Bringing care to the people: Lillian Wald's legacy to public health nursing.

Abstract

Lillian Wald invented public health nursing in 1893, making this year the field's centennial. One of nursing's visionaries, Wald secured reforms in health, industry, education, recreation, and housing. This historical inquiry examines three of Wald's critical experiments, each of which illuminates the past of public health nursing and its contemporary dilemmas: invention of public health nursing itself, establishment of a nationwide system of insurance payments for home-based care, and creation of a national public health nursing service.

What History can Teach us Today, Looking at the Development of Advanced Nursing Practice and Clinical Nurse Specialism

“…Interestingly as we look at the situation today, registers of clinical nurse specialists and advanced practice nurses are only starting to develop, perhaps echo's of a hundred years ago. Another aspect of interest which Buhler-Wilkerson, [11] highlights is the contribution of nurses to nursing literature. This skill is still developing, as we move to higher levels of education for nurses, particularly for those working in advanced and specialised roles, such nurses carry out research and publish.…”

“…She is an example of a woman with this dual role -nursing and politics. She commenced nurse training in the New York Hospital School of Nursing and graduated in 1891 [11]. After a short, but unsatisfactory experience working in an institution, where she was frustrated in any attempt to contribute to nursing policy and development, a complaint which anecdotally we still hear today, Wald sought work elsewhere.…”

“…Invited to run nursing classes in New York's poorer East Side (an early example of the educational component of the nurse's role), Wald recognised what she saw as a need for nurses to live and work in their area of practice. Obtaining some financial backing from a philanthropic source, she and a colleague from her New York nursing school, Mary Brewster, established a system that allowed them to live in the community and not only to care for the sick, but also to encompass reform in other areas such as health, industry, education, leisure and housing [11]. Wald coined the term 'public health nursing' to describe such work.…”

“…Areas such as tuberculosis, mental health, and infant, child and maternal health are all examples of the specialised fields that nurses chose to work in. In addition, these nurses started to write and contributed to the nursing literature [11]. Thus ensuring that nursing knowledge was shared.…”

“…Wald herself was not in full agreement with the increasingly specialised roles that public health nurses were developing, but her work had opened the door and specialised nurses became part of nursing [11]. The work of Wald and her colleagues, the formalisation of nurse training and the educational opportunities at higher levels becoming available to nurses were all factors that impacted on the development of nursing in specialised fields, particularly in the USA [7].…”