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subfield code a C53-000442 USFLDC DOI0 245 Gertrude Lee oral history interviewh [electronic resource] /c interviewed by Unknown Unknown.500 Full cataloging of this resource is underway and will replace this temporary record when complete.Transcription and timecoding of this interview is underway and will be added when complete. At that time the audio link will be replaced with the OHPi player link (player supporting syncronized audio and full-text transcription).7 655 Oral history.localOnline audio.local710 University of South Florida.b Library.Special & Digital Collections.Oral History Program.1 773 t USF College of Public Health oral history project4 856 u http://digital.lib.usf.edu/?c53.44
xml version 1.0 encoding UTF-8 transcript
text E. Charlton Prather (CP): Well, its a pleasure to have with us this afternoon Mrs. Gertrude Lee of Holmes County and Bonifay, Florida, where she served as the director of public health nursing there in that county health department for many, many years. She wont let me tell you exactly how many years, but a lot of years. And its just truly a pleasure to have you here, Mrs. Lee, to share with us some of your observations and your doings in public health in a very rural and poor Florida county. What ever got interested in public health?
Gertrude Lee (GL): Well, Dr. Prather, my interest goes way back in public health because one of the first times I was exposed to public health was when I was still in grammar school. And a nurse came, and this was before we even had the organized public health in our area and what have you, but
CP: Where was this grammar school?
GL: This was in Washington County, and it was Union Hill, Florida.
GL: Union Hill.
CP: Thats important for the record. Im talking to a Floridian.
GL: Yeah, youre talking to a bona fide Floridian. I was born and reared in Washington County and finished school there, and what have you. But she came when we were in the fourth grade, and she was, I guess, trying to teach people about maternal and child health and that sort of thing.
And we had a little fair at that school. They had little fairs every year at the school, and she came and did the demonstration. And she set up and had all the layouts for the baby and was teaching the mothers about children and just everything about children and trying to talk to them about, even way back then, about prevention.
CP: This was a public health nurse?
GL: It waswell, to tell you the truth, Dr. Prather, I dont know whether it was a public health nurse or not, but I figured it was a public health nurse.
CP: Because she was doing public health stuff.
GL: Yeah, she was doing public health stuff, whether she was a public health nurse. I can tell you her name was Ms. Hale, but now, I dont know where she even came from. But anyhow, I was really interested in that. I thought that was the most fascinating thing and all. And I thought, Thats what Im going to be when I grow up.
I told the superintendent of the schools one time, when everybody was talking about children having to find themselves, Well, I reckon thats something that I missed, having to find myself because from the time I was in fourth grade at school, I wanted to be a nurse. And it narrowed down to public health.
And then when I went in nursing school, and I finished nursing school at the old Sacred Heart Hospital in Pensacola. And Elizabeth Reed taught us public health.
CP: She did? She was a nurse at the Escambia County Health Department.
GL: Yes, she was. And she taught us the theory on public health. And, [of] course, when we were in, and I would suspect it was because of Elizabeth Reed, that we, in our nursing curriculum, we had six weeks of on-hand experience with the Escambia County Health Department. And, of course, by the time that I got to the place where I was ready to do that, well then, Mrs. Elizabeth Reed had already moved into Jacksonville and started working there.
CP: As the director of health education.
CP: For the record, for our audience, I want them to know that Mrs. Elizabeth Reed, who was a nurse and got her career started in Escambia County as, I think, the director of nurses there.
GL: Yes, she was the director of nursing.
CP: But we ascribe to her, too, the rejuvenation of health education for Florida when she came to Jacksonville. We just love Elizabeth Reed.
GL: She was just a wonderful person, and she excited you. She made you feel like that was the only place in the world to be was in public health. And, of course, I already had that background of
CP: You were already motivated.
GL: I was already motivated, I guess.
CP: You only need to learn how to spell it.
GL: And needed to know what it was, really. And it took me a lot of years before I really found out what I was. But anyhow, when I went to do my six weeks of on-hand orientation and what have you in public health at the health department, then, Betty King was there as the director of nursing.
CP: And she was?
GL: So, I had Betty King, then, as her influence on me, too. And then, another thing, when I was finishing my six weeks, I was alreadyI knew that was what Ior thought I knew that was what I was going to do, but I had said this in the beginning, whenever I first went in school.
And so, the girl that was supposed to relieve me on rotation on Sunday night, she had appendicitis, and they had to operate on her. So the sister sent me back for a second six weeks of orientation over there. So, I had that much orientation of it.
CP: Oh, that was the full contingent.
GL: I was in my senior year at that time, and so then I went on, of course, I went then in the Army. And then, when I got out of service and came back home, my daddy, in the meantime, had died. And my mother was there, and she was sick, and she had two children that were still in high school. And back in those days, you didnt have a whole lot of money put aside to support the family.
CP: Well, it hadnt been long since the Depression.
GL: Yeah, didnt have no welfare to support the family. So I came back to stay with mother and to help her with the bills and help get those other two kids through school and what have you.
CP: Oh, director of nursing for the state board of health.
GL: I had met Ms. Mettinger whenever I was in Pensacola. So, I wrote her a letter and told her that I was interested in public health. And she wrote me right back and sent me an application. So, I got my application. And whenever I got my application, and as soon as I got home, well then, I went to work pretty quick thereafter.
CP: You were hired from one jobyou didnt have any off time, did you?
GL: Not really. I had to take time to go buy me a car because I didnt even know how to drive a car. Id been behind the steering wheel of a car one time.
CP: The military didnt teach you to drive?
GL: We didnt have no cars in the military. I didnt have a boyfriend that even had a car, so that was terrible. But I went and bought me a car. I went to Pensacola and bought me a car. And whenever we were coming back, I told my sister-in-law, who went with me, Pull over on this road here. Im fixing to drive this car.
I knew I had to learn to drive before I can do public health nursing. They told me I had to be able to drive a car and had to have a car before I could public health nursing. So, I had to learn to drive that car, and I drove that booger. But she would laugh and tell my family about me and driving after that, but anyhow, I learned to drive it.
CP: You refer to her as your sister-in-law. This was your sister-in-law to be?
GL: No, she was my sister-in-law at the time.
CP: Oh really?
GL: See, I came from a large family, Dr. Prather.
CP: Okay. Excuse me, I apologize.
GL: But anyhow, I ended up in Holmes County. And a while ago, you wouldnt say how long, but I really stayed there 38 years as staff nurse.
CP: Your first job was in Holmes.
GL: Well, no, my first job was doing maternity nursing care at Brunswick City Hospital in Brunswick, Georgia. And my first public health job was in Holmes County. And I stayed in Holmes County with all the rest of the things
CP: You got married and had all your children there. Thirty-eight years. You started out as a staff nurse. How many nurses did you have?
GL: One. I was the nurse.
CP: And you were called the staff nurse?
GL: I was called a staff nurse.
CP: Oh, you were also the director of nurses and major bottle washer, too, because you only had one.
GL: Back in the early days, in the rural counties, you didnt have the staff nurse and director of nursing services, supervisors, and all that sort of thing. And when we did ever get a nurse, well, we were both just staff nurses. And I worked as a staff nurse, and then my classification had later on changed to supervising nurse.
And back whenever the nurses began to unionize, so to speak. But anyway, whenever I wrote my job description it isnt about, you know, to whenever you had to make a determination of who was going to vote and what have you? They wouldnt let me vote because I was supervisor, and I didnt take that very lightly.
I thought that I needed to vote if I was a supervisor because all the rest of the supervisors were going to get to vote. So, anyhow, whenever I made the protest, well, then, all of a sudden, they decided they would give me director of nursing service.
Thats how I got director of nursing service. I wrote the job description. And, Ms. Matheson wrote me back and saidlet me see how it was thatthat was not a job of supervisor. That the things that I was doing or the things that my job description showed was that that was director of nursing service.
And so she asked one of the nursing consultants did she help me to write that job description? And she looked at it and she said, No, she wrote that job description telling you just exactly what she does, and she does a whole lot more than that. So, that ended that, anyway, then.
CP: When you first joined the health department and you were the only nurse, had there been a nurse there before?
GL: There had been a nurse there before, Dr. Prather. Ms. Lionel.
CP: Nurse Lionel?
GL: Helen Lionel. I dont know whether you knew her or not.
CP: No, I dont remember her.
GL: But she came out there when they were organizing to organize that health department over there. The citizens themselvesand Im sure, because you know Dr. Sowder was state health officer then, and he was interested in trying to get health departments organized in every county in the state.
And so, when they came and talked to the county commissioners and that sort of thing about itwhoever came from the state, I dont know right nowbut they came. And Ms. Lionel, Helen Lionel, came out there. And she and the Holmes County agent spearheaded
GL: Homemakers. Home economy.
CP: Home economics. The county home economics. Thats right.
GL: And they spearheaded a drive in order to get a building and got a building and got the building renovated. Got it all painted up, and it was right on the main street. And then, of course, the people at the county commissioners didnt have too much room to say no whenever they got the building all set up and what have you, but they took
CP: This was a community public, the populous effort?
GL: Absolutely. And they would take a dollar or 10 dollars or 500 dollars, however much somebody had they wanted to contribute to it. And a lot of those people, they were poor enough back then that a dollar was probably all they could contribute. But they contributed enough to it that they built that building.
And then the county commissioners didnt think they had money enough in the budget to draw down the state and federal monies. You know, then, they probably didnt have it at that time. But then the school boardwe had two lawyers in the county and one of them served as the attorney for the school board and the other one served as the attorney for the county board of commissioners.
And so, the schools felt like they needed nursing service and public health service. And so, they went in, and the school board put half the money in, and the county commissioners put half the money in. And do you know how much money they put in the first year?
CP: No, I dont, but I want you to tell me.
GL: Three thousand and five hundred dollars each. So we had 7,000 dollars. And what little money that was left over that timethere was enough that it was right close to 10,000 dollars of it all pooled that they put in there.
And so, Ms. Lionel stayed there. Now, see, this was in October of 1944. And Ms. Lionel stayed there until some time the following year. And then there was another nurse that came in, and her name was Buckley. I never met her. She left before I came, but she stayed there until the rest of, let me see, 44, 45. And at the end of 45, or the very first of 46, she left.
So I can look back now and I think, Well, howbecause Ms. Mettinger answered my letter right away whenever I wrote and sent me the application. And I imagine that she was pretty desperate for a nurse out there.
CP: Ill bet you she was, yeah. Go back to the organizing, too. From your knowledge, on what basis was the community interested in having a health department?
GL: Dr. Prather, I think that one of the driving things from it was the fact that back then they would come fromand it must have been from Jackson Countythey would come into the schools and give some immunizations and what have you. And I think that people really began to be concerned about the diseases that their children were having, and I think the school
CP: Diphtheria, tetanus, yeah.
GL: Well, whooping cough. Whooping cough. That was because, I think, a lot of those children that had whooping cough. And the first year I was in public health and working in the schools, we had 22 children with whooping cough. And that whooping cough left almost of those children with some residual lung problems. All the time.
CP: It was a frightful disease, and the health department could bring prevention from that, couldnt they?
GL: Yeah, and I think that thats really the thing thatthat plus the education that Ms. Lionel and the homemakers provided for them and what have you, what good the health department would be able to do and all that sort of thing. And that thats what motivated them to start.
And I can remember that, when I came there, they were talking about not having money enough to support the health department. And one man got up and said, Well, the hog farmers around here, that we support their cholera vaccination for the hogs? And dont you gentlemen think that its more important to protect the children than it is the hogs? If those hog farmers want cholera vaccine, they can buy it! And, then, they supported the health department. But, thats the way they really started that.
But when I came in 1946, they hadnt had a public health nurse in about three months. I came the first day of April in 1946, April Fools Day. And its been April Fools Day ever since. But the only orientation that I had had to that time, in public health, was what I got when I was in Escambia County. But I went in, and I knew about immunizations, and I knew about tuberculosis control, too, and venereal disease control. And I had that background to start
CP: Were those major programs in Bonifay when you joined? Tuberculosis, immunization, and venereal disease.
GL: Thats right. When I first started, I began to read the records of what the girl had done before and looked at her diary that she had and all that sort of thing. We had a clerk typist there that wasshe was Dr. Pauls niece. And she was real knowledgeable about health care and health services. And she had worked, well, almost there since the health department had been started, she had been working at the health department.
And she helped me. And she told me, Theres some children, they had their beginning immunizations in some schools. Those things need to be finished up in a reasonable time, in order to make sure that they see the reason thats affecting everything. And I told her, Well, help me to find where its all at and everything, and well
CP: Ill get on it.
GL: And thats exactly what we did. But then, right after I started with immunizations and what have you and then Betty ThickettI dont know whether you remember Ms. Betty Thickett or not, but she was a nursing consultant. And they sent Betty Thickett out there, and she stayed out there about three weeks with me and oriented me to
CP: Your duties.
GL: And responsibilities and all that sort of thing. And we had, at the time that I started, we had 28 schools in Holmes County. And we only had about 3,000 students because, at that time, there was less than 12,000 population in Holmes County, and then it decreased and decreased until we got to a place where there was a little better than 9,000 population, and then it began to come up again and build back up again. But with those schools, we had a superintendent that was totally blind.
CP: You did? That shouldnt affect his head, though.
GL: It didnt because I was telling my grandson not too many days ago thathe was taking me back, when I had my eyes done, he was taking me back to the doctor. And I was telling him that the superintendent took me, went with me in my car, to visit all those schools and to introduce me. And it took us about two days to make all of those schools for him
CP: Yeah, the superintendents going around to introduce the nurse.
GL: Thats right. Thats what they did back in those days. I doubt that they do that now, but they sure did back in those days. And one of the first things I had to do was to learn how toI told you I had to learn how to drive, but I also had to learn how to drive on
CP: Those dirt two roads?
GL: Dirt roadsslick roads and sandy roads. You were either on one or the other. You were on a clay road that was as slick as a button, and especially if it had rained, or you were on sand, where you bogged down in it.
CP: Did you ever get stuck?
GL: Oh yes. Many times.
CP: What did you do?
GL: Well, there usually was somebody that would come along, or else there would be a farmer close by that had a pair of mules that would come and drag me out. I would get out and walk to the house and tell him I was stuck. That was a marvelous thing, back doing public health nursing back then.
CP: Did you wear a uniform?
GL: Yeah, I wore a uniform. Wore a uniform. But, to begin with, I wore my Army uniform. I kept wearing my Army uniform to begin with until I could get me some uniforms. But anyhow, way back, whenever we were doing public health nursing, the people were proud of their public health nurses. And I said that I take it from the standpoint they had ownership of their county health department.
CP: Yes, and they felt it.
GL: And they felt the ownership of their county health departments. And they protected not only the nurse but the sanitation officer as well and all of that sort of thing back in those days. You were not afraid to go anywhere that you needed to go because you just were not afraid to go because you were a special person back then. And maybe thats the reason I stayed in public health, I wanted to be a special person.
CP: Because you were a special person. Im interested in your orientation by Ms. Fiske.
CP: Thickett, that came out of Jacksonville. What all went into this orientation for her to tell you what your duties are and kind of get you settled in. You were the only nurse there, and they were afraid, if you left, they might not get another one, so
GL: I have an idea. But the other thing that we did at the health council, we didnt have a health officer at that time, either, because Dr. Robins had been the health officer and Dr. Robins left.
But another interesting thing to me was that the doctors that were in the communitywe had two physicians in our community. And both of those doctors was real interested in public health. And they were so glad thatand I was welcomed with open arms by those physicians. There was no competition between us at all. It was full cooperation all the way. They came and helped the venereal disease clinics when we had to hold the venereal
CP: They did? Did you pay them a fee, or did they do this as a volunteer?
GL: They did as volunteers. They rotated. One, one week, and the other one, the next week. And when we started working, we worked five and a half days a week.
CP: Yeah, we did when I started in public health too.
GL: And they paid me the sum total of 135 dollars a month and the clerk told that I had a limit of 40 dollars for my mileage. And I looked at the county and all that sort of thing, and paying payments on a car and what have you. And after about two or three months, I decided I cant cut this no longer, so I called Ms. Mettinger up and told her, I think I am going to have to quit.
And she said, Dont you dare quit until you meet me in Marianna. And she flew up on some kind of a little plane. They had an airport out in Marianna, and I met her over in Marianna. And she asked me would I stay on at 150 dollars a month and I stayed, and I worked for 150 dollars a month. And then, she said I would have unlimited mileage. So, whatever I needed
CP: In that rural county, yeah.
GL: In thatyeah. So, in the beginnings.
CP: Yeah. And youre still the only nurse.
GL: Im still the only nurse.
CP: Yeah. But without a health officer. Where did you get your medical backup? You did
GL: Dr. Paul and Dr. Segrist. The two doctors that was there. And if I had any kind of a question or they wereif I called them on the telephone, day or night, they were available and all that sort of thing. It was just a good working relationship, whenever I come right into it. Of course, on the other hand, even though, at that time, that they werewe probably shouldnt have been doing some of it, but we did it becausesee, they did home deliveries back in those days.
And if they delivered a baby out in the county, well, then, they would call us and say, Hey, when youre up at such and such, in the area of whatever it is, how about checking in on whats her name?
CP: The baby up there.
GL: Well, it was good for us because we gotwe were in the home without having to do anything, where we could teach public health. We could teach them about the immunizations, and we could teach them about how they bathe that baby, and how they needed to feed that baby, and all that sort of thing. So, I felt like that was a really good thing and we did that, but it was a good working relationship with the community professionals that was already there.
CP: When did you finally get a second nurse?
GL: Well, it must have been about October that a nurse thatsee, we didnt have nurses in our county. They had to come in. There were very few nurses in Holmes and all of Washington County, either one.
CP: Neither had a hospital.
GL: Neither had a hospital, and so there was no nurses inand the nurses that were there, well then, they were working in the doctors offices. But, sometime around October, an oil company came in there, surveying for oil, and one of their wives was a nurse, and she came to work. And she worked until about February, and then they moved on out. And we didnt have another nurse then.
And then Dr. Reems came as a health officer, part-time health officer for the three counties. Okaloosa County, Walton County, and Holmes County were our three county health units.
CP: I think yall shared a sanitarian too, didnt you?
GL: Not to begin with, we didnt. We each one had our own sanitarian, but they had the health officer that they shared. And he came, and he would hold clinics when he came. On whatever days thathe had a day and a half in each one of those counties that he came.
And then, after that, well, then they hired Sarah Williams. And Sarah, she was a staff nurse and I was a staff nurse, and the river divided the counties, so we divided the county at the river. She took care of that business on the other side of the river, and I took east of the river. And I took it on the east of the river and she took it on the west of the river to make all the schools and what have you
CP: Yeah, the house calls and baby follow-ups.
GL: Everything. But our main programs, then, were the control of communicable diseases. And whenever the source case, whenever a case was reported, then, we checked on that case and we followed that case, whatever communicable disease it was that was reported.
And back then we were having diphtheria. We were having whooping cough. You had typhoid fever. We had some Brills fever, and undulant fever. And then all those things had to be followed up and followed through, which we did.
And the venereal disease program, we had about anywhere from 30 to 60 patients every week that came to get. And back in those days, it was mapharsen and bismuth because we didnt have anything else.
CP: And Dr. Reems came over to do the injecting?
GL: Dr. Paul and Dr. Segrist.
CP: Oh, they would come in. Thats right.
GL: They came in and did the injections.
CP: And you were patrolling the 40 for tertiary syphilis.
GL: Well, Im sure that part of it was late syphilis that never had been treated because, at that time, we had a sizableand I cant tell you, now, Dr. Prather, a lot of these things is if you had asked me to do this before I threw it away, all when I had kind of cleaned my house out. We were getting ready for a 50th wedding anniversary, my daughter insisted that
CP: You clean house?
GL: Clean house. So, I threw away some of that history in all of that time. But anyway, they came and didwe had, as I started to say, we had a sizable number of people that were sent to Chattahoochee, because of
GL: Syphilis. And we had, we also had right smart of primary syphilis too, at that time, that we were treating. And whenever you got a case of primary syphilis, we sent some of our patients to Jacksonville, when they used the fever treatment, heat treatments for them.
CP: Yeah, the old heat ship, sitting there in the harbor, in the river.
GL: And thats a lot of the primary syphilis, thats where they went.
CP: Fever ship, US Public Health Service. That wasnt the name of it. But I was on that boat, not as a patient. I was on that boat. I know what youre talking about.
GL: Well, and then, of course, they advanced on until they got to where doing penicillin with that beeswax.
CP: With the beeswaxdo you remember the first that you got? And what did you think of it?
GL: I dont know.
CP: It was painful. And you, the nurse, probably had to give it.
GL: We did.
CP: Penicillin in beeswax.
GL: And we had to give them bismuth. The doctors gave the mapharsen IVs, but we had to give the bismuth.
CP: Oh, the beeswax hurt much more than the bismuth, though.
GL: Yeah, yeah. And it didnt last too long, thank goodness, before they came out with something else. But anyway, we had to go through that painful process of that.
CP: Yeah. That was good stuff, that penicillin.
CP: Because in my first penicillin and VD we collected, wed keep the patient for eight hours and collect all the urine, where we would get the penicillin back.
GL: Then you know about it, too. Youve been there. You like I have. Youve been there for a long period of time. But it was interesting. It was, from the standpoint of the control of the communicable diseases, to do the follow up on those people and what have you. And we had to do all the follow-up from your primary syphilis cases and track down the sources, the contacts, and all this sort of thing.
CP: You did that? The nurse did that?
GL: The nurse did it. The nurse did it. We were busy, you know?
CP: Im sensing that.
GL: We were. And you did not have a minute to drag around, really, whenever itd come right down to it. And, of course, we probably didnt keep as good records as what we ought to have kept back in those days, but the thing about it is, we knew what we were doing, and the other feller could come in.
Even like when I came in, I could pick up the records that Ms. Buckley had written and I could know which direction she was trying to take a family in from the records. So, you kept the records that was necessary to be kept, but you didnt keep a whole lot more.
CP: Good. Mention tuberculosis. You havent mentioned tuberculosis.
GL: We had tuberculosis, and back in those days, well, most of your tuberculosis cases were treated at home. And we had people that would build little screened-in houses, out behind, just a little dirt floor, screened houses, and theyd put their tuberculosis patient in there. And I would suspect that that mightve been what saved some of them from getting tuberculosis because they were kind of isolated.
And, of course, we had to teach them isolation technique and what you. And they did a pretty good job, whenever itd come right down to it, isolating them. But we also had some deaths from tuberculosis, where they just plain out hemorrhaged to death because they had tuberculosis.
And we had a pretty good load of tuberculosis cases. Well, I came to work in 46, and I would say, even until, maybe 1966 that we had some of those families that were still transmitting TB. But we would send them to the hospital, but a lot of them it would be far enough advanced because the programs of detection was not near that good and you could
CP: Forty-six, we hadnt started the x-ray surveys. Those were started in 1950, that first x-ray survey.
GL: Yeah, and the other thing was that we didnt even have a tuberculin skin test that was reliable that you could do the tuberculosis skin test with them and what have you. And it was not until we got to the place where we had the tuberculin skin test that we could do and then follow up with x-rays on those people that we began to make any headway in control of tuberculosis.
CP: Well, those were the tough times. You mentioned undulant fever early. Do you recall anything specific about undulant fever that you can share with us?
GL: Not too much, Dr. Prather. It seemed to me like we only had about two cases of it, was all that we had.
CP: Well, thats plenty. Thats plenty.
GL: But my memory is kind of fuzzy on that.
CP: My memorys getting a little fuzzy, too.
GL: Mines fuzzy about a lot of things, now. But tuberculosis was a real hard program to do anything about, really, whenever itd come right down to it.
CP: Yeah. In the early days before drugs, before tuberculin, and before a reasonable x-ray to travel to the rural areas. And that traveling x-ray, as Im remembering, only started in 49 in Florida, too, for the rural counties. You sent your patients in somewhere else, if you need an x-ray. At a private doctors office, some of them had that
GL: That was the only thing we had was a private doctors office, to send them in a private doctors office to get it done. And Dr. Segrist was the only one that had. And the other thing was that the people did not have the money to pay for those things. And the doctor couldnt afford to do x-rays on them, even if they did have tuberculosis, without being paid for it.
And that was the only alternative we had for patients in Holmes County, at that time. But they, finally, whenever they started coming with the mobile x-ray unit, well, then we had good turnouts for the mobile x-ray unit because that was one thing people was afraid of. They were afraid of tuberculosis.
CP: Did you have a tuberculosis association, tuberculosis society, or whatever you call it?
GL: Yeah. We had a small one, not enough to really do too much, but they did sponsor the annual survey, whenever it came, and did the publicity for it and did the volunteer to help with the registration of them and that sort of thing.
CP: Were you involved with the TB society, tuberculosis association?
GL: Uh-huh. Uh-huh.
CP: Yeah, I would imagine.
GL: I helped organize it. We didnt have any much of any kind of organizations whenever I went. And
GL: Well, I would suspect that needing the help was the thing that
CP: That sounds pretty good. That sounds pretty good.
GL: I think thats what motivated me to do some of the other things, was because I needed the help. I needed them women to come out of their house. But, you see, Dr. Prather, public health was so much different, then, than what public health is now because a lot of our public health was done in the homes themselves, back then. That you were in the homesyou were not sitting in the office, then, there and writing them a card and telling them to come and see you and all that sort of thing.
You were out there. And not only did you look for tuberculosis but whenever I first started in public health, we had babies that were born with syphilis. See, a lot of our births were delivered by midwives. I had a midwife program where we had 22 lay midwives
CP: In that one county?
GL: In that one county. And they did a big part of the delivery.
CP: Talk about that some. Talk about the lay midwifery program and your association with it and how it went.
GL: Well, they were allJule Graves haddo you remember her?
CP: Its not ringing a bell yet.
GL: Well, Jule Graves was head of the lay midwife programs in the state of Florida.
CP: Okay, is she associated with the state health department?
GL: She was with the state health department. And then, Ethel Kirkland, after Jule Graves
CP: Oh, I know Ethel Kirkland.
GL: Well, see, Ethel Kirkland came, and she worked with Ms. Jule Graves. But she also took the place for Jule Graves, whenever after Jule Graves. But Jule Graves had a manual that she had done for you to teach lay midwives.
And the teaching of those lay midwives, some of it had been done, a little bit, by Ms. Buckley and Ms. Lionel. A little bit, not much. But I got that manual, and I held monthly classes with them, and I had them to come in. And Ill never forget
GL: Yeah. And all 22 of them always came to most of the classes, unless they were
CP: Delivering a baby.
GL: Doing the delivery of a baby. And they would come, and they would bring their covered dish, and theyd have covered dish and eat their meal, and then we went into the class and taught them. I taught them about the sterilization, how they could sterilize in their ovens, to do their pack, and fix it up to go to the home to do the delivery and all that sort of thing.
CP: Were they doing any reasonable sanitary deliveries prior to a focus by the state health department? What was the condition of the deliveries?
GL: Not very sanitary. Not nearly as much as what it shouldve been. But they were all, I think that the midwives were, I think they wanted to do the right thing, and I think that they did what they knew to do, but there was just so many things that they didnt know about. And that was the
CP: Yeah, there was a midwife in Walton County, by the name of Gladys
GL: Gladys Milton.
CP: Thats right. Gladys Milton. The message she told me of the early days of having dung from a newborn calf, that there was a problem keeping dung from a newborn calf to treat the umbilical stub with after the delivery.
GL: Well, now, I never did run into that.
CP: She told me about that, and she didnt think that was very good because her physician had tried to talk her out of that. But that was the way because itd make the stump fall off quicker. But you had to have the dung from a newborn calf.
GL: I never ran into that one, but I tell you what, I remember we were talking about thein the manual where they talked about maternal deaths and infant deaths and that sort of thing. And I can remember that this one midwife, and I can see that moment today as good as I could then. She was long, tall, and black.
And she said, I dont have noIm never going to have that. Im not going to have that. And I said, Now, you say youre not going to have it, but you may. Not me, and that just interested me. And I said, Well, how come youre not going to have it? She said, Because Ive been mersmerized [sic].
CP: She had been mersmerized, okay.
GL: And of course, I wasnt about to let her know that I didnt know what mersmerized was. So, one of the first things I did was soon as they got out and everything, I called Dr. Paul. And I said, Dr. Paul, Ive just heard something another. I dont know what it is. Ive got to call you and ask you about this.
And I told him that she had, that this woman had told me that she had been mersmerized. And I said, What was she talking about? Do you know what she wouldve been talking about? I didnt ask her because I didnt want her to know that I didnt know.
And he threw his head right down and he laughed. He said, Yeah, I know what shes talking about. The water broke and the head came out with a sack over her head, over her face and everything. So she had the veil over her face, and thats why she was mersmerized.
That just tickled me so good. And I think of it, today, it is just as funny as it was back then because it was one of those things that I had never heard of. And I thought, That is really something. But anyhow, we finally got them to the place where they were doing a pretty good job of doing sterilization
CP: But still doing most of the deliveries in Holmes County?
GL: Yeah. They were getting
CP: When did that tide turn? When did they begin to do less and more were in the hospital?
GL: If that was in 46, then it probably was somewhere around 58, 58.
CP: Fifty-eight. Lord. But now you have a hospital, too.
GL: Weve got a hospital there, but they dont do deliveries there.
CP: Did they not ever? When it was recently built?
GL: Yeah, they did some, when it was originally built, but not very many.
CP: That was a criterion for the Hill-Burton hospitals. You had to have OB service.
GL: Well, you know you did it. And then but when you got to where you didnt have doctors that did it, well then, you just didnt havethere wasnt nobody to do deliveries. They were not going to let those lay midwives come and do them.
And so our deliveries, that was a thorn in my side as a public health nurse that I never did get solved because I felt like, all those years, that it was wrong to expect women to leave and ride 50, 75, or 100 miles to go someplace to have their babies delivered.
CP: And whered they go? Pensacola and Panama City?
GL: Pensacola, Panama City, Milton, Jackson County, Dothan, Geneva. Wherever they could find a doctor to deliver.
CP: You know, thats kind of sad.
GL: And we did. I figured that the health department, our health department, was going to get in trouble with this. I think I even talked to you about it one time, about that we provided prenatal care for them and trying to get, all the time, trying to get them to go to the doctor and trying to get them to get a doctor.
CP: Get a doctor on line for the delivery.
GL: And they justof course, I know it was a matter of transportation and it was a matter of money. Money and transportation. They didnt have transportation to go to those places, and they didnt have the money to go to those places.
CP: Took a little break, but we were talking about lay midwifery somewhat and your concerns. And one of your major disappointments was that you never did get a good delivery service for homes that
CP: Is that true as of 1997?
GL: Thats right.
CP: It is? What are yall doing then?
GL: We have a woman doctor there, now, that is doing some deliveries.
CP: Okay, low-risk deliveries.
GL: But I think shes doing it in Jackson County.
CP: Theyve got a good delivery unit and
GL: Theyve got a good delivery unit there.
CP: service there. Yeah, and they got a number of boarded, at least two boarded obstetricians that I know about there.
GL: But most of the ones that the health department is following and that sort of thing is going to Panama City. I think, now, theyve got a contract with that one doctor to have
CP: And who is paying his Improved Pregnancy Outcome or Healthy Mothers, Healthy Babiespaying for that stuff?
GL: Ive not talked to Margie about it, really. Lately, Dr. Prather, Ive beenso I dont really know what theyre doing, but I think that thats must be where he was coming from.
CP: Yeah, thats modern times. Im going to come back to your most disappointing moments. Thats one, but lets dont go to that yet. Okay, we also want to talk about your highlights, too, but dont want to go to that yet, either. I want to get back to how you began to expand the nursing service. Up to this point, weve got one nurse over there, and thats Ms. Lee.
GL: Thats right. And Sarah Williams came, and when Sarah Williams left, she had been gone three or four months when Norma Simms came to work with us. And Norma and I worked, then, untilshe had one side of the river, and I had the other side of the river, doing the same old thing that we did until
And, Dr. Prather, back when I said that we in Holmes Countythe schools, a lot of our public health nursing actually started within the schools because we hadand its like I told you on the phone the other day, that we were one of the few counties that they wouldvepublic constructions contributed to the health department, and it continued to contribute to the health department.
Now, in about 1959, we got a superintendent in there that decided the schools should not be contributing to the health department. So, that year, he didnt put any money in the budget, nor he did not notify anybody he wasnt putting any money in the budget. And we would have been crippled had it not been for the state health office coming forth and, kind of, taking up some of that slack and what have you.
Of course, I think the thing about it was that we probably had money in theI didnt do all the money business. I did a lot of it, but there some of it that I didnt do. And thats one of it that the health officer, Dr. Nelson was supposed to have been the health officer, and Dr. Nelson at that time was supposed to have been seen about the budget and what have you, and Dr. Nelson had neglected to say anything about it one way or the other and just depended that they wouldnt
CP: As theyve always done.
GL: As theyve always done and what have you. But that year, we had a new superintendent, and they didnt do it. But we continued to provide.
CP: The school health services?
GL: We cut down some on it, and we told them why were cutting down. And whenever they called us, and they thought they had a case of measles or something another, well, then, we told them, Well, you just have to have them handle it and you can send them home, or whatever you want to do.
Of course, whenever itd come time, then, for the next timebut two lawyers that were still interested in the health department, and when itd come time for the next legislative session to meet, they got a special bill passed for populations of such and such, how they used to do it? But that in Holmes County that the racetrack money could not be divided until the county health departments was adequately supported.
CP: Really? I wasnt aware of that. That started in Holmes County?
GL: Yeah. They did it in Holmes. And they did it because that superintendent then decided they didnt want to put no money in back then. But we continued providing. And our schools, our children hadlet me see, Rupert was the sanitarian by then, so it mustve been 49, 50, thereabouts, maybe 48, 49. But we had 75 percent of our children was infested with hookworms. We did a total survey
CP: My gracious. In 50?
GL: And, well, it was over the last of the 40s.
CP: Okay. Thats still pretty late, though. Im still surprised at that.
GL: But I will tell you that we didnt have all that much sanitation back then.
CP: And you still had a lot of surface privies, Ill bet, too.
GL: That we had and some places didnt even have privies. And, so Rupert and I tookthat year, when we did that survey, and we found that we had had several children that were so anemic until they had to be hospitalized.
And we did. In 1947, the US Public Health Service sent some physicians in our county. And they were, I dont know, they were just not finished school yet, but they did the examinations. They did physical examinations on almost all the children in the county. And
CP: US Public Health Service externship program.
GL: Yeah. And so, when they did that, we did hemoglobins on them, and we found that they were low, low, low in the hemoglobin. And Rupert and I started going from and would call a community meeting for all the people in the community, and we wore out two or three sets of that Hookworm Charlie, showing them Hookworm Charlie.
CP: Yeah, I remember Hookworm Charlie.
GL: And talking to them about why they got hookworms and what we had to do in order to control them. And they started, they were building
GL: Sanitary pit privies, yes. But a lot of men, by then, had come back from World War II, and a lot of them were begin to get interested in trying to put bathrooms in their houses and to put in their buildings. And at that time, they put in a lot of pit privies, and then a lot of people went ahead and put in
CP: Indoor plumbing? Building their septic tanks?
GL: and what have you. But one of the things that, and, you would think that people just would have better sense than to do this sort of thing, but we found out that one of the men there in town was selling deep wells to people in their bathrooms and was selling all the materials to fix their bathroom and everything.
And instead of building them a septic tank, like he was supposed to be, he was piping all back in the dug well that they had before they put the thing down, and then that created quite a problem.
CP: Oh my gracious. What did your health department do about that?
GL: Well, they cited him for it. And
CP: Did Rupert get out there and get on his high horse?
GL: He did, more. And he got some other people on their high horse and what have you about it. So they took care of that right away. I dont think he got away with but one or two of
CP: Thats worrisome.
GL: Yeah. Because you wouldve thought that a businessman wouldve had
GL: He could make more profit. He knew that that was the whole thing, that it was a profit incentive. But anyway, we began to see a decline from then on with the hookworms and what have you.
CP: Did you do mass treatment? I remember, when I was younger than I am now, the state board of health coming through and doing the surveys. And then the health department would come to the school, and wed all take our medicine. I mean, wed line up and get our medicine.
GL: Well, we didnt do that. But we notified all the parents, and the parents came in and got their medicine. Or else, if we were in the home, and we didnt go out without taking hookworm medicine with us because we knew that if we got into a home where we had notified them that their kid had hookworms that they were going toand the whole family, the whole family would take the treatment.
CP: That was recommended that any family, the whole group, would take the treatment.
GL: And so we began to kind of beat on that problem with the
CP: In essence, I cut my teeth on hookworm in public.
GL: We got all the women in the schools, surrounding schools, and what have you, involved in it. And they helped us to get the specimens out and bring them back in and get them wrapped up and all that sort of thing. You couldnt get anyone to do that today. No way you could get them. We couldnt. I know women, and I know you couldnt get them involved in that sort of thing.
CP: But it was a community effort, and that was largely because of your organizing them.
GL: And I take my hat off to them because I think that they were the bestest [sic] women there was in the country, really, when it comes right down to it. Some of them were, of course, you know, a lot of my people at that time, their education level was low, even whenever Dr. Simpson came in.
And you ask about when we continued to nurses, when we first added on another nurse was, and I dont know whether you know it or not, but you remember when the OEO program, Office of Economic Opportunity came out?
CP: Yes, yes, I remember.
GL: Well, a man working with the Farmers Home Administration and I got together, and we decided that we wanted to get some of that money.
CP: All right. I think thats okay.
GL: We wrote us a project. And we did get some money for the three counties. Then, we had gone to Washington, Holmes, and Walton County. Okaloosa County had got their own health officer and all that sort of thing.
CP: And Simpson was the director.
GL: Dr. Simpson. Well, Dr. Simpson came as the director just about the time that we got the OEO project and when the people from Washingtonand the first time Dr. Simpson came into Holmes County and Dr. Parks brought him over to Holmes County. And Dr. Parks and Dr. Simpson sat in on the meeting with the people from Washington DC.
And they didnt think too muchin Atlantaand they didnt think too much of the health department having that money from the OEO. They thought that we ought to be getting money from the US Public Health Service or something another, rather than their OEO monies. And Fred Johnson, he was superintendent at that time, and he finally got tired of all their bickering back and forth and what have you.
And he said, Well, Ill tell you what you gentlemen do. You all just get up from here and go back from which you come. Weve taken care of Holmes County problems for a lot of times. And if you dont want us to have that money, well continue to take care of Holmes County problems. Well just throw this thing right in the trashcan.
Well, then they began fishtailing back and what have you. And the reason they did, because they knew that Bob Sikes was already involved in it before the project ever got off, got sent up there, well then, Bob Sikes was already involved.
CP: They better back off if Bob Sikesyeah.
GL: They knew. And so, in all three of them counties: a nurse, a sanitarian, and another doctor. And each one of us got us a park.
CP: From the OEO money?
GL: From the OEO money.
GL: And we had that for a year, but thats all we had for the year. So then we had to find something another when that year was out, to take over. And
CP: What did you do?
GL: Well, I guess that we had gotten to the place, by then, where our county commissioners had more money, and maybe we had better rapport with them or something
CP: And they were seeing results.
GL: And they were seeing results. And they picked up the slack and supported it and continued to support it.
CP: And then so you moved into the 20th century, in so many words, with that OEO money.
GL: And from there, then, and of course, about that time, seebut now, we werentand let me tell you, this is when we went into home health services, whenever you got the place where we could go into home health services.
Of course, we had already been doing some home health services ever since I had been there because in doing those notesI wonder what it is, but I threw them awaybut anyway, I began to think in Holmes County, in the early days, in the early times of public health in Holmes County and social welfare in Holmes County, that we had a collaborative effort.
A total collaborative effort between the private practitioners, who were the backbone, the social service workers, the home demonstration and county agent people, and the Farmers Home Administration people. We had a total collaboration. And then you get to a place that public health and HRS [Department of Health and Rehabilitative Services] and that they get all thrown together and everything.
They spent from 1970 right up until the day I left there, trying to get back to a collaborative effort. And I thought, Well, you threw it away, a way back, and thats why you want to go back to it because they did. We had.
CP: Did you have any insight into that?
GL: Back then?
CP: Yeah, Im aware that HRS was designed to force that collaboration. But many of you small county health departments, you had it going. And one of the early secretaries would speak to, didnt speak to Holmes County in specific because he didnt have knowledge of that, but he would talk about the way these rural counties, they knew each other, and they did this.
GL: They did, Dr. Prather, but what you got into was that it all goes back to the money situation because all of a sudden, they were in competition with each other. They were in competition for the dollars that was going to be spent. And whenever you get to the place becauseand I think that, whatever, if theI dont know whether it was the legislation itself or whether it was
CP: An attitude of the administrators.
GL: Yeah, or what. But anyhow, they put into force the county health department, so to speak, to be the medical arm for the social service patients.
CP: Yeah. That was an early philosophy.
GL: And when you began to do that, then the county health departments were no longerthey couldnt claim ownership. The public officials could not claim ownership of the health department.
CP: They had no sense of belonging.
GL: And they had no sense of belonging, and the other thing was that you could not do what was needed within your county because the programs were prescribed to you and, more or less, handed down to you. And you had to do it. We had a consultant come by one time, and he was going the one program, and I cant even think what he was pushing, now.
But anyway, he was telling me that we could take time away from the schools and do his program, whatever it was. And I think they were putting, in our county budget, that they were putting something like 1,000 dollars in there to do whatever it was that he was wanting to do.
And I took him and I said, Let me tell you something, when you get to the place where youre putting the kind of money in my health department budget that the board of public constructions is, then Ill do your program. But now, theyre putting in a big part of my money, and theyre going to get the biggest part of my time. And I
CP: Makes sense to me.
GL: Well, it makes sense to me, and it always has. But anyway, but thats some of the fights that we got into in the (inaudible). Because, all of a sudden, you could not do what you knew, and what you could see, and what your people who were around you was telling you what needed to be done and what the services that ought to be provided because you were so busy trying to provide the services that somebody else was imposing on you and also trying to justify the jobs of some of those people that were in those positions. But thats my
CP: Thank you. Thats very good. I happen to agree with you.
GL: Well, if you agree with me or not, its the way that I felt.
CP: I got you off course. But you were beginning to tell me about your early days in home health services. The county health departments, seems to me, have always done home health services. I remember a public health nurse coming in my house because she had heard that I had been diagnosed with measles. And she came over to check on me and to instruct my mother in my care. I render, now, that was home health care.
GL: Well, we did that, and, of course, we considered that being follow-up on communicable diseases. But with pure home care, we had, and particularly, I can remember this one man that was a World War I veteran, and he lived by himself, and he had cancer. It had just eaten out the whole side of his face. He couldnt see anything.
And the social service worker called me, and she says shed come in, and she was just all in a dither. And she says, You have got to go with me. I said, I dont know nothing to do to tell that man, but that mans got to have help see him.
Now, one of the things that she was in such a dither about was the man had maggots in that thing. And I said, Well, Margaret, you neednt get so upset about that. They usually put maggots in places to take care of the debris. So, its just taking care of the debris. Hes probably better off with it than he would be without it.
But anyhow, I went over to see the man. And we did this. And even from the standpoint ofI picked up on the man right then, and I talked [with him]. He didnt have anybody to live with him, but he had a niece that came in the afternoon to see after him and what have you.
And I went at night to teach her how to change the dressings on his face and how to take care of the wound and everything. And of course, then, whenever we got back, well, I called the doctor to try to get him because he was in the terminal stage, and he didnt have any pain medicine or anything else and thats just one that I can remember doing. And we went
CP: And this is in times when you did not have a, quote, formal visiting home healthcare service yet.
GL: No. And Dr. Paul and Dr. Segrist was frequently calling us. Maybe they would have a patient that they needed a catheter put in the patient because they were not able to pass their urine or something another. And they would call us and ask us. Well, we never refused to go because they were
CP: They were your friends, and they were helping you.
GL: Thats right. And when we did not have a doctor, and a lot of times Holmes County didnt have no doctor
CP: Yeah. And even when you had one, you didnt have him because he was somewhere else.
GL: Yeah, thats right. But there was a lot of times when we did not even have one, that the position was vacant. And we had to depend on the local doctors there to give us the medical directions that we needed in order to continue to do this public health nursing service. And Im sure that they did in other counties, too. I can remember when we had the polio epidemic. That was a scary time and a kind of a trying time for us because, see, we had a couple of children that died from polio, got bulbar polio, back then.
CP: That would upset that little, small community.
GL: You better believe it upset that community. And Walton County was even worse than we was and they called forand the medical doctors themselves was the ones that provided the leadership and all of that sort of thing, in order to get it. But gamma globulin [immunoglobulin] was the only thing we had to give back in those days. And all the nurses, whenever they called us and said, Now, were going to be doing this, and we need some more nurses.
Well, this was like disaster nursing because the nurses from Okaloosa County and the nurses from Holmes County went, and the doctors were there, and they were giving injections, and we were giving injections. And we immunized, I dont know how many children that we immunized there that day, but they have had a couple, three deaths from polio.
CP: Keep talking about that, about the polio scare, and how come it came on, and what the community did. Did you close theaters? Or did you have a theater?
GL: We had a theater, and they did close the theater. And fortunately, it happened just as school was finishing, so we didnt have to close the schools or anything like that. But they encouraged them to end the nursery, whenever they would take the children to church. They closed the nurseries and parents were encouraged to just leave their children at home if they went to church and what have you.
But there was not too much public gathering. But then they were advised to not do too much public gathering and what have you. And the ones who had been in contact with the cases that we had, we gave all of them gamma globulin.
CP: Yeah, thats the only thing you had to do.
GL: The only thing we had to do.
CP: But it worked. It could do a lot of good, a lot of good.
GL: It mustve done a lot of good because it stopped it. And I can remember that we called Dr. Batson, he worked, but he was with Childrens Medical Service, and we were so upset. See, because by then, Dr. Paul had gotten to the place where he was semi-retired, and Dr. Segrist was the only doctor we had in town.
And so I called Dr. Batson, and I told him. I said, We are in a predicament because we are able towith these kids that weve And it seemed like there was 12 cases besides the two deaths that we had.
CP: Really? Any of them paralytic? What did you do the cases? Did you send them off to the rehab center in Jax [Jacksonville]?
GL: What we did was, and this was the reason I called Dr. Batson. And I asked him, Can we, if we have some of these children and we cannot get them diagnosed, can we send them through the Childrens Medical Service since I called you and get them in here? And he reluctantly gave permission because he knew what the situation was in Holmes County, fortunately. As a medical doctor, he was concerned.
CP: So he was in Pensacola?
GL: Uh-huh. And, of course
CP: And this was crippled childrens, crippled childrens
GL: Um-hm. And when Dr. Segrist would see one, well, then, he would call Childrens Medical Services. So Childrens Medical Services took most of the cases that we had from Holmes County. And one of those girls, she was the high school principals daughter. One of the first cases we had. And she was, the last time I knew anything about her, she was still in one of those iron lungs.
Of course, its been several years since Ive heard anything from her and what have you, and weve got some of the kids thatweve got one that I know right now, and shes still paralyzed, wears a brace and all. And she was about ten years old whenever she had it and shes still, from her waist down, paralyzed.
CP: Too sad a lot of our legislators, none of our legislators today know that firsthand. That is frightful. Polio to come through a community is frightful, and itd really make you call for your county health department.
GL: Well, it did then. And we worked and I guess the most frustrated that I ever got in doing public health work was that somebody at that time accused me of giving the bankers daughter preferential treatment. It made me so mad that I liked to have died because she was the very best friend of the principals daughter, the first one that had it.
And, of course, he called me at night and told me that the doctor had diagnosed her as it. And he said that they had been to the doctor, and the doctor told him that the only thing he could do was get gamma globulin. And he said the county health department has the gamma globulin. Then, what?
He called me, and I went that night and gave it to her. And then to have somebody say preferential treatment when they didnt know what they were talking about. That always irritated me to death, anyways. People that didnt know what they was talking about, second guessing you, and telling you what you were doing and that you were not very good.
CP: Im going to pull you back to home healthcare now. We dealt with the man with the bad cancer and that was kind of beginning. But you got formally into home healthcare, and you became kind of one of the first for home healthcare.
GL: Yeah, we did because when they first came out with the legislation that we could getand I had a time trying
CP: Medicaid reimbursement.
GL: Uh-huhto getbecause the one lawyer that we had that was still interestedand he had got kind of old and crotchety by that time. And Amy Mattison and them kept telling us that you had to form a separate
GL: And when I came and talked to him about it, he says to me, You dont have to form another organization to do it because the county commissioners can give you, under some kind of law or something another, that they can give you permission to do home healthcare in your county health department, in their county health department, if they want to.
And I said, Yeah, but it has something another to do with the budget, that that money has to be spent for home nursing care. He said, Well, whats to keep it from being spent for home nursing care? And he was right, whenever it comes right down to it. He was more right than what they were down there, but I didnt know it. And I didnt know nothing to do except follow what they said.
So then I went to Walton County, and I had a friend over there that was a lawyer. And I got him to fix up all the papers and everything to put us in the home healthcare business. And we got our group organized and all that sort of thing, and we got certified and licensed as a home health agency. And it took off just like that.
And the first year that we were in it, thatwell, we were not in it all the year. We didnt have any of the other services. You had to have nursing service, and you had to have one of the other services: physical therapy, occupational therapy, social service work, and all that sort of thing. But home health aid was one of the ones you could have, so we trained us some home health aides.
Norma Simms and Mary Spence did the training of the home health aides, and we trained us some home health aides and got busy in it. And we started, I think we started sometime in December, something like that. And from then until the end of the budget year, we had already collected more than 10,000 dollars in the home nursing program.
CP: How did it impact your nurse staffing?
GL: We worked. We continued in a lot of the nursing that they have now. We continued to be able to put more nursesas a home health agency were able to begin to put some more nurses in. And then, of course, we had Medicaid.
And then, whenever we started doing the Medicaid screening and what have you, we got money from that and increased the nursing staff and what have you. And I dont even know how many nursing staff they have at the health department now.
CP: You cant keep them in a warehouse over there. I dont know either. But theres a bunch of them.
GL: Yeah, it is. I know that whenever I left there thatlet me see if I can count them up and seeI think whenever I left we had 10 public health nurses in Holmes County.
CP: From beginning with one.
GL: Beginning with one.
CP: Beginning with one. Thats amazing. Looking back over all that career, whats the highlight of your career?
GL: I would say that, I guess, I dont know what youd say was the highlight, but Id say the growth thatmy own personal growth.
CP: Yes, okay.
GL: That it probably was when we started doing the hypertension control program that we did.
CP: Oh really?
GL: Oh see. You forgotten that?
CP: No, Iyeah, I had.
GL: We had whenever Dr. Gruber and Dr. Simpson wrote that thing up for us to do the hypertension control program. And, of course, Dr. Simpson had talked to me all along about the program and what they hoped to be able to accomplish and all this sort of thing. And we knew that we were having a lot of people that was having strokes, that a lot of the home nursing load that we had was post-stroke patients.
And we were all concerned about that. And, of course, when Dr. Simpson got there, and he began to look at the figures on it and what have you, well then our death rate from heart disease and strokes was way out, more than what the state was, in those three counties.
And, of course, he had some resistance from the physicians over in Washington County, a lot of resistance there, in Walton County. And they didnt get started over there early. But he had advertised for maybe a couple of months for a project director to direct it.
And he finally came in there and sat down in my office. And he told me, Well and he had interviewed several people. I dont know how many people he had interviewed. I finally found me a project director for our hypertension control program. And I said, Oh good. Who did you find? I was so excited because I thought He said, I found you.
And I said, No, Dr. Simpson, I cannot do that. You just dont know how limited I am. And he says, Youre limited because you limit your own self. I have interviewed and interviewed. I dont think theres another soul that can head this project and do the work and get it off the ground like I think you can.
CP: I wouldve agreed with him.
GL: So, of course, I felt real flattered, and I felt humble, too, at the same time. But I thought, Well, if hes got that much confidence in me, I reckon I ought to have that much confidence in myself. And so, he told me that he would put Norma in charge of nursing in our county and that I would be the project director of the three counties and what have you.
CP: Thats where I really met you, was when you were doing that.
GL: And so, I started doing that thing.
CP: And you had fun at it.
CP: Because you went to all the statewide meetings and talked about it.
GL: Well, it was exciting because we did things that I had voted to do with a lot of other programs. Now, the first couple of months, I spent at my desk, writing the project guidelines and deciding what kind of forms we was going to use, and all that sort of thing and what have you.
And added 19 pounds, during the time, that I didnt need but whenever you took me away from being a racehorse, and I didnt slight, then, on my eating. So he put 19 pounds on me that I have had trouble trying to get off ever since.
But we did, and we found a lotand I was going to bring that to you, that article that I wrote for the nursing journal on that thing and let you see it. But I did have a good time with it, and
CP: Send it to me, at my home, and Ill put it with this tape.
GL: Okay. And I said, I guess one of the things thatyou know how I went to New York and spoke to the New York Heart Association of Nurses and that was something else, that was, poor little old me from out in the countryside. But I had a sister that lived in New Jersey. And so when that woman called me, I just couldnt resist.
I knew I shouldnt do it, but I just couldnt resist having my trip paid up there to see my sister. So I went, and I did it. And it went over real good because whenever I did it, I was scared to death, like I was with this, but I did it anyhow. And, of all the questionsthere were several of us on the programbut of all the questions that was asked, I got almost all of the questions about how we did the program.
CP: And you had the answers.
GL: Um-hm. Yeah, because we had done it, and I knew what to do with it. And they wanted to know if there was a way that they could integrate this into the hospital. And I said, You shouldve already integrated a long time ago. In all the hospitals, that blood pressure checking shouldve been a routine thing and notification of the doctor, and to talk to him about it and to make sure that the people were being followed with there and continued to follow on their medication, and this sort of thing.
And you know that one of the best part of that whole thing was, that as long as we were on and as long as public health in those counties had that control of hypertension as a part of the program, we saw the stroke cases go down. And gradually, theyre beginning to go back up again.
CP: Thats disappointing. Thats disappointing that the health departments forgot yesterday.
GL: Well, I dont think they
CP: Forgot our history.
GL: I think that they just are so overwhelmed, Dr. Prather, with all the other things, that theyre notand you see, theyre not, or they had, for a while now, that maybe changed some nowbut for a while, they were not emphasizing hypertension control and the control of chronic diseases.
But, we picked up a lot of diabetic cases there. We picked up a lot of heart disease. We picked up heart disease in children, in two or three children that their doctor said that they would probably have keeled over at physical education, that sort of thing, if they hadnt had [gotten] surgery
CP: Hadnt been picked up early. Thats terribly valuable, terribly valuable. Well, our attention has been directed to the wrong places
GL: I think it has, too.
CP: Thats your outstanding. And you mentioned your most disappointing disappointment while you were there. You mentioned that. Give me the second mostoh, and dont you talk about training of nurses.
Now, as you begin to advance these nurses, you came in, they sent a consultant over to orient you and, quote, train you in what to do. Now, with all your new nurses, how did you get them trained?
GL: Well, they had started an orientation program for the nurses at the time. And I told you that Norma Simms went down to Gainesville to the orientation program down there, and, of course, she had been working for a good little six months before they ever got the spot, before they could send her down there.
And when she went down there, where she stayed a month, she finally told them, Now, Im going to tell you all. You all dont do public health nursing in Alachua County like we do in Holmes County. Im going back home because they need me up there a whole lot worse than I need to be down here, and thats what she did. She came back home. That was just the way she felt about it, and so, she came back.
She never did go back to orientation. And then they got to the place where they were sending them to Pensacola, and they wereof course, I dont know. I feel like, from some of the things that the nurses came back and said, that those orientation programs was not set up in the way that they should have been set up.
I think they were set up for a longer time and that they taught or tried to teach those nurses to do things that they already knew how to do because I know that a couple of the nurses came back and said, All I did while I was down there was to stay in a VD clinic drawing blood. And so, I learned how to draw blood. So we addressed that in one of our
GL: Well, not the case conference, but we started having a director of nurses, a real conference. And so we addressed that in that and told the director of nursing over in Pensacola, who was over that that, Uh-uh, we werent sending more nurses over there for that kind of thing, that that was not why we sent them. And then, she changed it where that they did begin to get some of the things that we felt like they needed.
CP: That shouldve been on the front end.
CP: It got straightened out, though, in due course. If you had all this to do again, what would you change? If you were coming out of the Army again, would you write Ms. Mettinger?
CP: You would.
GL: Do you know, Dr. Prather, Ive had different people ask me this, and I am happy with what I did. And Im glad that I stayed in the same community and did my public health nursing
CP: Yes, your effectiveness increased over time.
GL: Well, it did. It wasnt just my effectiveness, note, but also that I saw the changes. So many times in public health, you dont ever see the results, and you dont get to see the benefits and what have you.
But I saw families that would not come in and get their suggested immunizations that they didnt have the transportation, they didnt have this and they didnt put forth the effort. And despite the fact that they told me I was not to do it, I carried my immunizations and gave it to those children at home. And they
CP: You were selective in the ones that you did that for.
GL: Yes, I did because I knew that that was the only way they were going to get it. And yet, I saw those kids, when they had their children that they were the first ones to get on the doorstep to see that those immunizations were given to them.
CP: Okay, thats lasting education.
GL: I mean, it was lasting education, yes. And thats rewarding, it really is. And I told my children a long time ago that the most rewarding thing in the world is not doing the job that youve got, that youre hired to do, and its not doing the job good, that youre hired to do. But the most rewarding thing is what you do above and beyond the call of duty. You know, the
CP: Yes, thats true. Thats the personal satisfaction.
GL: Thats where you get your personal satisfaction.
CP: That inner feeling of knowing, I helped somebody in need. Oh, thats just splendid.
GL: And there, you help yourself.
CP: And therein, you help yourself. But you dont approach it from a selfish point of view.
GL: No, no, no. But I dont know that I would change anything in my life. I think Ive had a most rewarding life, whenever it comes right down to it. And Ive met some of the most wonderful people in the world and
CP: Let me tell you, theres a good prospect that your great-great-grandchildren will look at this tape as a part of the worldwide Internet information highway. What do you want to tell them?
GL: I guess if I would tell them anything, if I had an opportunity to tell them, theyinvolve me in the first place, still trying to get some of this weight off from me, that 19 pounds that I put on but anyhow, some others too. But the woman who was leading in that has told us to set some goals.
And I was sitting down there, and I told them that one of my goals would be to teach my children some of the wisdom that Ive learned over the years, so that they wouldnt have the pain and heartache and that sort of thing of having to learn it on their own. And I dont think you can do that. I think they have to have
CP: So much of it theyve got to learn for themselves.
GL: Theyve got to learn for themselves that would be my goal to do that thing, but if I would say to my grandchildren and great-grandchildren that what they need to do is to put God first. And from the standpoint of doing that, and then to ask him every day, What is it that I am to do today? And help me along the way to make the choices that I need to make in order to do what needs to be done to help humanity wherever. And thats what I would tell them.
CP: Thats good. They will watch that. Well, on behalf of the University of South Florida library system and the School of Public Health, there, Mrs. Lee, I thank you sincerely for coming by and sharing with us whats been a glorious career in public health for you. And I just thank you sincerely for doing it. And Im Skeeter Prather.
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