considered whereby college students who have had two years of specially arranged work in approved colleges may enter the regular course of training and at the end of the allotted period receive their degree of Bachelor of Science as well as their diploma of nursing. Already the University of Cincinnati is providing a five year combined collegiate and professional course leading to a Bachelor's degree and the Ohio State University hopes soon to offer a similar opportunity.

Nursing schools throughout the country are in need of more pupils. As so many of the private nurses will go to the front, many more sick people will probably go to hospitals for care, and a larger student force will be needed to meet this emergency.

One real danger to be guarded against in the unprecedented call for nurses, is that women with insufficient public health training may be pressed into service. The mental discipline of a college education with the scientific knowledge acquired will very materially help in the training of a nurse, but I do not believe that anything will take the place of the hospital experience. After the war is over, if we have many health workers who fail to come up to standards which we have been fighting to maintain, we may have as difficult a problem on our hands as we have now.

One means of conserving the public health nurses who are employed by city organizations is by combining all the nursing forces under one head. They are all laboring for the same end- better health and better living conditions. The tuberculosis nurse cannot fully understand her problem if she does not view it in its relation to the children; and the child welfare.

nurse cannot be an expert in her line if she does not recognize the dangers with which tuberculosis threatens her little charges. The school nurse soon sees how closely her work touches pre-natal and infant welfare nursing. We are already forced to make our small supply of nurses go as far as possible, but such an arrangement of generalization can hardly be called an experiment or a makeshift, as it has already been so successfully carried out in many cities.

While the extra demand is being made by the American Red Cross upon our little army of public health nurses, the call for nursing service at home is daily growing more imperiative. Poor stricken France is warning us not to make her mistake. Her five hundred thousand tuberculous soldiers will be a sad problem for years to come. A half a million centers of infection! England has learned that the best way to replace the lives lost in battle is to try to save the lives of babies who die from preventable causes. Poland has no little children left. A generation has been wiped out. The New York Milk Committee after gathering statistics from 150 American cities with a population of 25,000 and over reports that in these cities one baby out of every ten dies before it is one year old. There are 20,000,000 school children in the United States and these little citizens should not be allowed to grow up with defects which can be detected and corrected. Surely there is plenty of work for our 6,000 public health nurses.

For the public health nurse who sincerely asks herself "How can I best serve my country in the hour of her need?" there is a serious problem and no one can make her decision for her. She knows that

of all women she is best prepared for military service. She knows how to put her ideals into practical use, she has been accustomed to keeping faithful watch while others slept, to making accurate observations and concise and unexaggerated reports of her patients' symptoms, to obeying promptly the orders of her superior officers in the same spirit in which soldiers obey, and to giving orders to those under her and for whose work she is responsible. The fear of personal danger will not keep her from enlisting for war service. She is used to danger, and would be a poor representative of her profession if she were to consider her own safety and comfort first. Infectious diseases did not come in with a state of war, and to this particular danger the nurse is less exposed than many others. would be, because she has learned how to protect herself and others from infection. She knows that it is going to be a difficult undertaking to supply enough nurses for foreign service, that the base hospitals will need a small army like her, and that the cantonments and the sanitary zones surrounding them also call for nursing service. She reads of battles in the trenches, on the sea and ir the air, and she feels a restlessness and longing to be near the front because she has a tremendous pity for the men who are in danger. It is inevitable that many of them be hurt, but the thought of their suffering unnecessarily for want of nursing care which she could and would so gladly give, makes her anxious to share the dangers. The love of adventure and the knowledge of the possession of just the skill and experience needed for the service make the call very strong.

If our nurse happens to be a member of the staff of a nursing organization it may be right for her to go. Probably the other members of the staff are willing to work a little harder or it may be that the establishment of a new branch of work which was planned can be delayed, so that she can be spared for the greater need.

If, however, this nurse should be the one and only representative of her profession in a small city or rural community she will remember that her people need her as never before. The city organization may be able to meet the extra responsibilities with depleted ranks, but what of the community whose whole nursing force departs? The call to remain at her post cannot go unheeded by the conscientious nurse. The effects of war will be felt in all communities large or small. The departure of the men and youths who are enlisting for war service will take from many families their protectors and breadwinners, thus in many instances lowering the family income and standard of living; will bring about abnormal social conditions by sending women and girls into industrial positions, leaving the aged, the prospective mothers, infants and children without their usual care and comforts, and will cause more than ever before the demands for the services which the public health nurses are giving and are especially qualified by their training to give. In the smaller cities and rural communities there are no agencies or charity organizations and the nurse is the only welfare worker. The absence of physicians who have enlisted for service has also laid upon the shoulders of the public health nurse a few added responsibilities. If after hearing the call to go to the front

this nurse decides to stand by her post, it is not because she is a slacker but because she is a patriot.

One real war problem of the public health nurse is the fact that her community in its enthusiasm for Red Cross work has forgotten her and her needs and the needs of the people at home. It has forgotten that "civilian health is the rock on which military efficiency rests." Dr. Herman Biggs of New York State speaks of the service of the public health nurse as follows: "If we as a public are to conserve our greatest war resource, the health of our people, the individual must realize the part that obedience to the laws of health plays in the working out of our united destinies. No one can bring this realization to the people that need it most, repeatedly as it must be done, so well as the public health nurse." No loyal American wants this war to last one minute longer than is necessary, and in order to hasten its end, we must do extra work and make special sacrifices, but it will surely weaken. our defense to neglect health work already established at home. Our men at the front will need tons of sweaters and socks and surgical dressings too, and they can all be made by already busy women if there is no time left for bridge whist and no money left for ten dollar knitting bags in which to carry fifty cents' worth of knitting. Both needs exist and we cannot afford to forget either the public health nursing or the war supplies. The hour of service is at hand.

Arthur Guy Empey, American volunteer in the British Army, says in his book "Over The Top": I can't see any sign of peace for three years. It will be a long war, and every one will be needed. About 30 per cent of the work will

be done by the men in the trenches, the rest must be done at home by the women, by those too old for service and by those physically unfit for fighting. The sooner we realize this the better." For the women who are no longer young enough for active service there is plenty of work. Their wisdom and experience is of value in planning for the country's home needs as well as for the needs of the enlisted men. Some of them have made the supreme sacrifice and have given their sons, and they will be asked to lend their daughters. There are many women who are physically unfit for active service, and more who are held back by insufficient preliminary education. Some are already doing work which it would be inexcusable to leave, and it is the part of patriotism to stand by one's post if by so doing one can serve the country better than by going to the front. But in this United States of ours are thousands of young women who are strong in body, who have had the advantage of a good education, who have no one dependent upon them, and whether the war lasts three years longer or three days longer, one thing is certainproperly qualified nurses will be desperately needed both at home and abroad for years to come. Should the work of destruction in the European countries end tomorrow, the work of reconstruction could at best but make its beginnings, and thousands of young women with trained minds and skilled hands will be in demand for that service.

At home the field will be unlimited. Our tuberculosis problem will probably grow with every month of the war; we must do more for the health and welfare of our rural mothers and their

babies; Compulsory Health Insurance is on its way, and in this country public health nursing is included in the plan; and 12,000,000 rural school children need physical inspection and school nursing.

If it were possible for young women to take a three weeks' course in nursing and then be ready. for service we should probably have many volunteers, but the long course in the hospital is necessary in order to acquire the technical skill and the mental and physical training and discipline as well as the knowledge of the care of the sick. and the prevention of disease. It takes many long months to train soldiers, but they are serving the country the minute they go into training camp; and as soon as a woman enters a nursing school she "becomes part of the nation's war equipment" and is giving patriotic service. Because she is working in the hospital under the supervision of an expert, she may very soon be able to take the place of some graduate nurse who can be spared to go. Columbia University has given its wonderful base hospital for our soldiers' needs, but it might as well have presented the nation with a toy factory if no doctors and nurses can be found to care of those for whom it was given. Untrained and half trained nurses are of no more use at the front than are untrained or half trained soldiers, and judging by the reports no effort is spared to see that the soldier is prepared for the responsibility which he must meet. There is no use in sending burdens when it is burden bearers that are needed, and the woman, like the man, who goes to the front must be able to care for others as well as for herself.

Looking into the future one cannot help wondering what will be the outcome of our struggles and anxieties. As terrible as warfare must necessarily be, the results, we hope, will bring better conditions. For the profession of nursing, we may safely prophesy higher standards, because the public will see that the method of of training and better facilities for nursing nurses is partly its responsibility, education will be provided. More and better educated women will enter the nursing schools when schools offer the right opportunities. War already has had a strong influence in the development of the nurse. The Crimean war produced Florence Nightingale, and her vision and ability organized the first training school. Our National Government has recognized the value of the nurse in time of war and has appointed Committees of Nursing on its Council of National Defense. Our Miss Crandall, who is the secretary of the three committees, wrote: "It is particularly fortunate to have established at this time this official connection between the Council of National Defense and the National Associations of Nurses, because it unquestionably offers the greatest opportunity that has ever come to nurses since the days of Florence Nightingale, both to serve humanity and to lift their calling to a new and higher professional status." war teaches us the dignity of work well done, the vulgarity of extravagance, the prevention of preventable diseases, the sisterhood of women, and the responsibility to all the children of the world; out of its horrors and problems and responsibilities may come a better civilization than the world has yet known.

If