During these visits, nurses routinely dispensed physician-prescribed medicines obtained from local pharmacists and household remedies which they carried in their black leather nursing bags, filled from the HSS medicine closet ( Keeling, 2006 Wald, 1901-02, n.p).Īt the turn of the 20 th century, the medical/nursing professional boundaries changed almost daily as new treatments became available and state and federal legislative acts regulated the professions of medicine, pharmacy and nursing. The nurses’ dispensing practices would be questioned a few years later, however, with the passage of the 1903 state nursing registration act, which declared: “Nothing contained in this act shall be considered as conferring any authority to practice medicine or to undertake the treatment or cure of disease.” (Article XII, 1903). By 1900, the Settlement employed 12 nurses who made 26,600 home visits.

43)Īs demand for the nurses’ services increased, so did the numbers of nurses on the HSS staff and the need for regulation of their practice. a young girl dying of tuberculosis amid the very conditions that had produced the disease.” ( Duffus, 1938, p. there were children scarred with vermin bites. According to Wald, the immigrants’ needs were limitless: “There were nursing infants, many of them with the summer bowel complaint that sent infant mortality soaring during the hot months there were children with measles, not quarantined. In addition, the nurses made referrals to physicians and the city’s hospitals. Initially she and her colleague, Mary Brewster, made visiting nurses rounds there, providing not only physical care to the poverty-stricken European immigrants but also mobilizing an array of services to provide them with such necessities as ice, sterilized milk, medicines, and meals. Lillian Wald and the Henry Street Settlement Visiting NursesĪs demand for the nurses’ services increased, so did the numbers of nurses on the HSS staff and the need for regulation of their practice. In 1893, during a period of rapid industrialization and immigration in the Northeast, Lillian Wald, a young graduate nurse from New York Training School, established the Henry Street Settlement (HSS) on the Lower East Side of Manhattan ( Keeling, 2006). Beginning with Lillian Wald’s work in Henry Street Settlement in 1893, through Mary Breckenridge’s founding of the Frontier Nursing Service in 1925, the next section describes how nurses provided access to care for thousands of urban and rural citizens throughout the United States in the past. This article identifies and describes several historical antecedents, cornerstone documents, and legislative acts that served to set the stage for today, laying the groundwork for an expanded role for advanced practice nursing in the 21 st century.

However, the nurse’s role in providing access to care for underserved populations throughout the United States predates the inception of the formal nurse practitioner role by almost three-quarters of a century. Combining primary care medical services with advanced practice nursing skills, NPs meet the needs of underserved rural communities or those who lack access to care in inner cities. Combining primary care medical services with advanced practice nursing skills, NPs meet the needs of underserved rural communities or those who lack access to care in inner cities. From the inception of the nurse practitioner (NP) role in the 1960s, NPs have been identified as healthcare providers who can serve a combination of needs.

Historical role models