Extending Our Influence

This paper was presented at a meeting of the Southern Institute of Hospital Administrators, held at Duke University, Au­gust 4.

K.L.J., R.N. 

Sometime ago, Dr. John Brownsberger, medical superintendent of the Mountain Sanitarium and Hospital at Fletcher, North Carolina, was asked to prepare a paper on "Nursing Education and Nursing Service in Rural Areas." This paper was presented at a meeting of the Southern Institute of Hospital Administrators, held at Duke University, Au­gust 4.

Many local papers of the Southland printed large sections of this report, and one New York daily presented a front-page half-column abstract. The paper reemphasizes the ideals of community service and education held by our institutions, and has so much of value, that we herewith present a rather extensive ab­stract for the readers of the Ministry.

"In presenting this problem I have not at­tempted to consider the basic curriculum of schools of nursing, taking it for granted that the curriculum advocated by the National League of Nursing Education is and should be the basis of study in schools of nursing, not only in urban areas, but in rural areas as well. However, in making a study of the rural situa­tion, especially in the Southern States, and profiting by our own experience in operating a school of nursing in a rural district, we find different problems and conditions which re­quire some additions and adjustments in the nurses' education which we feel will aid in better preparing nurses to work in rural dis­tricts."

After discussing the need of better medical and nursing service, with special emphasis on the need of "well-trained superior nurse mid­wives," Doctor Brownsberger continues:

"There are other rural needs for which our nurses should be prepared. There is the field of health preservation, or preventive activities; health education in the school and home; and the ever-present need of nursing the sick in the rural home. If we are to graduate nurses who are willing to go into rural areas, who are willing to endure the isolation, the inconven­iences, and the poor pay, the education of the rural nurse should begin early in the course with a well-planned scheme for the integration of rural needs throughout the entire basic course. Schools of nursing located in small towns or rural areas would do well to incor­porate in their objectives the preparation of the nurse for community service in rural areas, the training of the rural-minded pro­fessional nurse. In order to do this, no radical changes are necessary, but rather a careful integration of the rural idea in all class in­struction and clinical experience. We recog­nize that the integration of the public health and social aspects are important throughout the basic course. . . .

"In attempting to integrate the rural-nursing idea in the basic course, there should be a well-planned scheme for the continuity of rural public health teaching beginning in the preliminary period and continuing through the entire three-year course.

"In the first year, the student should be orientated to the rural community in which the school is located. Observation visits may be made in homes of the rural people, and con­tacts made with the county health department and its nursing staff, with the Red Cross nurs­ing service if it operates in that community, and with all other health-promotion agencies at work in that area. Case studies may be selected from patients who live in the local rural vicinity, and arrangements made for student nurses to follow up such patients after their dismissal from the hospital.

"Formal class instruction may well include a course in rural sociology. In one school we noted that such a course was incorporated in the curriculum. This school utilized county farm agents and health officers to present the local economic and health conditions of the county. The course was climaxed by a trip of the entire class to the well-known John C. Campbell Folk School in Brasstown, North Carolina, where country living is made un­usually attractive and successful. Reference reading of inspirational and educational books dealing with country life and its problems was required as a part of this course. One student nurse, a city girl from one of our larger Southern cities, was heard to remark at the termination of the class, 'I always thought that I could never stand to live in the country, but now I not only want to work there, but I want to make my home there as well.'

"In the second year the integration of rural health should continue, with observation and independent visits in the home, follow-up visits to clinic cases and hospital dismissals, and contacts and observation of the school nurse at work. Continued efforts should be made to acquaint the student with tuberculosis and venereal disease control, and other social prob­lems of the community.

"During the third year, a month's field ex­perience with the public health nurse of the county or with the school's community nurse, would give the student one of the best oppor­tunities for acquaintance with rural needs. A rotating service of one month in such work would contribute largely to the education of the potential rural nurse. Many schools and hospitals find this difficult to arrange, because of financial problems and various complica­tions. When schools of nursing can arrange such an affiliation with county health depart­ments for monthly services in field work, this would be ideal.

"The outpatient department also has un­limited resources for educating the student for rural work, especially when opportunity is given for follow-up work in the homes. The course in obstetrics offers excellent opportunities for integration of rural public health. Rural home deliveries, by resident or staff physicians, assisted by graduate and student nurses, aid in preparing the student for rural nursing. Prenatal and postnatal care and preparations for home deliveries may be stressed in the classroom and practiced in the community.

"In the course known as Community Health, home-hygiene classes or health-preservation courses should be organized by the instructor for the women in the community, student nurses assisting in instruction and demonstra­tion. Just last week it was my privilege to attend the closing exercises of such a class, held in a rural Negro church for a group of Negro women. The course was twenty-four hours in length, two hours a week for twelve weeks, and was taught by a graduate nurse on the school of nursing faculty. Not only did the student nurses participate in the practical instruction on the proper care of the body and simple ways of caring for the family's health, but they went beyond that and helped to organize garden, corn, and poultry contests in order that these Negro mothers and their fam­ilies might be encouraged to raise foods essen­tial for the health of their families. This helped the student nurse to understand the relationship between good health and the eco­nomic status of the family.

"Even the extracurricular activities may serve to inculcate the rural idea in the stu­dent. Rural, health-giving types of recrea­tion, such as camping in the open, mountain climbing, hiking, trips to nature's beauty spots in the county, will all contribute to fit the student nurse for rural life. In one school the Christmas season offered opportunity for the student nurse to further contact the needs of the rural people. A list of former patients from impoverished rural homes was secured; visits were made to some of these homes in order to ascertain the needs of the families ; student nurses organized a campaign to raise funds to meet these needs in order to bring cheer and comfort to these destitute families. These nurses called on department-store man­agers of near-by towns, soliciting gifts of broken toys or shelf-worn clothes. These were gathered together, mended, repaired, and then, with funds collected on a dime-board placed in the hospital lobby, fruit, candy, and nuts were purchased. Heavily laden with 'boxes for each family, the student nurses, at an early morning hour, drove by truck from home to home, distributing gifts and singing carols. Small incidents these are in the education of the nurse, but they all contribute to the de­velopment of the rural-minded nurse.

"I have cited but a few of the opportunities in the basic course for the integration of the rural public health problem in formal class instruction, in clinical experience, and in extracurricular activities of the school. There are many others, but time forbids further dis­cussion.

"We recognize that a nurse graduating from a school in which the rural health needs are stressed is not ready for active rural public health responsibilities. Special study in the postgraduate field is necessary. Such nurses should further qualify themselves by enrolling in some of the splendid public health courses offered by our universities. But the integration of the rural health idea in the basic course does promote an interest in, and fosters an ambition for, this type of service, and the possibilities are greater that the nurse so trained will more willingly serve in rural areas."                                                       

K. L. J.

Ministry reserves the right to approve, disapprove, and delete comments at our discretion and will not be able to respond to inquiries about these comments. Please ensure that your words are respectful, courteous, and relevant.

comments powered by Disqus

K.L.J., R.N. 

November 1939

Download PDF
Ministry Cover

More Articles In This Issue

Hold Steady Under Crisis Conditions

Shun the temptation to prognosticate what has not been revealed.

Blessings of Sacrificial Giving

Whether our responsibility centers in the local church or in general admin­istrative work in any capacity, as leaders in the cause of God we need to be reminded often of the spiritual objectives that are before us and our believers, and need to have a knowl­edge of how these are attained.

Adventist Editorial Council

Denominational editors meet in council convened at Washington, D.C. on August 23-29.

Editorial Defenders of the Faith--No.1

A devotional study from the morning of August 25.

Cultural Cycles and Religious Trends

This is the first of four studies that lay bare the notable revolution that is taking place in religious world thought.

Facing the India Problem No. 1

India presents such a variety of conditions—geographical, economic, sociologic, and religious—that it is well-nigh futile to attempt any general statement about the country which would apply accurately to all parts or to all classes of people found there.

Schools, an Evangelizing Agency

One of the difficulties that stands in the way of carrying on evangelistic work in a large way in the native reservations and villages of Africa, is the inability of the people to read.

Statistical Report for 1938

Have you stopped to think that nearly one hundred years have passed since this movement began?

Principles of Hymn Choice—No. 1

Hymns and hymn tunes, gospel songs, and other types of music used in the work of the church are often criticized. Why this difference of opinion?

Baptism for the Dead

How may one deal effectively with the Latter-day Saints' (or Mormons') contention on vicarious baptism for the dead, which they base on 1 Corinthians 15:29?

Editorial Keynotes*

Ideals of Presentation--No. 1

The Art of Tactful Approach

I have found that a frank, practical, sym­pathetic appeal to the people through avenues of natural approach is a wonderful success in the country.

How to Deal With Hecklers

If we find that our meetings are being regularly interrupted, there is either some­thing wrong with our manner of lecturing or with our method of advertising.

A Departmental Secretary's Duty

As a home missionary secretary, I view with grave misgivings the alarming in­difference toward Christian education which is manifested by many parents.

Medical Missionary Activities

The following postscript on a letter under date of August 8, 1939, is from one of our College of Medical Evangelists graduates in New Mexico, who located in that State in 1935.

Medical Relief at Chungking

We feel that the following excerpt from a letter written by Dr. Herbert Liu, of China, will be of interest to our medical group at this critical time.

Daily Nutritional Needs*

Fasting for short periods is physically beneficial and health promoting for those who overeat. Were it not for overeating, fast­ing would be largely unnecessary, and entire abstinence from food would be harmful.

Medical Work in South China

From about the middle of 1937 and onward our people in China have been given a rare opportunity for service. This is espe­cially true of our medical workers.

Dispensationalism's Basic Fallacies--No. 1

Professor Price's article on dis­pensationalism in the August, 1938, Ministry, is most timely, and worthy of careful study by every Seventh-day Adventist minister. But I believe that we con­cede too much when we classify dispensa­tionalists as fundamentalists.

Carefulness in All Utterances

Of all people, Seventh-day Adventists should be the most careful of what they present orally or publish in written form.

Ambassadors for Christ

What careful­ness it should beget in us to be fit representa­tives of the government of God and His grace to lost humanity! What zeal we should have to improve ourselves, and to advance His work!

Editorial Postscripts

From the Ministry back page.

View All Issue Contents

Digital delivery

If you're a print subscriber, we'll complement your print copy of Ministry with an electronic version.

Sign up
Advertisement - Southern Adv Univ 180x150 - Animated


Recent issues

See All
Advertisement - NAD Stewardship (160x600)