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Child Health and the Community by Courtenay DinwiddieReview by: Abbie Roberts WeaverThe American Journal of Nursing, Vol. 32, No. 5 (May, 1932), pp. 614-616Published by: Lippincott Williams & WilkinsStable URL: http://www.jstor.org/stable/3410680 .

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THE AMERICAN JOURNAL OF NURSING THE AMERICAN JOURNAL OF NURSING

over $100 per year per student. It is probable that more studies based on actual replacement of students with graduates will be required to clear this point which, from a hospital point of view, is the nub of the dis- cussion. If, as we believe, Canadian schools are very similar to our own, this discrepancy in results must be taken very seriously and further studies on both sides should be made.

The Survey points out, again paral- leling our own situation, a serious shortage of teachers. On the basis of certain sociological studies it indicates the need for rapid expansion of public health nursing services.

The Survey puts the economic prob- lem of adequate nursing service suc- cinctly by asking: "How shall the gap between the needy patient and the needy nurse be filled?" State health insurance is stated to be a prerequisite if all patients are to receive adequate nursing service. " Nursing in Canada has taken short views of nursing and educational problems" when long views were very desirable and the eco- nomic welfare of the citizen of mod- erate means has been overlooked.

The Survey recommends the social- ization of nursing through the setting up of a federal council of nursing, with functions of an advisory, directive, educational, research, and integrat- ing nature, together with provincial councils with executive and adminis- trative, as well as educational, powers. These councils, non-political in nature, should require registration of all who care for the sick for hire. At the out- set, says the report,

there would be no reason to modify the present status of public health and insti- tutional nurses. The prime function of provincial councils would be to organize and supervise the work of private duty nurses and of various types of attendants who care for the sick for hire. Private duty nurses, working directly through

over $100 per year per student. It is probable that more studies based on actual replacement of students with graduates will be required to clear this point which, from a hospital point of view, is the nub of the dis- cussion. If, as we believe, Canadian schools are very similar to our own, this discrepancy in results must be taken very seriously and further studies on both sides should be made.

The Survey points out, again paral- leling our own situation, a serious shortage of teachers. On the basis of certain sociological studies it indicates the need for rapid expansion of public health nursing services.

The Survey puts the economic prob- lem of adequate nursing service suc- cinctly by asking: "How shall the gap between the needy patient and the needy nurse be filled?" State health insurance is stated to be a prerequisite if all patients are to receive adequate nursing service. " Nursing in Canada has taken short views of nursing and educational problems" when long views were very desirable and the eco- nomic welfare of the citizen of mod- erate means has been overlooked.

The Survey recommends the social- ization of nursing through the setting up of a federal council of nursing, with functions of an advisory, directive, educational, research, and integrat- ing nature, together with provincial councils with executive and adminis- trative, as well as educational, powers. These councils, non-political in nature, should require registration of all who care for the sick for hire. At the out- set, says the report,

there would be no reason to modify the present status of public health and insti- tutional nurses. The prime function of provincial councils would be to organize and supervise the work of private duty nurses and of various types of attendants who care for the sick for hire. Private duty nurses, working directly through

local or district registries as a part of the provincial organization, would be given continuous employment on a regular salary.

Details of desirable organization are set up.

The chapter headings, some of which are as follows, indicate the broad scope of the study: "Historical Sidelights and Evolutionary Tenden- cies," "Objectives," "Is Nursing A Profession?" "Intelligence of Student Nurses," "Nursing Registries," "Methods of Teaching and Learn- ing," "The Examination System," "The Curriculum," "Does the Nurse Need To Be Educated," "The Ap- praisal of the Patient," "The Nurse and the Public," "Some Administra- tive Problems," "Some Comparative Costs," "The State and Public Health," "Control and Supervision," "The Nurse and the Medical Profes- sion," " Instructors of Student Nurses."

The report is well set up. To this reviewer, at least, there seems to be some unnecessary duplication since cross references are freely and help- fully used in the summaries. The book needs an index. Doubtless this was omitted in the interest of econ- omy.

The book is recommended to all Americans, nurses or others, who are dealing with nursing education and nursing service. It is^ replete with illuminating data which have been carefully interpreted as a basis for the far-seeing recommendations.

CHILD HEALTH AND THE COMMUNITY.

By Courtenay Dinwiddie. 80 pages. The Commonwealth Fund, New York. 1931. Price, $1.00.

AN a health conscience be devel- oped and made to function in the

average American community? This is no new question but a new ap- proach to its final solution has been

VOL. XXXII. No. 5

local or district registries as a part of the provincial organization, would be given continuous employment on a regular salary.

Details of desirable organization are set up.

The chapter headings, some of which are as follows, indicate the broad scope of the study: "Historical Sidelights and Evolutionary Tenden- cies," "Objectives," "Is Nursing A Profession?" "Intelligence of Student Nurses," "Nursing Registries," "Methods of Teaching and Learn- ing," "The Examination System," "The Curriculum," "Does the Nurse Need To Be Educated," "The Ap- praisal of the Patient," "The Nurse and the Public," "Some Administra- tive Problems," "Some Comparative Costs," "The State and Public Health," "Control and Supervision," "The Nurse and the Medical Profes- sion," " Instructors of Student Nurses."

The report is well set up. To this reviewer, at least, there seems to be some unnecessary duplication since cross references are freely and help- fully used in the summaries. The book needs an index. Doubtless this was omitted in the interest of econ- omy.

The book is recommended to all Americans, nurses or others, who are dealing with nursing education and nursing service. It is^ replete with illuminating data which have been carefully interpreted as a basis for the far-seeing recommendations.

CHILD HEALTH AND THE COMMUNITY.

By Courtenay Dinwiddie. 80 pages. The Commonwealth Fund, New York. 1931. Price, $1.00.

AN a health conscience be devel- oped and made to function in the

average American community? This is no new question but a new ap- proach to its final solution has been

VOL. XXXII. No. 5

614 614

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ABOUT BOOKS

presented by Mr. Dinwiddie, Director of the Child Health Demonstration Committee of the Commonwealth Fund. In this book he focuses atten- tion upon two hitherto more or less neglected elements in the solution, to wit, the practicing physician and the community, and thus gives a renewed emphasis to the principle that the entire community must be actively mobilized to solve its own health problems if they are to be solved per- manently.

The book reviews briefly a series of child health demonstrations sponsored by the Commonwealth Fund during the years 1923-1929, inclusive, and stresses the complete interdependence of the different social and professional groups taking part in the experiment. During this period intensive demon- strations in child health were con- ducted in Fargo, North Dakota; Athens, Georgia; Rutherford County, Tennessee; and Marion County, Wash- ington. These demonstrations, which were made possible by annual appro- priations from the Fund, had for their primary purpose the proof of what could be accomplished when all the forces of a community were directed toward the safeguarding of child health when backed by reasonably adequate appropriations.

The communities named were chosen for two reasons: (1) they pre- sented health problems which were typical of the average American com- munity and still largely unmet; (2) they gave reasonable assurance that the services which the demonstrations proved to be essential would be con- tinued by community funds at the expiration of the demonstration pe- riod. A detailed report of these demonstrations, giving an account of the problems confronted, procedures used, and results obtained has already been published. The present book

MAY 1932

opens with a summary of the public health situation in the country at large at the time the demonstrations were started and is followed by a brief description of the setting for each of the demonstrations, showing that the communities chosen differed widely in type of population and specific prob- lems presented. The latter half of the book, consisting of two chapters, is devoted to a consideration of the vital part played in the demonstra- tions by the family physician and the public at large.

At the beginning of the experiment the local medical societies were asked to approve all projected programs and procedures, and throughout the ex- periment they were kept fully in- formed of developments. As a result the family physician was made to feel his responsibility for the health and well-being of the entire community and with it the need for more adequate preparation for the practice of pre- ventive medicine. To meet this need the Commonwealth Fund has appro- priated funds for scholarships and fellowships in certain selected medical schools not only for those preparing to enter the field of medicine but for mature practitioners as well.

In order to create public opinion in support of the health programs in- augurated, the interest of all local organized groups was fostered. These groups consisted of parent-teacher associations, civic clubs, church so- cieties and other neighborhood groups. Some form of local organization was set up in each of the demonstration communities which enabled the people to assume an increasing amount of responsibility as time passed.

Complete success is claimed for no one of the demonstrations. Perma- nent results, however, were achieved. The best evidence of this fact is to be found in a comparison of expenditures

615

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THE AMERICAN JOURNAL OF NURSING THE AMERICAN JOURNAL OF NURSING

for public health in the respective communities during the year preced- ing and the year following the demon- strations. In Fargo expenditures in- creased from 27 cents to $1.13; in Athens from 63 cents to $1.09; in Rutherford County from 11 cents to 98 cents; and in Marion County from 14 cents to 60 cents.

One of the strong points of the book is the emphasis placed upon the need for developing public opinion to the point where it will lead people to seek health service continuously and in- creasingly from the family physician. In order to make this possible the fam- ily physician must be prepared to give this larger public service.

ABBIE ROBERTS WEAVER, R.N.

Auburn, Alabama

AN INTRODUCTION TO GYNECOLOGY.

By C. Jeff Miller, M.D. 327 pages. Illustrated. C. V. Mosby Company, St. Louis. 1931. Price, $5.00.

AS stated by Dr. C. Jeff Miller in L the preface of An Introduction to Gynecology, the book is intended solely for beginning students who lack the ability to use selectively the more comprehensive texts. This purpose is well carried out in the careful selection of subject material, good organization for teaching, carefully chosen illustra- tions, and his direct simple style of writing.

The book deals only with the essen- tials of gynecology and does not include therapy, as the author himself says "Since this text deals only with the fundamentals of gynecology, I make no claims for originality, though nat- urally every statement is colored by

for public health in the respective communities during the year preced- ing and the year following the demon- strations. In Fargo expenditures in- creased from 27 cents to $1.13; in Athens from 63 cents to $1.09; in Rutherford County from 11 cents to 98 cents; and in Marion County from 14 cents to 60 cents.

One of the strong points of the book is the emphasis placed upon the need for developing public opinion to the point where it will lead people to seek health service continuously and in- creasingly from the family physician. In order to make this possible the fam- ily physician must be prepared to give this larger public service.

ABBIE ROBERTS WEAVER, R.N.

Auburn, Alabama

AN INTRODUCTION TO GYNECOLOGY.

By C. Jeff Miller, M.D. 327 pages. Illustrated. C. V. Mosby Company, St. Louis. 1931. Price, $5.00.

AS stated by Dr. C. Jeff Miller in L the preface of An Introduction to Gynecology, the book is intended solely for beginning students who lack the ability to use selectively the more comprehensive texts. This purpose is well carried out in the careful selection of subject material, good organization for teaching, carefully chosen illustra- tions, and his direct simple style of writing.

The book deals only with the essen- tials of gynecology and does not include therapy, as the author himself says "Since this text deals only with the fundamentals of gynecology, I make no claims for originality, though nat- urally every statement is colored by

my own clinical experience." The book has a most interesting chapter on "Glands of Internal Secretion" and the chapter on "Anatomy and Physiology of the Pelvic Organs" in- cludes some clearly and simply stated material on the development of the reproductive organs.

Exception to accuracy of state- ment might and should be taken to that on page 39 where the author states "True menstrual blood does not clot and it is generally accepted that the presence of clots indicates some abnormality." In a study which the reviewer made dealing with over a thousand normal young women it was found that menstrual blood does tend to form small clots at the onset when the flow is greatest in over 99 per cent of the cases studied.

From a teaching standpoint the short bibliographies at the end of each chapter are excellent in that a few well-chosen references to current literature are much more likely to be read than where the lists are long ones.

As to format, a bit smaller book is easier to handle and the print on paper with less gloss is easier to read.

While the book has not been written for nurses, nevertheless, the advan- tages which it affords the beginning medical student hold true for the stu- dent in nursing and An Introduction to Gynecology will make a very valuable addition as a reference for our nursing schools where our problems in teach- ing the essentials are much the same as in the medical schools.

M. CORDELIA COWAN, R.N. Educational Director, Woman's Hospi-

tal, New York

my own clinical experience." The book has a most interesting chapter on "Glands of Internal Secretion" and the chapter on "Anatomy and Physiology of the Pelvic Organs" in- cludes some clearly and simply stated material on the development of the reproductive organs.

Exception to accuracy of state- ment might and should be taken to that on page 39 where the author states "True menstrual blood does not clot and it is generally accepted that the presence of clots indicates some abnormality." In a study which the reviewer made dealing with over a thousand normal young women it was found that menstrual blood does tend to form small clots at the onset when the flow is greatest in over 99 per cent of the cases studied.

From a teaching standpoint the short bibliographies at the end of each chapter are excellent in that a few well-chosen references to current literature are much more likely to be read than where the lists are long ones.

As to format, a bit smaller book is easier to handle and the print on paper with less gloss is easier to read.

While the book has not been written for nurses, nevertheless, the advan- tages which it affords the beginning medical student hold true for the stu- dent in nursing and An Introduction to Gynecology will make a very valuable addition as a reference for our nursing schools where our problems in teach- ing the essentials are much the same as in the medical schools.

M. CORDELIA COWAN, R.N. Educational Director, Woman's Hospi-

tal, New York

VOL. XXXII. No. 5 VOL. XXXII. No. 5

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