Academic journal article Journal of the Illinois State Historical Society

"I Will Make a Go of It Yet" Rena B. Jepsen and the Founding of the North Rockford Hospital

Academic journal article Journal of the Illinois State Historical Society

"I Will Make a Go of It Yet" Rena B. Jepsen and the Founding of the North Rockford Hospital

Article excerpt

In 1935, in the midst of the Great Depression, Rena ?. Jepsen opened the North Rockford Hospital in Rockford, Illinois, as a convalescent hospital to provide nursing care for aged and convalescent patients. The idea for the hospital was born out of the need for a new approach to the care of aged and convalescent patients whose needs were not being met by either conventional acute care hospitals or the county almshouse; but for her, it was also a means to support her family of six children. This essay examines how the evolution of modern medical practice and the economics of the mid-1930s created the need for new types of hospital care in Illinois and led to new paradigms in healthcare delivery.

From the mid-nineteenth century to the 1920s, care for the aged and convalescent had largely been provided in their homes by visiting nurses. Wealthy and middle-class families who were able to pay for the services of a visiting nurse would contract with a visiting nurses' association, which maintained a registry of available nurses. The poor and indigent, however, had to rely on the nursing support provided by the local public health department, or a charitable organization. For the indigent aged, the county almshouse became the home of last resort when they became unable to live independently.

By the 1920s, the practice of sending out visiting nurses began to decline. It was becoming clear to many that a better place to practice medicine was the hospital; advances in medical practice required technology, skills, and an antiseptic environment not available in most homes. The visiting nurses found that more of their time was spent dealing with basic issues of sanitation and cleanliness than with actual patient care when caring for patients in the home.1

The concept of the hospital itself was undergoing a radical change at this time. From the Middle Ages to the mid-nineteenth century, hospitals operated by religious orders and charitable organizations had been viewed as the last refuge of the indigent and the dying. A new model of healthcare delivery, based on a scientific approach to medicine and sound business management principles, began to emerge in the late nineteenth century. Pasteur's theory of germs and Lister's development of antiseptic practice, together with the discovery of x-rays and effective antibiotics, made the modern hospital a place where scientific methods resulted in recovery and cures. In this model, instead of providing a last refuge for the poor, the hospital became a place where a growing middle-class patient population could expect to receive effective treatment.

The increasing sophistication of medical practice also led to greater specialization of hospital operations. While most hospitals provided emergency care, treatment of disease, and a sterile environment for performing operations, the need arose for specialized care facilities to care for specific patient groups such as children and the elderly, and to provide specialized treatment for specific diseases, such as tuberculosis.

One such specialized facility was the convalescent hospital. In order to more efficiently use their technologically advanced facilities, hospitals tended to focus on short-term procedures, such as surgeries and caring for accident victims. Convalescent care - care for the chronically ill and the aged, who might require hospital stays of indefinite length, and patients recovering from medical procedures - was seen as an inefficient use of hospital facilities. This led to the development of the convalescent hospital as a separate entity in the late nineteenth century.2

However, scientific medicine and specialization of medical practice came at a cost. Building modern facilities and equipping them with the latest technologies was expensive, requiring extensive outlays of capital. While the indigent patients of the earlier charitable hospitals had received minimal care for free, the increasingly middle-class patient population of the early twentieth century had to absorb the cost of advanced treatment, a burden for many in an age when healthcare insurance was largely nonexistent. …

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