Profiles in Caring:

Lillian D. Wald

1867 - 1940

Nursing is love in action, and there is
no finer manifestation of it than the care of
the poor and disabled in their own homes


Lillian D. Wald was a nurse, social worker, public health official, teacher, author, editor, publisher, women's rights activist, and the founder of American community nursing. Her unselfish devotion to humanity is recognized around the world and her visionary programs have been widely copied everywhere.

She was born on March 10, 1867, in Cincinnati, Ohio, the third of four children born to Max and Minnie Schwartz Wald. The family moved to Rochester, New York, and Wald received her education in private schools there. Her grandparents on both sides were Jewish scholars and rabbis; one of them, grandfather Schwartz, lived with the family for several years and had a great influence on young Lillian.

She was a bright student, completing high school when she was only 15. Wald decided to travel, and for six years she toured the globe and during this time she worked briefly as a newspaper reporter.

In 1889, she met a young nurse who impressed Wald so much that she decided to study nursing at New York City Hospital. She graduated and, at the age of 22, entered Women's Medical College studying to become a doctor.

At the same time, she volunteered to provide nursing services to the immigrants and the poor living on New York's Lower East Side. Visiting pregnant women, the elderly, and the disabled in their homes, Wald came to the conclusion that there was a crisis in need of immediate redress. She dropped out of medical school and moved into a house on Henry Street in order to live among those who so desperately needed help. In 1893, she organized the Henry Street Settlement, otherwise known as the Visiting Nurse Society (VNS) of New York. The VNS program became the model for similar entities across America and the world.

Wald began with 10 nurses which increased to 27 by 1906 and to 250 nurses serving 1,300 patients a day in 1916. During this same time frame, the budget increased from nothing to $600,000 a year -- all from private donations. Wald was a fund-raising genius, but the program was also so good and so helpful that it attracted volunteers and contributors.

Wald and her colleagues visited the poor and the forgotten in their five-story, walk-up, cold-water flats. They helped educate residents about germs, about how diseases are transmitted, and stressed the importance of good personal hygiene. They provided preventive, acute, and long-term health care. So successful was the program that it was expanded to include assistance with housing, with employment, with education for exceptional and retarded children, as well as recreational activities.

But Wald's innovations did not stop with the VNS. She persuaded the New York Board of Education to hire a nurse for the first time; not long thereafter, all schools in New York and elsewhere found it mandatory to have a nurse on duty during school hours. She persuaded President Theodore Roosevelt to create a Federal Children's Bureau to protect children from abuse, especially in the form of improper child labor. She lobbied successfully to change the divorce laws so the abandoned spouse in a marriage could receive compensation in the form of alimony. She helped form the Women's Trade Union League to protect women and prevent their having to work in "sweatshop" conditions.

Wald was also a suffragist who worked to secure the right of women to vote and supported her employee and protégé, Margaret Sanger, in her battle to give women the right to birth control. She fought for peace, leading several marches in protest of World War I. But when war became inevitable, she pitched in to do her part as Chairman of the Committee on Community Nursing of the American Red Cross. She also helped chair the Red Cross campaign to wipe out the influenza epidemic of 1918 and represented the U.S. at International Red Cross meetings.

Wald also took on major industries, lobbying for health inspections of the workplace in order to protect workers. She tried to persuade corporations that protecting the health of their employees made good business sense. She encouraged them to implement preventive medicine and to have nursing or medical professionals on the work site at all times.

Another of her major achievements was persuading Columbia University to appoint the first professor of nursing at a U.S. college or university. Until that time, nursing had been taught in hospitals and consisted largely of supervised work experience. Thanks to Wald, most nursing education now takes place in universities, augmented by practical experience in a teaching hospital.

By the time she reached her fifties, Wald began to receive some of the recognition that she deserved. In 1922, she was named in the New York Times as one of the twelve greatest living American women. Ten years later, in 1932, she was chosen by historian J. Addams as one of the top twelve American women leaders in the past century. In 1936, she received the Lincoln Medallion and was proclaimed the Outstanding Citizen of New York.

Wald died on September 1, 1940, but her legacy lives on in the institutions she helped build. The New York VNS has not only survived but prospered. In the 100 years since Wald gave it birth, the number of employees has increased from 10 to 3,000; the budget has increased from zero to more than $270 million a year; and the number of people served has increased from 50 a day and 18,000 a year to 2,000 a day and 700,000 a year. The number of visiting or community nursing programs during this same time frame increased from seven to more than 13,000 today.

Wald chose never to marry, but she has thousands of progeny today in the form of home care nurses, therapists, and aides who were motivated to follow in her footsteps. "Nursing is love in action," said Wald, "and there is no finer manifestation of it than the care of the poor and disabled in their own homes."


Profiles in Caring

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