History Of Nursing In The United States
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The history of nursing in the United States focuses on the professionalization of
Nursing in the United States Nursing is a health care profession that "integrates the art and science of caring and focuses on the protection, promotion, and optimization of health and human functioning; prevention of illness and injury; facilitation of healing; and alle ...
since the Civil War.


Origins

Before the 1870s "women working in North American urban hospitals typically were untrained, working class, and accorded lowly status by both the medical profession ...and society at large". Nursing had the much the same lowly status in Europe. However D'Antonio shows that in the mid-19th century nursing was transformed from a domestic duty of caring for members of one's extended family, to a regular job performed for a cash wage. Nurses were now hired by strangers to care for sick family members at home. These changes were made possible by the realization that expertise mattered more than kinship, as physicians recommended nurses they trusted. By the 1880s home care nursing was the usual career path after graduation from the hospital-based nursing school.


Civil War

During the
American Civil War The American Civil War (April 12, 1861May 26, 1865; also known by Names of the American Civil War, other names) was a civil war in the United States between the Union (American Civil War), Union ("the North") and the Confederate States of A ...
(1861–65), the
United States Sanitary Commission The United States Sanitary Commission (USSC) was a private Aid agency, relief agency created by federal legislation on June 18, 1861, to support sick and wounded soldiers of the United States Army (Federal / Northern / Union Army) during the Ameri ...
, a federal civilian agency, handled most of the medical and nursing care of the
Union armies Union commonly refers to: * Trade union, an organization of workers * Union (set theory), in mathematics, a fundamental operation on sets Union may also refer to: Arts and entertainment Music * Union (band), an American rock group ** ''Union ...
, together with necessary acquisition and transportation of medical supplies.
Dorothea Dix Dorothea Lynde Dix (April 4, 1802July 17, 1887) was an American advocate on behalf of the poor insane, mentally ill. By her vigorous and sustained program of lobbying state legislatures and the United States Congress, she helped create the fir ...
, serving as the Commission's Superintendent, convinced the medical corps of the value of women working in 350 Commission or Army hospitals. In both the North and South, over 20,000 women volunteered to work in hospitals, usually in nursing care. They assisted surgeons during procedures, administered medicines, supervised the feedings of patients, and cleaned bedding and clothes. They gave good cheer, wrote letters the patients dictated, and comforted the dying. A representative nurse was Helen L. Gilson (1835–68) of Chelsea, Massachusetts, who served in Sanitary Commission. She supervised supplies, dressed wounds, and cooked special foods for patients on a limited diet. She worked in hospitals after the battles of
Antietam The Battle of Antietam ( ), also called the Battle of Sharpsburg, particularly in the Southern United States, took place during the American Civil War on September 17, 1862, between Confederate General Robert E. Lee's Army of Northern Virgin ...
, Fredericksburg, Chancellorsville, Gettysburg. She was a successful administrator, especially at the hospital for black soldiers at City Point, Virginia. The middle-class women North and South who volunteered provided vitally needed nursing services and were rewarded with a sense of patriotism and civic duty in addition to opportunity to demonstrate their skills and gain new ones, while receiving wages and sharing the hardships of the men.
Mary Livermore Mary Ashton Livermore ( Rice; December 19, 1820May 23, 1905) was an American journalist, abolitionist, and advocate of women's rights. Her printed volumes included: ''Thirty Years Too Late,'' first published in 1847 as a prize temperance tale, ...
,
Mary Ann Bickerdyke Mary Ann Bickerdyke (July 19, 1817 – November 8, 1901), also known as Mother Bickerdyke, was a hospital administrator for Union (American Civil War), Union soldiers during the American Civil War and a lifelong advocate for veterans. She was re ...
, and Annie Wittenmeyer played leadership roles. After the war, some nurses wrote
memoir A memoir (; , ) is any nonfiction narrative writing based on the author's personal memories. The assertions made in the work are thus understood to be factual. While memoir has historically been defined as a subcategory of biography or autob ...
s of their experiences; examples include Dix, Livermore, Sarah Palmer Young, and
Sarah Emma Edmonds Sarah Emma Edmonds (born Sarah Emma Evelyn Edmondson, married name Seelye, alias Franklin Flint Thompson; December 1841 – September 5, 1898) was a British North America-born woman who claimed to have served as a man with the Union Army as a nu ...
.
Clara Barton Clarissa Harlowe Barton (December 25, 1821 – April 12, 1912) was an American nurse who founded the American Red Cross. She was a hospital nurse in the American Civil War, a teacher, and a patent clerk. Since nursing education was not then very ...
(1821-1912) gained fame for her nursing work during the American Civil War. She was an energetic organizer who established the
American Red Cross The American National Red Cross is a Nonprofit organization, nonprofit Humanitarianism, humanitarian organization that provides emergency assistance, disaster relief, and disaster preparedness education in the United States. Clara Barton founded ...
, which was primarily a
disaster relief Emergency management (also Disaster management) is a science and a system charged with creating the framework within which communities reduce vulnerability to hazards and cope with disasters. Emergency management, despite its name, does not actu ...
agency, but which also supported nursing programs. Several thousand women were just as active in nursing in the
Confederacy A confederation (also known as a confederacy or league) is a political union of sovereign states united for purposes of common action. Usually created by a treaty, confederations of states tend to be established for dealing with critical issu ...
, but were less well organized and faced severe shortages of supplies and a much weaker system of 150 hospitals. Nursing and vital support services were provided not only by matrons and nurses, but also by local volunteers,
slaves Slavery is the ownership of a person as property, especially in regards to their labour. Slavery typically involves compulsory work, with the slave's location of work and residence dictated by the party that holds them in bondage. Enslavemen ...
, free blacks, and
prisoners of war A prisoner of war (POW) is a person held captive by a belligerent power during or immediately after an armed conflict. The earliest recorded usage of the phrase "prisoner of war" dates back to 1610. Belligerents hold prisoners of war for a ...
.


Professionalization

Nursing professionalized rapidly in the late 19th century following the British model as larger hospitals set up nursing schools that attracted ambitious women from middle- and working-class backgrounds. Agnes Elizabeth Jones and
Linda Richards Linda Richards (July 27, 1841 – April 16, 1930) was the first professionally trained American nurse. She established nursing training programs in the United States and Japan, and created the first system for keeping individual medical recor ...
established quality
nursing schools Nurse education consists of the theoretical and practical training provided to nurses with the purpose to prepare them for their duties as nursing care professionals. This education is provided to student nurses by experienced nurses and other me ...
in the U.S. and
Japan Japan is an island country in East Asia. Located in the Pacific Ocean off the northeast coast of the Asia, Asian mainland, it is bordered on the west by the Sea of Japan and extends from the Sea of Okhotsk in the north to the East China Sea ...
. Richards was officially America's first professionally trained nurse, graduating in 1873 from the ''
New England Hospital for Women and Children The New England Hospital for Women and Children was founded by Marie Elizabeth Zakrzewska, Marie Zakrzewska on July 1, 1862. The hospital's goal was to provide patients with competent female physicians, educate women in the study of medicine, an ...
'' in Boston. Hospital nursing schools in the United States and Canada took the lead in applying Nightingale's model to their training programs. For example,
Isabel Hampton Robb Isabel Adams Hampton Robb (1859–1910) was an American nursing theory, nurse theorist, author, nursing school administrator and early leader. Hampton was the first Superintendent of Nurses at the Johns Hopkins School of Nursing, wrote several infl ...
(1860–1910), as director of the new Johns Hopkins Hospital Training School for Nurses, deliberately set out to use advanced training to upgrade the social status of nursing to a middle class career, instead of a low pay, low status, long hours, and heavy work job for working-class women. After 1880, standards of classroom and on-the-job training rose, as did standards of professional conduct. For textbooks, many schools used: ''A Manual of Training'' (1878); ''A Hand-Book of Nursing for Family and General Use'' (1878); ''A Text-Book of Nursing for the Use of Training Schools, Families, and Private Students'' (1885); and ''Nursing: Its Principles and Practice for Hospital and Private Use'' (1893). These books defined the curriculum of the new nursing schools and introduced nurses to modern medical science and scientific thinking. In the early 1900s, the autonomous, nursing-controlled, Nightingale-era schools came to an end. Schools became controlled by hospitals, and formal "book learning" was discouraged in favor of clinical experience. Hospitals used student nurses as cheap labor. In the late 1920s, the women's specialties in health care included 294,000 trained nurses, 150,000 untrained nurses, 47,000 midwives, and 550,000 other hospital workers (most of them women). Sandelowski finds that by 1900 physicians were allowing nurses to routinely use the
thermometer A thermometer is a device that measures temperature (the hotness or coldness of an object) or temperature gradient (the rates of change of temperature in space). A thermometer has two important elements: (1) a temperature sensor (e.g. the bulb ...
and
stethoscope The stethoscope is a medicine, medical device for auscultation, or listening to internal sounds of an animal or human body. It typically has a small disc-shaped resonator that is placed against the skin, with either one or two tubes connected t ...
, and in some cases even the new
X-ray machine An X-ray machine is a device that uses X-rays for a variety of applications including medicine, X-ray fluorescence, electronic assembly inspection, and measurement of material thickness in manufacturing operations. In medical applications, X-ra ...
s,
microscope A microscope () is a laboratory equipment, laboratory instrument used to examine objects that are too small to be seen by the naked eye. Microscopy is the science of investigating small objects and structures using a microscope. Microscopic ...
s and laboratory testing tools. For the first time, nurses could supplement their subjective observations with scientific tools. Most nurses remained at the bedside, where they used the new technology to gather information for doctors, but were not allowed to make a
medical diagnosis Medical diagnosis (abbreviated Dx, Dx, or Ds) is the process of determining which disease or condition explains a person's symptoms and signs. It is most often referred to as a diagnosis with the medical context being implicit. The information ...
. Their bond with the patient remained their primary role. The John Sealy Hospital Training School for Nurses opened in 1890 in Galveston, Texas. It grew rapidly and in 1896 became the School of Nursing, University of Texas; it was the first nursing school to become part of a university in the state of Texas. In recent decades, professionalization has moved
nursing degrees Nursing is a health care profession that "integrates the art and science of caring and focuses on the protection, promotion, and optimization of health and human functioning; prevention of illness and injury; facilitation of healing; and alle ...
out of RN-oriented hospital schools and into community colleges and universities. Specialization has brought numerous
journals A journal, from the Old French ''journal'' (meaning "daily"), may refer to: *Bullet journal, a method of personal organization *Diary, a record of personal secretive thoughts and as open book to personal therapy or used to feel connected to onesel ...
to broaden the knowledge base of the profession. Very few blacks attended universities with nursing schools. The solution was found by the Rockefeller's
General Education Board The General Education Board was a private organization which was used primarily to support higher education and medical schools in the United States, and to help rural white and black schools in the South, as well as modernize farming practices in ...
, which funded new nursing schools headed by Rita E. Miller at
Dillard University Dillard University is a private, historically black university in New Orleans, Louisiana. Founded in 1930 and incorporating earlier institutions founded as early as 1869 after the American Civil War, it is affiliated with the United Church of C ...
in New Orleans (1942) and by Mary Elizabeth Lancaster Carnegie at Florida A. & M. College in Tallahassee (1945).


Hospitals

The number of hospitals grew from 149 in 1873 to 4,400 in 1910 (with 420,000 beds) to 6,300 in 1933, primarily because the public had more trust in hospitals and could afford to pay for more intensive and professional care. Most larger hospitals operated a school of nursing, which provided minimal training to young women, who in turn worked without pay. The graduates obtained RN status, but there was little professional work for them. Hospitals only hired a few; in the 1920s, 73 percent employed no graduate nurses, and only 12 percent employed five or more. Most RNs worked for private families, or left nursing. The number of active graduate nurses rose rapidly from 51,000 in 1910 to 375,000 in 1940 and 700,000 in 1970. Hospitals were operated by city, state and federal agencies, by churches, by stand-alone non-profits, and by
for-profit Business is the practice of making one's living or making money by producing or buying and selling products (such as goods and services). It is also "any activity or enterprise entered into for profit." A business entity is not necessari ...
enterprises run by a local doctor.


Religious hospitals

All major religious denominations in the United States built hospitals staffed by primarily by unpaid student nurses supervised by some graduate nurses.
Catholics The Catholic Church (), also known as the Roman Catholic Church, is the largest Christian church, with 1.27 to 1.41 billion baptized Catholics worldwide as of 2025. It is among the world's oldest and largest international institut ...
led the way. In 1915, the Catholic religious orders for women operated 541 hospitals. Costs were minimized relying on the work of women students who paid tuition and nuns who had taken a vow of poverty. The
Lutheran Lutheranism is a major branch of Protestantism that emerged under the work of Martin Luther, the 16th-century German friar and Protestant Reformers, reformer whose efforts to reform the theology and practices of the Catholic Church launched ...
and
Episcopal Episcopal may refer to: *Of or relating to a bishop, an overseer in the Christian church *Episcopate, the see of a bishop – a diocese *Episcopal Church (disambiguation), any church with "Episcopal" in its name ** Episcopal Church (United States ...
denominations also entered the health field, especially by setting up orders of women, called
deaconess The ministry of a deaconess is a ministry for women in some Protestant, Oriental Orthodox, and Eastern Orthodox churches to provide pastoral care, especially for other women, and which may carry a liturgical role. The word comes from the Greek ...
es who dedicated themselves to nursing services. The modern deaconess movement began in Germany in 1836.
William Passavant William Alfred Passavant (October 9, 1821 – June 3, 1894) was a Lutheran minister who brought the Lutheran Deaconess movement to the United States. He is commemorated in the Calendar of Saints of the Lutheran Church on November 24 with Justus F ...
in 1849 brought the first four deaconesses to Pittsburgh, in the United States, after visiting Kaiserswerth. They worked at the Pittsburgh Infirmary (now Passavant Hospital). American Methodists engaged in large-scale
missionary A missionary is a member of a Religious denomination, religious group who is sent into an area in order to promote its faith or provide services to people, such as education, literacy, social justice, health care, and economic development.Thoma ...
activity in Asia and elsewhere in the world, making medical services a priority as early as the 1850s. Methodists in America took note, and began opening their own charitable institutions such as orphanages and homes for the elderly after 1860. In the 1880s, Methodists began opening hospitals in the United States, which served people of all religious backgrounds. By 1895, 13 Methodist hospitals were in operation in major cities. In 1884, U.S. Lutherans, particularly
John D. Lankenau John Dietrich Lankenau (1817–1901) was a German-American businessman and philanthropist, an executor of financier Francis Martin Drexel, and the namesake of Lankenau Medical Center. Some sources give his middle name as Diederich or Diedrich. Bi ...
, brought seven sisters from Germany to run the German Hospital in Philadelphia. By 1963, the
Lutheran Church in America The Lutheran Church in America (LCA) was an American and Canadian Lutheran church body that existed from 1962 to 1987. It was headquartered in New York City and its publishing house was Fortress Press. The LCA's immigrant heritage came mostly fr ...
had centers for deaconess work in Philadelphia, Baltimore, and Omaha.


Public health

Public health nursing Public health nursing, also known as community health nursing is a nursing specialty focused on public health. The term was coined by Lillian Wald of the Henry Street Settlement, or, Public health nurses (PHNs) or community health nurses "integr ...
after 1900 offered a new career for professional nurses in addition to private duty work. The role of public health nurse began in Los Angeles in 1898, and by 1924, there were 12,000 public health nurses, half of them in America's 100 largest cities. Their average annual salary of public health nurses in larger cities was $1390. In addition, there were thousands of nurses employed by private agencies handling similar work. Public health nurses supervised health issues in the
public In public relations and communication science, publics are groups of individual people, and the public (a.k.a. the general public) is the totality of such groupings. This is a different concept to the sociology, sociological concept of the ''Öf ...
and
parochial Parochial is an adjective which may refer to: * Parish A parish is a territorial entity in many Christianity, Christian denominations, constituting a division within a diocese. A parish is under the pastoral care and clerical jurisdiction of a ...
schools, to
prenatal Prenatal development () involves the embryonic development, development of the embryo and of the fetus during a viviparity, viviparous animal's gestation. Prenatal development starts with fertilization, in the germinal stage of embryonic develop ...
and infant care, handled
communicable diseases infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable disea ...
such as
tuberculosis Tuberculosis (TB), also known colloquially as the "white death", or historically as consumption, is a contagious disease usually caused by ''Mycobacterium tuberculosis'' (MTB) bacteria. Tuberculosis generally affects the lungs, but it can al ...
, and dealt with an aerial diseases. Historian Nancy Bristow has argued that the great
1918 flu pandemic The 1918–1920 flu pandemic, also known as the Great Influenza epidemic or by the common misnomer Spanish flu, was an exceptionally deadly global influenza pandemic caused by the Influenza A virus subtype H1N1, H1N1 subtype of the influenz ...
contributed to the success of women in the field of nursing. This was due in part to the failure of medical doctors, who were predominantly men, to contain and prevent the illness. Nursing staff, who were predominantly women, felt more inclined to celebrate the success of their patient care and less inclined to identify the spread of the disease with their own work. During the
Great Depression The Great Depression was a severe global economic downturn from 1929 to 1939. The period was characterized by high rates of unemployment and poverty, drastic reductions in industrial production and international trade, and widespread bank and ...
, federal relief agencies funded many large-scale public health programs in every state, some of which became permanent. The programs expanding job opportunities for nurses, especially the private duty RNs who suffered high unemployment rates. In the United States, a representative public health worker was Dr.
Sara Josephine Baker Sara Josephine Baker (November 15, 1873 – February 22, 1945) was an American physician notable for making contributions to public health, especially in the immigrant communities of New York City. Her fight against the damage that widespread ur ...
who established many programs to help the poor in New York City keep their infants healthy, leading teams of nurses into the crowded neighborhoods of
Hell's Kitchen Hell's Kitchen, also known as Clinton, or Midtown West on real estate listings, is a neighborhood on the West Side of Midtown Manhattan in New York City, New York. It is considered to be bordered by 34th Street (or 41st Street) to the south, ...
and teaching mothers how to dress, feed, and bathe their babies. The federal Office of Indian Affairs (OIA) operated a large-scale field nursing program. Field nurses targeted native women for health education, emphasizing personal hygiene, and infant care and nutrition.


Military nursing

During the
Spanish–American War The Spanish–American War (April 21 – August 13, 1898) was fought between Restoration (Spain), Spain and the United States in 1898. It began with the sinking of the USS Maine (1889), USS ''Maine'' in Havana Harbor in Cuba, and resulted in the ...
of 1898, medical conditions in the tropical war zone were dangerous, with yellow fever and
malaria Malaria is a Mosquito-borne disease, mosquito-borne infectious disease that affects vertebrates and ''Anopheles'' mosquitoes. Human malaria causes Signs and symptoms, symptoms that typically include fever, Fatigue (medical), fatigue, vomitin ...
endemic and deadly. The United States government called for women to volunteer as nurses. The
Daughters of the American Revolution The National Society Daughters of the American Revolution (often abbreviated as DAR or NSDAR) is a lineage-based membership service organization for women who are directly descended from a patriot of the American Revolutionary War. A non-p ...
and other organizations helped thousands of women to sign up as nurses, but few were professionally trained. Among the latter were 250 Catholic nurses, most of them from the Daughters of Charity of St. Vincent de Paul. The Army hired female civilian nurses to help with the wounded. Dr.
Anita Newcomb McGee Anita Rosalie Newcomb McGee (born: Anita Rosalie Newcomb) (November 4, 1864 – October 5, 1940) was an American physician who is remembered for her work with the United States military. Early life and education Anita Newcomb was born in Washi ...
was put in charge of selecting contract nurses to work as civilians with the
U.S. Army The United States Army (USA) is the primary land service branch of the United States Department of Defense. It is designated as the Army of the United States in the United States Constitution.Article II, section 2, clause 1 of the United Stat ...
. In all, more than 1,500 women nurses worked as contract nurses during the Spanish—American War. Professionalization was a dominant theme during the
Progressive Era The Progressive Era (1890s–1920s) was a period in the United States characterized by multiple social and political reform efforts. Reformers during this era, known as progressivism in the United States, Progressives, sought to address iss ...
, because it valued expertise and hierarchy over ad hoc volunteering in the name of civic duty. Congress consequently established the Army Nurse Corps in 1901 and the
Navy Nurse Corps The United States Navy Nurse Corps was officially established by Congress in 1908; however, unofficially, women had been working as nurses aboard Navy ships and in Navy hospitals for nearly 100 years. The Corps was all-female until 1965. Pre-19 ...
in 1908. The Red Cross became a quasi-official federal agency in 1905 and its
American Red Cross Nursing Service The American Red Cross Nursing Service was organized in 1909 by Jane Arminda Delano (1862-1919). A nurse and member of the American Red Cross, Delano organized the nursing service as the reserve of the Army Nurse Corps to be ready just before the ...
took upon itself primary responsibility for recruiting and assigning nurses. During
World War I World War I or the First World War (28 July 1914 – 11 November 1918), also known as the Great War, was a World war, global conflict between two coalitions: the Allies of World War I, Allies (or Entente) and the Central Powers. Fighting to ...
, from 1917 to 1918, the military recruited 20,000 registered nurses (all women) for military and navy duty in 58 military hospitals; they helped staff 47 ambulance companies that operated on the Western Front. More than 10,000 served overseas, while 5,400 nurses enrolled in the Army's new
School of Nursing Nurse education consists of the theoretical and practical training provided to nurses with the purpose to prepare them for their duties as nursing care professionals. This education is provided to student nurses by experienced nurses and other me ...
. Key decisions were made by
Jane Delano Jane Arminda Delano (March 12, 1862 in Montour Falls, New York – April 15, 1919 in Savenay, Loire-Atlantique, France) was a nurse and founder of the American Red Cross Nursing Service. Personal life A descendant of one of the first settlers to ...
, director of the Red Cross Nursing Service,
Mary Adelaide Nutting Mary Adelaide Nutting (November 1, 1858 – October 3, 1948) was a Canadian nurse, educator, and pioneer in the field of hospital care. After graduating from Johns Hopkins University's first nurse training program in 1891, Nutting helped to found ...
, president of the American Federation of Nurses, and
Annie Warburton Goodrich Annie Warburton Goodrich (February 6, 1866December 31, 1954) was an American nurse and academic. She was born in New Brunswick, New Jersey, and grew up in Hartford, Connecticut. Her grandfather was John S. Butler.Judith Schiff,Yale's first fema ...
, dean of the Army School of Nursing. Delano proposed training aides to cover the shortage of nurses, but Nutting and Goodrich were strongly opposed, arguing that aides devalued nursing as a profession and would undermine their goal of advancing nursing education at the college level. The compromise was to establish the Army School of Nursing, which operated from 1919 to 1939. The nurses—all of whom were women—were kept far from the front lines, and although none were killed by enemy action, more than 200 died from disease, especially the
Spanish flu epidemic The 1918–1920 flu pandemic, also known as the Great Influenza epidemic or by the common misnomer Spanish flu, was an exceptionally deadly global influenza pandemic caused by the H1N1 subtype of the influenza A virus. The earliest document ...
.
Demobilization Demobilization or demobilisation (see American and British English spelling differences, spelling differences) is the process of standing down a nation's armed forces from combat-ready status. This may be as a result of victory in war, or becaus ...
reduced the Army and Navy corps to skeleton units designed to be expanded should a new war take place. Eligibility at this time included being female, white, unmarried, volunteer, and a graduate from a civilian nursing school. In 1920, Army Nurse Corps personnel received officer-equivalent ranks and wore Army rank insignia on their uniforms. However, they did not receive equivalent pay and were not considered part of the US Army.


American Nurses Association

In 1901 the American Society of Superintendents of Training Schools for Nurses and the Nurses' Associated Alumnae of the United States and Canada merged to form the American Federation of Nurses. It joined the National Council of Women and the
International Council of Nurses The International Council of Nurses (ICN) is a federation of more than 130 national nurses associations. It was founded in 1899 and was the first international organization for :Health care occupations, health care professionals. It is headqua ...
. The federation was replaced in 1911 by the new American Nurses' Association. The
United American Nurses National Nurses United (NNU) is the largest organization of registered nurses in the United States. With more than 225,000 members, it is the farthest-reaching union and professional association of registered nurses in the U.S. Founded in 2009 t ...
(UAN) was a
trade union A trade union (British English) or labor union (American English), often simply referred to as a union, is an organization of workers whose purpose is to maintain or improve the conditions of their employment, such as attaining better wages ...
affiliated with the
AFL–CIO The American Federation of Labor and Congress of Industrial Organizations (AFL-CIO) is a national trade union center that is the largest federation of unions in the United States. It is made up of 61 national and international unions, together r ...
. Founded in 1999, it only represented
registered nurse A registered nurse (RN) is a healthcare professional who has graduated or successfully passed a nursing program from a recognized nursing school and met the requirements outlined by a country, state, province or similar government-authorized ...
s (RNs). In 2009, UAN merged with the
California Nurses Association/National Nurses Organizing Committee The California Nurses Association/National Nurses Organizing Committee (CNA/NNOC), an affiliate of National Nurses United, is a labor union and professional association of registered nurses in the United States. Since 2018, CNA/NNOC has been led ...
and Massachusetts Nurses Association to form
National Nurses United National Nurses United (NNU) is the largest organization of registered nurses in the United States. With more than 225,000 members, it is the farthest-reaching union and professional association of registered nurses in the U.S. Founded in 2009 t ...
.


World War II

As Campbell (1984) shows, the nursing profession was transformed by
World War II World War II or the Second World War (1 September 1939 – 2 September 1945) was a World war, global conflict between two coalitions: the Allies of World War II, Allies and the Axis powers. World War II by country, Nearly all of the wo ...
. Army and Navy nursing was highly attractive and 30% volunteered for duty—a larger proportion than any other occupation in American society. The 59,000 women of the Army Nurse Corps and the 18,000 of the
Navy Nurse Corps The United States Navy Nurse Corps was officially established by Congress in 1908; however, unofficially, women had been working as nurses aboard Navy ships and in Navy hospitals for nearly 100 years. The Corps was all-female until 1965. Pre-19 ...
at first were selected by the civilian men of the Red Cross. No men were allowed in. But as the nurses rose in rank they took more control and by 1944 were autonomous of the Red Cross. As veterans, they took increasing control of the profession through the ANA. As the Air Force became virtually independent of the Army, so too did the United States Air Force Nurse Corps. The services built a very large network of hospitals, and used hundreds of thousands of enlisted men (tens of thousands of enlisted women) as nurses' aides. Congress set up a major new program, the
Cadet Nurse Corps The United States (U.S.) Cadet Nurse Corps (CNC) for women was authorized by the U.S. Congress on 15 June 1943 and signed into law by president Franklin D. Roosevelt on 1 July. The purpose of the law was to alleviate the nursing shortage that ...
, that funded nursing schools to train 124,000 young civilian women (including 3,000 blacks). The plan was to encourage graduates to join the nurse corps of the Army or Navy, but that was dropped when the war ended in 1945 before the first cadets graduated. The public image of the nurses was highly favorable during the war, as the simplified by such Hollywood films as '' Cry 'Havoc''' (1943) which portrayed nurses as selfless heroes under enemy fire. Some nurses were captured by the
Japanese Japanese may refer to: * Something from or related to Japan, an island country in East Asia * Japanese language, spoken mainly in Japan * Japanese people, the ethnic group that identifies with Japan through ancestry or culture ** Japanese diaspor ...
, but in practice they were largely kept out of harm's way, with the great majority stationed on the
home front Home front is an English language term with analogues in other languages. It is commonly used to describe the civilian populace of the nation at war as an active support system for their military. Civilians are traditionally uninvolved in com ...
. However, 77 were stationed in the jungles of the Pacific, where their uniform consisted of "khaki slacks, mud, shirts, mud, field shoes, mud, and fatigues." The medical services were large operations, with over 600,000 soldiers, and ten enlisted men for every nurse. Nearly all the doctors were men, with women doctors allowed only to examine the WAC.Campbell, ''Women at War with America'' (1984) ch 2 President
Franklin D. Roosevelt Franklin Delano Roosevelt (January 30, 1882April 12, 1945), also known as FDR, was the 32nd president of the United States, serving from 1933 until his death in 1945. He is the longest-serving U.S. president, and the only one to have served ...
hailed the service of nurses in the war effort in his final "
Fireside Chat The fireside chats were a series of evening radio addresses given by Franklin D. Roosevelt, the 32nd President of the United States, between 1933 and 1944. Roosevelt spoke with familiarity to millions of Americans about recovery from the Great D ...
" of January 6, 1945. Expecting heavy casualties in the invasion of Japan, he called for a compulsory draft of nurses. The casualties never happened and there was never a draft of American nurses.


Postwar transformation

Tensions of long standing had pulled nursing in two directions, as Campbell explains: Before the war the nurses were too weak to resolve the tension. Nurses in hospital service and public health were controlled by physicians; those in private practice operated as individuals and had no collective power. The war changed everything; nurses ran the nurse corps and as officers they had senior administrative roles over major operations. They commanded hundreds of thousands of men (as well as Wacs and WAVES) who worked in the wards. They learned how power works. After the war they took control of the ANA; they dispensed with control by the Red Cross. The women who had served in field and evacuation hospitals Europe and the South Pacific ignored the older traditionalists who resented the superior skills and command presence of the new generation. They had "become accustomed to taking the initiative, making quick decisions, and adopting innovative solutions to a broad range of medical-related problems." They used the prestige of their profession to chart their own course. The American Nurses Association became the premier organization. It integrated racially, absorbing the
National Association of Colored Graduate Nurses The National Association of Colored Graduate Nurses (NACGN) was a professional organization for African American nurses founded in August 1908 in New York City to support and elevate African American nurses in the United States during an era of rac ...
in 1951.
Male nurses Nursing is a profession which is staffed unproportionately by women in most parts of the world. According to the World Health Organization's (WHO) 2020 ''State of the World's Nursing,'' approximately 10% of the worldwide nursing workforce is ma ...
, however, remained outsiders and were kept out of nursing schools. The Red Cross lost its central role in supplying military nurses. The National Nursing Council was disbanded, as was the Procurement and Assignment Service of the War Manpower Convention. The
Cadet Nurse Corps The United States (U.S.) Cadet Nurse Corps (CNC) for women was authorized by the U.S. Congress on 15 June 1943 and signed into law by president Franklin D. Roosevelt on 1 July. The purpose of the law was to alleviate the nursing shortage that ...
closed in 1948. The ANA campaigned for better pay and working conditions, for in 1946, the average RN earned about one dollar an hour—or $175 a month, ranging from $153 for private duty nurses to $207 for nurse educators. The hospital system fought back, and secured an exemption from the National Labor Relations Act that made unionization very difficult. They National Organization of Hospital Schools of Nursing launched a last-ditch fight to stop the movement of all nursing education into universities. Private duty nursing rapidly declined after the Great Depression of 1929-39 lowered family incomes. Hospitals increasingly handled the round-the-clock care of sick people for they had the staff, the expertise and the equipment to treat them. Furthermore, hospitals were more efficient and cheaper than private duty nurses who cared for one patient at a time. Nursing students spent their time mostly studying. To replace their work, hospitals hired graduate nurses who had finished their training and wanted permanent careers, as well as lower-paid aides, attendants and practical nurses who handled many chores. In 1946, the nation's hospitals employed 178,000 nursing auxiliaries; six years later they employed 297,000. The new staff allowed the proportion of hospital patient care provided by RNs to fall from 75% to 30%.


Since 1964

The Nurse Training Act of 1964 transformed the education of nursing, moving the locale from hospitals to universities and community colleges. There was a sharp increase in the number of nurses; not only did the supply increase, but more women remained in the profession after marrying. Salaries increased, as did
specialization Specialization or Specialized may refer to: Academia * Academic specialization, may be a course of study or major at an academic institution or may refer to the field in which a specialist practices * Specialty (medicine), a branch of medical ...
and the growth of administrative roles for nurses in both the academic and hospital environments. Private duty nursing, once the mainstay for older RNs, became less prevalent. D'Antonio traces the history over six decades of a cohort of nurses who graduated in 1919, going back and forth between paid employment and housework. From 1965 through 1988, a surge of 70,000 trained nurses immigrated to the U.S. for jobs that paid much better than those in their home countries. Most were from Asia. The Philippines had strong connections with American nursing since 1898 and after World War II adopted a national policy to train and export highly skilled nurses across the globe to bolster the Philippine economy. The number of Philippine nursing schools soared from 17 in 1950 to 140 in 1970, together with a stress on building English language proficiency. The new arrivals organized and formed local groups that merged into the National Federation of Philippines Nurses Associations in the United States. As of 2013, the nursing profession remained overwhelmingly female, but the representation of men has increased as the demand for nurses has grown over the last several decades, according to a
U.S. Census Bureau The United States Census Bureau, officially the Bureau of the Census, is a principal agency of the U.S. federal statistical system, responsible for producing data about the American people and economy. The U.S. Census Bureau is part of the U ...
study. The proportion of male licensed practical and licensed vocational nurses has more than doubled from 3.9 percent to 8.1 percent. According to the
U.S. Bureau of Labor Statistics The Bureau of Labor Statistics (BLS) is a unit of the United States Department of Labor. It is the principal fact-finding agency for the U.S. government in the broad field of labor economics and statistics and serves as a principal agency of ...
(BLS), 12% of registered nurses in 2019 were men, up from 2.7% male registered nurses in 1970. As outlined in recommendations from the
Occupational Safety and Health Administration The Occupational Safety and Health Administration (OSHA; ) is a regulatory agency of the United States Department of Labor that originally had federal visitorial powers to inspect and examine workplaces. The United States Congress established ...
, nurses have a high rate of workplace injury, mainly when lifting patients. The agency recommends eliminating manual lifting in favor of mechanized devices, and in 2015, began an enforcement campaign to force hospitals to do so. In 1998, nurse Fannie Gaston-Johansson became the first African American woman
tenured Tenure is a type of academic appointment that protects its holder from being fired or laid off except for cause, or under extraordinary circumstances such as financial exigency or program discontinuation. Academic tenure originated in the United ...
full professor at
Johns Hopkins University The Johns Hopkins University (often abbreviated as Johns Hopkins, Hopkins, or JHU) is a private university, private research university in Baltimore, Maryland, United States. Founded in 1876 based on the European research institution model, J ...
.


See also

*
History of medicine in the United States The history of medicine in the United States encompasses a variety of approaches to health care in the United States spanning from colonial days to the present. These interpretations of medicine vary from early folk remedies that fell under vario ...
*
History of public health in the United States The history of public health in the United states studies the US history of public health roles of the medical and nursing professions; scientific research; municipal sanitation; the agencies of local, state and federal governments; and private phi ...
*
Medicine in the American Civil War The state of medical knowledge at the time of the Civil War was quite limited by 21st century standards. Doctors did not understand germs and did little to prevent infection. It was a time before antiseptics, and a time when there was no attempt to ...
*
History of Philippine nurses in the United States Since the 1890s, the United States has periodically relied upon Filipino nurses to help meet the needs of the healthcare system. This collaboration has been a significant contributor to the migration of Filipinos to the U.S., as Filipino citizens ...
*
History of nursing The word "nurse" originally came from the Latin word "nutricius", meaning to nourish,to protect and to sustain, referring to a wet-nurse; only in the late 16th century did it attain its modern meaning of a person who cares for the infirm. From t ...
* Nursing in Canada#History


References


Further reading


Surveys

* Andrist, Linda C. et al. eds. ''A History of Nursing Ideas'' (Jones and Bartlett, 2006), 504 pp. 40 essays; focus on professionalization * Bullough, Vern L. and Bonnie Bullough. ''The Emergence of Modern Nursing'' (2nd ed. 1972) * Dock, Lavinia Lloyd. ''A Short History of Nursing from the Earliest Times to the Present Day'' (192
full text online; abbreviated version of her four volume ''A History of Nursing''
also
vol 3 online
* Donahue, M. Patricia. ''Nursing: The finest art, an illustrated history.'' (2nd ed. Mosby, 1996), with 441 illustrations (229 in color). * Goodnow, Minnie. ''Nursing history'' (9153
online
* Judd, Deborah and Kathleen Sitzman. ''A History of American Nursing: Trends and Eras'' (2nd ed. 2013) 382 p
excerpt and text search 1st edition
* Kalisch, Philip A., and Beatrice J. Kalisch. '' Advance of American Nursing'' (3rd ed 1995); 4th ed 2003 is titled, '' American Nursing: A History''; a major scholarly history 756pp; well illustrated. * Kaufman, Martin, et al. ''Dictionary of American Nursing Biography'' (1988) 196 short biographies by scholars, with further reading for each * Reverby, Susan M. ''Ordered to Care: The Dilemma of American Nursing, 1850–1945'' (1987
excerpt and text search
* Roberts, Mary M. ''American Nursing: History and Interpretation'' (1954
online
older scholarly history down to 1950 * Snodgrass, Mary Ellen. ''Historical Encyclopedia of Nursing'' (2004), 354pp; from ancient times to the present


Specialty studies

* Bankert, Marianne. ''Watchful care: A history of America's nurse anesthetists'' (Continuum, 1989) * Bradshaw, Ann. "Compassion in nursing history." in ''Providing Compassionate Health Care: Challenges in Policy and Practice'' (2014) ch 2 pp 21+. * Choy, Catherine Ceniza. ''Empire of Care: Nursing and Migration in Filipino American History'' (2003
excerpt and text search
* Connolly, Cynthia A. "Hampton, Nutting, and Rival Gospels at The Johns Hopkins Hospital and Training School for Nurses, 1889–1906." ''Image: the Journal of Nursing Scholarship'' 30.1 (1998): 23-29.
online
* D'Antonio, Patricia. ''American Nursing: A History of Knowledge, Authority, and the Meaning of Work'' (2010), 272p
excerpt and text search
* D'Antonio, Patricia O’Brien. "Historiographic Essay: The legacy of domesticity: nursing in early nineteenth-century America." ''Nursing History Review''1.1 (1993): 229-246. * Dawley, Katy. "Perspectives on the past, view of the present: relationship between nurse-midwifery and nursing in the United States." ''Nursing Clinics of North America'' (2002) 37#4 pp: 747–755. * Fairman, Julie and Joan E. Lynaugh. ''Critical Care Nursing: A History'' (2000
excerpt and text search
* Hine, Darlene Clark. ''Black Women in White: Racial Conflict and Cooperation in the Nursing Profession, 1890-1950'' (Indiana UP, 1989
online
* Malka, Susan Gelfand. ''Daring to care: American nursing and second-wave feminism'' (U of Illinois Press, 2007
online
* Marshall, Helen E. ''Mary Adelaide Nutting: Pioneer of Modern Nursing'' (Johns Hopkins Press. 1972) * Melosh, Barbara ''"The Physician's Hand": Work Culture and Conflict in American Nursing'' (1982), traces nursing from its early role in the home to hospitals, home duty, public health, and nursing school
excerpt and text search
* Mottus, Jane E. ''New York Nightingales: the emergence of the nursing profession at Bellevue and New York hospital, 1850-1920'' (UMI, 1981) * Nelson, Sioban. ''Say Little, Do Much: Nurses, Nuns, and Hospitals in the Nineteenth Century'' (U of Pennsylvania Press, 2001). * Olson, Tom Craig, and Eileen Walsh. ''Handling the Sick: The Women of St. Luke's and the Nature of Nursing, 1892-1937'' (Ohio State UP, 2004), the story of 838 women who entered St. Luke's Hospital Training School for Nurses, St. Paul, Minnesota. * Pryor, Elizabeth Brown. ''Clara Barton: professional angel'' (U of Pennsylvania Press, 1987
online book review
* Schell, Ellen. "The origins of geriatric nursing: the chronically ill elderly in almshouses and nursing homes, 1900—1950." ''Nursing History Review'' 1.1 (1993): 203-216. * Wall, Barbara Mann. " 'We Might as Well Burn It': Catholic Sister-Nurses and Hospital Control, 1865-1930." ''US Catholic Historian'' 20.1 (2002): 21-39. * Wall, Barbara Mann. ''Into Africa: A Transnational History of Catholic Medical Missions and Social Change'' (Rutgers UP, 2015
online review
* Ward, Frances. ''On Duty: Power, Politics, and the History of Nursing in New Jersey'' (2009
Excerpt and text search
* West, Edith A., W. P. Griffith, and Ron Iphofen. "A historical perspective on the nursing shortage." '' Medsurg nursing: official journal of the Academy of Medical-Surgical Nurses ·'' 16.2 (2007): 124-130
online


Military nursing

* Bellafaire, Judith. ''Women in the United States Military: An Annotated Bibliography'' (Routledge, 2011
online
* Campbell, D'Ann. "Victory for the Angels of Mercy: The Nurses Break Through" in ''Women at War with America: Private Lives in a Patriotic Era'' (1984) pp. 47–62, on Army and Navy nurses in World War II
online
* Donahue, M. Patricia. ''Nursing: The finest art, an illustrated history.'' (2nd ed. Mosby, 1996), pp 339–404
online
* Egenes, Karen, and Frances Vlasses. "Clara Barton: Angel of the battlefield." in ''Nursing’s Greatest Leaders: A History of Activism'' (Springer, 2016): 71-104. * McLarnon, Colleen O., and Jamie H. Wise. "Blue water nursing: The role of Navy nurses on board US Navy combatant ships." ''Critical Care Nursing Clinics'' 15.2 (2003): 233-243. * Norman, Elizabeth M. ''Women at war: the story of fifty military nurses who served in Vietnam'' (U of Pennsylvania Press, 1990
online
* Norman, Elizabeth M. ''We Band of Angels: The Untold Story of the American Women Trapped on Bataan'' (Random House, 2011
online
* Sarnecky, Mary T. ''A History of the U.S. Army Nurse Corps'' (1999
excerpt and text search
* Sterner, Doris. ''In and Out of Harm's Way: A History of the Navy Nurse Corps'' (1998) * Telford, Jennifer Casavant. "The American Nursing Shortage during World War I: The Debate over the Use of Nurses’ Aids." ''Canadian Bulletin of Medical History'' 27.1 (2010): 85-99
online
* Tomblin, Barbara Brooks. ''G.I. Nightingales: The Army Nurse Corps in World War II'' (2004) 272 page
excerpt and text search
* Vuic, Kara D. ''Officer, Nurse, Woman: The Army Nurse Corps in the Vietnam War '' (The Johns Hopkins University Press, 2009
online
h3>

Civil War

* Campbell, D’Ann. "Women's Lives in Wartime: The American Civil War and World War II." in ''Life Course Perspectives on Military Service'' (Routledge, 2013) pp. 48-67
excerpt
* Coddington, Ronald S. ''Faces of Civil War Nurses'' (2020
online book review
* Grant, Susan-Mary. "On the Field of Mercy: Women Medical Volunteers from the Civil War to the First World War." ''American Nineteenth Century History'' (2012) 13#2 pp: 276–278. * Hilde, Libra Rose. "Worth a Dozen Men: Women, Nursing, and Medical Care during the American Civil War" (PhD dissertation, Harvard U., 2003; UMI Microform 3091579) * Lesniak, Rhonda Goodman. "Expanding the role of women as nurses during the American Civil War." ''Advances in Nursing Science'' 32.1 (2009): 33-42
online
* Maher, Mary Denis. ''To bind up the wounds: Catholic sister nurses in the US Civil War'' (LSU Press, 1999). * Pokorny, Marie E. "An historical perspective of Confederate nursing during the Civil War, 1861–1865." ''Nursing research'' 41.1 (1992): 28-32. * Schultz, Jane E. "The inhospitable hospital: gender and professionalism in Civil War medicine." ''Signs: Journal of Women in Culture and Society'' 17.2 (1992): 363-392. * Schultz, Jane E. "“Are We Not All Soldiers?”: Northern Women in the Civil War Hospital Service." ''Prospects'' 20 (1995): 39-56. * Schultz, Jane E. "The Inhospitable Hospital: Gender and Professionalism in Civil War Medicine," ''Signs'' (1992) 17#2 pp. 363–39
online
* Schultz, Jane E. ''Women at the front: Hospital workers in Civil War America'' (Univ of North Carolina Press, 2005
online
* Schultz, Jane E. "Race, gender, and bureaucracy: Civil War army nurses and the Pension Bureau." ''Journal of Women's History'' 6.2 (1994): 45-69
excerpt
* Seigel, Peggy Brase. "She Went to War: Indiana Women Nurses in the Civil War." ''Indiana Magazine of History'' (1990) 86#1: 1-27
online
* Wall, Barbara Mann. "Grace under Pressure: The Nursing Sisters of the Holy Cross, 1861-1865." ''Nursing History Review'' 1#1 (1993): 71-87. * Wardrop, Daneen. ''Civil War Nurse Narratives, 1863-1870'' (University of Iowa Press, 2015).


Primary sources

*Hine, Darlene Clark, ed. ''Black Women in the Nursing Profession: A Documentary History'' (Taylor & Francis, 1985) * Jones, Anne Hudson, ed. ''Images of Nurses: Perspectives from History, Art, and Literature'' (U. of Pennsylvania Press, 1988) * Safier, Gwendolyn, ed. ''Contemporary American Leaders in Nursing: An Oral History'' (1977) oral history interviews


External links


American Association for the History of Nursing (AAHN) website
(See AAHN.) {{Authority control Nursing in the United States * History of nursing