Mary Breckinridge, born in 1881 to an influential Kentucky family, enjoyed a privileged childhood and education in the U.S. Her father was the U.S. Ambassador to Czar Nicholas II of Russia from 1894 to 1897. In 1906, Breckinridge was widowed at age 26. Mary Breckinridge, born in 1881 to an influential Kentucky family, enjoyed a privileged childhood and education in the U.S. Her father was the U.S. Ambassador to Czar Nicholas II of Russia from 1894 to 1897. In 1906, Breckinridge was widowed at age 26.
AbstractThe 2010 Institute of Medicine report, the Future of Nursing, recommended that nurses work to the “full extent of their training” to address the primary healthcare needs of United States citizens. This article identifies and describes 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 nurses in the 21 st century. Beginning with in 1893, through in 1925, the discussion describes how nurses provided access to care for thousands of urban and rural citizens throughout the United States in the past. The article also discusses and the creation of role with the premise that nurses can learn from these early initiatives to create new models for nurses’ roles in primary care today.Citation: Keeling, A., (May 31, 2015) 'Historical Perspectives on an Expanded Role for Nursing' OJIN: The Online Journal of Issues in Nursing Vol. 2, Manuscript 2.DOI: 10.3912/OJIN.Vol20No02Man02Key words: history, expanded nurses’ roles, IOM Report 2010, access to care, ANA definition of nursing, Committee to Study Extended Roles, Lillian Wald, Mary Breckenridge, Food and Drug Act 1906, Frank v.
South, Harrison Narcotic ActCombining 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. 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.
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. 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. 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. Lillian Wald and the Henry Street Settlement Visiting NursesAs 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. 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. In addition, the nurses made referrals to physicians and the city’s hospitals. 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.
There were children scarred with vermin bites. A young girl dying of tuberculosis amid the very conditions that had produced the disease.” As demand for the nurses’ services increased, so did the numbers of nurses on the HSS staff and the need for regulation of their practice. By 1900, the Settlement employed 12 nurses who made 26,600 home visits. Related Articles.Blanca Miller, MSN, RN (September 6, 2017).Pamela A. Kulbok, DNSc, RN, APHN-BC; Joan Kub, PhD, RN, PHCNS-BC; Doris F. Glick, PhD, RN (April 18, 2017).Pamela A. Kulbok, DNSc, RN, APHN-BC; Joan Kub, PhD, RN, PHCNS-BC; Doris F.
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Mary Breckinridge: The Frontier Nursing Service and Rural Health in Appalachia By Melanie Beals Goan (Chapel Hill, North Carolina: University of North Carolina Press, 2008) (348 pages; $45.00 cloth)Melanie Beals Goan's Mary Breckinridge: The Frontier Nursing Service and Rural Health in Appalachia traces the life of Mary Breckinridge and her establishment of the Frontier Nursing Service in rural Kentucky. Goan does a fine job placing Breckinridge, her life, her ideas, and her achievements in their historical and cultural contexts. The author admirably shows how this historical case study of Mary Breckinridge and the Frontier Nursing Service enlarges our understanding of Appalachia, social reform, and scientific medicine in the twentieth century.Coming from a long line of prestigious American leaders, Mary Breckinridge established the Frontier Nursing Service, an organization designed to meet the medical, emotional, and social needs of the residents of rural Kentucky. Originally intended to serve women and children, the Frontier Nursing Service soon offered medical care to the men of Leslie County too. Breckinridge emphasized the right of every human being to health care, realized that nurses had important roles in providing that care, and appreciated the wisdom of preventive medicine (252).Goan's biography of Breckinridge and her institutional history of the Frontier Nursing Service pay close attention to the historical and cultural context from which Breckinridge and the organization came.
Goan recognizes that Breckinridge's drive to provide medical care was shaped by both maternalist philosophy and the ideal of the New Woman. Goan takes great pains to elucidate Breckinridge's class and racial bias; she acknowledges that such bias emerged from Breckinridge's upbringing by parents who promoted the Lost Cause of the South. Goan maps out how Breckinridge navigated the difficulties that the Frontier Nursing Service experienced as a result of events like the Great Depression and World War II.In addition to contextualizing Breckinridge's achievements as well as her shortcomings, Goan succeeds in placing the story of Breckinridge and the Frontier Nursing Service into the historiography of Appalachia, social reform, and scientific medicine. Goan says that her study is 'another attempt to complicate.