Nursing in New Deal programs in NC by Phoebe Pollitt
NURSING AND THE FEDERAL EMERGENCY RELIEF ADMINISTRATION
AND THE CIVIL WORKS ADMINISTRATION IN NORTH CAROLINA
“The great object of the institution of civil government is the
progressive improvement of the condition of the governed.”
John Quincy Adams, 1825
Our current national debate about health care echoes one held over half a century ago. The proper role for government to play in establishing, financing and staffing health care institutions has long been a source of controversy. During the Great Depression of the 1930’s, the voters and their representatives in Washington opted for a massive expansion of the Federal programs and dollars into what had been an almost entirely private-for-profit health care delivery system. These new programs: The Federal Emergency Relief Administration (FERA), the Works Progress Administration (WPA), the Civil Works Administration (CWA) and the Social Security Administration (SSA), all part of the “New Deal,” changed national thinking about health care in a myriad of ways. Before these programs began it was unusual for local and state governments to take an active role in the provision of direct patient care; since their inception, it is rare for a county to not sponsor a well-funded health department, as well as a school nursing program, a hospice program, and health programs aimed at the aging population. The current debate centers on how best, as opposed to whether or not, the government should facilitate optimal health for the citizenry.
While much has been written about the major construction and artistic projects undertaken by New Deal agencies, few scholars have studied the nursing programs concurrently initiated by the federal government. This article explores how the New Deal programs dealing with health care affected nursing in one state, North Carolina. Knowing about past health care reform efforts can inform and shape our current debate.
Hard Economic Times
The Stock Market crash in 1929 worsened a period of economic depression, unemployment and great financial hardship for many people in the United States. Virtually all areas of the country and sectors of the economy were adversely affected. In 1930, 26,355 businesses failed. Many factories were idle. The most fertile topsoil on farms in the midwest, the “breadbasket of America,” was literally blown away in the Dust Bowl. Unemployment rose from 4 million in 1930 to 12 million in 1932 (Davidson & Lytle, 1988).
The nursing profession suffered from unemployment along with every other occupational group. Local, state, and federal government provided few employment opportunities. In 1933, there were approximately 3,000 counties in the United States. Of that number, one-third did not employ any community public health nurses and 45 percent had no hospital for general community use (Sargent, 1933). Nurses who had been employed through private and philanthropic organizations in the 1920’s often found themselves jobless when their sponsoring organizations were no longer able to raise sufficient funds to pay them. For example, the Red Cross, the largest world-wide employer of nurses in the 1920’s, had reduced its number of public health nursing programs in the United States from a peak of nearly 3,000 in the 1920’s to approximately 650 in 1950. Thousands of former Red Cross nurses were jobless in the midst of the depression (Buhler-Wilkinson, 1993). As Mary Roberts, R.N., noted during the 1933 conference of the Southern Division of the American Nurses Association:
“… we have the social and economic paradox of the unemployed nurse and the unnursed patient, which is, however, no more paradoxical than the farmer with unsold wheat and children in the city begging for bread…”
Most nurses in the 1930’s, in North Carolina as in the rest of the country, were self-employed in private duty. Their hours and days of employment naturally varied, making accurate records of un and under-employment impossible to ascertain. However, contemporaneous articles in nursing journals describe a dire employment situation for nurses. Ashmun (1933) wrote in the American Journal of Nursing: “The existence of serious and growing unemployment in the nursing profession is unquestioned. Just how much unemployment exists among the private duty nurses can hardly be determined accurately…” Six months later in the same journal, Sargent (1933) noted: “One hears and reads of overcrowding in every profession, particularly in nursing, education, medicine, and law. It is not without reason that nursing was mentioned first…”
In light of decreasing rates of unemployment and increasing rates of poverty and despair, citizens sought a more active role for the federal government in meeting their economic and social needs. Soon after the election of 1932, Roosevelt noted that one-third of the nation was ill fed, ill clad and ill housed. The new administration embarked on a course of government expansion known as the New Deal.
North Carolina in the Great Depression
North Carolina did not escape the ravages of the Great Depression. In 1930, North Carolina was a largely agricultural state. While thousands of North Carolinians, especially white men, owned some land, sharecropping and tenant farming were common. Small towns dotted the map. As early as 1930 there were reports of farmers starving. In that same year, 7.5 million dollars were owned in delinquent property taxes and over 150,000 parcels of land were for sale for nonpayment of taxes. Tobacco prices (North Carolina’s primary cash crop) which were 22.5 cents a pound in 1922 dropped to 6 cents a pound in 1931. Similar devaluations occurred in the cotton and peanut markets (Badger, 1981).
The business and industrial sector of the state’s economy also suffered during the Depression. Between 1930 and 1933, 195 banks collapsed losing over $103 million dollars of customers’ deposits (Badger, 1981). Industrial unemployment trebled in 1930-70,000 workers were without jobs and 20,000 more were working only part time. By September 1931, an estimated 100,000 industrial workers in North Carolina were unemployed (Badger, 1931). In this era before unemployment compensation, food stamps and other programs providing a “social safety net,” unemployment and lowered pay often led to homelessness, hunger and ill health.
Martha Gellhorn was employed as a “social surveyor” for the federal government. In this capacity she traveled the country writing first-hand accounts of the conditions she found. In 1934 she visited several small towns in North Carolina. She had this to say about health conditions in Wilson, North Carolina:
“According to clergy, caseworkers and relief administrators most [people on relief] were illiterate, afflicted with tuberculosis and “social diseases.’’ Of the white families, many had pellagra and hookwork.”
She described a father with two daughters living in a tobacco barn while the father looked for work. Shortly they would have to move from the barn with no place to go, no money and no work.
In Gastonia she saw “latrines draining down a gully to a well from which residents get their drinking water.” Gellhorn estimated half the mill families she met in Gastonia “are syphilitic and moronic,” and she wondered “why they aren’t all dead of typhoid.” She also observed venereal disease, dietary deficiencies, colitis and typhus in North Carolina (Gellhorn, 1934).
Prior to 1932, relief from destitution was a minor phase of governmental activity in North Carolina. Each county provided for its own indigents by offering minimal financial help and/or a county poorhouse for its poorest citizens. A relatively small number of people, mostly the elderly, mentally ill and physically infirm were cared for out of public funds. Churches and private relief agencies such as the Community Chest and the Red Cross provided the majority of relief to poor and needy citizens (O’Berry, 1935). As the Great Depression wore on, the employment, financial, housing, food and health needs of increasing numbers of people overwhelmed the resources of charitable and governmental agencies in North Carolina and every other state.
A Brief History of Public Health Nursing in North Carolina
At the turn of the twentieth century gains in knowledge related to the etiology, transmission, treatment and prevention of many diseases gave rise to the new field of public health. Nurses educated in the emerging discipline of public health translated these scientific findings into action. North Carolina nurses were among these pioneers.
Lydia Holman, for instance, began a thirty year practice as an independent community health nurse in remote Mitchell County in 1902 (Pollitt, 1991). In the village of Salem, in 1911, Percy Powers initiated school nursing in North Carolina (Wyche, 1937). Her work was emulated by the State Board of Health in 1918 when six full time nurses were employed to inspect and assist school children throughout the state (Cooper, 1926). Amelia Lawrison of Wilmington is thought to be the first home health nurse in the state. Her work, funded by a group of public spirited citizens, began in 1904 (Wyche, 1937).
North Carolinians’ concern with public health grew as the years went by. The first County Department of Public Health in the nation was founded in Guilford County in 1911. According to Wyche (1937), The American Red Cross employed “a number of graduate nurses” to provide health services in fifty-two counties in North Carolina between 1915 and 1935. Local committees supported each Red Cross nurse with office space, volunteers and supplies. In many North Carolina cities, including Greensboro, Winston-Salem, Asheville, Charlotte, Raleigh, Wilmington and Durham various civic, religious and charitable organizations initiated and supported public health nursing programs. In December, 1919, a new Bureau of the State Board of Health, the Department of Public Health Nursing and Infant Hygiene was created. Funds were contributed equally from the State of North Carolina and the American Red Cross for a total annual budget of $12,000. Rose M. Ehrenfeld, R.N. was the director of the new Department. The passage of the Sheppard-Townsend Act in 1921 by the U.S. Congress allowed the state to assume even greater financial responsibility for expanded maternal and child health programs in the state.
The increasing governmental financial support for public health programs in North Carolina was greatly curtailed by the Depression. Dr. James M. Parrott, the State Health Officer, wrote in 1932 a report to the state medical society:
…our state appropriation has dropped from $486,000 in 1929 to $263,647 now available. I remind our people that were it not for the assistance which we get from the International Health Board, the U.S. Public Health Service, the Rosenwald Fund, life insurance companies and other private agencies and particularly the Parent Teacher Association, we would be compelled to fold our tents and solemnly and shamefully slip away. We are begging! Yes, and it is humiliating too; but I’ll beg for the sake of this service.
The North Carolina experience was echoed across the country. Due to the economic depression, state and charitable resources were insufficient to sustain much less expand public health services to meet the needs. Several federal programs were enacted to fill the void.
The Federal Government Response: The New Deal
In his speech accepting the Democratic Party’s nomination for the Presidency in 1932, Franklin Roosevelt pledged himself to a “new deal” for the American people. This phrase came to stand for a constellation of temporary and permanent measures designed to provide relief from the Great Depression. Four of these programs are of particular interest to nursing. Chronologically, they are the Federal Emergency Relief Act (FERA) 1933-1936, the Civil Works Act (CWA) 1933-1934, the Works Progress (later Projects) Act (WPA) 1936-1943, and the Social Security Act (SSA) 1935-present. The evolving nature and sheer volume of new programs, each with its own administration, regulations and eligibility requirements, but with overlapping purposes and at times personnel, created considerable confusion during the New Deal era as well as for its historians. Perhaps the outstanding legacy of the New Deal is the assumption that government has a responsibility to ensure a minimum quality of life for its citizens.
The Federal Emergency Relief Act
“Be it enacted … that the Congress hereby declares that the present economic depression has created a serious emergency, due to widespread unemployment and increasing inadequacy of State and local relief funds, resulting in the existing or threatened deprivation of a considerable number of families and individuals of the necessities of life, and making it imperative that the Federal Government cooperate more effectively … in furnishing relief to the needy and distressed people.”
(First paragraph of the FERA, passed by Congress May 12, 1933.)
The Federal Emergency Relief Act (FERA), which produced the largest relief agency ever created, was one of the first pieces of legislation President Roosevelt sent to Congress. Its purpose was to provide immediate “relief” [cash] payments to the unemployed. Roosevelt soon came to believe jobs were superior to handouts, and the FERA was joined by several job creating programs.
FERA was responsible for disbursing federal relief monies and coordinating relief activities among and between the states. It had a dual purpose of providing help to those in need and of employing people needing jobs. Its initial budget was five hundred million dollars. Section 4(a) of FERA specifically provided funding for “… services, materials and/or commodities to provide the necessities of life” to persons in need.
Bedside care for the indigent was specifically mentioned for the first time, as a legitimate expenditure of federal tax monies under FERA regulation #7. Even though all FERA activities were optional and required a locally tax supported agency as cosponsor, by September, 1934, thousands of Registered Nurses were hired in the 20 states participating in the program to provide health services to distressed persons. FERA provided jobs for nurses and care for those who needed it (Kalish & Kalish, 1995).
The passage of FERA heralded a new understanding of the role government could play in providing basic services, including health care for its citizens. Prior to the passage of FERA, the federal government’s role in health care was minimal, confined to some sanitation work through the U.S. Public Health Service and funding of a few maternal child health clinics with the CWA, WPA, and SSA, ushered in an era in which citizens expected and government provided billions of dollars for direct patient care as well as monies for construction of health care facilities, education of health care workers and research for advances in medicines and technology.
The Civil Works Administration (CWA)
Despite the existence of FERA, and numerous other New Deal programs, there remained at least 10 million unemployed people in 1933. In order to stave off mass starvation, homelessness and poverty during the winter of 1933-34, and because Roosevelt believed using Federal monies for jobs was better for the individual as well as society than having people on the “dole,” he created the Civil Works Administration (CWA). Although it was a “jobs” rather than a “relief” program, it was administered under the FERA. The CWA existed from November 12, 1933, through May 1, 1934. During this brief time, over four million people were employed using CWA (Leuchtenburg, 1963).
Nationally, more than 2,000 unemployed Registered Nurses found work through the CWA. Hospitals, sanitariums, asylums, schools, nursery schools and public health departments all benefited from the work of CWA nurses (Fitzpatrick, 1975). The CWA was a very popular program with the unemployed and their advocates, but it was also very costly. Due to fears that people might come to rely on government funded jobs in lieu of private sector employment, and having gone through the Congressional allotment of funds for the CWA, the program was discontinued as warm weather approached. By the end of May 1934, the CWA was history,
The Works Progress Administration (WPA)
As the Depression entered its sixth year, widespread unemployment continued to plague the United States. In 1935, twenty million people were receiving some form of governmental relief, and millions more were without jobs or relief payments. Roosevelt decided only a massive public works program would provide the jobs needed to stimulate the economy. Congress concerned, and In May, 1935, passed the Emergency Relief Appropriations Act, which created the Works Progress Administration (Davidson & Lytle, 1988). The purpose of the new agency was to “… provide relief, work relief and to increase employment by providing useful projects…” (Kalish & Kalish, 1995). WPA workers built or improved 664,000 miles of roads, 24,000 miles of sewage lines, 2,500 hospitals, 5,000 schools, 13,000 parks and playgrounds and 1,000 airports. In addition to construction, artists, writers and performers were employed. The school lunch program was launched as a WPA experiment. Thousands of libraries were built and staffed, foods were grown and canned, sewing projects of all types abounded.
At least 10,000 Registered Nurses worked for the WPA over its eight years of existence. The WPA nursing and public health projects were all sponsored by local or state departments of public health. Office space, supplies and equipment were donated by the sponsoring agency while the WPA was responsible for wages. The education, home visits for ante and post-partum care, bedside nursing for illness and injury, conducting clinics and screenings for immunization, dental health, tonsil and adenoid inflammation, examining school children for growth and “defects” and responding to various local health needs (Kalish & Kalish, 1995). 1936, WPA projects provided jobs for 4,406 nurses on 75 projects in 16 states (McIver, 1937).
In its first 18 months WPA nursing services amounted to 9,000,000 visits, inspections and treatments (Woodward, 1937). These projects included visiting nursing services, public health clinics, health education, school nursing, health camps, tuberculosis surveys, trachoma clinics and cancer surveys (McIver, 1937).
By May, 1937, there were 2,241 nurses paid by WPA in 31 states, including 66 registered nurses working on WPA projects in North Carolina (Woodward, 1937).
Social Security Act (SSA)
While the WPA created 3,000,000 jobs between 1935 and 1943, those citizens unable to work were not helped by this massive federal program. In order to aid the elderly, blind, disabled and single mothers with young children, President Roosevelt and the Congress passed the Social Security Act (SSA). The SSA, enacted in September, 1935, provided federal money for maternal child health, rural public health work, training for public health workers, financial assistance for the elderly, blind and disabled citizens. The SSA programs were largely responsible for the shift in employment of public health nurses from voluntary health agencies to government funded jobs. In 1931, 40% of community health nurses worked for League and local church and civic groups. By 1938, only three years after the enactment of SSA, only 25 percent of community health nurses worked for voluntary health agencies and 75 percent for local, state and federal public health programs (Melosh, 1982). In 1936, 1,000 registered nurses received stipends through the U.S. Public Health Service through SSA funding for post graduate training in public health nursing.
Nursing and the Emergency Relief Administration in North Carolina
North Carolina received its first allotment of New Deal money for health care through the Federal Emergency Relief Administration allotment in June, 1933. On August 8, 1933 the North Carolina Emergency Relief Administration (NCERA) began operation. As O’Berry (1935) noted at the time:
“The relief program under the Governor’s Office of Relief was the pioneer program in the State. There was no precedent to follow. No definite policies nor regulations had been formulated by the Federal Government. Each state was feeling its way on unchartered seas.”
If there was a lack of precedent, there was no shortage of work. The state of health in North Carolina was generally poorer than much of the nation. In 1929 the infant mortality rate in the United States was 68, in North Carolina it was 79. Death rates from infectious diseases such as tuberculosis and influenza far exceeded national averages. Between 1933 and 1935 11 percent of the people in North Carolina were on relief. NCERA disbursed over forty million dollars in relief payments to an average of over 300,000 people per month.
NCERA sponsored public welfare and public health projects providing employment for 216 Registered Nurses in North Carolina (O’Berry, 1935). These nurses worked on health promotion and disease prevention by dispensing general health information, teaching lay midwives sanitary practices, staffing clinics, examining school children and providing home health nursing. Between August 1933 and December 1934 NCERA nurses visited 23,450 homes, examined 39,608 school children and gave 19,934 immunizations (O’Berry, 1935).
One interesting NCERA nursing project was the Catawba County Preventorium for Undernourished and Underprivileged Children. The Preventorium was a cooperative effort to provide medical care, proper nutrition and inculcate good health habits in indigent children. The county government, county hospital, and a variety of civic clubs including the Kiwanis, Rotary, Women’s Club, American Legion, Red Cross and Business and Professional Women’s Club provided this four month summer program under the general supervision of the school nurse. The Depression threatened the ability of local supporters to continue the Preventorium. In the summer of 1935 NCERA paid salaries for all the staff, including two Registered Nurses. During the summer of 1935, 73 children were helped by the Preventorium. Thirty-nine had tonsils removed, six got glasses, sixteen had dental work and twenty had “other” medical treatments. The group ate three meals a day, gained a total of 273 pounds and consumed 5,640 quarts of milk. Without this NCREA nursing program, it is unlikely these children would have received needed health care or an adequate diet (McKay, 1935).
Mrs. Elizabeth McMillian Thompson, one of the first African American public health nurses in North Carolina remembered her New Deal work this way:
“Of course there was small pox. The first week I was here (Tarboro, N.C.), I vaccinated over 3,000 black people. What was so peculiar about it was that the local doctors would refer a case to us as small pox, and after I went to visit the patient, I would discover that it wasn’t small pox at all but syphilitic lesions. We began to pick up many of our veneral disease cases this way. As I recall, the first problems we addressed were smallpox, veneral disease, tuberculosis and poor sanitation… Many of the families had no sanitary facilities, so one of our big projects in the early thirties was to provide privies for the tenant farmers. The only reason we got as many in as we did was that the county commissioners passed a law that every family must have a privy. This law was important, for the landlords hadn’t been too cooperative in the past. WPA workers built the privies at a local lumber yard and transported them to the homes. They must have distributed a thousand or more in Cumberland County… We’d go back sometimes a month later and the privy hadn’t been used at all. So we ended up showing them how to sit on the seat, then you had to show them how to keep the snakes from going in and making ho9mes, and how to keep the spiders out so the children wouldn’t be bitten…”
Financial records of the NCERA expenditures from March 1934 through May 1935 show 62 nursing projects with a total budget of approximately $48,000. These projects included employment in schools, hospitals, clinics, home health and other public health agencies. In May, 1935 there were 125 Registered Nurses employed by NCERA (Council, 1935). According to O’Berry (1935) Practical Nurses were paid 30 cents an hour, Registered Nurses were paid 45 cents an hour and nursing supervisors were paid 45 or 50 cents an hour.
This way. As I recall, the first problems we addressed were smallpox, venereal disease, tuberculosis and poor sanitation…. Many of the families had no sanitary facilities, so one of our big projects in the early thirties was to provide privies for the tenant farmers. The only reason we got as many in as we did was that the county commissioners passed a law that every family must have a privy. This law was important, for the landlords hadn’t been too cooperative in the past. WPA workers built the privies at a local lumber yard and transported them to the homes. They must have distributed a thousand or more in Cumberland Country…. We’d go back sometimes a month later and the privy hadn’t been used as all. So we ended up showing them how to sit on the seat, then you had to show them how to keep the snakes from going in and making homes, and how to keep the spiders out so the children wouldn’t be bitted….”
Financial records of the NCERA expenditures from March 1934 through May 1935 show 62 nursing projects with a total budget of approximately $48,000. These projects included employment in schools, hospitals, clinics, home health and other public health agencies. In May, 1935 there were 125 Registered Nurses employed by NCERA (Council, 1935). According to O’Berry (1935) Practical Nurses were paid 30 cents an hour, Registered Nurses were paid 45 cents an hour and nursing supervisors were paid either 45 or 50 cents an hour.
Nursing and the CWA in North Carolina
The NCCWA spent over $800,000 providing emergency jobs for over 70,000 unemployed people (Badger, 1980). CWA funds were used to establish 30 emergency nursery schools in 1934. Each nursery school employed a full time Registered Nurse. In this capacity, thirty five white and fifteen African American nurses coordinated and assisted in 2,056 physical examinations, administered 1,117 vaccinations and immunizations, assisted in 970 dental examinations and gave countless hours of health advice to parents. Their salary was $12.50 a week (O’Berry, 1935).
According to O’Berry (1935) approximately 300 Registered Nurses worked on Civil Works Administration projects in North Carolina from December 1933 through May 1934. A brief account of the 65 nurses employed by the Department of Child Health, a division of the NC State Board of Health was written in 1934 for “the Bulletin,” a publication of the State Board of Health. Although their tenure was brief, their work benefited thousands of North Carolinians.
CWA funds in North Carolina were used by the Department of Child Health Work, a division of the State Board of Health, to hire 65 unemployed Registered Nurses. Thirty-five were assigned to work in established county health departments and thirty worked out of the State Offices of the Department of Child Health Work. During their short, fifteen week tenure, from February 5, 1934, through May 12, 1934, they accomplished an amazing amount of work. People with communicable diseases such as syphilis and tuberculosis were contacted and treated. Thousands of school children were examined and treated for various ailments. Hundreds of expectant and post-partum mothers received care (Health Bulletin, August, 1934).
Several nurses summarized their experiences with the CWA program in an article for “The Health Bulletin.” One wrote:
“You might have noticed from the report the number of undernourished children and wondered if anything was being done for correction. It was thought more practicable to have hot lunches served to undernourished children at schools than to try individual corrections. At the time I began we had only one lunchroom outside the city limits. Up to this writing we have ten lunchrooms. Cod-liver oil treatment had been employed in some cases.”
Another wrote, in a more personal vein:
“I use this means to thank you for giving me work in the Relief Nursing Project. I regard this appointment, which has provided a living for my family and me, a godsend, a blessing that I am sure each of us will remember. Yet the financial side has not been all; the actual knowledge of conditions among my fellow-people that I have derived by coming in direct contact with those who are weak and those who are strong, many of whom were as rich or as poor as I, has helped me as nothing else could. I thank you again for this opportunity. It has certainly given me a different view on life and an inspiration for public health work.”
Nursing and the SSA in North Carolina
Watauga County is a rural rugged county in the Appalachian Mountains with severe winter weather. Amy Louise Fisher moved to Boone, North Carolina in 1930 to work as a parish nurse with the Watauga Lutheran Mission. In June 1935 she became the first public health nurse funded through the SSA in Watauga County. In an article about her work in the December 1936 “Public Health Nurse” she noted:
“Last year was the first year the health department has been in existence here and we tried to cover practically the whole county. Over five thousand people took the typhoid fever vaccine and one thousand six hundred and twenty-five babies and children were given diphtheria toxoid. The need is much too large for the individual physicians to cope with in this county…”
Fisher described some of the problems associated with making her school rounds this way:
“There are about fifty schools in the county, and we plan our schedules so that we may get to the most inaccessible ones before bad weather sets in. But even then we sometimes have to walk part of the way. We don’t try to go to Lower Elk after a hard rain because you ford the creek twenty two times and some of the fords are pretty deep.”
Fisher also taught a midwife class. Over three sessions lay midwives learned about proper care of the mother and newborn including sanitizing instruments and washing their hands. Fisher reported one of her student’s reactions to the class: “One woman over seventy years of age patted me on the shoulder and said, ‘Law, Honey, I’ve catched hundreds of babies and I ain’t never gone through all this fixin’ before.’” (Fisher, 1936)
NEW DEAL NURSING
After the CWA closed in May, 1934, all NCERA women’s projects with the exceptions of lunch room and clerical workers were suspended for a few months. This allowed time for thoughtful reorganization. Trained women, such as nurses, were matched to work in their specialized fields. Untrained women were given minimal instruction and job training in more general fields. A chart of the NCERA expenditures from March 29, 1934, through December 5, 1935, shows nursing projects received $56,135.64. The topical breakdown of expenditures is confusing, but shows $140.44 for material, $6,434.13 for unskilled labor, $450.95 for semi-skilled labor, $382.45 for skilled labor, $338.10 for supervision, $7,808.80 for professional labor and $40,581.77 for “other.”
Using “New Deal” dollars, available from June 1933 through December 1935, being the 30 month lifespan of ERA and a concurrent 7 months of CWA, 47 of North Carolina’s hundred counties hired hundreds of Registered Nurses to provide services for their indigent citizens. A list of the counties the amount and source3 of money spent and the nursing services as described by the state ERA office are given below.
County Dollars Description of Services Source of Money
Alexander 335.60 Home nursing services FERA
Beaufort 70.00 Nursing, county wide FERA
Bertie 432.00 Nurse for county health officer FERA
Bladen 163.70 Nurses for relief families FERA
Buncombe 141.21 Nursing project, county wide CWA
408.00 Nurses, county home (poorhouse) FERA
108.00 Public Health Nursing-Asheville CWA
139.84 Helper and incidentals in nursing
85.30 fed ERA funds and 54.54 NCERA funds
1,045.25 Relief nurses, Asheville FERA
Cabarrus 2,403.90 Nurses and stenographer, county
Health department, Concord
216.00 CWA funds, 2,178.90 FERA funds
1,605.00 Nurses, county preventorium
1,777.70 FERA funds,
427.30 local ERA funds
Caldwell 86.40 Nursing care, county wide FERA
Carteret 249.38 Relief nursing, county wide FERA
Caswell 63.45 Nurses in school CWA
Catawba 634.80 Nursing and janitorial services, CWA
Chowan 37.35 Nursing, county wide FERA
Craven 264.50 Nursing for clinic, county wide FERA
Cumberland 139.20 Nurses for janitress, convalescent home CWA
534.15 Nurses for convalescent home FERA
Duplin 2,227.85 Nursing Duplin’s needy FERA
Durham 766.80 Practical nursing, county wide FERA
111.50 Nurses FERA
Edgecombe 343.13 Professional Nurses, Tarboro FERA
756.00 Nurse for city schools, Rocky Mounty
27.00 CWA, 729.00 FERA
Forsyth 363.25 General nursing, county wide FERA
24.00 Nursing school (overdraft) countywide FERA
Gaston 28.80 Visiting nurse in schools of Lowell CWA
Granville 418.18 Nursing County wide, 54.00 CWA
902.00 Public health campaign county wide
900.00 NCERA, 2.00 FERA
Guilford 316.00 Nursing relief, county wide
216.00 FERA, 100.00 NCERA
938.80 Nursing and first aid work, Greensboro FERA
4,209.60 Nursing and first aid work
Haywood 48.00 Two additional nurses for Haywood CWA
164.40 Nursing county wide FERA
Henderson 81.90 Home school nursing county wide CWA
Hyde 54.00 Trained nurse for schools CWA
195.19 Nursing county FERA
Iredell 860.85 Nurse Statesville school FERA
1,615.40 Home nursing service in county, FERA
205.20 Nurse in Mooresville school FERA
783.90 Nurses county schools, countywide FERA
Johnston 313.00 Home nursing county wide FERA
Lee 591.87 Bedside nursing rural section FERA
Mecklenburg 535.30 Public health nurses FERA
Mitchell 21.60 Nurses to examine children of relief CWA
Families, county wide
New Hanover 1,388.40 Nurses in public school, Wilmington 330.00 CWA, 1,058.40 FERA
2,332.21 Nurses in indigent homes, county
129.60 CWA, 2, 203.21 FERA
1,570.95 Trained nurses – 108.00 CWA, 1, 462.95 FERA
Onslow 66.00 Relief nursing FERA
Pamlico 2,169.95 Practical nursing county wide FERA
Perquimans 210.20 Nurses for relief families FERA
Person 12.80 Practical nursing county wide FERA
Randolph 1,622.90 Nursing school and home county wide
1,487.90 FERA, 135.00 NCREA
Richmond 180.00 Nursing FERA
Robeson 1,465.95 Nursing, Lumberton FERA
237.15 Nursing for county relief clients FERA
Scotland 238.50 Nursing county wide= FERA
134.67 Nursing school helpers, Laurinburg FERA
Stokes 1,610.10 Nursing county wide FERA
Surry 937.25 Nursing county wide FERA
Swain 229.60 Nursing in relief houses, county wide FERA
Tyrrell 759.15 Nurse for county, countywide
13.50 CWA, 745.65 FERA
Wake 159.00 Nursing, relief families FERA
426.00 Home nursing, Raleigh CWA
8,005.45 Nursing relief families, Raleigh, FERA
Warren 210.15 Practical nursing, Macon
201.15 FERA, 9.00 CWA
Wayne 190.80 Bedside nursing, Goldsboro, Fremont CWA
And Mt. Olive
1,327.80 Visiting nurses, throughout county
108.00 CWA, 1,450.00 local government
1,451.16 Nursing relief families throughout FERA
Wilkes 137.73 Practical nurses, county FERA
Wilson 802.75 Emergency nursing, county wide
699.75 FERA, 103.00 NCERA
Yancey 16.03 Nursing relief clients in Jack’s Creek FERA