“Miss Bailey Says…” – Practical Advice for Relief Workers in the 1930s #5

Introduction: In the depth of the Great Depression, the March 1933 issue of Survey Mid-monthly carried the first in a series of columns that would continue for a decade. The subject of the columns — Amelia Bailey — “Miss Bailey” to most people — was a 1930s-style virtual-reality public relief supervisor. She existed on paper only, created at the typewriter of Gertrude Springer, an associate editor at the Survey magazine in New York City. In what became a popular monthly column, Miss Bailey listened to and advised the inexperienced social workers faced with coping with the Depression’s desperate unemployed relief applicants. “Miss Baily Says…” columns dealt with issues such as: “When Your Client Has a Car,” “Are Relief Workers Policemen?,” “How We Behave in Other People’s Houses.” She gave common-sense advice to questions such as what to do when the relief worker observes situations such as bootlegging, clients with a bank account, a family on relief seen attending a movie, the daughter of a family on relief sporting a new permanent wave.  Below is one of her columns written by Mary Ross.

By Mary Ross
 Survey Mid-monthly, July 1933, pp. 253-254.

What about relief investigators who, in visiting families:

•  Find a public‑health nurse also on the job?

•  Opine that codliver oil is an old wives’ tale?

•  Predict the goryness of approaching tonsillectomies?

•  Report prenatal patients when the stork is on the wing?

– – – – – – – – – –

The midsummer afternoon was no heavier than Miss Bailey’s spirits as she laid the telephone receiver decisively on its hook. Mrs. Harris must be removed from the list of relief workers. Conscientious she had been, oh woefully so! Armored in a sheathing of will that apparently knew no yielding. The calm accents of the VNS director still rang in Miss Bailey’s cars and the painful scene stood before her eyes. A bed in which lay a man with only a few days to live. On one side the nurse, on the other the determined Mrs. Harris. In the background an anxious wife and children. And Mrs. Harris insisting despite the nurse’s protests that the ambulance must be called, the patient sent to the hospital. “We can’t waste taxpayers’ money,” Mrs. Harris enunciated clearly over the sick man’s head, “by having a nurse come to this house every day when there isn’t a thing she can do for your husband anyway. Acute cases have got to go to the hospital even if they’d rather die at home.”

Mrs. Harris had been wrong in her facts: it wasn’t cheaper, but more costly to the city to keep a sick man in a hospital than at home when the family could care for him with

the help of the advice and skilled service that a nurse could give on a daily visit. There was much a nurse could do to keep him comfortable and even more to keep up the family’s morale. Mere ignorance was excusable and remediable, but this sadly true incident, coming on top of less glaring lapses, made it clear that Mrs. Harris just hadn’t the attitude in her which would make it possible for her to play ball with a co‑worker, with her own supervisor, whom she had not consulted; with the family whose service was the only reason for her job, and the doctor who had continued to see them long after he knew there was no money to pay him. Her services were discontinued.

Happily the Mrs. Harrise’s among new relief recruits have been so rare in the experience of the nurses that a story like this is a museum piece. “Absolutely no complaints,” writes a director of nursing in a large eastern city. “Naturally an occasional misunderstanding but not any more so than at any other time.” “On the whole,” comes a report from the South, “our working relationships with the new recruits among relief workers have been very pleasant and friendly. Difficulties that have arisen have been taken up with the executive or assistant executive as a matter of policy in working relationships rather than a direct complaint and settled very amicably.” From a Pacific city, “Cooperation between relief workers and public‑health nurses has improved during the time in which many untrained workers were added to the staffs of relief organizations. We are called much more frequently.”

Cooperation, these letters point out, is not one of those things that just drops like manna from providence. In one city success is attributed to the “exceedingly intelligent and careful person” loaned by a social agency to supervise new relief workers; in another, to the fact that calls for visiting nurses from the largest relief organization come through a special department long under the direction of a medical social worker. In some cities and states effective institutes have acquainted new relief workers with the duties, privileges and perquisites of co‑workers from the allied professions; in some places, emergency relief organizations are organizing meetings for nurses, giving them the advice of dieticians and other specialists in ways to use best the relief in food or money that is available for welfare clients. Instruction will “take,” of course, only when it falls into open minds of people ready to offer in teamwork the consideration and common sense they themselves would like to receive, and experience shows that among the new relief workers such minds are the rule. The rubs that come are mostly the inevitable and usually transitory result of inadvertence and failure to realize what damage a casual remark may wreak in a delicate professional situation, and above all, the complicating pressure of busyness.

“Our principal trouble in these busy times,” writes a director in an eastern city, “is that no agency seems to have time to cooperate. Policies are changed, workers discontinued and plans left in the air, with apparently no one at fault. Our own staff had a 25 percent reduction so I can sympathize with agencies having to double up and workers take on new responsibilities!” Sometimes the delay of busyness brings tragic consequences. It was costly for the relief worker to have forgotten to telephone the nurse that the Tonettis were spotted and snuffling when she called with the food card three days before; in the intervals measles were scampering up and down the sidewalk to all the families in the neighborhood. Even less urgent matters bring their complications. “One of the most annoying lapses,” writes a nursing association in a middle‑sized city, “is the eleventh‑hour reporting of prenatal patients. We are having the utmost difficulty in getting medical supervision. With time, plans can be worked out, but the reporting of a patient due any day and no plan made, makes our problem many times more difficult. The irritating part of it is that often the worker has known of the pregnancy for some time.”

Probably nurses have had more opportunity than most to learn that an important part of wisdom is the knowledge of what one is ignorant of, and not infrequently they have had occasion to see that adage underscored in the too‑ready advise or even diagnosis handed out by inexperienced case workers, as by one’s personal friends. Scientific opinion on such everyday matters of food or colds has traveled a long way from the saws Of one’s childhood and it is best to hold off On well‑meant advice till one is sure of one’s authority. Maybe the nurse was right when she said the baby could have ripe bananas. Few, fortunately, are the relief workers who fail to realize the newer rationale of codliver oil, but a few there are who indulge their private shudders before wide‑eyed youngsters quite willing to rebel. Call it lack of common sense or mental hygiene or fairness to someone else on her job, the very occasional worker who details the horrors of her own tonsil operation or stirs up the client’s doubts about the adequacy of a clinic or airily suggests a change of doctor or treatment may in a minute undo many weeks of skilled, sagacious nursing visits. If one has doubts, the client is the last person to whom to communicate them. A friendly word direct to the nurse ordinarily lays them; persistent misgivings are the business of supervisors.

Occasionally a relief worker has rushed in where no nurse would dare to tread. From the annals of a city nursing service comes the story of a public‑health nurse called in from the street by a neighbor to see a woman sick in a rooming‑house. The landlady said that her roomer was on the relief lists and she had asked the relief worker to call the nurse. The worker refused, saying the client was lazy and could get up if she wanted to. When the nurse brought in the city doctor he sent the client to the hospital where she died a week later from cancer.

From a mid-western city comes the tragi‑comic story of a relief worker calling on a 300‑pound client who had complained that she needed a larger grocery order for her‑ children. “Perhaps,” the worker tactlessly suggested, “if you ate less, there would be enough food for the children.” The mother, in tears, hurried for comfort to the nurse who had been arranging for her visits to a clinic for treatment of the glandular condition to which her weight was due. It took a series of interpretations to client and social worker to smooth out an upset that might have been averted by a question. The obverse of this incident, showing what happened when a new relief worker realized her inexperience and used skilled aid constructively, appears in an incident from another city where a family had been badgering the worker for a higher food order, also on the ground that there wasn’t enough for the children. The nurse, consulted, knew the family as old‑timers whose story would bear examination. In the light of her previous dealings with them, the prestige these had given her and her special knowledge of foods, she was able to convince them that the trouble was not with the amount of the order but with what they were trying to buy with it; a firm lesson or two and it became quite adequate.

Granting, as the nurses so wholeheartedly do, the rubs that come from inevitable differences or mistakes in judgment, from inexperience and haste, there still seems reason to believe that some of the new relief workers, like the general population, are a bit foggy at times as to just what is the nurse’s job. The girl who commented while visiting a client with a new baby that it was strange that the kitchen floor wasn’t scrubbed up when the nurse had been there just that morning, was guilty of an error in manners and professional ethics in criticizing a colleague behind her back instead of talking things over with her own supervisor; and beyond that, she was wholly ignorant also of the nurse’s aim in her visit. The National Organization for Public Health Nursing offers as a definition of their profession, “An organized community service rendered by graduate nurses to the individual, family and community. This service includes the interpretation of medical, sanitary and social procedures for the correction of defects, the prevention of disease and the promotion of health, and may include skilled care of the sick in their homes.”

A public‑health nurse is essentially a teacher of health, a teacher whose skill and experience stand ready for the patient and all who have an interest in him, for the community and all the groups working for its welfare. She is not a house worker and she is not a doctor. Save for a first visit or a sudden emergency, she does not care for sick people except under the direction of a physician. It isn’t cussedness, but professional duty that occasionally makes it necessary for a nurse to withdraw from a case when the family refuses to receive or follow a doctor’s advice. Nor is it laziness or indifference that makes her decline to give actual bedside care to sick people when she is working with one of the nursing organizations whose services are wholly educational and does not include care of sick people; if the need is crucial you’ll find that she usually does tuck in a little care on the side out of her so‑called free time.

Like everyone else, the public‑health nurses are walking through shoeleather and racing Fords to keep up with the extra calls from people who in usual times would not have occasion to ask for the community’s service. But in a sheaf of letters and a clutch of conversations the answer that comes from them is not a complaint at the repercussions that relief emergencies cast on an allied profession but first a warm sense of appreciation of how well a difficult job is gearing in and second a readiness to serve even more fully in using the professional and social skills with which training and experience have endowed them.

Source: Social Welfare History Archives, University of Minnesota Libraries: www. special.lib.umn.edu/

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