Nurses In “Settlement” Work

A presentation by Lillian D. Wald, New York:  at the Twenty-Second Annual Session of

the National Conference Of Charities And Correction, 1895

Editor’s Note: Though she was not familiar with the work of Jane Addams when she moved to the Lower East Side, Lillian Wald led the Nurses’ Settlement in the direction of a full-fledged settlement house – eventually changing the name to Henry Street Settlement – as she saw the social causes of poverty in the neighborhood.  Ms. Wald was also an early advocate for the creation of the National Federation of Settlements.

Everybody seems stirred by the social conditions that have given rise to Hull House in Chicago, the College and University Settlements in New York, and other settlements in other cities; and the hope is that these may be the means of showing the way to a better understanding of opposing classes. Considered from this point of her usefulness, the nurse’s claim to know the conditions of the neighborhood in which she works comes directly from an intimate knowledge of the people in their homes. It has been-the experience of two nurses, who live in a tenement house in the congested East End of New York, that this way of becoming part of the neighborhood has been successful.

Two years ago another nurse – Miss Brewster – and myself came to the College Settlement to start our plan of work. One of us had had a previous experience of the neighborhood as an “outside worker “; that is, coming from up-town to instruct a class of women. The Board of Health allowed us the privilege of wearing a badge which read, “Visiting Nurses under the Auspices of the Board of Health.” The advantage of this is evident. Moral suasion failing, it insured many times the cleaning of vaults, halls, and yards. We went at first to learn officially the condition of the interior of the tenements; but in this neighborhood, the poorest and most crowded in the world, we soon found tremendous material for nursing, for sending to hospitals, dispensaries, schools, country homes, and so forth, and followed up each want with all the energy we possessed. All the philanthropic organizations, the municipal authorities, and well-meaning individuals at a distance were ready to place their aid within easy reach of the people we encountered.

After a few months we established ourselves as residents in a tenement house in the centre of our most active work, and there more fully carried out our ideas of being “of the neighborhood.” Our calls for nursing have come mainly from some near neighbor of the person needing it or from the physician. Some have come from the teachers in the different schools; but each case has been served according to the special needs of that particular case, whether it required the usual carrying out of the doctor’s orders, or, where none was in attendance, procuring one, or perhaps sending the applicant to a hospital or a clinic. We have aimed not to be considered almoners or agents of a society, but yet have found it necessary frequently to give or procure assistance.

The actual nursing in the tenements, the lending of sick-room utensils and bedding, and the making of delicacies and carrying of flowers have not been different from the usual methods of district nursing.

By a judicious loan of money we have helped in the bridging over of tight places, and usually received the money again. We have tried to’ teach lessons of thrift and economy, and have taken charge of many a small sum of money until the bank-book has been started. We have tried not to appear “professionally good” or “professionally neighborly,” but have taken many lessons to heart from our neighbors of personal service and comprehension of the limited resources of the poor.

When the hard winter of I893-94 was upon us, we took part in the plans for giving employment, and started an undertaking which we have continued ever since. With money given for the purpose by the women of the Ethical Society, we undertook to make the most unskilled women serviceable by giving them, when they needed it, employment as charwomen in the homes of our sick, where there was no one to do the cleaning. Almost hopelessly ignorant, it was not the simplest matter to suggest even an intelligent way to scrub. But some of these women have graduated from our hands into fairly competent workers.

It is not possible to calculate the mutual value and gains of such experiments as ours. We feel the privilege and educational value ourselves. We must recognize also that their hearty and generous acceptance of us as neighbors, and their frequent appeals to our different experience for advice, and their desire to talk things over from their individual labor problems to securing a lot in which the boys can play base ball, are but expressions of their neighborliness to us.

Our yard, the largest play-ground on the East Side, is to be thrown open to the children, convalescents and the crippled to be favored. In it will be a sand pile, hammocks, swings, and a music-box or organ that can play the songs the children of the tenements love, and to which they dance so beautifully.

There will be an extra bath-room for regular and emergency uses, particularly needed in the preparation of many we are fond of sending into the country in the summer.

The residence part of the house is to be comfortable, and supplied with good pictures, books, and music, and whatever educational aids a home that aims to be a social centre has in any locality.

We shall consider the family most valuable when its members do not exceed six, and when the nurses represent different schools of training. The esprit de corps should be so pronounced that all may work well together; yet each member should be allowed her own individuality and personality in her work, that every friend she makes may know her as such, and not, as the small boys about us would say, “a teacher in a settlement.”

This work may also be read through the Internet Archive.

Source: Proceedings Of The National Conference Of Charities And Correction at the Twenty-Second Annual Session Held in New Haven, Conn. May 24-30, 1895 pp. 264-267 (Accessed: October 16, 2014)). The proceedings of annual meetings of the NCSW, 1874-1983, are available on the web thanks to a digitization project undertaken by the University of Michigan Library, with assistance from the Social Welfare History Archives at the University of Minnesota.  The web site for this resource is: http://www.hti.umich.edu/n/ncosw/