On March 31, 1736, a six-bed almshouse (home for the poor) was founded in New York City with construction starting only a year earlier. That almshouse would eventually become Bellevue Hospital, which is often cited as the oldest public hospital in the US.
By 1731, New York City had a population of over 8,000 people. A number of these were described as “vagabonds and idle beggars.” To help these people, work began in 1735 on the construction of a public workhouse and house of correction.
The cost of building this almshouse was £80 and 50 gallons of rum. The building included a 25- by 23-foot six-bed infirmary, overseen by Dr. John Van Beuren. The workhouse also provided a form of “occupational therapy,” offering those who entered work in hard labor, as well as instruction in sewing, knitting, spinning, weaving and leather, and iron working. The property also included a nearby farm.
There is little information about the workhouse during its first few years, except that it appears to have expanded several times. When the British occupied the city during the Revolution, the inmates were moved to Poughkeepsie. And after a fire later that year, a large number of now-homeless persons were admitted. Eventually, several more buildings were added to house the increased number of poor and destitute residents. In 1799, the hospital opened the country’s first maternity ward.
In the late 1700s, outbreaks of diphtheria, cholera, and yellow fever were on the rise in the city. Over the years, the Belle Vue farm near the East River served as quarantine during these epidemics. Eventually, the city purchased it and expanded a number of buildings there. While the War of 1812 slowed progress, the complex was ready for use by 1816.
For some time, one doctor served as physician, surgeon, midwife, and pharmacist. Eventually, more staff was brought in and in 1817, a second doctor was hired, as one man couldn’t care for over 200 patients. Soon, there were two visiting doctors and two interns.
The hospital suffered in the early 1800s because of mismanagement. Supplies were stolen, patients weren’t cared for, and many employees simply left. Eventually, the hospital’s commissioners started to make major changes. They removed the penal institution, sending prisoners to other penitentiaries and eventually removed the almshouse as well. Soon, the board was run by a group of distinguished physicians, dedicated to providing excellent medical care. It was also during this era that the hospital introduced clinical lectures, expanding its medical education offerings. The hospital doctors also helped to develop the city’s sanitary code, the first in the world.
In June 1869, Bellevue inaugurated its ambulance service, based on the successful practices instituted by Dr. Edward Dalton during the Civil War. It was one of the world’s earliest hospital-based ambulance services. It was so successful that five more ambulances were added the following year.
In 1873, Bellevue was home to the country’s first nursing school based on Florence Nightingale’s instruction. Other firsts followed: a children’s clinic in 1874, an emergency pavilion in 1876, an ambulatory cardiac clinic in 1911, a ward for metabolic disorders in 1917, a public school for emotionally disturbed children in 1935, a hospital catastrophe unit in 1941, a cardiopulmonary laboratory in 1942, and the first intensive care unit in a municipal hospital in 1962. Bellevue also established a psychiatric hospital and a unit for alcoholics.
In 1964, Bellevue was selected as the stand by hospital for visiting presidents, foreign dignitaries, members of the city’s uniformed services, and UN diplomats. Today, Bellevue handles about 460,000 non-emergency visits, 106,000 emergency patients, and about 30,000 inpatients each year. A staff of 1,200 attending physicians and 5,500 in-house physicians cares for these patients.
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