Public Health nurses
see a century of change

Nurses Week, May 5 to 12, marks more than a “Century of Caring” for the public health nurses at the Logan County Health Department.   Nurse Mary Anderson, who has made a study of the history of public health nursing, is well aware of the differences between the work these nurses did early in the 20th century and the work they are doing today.

Anderson points out that her profession goes back to 1893, with the founding of the first public health nursing agency, the Henry Street Settlement in New York City, started in 1893 by Lillian Wald. Wald wrote two books about her experience: “The House on Henry Street” and “Windows on Henry Street.”

 


[Kristine Skelton and son Tyler, age 3, get a checkup from WIC nurse Jennifer Onken at the Logan County 
Health Department.]

 

Those first public health nurses provided services to poor people in their homes, traveling in any way they could to serve those in need.  Throughout their history the nurses walked, rode horseback, took trains and streetcars, and even wore snowshoes when there was no other way to get to rural residents.  Later, when they no longer had to wear floor-length uniforms, they rode bicycles.  The first cars available to them were donated.

 

One surprising thing, Anderson says, was that these pioneer nurses received little or no salary.  Fund-raisers were held which provided their pay and covered expenses like buying dressings or warm blankets for patients.   Autographs of famous people, such as Mrs. Warren Harding, Woodrow Wilson and Herbert Hoover, were sold at auction to encourage larger donations.

A cartoon poster in 1920 asked patients to raise funds for the nurses.  A mother and her newborn are in bed, with a small child at the mother’s side.  The nurse is climbing the steps to the home.  The caption reads:             “Send the Nurse to the Sick at Home.  Contribute to the $50,000 fund for the Instructive Visiting Nurse Society.  Only 10% of the sick go to hospitals.  Help send the nurse to the other 90%.”

In the early years of the 20th century, nurses had to cope with many diseases which have been eliminated today, such as smallpox, scarlet fever, polio, typhoid, whooping cough and diphtheria, Anderson explains.  There were no antibiotics to bring about quick cures, and the nurses could only do their best to try to prevent diseases from spreading. 

 


[In the first decade of the 20th century, nurses wore floor-length uniforms that had to be starched so heavily they would stand up by themselves.  Here Alma Hieser of Minier poses after graduating from the Mennonite School of Nursing in Bloomington.]

 

They made frequent visits to critically ill people, often giving them sponge baths and alcohol rubs to keep fever down.  They changed dressings and checked for infections.  They visited mothers-to-be, newborns and children.  They had standing orders from physicians and reported on the ill person and on the spread of the illness.  “They were the doctor’s eyes in the home,” Anderson says. 

In these early years, contaminated food and water caused many food-borne infections.  Anderson notes that often nurses had to show families how to cook food so that it was nutritious and safe to eat.  One of their most important tasks was to teach the importance of cleanliness in preventing the spread of disease. 

At the turn of the century, public health nurses screened the new immigrants at Ellis Island in New York.  Gold miners in California, who may have developed ulcers from inadequate shoes, received foot care in 1910.  Nurses tended the sick during the influenza epidemic in 1918-19.  School children in rural settings were weighed and measured in the 1920s as part of a Children’s Bureau Program.  After the California earthquake in 1925, the nurses visited displaced residents in their makeshift outdoor homes and tents.

Today, the public health nurses in the Logan County Health Department provide services to people of all socioeconomic classes, not simply the poor.  “We try to be user friendly,” says Debby Cook, director of nursing.  “We are open from 7:30 to 5 p.m., and we are here over the noon hour for people who work.  We offer almost all of our services on a walk-in basis, which is not common.

 

“A lot of what we do is what public health nurses have always done – try to prevent illness from occurring.  We emphasize prevention.  We are the first step to ultimately keeping people healthy.  We give the most immunizations in the county, against childhood diseases, tetanus, flu and  pneumonia, as well as immunizations for foreign travel.”            

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The Health Department nurses provide many of their services at the clinic at 109 Third St.  Like their predecessors, they help mothers-to-be with prenatal care and education.  They promote the health of children with a number of programs, including immunizations, physical examinations, car seat rental, a clinic for children from infancy to age three and testing of blood lead levels.

For lower income families, the WIC program (Women, Infants and Children) provides supplemental food and other services.   AIDS testing and counseling, chest X-rays, TB skin tests and Hepatitis B vaccinations are some of the ways the nurses help to prevent the spread of contagious diseases today.  Family planning services are also available through the health department.

Nurses help those with chronic health problems, screening for high blood pressure, anemia, diabetes and cholesterol.  Through a grant from the Area Agency on Aging, the nurses can provide free blood screenings for those over 60 on the first five weekdays of the month through September of this year.   Blood pressure screenings are always provided free of charge.    

A few years ago, most public health nursing was done in the home, Cook says.  Although many services are offered at the Health Department, in some ways the public health nurses have come full circle.  In the new millennium, many of them are on the road again and some are actually making house calls. 

 

 

A nurse practitioner travels on the Rural Health Van to provide care to people in surrounding communities who would have difficulty getting to the Health Department.  The Rural Van is the result of a unique five-way partnership of Abraham Lincoln Memorial Hospital, Family Medical Center, Logan-Mason Mental Health, the Lincoln Chamber of Commerce and Public Health Department. 

This group, called Healthy Communities Partnership, received a grant of $400,000 which bought the van and has funded its operation.  The van goes to rural areas – Hartsburg, San Jose, Emden, Chestnut, Cornland, Mount Pulaski, New Holland, Middletown, Elkhart, Atlanta, Latham, Beason and Broadwell – and provides almost all of the services which are offered by the Health Department.

 

 

Nurses also visit new mothers and babies free of charge through a “Special Delivery” program.  They may encourage breast-feeding, explain the immunization program, weigh and measure the baby and spot any potential problems early.  This program is especially helpful to first-time mothers, Cook says.  “Many people don’t have extended families any longer.  They don’t have a mother or grandmother to call, and they may feel embarrassed to go to the doctor’s office with their concerns.”

Nurses in the WIC program may make Family Case Management house calls, providing support to lower-income families when the doctor thinks such a visit is needed.  The nurse may help the family find information or referrals for housing, groceries, utilities, domestic problems or other needs.

The Home Health Agency, a Medicare-funded program, provides care and therapy for homebound persons, frequently seniors.   Nurses help by changing dressings, giving medical tests, IV therapy, catheter changes and making sure the patient receives whatever other therapy is appropriate.  These services are available to non-Medicare patients for a nominal fee.

Nurses are also on the road providing health education at schools, health fairs, day care centers, women’s groups, church groups – wherever there is a need, Cook says.  “We will provide health education about all sorts of topics: AIDS, cancer prevention, smokeless tobacco, even getting rid of head lice.”

The Health Department staff includes seven full-time public health nurses, three  full-time WIC nurses, a nurse at Lincoln Community High School when it is in session,  four home health nurses, one education coordinator and the director of nursing.   All are registered nurses and many have a bachelor of science degree in nursing.   Like their predecessors, they work closely with area doctors.

Navy blue has always been the official color of the public health nurse.  The first public health nurses wore floor-length uniforms.  In cold weather, navy blue wool capes were standard.   In the 1920s, the uniforms rose to mid-calf length, and by mid-century the skirts were just below the knee.  Today the dress code is much less formal, but navy is still the official color.  Most of the Health Department nurses today wear navy pants, print jackets, and shirts that can be white, navy or light blue.

“Many changes have occurred within public health throughout the years,” Mary Anderson says.  “Our goals, however remain a constant:  to preserve, protect, and enhance the health of the public.”

 

[Joan Crabb]

 


Step up to summer safety
Summer is almost here. It is a time for lazy afternoons, vacations and picnics. And with these fun summer activities comes the arrival of high temperatures, unbearable humidity and a whole slew of potential hot weather hazards. Do you know how to beat the heat for an enjoyable summer?

While most like to bask (or bake) in the sun to get that “golden glow,” overexposure to the sun can be a precursor to potential health problems, according to Debby Cook, director of nursing for the Logan County Health Department.  If you want to get a nice tan for the summertime, use sunscreen. The higher the SPF, the more protection provided. This will help prevent burning, peeling, blistering and premature aging that can be caused by too much time in the sun. “Taken to the extreme, (tanning) can be very dangerous,” she says. 

Cook explains that sunscreen should be applied frequently—every two to three hours— to all exposed body parts. That includes the face, neck and ears—areas that are often overlooked.  Also don’t forget to protect young children, infants and seniors who have delicate and vulnerable skin.  

 

Not only can overexposure to the sun cause a bad burn, it can potentially lead to more serious health concerns such as heat exhaustion and heat stroke. Heat exhaustion, says Cook, is the most common health issue during the summer months.  She explains that it is caused by a loss of fluids, electrolytes and salt from the system. Symptoms include dizziness, cool and clammy skin and an upset stomach. When conditions seem favorable for heat exhaustion, it is vital to drink plenty of fluids, such as water and fruit juices, and avoid drinks that contain caffeine or alcohol.

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Preventing many summer health problems is mostly “common sense,” says Cook.  When watching children, she adds that parents should keep a close eye on children and provide rest breaks in a cool area. “Parents need to be aware,” she adds, suggesting that quiet activities be intermingled with strenuous activities.

Prevention is the key, says Cook. “We (the Health Department) are here to provide education and to prevent these type of things from occurring,” she explains. “(People) need to be aware of potential hazards."

For more information about how to protect yourself this summer, contact the Logan County Health Department at 735-2317. Or stop in and pick up some valuable summer safety information.

 


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