nursing workforce, the feminine pronoun was used
almost exclusively.
Hall died of heart disease on February 27, 1969,
at Queens Hospital in New York. In 1984, she was
inducted into the American Nurses’ Association
Hall of Fame. Following Hall’s death, her legacy was
kept alive at the Loeb Center until 1984, under the
capable leadership of her friend and colleague
Genrose Alfano.
Remembered by her colleagues for her passion
for nursing, her flamboyant personality, and the ex-
citement she generated, Hall was indeed a force for
change. At a time when task-oriented team nursing
was the preferred practice model in most insti-
tutions, she implemented a professional patient-
centered framework whereby patients received a
standard of care unequaled anywhere else. At the
Loeb Center, Lydia Hall created an environment in
which nurses were empowered, in which patients’
needs were met through a continuum of care, and
in which, according to Genrose Alfano, “nursing
was raised to a high therapeutic level” (personal
communication, January 27, 1999).
Historical Background
During the 1950s and 1960s, the health-care milieu
in which Lydia Hall functioned was undergoing
tremendous change. As previously stated, the type
of nursing home model then in use failed to meet
expectations, and care of the elderly was a growing
problem. Increasing recognition that the elder pop-
ulation was in the greatest need of health-care in-
surance generated years of debate among
legislators, the medical profession, and the public.
Finally, in 1965, Medicare legislation was enacted
that provided hospital, nursing home, and home
care for those citizens age 65 and over. Medicaid
was established to provide health-care services for
the medically indigent, regardless of age. These
programs provided a source of revenue for the na-
tion’s hospitals and, as public confidence in hospi-
tals grew, there was concomitant growth in the
need for more hospitals. Subsequent congressional
legislation provided for construction of new facili-
ties, which, in turn, created more opportunities for
the employment of nurses. Undoubtedly, all of
these factors were relevant to Hall as she proceeded
to implement her vision.
With respect to nursing, the 1960s witnessed the
growth of specialization, the movement toward
preparation of nurse practitioners and clinical
nurse specialists, and the emergence of new prac-
tice fields such as industrial nursing. Although
most nurses worked in hospitals at that time, a be-
ginning trend to community-based practice was
evolving. In regard to nursing education, the advent
of degree-granting, two-year programs in commu-
nity colleges proved to be an attractive alternative
to the apprenticeship model—hospital-based,
diploma school education—through which most
nurses had previously been prepared. And, with
publication of the American Nurses’ Association’s
position statement on educational preparation in
1965, baccalaureate education was receiving re-
newed recognition as the preferred method for
preparing professional nurses. The correlation be-
tween higher education and professional practice
seems to agree with Hall’s ideas and probably
elicited her support. Her model of nursing at the
Loeb Center clearly required nurses to be educated,
professional, and caring. Its success depended upon
the ability of the nurses to relate to each patient
with sensitivity and understanding. Hall was clear
in her vision of the registered professional nurse as
the appropriate person to fulfill that role.
Scholars and practitioners today continue to
grapple with questions about how to define nursing
and to demonstrate the unique contribution of
professional nursing to the health and well-being of
people. Lydia Hall’s belief that the public deserves
and can benefit from professional nursing care was
articulated in her theory of nursing and was
demonstrated in practice at the Loeb Center under
her guidance. Hall stated:
The program at the Loeb Center was designed to alle-
viate some of the growing problems which face our
health-conscious public today: the complex and long-
term nature of illnesses besetting all age groups; the
high cost of services utilized in overcoming these ill-
nesses; the negative reactions of the public and the
health professions to patient care offered by institu-
tions; and the confusion among all groups about the
definition of nursing, its organization for service, and
the kind of educational preparation it requires.
(1963c, p. 805)
These questions and concerns are as relevant
today as they were when Hall articulated her ideas
over 30 years ago. Perhaps they are even moreCHAPTER 10 Lydia Hall:The Care, Core, and Cure Model and Its Applications 115