From Battlefield to Baccalaureate Degree: The Evolution of Registered Professional Nursing in America, 1865-1929 (MAT)
By MegT
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Period: to
Pre-1865
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Civil War Nursing
During the Civil War, for "every man killed in battle, two died from disease" including dysentery, diarrhea, typhoid and malaria. On June 9, 1861, the United States establishes a Sanitary Commission to "improve sanitation, build large well-ventilated hospitals and encourage women to join the newly-created nursing corps." Nurses often traveled great distances and worked in harsh conditions, "blazing their own trail" as there were no role models--they learned on the job in military hospitals! -
Period: to
1865 to 1890
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First American Nursing School Founded
"A good nurse is indispensable to every sick room..." wrote Dr. Samuel D. Gross, President of the American Medical Association, to its members after returning in 1868 from travels to England to study model British nurse-training programs implemented by Florence Nightingale. In 1869, the nursing school of Women's Hospital of Philadelphia is established, becoming the first American program to be founded upon Nightingale's nursing principles, including strict rules of hygiene and cleanliness. -
First African American Trained Nurse
In 1878, 33 year-old African-American Mary Mahoney applies to the nurse training program at the New England Hospital for Women and Children in Boston, Massachusetts, where "charitable" efforts of the day provide for the admission of "one African American student and one Jewish student per year." Nurse training schools in America would continue to be segregated for decades to come, as would the hospitals who supported the schools. -
Modern Hospital Care Emerges
Pre-Civil War, hospitals evolved from city "almshouse" institutions designed to provide custodial care for the mentally and chronically ill (often with "undesirable" female staff as nurses). American industrialization, urbanization and economic expansion, along with the acceptance of aseptic germ theory in 1867 and steam sterilization in 1881, bring rise of the modern inpatient hospital with professional physician and nurse staffing in an effort to create a "germ-free" aseptic environment. -
First Nursing Textbook Published
A Textbook of Nursing by Clara S. Weeks-Shaw is the "first book in a long tradition of texts in which nurses themselves codified the knowledge and skills necessary for nursing practice." Ms. Shaw saw her work as "important to training schools, families and private students." Her text included instruction in areas such as the "sick room," "observation of symptoms," "medicines and their administration," and "poultices, fermentations and other applications." -
Period: to
1890 to 1915
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First Formal Nursing Organizations
The first major nursing organizations are founded: The National League for Nursing (originally the American Society of Superintendents of Training Schools for Nurses) in 1893 and Nurses Associated Alumnae of the US and Canada in 1896 (which would become in 1911 the American Nurses Association). Also in 1893, the Nightingale Pledge, a modified Hippocratic oath composed by Lystra Gretter in Detroit, Michigan, was adopted for nursing graduates (not yet formally called "registered nurses"). -
First Public School Nurse
In 1893, nurse Lillian Wald founds Henry Street Settlement House in New York City's Lower East Side, a precursor to formal neighborhood healthcare and social-service providers. In October of 1902, having expanded twice, Ms. Wald becomes aware of the high absence rate in New York City Public School children due to chronic illness and disease. Henry Street Settlement House agrees to fund the first official school nurse in New York, Lina Rogers, who cared for 10,000 students on four campuses. -
First Nurse Licensure Act
North Carolina becomes the first state to require nurse licensure, following formal attempts to organize state nursing associations in New York, New Jersey, Illinois and Virginia as early as 1901. Within twenty years (by 1921), 48 states plus the District of Columbia and the territory of Hawaii would regulate the practice of professional nursing by statute. Each of these early nurse practice acts mandated formal registration of nursing-school graduates, hence the title "registered nurse." -
First University-Based School of Nursing
In 1909, the University of Minnesota School for Nurses is founded by Dr. Richard Olding Beard, a physiology professor at the University of Minnesota Medical School who understood the importance and relevance of professional, academic nursing education (and who especially believed in higher education for women!). Before this, each of the approximately 1,100 schools of nursing in the United States were located and operated within hospitals, with nursing "students" used essentially as free labor. -
First Public Health Nurse
In 1912, the National Organization for Public Health Nursing is founded by the efforts of Lillian Wald (of Henry Street Settlement House service in New York). Wald's statement, "Our basic idea was that the nurse's peculiar introduction to the patient and her organic relationship with a neighborhood should constitute the starting point for a universal service to the region," would largely define public-health nursing the US. The first U.S. Public Health Service nurse would be appointed in 1913. -
Period: to
1915 to 1929
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Nurses in War and Flu Epidemic
World War I (1914-1918) followed by the 1918 Spanish Flu Epidemic created one of the largest demands in U.S. history for professional nurses. More than 23,000 nurses provided care to soldiers serving on the front lines, as well as injured servicemen returning home. Stateside, the Spanish Flu Epidemic of 1918 lasted for one year and claimed the lives of 675,000 people (of 22 million people infected with the disease). Crowded urban living conditions contributed to the rapid spread of infection. -
Nursing Baccalaureate Degree
In 1919, the University of Minnesota in Minneapolis creats a five-year baccalaureate degree program for nurses. The first director of the nursing program, Bertha Erdman, serves for only one year before developing tuberculosis in 1910 and resigning, to be replaced by Louise M. Powell. A master's degree program would be added in 1950. Today, the University of Minnesota School of Nursing remains the longest continually-operating university nursing school in the United States and the world!
