The Fort Wayne Visiting Nurse League

Josephine Shatzer, first paid nurse, image courtesy of Visiting Nurse Archives.

With a staff of over 155 and over 170 volunteers, today’s Fort Wayne Visiting Nurse is a far cry from its humble beginnings. In 1888, a group of Fort Wayne women organized the Ladies Relief Union with a mission to “help the sick poor of Ft Wayne.”  Calling themselves the Visiting Nurse Committee, they soon discovered a link between poverty and disease.  Dr. Jessie Calvin, a Fort Wayne sanitation and indoor plumbing pioneer, encouraged women’s church groups to raise money for a qualified nurse that could meet community needs.

Prior to the 1860s, nursing was “typically considered a domestic responsibility provided in the home by family members.” Nursing as a profession evolved after the Civil War, when women gained experience caring for wounded soldiers. Historian Clifton J. Philips noted that in the post-war period, women’s religious orders were “especially active in establishing hospitals in an attempt to extend to the general public, and the poor in particular, some of the services formerly rendered to sick and wounded soldiers.” As hospitals materialized, so too did nursing groups and training programs. By 1897, The Fort Wayne Journal-Gazette noted that “modern nurses” wished to “be given her proper position as a skilled assistant in serious illness.”

Nurse with a Ford Model T purchased in the 1920s, so that nurses could more efficiently reach patients, image courtesy of Visiting Nurse Archives.

The paper added that:

The daily or visiting nurse is a recent development of modern nursing and meets the needs of many people who find it inconvenient to have a nurse stopping in the house and requiring more or less attention from servants perhaps already overtaxed. The visiting nurse comes in for an hour or so every day to perform those services for which her skill is needed.

On March 1, 1900, an organizational meeting was held in Fort Wayne and the Visiting Nurse League became a reality. At a salary of $10.00 a week, Josephine Shatzer was hired as the League’s first nurse.  During harsh weather she took a trolley, but normally she could be seen making her rounds on her bicycle.  Regardless of transportation, it was clear that she wasted no time.  On her first day she saw six patients.  Next she established a baby milk station at First Presbyterian Church, instructing new moms how to prepare formula.

Fort Wayne Daily News, September 29, 1900, 5, accessed Newspapers.com.

She also volunteered at free immunization clinics, bathed patients, delivered meals, changed bedding, dressed wounds, cared for the elderly and ill in their homes and endeared herself to all she served. At the end of her first year she had made hundreds of calls, utilizing supplies donated by local churches, relief societies, and drug stores. For those patients who could pay, the charge of a one-hour visit was fifteen cents.

The Fort Wayne Daily News praised the program in 1900, noting that the league “found favor with all classes of people” and that visits to the “sick poor” conveyed not only “help and benefit, but hope and good cheer to every member of the family.” In 1913, the Public Health Nursing Association appointed a visiting nurse to serve African American patients at the Flanner Guild. Dr. Calvin continued to guide the League, through the years of World War I and the 1918 flu epidemic, which took the lives of 3,266 Hoosiers.

Nurse treating a young burn victim, image courtesy of Visiting Nurse Archives.

By 1919, a nurse named Dixon had reached a salary of $100.00 a month. League expenditures in 1920 stood at $1,300 annually and in 1922 the Community Chest offered its support.  Insurance companies began to hire nurses from local visiting nurse groups to assess policyholders who were ill, and paid the League seventy-five cents a visit.  By 1923, the League reorganized and served in an advisory, instructional health teaching capacity. The Great Depression wrought poor health conditions: eight nurses made over 29,000 visits to 4,477 patients.  One made 3,255 orthopedic visits to 104 crippled children, many of whom were victims of polio.  Sisters of Saint Joseph Hospital provided free hospitalization in the pediatric ward for those who could not pay.  In the 1940s, World War II increased demands for nursing schools to produce eligible Nurse Corps candidates.

In 1954, the agency changed its name to Visiting Nurse Service, Inc.  By 1956, it undertook a program that cared for stroke victims in their homes, which served to collect data on medication, exercise, loss of function and the need for expanded therapy service. By 1962, the agency’s director Eva Rosser introduced a State Board of Health-funded program that focused on treating the chronically ill in their homes, instead of a hospital or nursing home.  Later the group provided care as home health aides and the agency became certified for Medicare on July 1966.

Nurse visiting a patient, likely just after World War II, image courtesy of Visiting Nurse Archives.

With certification came additional paper work.  According to History of Visiting Nurse, by 1983, “a record number of visits for a single month occurred (2,200), due to earlier hospital releases and greater technology used in the home.” During this period, the glucometer was used for the first time, registered nurses were trained to perform phlebotomy services, and around-the-clock care was made available for all patients. In 1984, Medicare Hospice Benefit became available and Visiting Nurse Service merged with Hospice of Fort Wayne, Parkview, and Lutheran Hospices.  The agency introduced computerized billing and, by the end of the decade, services for the frail and disabled.  By 1990, Hospice service visits totaled 38,177, a forty percent increase over previous months.

History of Visiting Nurse noted that in 1990 the agency moved to the “Moellering Unit of the nearly vacant former Lutheran Hospital.” In 1995, the 1984 merger dissolved and Visiting Nurse Service and Hospice became a free standing agency. By February 2001, a new Hospice Home facility opened and in 2006 a building expansion added patient rooms. In 2011, nurse practitioners joined the staff and the “Watchful Passage” program began, in which trained volunteers remained at patient’s bedside during the last few days of life. In 2018, Visiting Nurse staff and volunteers can proudly stand tall celebrating 130 years of community service.

Visiting Nurses, Tuberculosis Assailants, and their Ball Family Champions

As the United States exited the Gay Nineties and entered the 20th century, an increased concern for better systems of disease control and education swept the nation. As industry boomed, more and more people crowded into cities, both large and small. With crowds came germs and disease. Soon tuberculosis ranked as the leading cause of death in the country.

In Muncie, Indiana anxiety over bacterial diseases loomed just as large as in major cities like New York and Chicago. To combat these and other public health issues of the time, individuals stepped up to the plate and played vital roles in getting new organizations off the ground.

Fruit jar made by Ball Brothers Manufacturing Company, 1910-1920
Fruit jar made by Ball Brothers Manufacturing Company, 1910-1920, courtesy of the Minnetrista Heritage Collection.

By the early 1900s the term “Ball jar” had become a household phrase, and Ball Brothers Manufacturing Company distinguished themselves as the largest producer of canning jars in the world. In addition to the successful business bearing their name, the Ball family also left their mark on Muncie through civic work and philanthropy. During the first decades of the 20th century two notable women of the Ball family worked to improve public health in their region, and personally invested time and energy into advancing sanitation, hygiene, and medical access.

Bertha Crosley Ball, around 1900 and Sarah Rogers Ball, around 1890
Bertha Crosley Ball, around 1900 (left) and Sarah Rogers Ball, around 1890 (right), courtesy of the Minnetrista Heritage Collection

Bertha Crosley Ball was the wife of Edmund Burke Ball – the middle son of the Ball brothers. Born in 1875 in Terre Haute, she was the daughter of a well-known Universalist minister and had familial roots stretching back to the American Revolution. Her advantaged upbringing left her wanting for very little in her youth. After graduating high school she began her collegial studies at Vassar College where she received a degree in Social Work in 1898.

Cincinnati Enquirer, September 2, 1903, courtesy of the Minnetrista Heritage Collection

After completing her studies, Bertha moved with her parents to Indianapolis where her father served as state superintendent of the Universalist Church of Indiana. Shortly after, Bertha made a visit to her friend Bessie Ball in Muncie. There, Bertha was introduced to Bessie’s brother-in-law, Edmund. Despite a twenty year age difference the two hit it off right away and in 1903 the couple married. Edmund’s distinction as the wealthiest man in Indiana, led to many headlines stretching from Indianapolis to Muncie, and even into Cincinnati.

Contrasted with Bertha’s advantaged upbringing is that of her sister-in-law, Sarah Rogers Ball. Nearly twenty years older than Bertha, Sarah married Edmund’s older brother, Dr. Lucius Ball in 1893. Born in upstate New York, Sarah was the daughter of immigrants. With six siblings, Sarah’s childhood home grew crowded and did not come with many opportunities. By the age of 16 she had moved into the home of her older sister and brother-in-law. For Sarah this move opened up doors that had been previously closed. Her brother-in-law, himself the son of immigrants, made a name as a ship captain and built up a very profitable shipping fleet. When Sarah began studies at the Buffalo General Hospital School of Nursing in 1885 her sister and brother-in-law likely paid the tuition.

Dr. Lucius and Sarah Rogers Ball in Japan, 1917, courtesy of the Minnetrista Heritage Collection.

While Bertha and Sarah could not be more different on the surface, their interest in public health and service to their community tied them together. In the 1880s the discovery of natural gas created a boom of industry in the Muncie area. This development led to a period of growth and an expanding population that required social amenities and services, such as health care. Over the next few decades small hospitals came and went until Ball Memorial Hospital opened its modern facility in 1929. In the meantime, it became obvious that the industrial town not only needed reliable hospitals, but also advocates for improving the overall public health of the community.

Two such promoters came in the form of Muncie’s Visiting Nurses Association and the Delaware County Tuberculosis Association. Both organizations tackled issues of public health, and felt the influence of Bertha and Sarah Ball.

Formed in 1916, the Visiting Nurses Association existed “for the benefit and assistance of those otherwise unable to secure skilled assistance in times of illness; to promote cleanliness and prevent sickness by the teaching of hygiene, sanitation and the science of domestic management.” To accomplish these feats they provided general nursing, maternity service, child welfare service, nurses training, and a mental hygiene program.

Among those involved with the organization of the association was Sarah. As a former nurse it comes as no surprise that she had an interest in seeing the group established. When living in Buffalo, she had been involved in organizing a local Visiting Nurses Association as well.

Muncie Visiting Nurses Association staff, 1932
Muncie Visiting Nurses Association staff, 1932, courtesy of the Minnetrista Heritage Collection.

While Sarah’s role with the Visiting Nurses was low-profile, Bertha’s involvement was not. At the time of the group’s founding, the organization elected Bertha to serve as second vice president and she continued to actively serve on the board of directors into the mid-1930s; serving as president in the 1920s. Between 1922 and 1932 the association experienced rapid growth. Under Bertha’s leadership nursing staff expanded, the numbers of patients served grew, and community health rapidly improved.

Modern Health Crusade pamphlet. In the mid-1920s, the Delaware County Tuberculosis Association won the state award for the highest percentage of student participants in the program
Modern Health Crusade pamphlet. In the mid-1920s, the Delaware County Tuberculosis Association won the state award for the highest percentage of student participants in the program, courtesy of the Minnetrista Heritage Collection

Three years after the founding of the Visiting Nurses, the Delaware County Tuberculosis Association began to develop. With tuberculosis-related deaths on the rise, the group hoped to spread knowledge concerning the disease’s cause and treatment, and to take steps towards preventing its spread. Through lectures, anti-spitting campaigns, advertisements, tuberculin testing of cattle, and instructive visits from nurses, the association tackled its goals head on. Over time their work paid off and by the 1940s tuberculosis-related deaths in the county had almost completely disappeared.

In the association’s first years, Bertha and Sarah again found themselves highly involved. Both women helped incorporate the organization and were also among the first board members. Sarah personally offered up the use of her automobile to the organization, and Bertha regularly gave monetary gifts to the group when they struggled financially.

Bertha Crosley Ball, mid-1930s and Sarah Rogers Ball, around 1917
Bertha Crosley Ball, mid-1930s (left) and Sarah Rogers Ball, around 1917 (right), courtesy of the Minnetrista Heritage Collection.

A scan of both organizations’ records show Bertha and Sarah’s names regularly mentioned in formative years. Through their labor, a strong foundation was established for both organizations, cooperative relationships developed between the boards, and both associations experienced rapid growth. With backgrounds in social work and nursing, Bertha and Sarah each possessed an understanding of society’s larger public needs and desired to improve the well-being of all people. Through their work, public health efforts in the Muncie area improved, leading to an established concern with human and community health that continues today.