1907

. . . District nursing of today follows the tradition of its earliest conception. It has been used since the beginning of its history to carry propaganda as there has been always an enthusiastic belief in the possibility of the nurse as teacher in religion, cleanliness, temperance, cooking, housekeeping, etc. My argument loses none of its force, I think, if much of this education has seemed to her lost energy because with greater knowledge and wider experience she has learned that the individual is not so often to blame, as she first supposed. That while the district nurse is laboring with the individual she should also contribute her knowledge towards the study of the large general conditions of which her poor patient may be the victim.
 
Many of these conditions seem hopelessly bad but may are capable of prevention and cure when the public shall be stimulated to a realization of the wrong to the individual as well as to society in general if [they] are permitted to persist. Therefore her knowledge of the laws that have been enacted to prevent and cure, and her intelligence in recording and reporting the general as well as the individual conditions that make for degradation and social iniquity are but an advance from her readiness to instruct and correct personal and family hygiene to giving attention to home sanitation and then to city sanitation, and advance from the individual to the collective interest. The subject is tremendously important, even exciting, and adds the glamor of a wide patriotic significance to the daily hard work of the nurse. The prevalence of tuberculosis, for instance, brings attention directly to conditions of industry and housing, next to hours of work, to legal restrictions, to indifference to the laws, to possible abuse of the weaker for the benefit of the stronger.
 
It is splendid vindication of the value of comprehensive education and stimulated social conscience that the district nurses who have had this vision have been the most faithful ad hard working and zealous in their actual care of the sick . . . [The] wider vision of the district nurse] makes for thoroughness as an all important educational, social and humanitarian necessity where the patients are concerned.
 
These opportunities . . . bear the closest relationship to the immigrants, because they are the most helpless of our population and the most exploited; the least informed and instructed in the very matters that are essential o their happiness. The country needs them and uses them and it is obviously an obligation due them as well as safe guarding of the country itself to give them intelligent conception and education of what is important to their and our interests . . .

Source: The Lillian Wald Papers, Rare Books and Manuscripts Division, The New York Public Library, Astor, Lenox, and Tilden Foundations.

Also: Lillian Wald: Progressive Activist, ed. Claire Coss (New York: The Feminist Press, 1989), pp. 66-67.