An Interview with Professor Donald Elder: A Nurse in Every School in America

Apr 8, 2019 by

Michael F. Shaughnessy –

1. Another famous woman who contributed much to human rights and is still known as the founded of American community nursing is Lillian Wald. When and where was she born, and what was her childhood like?

Lillian Wald was born on March 10, 1867 in Cincinnati, Ohio. Her father owned an optical business, and this gave Wald an affluent upbringing. Thus, when Lillian’s father relocated the family to Rochester, New York in 1878, he had the means to send her to Miss Cruttenden’s English-French Boarding and Day School for Young Ladies in that community. Wald hoped to attend Vassar College, and applied at the age of 16. The college rejected her, however, because of her age. By the time she reached an age that Vassar would have found acceptable, Wald had changed her mind about her educational future, having decided instead to pursue a career in medicine. Apparently, she considered applying to medical school, but at the age of 22 she chose to enroll in the School of Nursing, operated by the New York Hospital. Two years later, she received her nursing certificate from the New York Hospital’s Training School.

Over the next two years, she would continue her medical studies at the Women’s Medical College. During that period, she served as a nurse at the New York Juvenile Asylum. In 1893, Wald decided to become more directly involved in her chosen avocation. First, she began to teach classes on nursing at the Hebrew Technical School for Girls. Second, she started to visit poorer neighborhoods, offering her nursing services for free. And finally, she decided to found a settlement house. She would remain actively engaged in running that establishment until the end of her life.

2. She is probably most well known for her establishment of the famous Henry Street Settlement in New York City. First, can you tell us about the Henry Street Settlement, its founding and purpose, and why she is inexorably linked with this establishment?

While doing her volunteer nursing class in 1892, a young immigrant approached Wald and said the words “mommy,” “baby,” and “blood.” Wald deduced that something had gone wrong for the immigrant’s family, and followed her home. There, she found that the immigrant’s mother had had complications during childbirth, but a doctor refused to provide medical care because the family couldn’t pay him. Wald later said that at that point in time, she decided to open an institute that would provide aid and information to the poorer residents of New York City. Originally simply called the Nurses Settlement, this became known as the Henry Street Settlement in 1895 when a wealthy philanthropist named Jacob Schiff bought a house on that thoroughfare and donated it to Wald. Over the next twenty years, the Henry Street Settlement expanded to include buildings around the original facility. It has also expanded its range of services, now offering housing, youth and senior programs, and workforce training. The Henry Street Settlement also has a working relationship with the nearby Abron Arts Center. According to a recent estimate, the Henry Street Settlement helps 50,000 people every year in one way or another.

3. Dr, Elder, today, if you go into almost any school in America, you will find a nurse, who may be taking a child’s temperature, administering medication or helping with an asthma attack or hay fever. Apparently we have Lillian D. Wald to thank for this. Can you provide some background on her contributions to this?

As was the case with her decision to open the Henry Street Settlement in the first place, Wald became involved in school nursing through an encounter with a poor child on the lower east side of New York City. This individual had a form of eczema on his head, and his school had sent him home because of it. Upon talking with him, Wald learned that the boy had received an ointment to treat the condition, but did not understand how to use it. After Wald taught him how to apply the cream, the boy’s condition improved, and the school readmitted him. Wald realized that many children probably had lost out on an education for similar reasons, and she suggested to the New York Board of Health that it should assign medical examiners to each school to identify children with treatable medical conditions.

Agreeing with her recommendation, in 1897 the Board of Health began putting examiners into the schools. While pleased with this step forward, Wald soon recognized its limitation: the examiners identified children with conditions and recommended treatment, but few actually administered any medicine. Soon, Wald realized that placing a nurse in every school with the power to provide basic medical treatment to the students would prove much more beneficial. An outbreak of trachoma in 1902 gave Wald the opportunity to suggest placing nurses in schools (an idea that had already been implemented in England), and a recently elected mayor of New York City embraced the concept.

An immediate success, the practice of placing a nurse in public schools gradually spread across the United States. While budget cuts have diminished the number of school nurses and the hours that schools have them in attendance, these individuals still help hundreds of thousands of school children every year.

4. Author, humanitarian, and other words have been used to describe her. What exactly did she write and what were her various humanitarian contributions?

In addition to her involvement with the Henry Street Settlement, Lillian Wald also became associated with a number of other Progressive causes during the first decade of the twentieth century. First, she helped to found the Women’s Trade Union League in 1903. This group formed to help women become involved in skilled trades, and as such worked closely with the American Federation of Labor. Four years later, Wald turned her attention to the plight of child labor. At that time, close to 20% of children in the United States between the ages of 5 and 10 held jobs, and many of them worked in unsafe occupations. To combat this, influential individuals (both men and women) founded the National Child Labor Committee. Along with fellow reformers Jane Addams and Florence Kelley, Wald became one of the first directors of that organization.

Pleased with the success that the Henry Street Settlement had had in advancing general wellness, Wald took her efforts to a national level, helping to found the National Organization for Public Health Nursing in 1910. When the First World War broke out in 1914, Wald began to give speeches in favor of pacifism. After like-minded individuals created the American Union Against Militarism, they selected Wald to become the organization’s first president. Perhaps most impressively, Wald became a champion of equal rights for African-Americans. Indeed, in 1909 she helped to found the National Association for the Advancement of Colored People, and offered the Henry Street Settlement to the organization for its first meeting. By the time of her death in 1940, then, Wald had amassed a stellar record in the realm of humanitarianism. Fittingly, the National Women’s Hall of Fame inducted her posthumously in 1993.

5. One always wonders why such famous women are not more universally recognized. Did she simply work behind the scenes quietly? Why have her contributions not been more acknowledged?

In retrospect, Wald clearly deserves to be remembered as a great American, regardless of gender. In today’s day and age, however, few Americans could probably identify her. Perhaps Wald was too far ahead of her time, or other luminaries may simply have overshadowed her. Her religious affiliation may also have worked against her. Finally, the fact that she never married may have gone against the accepted norms of the time. Whatever the reason for her lack of name recognition, hopefully her inclusion in this series will help acquaint the American people with a person who helped make the nation a better place to live in.

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