PUBLIC HEALTH NURSING Successful work in disease control and prevention largely depends upon the degree of attention paid the individual human units of an area. The realization of this responsibility pri marily arose in the out-clinic departments of some of the larger eastern hopitals. It was long realized that many patients ceased attendance at the clinics before being fully benefited by their treatment, or that bed patients following their discharge in a condition of distinct improvement, returned to home sur roundings so unfavorable that the improvement laboriously achieved by the hospital was soon lost. Efforts were made to improve these conditions through the frequent visitation of patients in their homes, by urging the continuation of their clinic attendance, by instructing the responsible members of the family in their proper feeding and care, by providing the assistance of charitable agencies where such assistance was required. As a consequence the benefits of the hospitals have been greatly extended and their accomplishments afforded a greater degree of permanency. This type of service has been adopted by various health departments, for the most part se curing the services of graduate nurses for this purpose. We
have previously called attention to public health nursing in connection with maternity and child welfare clinics. A similar service can be rendered in the control of communicable diseases, through proper follow up care of patients discharged from isola tion. Another variation of this type of service is afforded by the so-called visiting nurse, who makes periodical visits to the homes of those unable to provide hospital facilities or trained nursing, or where free hospital beds are not available, re gardless of the character of the patient's illness. Instruction is given the responsible members of the household the proper feeding and care of the patient and in the execution of the physician's directions. The daily visits are continued as long as necessary to insure a continuation of the lessons given and to give further instruction. Thus in the public health nurse there has developed a distinct type in the social worker.