护理名人堂 | 美国临终关怀运动之母—Florence Wald

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Florence Wald (April 19, 1917 – November 8, 2008) was an American nurse, former Dean of Yale School of Nursing, and largely credited as "the mother of the American hospice movement".[1][2] She led the founding of Connecticut Hospice, the first hospice program in the United States. Late in life, Wald became interested in the provision of hospice care within prisons. In 1998, Wald was inducted into the National Women's Hall of Fame.[3]

Early life

Wald was born as Florence Sophie Schorske in New York City on April 19, 1917. Due to a chronic respiratory ailment, she spent several months as a child in a hospital. This hospitalization experience led her to pursue a career in nursing.[4] Wald received a B.A. from Mount Holyoke College in 1938 and an M.N. from Yale School of Nursing in 1941.

After World War II, she became a staff nurse with the Visiting Nurse Service of New York, a research assistant at the Columbia University College of Physicians and Surgeons, and was an instructor at the Rutgers University school of nursing. She received a second master's degree from Yale University in mental health nursing in 1956 and became an instructor at the school's nursing program. She became Dean of Yale School of Nursing in 1959, after being named to the position on an acting basis the previous year.[4][5] A short time later, she reconnected with Henry Wald, whom she met initially while she was conducting a study with the United States Army Signal Corps. The couple married later that year.[1]

Hospice movement

Wald's interest in the care of the terminally ill was piqued in 1963 when she attended a lecture at Yale University presented by the English physician Cicely Saunders, an innovator in the field who later created St. Christopher's Hospice, the world's first purpose-built hospice. Dr. Saunders spoke that day about her methods of using palliative care for terminally ill cancer patients, with the intention of allowing those in the latest stages of their disease to focus on their personal relationships and prepare themselves for death. An "indelible impression" was made by Dr. Saunders, with Wald noting that "until then I had thought nurses were the only people troubled by how a terminal illness was treated".[4]

Following the Saunders lecture, Wald worked to update the nursing school's curriculum to encourage students to focus on the patient and their family, and to keep all of them involved in the patient's care.[4] She left her position as dean in 1966, with plans to develop a hospice in the United States similar to the one Saunders was developing in England.[1] Though she stepped down as dean, Wald retained a faculty position as a research associate and as a member of the clinical nursing faculty, and was promoted to a full professor there in 1980.[2] Despite the financial impact on their family, she continued her goal of building a program and visited England twice with her husband to visit Dr. Saunders. St. Christopher's Hospice opened in 1967; Wald worked there for a month in 1969.[1][4]

Her husband left his engineering firm and enrolled at Columbia University in 1971 with a major in hospital planning. It was his master's degree thesis that provided the framework for the Connecticut Hospice. Wald conducted a two-year research program studying how terminally ill patients fared at home or in a healthcare facility, and tracked how patients and their families felt throughout the process.[1] After returning to the United States, she organized a team of doctors, clergy and nurses to investigate the needs of dying patients. In 1974, she, along with two pediatricians and a Yale medical center chaplain, founded the first hospice in the United States at the Connecticut Hospice, located in Branford, Connecticut.[6] Initially the program provided home care, and had its first inpatient location in 1980, a 44-bed facility in Branford. Disagreements had been brewing within the board about her vision for the hospice program, and she was forced to resign shortly after its opening.[1]

Other hospice programs were created building on Wald's innovation at Branford. By 1980, Medicaid began to pay for care provided at a hospice, which led to a sharp rise in such facilities. By the time of her death in 2008, there were more than 3,000 hospice programs in the United States, serving some 900,000 patients annually.[4]

Later life

Well into her 80s, Wald traveled to prisons in Connecticut performing a research project on behalf of the National Prison Hospice Association, an organization founded in 1991 and based in Boulder, Colorado. Wald served on the organization's board of directors. Wald worked on considering ways to make hospice care available to those incarcerated in the prison system, including training inmates to become hospice volunteers for dying inmates or arranging for outside hospice care for inmates granted compassionate leave given their medical condition. Wald noted that training prisoners to provide such care would assist the terminally ill and help rehabilitate the volunteers at almost no cost to the prisons.[1] She was awarded an honorary doctorate in 1996 from Yale University, Wald was introduced as "the mother of the American hospice movement".

Speaking of her interest in prison hospice care in 1998, Wald said, "People on the outside don’t understand this world at all. Most people in prison have had a rough time in life and haven’t had any kind of education in how to take care of their health. There is the shame factor, the feeling that dying in prison is the ultimate failure."[7]

Florence Wald died at age 91 on November 8, 2008 at her home in Branford, Connecticut.[4]

全文翻译（仅供参考）

弗洛伦斯-瓦尔德（Florence Wald）（1917年4月19日-2008年11月8日）是一位美国护士，曾任耶鲁大学护理学院院长，被誉为 "美国安宁疗护运动之母"。[1][2]她领导成立了康涅狄格安宁疗护组织，这是美国第一个安宁疗护项目。在生命的晚期，沃尔德对在监狱中提供安宁疗护感兴趣。1998年，沃尔德被选入国家妇女名人堂[3]。   早期生活 瓦尔德于1917年4月19日在纽约市出生，名叫弗洛伦斯-索菲-肖尔斯克。由于患有慢性呼吸道疾病，她小时候在医院住了几个月。这次住院经历使她开始追求护理事业。[4] 瓦尔德于1938年获得霍利奥克山学院的学士学位，并于1941年获得耶鲁大学护理学院的护士硕士学位。 二战结束后，她成为纽约探访护士服务处的一名工作人员，在哥伦比亚大学内科和外科医生学院担任研究助理，并在罗格斯大学护理学院担任教员。1956年，她获得耶鲁大学精神健康护理学的第二个硕士学位，并成为该校护理课程的讲师。1959年，她成为耶鲁大学护理学院院长，此前她被任命为代理院长。[4][5] 不久之后，她与亨利-瓦尔德重新联系，她最初是在美国陆军信号部队进行研究时认识他的。这对夫妇于当年晚些时候结婚。 安宁疗护运动 1963年，沃尔德对临终病人的护理产生了兴趣，当时她参加了英国医生西西里-桑德斯在耶鲁大学的讲座，桑德斯是该领域的创新者，后来创建了世界上第一个专门建造的临终关怀医院--圣克里斯托弗临终关怀医院。那天，桑德斯博士讲述了她对身患绝症的癌症患者使用姑息治疗的方法，目的是让那些处于疾病晚期的患者专注于他们的个人关系，为死亡做好准备。桑德斯博士给人留下了 "不可磨灭的印象"，沃尔德指出，"在此之前，我一直以为护士是唯一被临终疾病的治疗方式所困扰的人"[4] 。 在桑德斯的讲座之后，沃尔德致力于更新护理学校的课程，鼓励学生关注病人及其家属，并让他们都参与到病人的护理中来。[4]她于1966年离开院长职位，计划在美国发展类似于桑德斯在英国发展的临终关怀机构。[1]尽管她卸下了院长的职务，但瓦尔德保留了研究助理和临床护理教师的职位，并在1980年被提升为那里的全职教授。[2]尽管他们的家庭受到了经济上的影响，但她继续实现她建立一个项目的目标，并与她丈夫两次访问英格兰，拜访桑德斯医生。圣克里斯托弗临终关怀医院于1967年开业；瓦尔德于1969年在那里工作了一个月[1][4] 。 她的丈夫离开了他的工程公司，于1971年进入哥伦比亚大学学习，主修医院规划。正是他的硕士学位论文为康涅狄格州安宁医院提供了框架。瓦尔德进行了一项为期两年的研究计划，研究临终病人在家中或医疗机构中的表现，并跟踪病人及其家属在整个过程中的感受。[1] 回到美国后，她组织了一个由医生、神职人员和护士组成的团队，调查临终病人的需求。1974年，她与两位儿科医生和耶鲁大学医学中心的牧师一起，在康涅狄格州布兰福德的康涅狄格临终关怀中心成立了美国第一家临终关怀机构。[6]该项目最初提供家庭护理，1980年在布兰福德设立了第一个住院点，有44张床位。董事会内部对她的安宁疗护项目的愿景一直在酝酿分歧，她在项目开始后不久就被迫辞职了。 其他临终关怀项目是在沃尔德在布兰福德的创新基础上创建的。到了1980年，医疗补助计划开始支付临终关怀服务的费用，这导致了这类设施的急剧增加。到她2008年去世时，美国有3000多个安宁疗护项目，每年为大约90万名病人提供服务。 晚年生活 在她80多岁的时候，沃尔德前往康涅狄格州的监狱，代表全国监狱临终关怀协会执行一个研究项目，该组织成立于1991年，总部设在科罗拉多州博尔德。瓦尔德在该组织的董事会任职。瓦尔德的工作是考虑如何让监狱系统中的被监禁者获得安宁疗护，包括培训囚犯成为临终囚犯的安宁疗护志愿者，或为因身体状况而获得同情假的囚犯安排外部安宁疗护。瓦尔德指出，培训囚犯提供这种护理将帮助临终病人，并帮助志愿者康复，而监狱几乎不需要任何费用。[1]她于1996年被耶鲁大学授予荣誉博士学位，瓦尔德被介绍为 "美国临终关怀运动之母"。 在1998年谈到她对监狱临终关怀的兴趣时，沃尔德说："外面的人根本不了解这个世界。监狱里的大多数人都有过一段艰难的生活，没有接受过任何关于如何照顾自己健康的教育。还有羞耻的因素，觉得死在监狱里是最终的失败。"[7] 。 2008年11月8日，弗洛伦斯-瓦尔德在康涅狄格州布兰福德的家中去世，享年91岁[4] 。