f 5,000 nurses studied, the 3,950 who plan to continue nursing reported their ference for one or more fields of nursing. The percentage of nurses indicatneed for additional training according to their chosen fields of nursing is sented in table 7 below. Fifty percent of the nurses who chose public-health - sing as their field of interest indicated that they needed additional preparafor work in that field; 33 percent of the nurses who prefer industrial nurs would like additional preparation; 62 percent of those who chose teaching school of nursing signified a desire for further preparation; et cetera. LE 7.-Field of nursing interest and desire for additional preparation in fleld TABLE 8.--Type of position desired by type of nursing service 12 1 32 2 1 84 52 1 63 nurses in 4 States; 17 in 5 States; 7 in 6 States; 1 in 7 States; and 1 in 8 States. The majority (54 percent) of the group have expressed their preference to continue in their present positions; 21 percent plan to retire. The remaining 25 percent are either contemplating a change of position or are undecided about their plans. One-third of the nurses who plan to continue in their present positions or to change to other positions have indicated a desire for further preparation. Table 4, following, presents the choice of 3,950 nurses for the various types of nursing service. The percentage of nurses who wish additional preparation in medicine, surgery, obstetrics, psychiatry, and pediatrics is given in table 5. From table 6 below it will be seen that the percentage of nurses who plan to continue in their present positions is highest (67 percent) in the age group 51-60 and that of those who wish to change to another position is highest (15 percent) in the 21-30 year age group. In this connection, It is interesting to note that the percentage of nurses planning to retire in the age group over is only 1 percent higher than those who plan to retire in the youngest age group Of 5,000 nurses studied, the 3,950 who plan to continue nursing reported their preference for one or more fields of nursing. The percentage of nurses indicating need for additional training according to their chosen fields of nursing is presented in table 7 below. Fifty percent of the nurses who chose public-health nursing as their field of interest indicated that they needed additional preparation for work in that field; 33 percent of the nurses who prefer industrial nursing would like additional preparation; 62 percent of those who chose teaching in a school of nursing signified a desire for further preparation; et cetera. TABLE 7.-Field of nursing interest and desire for additional preparation in field TABLE 8.-Type of position desired by type of nursing service Table 8 above shows the type of position for which these nurses have indicated a preference and the nursing service in which they would like to hold positions. Thus, of the 535 nurses who would like to have general staff positions, 10 percent chose medical nursing as their preferred type of service, 27 percent surgical nursing, 12 percent obstetric nursing, 8 percent pediatric nursing, 4 percent psychiatric nursing, et cetera. In the supervisory positions, 27 percent would like the supervisory position in surgical nursing, 18 percent in obstetric nursing, et cetera. This preliminary study is concerned only with the expressed postwar plans of 5,000 of the nurses who remained in civilian service. A further survey will be made which will include pertinent data regarding the background of these civilian nurses their education and experience, and their present positions in nursing [Reprinted from the American Journal of Nursing, vol. 45, No. 11, November 1945] SOCIAL SECURITY-THE WAGNER-MURRAY-DINGELL BILL (1945), SENATE BILL 160, H. R. 3293 By Donald W. Smith The new Wagner-Murray-Dingell bill (which should be distinguished from a somewhat similar bill referred to by the same name which was introduced in 1943 and was pending during 1943 and 1944, but never enacted) was introduesd in both Houses of Congress on May 24, 1945, and was referred to the appropriate committees, where it is now pending. In this article I shall not attempt to set forth all the detailed provisions of the bill, but shall merely outline its general features. The bill, which is described as the "Social Security Amendments of 1945" tains the following six principal divisions, each of which will be briefly sum marized. I. Grants and Loans for Hospital and Health-Center Construction II. Grants to States for Public Health Services III. Grants to States for Maternal and Child Health and Welfare Services V. A National System of Employment Offices VI. A National Social Insurance System I. GRANTS AND LOANS FOR HOSPITAL AND HEALTH-CENTER CONSTRUCTION The bill would amend the Public Health Service Act by adding a new title providing for grants and loans for the construction of hospitals and health centers (including nurses' homes and training facilities). This title would en power the Federal Government to donate to States, counties, health, or hospitai districts, or to nonprofit organizations, from 25 to 30 percent1 of the cost of such construction projects, and to extend a loan of an additional 25 percent of tha cost. An appropriation of $50,000,000 would be authorized for the year ending June 30, 1946, and an appropriation of $100,000,000 a year for each of the DFIT 9 years, in addition to separate appropriations for the States' expenses of admir istration. The new title would be administered by the Surgeon General of the United States Public Health Service and the Federal Security Administrate, with the advice of a National Advisory Hospital Construction Council (consist 12 of the Surgeon General of the Public Health Service and eight members apported by him) and of conferences of representatives of State agencies. Construct; & projects would be in conformity either with a State plan approved by the Surgeon General and the Federal Security Administrator or with the Surgeon Generaik determination of needed hospital projects. NOTE. This article is the substance of an address delivered by Mr. Smith at a conference of memberes of the board of directors of the American Nurses' Association with representar tives of State nurses' associations held in Chicago, Ill., on September 19, 1945 Mr Smith is a member of the bar of the State of New Pork and is associated with counsel for the American Nurses' Association. 1 In several places throughout this article, reference will be made to similar ranges of percentages contained in the bill. In each instance the bill provides that the exact p centage shall be computed on the basis of the per capita income of the State in which the project is to be located, with the result that States having the lowest per capita incomm would receive the highest percentage of Federal aid. II. GRANTS TO STATES FOR PUBLIC HEALTH SERVICES The bill would amend the Public Health Service Act to provide increased aid to States for public health services, including specifically venereal disease control, tuberculosis control, and general public health work (which in turn includes public health nursing). The bill would authorize the appropriation of a "sufficient sum" each year for each of these enumerated public health services. (The present maximum annual appropriation for general public health services is $20,000,000 per year.) States wishing to qualify for grants would be required to present plans for the approval of the Surgeon General of the Public Health Service. If such plans were approved, the Federal Government would provide 25 to 75 percent of the funds expended under each plan. program of grants would be under the supervision of the Surgeon General and the Federal Security Administrator; and an appropriation of $5,000,000 a year authorized for demonstrations, training of personnel, and administrative expenses. The Surgeon General would also be directed to consult with conferences of State health authorities. 2 The III. GRANTS TO STATES FOR MATERNAL AND CHILD HEALTH AND WELFARE SERVICES 3 The bill would amend the Social Security Act to authorize the appropriation of a "sufficient sum" annually for grants to States for each of three services: (1) maternal and child health services, (2) services for crippled children, and (3) child-welfare services. This program would be under the supervision of the Chief of the Children's Bureau and the Secretary of Labor. The former is directed to consult with an advisory committee appointed by himself (with the approval of the Secretary of Labor) and with conferences of State officers. States wishing to participate would be required to submit plans for approval by the Chief of the Children's Bureau. The Federal Government would provide from 25 to 75 percent of the funds expended under each approved State plan. IV. GRANTS TO THE STATES FOR PUBLIC ASSISTANCE The bill would amend the Social Security Act by adding thereto a new title providing for a comprehensive program of public assistance. It would authorize the appropriation of a "sufficient sum" for grants to States for the purpose of aiding the needy, especially children, the aged, and the blind. States would be required to have plans approved by the Social Security Board; and the Federal Government would pay 50 to 75 percent of the sums expended under each approved State plan. The term "assistance" is defined as including medical care for needy individuals. Administration of the new title would be committed to the Social Security Board. V. A NATIONAL SYSTEM OF EMPLOYMENT OFFICES The bill would establish in the Social Security Board a new permanent United States Employment Service, similar in many ways to the present agency of the same name. The Social Security Board would be directed to consult with a National Advisory Employment Service Policy Council appointed by the Board and to establish local advisory councils as well. VI. A NATIONAL SOCIAL INSURANCE SYSTEM This part of the bill contains the provisions relating to "socialized medicine" or compulsory health insurance, and has perhaps attracted the greatest amount of attention. It would amend the Social Security Act to provide for three large groups of benefits, as follows: Prepaid personal health service insurance. The provisions for health service insurance are entirely new. The benefits available under such insurance are listed as: 1. General medical benefit (service by a general practitioner). 2. Special medical benefit (service by a specialist or consultant). 3. General dental benefit. 4. Special dental benefit. 5. Home-nursing benefit. 7. Hospitalization benefit. 2 See footnote 1. 3 The appropriation for child-welfare services would be $15,000,000 a year for each of the first 2 years. 4 See footnote 1. See footnote 1. |