Nursing and the March of Dimes: An Historical Summary
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| Nurses tending to polio patients, Colorado, 1946. |
The March of Dimes was founded as the National Foundation for
Infantile Paralysis (NFIP) in 1938 to lead the fight against polio just as
polio epidemics began to increase in severity. One of the first problems the
new foundation faced during the World War II years was shortages of trained medical
personnel, especially nurses. March of Dimes President Basil O’Connor
immediately saw the need to support nursing education to correct this
shortfall, and he joined the Advisory Council on Orthopedic Nursing of the
National Organization for Public Health Nursing to forge a partnership that had
a wide-ranging effect. NFIP grants for nursing consultants in epidemics,
scholarships for nursing education, and a manual for orthopedic nursing care
followed. In 1940, the publication of Nursing
Care of Patients with Infantile Paralysis by Jessie Stevenson, RN, alone was a vital step in rallying the nursing
profession to the forefront in the fight against polio.
Grants for nursing education at university centers throughout the
nation became an integral feature of the March of Dimes professional education
program. Dr. Catherine Worthingham,
Director of Professional Education, oversaw the coordination of educational
programs relating to physical therapy in its relation to fields such as
nursing. The foundation collaborated with the National Organization for Public
Health Nursing to empower the Joint Orthopedic Nursing Advisory Service
(JONAS), which coordinated in-service training with epidemic relief in response
to polio emergencies. In 1946, the March of Dimes created the Polio Emergency
Volunteers (PEVs) to train volunteer assistants to help nurses and physical
therapists in the bedside care of patients with paralytic polio. The NFIP and
American Red Cross together adopted procedures for emergency nursing service
that set standards in recruitment, qualifications, terms of employment,
salaries, and per diem payments of registered nurses to ensure nationwide
uniformity of the treatment of nurses in polio epidemics.
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| Dr. Catherine Worthingham |
In addition to its contributions to these important developments
to post-war nursing professionalization, the NFIP recruited over 10,000 nurses
during the period 1946 to 1951. In the Salk polio vaccine field trial organized
by the NFIP in 1954, over 40,000 nurses participated as volunteers. A Nursing
Advisory Committee of the NFIP was created the following year to review nursing
problems and resources; though the committee was short-lived, it played a vital
role in formulating how polio respiratory centers created with March of Dimes
funds were to be utilized in nursing education. By the end of the polio era,
the NFIP had funded the National League of Nursing alone over $2 million to improve
the quality of care for polio patients and others. This investment was over and
above the many sizeable individual grants for nursing education at colleges and
universities, including African-American institutions such as the Tuskegee
Institute.
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| Nurse graduates from the Tuskegee Institute |
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| March of Dimes Nurse Volunteers, 1968 |
By the 1960s, as polio declined rapidly in response to the new
vaccines, the March of Dimes renewed its commitment to the nursing profession
by announcing a ten-year, $12 million college scholarship program that included
nursing as one of five fields relevant to its new mission of birth defects
prevention. During a decade of transition, the foundation began to re-orient
its new mission from a clinical model of birth defects to a more encompassing
perspective on perinatal health. With the announcement in 1972 that a shift in
focus to maternal and child health had re-aligned its mission within the field
of perinatology, the Foundation helped to establish the Committee on Perinatal
Health which published recommendations in 1976 for the regionalization of
perinatal health care in Toward Improving
the Outcome of Pregnancy. The shift in approach had an immediate and
profound implication for nursing. Dr. Mitzi Duxbury, Assistant Director for
Nursing Service and Education, organized a meeting at the University of
Wisconsin School of Nursing to initiate plans for the development of training
programs to improve the skills of nurses who provide care to mothers and
infants. The meeting led to a pilot test of training modules on the physical
assessment and care of the newborn. Thus, just at the time the Committee on
Perinatal Health deliberated on the issue of regionalization, Dr. Duxbury led
the initiative to create a continuing education program for nurses. The
centerpiece of the new development was the nursing module program.
March of Dimes nursing modules launched in 1975 are a series of
training booklets for the continuing education of nurses in the field of
perinatal health on the care of pregnant women and newborn infants, designed
for both group instruction and independent study. March of Dimes is an approved
provider of continuing education by the New York State Nurses Association, an
accredited approver by the American Nurses Credentialing Center’s Commission on
Accreditation. The modules are written
by nurses for nurses and have been widely utilized in nursing education in
hospitals, nursing schools, prenatal clinics and public health agencies. The
modules have covered key topics in neonatal clinical care and contemporary
issues in nursing such as adolescent pregnancy, diabetes, multiple births, and
obstetrical emergencies as well as issues in ethics and genetics. The program provides
the most up-to-date information on nursing practice, assessment of risk, care
of the client, and provision of care in normal and emergency situations.
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| NICU Nurse, 1990. |
Beverly S. Raff succeeded Dr.
Duxbury as the head of professional education, and in 1993 the Foundation
established a National Nurse Advisory Council with oversight over the nursing
module program. Dr. Margaret Comerford Freda served as the first chairperson of
the council. During the evolution of the nursing module program, the March of
Dimes has sought to improve its support to the profession by sponsoring
perinatal nursing conferences and nursing grand rounds, establishing
scholarships and awards, and forging mutually helpful collaborations with
organizations such as the Association of Women’s Health, Obstetric and Neonatal
Nurses (AWHONN), the American College of Nurse-Midwives (ACNM) and the National Association of Neonatal Nurses NANN.
In 1998, the Foundation established an
annual Graduate Nursing Scholarship to assist registered nurses enrolled in graduate
programs in maternal-child nursing. The Nurse Advisory Council continues to
give critical guidance to the Foundation on nursing issues relating to its
Prematurity Campaign as the reach of the nursing module program has expanded to
online versions. The March of Dimes investment in the nursing profession has
become a collaborative model of how to achieve excellence in nursing leadership
and education.
June 27, 2011 / David Rose / March of Dimes
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