Queen Alexandra's Royal Naval Nursing Service is a small on, which also has a reserve. The Royal Air Force Nursing Servic was established in 1921. (See MEDICAL SERVICE, ARMY.) (E. S. H.) Nursing in the United States under the Nightingale plan according to which student nurses are educated by nurses as well as by physicians, began in 1873 at the Bellevue Hospital, New York, the Connecticut Training School, New Haven, and the Massachusetts General Hospital, Boston. Mention of it, however, is made earlier in connection with care of the sick in the Pennsyl vania Hospital, the charter of which was granted in 1751, the New York Hospital in 1798, the Philadelphia Dispensary in 1855 and the New England Hospital for Women and Children in 1859-60.
Training generally begins at 18, though in some hospitals the minimum entrance age is 19, 20 or 21. Under the apprenticeship system, making of a hospital anti school of nursing not two sepa rate institutions but one and the same, the nursing in the wards is done by these young students in most of the hospitals where they are trained. Of the 7,416 hospitals in were very small or State institutions without schools and in 75% of the remaining 2,155 the nursing was done by students in most schools without the assistance of a single general-duty graduate nurse. After from one to four years training nurses pass out into professional life at the average yearly rate of approximately 18,00o.
Each State has a board of nurse examiners with which properly accredited nurses may register of ter passing an examination. On Jan. I, 1928, there were 200,000 registered nurses in the United States. Of the various branches of nursing 54% go into private duty, 19% into public health, and 23% into institutional work but they change from field to field, especially away from private duty with its uncertainty of employment and its demand for 24 hour duty arising from the fact that many families are unable to afford a night nurse as well as a day nurse in sickness.
A field for nurses developed generally in 1905 when the Massa chusetts General Hospital, Boston, instituted hospital social serv ice. The idea originated in 1879 when the Ethical Culture Society of New York employed a nurse with a visiting physician in con nection with the dispensary. It means follow-up work among discharged patients and their families, carrying the treatment of the hospital into the home and utilizing the opportunity of educa tion, systematizing and co-ordinating treatment with rehabilitation of the family through public and private agencies. Staffs of social workers and nurses are now employed for this purpose.
The usual yearly salary of the typical private duty nurse throughout her professional life was computed in 1928 to be $1,311 since the months of employment average but 7 out of 12; public health nurses begin at about $1,450, with the yearly aver age $1,720; and nurses in institutions begin at $1,75o plus main tenance, with the yearly average $2,079 plus maintenance. The
superintendent of a hospital receives an average salary of $2,600 to $2,700; the superintendent of nurses of $2,500 to $2,600 plus maintenance; and the superintendent of hospital and nurses jointly an average of $2,400 to $2,500 plus maintenance. Nurses in the United States are recruited largely from the agricultural, manu facturing, trade and professional classes with proportionately more from the last group than from the first, considering the extent of agricultural pursuits in the country.
As a profession, nurses in the United States are organized into three national organizations for which they themselves are re sponsible, the American Nurses Association, the National Organ ization for Public Health Nursing and the National League of Nursing Education. Each organization has its individual staff of full-time workers engaged in promoting the various aspects of nursing interests. The remarkable progress made in the nursing field in the past 3o years is due to the distinctive service rendered by these national organizations because of their specialized knowl edge and experience and steadfast insistence on the maintenance of the highest standards.
Veterans' Bureau nursing service also has a woman superintendent who is a registered nurse. It is now (1928) the largest of the Government nursing services and is composed of two groups of nurses, those who care for the patients in the nation-wide chain of Veterans' Bureau hospitals and those who do welfare work among the ex-service men in their homes. The U.S. Government has a great nursing reserve upon which it can draw in time of need in the American Red Cross Nursing Service (see RED CROSS : America) which has been closely linked with the American Nurses Association throughout its history, and membership in this association is essential to enrollment, as an insurance of standards.
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