Visiting Nurse Society of Philadelphia records
Held at: University of Pennsylvania: Barbara Bates Center for the Study of The History of Nursing [Contact Us]Claire Fagin Hall, 418 Curie Boulevard, Floor 2U, Philadelphia, PA 19104-4217
This is a finding aid. It is a description of archival material held at the University of Pennsylvania: Barbara Bates Center for the Study of The History of Nursing. Unless otherwise noted, the materials described below are physically available in their reading room, and not digitally available through the web.
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On March 2, 1886, a group of Philadelphia women gathered to establish an organization to give nursing care to the sick in their homes. They named it the District Nurse Society after a system employed in Britain. Mrs. William Furness Jenks founded the organization (which was later renamed Visiting Nurse Society of Philadelphia in 1887). She recalled that, "No one had ever heard of such a thing as nursing the sick poor except in hospitals." Only Buffalo and Boston preceded Philadelphia in bringing this innovation to the United States. Mrs. Jenks envisioned a voluntary organization which would assist the contagiously and chronically ill who were turned away from institutions or who needed additional help during childbirth. Churches, relief organizations, and individuals contributed food, clothing, bed linens, and money to the organization.
In its first year, the organization made 380 home visits. Most of these visits were to run-down areas which housed the city's workers. Many were immigrants from Europe and Blacks from the rural South. Typhoid and diphtheria were common among the poor. Tuberculosis, the "great white plague," reached epidemic proportions during the nineteenth century and was a leading cause of death. The Society applied new concepts about the treatment of these diseases after it became known that they were communicable. The nurses sought to isolate tuberculosis patients and to educate them and their families about the role of personal habits and hygiene in reducing the risk of contamination. As one early officer of the organization explained, the nurses also did many things which were not technically nursing but were considered important to it, such as "cleaning the sick room of lumber and unnecessary furniture, sweeping floors, and lighting fires." The nurse was expected "to set an example of that neatness, order, sobriety, and obedience which she was to impress upon others." The work was so exhausting that few of the nurses employed by the Society in its first decade stayed more than eighteen months.
More than half the cases involved maternity and child care. The nurse aided physicians with home deliveries and made follow-up visits to help the mothers bathe and feed the newborns. They also provided care and instruction for expectant mothers to reduce infant mortality. During the early 1900s the Society joined with physicians, city officials, and social workers in a movement to educate the public about recent discoveries which showed that many once-fatal and debilitating illnesses could be prevented. Because of its familiarity with neighborhood health and social conditions, the Society was a valued member of this crusade. It staged dramatic exhibits about tuberculosis as well as festive events like Better Baby contests to spread the gospel of improved child care. In 1903, the Society cooperated with the city's Bureau of Public Charities to conduct a medical inspection to reduce the incidence of ringworm, pink eye, and nutritional disorders such as rickets among schoolchildren. This was the beginning of the school nursing program that was taken over by the city in 1908. From 1905-1908 the Society stationed a nurse at Starr Centre Association of Philadelphia, 7th and Lombard, to help with maternity and child care clinics, vaccination drives, nutritionally sound "penny lunch" programs, and in distributing inspected milk.
World War I accelerated the growth of the nursing profession and the demand for home care. With this development, the Society turned to new groups of clients and new interests. Between 1913 and 1922, the Society caseload nearly doubled. In 1925, the Society described itself as "a visiting hospital with wards all over the city corresponding to the various branches." It employed more than 80 nurses in a downtown building and at several branch offices including Kensington (opened 1896), Manayunk (1901), Germantown (1902), and West Philadelphia (1903). The Society borrowed public relations techniques from hospitals with whom it was now competing for patients. Society branch staffs were encouraged to enlist neighborhood people to serve on home nursing committees and fundraisers and to keep the central office in touch with the needs of each locality. Brochures emphasized that all of the Society's nurses were hospital-trained. The Society was still actively involved in the treatment of communicable diseases, maternity, and child care, but it was no longer an exclusively low-income patient population. Contracts with insurance companies and manufacturing firms to provide care for industrial policy-holders brought annual caseloads to record highs of 40,000 or more in the late 1920s. Seventy percent of the patients were less than 45 years of age. By 1920, the Society was also treating a greater number of older patients in a new occupational therapy program. The Society added a mental hygiene supervisor in 1934. A decade later, physical therapy (1943) and orthopedic service (1944) became mainstays of the Society's program.
Society superintendent Katherine Tucker (1916-1928) and her successor, Ruth Weaver Hubbard (1928-1955), were instrumental in transforming the organization from a multipurpose home welfare agency into a modern professional nursing organization. Both women held offices in the National Organization for Public Health Nursing and helped widen educational opportunities for home nurses. They also developed the Society internship program which allowed nursing students to complete in-service training at the Society.
Despite the progressive leadership of its professional staff and board, the Society lost half its revenues when insurance companies, which had previously contracted for home nursing, terminated these arrangements after World Ward II. The Society also lost some of its traditional clients to city programs for maternity cases and preventive care. These problems were addressed in the Philadelphia Public Health Survey produced by the City Planning Commission in 1950. The Commission recommended a merger of the nursing activities of the City and voluntary home care agencies. The City invited Society director Hubbard to help merge City and private home care services into a single operation. Negotiations continued until May 1959, when the Society's president, Mrs. Samuel Y. Gibbon, joined City Health Commissioner Dr. James Dixon and Mayor Richardon Dilworth to create Community Nursing Services of Philadelphia (CNS).
Plans for CNS focused on the health center: a multiservice facility for consolidating public and voluntary nursing programs. Before 1959, the Society primarily did home bedside care while City nurses worked in Department of Public Health clinics, making house calls as required by their work in child hygiene, tuberculosis, and venereal disease. Before the creation of CNS, it was possible for both Society nurse and city nurse to call on a single family. Under CNS, each nurse would be a general practitioner who could administer bedside care as well as preventive treatment. The centers would serve all residents of a designated area, in much the same fashion used in the combined Starr Centre Association/Society branch office opened in Germantown in 1944. This pilot project became the model for dividing the city into health districts based on a Planning Commission scheme for using census tracts as the unit for organizing health services on a uniform geographical basis. Actually, the plan built on the Society system for conducting generalized nursing out of its branches. With this framework in place, CNS made rapid progress under Directors Dorothy Wilson and Margaret Kauffman toward integrating nursing personnel and caseloads in all ten City health districts.
During the late 1970s the environment for providing home health services in the public and private sectors underwent many changes which led the Society and city officials to reorganize their relationships. Today the city contracts for home nursing services through CNS's successor—an independent, voluntary nonprofit organization, Community Home Health Services of Philadelphia (CHHSP), created in 1979. The Visiting Nurse Society is now a foundation which is a leading source of support for CHHSP's work with the indigent.
One change has been increased care for the elderly. In 1951, 72 percent of Society's patients suffered from long-term illnesses. Some participated in its intensive Home Care Plan (1949), an early attempt to coordinate medical and social services for the chronically ill. More recently, the Society and its successor, CHHSP, have sought to develop programs that address medical and personal consequences of cancer, cardiovascular disease, arthritis, and mental changes associated with aging. Medicare, created in 1965, increased public funding for these services. In 1985, over 68 percent of CHHSP's patients were over 65 years of age.
Another contemporary characteristic is size. In 1886 the Society began with one room, one nurse, one table, and $100. In 1985 its successor, Community Home Health Services of Philadelphia, made 220,000 visits and had an operating budget of $9 million. At one time, the Society was the only professional organization involved in home nursing. Today it is part of a complex national health industry transformed by science, technology, and public oversight. Plans, procedures, and methods have also changed with the needs of the patients.
Despite innovations in financing and fundraising, home nursing still retains elements that were present a hundred years ago. CHHSP is an active presence in the health and medical communities. Both historical roles-those of health educator and health planner-continue to find a place in its work.
The records of the Visiting Nurse Society of Philadelphia document a wide range of themes and issues in home nursing and the care of the indigent poor. It dates from the inception of the visiting nurse movement in the United States in the 1880s and continues up through 1977. The collection includes trustees' minutes, board correspondence, committee reports, and branch association files. There is also a significant amount of material documenting the Society's role in the public health crusades of 1902-1918, including school nursing services, infant and maternity care, and care of tuberculosis patients. Other material represents the impact of hospitals on home nursing beginning in the 1920s, as well as the efforts of agency officials to respond to the needs of an aging population especially after World War II. There are also files relating to the Philadelphia Home Care Plan (1949-1960s) and Community Nursing Services of Philadelphia (1959 1979) which was planned and run conjointly with the City of Philadelphia. Also included is a well-documented collection of photographs, many of which were reproduced in the Society's annual reports at the turn of the century.
A scrapbook of newspaper clippings 1918-1919, select meetings and minutes, and select annual reports have been digitized as part of our online exhibit of the 1918 Influenza Pandemic- Calm, Cool, Courageous- at https://www.nursing.upenn.edu/history/publications/calm-cool-courageous/.
Please contact the Center for more information about the online digitized materials as well as access to those digitized clippings not available online at this time.
Gift of G. Lloyd Kirk.
- World War, 1914-1918 -- Medical care
- Visiting nurses
- Influenza Epidemic, 1918-1919
- Community health nursing
- University of Pennsylvania: Barbara Bates Center for the Study of The History of Nursing
- Finding Aid Author
- Center staff, updated by Bethany Myers
- Access Restrictions
This collection is unrestricted.
- Use Restrictions
Copyright restrictions may apply. Please contact the Center with requests for copying and for authorization to publish, quote or reproduce the material.
This series includes materials documenting the Society's founding and early activities. It provides perhaps the best overview, from an administrative perspective, of the activities of the Board of Managers. By 1916, the day to day administrative work of the Society gradually shifted to Katherine Tucker, the Society's first superintendent. Included in this series is the original charter of the Society and subsequent revisions (1887-1912); bylaws and subsequent revisions; a complete run of annual reports (1886-1987); minutes of the Board of Managers (1886-1986), its Executive Committee (1912-1919), and of the Society's annual meetings. The correspondence files include incoming and outgoing correspondence of the Board (1921-1982) and selected correspondence with coordinated funding agencies. There are also a few contemporary files dealing with issues such as minority representation on the Board and policies relating to conflicts of interest.
This small series consists of published and unpublished histories by and about the Society ranging in date from 1915 to 1974; biographies of Board members including three folders about Ruth Weaver Hubbard, the Society's general director from 1929 to 1955. There are also a few files dealing with Board matters of antiquarian interest such as the restoration of several historical plaques.
Found within this series are the files of the Society's committees including the Advisory Committee (1973-1976), Budget Committee (1965-1979), Local Committee, Medical Advisory Committee (1936-1967), Men's Finance Committee (1935-1979), Nominating Committee (1952-1976), Nurses Committee (1919-1946), Public Relations Committee (1947-1977), Supervisor Conference/Staff Council (1945-1960), Personnel Committee (1967-1979), and Social Service Committee.
This series includes a variety of materials used for public relations purposes. This series consists of material that was created by the Public Relations Committee or by other sources whose origin is not apparent in the records. Although most of the documents were created and used in the post 1950s era, there are some brochures, pamphlets and press releases as early as 1915. Some typical examples of this series include fact sheets, radio and television scripts, and publicity relating to anniversary years.
In an effort to offer the Society's services to new population distributions in Philadelphia, and perhaps to attract middle class patients, the Society opened several branch offices in other parts of the city. The first was the Germantown Branch (later renamed the Germantown and Chestnut Hill Branch) whose records begin in 1933. This was followed by the West Branch (1937), South Philadelphia Branch (1939), Frankford Branch (1947), North Branch (1957), Northeast Branch (1957), Northwest Branch (1958), and the South Philadelphia Branch (1939). This series, arranged alphabetically by branch, also includes one file describing the branch boundaries in 1959. The files of the Germantown and Chestnut Hill Branch and the Northwest Branch are the most complete with minutes, bylaws, correspondence, and financial files.
This series includes nursing service programs either sponsored by the Society or by other agencies with the Society. It includes the files of Com¬munity Home Health Services of Philadelphia (1980-1984) and the yearbooks of the Child Federation of Philadelphia (1914-1915). There are also files relating to the Community Nursing Services of Philadelphia (1955-1979), a program coordinated by the Health and Welfare Council which ran conjointly the nursing programs of the City of Philadelphia with those of the Society. This includes background material, board member registers, manuals, minutes, annual reports, correspondence, evaluations and proposals, and financial reports. Also included are some correspondence files with the Health and Welfare Council (1949-1979); and general files about the Philadelphia Home Care Plan (1958-1965) and other nursing agencies.
This series includes the reports of the Society's auditor (1924-1970), cash books (1950-1960), correspondence (1945-1977), cost analyses and custodial accounts (1954-1968), and financial statements (1971-1986). There are also files describing the various general and named funds of the Society. This includes scholarships, endowed nurses, and donations to patients. Most notable is the Ruth Weaver Hubbard Foundation providing scholarship money to nurses interested in public health work. There are also agreements with Metropolitan Life Insurance Company and the John Hancock Company for patient care. The Society maintained several ledger books which are files in this series recording funds received from and expended on behalf of the Welfare Federation (1930-1936), its succeeding agency, the Community Fund of Philadelphia (1936-1949). The Society also maintained a general ledger for the years 1949 through 1956.
This is a small series that documents the properties acquired by and owned by the Society. In addition to the Society's properties, this series also includes the deed to the Starr Centre Association of Philadelphia, which the Society later acquired.
A variety of clippings, newspaper supplements, pamphlets, and manuals make up this series. Most of the materials promote the Society's work, others address broader social reform issues such as Mrs. James T. Fields' "How to Help the Poor." There are also some clippings relating to the Starr Centre Association of Philadelphia.
The photographs making up this series are largely from the twentieth century. The Society, like other reform groups of the era, used photographic images to communicate their message to broader audiences. Once it became economical to reproduce photographs in publications, the Society's use of photographs increased dramatically. The Society reproduced many of the photographs found in this series in their annual reports beginning in 1907. For a complete visual record of the Society's activities, consult the annual reports in "Series I. Administration." Due to the nature and use of photographs by the Society, this series has been divided into two subseries of representing photographs created between 1900 to 1939, and 1940 to 1986. Within each subseries, they are divided into exterior and interior images and thereunder by subject of the images, i.e. general, group, nurses, people, etc.
This series includes memorial plaques, uniforms, caps, dolls, and a wooden toy "visiting nurse society" automobile.