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No Place Like Home: a History of Nursing and Home are in the United States.

by Karen Buhler-Wilkerson, PhD, RN, FAAN; Baltimore: Johns Hopkins University Press, 2001; 293 pages, $48.00

Buhler-Wilkerson's historical account provides a sense of the struggles and honor in the changing role of the home care nurse. With photographs of nurses interacting with patients, at home, dating from the early 1900s to the 1970s, history comes alive.

The reader learns that white and black nurses had many unique challenges in performing their duties. An account of how home care nursing was practiced along racial lines in Charleston, South Carolina, through the Ladies Benevolent Society, and Philadelphia, Pennsylvania, through the Visiting Nurses Association, indicates that strict social guidelines dictated who received care from whom.

One of the most interesting stories is that of the evolution of Lillian Wald's Henry Street Settlement in New York City. The author explores Wald's work with the Metropolitan Life Insurance Company (MLI) with regard to reimbursement for home care. MLI used the "nurse's judgement" as a factor as to whether or not nursing care was efficient and effective. It identified good professional judgment as follows: "a case involved the requisite number of visits, suitable nursing treatment, and quick disposition in the best interest of patient and family."

The book moves to the period after World War II, when the role of the visiting nurse associations was redefined due to expansive growth and funding deficits. MLI's involvement in home care was far greater than had been predicted. As people experienced the long-term effects of chronic illness, both MLI and Blue Cross conducted studies that found that home care nursing offered dramatic savings over longer hospital stays and the option of no home care services. The real fiscal problem came about when underwriters and other insurance companies would not comply with the logic of these studies and would not fund home care.

Just as agencies were facing financial ruin, Medicare came on the scene. A government-sponsored program would mean a new era for home care agencies that had difficulty staying solvent. Money was finally available to care for those who really needed the assistance.

Unfortunately, the passage of time led to the realization that funding can decrease and services can be denied. The prospective payment system was introduced, along with current limitations that would have seemed absurd to the women whose story is told in this book. The current system is described as one that is straining the seams of every home care agency still in operation.

Never before has the need for home care to be truly valued as cost-effective, cherished nursing care been so great. Those who make fiscal decisions could learn quite a bit by reading the history of home care in these pages. This book would be helpful for any nurse, but especially the discouraged home care administrator who may need to see that struggles have been inherent in home care's past and that the fight must go on.

reviewed by Carolyn McKenzie, MSN, RN, doctoral student and clinical assistant professor, University of North Carolina at Chapel Hill School of Nursing
COPYRIGHT 2003 National League for Nursing, Inc.
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2003 Gale, Cengage Learning. All rights reserved.

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Author:McKenzie, Carolyn
Publication:Nursing Education Perspectives
Date:Jan 1, 2003
Words:506
Previous Article:2002 Index: Nursing Education Perspectives volume 23, numbers 1-6.
Next Article:Complementary/Alternative Therapies in Nursing.


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