1870 - 1899

New England Hospital for Women and Children opens a school for nurses with a one-year curriculum

Three schools of nursing inspired by the work of Florence Nightingale open in New York City, New Haven, Connecticut, and Boston, Massachusetts

Although women physicians in Philadelphia, New York, and Boston had already established formal training schools for nurses in the 1860s, the New York Training School at Bellevue Hospital in New York City, the Connecticut Training School at the State Hospital (later New Haven Hospital) in New Haven, and the Boston Training School at Massachusetts General Hospital in Boston were the first three nurse training schools to claim their organization was based on the principles specified by Florence Nightingale. Nightingale’s principles included an endowment ensuring the independence of the training school, a superintendent of nurses reporting only to the head of the hospital, a strong emphasis on sanitary knowledge, clearly defined lecture and ward time for students and an insistence on the importance of technical skill and a disciplined character in nurses. Few training schools—even Nightingale’s own school at St. Thomas’s hospital in London—met all these criteria, and most reported to medical directors. Nevertheless, the idea of shaping a school around Nightingale’s principles became an animating spirit for the experimental idea of formal nurses’ training in hospitals and accounted in large measure for its success.

Women’s Branch of the New York Mission and Tract Society sends the first trained nurses into the homes of the poor to care for the sick

These missionary nurses were followed in the 1880s by visiting nurses sponsored by organizations in Buffalo, Boston, Philadelphia, and Chicago. By 1909, there were nearly 600 visiting nurse organizations across the country to save the poor from illness.

Mary Eliza Mahoney, the first African American professional nurse, graduates from the New England Hospital and Training School for Women and Children

The New England Hospital for Women and Children’s charter provided for the admission of one African American student and one Jewish student per year. Both groups were regularly excluded from most nurses’ training schools.

Louis Pasteur argues the case for the germ theory of infection before the French Academy of Medicine

Pasteur’s work, which established that specific organisms caused diseases, that they were identifiable, and that successful treatment to combat them could be devised, ushered in a new era of scientific medicine in which medical and nursing treatment became progressively more technical and complex. Although calls for an educated corps of nurse workers to deliver care to the ill had increased over the century, the treatment regimens called for by Pasteur and his followers validated and increased the demand for organized nursing services.

A Textbook of Nursing by Clara S. Weeks Shaw, the first textbook by a nurse, is published

Physicians had a long tradition of writing textbooks for nurses—nurses who might be both students training in hospitals and mothers caring for their families at home. Weeks Shaw’s A Textbook of Nursing, was the first book in a long tradition of texts in which nurses themselves codified the knowledge and skills necessary for nursing practice. Like other early nurse authors, Weeks Shaw, a graduate of the New York Hospital Training School and the Superintendent of the Training School for Nurses in Paterson, New Jersey, saw her work as important to “training schools, families, and private students.” Her text included instruction in such areas as “the sick room,” “the observation of symptoms,” “medicines and their administration,” and “poltices, formentations, and other applications.”

Spelman Seminary (later, Spelman College) in Atlanta, Georgia, begins a nursing program for African American women

African American women and men experienced severe discrimination in attempting to obtain a nursing education. Few gained admission to nursing schools in either the south or the north. In response, the black community set up schools of nursing in traditionally black hospitals and educational institutions. The segregated nurse education system, established in the late nineteenth century, prevailed until the mid twentieth century.

The Mills Training School for Men opens at Bellevue Hospital in New York City

Men have worked as nurses throughout history, yet, with few exceptions, until the late twentieth century, American professional nursing was a mainly female occupation. Recognizing that men as well as women were needed as nurses, philanthropist D. Ogden Mills provided the funds to open the Mills School of Nursing at Bellevue Hospital in New York City. This school later combined with the Bellevue School of Nursing and operated until the phasing out of both schools in 1969. Several other schools of nursing exclusively for men operated throughout the country, primarily in institutions affiliated with psychiatric hospitals. A few men gained admission to traditionally female schools. The reluctance of nursing schools to admit men through most of the late nineteenth and twentieth century resulted in an occupational workforce composed predominantly of females, a situation that prevails even today.

Provident Hospital Training School opens in Chicago as the first school of nursing for African American women in the northern United States

African American women and men in the north wanting to become professional nurses experienced discrimination similar to their southern counterparts. Few were allowed to attend nursing school or given access to jobs except in segregated settings. The Provident Hospital and Training School for Nurses resulted from the experience of one African American woman, Emma Reynolds. Denied entrance to the white schools of nursing then operating in Chicago, Reynolds prevailed upon leaders of the Chicago African American community to open an institution in which she could study nursing. Other historically black northern schools of nursing that opened around the turn of the century include Lincoln Hospital School of Nursing in New York City and Mercy Hospital School of Nursing in Philadelphia.

Nurses meeting at the Chicago World Columbian Exposition form the first national professional association for nurses: the American Society of Superintendents of Training Schools for Nurses

Composed mainly of leading nurse educators, and conceived of as an organization dedicated to reforming the nursing profession, the American Society of Superintendents of Training Schools for Nurses, focused on improving nursing education standards. In 1912, the organization changed its name to the National League of Nursing Education, and in 1952, it renamed itself once more to become the National League for Nursing.

Lillian Wald establishes the Henry Street Settlement House in New York City

Wald’s insistence that sickness should be considered in its social and economic context led to innovative and pragmatic reforms in health care, industry, education, recreation, and housing. She coined the term public health nurse and originated the ideas that eventually led to the establishment of the Children’s Bureau, the provision of school nurses in primary and secondary schools, insurance coverage for home care, and the first national nursing service: the Red Cross Town and Country Nursing Service.

Howard University opens a nursing education program, the first in the country in a university setting

The Howard University program marked the entrance of nursing education into a university setting initiating a very long process, remaining incomplete today, to educate nurses in institutions of higher education.

The Vermont Marble Company engages a trained nurse to care for sick workers and their families in the home

The growth of industrial nursing was slow. By 1910, there were only sixty-six firms employing graduate nurses to care for their workers. But, World War I created a dramatic increase in demand for industrial nurses. By 1919, 871 industries employed 213 nurses. The passage of Workmen Compensation laws also changed the organization of these nurses’ work. With health care no longer merely a charitable contribution, employers had strong financial incentives to reduce job-related injuries. As part of companies’ bottom lines, industrial nurses’ practice moved from caring for injured or ill employees in their homes to maintaining offices at factories where they focused on the prevention and treatment of injuries on site.

The Associated Alumnae of the United States and Canada organizes

The Associated Alumnae of the United States and Canada, was founded to be a professional association for all nurses. It was organized with significant support from the American Society of Superintendents of Training Schools for Nurses, which included only nurses involved in nursing education. The new organization began as an association of the alumnae societies of nursing schools, but it later changed its unit of membership to individual nurses. In 1911, the association renamed itself the American Nurses Association.

Spanish American War begins. The army organizes a nursing service under the direction of Dr. Anita Newcomb McGee

The outbreak of the Spanish-American War provided the nursing profession with an opportunity to demonstrate the value of an educated corps of nurses in the military. Organized under the auspices of the Daughters of the American Revolution and directed by physician Anita Newcomb McGee, the Army Nurse Corps Division of the Surgeon General employed about 1,600 nurses, not all of them trained nurses. High troop mortality rates related to disease rather than battle wounds led to a postwar government investigation. The investigating body suggested the creation of a reserve corps of trained nurses for use in future military encounters. Instead, support for establishing a permanent military nursing service grew. In 1901, Congress authorized the Army Nurse Corps.

The Association of Hospital Superintendents (later the American Hospital Association) forms

Teacher’s College at Columbia University in New York City offers a course for nurses in hospital economics

This course was the result of efforts by leaders of the American Society of Superintendents of Training Schools for Nurses. The society recommended a one-year course in hospital economics be established to augment the education of graduate nurses. The first class of two students entered in 1899. Students learned skills needed to successfully teach in and administer hospital-based nurse training schools. Leaders in the American Society of Superintendents of Training Schools for Nurses who served on the education committee promoting the course included Isabel Hampton Robb, M. Adelaide Nutting, Linda Richards, Agnes Snively, and Lucy Drown. They assured the program’s success by offering the society’s financial support as well as providing faculty. The course expanded to a two-year program in 1905, and by the fall of 1907, M. Adelaide Nutting, one of the first nurses to hold the position of professor at a university, assumed leadership of the program. She helped make Teachers College a mecca for leaders in nursing education and administration throughout the world.