The Nursing Service

On June 9, 1909, the first Henry Street nurse visited a sick policyholder. A revolutionary idea, indeed, that a visiting nurse should give bedside care to a policyholder at the expense of an insurance company. At the outset the Nursing Service was to be tried out for a three-month period in a part of the Borough of Manhattan. So valuable were the results that at the end of this time the plan was at once extended through­out New York City.

Soon managers, agents, and policyholders elsewhere clamored for the new service. It was extended to the city of Washington in August, 1909, and then in quick succession to Baltimore, Boston, Chicago, Cleveland, and St. Louis. In all, 13 affiliations with existing visiting nurse associations were completed in that year. In the early part of 1910 Montreal, Worcester, Lowell, Trenton, Phila­delphia, Harrisburg, Buffalo, and Cincinnati were added to the list.

The establishment of the Montreal service was notable in that it was the first affiliation with the Victorian Order of Nurses, which now does most of the Metropolitan's work for English-speaking policyholders in Canada. Forty-seven nursing affiliations were completed by 1910, and 350 by the following year. Thus, an experiment that had started on a very limited scale grew by leaps and bounds. Later the service was extended to include group policyholders (1918) and inter­mediate policyholders (1926).

In setting up the nursing service the company adopted the principle of utilizing existing public health nursing organizations wherever possible, instead of setting up separate and duplicating units of its own. As the demand for the nursing service spread, however, the company organized its own staff to serve communities that had inadequate or no visiting nurse agencies. Thus, in St. Paul, Minn., in 1910, the Metropolitan first engaged its own nurse on a direct salary basis.

By 1943, the Metropolitan nursing service reached 7,728 communities throughout the United States and Canada. It had contract affiliations with 819 public health nursing agencies, and its own staff of 571 salaried nurses. The nursing service was acutely responsive to changing needs of the times. Skilled bedside care of the sick was emphasized throughout the period, as was maternity care to women during the months before and after childbirth. But with the years, Metropolitan nurses more and more became instructors as well as healers.

Their teaching took many forms, ranging from the correction of some ignorant, harmful practice in the home, to more general matters such as the diet of the patients family or removal of accident hazards. Very frequently the nurse brought the physician into the home and insisted upon and arranged for the patients hospitalization. Her alertness and advice often prevented the spread of disease to other members of the family.

Her knowledge of community agencies and the services they rendered often spelled the difference between hardship and adequacy for families under her care. When disaster would strike, Metropolitan nurses were among the first to offer aid. In typical reports of emergency work, such terse statements were found such as: "On duty practically 24 hours every day...I gave 1,500 inoculations against typhoid...no doctor to help me, but an accurate check shows that most of my patients are safe."

Skilled bedside care of the sick was emphasized throughout the period, as was maternity care to women during the months before and after childbirth. But with the years, Metropolitan nurses more and more became instructors as well as healers.