MAJOR TRENDS IN PUBLIC HEALTH NURSING 1902 TO 1925: THE TRANSITION FROM SPECIALIZED TO GENERALIZED PRACTIC

This is a study of the change from specialized to generalized practice which took place in public health nursing between 1902 and 1925. In 1902 an experiment in school nursing, conceived by Lillian Wald, director of the Henry Street (Nurses') Settlement, and carried out by the health department of New York City, signaled the beginning of municipal payment for public health nursing service in cities throughout the United States. Besides school health programs, departments of health also campaigned against tuberculosis and infant mortality. The public health nurse became a valuable asset in the work of health education and prevention connected with public health campaigns. Specialization in practice evolved and nurses came to be called school nurses, tuberculosis nurses, and infant welfare nurses.;In specialized practice nursing service was organized by health problem, while in generalized practice one nurse provided a complete nursing service to a small district. In 1925 the East Harlem Nursing and Health Demonstration study of the relative value of specialized and generalized practice in public health nursing was completed. This study lasted two and one-half years and demonstrated that, though there was no difference in quality of service, generalized practice in public health nursing was more cost effective and reached more people.;What were the events which led to the development of specialized practice in public health nursing? What was meant by specialized practice? What were the factors which facilitated movement toward generalized practice in public health nursing? What was meant by generalized practice? When did generalized practice become recognized as the appropriate method of organization for public health nursing? It is to these questions that this study addressed itself.;In a final summarizing chapter, an examination of nursing practice today focused on the "expansion" of the nursing role, which often means "narrowing" of that role again into specialties. With nursing theory emphasizing a holistic approach to practice, the study again challenged the appropriateness of the specialist in public health nursing, basing its statements on the conclusions reached in the years 1902 to 1925 and making application for practice today.