Document 1gdnRpRgRD189kZnRJ43wbw1m

te quarterly bulletin Vol. 13, No. 1 ro" Metropolitan Nurses Zf I could see each of you personally this season and say, "a merry Christmas to you.1" It would please me greatly. But considerstiona of numbers and geography make a personal greeting impossible. To each I wish the happiest Christmas ever! It is a wonderful season. Sven those for whom this Christmastime may have been saddened by some personal sorrow can find peace and con solation in the Founder of the great feast. You all deserve the happiest Christmas ever. In the continued progress of our Company you have played a prominent role during 1943. I am looking forward to our continued, productive association in 1949. Sincerely **7 A* President. THE FORTIETH ANNIVERSARY OF THE HEALTH AND WELFARE DIVISION The year 1949 is of special significance as the fortieth anniversary of the Health and Welfare Division and the visiting nurse program of the Company. This pioneer venture of an insurance company into the fields of health and welfare was initiated in 1909 through the vision and leadership of three great pioneers: Mr. Haley Fiske, then President of the Metropolitan; Dr. Lee K. Frenkel, the first Director of the Division; and Miss Lillian Wald, Director of the Henry Street Settle ment, who suggested the nursing service to Dr. ftankel. To the Officers, Home and Head Office Staffs, and to our Field Force goes our appreciation for their part in this great Company effort for the health of policy holders and the public generally throughout the United States and Canada. In this we speak confidently for all members of the Health and Welfare Division, including our Nurses in the Field. Donald B. Armstrong, M.D. Second Vice'President Health and Welfare NURSING BUREAU HEALTH and WELFARE DIVISION metropolitan urc insurance company RAISING SOME QUESTIONS ABOUT DETERGENTS AND COMMUNICABLE DISEASE NURSING Winter is here with the usual flurry of colds and other infectious diseases. For most public health nurses this means more time spent in communicable disease nursing. It also offers opportunities to share with mothers and fathers some of the newer know ledge about the transmission of cosnunicable diseases, and about preventive and therapeu tic measures for controlling them. Some parents need help in planning an immunization program for their children and in making arrangements for each child to receive his initial injections and booster doses at the proper time. Space is provided on the inside back cover of our pamphlet, COMMON CHILDHOOD DISEASES, for keeping a family immunization record. This seems the right moment, too, to discuss some of the new cleansing agents now on the market and their relation to the spread of disease and communicable disease nursing. These new substances, referred to as "detergents," "synthetic detergents," or "soapless soaps," are available uuier a variety of trade names. Although the word "detergent" means a cleansing substance and includes soap, water, and other types of cleansers, the group of products to which the term "detergent" is applied commercially has its own special characteristics. The first so-called detergent, "Qardinol," a wetting and cleansing substance with coco nut oil as a base, was manufactured in Germany in 1925, and was brought to the United States about 1930 by the Allied Chemical and Dye Corporation of New fork. Today, about 2,000 varieties of detergents are available, made mainly from vegetable oils and petroleum derivatives, through a complicated chemical process, by leading chemical and soap companies. These products are usually put out in grazular fbrm for dishwashing and laundering and in liquid form for shampoos, although a liquid detergent for household use has appeared on the market within the last year. Detergents, usually more complex products than soaps, possess some of the same proper ties, solubility in water, far example, aod cleansing action. They are high in wetting poser which enables the cleanser to penetrate the surfaoe of the article more effectively. Most of them work up a thick billow of suds but a few are nonsulsing. The latter are useful mostly in automatic washing machines where suds interfere with the mechanical operation of the machine. So far, this type has not been widely distributed. Unlike soap, they work just as well in hard water and salt water as they do in soft^ water. Water hardness interferes wlth^^ cleansing by reducing the active cleansing content of the solution. Since detergents act more efficiently in bard water than soaps do, less detergent than soap is required. Iliter hardness also is responsible for the curd or scum formed when soap is used - the cause of the streaks sometimes left on dishes after washing. A good detergent eliminates this unpleasant feature. With the aid of a good detergent, dishes can be washed, rinsed, and left to dry without wiping - and come out of it with a "sparkle." While it is not expected that these new chemical compounds will replace soap, they^fe are being widely promoted for a variety ofTM uses. Their performance with delicate fabrics it unusually effective, and they cleanse woolens in one-sixth of the t in that soap does. They are about equal for silk and rayon, and inferior for cottons, especially heavy, badly soiled cottons like workmen's overalls. They may be preferable to most soaps for baby clothes and diapers because they do not leave a deposit that may irritate the baby's skin. Since they do not streak, they are good for washing windows, mirrors, and similar shiny surfaces. Will detergents prove to be powerful instruments against the spread of disease? That is the most interesting possibility they hold out. As efficient cleansers some of Tht Quarterly uuuttin them are already making a contribution in this respect. They encourage cleanliness because they make cleaning easier and quicker. Some of them are capable of removing the greasy residue of food, breeding grounds for bacteria, from eating utensils; and they do not leave a residue of their own. Extensive experiments conducted by the Army have demonstrated the vast importance of inadequately cleaned eating utensils in the spread of disease. If detergents are * bacteria destroyers, the problems of sanitation in public eating and drinking establishments can be greatly reduced. A Proof of their bactericidal qualities is w not readily obtained. Detergents vary greatly in composition and effectiveness. Several interesting experiments have been conducted in order to set up criteria for evaluating them. Che of these was conducted by the United States Public Health Service to establish the soil-removing power of various compounds in dishwashing and laundering. A standard technique was esployed for this test, using glass slides in place of dishes and a photometer to detect and grade the amount of dirt remaining cn the utensil. Slides ware soiled with a special dirt mixture, then baked, washed, rinsed, dried, and examined. The results showed that the percentage of toil removed from the slides varied from about 5 percent for a very poor detergent to 98 percent for a very good one. A full report of this test is given in Public Health Retorts. June 14.1946, Federal Security Agency, tfaited States Public Health Servioe. The Allied Chemical and Dye Corporation has made a study of the bactericidal action of one of their products, "Swerl," with the results shown in the table below. The whole subject of detergents raises Important questions, many of which can be answered only after extensive scientific investigation. Where are detergents likely to take us in the field of communicable disease nursing? Will they revolutionize our techniques? How can we use them to the best advantage in the light of our present knowledge? So for, we do not feel justified in naldng any changes in the procedures given in Nursing Technlcuee. In time, however, we may be able to eliminate boiling dishes and linen where that is advised. Detergents seem to have some advantages for washing dishes and oertaln fabric*, especially in hard water areas, because-of their strong cleansing properties. The use for which the detergent is intended, and instructions for its use, appear on the package. By reading these directions carefully, you can find out whether the product is appropriate for the purpose you have in mind. Some persons nay develop akin allergies from using certain detergents and so it is well to try out the product before making prolonged use of it. Perhaps you have a "pet" detergent. Perhaps you know of studies on detergents made by a local firm. If so, we hope you will tell us about them. BACTERICIDAL ACTION SWERL 1-300 (ORDINARY WASHING SOLUTION) Organism Time foj Coirolete Kill Percent Organisms Killed in 5 Minutes Staphylococcus aureus Streptococcus haemolyticus Eberthella typhosa Corynebacterium diphtherias Diplococcua pneumoniae Streptococcus mastitidis 24-28 hours 0-5 minutes over 24 hours 0-5 minutes 1-2 hours 0-2 minutes 99.5 100.0 73.0 100.0 98.7 100.0 DR. LANZa RETIRES Nurses of the Metropolitan are losing a valued friend and counselor with the retirement of Dr. Anthony J. Lanza o- the first of January. For the past 23 years he has played a vital part in the welfare work of the Company. as Associate Medical Director, he has given us the benefit of his keen interest and insight on countless occasions. Re has assisted in formulating the policies of our Visiting Nurse Service as a whole, -and he has acted as counselor to our Group Nursing program. At nursing conferences in the Home Office, his wise counsel and unfailing understanding have contributed to the constructive discussions of our problems. It is not only to the Metropolitan that Dr. Lanza leaves a splendid record of achievement, but industry at large owes him a great debt of gratitude. A pioneer in his chosen field. Dr. Ienza soon recog nised the tremendous demands that would come to be made on physicians as America's Industries grew and developed. Graduating from George Washington University, he Joined the United States Public Health Service in 1907. During his 13 years with that organization, he gained experience in mass health problems which laid the ground work for his later outstanding success in Industry. For five years he was chief surgeon for the Bureau of Mines, During the next three years he was special staff member of the Rockefeller Foundation, and advisor to the Government of Australia on industrial hygiene. After that. Dr. Lanza served as Executive Director of the National Health Council and remained there until be joined the Metropolitan. His research and articles on occupational diseases - particularly silicosis - are well known. But, possibly his greatest contribution to industrial medicine resulted from his untiring efforts to expand and organize medical efforts for the worker. To this end, he devoted the major portion of his time during his service to the Company. His efforts have borne fruit from coast to coast. His was a missionary undertaking that has kept him on the road almost constantly. Dr. lanza performed outstanding service in two world wars. During World War I, he served as surgeon in charge of industrial hygiene, Ikited States Public Health Service. During World War II, he was commissioned a Colonel In tbs Medical Corps of the Ohited States Army. And from 1942 to 1945 he was Dlrsetor of the Division of Occupational Health, Preventive Medicine Service,-in the office of the Surgeon General. For his distinguished service during this period he received the Legion of Merit and the Knudsen award,. It is with deep regret that we announce the retirement of Dr. Lanza, His unfailing T.isdom and kindnsss have left an imprint which will never be forgotten on all who had the privilege of working with him. We have one consolation. Dr. Lanza's great experience and talents will not be lost to the industrial medical field. He leaves us to continue his work as Director of the Institute of Industrial and Social Medicine, New York University-Bellevua Medical Center. And In this undertaking, the good wishes of us all follow him.' THE PRENTISS AWARD TO DR. ARuiSTRONG At a luncheon in Boston of the Health Education Section of the American Public Health Association, of which Dr. Armstrong was chairman during the past year, he was given the fifth Elizabeth S. Prentifs Award which was established by the Cleveland Health Museum In 1943 for encouragement of more and better work in the field of health education. Dr. Armstrong was given the Award for his maqy surveys and studies, his leadership in rational health and safety organizations, and his work as director of the health and welfare services of the Metropolitan Life Insurance Company. Dr. Armstrong accepted the Award on behalf of the thousands of his coworkers and Company personnel who have carried on health education in collaboration with him. 7he Quarterly Bulletin page five METROPOLITAN NURSES AT THE AMERICAN RJBUC HEALTH ASSOCIATION CONVENTION Metropolltan Nurses who attended the Aaerleaa Public Health Association meeting in Boston were entertained at a tea on the 9th of November at the Statler Hotel. They had the opportunity of meeting Dr. and Mrs. Armstrong, and other members of the executive staff of the Home and Heed Offices. Nurses who attended were: Miss Henrietta N. Bonheyo Miss iferion Coggeshall Mrs. Elizabeth M. Donahue Miss Susan F. Hurst Mrs. Iferle H. Quinn .Malden, Mass. Miss Ifery L. Danahy.....................Newport, R. I. JMrs. Ifcry R. Corcoran *\ ...Attleboro, Mass. Miss Ruth C. Itorphy Students Mtimrpa College Miss Clare Blanchard...............Atlanta, Ga. Miss Esther Darning......... Glovereville, N.I. FIFTEENTH *KNUAL MEETING OF THE NURSING ADVISORY COMMITTEE The 15th annual meeting of the Nursing Advisory Committee of the Metropolitan was held under Dr. Armstrong's chairmanship in the Home Office on November 16, 1948, with representation from the Pacific Coast, Canadian, and Eastern Office Territories. Dr. Dublin expressed enthusiasm over the cost study of the National Organization for Public Health Nursing and recommenda tions were passed to the organization regarding its future implementation. The Committee approved the following: 1. Questionnaires to be sent our Salaried Nurses regarding Standing Orders. 2. "Criteria for Metropolitan Life Insure ance Company Affiliation with Health Departments."3 3. A proposed study of Metropolitan Nursing Service in combined agencies. REGIONAL CONFERENCES ON MATERNITY During September, October, and November Judith Wallin, Territorial Supervisor for the Great lakes Territory, took a swing through the eastern area giving two-day conferences on the subject of "Important Aspects of Public Health Nursing Service in a Maternity Service." The meetings were held in Boston, Pittsburgh, Columbus, New (Means, Ifenphls, Nashville, Harrisburg, and Albany. Approximately 125 Jfetropolitan Nurses were present at these conferences. Testimonies .of their excellence have been pouring in. Uisa Frances Murray of Middletown, Ohio, put in her notes sentiments frequently expressed by others. She wrote,"I would like to take this opportunity to thank you for inviting me to attend the Maternity Institute at Columbus, Ohio. For a long time I have felt that an improvement was needed in prenatal visits. The conference was a real answer ... I have obtained a new approach on all my visits and find patients and doctors quite interested in talking about it ... I discussed the book and book list with our local librarian. Dr. Grantly Dick Read's book "Childbirth Without Fear" is to he put in the library ... the whole conference fills me with renewed enthusiasm and new facts with which to make prenatal visits mich more interesting to patients and nuras." IN MEMCRIAM Cta September 12 Miss Nellie Irens Price, aged 51, formerly Staff Nuras in Frederick, Ml., passed away. She had been off duty due to Illness since June 1947. Miss Price was appointed to the Nursing Service November 1, 1927, and spent all her years of employment with the Company in Frederick. Her years of work were marked by a consistently high standard of service to patients and families. Sm was beloved in the community, and in time of trouble people called i&ss Price for help and guidance. Our synpathy is extended to her friends and relatives. V RECENT DEVELOPMENTS IN THE CARE ND TREATMENT OF BRUCELLOSIS By William J. McConnell, M.D., Assistant Medical Director Brucellosis, or undulant fever, named from the undulating, wave-like temperature curve commonly found in acute cases, is a communicable disease which is transmlssable from animal to man through direct contact with Infected animals, particularly cows, sheep, goats, and swine, or their freshly killed carcasses; and by the ingestion of unpasteurized milk or the milk products from infected cows and goats. There is some .evidence that the disease in man may also result from inhalation of the organisms in contaminated dust. It- is generally believed that the disease is rarely transmitted from human to human. The organism responsible for the disease was first discovered in 1887 by Sir David Bruce who rested it Micrococcus melitensis. Later, in honor of Sir David, this and other organisms of the same family were given the family name of Brucella. The Micrococcus melitensis was renamed Brucella melltensie. and is found largely in dleeased goats or their products. In 1917, Alice Evans, a bacteriologist in the United States Department of Agriculture laboratories, found that Brucella melitensis and the Bang bacillus, which caused abortion in cows, were practically identical and that people who drank raw oow'a milk from infec ted cows developed the disease. In recog nition of its family resemblance to Brucella melitensis, the Bang bacillus was ranamed Brucella abortus. Still a third organism found in swine, which closely resembled the others, and which was capable of causing the Illness, was named Brucella euis. Brucellosis is closely associated with oc cupation and its Incidence la highest among packing plant employees, livestock producers, veterinarians, and fhrm workers. Epidemics have been traoed to the use of raw milk and cre&m in certain sections of the oountry, but among urban residents who are supplied with pasteurized dairy products the inci- "'Jordan, Carl F. BRUCELLOSIS IN INDUSTRY, Industrial Medicine. 17:176-180, May 1948. dence is low. Jordan0' assembled during the period 1940-1946, through Iowa physicians, a series of 2,405 case reports in which 75 percent gave a history of direct contact with farm anioals prior to onset of symptoms. An acute attack of the disease is charac terized by an intermittent type of fever, chills, sweating, abdominal discomfort, and weakness. In the chronic type, the patient may experience no fever or only a slight rise in temperature in the afternoon. The most frequent symptoms are headaches, light headedness, nyalgla, neuralgia, digestive disturbances, and fatigue. The disease is A usually one of long duration with a variable ^ clinical course. The tissue reactions due to Brucella organisms have been reviewed in detail by Spink, and demonstrate the constancy with which Brucella invade the spleen, liver, bone marrow, and lymph nodes. The compli cations of the disease reported by Spink include destructive ossecus lesions, subacute bacterial endocarditis, encephalitis, and grossly suppurative lesions. The disease is quite often difficult to diagnose, especially in eases of the chronic type. Perhaps the moat reliable criteria are history of the patient, clinical signs and symptoms, and laboratory procedures. The moat important of the latter is the isola tion of Brucella from the blood by cultural methods. This method also aids in the identification of the organism and its probable source in cattle, goats, or swine. The agglutination reaction when the titer is 1 to IX or higher is another laboratory procedure employed. However, these agglu tinins may not be specific for the Brucella organisms, and blocking antibodies may cause negative agglutination tests. Intradermal tests, using Brucella antigen, is the least reliable diagnostic procedure. Those who "Spink, Wesley W. FATHOGENESIS OF HUMAN BRUCELLOSIS WITH RESPECT TO PREVENTION AND TREATMENT. Annals of Internal Medicine. 29:2, 238-258, August 1948. have had as old infection in the past also show a positire skin reaction. These procedures often give negative results in cases of chronic brucellosis. The control of human brucellosis is dependent upon eradication of the disease from domestic animals and the pasteurization of milk and all milk products consumed. Scientists have discovered measures which are effective against the disease in animals and if these are properly organized and used it is believed that brucellosis may be con trolled in animals just as efficiently as was tuberculosis. So far, no dependable methods of immunisation against the disease for man are known. Specific treatment for this disease has Dot been very satisfactory up to the last decade. In 1936, Carpenter and Boakmwho critically reviewed the therapeutic methods, including vaccine therapy, used up to that time, concluded that a successful method for the treatment of brucellosis still awaits development. With the advent of the newer chemothera peutic and antibiotic agents #iich have proved so effective in many diseases of bacterial origin, a number of studies have been made by different groups of investi gators to determine their effectiveness in the treatment of brucellosis. The sulfonlmlde compounds were found effective in some oases of acute brucellosis but in others the cultures remained positive after a period of treatment, and relapses occurred. Huddleston"'treated successfully four patients suffering from brucellosis by administering reduced doses of the sulfcnindd# drugs in combination with natural whola blood or plasma. His theory is that reduoed Carpenter, C.M., and Boak, R.A. THE TREAT MENT OF HUMAN BRUCELLOSIS. Medloine 15, 103-127, February 1936. I.F.Huddleston, COMMUNICATION TO THE FOURTH INTERNATIONAL CONGRESS FOR iCCRO- BI0L0GI. Copenhagen, July 1947. doses of the drug (sulfadiazine or sulfe mora sine) added to the blood or plasma destroys the organisms by increasing the action of the antibodies. live, Sperling and Stubbs</>found streptosyein therapy effective in protecting guinea pigs experimentally infected, but with the exception of a few Instances, results have been generally unfavorable in the treatment of human beings. The simultaneous use of sulfadiazine and streptomycin proved to have a much more effective action on Brucella organisms than either drug alone. Eisele and McCullough14'* * reported a case of brucellosis so treated and noted a striking clinical improvement and abrupt abatement of fever. During a 17 month period of observation, the patient remained well and without relapse. Pulaski and Amspacher17 reported favorable results in three eases of brucellosis treated with the combined use of sulfadiazine and streptosycin. other investigators have reported favorable results in both acute and chronic cases. A group^'from the Division of Inter nal Medicine, University of Minnesota, recently reported on a series of brucellosis oases treated during the past 10 years by sulfonidde compounds and. streptomycin alone and oomtalned, and found the combined admin istration of sulfadiazine and streptomycin <r>Uve, J., Sperling, F.G. and Stubbs, E.T. EFFECT OF STREPTOMYCIN ON EXPERIMENTAL BRUCELLOSIS IN GUINEA FIGS, American Journal of Medical Scienoe. 211s 267, March 1946. Hlsele, C. Ties ley and McCullough, Norman 9. COMBINED STREPTOMYCIN AND SULFADIAZINE TREATMENT IN BRUCELLOSIS. Journal of the Medical Association. 135: 1053-1055 (December 20, 1947) HilaaML, E. J. and Amspacher, W.H. STREP TOMYCIN THERAPY FOR CERTAIN INFECTIONS OF INIESTIKAL ORIGIN, New England Journal of Medicine. 237 419 (September 18, 1947) Spink, He slay 1., Hall, Wendell H., Ssaffer, uses M. and Braude, Abraham I. HUMAN OJCELLOSIS, Journal of the American Medical .sociation. 136: 332-387 (February 7, WW ClgAl 7/> Quarttrly Builttin to be acre effective than aqy other therapy used to d&te. While these investigators recommend for the present that streptomycin be administered intramuscularly in doses of 0.5 gm. every six hours for seven days, and therapy with sulfadiazine be initiated simultaneously with an oral dose of 4 gm. and then 1 gm. every four hours for at least two and preferably three weeks, they are of the opinion that the options dosage schedule has not been determined with certainty. They further believe that investigations on other antibiotics going on at tha present time, may bring forth other agents more -effective against the Brucella organisms. Spink has recently reported on the con* timotion of these studies (now 17 patients both acute and chronic) and believes the following conclusions appear Justified: A. The clinical course of both acute and chronic brucellosis is shortened by the com bination of streptomycin and sulfadiazine. g. The combination is effective against such complications of brucellosis as subacute bacterial endocarditis and spondylitis. . Optimum doses remain to be worked out, but at present it is recommended that 0.5 gm. streptomycin be given intramuscularly every six hours for two weeks (one week longer than that recoinmndad in the Initial report), at the same time that therapy with strepto mycin is started, 3 to 4 gm, of sulfadiasine should be administered orally, and then 1 gnu every four hours for a total of two weeks. ANNOUNCEMENT Miss Marie L. Johnson, Assistant Director of the Nursing Bureau, has been made the Nurse-Member of the Comaittee on Adminis trative Practice of the American Public Health Association, succeeding Miss Marion Sheah&n. CONGRATULATIONS.' Miss Mary Dickerman, retired, was married to Mr. Louis Sayer in New York, October 30, 1948* Best Wishes! THE GOAL 0? THE GROUP NURSING PROGRAM By Beroardins Striagel, Group Nursing Consultant A program my fall short of success not because of lack of interest or activity but because the activity is started before the ultimate goal is determined and plans are formulated. A Group Nursing program can be no exception, so before starting the Group Nursing activities for the coming year, each Metropolitan Nurse might ask herself "What is the goal of my Group Nursing program and how can 1 best *-urk toward it?" The answer, of course, to the first part of the question is "The goal of my Group Nursing program is to reach promptly all those Group-insured employeem who need and want professional home nursin^P care, treatment, or instructions so that I may give them the kind and amount of service which will be most helpful." The answer to "How can I best work toward my goal?" can be found by questioning your self further and by taking those steps that your answers indicate are necessary. Ask yourself: 1. Is my Group file (Forms N.S. 125 G.2) complete and up-to-date? 2. Do I have a record (Fora N.S. 125 G.3) of when and how such service has been used by these firms? 3. Has every firm in ny area with 50 em ployee e or more been visited within the past year? 4. Have those firms with fewer than 50 employees been visited within the past five years? 5. Does management in all these firms uierstand the purpose and scope of the service, the philosophy of the "Five-Point Plan," the local Nursing area, etc,, and has a definite procedure for using the service been adopted? 6. In between visits, has management been told when a good case has been closed, or when a case has not been referred for a long time? The Quarterly Bulletin Thu first step in arranging a wellfornulatad plan has been taken when a review of reports and Group files is com pleted. Assuming that the Group list (Forms N.S. 125 G.2) aid Nursing Experience Record (Form N.S. 125 G.3) are compete and up to date, the seoond step in making a definite plan is to determine which firms should be . visited. Then study your year's plan of activities for your total Metropolitan Service, and incorporate into it the pre posed visits to these firms according to your total case load, as well as to the size and needs of the fizms. As you know, it is not always possible to adhere to your year's plan rigidly, but it is a basis for the efficient administration of your program. With a defined goal and a written plan, the third step is to review such Group Nursing materials as "Essentials of the Group Nursing Program" and "Our Group Nursing Program" and then to think through carefully what you want to acconplish on a specific visit to a firm. For each fin you will want to review the content of your last visit, your experience with the firm and the employees since that visit, aid then to consider what new message you wish to add. This new message could be an emphasis on certain parts of the FivePoint Plan, or on the use of the employee educational materials, or on the value of a certain type of service. Finally, it would be helpful to susmarize, at least in written outline fbrm, what you feel the total content of this specific visit should be, so that during the interview you can be concise and accurate. With this background of preparation, you would then call the person whoa you wish to see, and tell him who you are and why you want to call on him. Early in the visit it is wise to determine how much that person understands about the service, and if he has any present plans of using it, (just as in home visiting you start with the person's present understanding and go on from this point.) At the conclu sion of this visit, the important agreements and plans would be briefly sumerized. When each of the Group-insured firms within your Nursing area understands ths purpose and scope of our service, and has established procedures for it, there will be ouch less concern about the question "How many eases and visits should I expect from the Group-insured firms in sy area?" We know that if management of each Groupinsured firm is reminded of the service at proper intervals, and if each firm in turn reminds the employees of it at the time of lllnes?, we need not worry about the ease and visit volume. Under these circumstances we would know that our volume, whatever it is, is meeting'the professional home nursing needs of the individual employee and that, after all, is our ultimate goal. COMING EVENTS Social Hygiene Day - February 2, 1949 Themes Not announced yet. Company Nurses may receive a special announcement. National Heart Week - February 7-13, 1949 Themes "Open Tour Heart." Local chapters of the American Heart Association will have their own campaign naterials and plana which will be synchronized with those of the ziational association. Cancer Month - April 1949 Themes "Cancer Can Strike Anyone - Give to Conquer Caneer," During April, the American Cancer Society will conduct a campaign to raise finds to combat oancer. ASSISTANT EDUCATIONAL DIRECTOR APPOINTED The Quarterly Bulletin welcomes Miss Anna Elizabeth Moors as the Assistant Edu cational Director of the Nursing Bureau. Miss Moore comes to the Company with experience on both staff and supervisory levels in visiting nurse work. She received her B.S. degree in public health nursing from New lork University in Fsbruary 1946. She will assist in tha staff education activitias of the Nursing Bureau aid will be largely responsible for the editing of the Quarterly Bulletin. I h* (Jtiar ter ly Bull * t II) 1 JST WISHES FOR IISS ECU. ANDERSON was appointsd to th Laaksville-Spray, N.C., Service July 1, 1926, and retired January 1, 1949, from Durham, N.C. She also had service in Union City, N.J., and Roanoke, Va. kiss Anderson had a gift for improvisation and provided a description of spiral dressings which was published in the Quarterly Bulletin. She - was active in State nursing affairs and was a frequent speaker at the local school of nursing. MISS SARAH RARDGN started her Metropoli tan career November 15, 1928 as a .Staff Burse in Cincinnati, Ohio. In 1936 she became Head Nurse in Cincinnati and when our service was affiliated with the visiting nurse association in 1941, aha became Head Nurse in Newport, Ky., from which position she retired November 1.6, 1948. patient as followsi "She is still that capable, efficient, and friendly Nurse that one enjoys having come in." MISS PEARL HOFFMAN, who was appointed to the Bellevue and Dayton, fyr. Service February 6, 1928, retired November 2, 1948. Miss Hoffman had a splendid attitude toward supervision, was much interested in the teaching of mtrltion, and developed con siderable skill in making ease studies. Patients often expressed appreciation because she was "kind, thoughtful, and gracious." On October 20, 1922, a new Territorial Supervisor, UISS CAROLINE U. HIDDEN, was appointed to the Keystone Territory now known aa Penn State Territory. Idas Rardon participated in professional nursing affairs, conducted classes in home care of the sick, and completed the American Red Cross first aid course. She was a gentle leader of her Staff and sat high standards of service. A local doctor said of her, "She is a wonderful nurse, very thorough in her work. I wish there were more nurses like her." MISS IRENE E. DUPFT came to the Metro politan February 15, 1928 as a Group Nurse in Chicago, 111. She also served in Oak Park, 111., and finally in Battle Creek, Mich. Ides Duffy maintained the goodwill of Agents and policyholders. One of her patients wrote."I do not know how I could have gotten along without her. The family and myself did appreciate her kindness." MRS. KAIHRZN D. BICKHAM spent her entire Metropolitan service in St. Louis County, Mo. from May 1, 1930 to November 1, 1948. Her high standards of patient cere were revealed by an excellent paper she gave at a staff meeting on "Objectives of a Nursing Visit." Appreciation was expressed by one With her snappy, laughing brown eyes, and gracious manner, Miss Hidden quickly won a'plaoe for herself with Nuraes, Super visors, and Field-Men. During the years, she hat served chiefly along the Atlantic coast in the Metropolitan and Atlantic Coast Territories. In 1936, at her own request, she was assigned to a nontravel ing position as Director of the Queens Nursing Service in New Tork where she^ stayed until 1942 when she was transferre<^P to Towson, Md., as Local Field Supervisor. Miss Hidden was always an enthusiastic and helpful Supervisor. She was interested in both administration and staff education, and served actively on many community committee a in Queens, New York, and in Towson, Md. Frequently letters of appre ciation were received from eoworkere, health officers, and directors of publio health nursing thanking the Company for Ulss Hidden's helpful and cooperative services. Cb Dscaaber 5, 1942, lfiss Hidden's retire ment data arrived, and she left to make her home in her native State, California, Our best wishes far usny happy years go with her. i IB N 1 HEALTH PROGRESS. 1936 to 1945 - A Supple ment to Twenty Five Years of Health Progress. Louis I. Dublin, Ri.D., Metropolitan Life Insurance Company, Nev fork, 1948. Dr. Dublin has brought up to date his original volume on the mortality experience among Metropolitan Industrial policyholders with a valuable supplement which reflects many of the advances Bade in public health during the last 10 years. Public health nurses in particular should find cause for reflection in the following statement quoted from the chapter on the principle ccaummlcable diseases of childhood. "Measles, scarlet fever, whooping cough, and diph theria, which, only a few decades ago exacted a heavy toll of child life have now been reduced to vanishing proportions as a factor in mortality." And again in the chapter on maternal mortality "the campaign to reduce the hasards of childbearing has been eminently successful in the past decade,* due in part to the efforts of public and private agencies which "have provided large numbers of public health nurses to render services in the homes of pregnant women and to educate them regarding approved practices of prenatal care and confinement." his community. It considers all phases of public health from the opening chapter Publio Health and the Practicing Physician to such sections es environmental sanitation, com municable disease control, maternal and child health, heart disease, and mental hygiene. It is e book for everyone who is interested .in public health and is highly recommended to public health nurses who play such an important part in the movement toward better health for all people. THE SOCIOLOGY OF CHILD DEVELOPMENT James S. Boss&rd. Harper, New York, 1948. This book, written by one of the best known sociologists in the United States, presents e different approach to the factors end problems involved in child development. Its emphasis is primarily on the social ituatioaa which confront the child from infancy to maturity. It discusses such factors in the child's family background as the relations of the children among themselves, the cultural background of the parents, and the parent-child relationships. It is an important book for a public health nurse or aiyone who is concerned with the welfare of children. ESSENTIALS 0* PtTRUC HEALTH - William P. Shepard, M.D.; Charles E. Smith, MD. j Rodney R. Beard, M.D.; and Ison B. Reynolds, J.B. Lippineott, Philadelphia, 1948. This excellent text, written by our own Dr. Shepard in collaboration with three men associated with him at Stanford Universi ty School of Medicine, is an important and timely contribution to public health. A clear* ly written condensation of the principles of public toalth, it is intended primarily for the use of physicians and medical students to emphasize the relationship of the general practitioner to public health problems in NURSING FOR THE FUTURE - A report prepared for the Rational Nursing Counoil. Esther Ludle Brown, Ri.D, Russell Sage Foundation New York, 1948. The enthusiastic reoeptlon accorded this report not only by leaders in the nursing profession, but also by leaders in the medical, publio health, and hospital fields, testifies to the Act that this is one of the most important books of recent years in the nursing field. Here is no dry report, but a challenging voice asking the professional worker and i page twelve The Quarterly Bulletin layman alike to view nursing service and nursing education in terms of what is best for society - not Just what is best for the profession of nursing as a possible "vested interest." It is rare to find a professional group thus "taking stock." Such self-questioning represents growth, whether in an individual or an organization, and as Dr. Richard Cabot once wrote, "One faeet of this growth is internal honesty, the impulse which turns our faoes to the light and pushes for more ... self questioning is like the draft of a furnace. It quickens the fire of living thought." BE SURE TO READ THESE: 2URatjjlaxions 25 Years of Service Mary A. Clifford........................... Auburn, N.I. Edna Lynch....Mount Royal, Montreal, Can. Octavie Prefontaine.. ..McGill, Montreal, Can. Jtyrtle A. Springer. ...Los Angeles, Calif. 20 Years of Service Mary G. Andrews...................... .Atlanta,Ga. Anna M. Currier.........................................Camden,N.J. Malsie Dwight..................Los Angeles, Calif. Sarah 7, Fahey.............. .....Bloomsburg, Pa, Eva Jackson............................ Richmond, Calif. Genevieve Olesiewicz..............................Camden,N.J. Dorothy C. Owen...................................... Atlanta,Ga. Eva Schultz....................................... Gary, Iai. Martha P. Shelinsld..............Aft. Carmel, Pa.^fe Germaine Tessier................Quebec City, Can.TM THE HBgPIflSIA PATIENT AS A PERSON - Dorothy Uoore, R.N. Public Health Nursing, October 1948, page 511. 15 Years of Service Isabella Johnson........... Los Angeles, Calif. Iona Reah............ .............Los Angeles, Calif. PARENTS AS TEACHERS - A Guide fbr Parents of Elementary School Children. Prepared by Com mittee on Baotional Stability of the Metro politan School Study Council. Teachers Collegs, Columbia University, New York, 1947. A PROGRAM FOR THE NURSING PROFESSION - Eli Ginsberg, M.D. Macmillan, New York, 1948. 10 Years of Service Mary Lower........................ Bakersfield, Calif. 5 Years of Sarvioe Jean Aubrey................... Los Angeles, Calif. Ruth Murray.............. ..Los Angelas, Calif. Nursing Office Clark LEAVES OF ABSENCE FOR STUDY Alice Contois.................................... .....Montreal, Qua..............................University of Montreal Appoline Coursol.........................................Montreal, Que............................. University of Montreal Regina Stroch.................................... Wheeling, West 7a....................................... Cathollo University THE QUARTERLY BULLETIN METROPOLITAN LIFE INSURANCE COMPANY 1 MADISON AVENUE NEW YORK 10, N. Y. See. J62, P.LtR. U. S. POSTAGE PAID Lorclilaad City l.N.Y. Permit No. 7 rwtMTto M UJJL V