Date of Award

2015

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Graduate Group

Nursing

First Advisor

Julie Fairman

Abstract

ABSTRACT

"WE WERE THE EYES AND EARS...": NURSING AND THE DEVELOPMENT OF NEONATAL INTENSIVE CARE UNITS IN THE UNITED STATES, 1955-1982.

Briana Ralston, MS, RN

Julie Fairman, PhD, RN, FAAN

In the 1960s and 1970s, neonatal intensive care units (NICUs) became the standard of care for critically ill newborns in hospitals across the United States. Though work has been done to examine how nurses participated in the development of ICU's for adult populations, scholarship related to the formation of NICUs is sparse. Using historical methodology to examine hospital archival data, oral history interviews, and scholarly literature, this work examines the roles nurses played in the development of NICUs as technological systems between 1955 and 1982 in the United States. By using the lenses of the history of nursing, the history of technology, and the history of children's healthcare, this work contributes to our understanding of the nuanced ways nurses participated in the formation of the NICU - a complex technological system of care - for a vulnerable and medically complicated newborn patient population. The value of newborns as a unique and valued medical population, seen as early the Progressive Era, contributed to the formation of premature infant units and particular nursing care for premature newborns during the first half of the 20th century. This premature infant care in turn influenced the development of later neonatal intensive care units and the ways nurses cared for a broader cadre of sick newborns. Hospitals valued the particular care they gave and made decisions about the dedication of spaces where newborns could be grouped together to receive nursing care. Two case studies of east coast children's hospitals - The Children's Hospital of Philadelphia and Boston Children's Medical Center - shed light on how particular hospitals chose to allocate resources, group patients, and how they made those decisions based on their value of specifically trained nursing staff. The history of NICUs speaks to broader contemporary healthcare themes and issues as we ask questions about who should receive care and precious healthcare resources.

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