Content area
Full Text
"You are sick - go home." This, along with a letter explaining the health reason the child was considered ineligible to attend school was the message conveyed by Mew York City Board of Health's Medical Inspectors to all ill students and their parents at the turn of the century. They presumed that, once sent home, that parents would take their children to the doctor and be treated. The Medical Inspectors, all of whom were physicians, gave little consideration to the fact that parents may not have received the note regarding their child, lacked the resources to seek medical care, could not leave work to do so, or were unable to read the note, either because they were illiterate or did not speak English (Rogers, 1908). This policy of exclusion failed miserably and the rates of infectious diseases and absenteeism among school students remained rampant. Something needed to be done. This article of the Presence of the Past in Pediatric Nursing journeys back in time to the late nineteenth century to revisit one of the most successful experiments in public health, the beginnings of school nursing in the United States, pioneered by Lina Rogers (Struthers).*
The Impact of the Industrial Revolution on the Children of New York City
During the late nineteenth century, the influx of foreign immigration, along with economic changes that resulted in a dramatic shift from agriculture to industry rapidly increased the population in New York City. By the early twentieth century, the city and its occupants were faced with an array of worsening issues related to health care delivery and public health. The living conditions in the overcrowded city were unsanitary and filled with disease, hunger, and poverty. Major causes of pediatric mortality included measles, scarlet fever, diphtheria, whooping cough, diarrhea, meningitis, and tuberculosis (Brodie, 1986). Contagious illness spread like wildfire throughout the growing numbers of tenements due to the lack of knowledge, resources, and access to health care. In the hope of protecting healthy children in school from becoming sick, and thus unable to attend school, the Board of Health put the 'rule of exclusion' into place. This meant that children with contagious diseases were sent home from school without treatment or a care protocol; rather, just a simple diagnosis written...