I should like to make it clear that from the beginning we were most profoundly moved by the wretched industrial conditions which were constantly forced upon us. In succeeding chapters I hope to tell of the constructive programmes that the people themselves have evolved out of their own hard lives, of the ameliorative measures, ripened out of sympathetic comprehension, and, finally, of the social legislation that expresses the new compunction of the community. [Illustration] CHAPTER II ESTABLISHING THE NURSING SERVICE When I first entered the training-school my outpourings to the superintendent,—a woman touched with a genius for sympathy,—my youthful heroics, and my vow to “nurse the poor” were met with what I deemed vague reference to the “Mission.” Afterwards when I sought guidance I found that in New York the visiting (or district) nurse was accessible only through sectarian organizations or the free dispensary. As our plan crystallized my friend and I were certain that a system for nursing the sick in their homes could not be firmly established unless certain fundamental social facts were recognized. We tried to imagine how loved ones for whom we might be solicitous would react were they in the place of the patients whom we hoped to serve. With time, experience, and the stimulus of creative minds our technique and administrative methods have naturally improved, but this test gave us vision to establish certain principles, whose soundness has been proved during the growth of the service. We perceived that it was undesirable to condition the nurse’s service upon the actual or potential connection of the patient with a religious institution or free dispensary, or to have the nurse assigned to the exclusive use of one physician, and we planned to create a service on terms most considerate of the dignity and independence of the patients. We felt that the nursing of the sick in their homes should be undertaken seriously and adequately; that instruction should be incidental and not the primary consideration; that the etiquette, so far as doctor and patient were concerned, should be analogous to the established system of private nursing; that the nurse should be as ready to respond to calls from the people themselves as to calls from physicians; that she should accept calls from all physicians, and with no more red-tape or formality than if she were to remain with one patient continuously. [Illustration]