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awards, however, has brought about an almost incredible
change in the attitude of farmers and townspeople during the
year.

Charleston County was split up into its seven natural
divisions and in each of these one prize of $25, one of $10
and three of $5 were offered, with a sweepstake of $100 to
be competed for by the entire county. Stimulated by these
awards, one hundred and three women out of one. hundred

and fifteen pledged
have carried out the
program in all its
phases, which are as
follows:

Dairying Each adult to
have not less than one
pint and each child
not less than one
quart of milk each
day;

Gardening Each home
to serve two fresh
vegetables daily;
Nutrition the combination of these two;
Poultry Each farm flock to have not less than twenty-five

standard bred birds;
Beautification of home and grounds.

The success of the plan seems to suggest a new and most
encouraging solution to the ever present problem of the
backward and unprogressive rural community. With prizes
that are small enough to be within reach of any local budget,
or even the purse of some individual public spirited donor,
the results have been out of all proportion to outlay, pre-
eminent among them a spirit of neighborly competition,
awakening pride, and community cooperation.

Praiseworthy results have been achieved in all five depart-
ments of the work, but it is the last beautification of home
and grounds which has aroused the most remarkable in-
terest and enthusiasm. Vines are beginning to cover new
fences and porches, flowers glow in neat beds,
Italian rye covers the bare stretches where grass
will not grow. The clean-up work has really been
of two classes those isolated farms which have
only their individual problems to consider, and the
towns where community work had to be done as
well. In many villages an Achievement
Day was chosen as a part of the program
and men, women and children worked to-
gether side by side.

The Home Demonstration Agent vis-
ited many of the towns on Achievement
Day and her report tells some-
thing of what happened:

When the agent arrived at X
at a little before eight o'clock,
she found the streets filled with
women hoeing, grubbing and




536




August 15 September 15, 1927

raking. Money had also
been raised beforehand,
with which were em-
ployed colored women
who were busily at work.
By mid-day the entire
street of the village had
jeen cleaned, the fences
repaired by volunteer Ne-
jro carpenters, and several
of the merchants started
on whitewashing their
shops. In the afternoon,
work was concentrated on
a plot of about one acre
at the end of the village,
right on the ocean, which
las a beautiful growth of
cedars. The undergrowth
was grubbed out, old tin
cans and trash hauled
away, two sheds and a
dilapidated fence torn
down, and benches built
jetween some of the trees.
This will be the community parking grounds, where visitors
will be welcome to park their cars and take their lunch. The
agent ventures to say that there is not a more beautiful spot on
the whole Atlantic Coast.

The approach to X lies through land owned by a citi-
zen. On one side of the road is his pasture, heretofore mostly
occupied by hogs. On the other side is a salt water slough
>ordered by beautiful trees but badly overgrown with under-
>rush. This side was terminated by a huge old commissary
hat was falling to pieces. Before the day was well on, Dr.
}. was pulling down this old building at his own expense and
lad put plows in the pasture to prepare it for oats. This will
>e kept as a lawn this winter, and he has also donated to the
village the entire creek edge to be used as a park.

At Z much the same work was done. The approach to
the village was grubbed, jasmine, wistaria and wild azalea
planted, and land around the old club-house on the river broken
for oaks. Money is now being raised to renovate this
building for the use of visitors. Each indi-
vidual garden had someone working in it that
day

For the rest of the program, every one
of the one hundred and three women
planted a "year round" garden, and many
homes served vegetables where the diet
has been corn pone, pork and rice. Seven-



T HE SURVEY



537




teen girls also planted gardens, as against eleven of last year.
Twenty women bought among them twenty-three cows as
a result of the pledge to serve more milk, and cattle are
beginning to look sleeker and more prosperous with addi-
tional care and better food. Two women found that they
could start out commercially with a little assistance from
the agent. One is now shipping milk to Charleston, and
the other sells it to passing motorists. Oddly enough, it
is more frequently the women of the families whose am-
bition and energy have found an outlet in this work, while
husbands have awakened suddenly to find the trail to pros-
perity already blazed.

Poultry too is gaining in health and prductivity under the
new plan of increasing the flock by good stock only, and a
number of women are finding an excellent market for their
eggs. Two have started raising ducks. These birds are very
easy to handle, for at the end of four weeks they care for
themselves and find their own food. Their upkeep is small
and they bring excellent prices.

In the girls' clubs, established for the teaching of hygiene,
nutrition was especially stressed, the members were taught
the proper methods of preserving and canning fruits and
required to do a certain amount of it at home. The mothers
have cooperated heartily and the girls are becoming most
interested in the arts of housekeeping. Lectures in their
clubs have also been successful in putting over the proper
nutrition ideas, and showing to the children the harmfulness
of their old diet of starches, bacon and coffee. Vegetables
are in style now, and milk drinking is quite the latest thing
among the younger set.

With such really remarkable results from a very small
outlay, the Foundation feels more than justified in its
decision to continue the series of awards. Miss Alston is
planning to work along much the same lines during the
coming year concentrating her attention on a territory
which, because of its isolated character,
has responded less readily to improvement
activity, and she feels that the interest
already aroused will be invaluable to her
in her future work. The award has, in
her own words, "transformed the whole
aspect of the service and made the carrying
out of it an inspiration and a pleasure."



Educating Nurses

By ISABEL M. STEWART



ONE gathers from a good deal of the current
comment on nursing, that the greatest present
menace to the profession is the danger of over-
education or "over-training" as it is usually
called. In this country, where education has
always been regarded as the mainstay of democracy, it is
strange that there should be so much fear that any group
should get an overdose of it. Those of us who know the
extreme poverty of our nursing schools, and the seemingly
unlimited demands made upon them, are far more concerned
about educational malnutrition than about over-feeding.
Proud as we are of the achievements of nurses, we are not



by any means satisfied with the present state of nursing
education.

Perhaps part of the general confusion lies in a failure to
distinguish between training and education. I am quite will-
ing to say for myself that while I have seen some nurses
who seemed over-trained, I have never seen one who was
over-educated. I doubt if there is such a thing as over-
educating any human being, though there may be a danger
of over-stressing one phase or another of her growth in
relation to the development of the whole individual.

Animals can be trained to do a great many things very
skillfully; even plants can be trained in certain ways, but



538



THE SURREY



only human beings can be educated. Training concerns it-
self with stamping in certain habits and skills mainly through
the process of repetition ; education concerns itself with the
growth and the development of all the potentialities in the
individual. In comparison with education, training tends to
rely on authority and coercion, rather than on guidance and
self-direction, to create dependence rather than independ-
ence and self-mastery. There is not much question that
nursing has suffered in the past from an emphasis on train-
ing at the expense of education, though training is a neces-
sary part of all education.

Nursing education, like all other branches of education,
should be concerned with two main purposes: to meet social
needs and adjust the individual to social requirements; and
to develop the individual herself in such a way as to secure
her best welfare and happiness now and in the future. The
nursing schools have usually emphasized the first. They
have been far more concerned with the quantity and quality
of the work produced by their students, fitting these young
women into the existing scheme of things, than in rounding
out and satisfying the fundamental needs of the students
themselves, or in allowing them to grow along the lines of
their own aptitudes and interests. Indeed, we have some-
times assumed that the demands of nursing service are in-
compatible with a full, normal, satisfying life for the in-
dividual nurse, and that no young woman is fit to be a
nurse unless she is willing to give herself up completely,
body, mind and spirit, to be molded and used in any way
which seems to best further the needs of the hospital serv-
ice or the sick patient. Recently a prosperous New York
surgeon declared that in order to develop the right kind of
nursing spirit, our young pupils must be taught that "the
only satisfactions they must ever expect in nursing are the
satisfactions that come through self-sacrifice." One won-
ders whether he would be willing to agree that "sauce for
the goose" might also be "sauce for the gander?" Florence
Nightingale long ago vehemently denied that nursing de-
manded complete sacrifice of self. "Nursing is not a sacri-
fice," she insisted; "it is a life the happiest of any."

FORTUNATELY nursing does provide satisfaction in
abundance an interesting life with its wide range of
contacts, problems which constantly challenge thought, con-
sciousness of achievement, the thrill of adventure, a few
modest material satisfactions, and above all, the gratitude
and confidence of our patients. But nurses need also satis-
factions beyond these. They need recreation and play,
friendship and social life, intellectual stimulation and spirit-
ual refreshment, just as other people do, and we must find
a place for all these things somewhere in their education
or we shall be in danger of turning out bloodless automatic
machines, or unnatural ascetics instead of wholesome normal
young women.

The popular conception of the nurse as we see her in
advertisements and plays, and very often in real life is
a neat, starched, capable looking person, who stands at the
doctor's elbow, hands him his tools, takes his orders, and
carries them out presumably with great efficiency; but there
is always something unpleasantly suggestive of one of those
automatic toys which moves only when someone pulls the
strings. The patient seems to be more or less incidental to
the picture the secondary rather than the primary object
of the nurse's attention. This is the type of nurse whom
some doctors delight in calling "the hand-maid of medicine."



August 15 September 15, 1927

She might properly be called a "doctor's assistant" or "med-
ical aide" but she is certainly not a complete nurse in either
the generic or the Nightingale sense of that word.

THE original nurse was the mother, the one who nour-
ished and sustained life. The nurse exists not primarily
to serve the physician but to serve the individual and the
community, to protect and conserve life in both sick and well.
She works hand in hand with the doctor because he has some-
thing to give which she cannot give and the patient prospers
best when these two combine their efforts and work in
harmony, supplementing and helping each other. But this
nurse is something much more than the doctor's "deputy"
or his "right hand man." The picture some people seem
to have of the nurse revolving like a pale satellite around
the great body of medicine and shining only in its reflected
glory, is wrong both historically and actually. Imagine Lil-
lian D. Wald as a satellite! Nursing has had a different
genesis and an independent history, and though its orbit lies
within that of medicine in certain areas, there are many
functions of the nurse which are as closely related to social
work, to home economics, to teaching or administration, as
they are to the work of the physican.

The functions of the nurse are constantly changing. In
the broad general field of nursing today, they include:

Guardianship and protection, including the physical care
and supervision of sick and helpless people and attendance
on all ordinary physical needs.

Conservation and prevention, including the application of
hygiene and sanitary principles to the general care of the
patient and to his environment, the building up of strength
and resistance, and all ordinary precautions for the pre-
vention of disease.

Intelligence or scouting functions, observing, recording
and reporting symptoms and other conditions about the
patient and his environment which have a direct bearing on
nursing and medical care.

Therapeutic or curative functions, giving definite treat-
ments for disease conditions or assisting the physician in
medical or surgical measures or in diagnostic procedures.

Executive and economic functions, management of the
general details of the patient's care and surroundings, secur-
ing and preparing supplies, organizing and coordinating
services, and so on.

Educational and advisory functions, teaching, both direct
and indirect, of the patient and others in the household or
family group, showing, explaining, suggesting, training, as
required for prevention or treatment.

Social functions, in the sense of social companionship,
and also in the larger sense of sharing in community efforts
to improve social conditions which affect health and general
welfare.

Professional functions, including service to the nursing
profession and cooperation with its members, cooperation
with other professional groups, the carrying out of profes-
sional courtesies, and so forth.

There was a time when the guardianship or custodial
function represented almost the whole duty of the nurse:
and she was little more than a keeper or attendant. The
therapeutic or curative function has been greatly enlarged
during the last half century, so that when most people think
of the nurse, they think of a sick-room where she and the
physician are engaged in a (Continued on page 568)




The Common Welfare




A MERRY tale of the bathtub and a glimpse into
one way of making history emerge from a buzz
of correspondence concerning the paragraphs on
the Cleanliness Institute which were published
in The Survey of July 15 (p. 408). Here
Dr. John H. Finley was quoted to the effect that the first
example of this popular American institution was installed
in Cincinnati in 1842, and that in Boston volunteer bath-
ing was forbidden by ordinance as late as 1848. At once
an anxious reader from Baltimore wrote in to report that
a leading citizen of that city, H. L. Mencken, declared
that he himself had invented these statements and had
published them with the intent to discover how far a suc-
culent legend could be spread. The source of Dr. Finley 's
information was a member of the staff of the Cleanliness
Institute, who had left for Switzerland to attend an inter-
national conference on faith and order. Other members
of the organization undertook to run to earth the genesis
of American plumbing. The data had been taken from an
article published in a serious monthly magazine in October,
1926; but back of that they appeared in a volume entitled
the Story of the Bath published in Chicago in 1922. The
publishers were questioned : their source was "a well-known
authority, Mr. H. L. Mencken." At present the research
department of the Cleanliness Institute, suspending further
mention of this interesting bit of folk-lore, is engaged in
making a search of pre-Mencken literature and an extensive
collection of post-Mencken publications which have accepted
these dates, including popular encyclopedias and "several
authoritative social service works." The Survey's original
correspondent suggests hopefully that it would be a great
joke if it could be established that these were the facts after
all, but Mr. Mencken, promising a full history of the
Great Bathtub Controversy in a volume now in press,
challenges all comers and adds that he is thinking of offer-
ing a case of Brauneberger 1917 to anyone who can prove
that these "facts" were published anywhere in the world
before his article appeared.




NEW chapters of the story of youth in the city streets
lie implicit in the survey of Negro children in New
York City just published by the Joint Committee on Negro
Child Study in cooperation with the National Urban League
and the Women's City Club of New York. San Juan Hill,
Harlem and the other colored neighborhoods of New York
have seen an unwonted rush of immigrants during the past
ten years, country-bred, from the farms and villages of
the South and the West Indian islands. In the wake of
each immigrant tide court records show an increase in
delinquency among the children of that particular group,



registering the painful readjustment which is likely to fall
heaviest upon the young members as families are crowded
into the least desirable homes and parents forced to pre-
occupy themselves with the stern business of eking out a
living under new and strange conditions. For the Negro
this has been intensified by the fact that there are only
certain districts where he may live, that many of the amuse-
ments and outlets provided for other races are closed to
his children. In Harlem, literary Negro Heaven, the home
of jazz, blues, and the night clubs where white people seek
amusement, the proportion of delinquent and neglected
Negro children is from four to six times as great as among
the white population of New York City. They are seldom
really bad these "delinquent" children. Among white boys
the two most common charges are stealing and burglary
for Negro boys disorderly conduct and desertion of home.
Their story calls insistently for the remedies the report
suggests chief among them more chance for play, more
friendly help for "mild" delinquents, opportunities for the
use of schools and school yards after hours, Saturdays and
in summer. Of fifty children picked at random only one
had known any organized recreation.




ON the doctors devolves the ultimate responsibility for
the forward march of public health. Yet if their
efforts are to be effective, they must be backed and supple-
mented by a host of lay workers, official and voluntary.
From time to time misunderstandings have arisen in one
camp or the other. Physicians have been known to complain
that the health and social agencies rush ahead without wise
scientific leadership perhaps even toward "state medicine"-
or that these bodies are fostering an abuse of free medical
diagnosis and treatment which operates unfairly toward the
private practitioner. The non-medical health workers, on
the other hand, sometimes have charged that doctors hold
jealously aloof from constructive social movements, that
they do not keep in touch with the rapidly advancing field
of public health and criticize what they do not understand.
Undoubtedly in some cases there has been some truth in
such charges as these. Yet far more often the trouble must
be laid to misunderstanding, a misunderstanding the more
natural since there has been no regular organized means of
contact between these two related, yet distinct professional
groups.

For this reason special interest attaches to the report
recently approved by the House of Delegates of the New
York State Medical Society and the Board of Managers
of the State Charities Aid Association and its state and
local committees on tuberculosis and public health. This
report, summarizing the experience of nearly two years' in-
formal experiment, gives not a final solution of the re-



539



540



THE SURREY



August 15 September 15, 1927



spective rights and duties of the medical profession and the
voluntary agencies, but a working plan which has proved
successful in use. Its backbone lies in the cooperation of
the county organizations of both groups, through representa-
tion on each others' boards of directors, through joint com-
mittees and joint meetings. It is recommended that new
or drastic changes in the policies of the voluntary agencies
be submitted to the representative medical organization for
study and suggestions before they are adopted. Should a
point of disagreement arise which cannot be smoothed out
locally, it will be reported to the state organization of
either body. In this way vague, prejudiced generalizations
can be reduced to concrete situations which may be dis-
cussed and settled in a friendly and intelligent fashion.




EMPHASIZING the increasing importance of recreation
for social work, psychiatry and medicine, Northwestern
University takes over this month for graduate and under-
graduate students the principal courses and staff instructors
of the Recreation Training School of Chicago. Training in
group organization and leadership, in folk dances and group
games, and in the social aspects of play, directed by Neva
L. Boyd, will be supplemented by many other courses con-
ducted by the department of sociology and related courses
in the schools of education, music, speech and commerce.
Miss 'Boyd's marked success in serving one of Chicago's great
public playgrounds as director of its activities for girls and
women opened to her many years ago the direction of the
department of recreation in the Chicago School of Civics
and Philanthropy. Its teaching and training for recreational
leadership were so distinctive that when the other depart-
ments of that school were taken over by the University of
Chicago, this work became the independently established
Recreation Training School of Chicago, located at Hull
House. Here for the past five years it has attracted students
from many colleges, east and west, offering the reciprocally
valuable cooperation of school, social settlement and the com-
munity centers of Chicago, and the unique combination of
practice in leadership under efficient supervision with the
academic technique of the classroom. The public spirited
offer of Northwestern University carries the potentialities
of the work still further through the added resources and
requirements of a great university.




TURNING from engineering problems in industry to
the human factor involved, technical experts met several
weeks ago to study and discuss fatigue at the first summer
school of the International Association for the Study and
Improvement of Human Relations in Industry at Baveno,
Italy. The group was made up of more than fifty engineers,
economists, physiologists, psychologists, employers and em-
ployes, representing thirteen nationalities. Its chairman was
Lillian M. Gilbreth, an American consulting engineer and
psychologist. She writes us:

"The group itself was a subject of never ending interest.
Not easy always to confine to formal procedure, seeming



at times rather to resent necessary routine and time schedules,
it listened hour after hour to technical lectures and transla-
tions with untiring interest. It participated in discussion
with a grasp on essentials, a measurement by standards of
practice and a passion to make everything learned of direct
and immediate service that was most impressive."

The lectures covered the history of fatigue study, the
application of fatigue study to a specific industry ; the length
of the working day and the results of various limitations
of hours ; fatigue caused by extremes of temperature, dust,
damp and eye strain ; and the relation between type of job
and individual temperament.

Mrs. Gilbreth summarizes the results of the meetings as
follows :

"No satisfactory definition or measure of fatigue has as
yet been made, though more careful distinctions between,
for example fatigue and weariness, monotony and repetitive
work and so on, are being drawn.

"A clearer knowledge was acquired of the investigations
that have taken place and those that should be made.



Online LibrarySurvey AssociatesThe Survey (Volume 58) → online text (page 120 of 130)