A Message from the AAHN President
March 2020

“Nurses and patients on Hospital Rooftop” - courtesy Bjoring Center for Nursing Historical Inquiry, UVA.

With reports of coronavirus (COVID19) and mandatory quarantines monopolizing the news, the idea of getting outside for some fresh air is becoming very appealing!  Right now, I am considering a few days at the beach myself – somewhere where sea breezes might blow away all nearby germs. ;-) And, it turns out that this is not a new idea.

Throughout our history, nurses, like the ones pictured above, considered fresh air and sunshine as therapeutic, even if it meant bundling up their small patients and taking them to the hospital rooftop.  This photo is from the 1940s in Charlottesville, Virginia, but it was not the first time that nurses used fresh air as a treatment. For example, in the 1860s Florence Nightingale recommended well-ventilated pavilion hospitals for the care of the sick; in the late 1880s Visiting Nurses in both New York City and Boston sent infants and children on all day excursions on the steamship Emma Abbot and the Boston Floating Hospital so they could experience the health benefits of “healthy sea breezes” and sunshine.[1]   At the turn of the 20th century Lillian Wald built playgrounds and established summer camps for immigrant children living on NYC’s Lower East Side, while Visiting nurses in Philadelphia staffed two open-air hospitals for babies on the riverfront.[2] Others sent “sickly” children to Preventoria near the sea or in the countryside in the hopes of preventing them from getting tuberculosis.[3]  Meanwhile, in both Europe and the United States, some physicians and nurses advocated for heliotherapy, even in frigid weather.[4]

Fresh air was also recommended for preventing the spread of disease. In the 1918 influenza pandemic, local governments mandated that church services be held outside; bus and trolley windows be opened. Recycling some of these mandates might be useful today as we try to prevent the spread of COVID19. Meanwhile, as we wait for spring and for more information about the extent of this novel virus, please continue to advocate for handwashing. We know that works, and nurses are very good at it.

Stay safe, and feel free to send me your thoughts: [email protected]

Arlene W. Keeling, PhD, RN, FAAN


[1] Arlene Keeling, Michelle Hehman, and John Kirchgessner. History of Professional Nursing in the United States: Toward a Culture of Health.

[2] S.W. Newmayer, “The Warfare against Infant Mortality,” Annals of the American Academy of Political Social Science, 37,(March 1911): 532-542

[3] Cynthia Connolly, Saving Sickly Children: The Tuberculosis Preventorium in American Life, 1909-1970. (New Brunswick, NJ: Rutgers University Press, 2008)

[4] Barbara Brodie, “Children of the Sun: Heliotherapy and Tubercular Children,” Windows in Time, 23, 2 (October 2015): 8-12