Friday, June 3, 2011

The VNA of Boston story continues...

Here's the next installment from Rebecca...

In this posting, I continue to share the historical insights I’ve been gleaning from reading Annie M. Brainard’s 1922 book, The Evolution of Public Health Nursing. As we enter the 1800s, we observe how the evolution of public health nursing from a service of the Church to a more independent function sets the stage for the entrance of public health nursing as an important component of the modern health care system in the early 1900s.

The Modern Deaconess Movement

It is said that travelers from Protestant countries would return home with stories of the wonderful care given by the Daughters of Charity, the ancient sisterhoods of Beguines and other groups of nursing sisters, the match of which was not to be found in their own countries. So great was the need for similar services that in 1815 an English doctor called for an order of women to be created, who like the Daughters of Charity would be “selected for good, plain common sense, kindness of disposition, indefatigable industry and deep piety; let them receive - not a technical and scientific – but a practical medical education.”

His call was not heeded in England, but in 1822, Theodor Fliedner, a young Lutheran pastor, established a Protestant sisterhood in the German town of Kaiserswerth. Inspired by an order of Mennonite deaconesses he had observed while visiting Holland and also by the work of Elizabeth Fry, a prison reformer in England, Fliedner and his wife created a Women’s Society with the mission of visiting the sick poor in their homes. Like his predecessor Vincent de Paul, he realized that the wealthy ladies interested in giving charity were not particularly suited to the work. So, as with de Paul, he sought out women of the working class with an interest in the vocation of helping the poor and nursing the sick. Fliedner took his organization a step further and provided these women with three years of training before they could be named Deaconess. Fliedner garnered great international respect and his most famous pupil was none other than Florence Nightingale. Nightingale first visited Kaiserwerth in 1846 as a crusading health care reformer, and was so favorably impressed that she later returned to enroll in Fliedner’s program, graduating in 1851.

On a side note, while researching information on deaconesses I stumbled across an article about Boston’s Beth Israel Deaconess Medical Center. I learned that the New England Deaconess Hospital (which later merged with Beth Israel) was founded in 1896 by a group of Fliedner’s deaconesses whose first 14-bed infirmary was opened in a converted five-story brownstone at 691 Massachusetts Avenue, not so far from the VNABA’s office at 561 Massachusetts Avenue (KELLY – I assume we were at 561 in 1896 yes?)

In Conclusion…

As I continue to study the history of visiting nursing and how the VNABA has grown as an organization, I will be interested to see how the roots of visiting nursing, so steeped in the culture of charity, underlie our modern identity and how we are perceived as a profession. I can’t help feeling that there must be a tension between the business entity we are today and the charitable efforts provided by our predecessors. There is a theme which runs through Brainard’s book; that the modern public health nurse is still animated by the same “spirit of service to mankind” that motivated the early deaconesses and sisters through the centuries. Even though Brainard proposes modern ideas of organization and business she still frames the career of a nurse as more of a calling or vocation rather than simply as a profession or gainful occupation. I am sure this partially reflects the time in which she was writing, but I do wonder how much our modern perception of nursing as a career still harbors an unspoken expectation that the choice to be a nurse goes beyond that of merely choosing an occupation and crosses into the realm of engaging in a “service to mankind” and if so, is there a resultant blurring of the line between the personal and the professional in the role of nurse which still persists today?

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