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From the Editor

FROM THE EDITOR - Home Nursing in 1920


Dear Readers,

Browsing in a used bookstore, I came across a copy of Nursing in the Home by Lee Smith M.D. published in 1920.  The first page alone made me thankful to be a nurse in the 21st century! The author offered advice on mattresses for the sick room – a hair mattress should be covered with a cotton ticking, and in the case of a fractured hip, a second hard mattress filled with straw should be placed under the hair mattress to prevent sagging.  A straw mattress was also recommended when the patient had a contagious illness so it could be burned afterward to prevent transmission of the disease. 

A total of twenty different therapeutic baths were described, including: acid, alkaline, iodone, sulphur, and spirit-vapor baths. I don’t know who I feel sorrier for – the home nurse of 1920’s who had to administer a Russian Bath, or the patient who was subjected to it! Hot vapors were applied, followed by a plunge into cold water.  Thought to be therapeutic for those with rheumatic diseases and “nervous affections”, I think it may have also produced some “nervous affections”.

Have you ever wondered why some of your older patients seem to be obsessed with daily bowel movements? Wonder no more. Dr. Smith blamed constipation for “nine tenths of all human sickness including jaundice, torpid liver, pimples, nightmares, drowsiness, and depression.  “...constipation is the indirect cause of many fevers and other dangerous diseases, because poisonous germs are not carried off, but remain to be taken into the circulation and the system” (p. 408). To cure chronic constipation, he recommended that the patient be given “Dr Pierce’s Pleasant Pellets” every morning.

Nursing in the Home was published a few years before the discovery of insulin, so diabetes was described as a wasting disease, although there was a beginning recognition that diabetes was different for older than younger patients: ”But fat old people, or middle aged people, often live for many years if proper care and treatment be taken” (p. 412) Proper treatment was described as high frequency electrical currents, which was thought to affect metabolism.

The sick room was to be filled with sunlight. The home nurse was advised to choose a light airy room with hard wood floors for the sick room. If only carpeted rooms were available, the carpet was to be covered with tealeaves and vacuumed daily (by the nurse of course). 

Dr. Smith also had words of advice on the characteristics of a good home nurse.  She should be:

 …attentive to the requirements of the physician and patient for she sustains an  intimate relation to both. The nurse must be kind but firm, and not yield to such  whims of the patient as may be detrimental to recovery; neither must she arouse  dislike or anger by opposition, but endeavor to win the patient from all delusions.

The nurse should possess an inexhaustible store of patience. … The nurse should always be cheerful, look on the bright side of every circumstance, animate them with encouragement, and inspire them with hope. … The nurse should possess moral principles, which alone can win the confidence of a patient. She should have judgment, circumspection, intelligence, forethought, alacrity carefulness and neatness. In a word, she should exercise common sense (p. 38)

To sum up Dr. Smith’s opinion of the contribution of nursing to patient outcomes he stated:

“Success in the treatment of the sick requires good nursing. Without it, the most skilled physicians fail to effect a cure; with it, the most unqualified may success.” (p. 36).

Wouldn’t we all agree? To see Dr. Smith’s “Don’ts for Young Nurses,” see below.


Best regards,

Maureen Anthony, PhD, RN



Smith, L. (1920). Nursing in the home. World’s Dispensary Medical Association: Buffalo, NY




Home Health News

The Home HealthCare News offers up-to-date information that we want you, the subscribers of Home Healthcare Nurse to know about and soon! These may be government initiatives, web sites with important information, new publications, and more! If you know of an item that might fit this section e-mail Ryan Brophy at ryan.brophy@wolterskluwer.com.



Call For Manuscripts

Home Healthcare Nurse, a refereed journal, is published 10 times/year. The goal of Home Healthcare Nurse is to bring up-to-date and practical articles to home healthcare and hospice providers. All manuscripts undergo review by the editor and members of the journal review team. Manuscripts should be original work. Topics include practice-oriented clinical topics, literature reviews, manuscripts that describe quality improvement projects, innovations or new approaches to patient care, and case studies.
Query letters are welcome but not required.  Email the editor at HHNEditor@gmail.com
Manuscripts should follow the guidelines of the Publication Manual of the American Psychological Association (APA) 6th edition.

Hospice & Bereavement Conference

The Art for Charlie Foundation is convening Michigan’s first-ever Pediatric Hospice and Bereavement Conference on Saturday, Nov. 1 in East Lansing.

Registration is $35, which includes breakfast and lunch, to attend the full day of sessions. 

Accommodation for the Friday and Saturday night is available at special rates at the Marriott at University Place, East Lansing through the link on the Art for Charlie website.

Please visit the website or email info@artforcharlie.org for more information.

Omaha System

The Omaha System International Conference will be held in Eagan, MN April 15-18, 2015.  The conference is held every two years and is intended for individuals who use or intend to use the Omaha System in  health practice, education, research, or inclusion in IT documentation system.

Guidelines for submission of poster abstracts and details regarding workshop registration can be found at www.omahasystem.org/conferences.html.

Poster abstracts are due 1/31/15 with notification sent by 2/28/15. 

Email abstracts to lchoromanski@gillettechildrens.com.

Maureen Anthony, PhD, RN

ISSN: 0884-741X

Online ISSN: 1539-0713

Frequency: 10 issues / year

Celebrating Diversity

To comemmorate the 100th anniversary of Abington Memorial Hospital and the Dixon School of Nursing, read the May 2014 supplement celebrating diversity among home healthcare nurses and interdisciplinary staff.