The development of a climate for caring: a historical review of premature care in the United States from 1900 to 1979
O'Donnell, J.
Neonatal Network Nn 8(6): 7-17
1990
ISSN/ISBN: 0730-0832 PMID: 2190078 Document Number: 4699
The data presented in this review of the history of premature care in the United States is limited to published material available within the local area. Additional manuscripts, records, and oral histories, would provide a more comprehensive perspective. The period from 1900 to the early 1940s represents the beginning of premature care in the United States characterized by efforts to provide an intrauterinelike environment. Energies were focused on the three identified basic needs of temperature support, nutrition, and protection against infection. The idea of caring for prematures in an especially designated area in the hospital evolved, and premature stations or wards were created. Advances in technology resulted in sophisticated systems for providing warmth for infants and some interventions for respiratory support using oxygen and an infant ventilator. The dangers of cold stress during transport were addressed with attempts to provide warmth using an especially designed transport incubator. A revolutionary growth in technology combined with the nationwide coordinated effort for organizing regional care has characterized this past 30-year period of premature care (1950-1980). The infant is now surrounded by sophisticated life-support systems and receives medical care from a much broader knowledge base than was available in the past. The environment for premature care has truly surpassed any expectations that health care professionals of the past may have held when the concept of an incubator emerged. Nursing of premature infants has expanded with the level of sophisticated equipment and the knowledge of the premature infant's physiologic needs. Nurses are no longer the gatekeepers of a sanctuary against infection. They care for the premature and the family by providing support, information, and caring during an emotionally stressful time. As the premature's physiological condition stabilizes, the nurse helps the family learn to care for the infant and thus transfers the responsibility of providing warmth, nutrition, and protection to the parents. Nurses are now gatekeepers of a very special sanctuary--the sanctuary of caring.
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