Enthusiasm, health, and uncommon good sense on the part of the nurse are essential, for without the vision of the importance of their task they could not long endure the endless stair-climbing, the weight of the bag, and the pulls upon their emotions. There has been an extraordinary development of the visiting-nurse service throughout the country since we began our rounds, and the practical arguments for sustaining such work would seem irresistible. It requires imagination, however, to visualize the steady, competent, continuous routine so quietly performed, unseen by the public, and its financial support is the more precarious because there can be no public reminder of its existence by impressive buildings and monuments of marble. CHAPTER III THE NURSE AND THE COMMUNITY The work begun from the top floor of the tenement comprised, in simple forms, those varied lines of activity which have since been developed into the many highly specialized branches of public health nursing now covering the United States and engaging thousands of nurses.[2] In trying to forestall every obstacle to the establishment of our nursing service on the East Side, it seemed desirable to have some connection with civic authority. Through a mutual friend I met the President of the Board of Health and, I fear rather presumptuously, asked that we be given some insignia. Desirous of serving his friend and tolerant of my intense earnestness, he sanctioned our wearing a badge which had engraved on its circle, “Visiting Nurse. Under the Auspices of the Board of Health.” As it transpired, we did not find it necessary or always felicitous to utilize this privilege, but our connection with the Board of Health was not a perfunctory or merely complimentary one. We found from the beginning an inclination on the part of the officials of the department to treat us more or less like comrades. Every night, during the first summer, I wrote to the physician in charge, reporting the sick babies and describing the unsanitary conditions Miss Brewster and I found, and we received many encouraging reminders that what we were doing was considered helpful. [Illustration] In the new activity for the promotion of public health many campaigns have been waged to popularize the study of social diseases. Education is the watchword, and where emphasis is laid upon the preservation of health rather than upon the treatment of disease, the nurses constitute an important factor. Appreciation of this is recorded by the Commission which drafted the new health law for New York State (1913). “The advent of trained nursing,” says its report, “marks not only a new era in the treatment of the sick, but a new era in public health administration.” This Commission also created the position of Director of the Division of Public Health Nursing in the state department of health. * * * * *