Official proceedings of the annual meeting: 1923

THE SOCIAL POINT OF VIEW IN NURSING-TUCKER

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ized types of public-health nurses, that social work has played and continues to play
an important part. So that there may be no misunderstanding of the use of the terms,
may I pause here to define what is meant by a public-health nurse, as the use of the
word "public" often causes misconception. It is a generic term for any graduate
nurse who serves and protects the health of the public, giving attention to the social
as well as the medical aspects of her function. This work may be supported out of
public or private funds, the real criterion as to whether a nurse is a public-health nurse
or not being whether her primary object is the protection of the health of the public.
The influence of social work, in the technical sense, on this phase of nursing has
chiefly been along two distinct lines-case work and community work. From the
former has come the emphasis on the family as the unit and on the development of a
technique in assisting the individual to adjust himself to his environment. The result
has been that increasingly we find the public-health nurse, whether as visiting nurse,
infant-welfare nurse, tuberculosis nurse, or school nurse, seeing her greatest opportunity as a family health worker, using the general case-work method in her planning
and carrying out of a health program for the family. Constantly she is observant of
social factors, calling in a social worker when intensive social diagnosis and treatment
are necessary. Out of this growing understanding of each other's procedure, at last,
we are getting the kind of co-operation that is real because it springs from an understanding and appreciation of the other's aims and emphasis.
The best sort of co-operation may spring from a comparatively slight knowledge
of the other's professional technique, and yet it is enough for intelligent observance
and reference to the proper resource at the right time. Beside the general philosophy
and certain processes of case work that have come to be part of the public-health
nurse's approach to her own job, social case work has led to an appreciation of the
importance of preserving the integrity of the family group which, if broken down at
one point, may be undermined throughout. No longer do nurses see family treatment,
therefore, just in health terms. Any constructive plan must take account of its effect
on all phases of family life. Probably the greatest factor in bringing about such
mutual understanding has been the case conference, where the various groups interested
in any given family have come together to give each other the benefit of their experience
and knowledge, so that a unified plan, with as little waste and duplication as possible,
may result. Certainly this is the clinical method of learning and teaching, and points
the way to the soundest basis for a constructive division of labor and responsibility in
closely allied fields.
Now let us turn to the second concrete influence of social work. Ever since visiting nursing was first organized in this country there has been a growing tendency to
make the work of the nurse in homes something more than a charity service. Small
fees were charged to those who were able to pay, until gradually the service has been
worked out on an actual cost basis, being used by everyone in the community, irrespective of their economic status. With the development of the public-health movement
the importance of a non-charity, community-wide basis has been especially felt.
Health, like education, is something that should belong to everyone in the community
and should not carry with it the stigma of charity.
Throughout the special educational program for public-health nursing, as well as
in nursing itself, is found the most definite evidence of the growth of the social point
of view. The education committee of the National Organization for Public-Health