Centennial Rita Dingman, R.N., M.P.H.

Miss Dingman is Assistant Chief, Nursing Section, and Principal PHN Consultant, Colorado Department of Health, Denver, Colorado.

n this Year of the Centennial, in this state, we will

I be looking to our past This is good. We need to know where we are and where we need or want to go. I n looking back over the past ten years, one decade out of one hundred years, we can all be proud of where you were and where you are now. Each of you has grown a great deal in this short decade. You've taken advantage of all kinds of continuing education opportunities. You have expanded your roles in your occupational setting to the extent currently possible. A number of you are Nurse Practitioners. You participate actively in this and other professional and community organizations; accept offices; work on committees on the local, state, and national levels. You persevere in those things in which you strongly believe and recruit others to support your efforts. You support the efforts of others. We have an opportunity, this Centennial Year, to look back - and we should use it We are being buffeted by many efforts for change. At the 85th Annual Visiting Nurse Service Luncheon, Dr. James Kimmey described the biggest change on the horizon, the National Health Planning and Resources Development Act of 1974, which he and others perceive as a foundation for the approaching National Health I nsurance. I n the course of his comments he recalled a speaker who was referred to in glowing terms. "The speaker," one man said, "was so great! He said so many good and new things." A friend of the Presented at the Colorado Association of Industrial Nurses' Installation of Officers Ceremony, Denver, Colorado, May 1, 1975. Occupational Health Nursing, September 1975

man listened to trus glowing report and with a sigh said, "I heard him. I heard him. However, what he said that was good - wasn't new. And what he said that was new - wasn't good." Dr. Kimmey felt this was also true of ideas for change - some of them that were good, weren't new. Some of them that were new, weren't good. RecentlY I participated on a panel which discussed the past and future of Public Health Nursing, One of the points that was made about Public Health Nursing is the change in the delivery system over the past thirty years. The changes have actually occurred in the past five years but the change potentials have been growing for the past twenty-five. Those of you who have Public Health Nursing background know we were all taught that the basic delivery system in Public Health Nursing is the home visit We go to where the family is, assess needs, and assist in the solutions of problems one way or another Several things have happened since 1945. One is that almost every family in Colorado has at least one car, and many families have several. That's one of the reasons we don't have public transit, rapid or otherwise. I t is also one of the reasons for the change in the delivery of Public Health Nursing services. We no longer visit families in their homes when it is easier for them to come to Health Departments, Neighborhood Health Centers, Health Stations, or to receive services from Occupational Health Departments, School Nurses, or other ambulatory health clinics. Public Health Nurses now spend more time in clinic and screening services than they do in home visiting. It is less expensive and the numbers 15

CENTENNIAL

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reached can be greater. Of course, nurses still must visit the homebound - the disabled and the aged. My point in mentioning this is that the books we learn from still describe the old concept of the Public Health Nurse. Because she was described as a field nurse, many could not see that the skills required of the School Nurse and the Occupational Health Nurse were the same, although the work setting was different The changes in services delivery are almost too new to learn from hard cover books. I'm not sure that in the immediate future it will be possible to learn a lot from hard cover books. By the time they are printed, we've reached another plateau in delivery of services and even the concepts are obsolete. But we must know where we have been, where we are, and where we need to go. Somehow we must sift through all the suggestions for change to find aspects which will be most useful in the future. As I mentioned before, you've come a long way in ten years. You've taken advantage of various learning opportunities. Now one of the big areas of need, as I see it, is research in Occupational Health Nursing. With the passage of OSHA and the development of Criteria Documents by NIOSH, we are beginning new kinds of documentation. We are beginning new efforts in medical monitoring. We can contribute, we must contribute, to the current information. The now information on our part is the health delivery system. We are where the action is. We shouldn't wait for someone else to do it for us in hard cover material which may not be accurate by the time it is published. When I talk about research, I'm not talking about profound investigative research such as finding the cause for cancer or plaque formation in blood vessels. I'm talking about answers to questions. Questions like: "What do the employees think I'm there for?" "What would they like from me?" "Why do six fellows develop skin rashes from the washing compound and forty-four don't What is different about the six?" I'm sure you can think of hundreds of other questions you'd like answers to.

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In Colorado we have a unique resource in our midst which is available and which we should use. Western I nterstate Commission for Higher Education, located in Boulder, has Dr. Carol Lindeman on its staff. Dr. Lindeman has only one job - to help nurses in the west to design small research efforts so that questions can be answered. So that evidence to effect needed change can be gathered. You only have to ask for her help. I think we are at a time when we must look at where we were, where we are, and where we need to go. The only useful way to do this is through the methodical fact gathering, data gathering process. Research. I tis not a process that is limited to Ph.D.s in moldy laboratories. It is a process you can get involved with easily, once an expert helps you limit your effort to something that's possible. I've started to read James Michener's book "Centennial." I am finished with the building of the mou ntains, and the era of the Indians and the buffalo. I'm now to the coming of the white man to the west The age of the candle. It seemed appropriate this year of the Centennial, that I give each new officer a candle as a gift from me. It can be held high to look at the past - from where we came. Its light can show us where we are now and illuminate the paths ahead so we may choose the best one for each of us and the best for the Association. I hope its light wi II help you see the questions that need answers and some of the ways to provide the answers. I hope the light wi II shine down on the paper as you share your observations with others. It is through this pooling of questions and answers, observations and data, that wi II create the hard evidence for appropriate change which we need and want I also hope the light is usefu I to each of the new officers in this Association so that they can lead this Association, in this year of the Centennial, to the best future conceivable.

Nursing: centennial.

Centennial Rita Dingman, R.N., M.P.H. Miss Dingman is Assistant Chief, Nursing Section, and Principal PHN Consultant, Colorado Department of Health,...
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