2023/01/01 by Michelle C. Hehman · 1 voice
Arts and Humanities · Psychology · #Historical Psychiatry and Medical Practices #Historical Studies on Reproduction, Gender, Health, and Societal Changes #Medical History and Innovations
paper · doi:10.5325/nursinghistory.31.0093
openalex publication_date 2023/01/01 · openalex created_date 2025/10/10 · openalex updated_date 2025/12/27
In 1941, Julius Hess, MD, and Evelyn Lundeen, RN, wrote these words in their book The Premature Infant, an updated, comprehensive guide for the care of preterm newborns that detailed the minimum standards necessary for establishing successful premature nurseries. The text presented a clear message about the importance of expert nursing, with the introduction declaring, “Since it is our conviction that untiring, unremitting care has no substitute in the care of the premature infant, we have deemed it essential to give equal prominence to the role of the nurse.”2 As the medical director and superintendent of nursing for the Hortense Schoen Joseph Premature Station (the Station) at Chicago’s Sarah Morris Hospital for Children, Hess and Lundeen had spent nearly twenty years working together to develop and refine their treatment model. Under their leadership, the Station established premature infant care as a hospital-based specialty that situated experienced nurses at the center of every treatment. Hess and Lundeen shifted the unit’s focus away from the technological wonders of the mechanical incubator to the specially trained and knowledgeable nursing staff in order to improve patient outcomes.Their approach proved revolutionary and challenged the conventional attitudes within the American medical community about providing advanced treatment for premature infants. The Station’s published morbidity and mortality data validated the effectiveness of their system of care. Beginning in 1928, the Station demonstrated survival rates over 72 percent, and follow-up data showed that graduates met growth and developmental milestones similar to their full-term counterparts.3 Additionally, Hess and Lundeen’s public and professional outreach—through publications, presentations, and the promotion of a specialized course in premature nursing—initiated a national conversation about the importance of comprehensive programs to address preterm birth. By the late 1930s and early 1940s, hospitals across the United States began developing their own plans for premature infant nurseries based largely on the standards and nursing procedures created at the Station.The process of increasing awareness of infant prematurity in the United States had begun decades earlier and had proven to be challenging and tenuous. Sociopolitical movements in the early twentieth century questioned the ability of “weaklings” to survive and become contributing members of American society.4 Home births predominated well into the twentieth century,5 and confusion arose around the responsibility for the care of premature infants in the immediate newborn period. Increasing physician specialization meant that obstetricians tended to focus more on the mothers than the babies, leaving women and female family members to navigate the complexities of caring for a preterm newborn on their own, often resulting in high mortality. Pediatricians generally only treated premature infants whose condition had drastically deteriorated. Few babies survived, despite any level of intervention.The invention and documented success of the infant incubator in France in the late 1800s initially generated excitement among American physicians eager to utilize the new and promising technology. Unfortunately, the pediatric hospital environment in the United States differed greatly from that of French lying-in hospitals, leading to disastrous results. Most Americans viewed infant hospitals—the descendants of foundling homes—as institutions that cared for abandoned children rather than as places to heal their sick children. Turn of the twentieth century infant hospitals also experienced exceedingly high mortality rates. Indeed, hospitalization led to death for most infants. 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Hess with of success that patient and Indeed, the of care at the Station a for the medical community at the that of on the in the of the nursing nursing also an for the of publications, Lundeen own ability to the of premature infant care nurses at the of Lundeen’s published in the late 1930s detailed the for nursing care of premature babies, at and in the and the importance of to growth and the responsibility of nurses in the environment of Lundeen to in nursing to the for in the and the of of the infant to with a message that the presented to the of a nursing staff the to the of nursing at the Station in in for their Hess and Lundeen that their system of care as a for nurses to a course for nurses to the and necessary to care for premature infants. for the in the to for pediatric and into a course for nurses in a specialty of premature infant at of on the of the of premature at the on the the of premature as well as the to and Lundeen on the the for nursing and in for at the to the of the nurses in of premature infant and of the care and of and and the of and nurses for the on the of and to and also experienced the system of follow-up care at the Station the care and at the for premature as more hospitals around the began to the of specialized for premature physicians and to the Station for as their own for preterm birth. Lundeen an for the hospitals and nursing staff in the care of incubator in of Lundeen spent a at Hospital in the established a premature as a Hospital Lundeen to the of premature care the the of a the for and the and The United States Lundeen to a premature course to the these Lundeen’s message role of the of importance in the successful care of premature MD, a had as director of public director of the of and as of and in for a national at premature infant mortality. had the of the United States in and infant mortality from births in to in that of prematurity the of that infant mortality years Indeed, the national infant mortality had drastically as a of in and medical national mortality rates had as the By the births for of infant that prematurity a in the infant mortality medical and public in prematurity a of care for premature birth. the and plans that in and In the late 1930s and 1940s, hospitals in and to the at the nursing care with the of the and comprehensive programs established in and on the of and of premature within of care and and a to the and of premature also began to that premature for national and often the ability of families The for premature infants the of care for premature infants to from to over infant, with infants from a hospital also demonstrated that only family of the families with a premature infant their care the to the hospital and to the success of any comprehensive for premature care. Under of the for infant, and and to improve to and the of premature infant