen Buhler-Wilkerson will present I.he Hannah LectuTe, "No Place Like H me: A History ofNufsing and Home Care in the United States.' The website address i . htlu;LL www.allemang.on.ca/CAHNcatl .hlml.

The Scientific Session of the Eastern Nursing Research Society. March 21-23.2002, The Pennsylva nia State Univer ity, State College, Pennsylvania. Every year ENRS pro vides an opportunity for nurses to hare cUlting-edge research finding in a state-of-thc-science forum for nUTse 'cholars involved in educ.1tion, practice, admini u·ation, and rc earch. This year's theme wa "Shaping a Healthier Tomor row lhrough Informed Practil:e.. Drs. Jean Whelan. Cynthia ConnoUy. Eliza beth A Reedy, Katy Dawley and Kathleen Burke presented a symposium n: " Les 'ons [rom the Pa t: Implications for the Future" Advance Guards of tile Health Army." The individua l prescnta tions were as follows: Cynthia Connolly: "The Bureau of Nursing Service for New York City' Association for Improving the Condition of the Poor, 1900-1940." Jean Whelan: "Expecting Too Much

from the Law: The 1938New York State Nurse Practice Act," Elizabelh A. Reedy: "Premature Infant Care: Creating a Spe ciallY for the 2011, Century," Katy Dawley : "Institutions for the Practice f Nursing and Midwifery : Impl i alions for the Development of Professional Di ci pline ." and Kathleen Burke: "Diffu 'ion of Health Care TCl.:hnology: A So inl His torical Case Study of the Swan-Ganz Catheter." This preSel1l3lion wu the re ' ult r their completed funded re earch. They agreed that the conference was a wonderful forum, especially ommending the technical facilities which are brand new and state-of tbe-art. Panel presenters welcomed the opportunity to demonIrate the relevance of hist ry to the con cems of current nursing research at Lhi~ notable c nfer nce.

CALL FOR PAPERS The American As 'ociation for the Hi s tory of Medicine will meet in Boston. MA, on May 1-4,2003. Papers arc invited on any topic in the history of medicin . Plea e contact U,e co-chair of the pro gram committee for mOTe informulion: Pr fessor John Eyler, Pr gram in the I-Li tory of Medicine. 51 1 Diehl Hall. Univer sity of Minnesota, Minneapolis, MN 55455. Deadline forpaperpropo als is September t 5, 2002.

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