In Her Words

Memo from Julia C. Stimson to George Dock, October 31, 1911

Julia C. Stimson assumed the position of “Headworker” of the Social Service Department of the Washington University Hospital and St. Louis Children’s Hospital on October 16, 1911. The Washington University Medical School had recently affiliated with the St. Louis Children’s Hospital, making it a teaching hospital over which the school would assume control over medical care. The Board of Managers of the Children’s Hospital, however, hired Stimson directly, without first consulting the medical school’s faculty. Stimson was compelled to use her diplomatic skills immediately to overcome the medical school faculty’s resentment and suspicion. She wrote this memo to the dean of the medical school, Dr. George Dock, two weeks after her arrival in St. Louis. In it she emphasized the collaborative role of social work and its basis on “medical need.”

October 31, ’11

To:    Dr. Dock,
         Dean of the Medical School
         Washington University

The SOCIAL SERVICE DEPARTMENT aims to be the agent of the physicians and the executive management of the hospital. It rests upon the fundamental basis of medical need and moves into social action only as a fulfillment of that need. Acting as an intermediary or connecting link between the patients and the helpful resources of the city, it hopes to prove its usefulness as an aid to the hospital not only in its efforts at social betterment, but in securing better results with individual patients by enlisting family and community interests.

The general principles of method are simple.

The first is to ascertain the family situation and to establish a feeling of friendliness and confidence.

The second is to find out whether any other agencies have dealt with the family.

The third, to bring the patient immediately in touch with the agency best able to meet the needs.

The Dept. does not intend to be a relief society. In cases, however, where no agency can be found to meet a pressing need it is hoped to raise funds, and for emergencies it is desirable that a small loan fund be established to assist patients to secure necessary appliances or for immediate needs that can not be taken care of in any other way.

It may be found of assistance to the hospital if requests for free treatment or free medicine be referred to the Dept. It is probably difficult for the doctors to go far enough into the social conditions of a patient to decide as to the justice of granting such requests. The Dept. would look into such matters with the greatest care.

The appended list of needs on the part of patients that might be referred to the Dept. may give some idea of the proposed scope of the work.

Cards have been prepared, upon which the name of a patient to be referred may be written, also the reason why he is referred. Records, as complete as possible, of the steps taken for the relief of the patient will be kept in the office of the Dept., with a record of the family situation, but a report in writing will also be made to the doctor by whom the case was referred. This record could be filed with the patient’s hospital or clinic history if so desired.

For the present the Dept. consists of a Headworker on half time, because half of her time is employed by the Children’s Hospital; and a stenographer, on half time for the same reason.

It is important that an assistant be engaged as soon as possible, to devote her whole time to the Wash. Univ. Hosp. cases, under the direction of the Headworker. To secure a competent woman for this position, a salary of not less than $1200 per annum should be offered. It would be hoped to secure a graduate nurse who had also been trained in social work.

It can already be seen that the time is not far distant, when to secure the best results, it will be necessary to engage a graduate nurse to give her whole time to the tuberculous patients; to be present at the clinics and to visit and instruct the patients in their homes.

At the present time, the Visiting Nurse Ass’n and the Antituberculosis Society are fully able to handle all the cases in need of home nursing, and are glad to co-operate in the matter of careful reports of all visits. It is suggested that all calls for home nursing be sent to the Dept. where they will be forwarded at once.

As the work develops it is hoped that the data collected will be useful in medical and philanthropic campaigns.

The Headworker requests the privilege of reporting in person at regular intervals to the Hospital Committee.

Respectfully submitted,
Julia C. Stimson, A.B., R.N.