For the month of May, the History of Medicine section at Miner Library will be displaying items from our rare book and archival collections that represent key moments in American nursing history.
Although the act of caring for the sick is as old as time, this exhibit focuses on the development of nursing as a profession in the United States since the late 18th century. Nurses have historically faced a variety of challenges and healthcare needs—and still do—but with over 4.7 million registered nurses working in a variety of healthcare settings today, the profession continues to grow, adapt, and diversify.
This exhibit features items from figures that left their mark on the nursing profession—from Florence Nightingale to Loretta Ford—along with material from key events in the development of nursing. The history of local nursing education and practice is also highlighted through archival material and nursing uniforms from Highland Hospital and the University of Rochester Medical Center.
Thank you to the collections team at The Strong for loaning us the mannequins used in this exhibit!
Melrose Harding, the owner of the cape and beret on display, is in the middle of the second row from the front.
Nursing, the practice of caring for the sick, has existed for centuries—although its status as a profession has evolved considerably. This 1932 pageant put on by nursing students at the University of Rochester features students dressed as historical nursing figures ranging from Hygeia (the Greek goddess of health) to their modern-day Red Cross nurse.
When Philadelphia faced a severe nursing shortage during its yellow fever epidemic, The Free African Society recruited Black volunteers to provide care. Carey’s pamphlet repeated claims that Black nurses and volunteers had profited by overcharging and stealing from the sick and were responsible for spreading the disease.
Jones and Allen, leaders of the Society’s volunteer nursing efforts, published a pamphlet to refute Carey’s claims. In their publication, they describe nursing as “a considerable art, derived from experience, as well as the exercise of the finer feelings of humanity.”
Before nursing was professionalized through training and education programs, the women employed in urban hospitals were typically untrained and working class. America’s early hospitals were large, overcrowded, and unsanitary, and primarily sites for “the poor and infirm.” Much of the work to care for the sick took place in homes and was the responsibility of friends, family, and neighbors. This book by Lydia Marie Child (1802-1880) is intended for “the inexperienced [to] consult when medical advice is unnecessary or cannot be obtained.”
When the American Civil War began, both sides primarily employed male nurses, or stewards—until the demand for nurses required women to fill volunteer positions. Superintendent of Army Nurses Dorothea Dix (1802-1887) set strict requirements: only “plain-looking” women ages 35-50 were accepted and they could wear no cosmetics or jewelry. Many army doctors still resisted the hiring of women, and so in 1863 this order was issued to allow Dix to appoint female nurses.
While many women volunteered during the war, their labor was not recognized equally. Free Black women were often assigned menial labor and could only treat Black Union soldiers. Harriet Tubman, who served as a cook and nurse, was denied a nurse’s pension along with many other Black nurses. In the Confederacy, enslaved women were forced to perform nursing duties, with slaveowners receiving their compensation.
Florence Nightingale (1820-1910), known as the founder of modern nursing, managed and trained nurses during the Crimean War and founded the first secular nursing school. She helped establish nursing as an acceptable profession for women by promoting a respectable (and ultimately gendered) image of nurses that persists today.
This letter from Nightingale was sent in response to a request for advice on preventing the spread of cholera. Her recommendations to improve sanitary conditions align with our modern understanding of the disease.
In 1873, Linda Richards (1841-1930) became America’s first professionally trained nurse. She was the first of a cohort of five to enroll in the New England Hospital for Women and Children—and was the first to graduate one year later. Richards also trained under Florence Nightingale in an intensive, seven-month program in England in 1877. After returning to America, she helped found multiple training programs throughout the United States and Japan.
In 1873, inspired by the principles of Florence Nightingale, training schools were founded in New York City, New Haven, and Boston. Although Nightingale’s model called for autonomous schools, these early programs were affiliated with or owned by hospitals and operated much more like apprenticeship programs.
This manual comes from Bellevue Training School for Nurses, the nation’s first nursing school explicitly guided by Nightingale’s philosophy. Bellevue Hospital, New York City’s oldest operating hospital, opened the pioneering Mills Training School for Male Nurses only fifteen years later.
In 1879, Mary Eliza Mahoney (1845-1926) became the first Black woman to graduate from an American nursing school and work as a trained nurse. Following her training at the New England Hospital and Training School for Women, she spent much of her career working in private care for primarily white, wealthy families. As a professional nurse, Mahoney fought against inequality and discrimination and advocated for civil rights and women’s suffrage.
While textbooks written by physicians had been utilized by nurses in training schools for some time, Clara Weeks-Shaw was the first nurse to publish a textbook for her profession. Weeks-Shaw intended her book to be useful for both nurses in formal training schools and women taking on nursing duties in the home; it includes topics ranging from surgical nursing and gynecology to bed-making and administering food.
Highland Hospital was originally established in 1889 as the homeopathic Hahnemann Hospital, named after founder of homeopathy Samuel Hahnemann. The hospital opened a training school for nursing in 1891, and the women pictured here made up the first graduating class in 1893. The school graduated its final class in 1979.
Nurse and activist Lillian Wald (1867-1940) grew up in Rochester before attending the New York Hospital School of Nursing. While working as a nurse, her eyes were opened to the need for community-embedded health care services in the Lower East Side. Wald secured funding for a neighborhood nursing plan and in 1893 coined the term “public health nurse” to describe her paradigm for nursing. The Henry Street Settlement, founded by Wald, still operates today—providing health care and social services to New Yorkers.
In 1900, Jesse Sleet Scales (1865–1956) became the first Black public health nurse in America. She was hired as a New York City district nurse, with the goal of persuading the African American community to accept treatment for tuberculosis. Her work is described in this article, where she states that “I cannot help but feel that this house-to-house visiting, these face-to-face practical talks…must bring about good results.”
Perioperative nursing (surgical nursing) is thought to be one of the earliest professional nursing specialties. Students received instruction on assisting with operations and caring for surgical patients as early as the end of the 19th century, and by 1900 the term “operating room nurse” was in use. The nurses pictured here practiced in an operating theater in New York Hospital, but nurses were also trained to prepare private homes for surgical procedures.
The passage of Nurse Registration Acts throughout the early 20th century provided nurses with their modern title: registered nurse (RN). Advocates believed that registration would raise standards and help legitimize nursing as a profession. A law to standardize credentials was first discussed here in Rochester during a 1902 meeting of the New York State Nurses’ Association. There was a debate over the title to be given to certified nurses—but following a vote “registered nurse” was included in the act and set a nationwide precedent.
The Tuskegee Institute Training School of Nurses was opened in 1892, one of several early schools of nursing established by the Black medical community in response to the discrimination and barriers faced by prospective nurses. In this article, educator and reformer Booker T. Washington (1856-1915) connects the growth in Black physicians and hospitals to new opportunities for Black nurses.
When the United States entered World War I, the Army Nurse Corps had a reserve of 8,000 Red Cross nurses. By the time the war ended, over 20,000 nurses were on active duty. This was partly due to recruitment efforts such as this address, as well as less restrictive requirements and the use of untrained nurses’ aides. The 1918-1920 influenza pandemic also broke out during the final stages of the war; with so many trained nurses overseas, much of the necessary care in American hospitals was delivered by student nurses.
Following the influenza pandemic of 1918, a need was recognized for a service to provide home care to Rochester residents. In September 1919, eight nurses reported for duty. The Visiting Nursing Association took charge during a second influenza outbreak in 1920 and grew their services and reach throughout the 20th century to include visits by physical and occupational therapists, as well as a meals-on-wheels program.
In 1938, New York became the first state to require a license for all nursing practice. The mandatory practice act established two levels of nursing: registered and practical. While previous acts had simply established the conditions for using the title “registered nurse,” these new laws made it illegal to practice nursing outside of the authorized categories. Registration acts did not receive unanimous support, as some in the profession believed strict requirements could prevent adequately trained nurses from finding work.
In 1902, Henry Street Settlement nurse Lina Rogers Struthers (1870-1946) became America’s first school nurse. Early school health care consisted only of screenings by physicians—so students at risk of spreading communicable diseases were sent home—but the introduction of the school nurse allowed for students to be treated at school.
In this datebook, Rochester school nurse Bess Masseth kept a log of her nursing duties: visits to schools for vaccinations and medical care, home visits to families, and frequent trips with children to the Dental Dispensary.
On September 15, 1925, the University of Rochester School of Nursing opened its doors to a first class of 16 students for its diploma program. Pictured here is the Class of 1928; these early infirmary rules would be similar to those followed by the first graduating class.
In the 1890s, associations for nurses began to form as the profession continued to grow. The American Society of Superintendents of Training Schools for Nurses (later renamed the National League of Nursing Education, and then the National League for Nursing) was founded in 1893. The Associated Alumnae of Trained Nurses of the United States (later renamed the American Nurses Association) first assembled in 1896.
When the US entered World War II in 1941, nurses were once again needed to serve in the armed forces. This poster for the United States Army Nurse Corps was part of a larger recruitment campaign that resulted in over 57,000 Army nurses on assignment in 1945—the largest number of active-duty nurses in the history of the Corps.
The nurses shown here are taking part in a gas mask drill in San Francisco before heading overseas.
The U.S. Cadet Nursing Corps was signed into law by President Franklin D. Roosevelt on July 1, 1943, with the purpose of alleviating the nursing shortage that worsened during World War II. Participating schools of nursing offered a compressed 30-month training program to eligible high school graduates between the ages of 17 and 35. During its five-year existence, nearly 180,000 student nurses enrolled. The program included an amendment preventing discrimination based on race, color, or creed—but there is little record of how participating schools followed this mandate.
This letter from University President W. Allen Wallis was written in support of the Nurse Training Act of 1964: the most comprehensive nursing legislation in American history. It allocated over $280 million for the construction of nursing schools, the improvement of nursing education, the continuation of the Professional Nurse Traineeship program, and the establishment of a student loan program. When signing the act, President Lyndon B. Johnson named Senator Hill as a representative that helped to pioneer the legislation.
During a primary care physician shortage in the 1950s and 1960s, registered nurses began assisting with education and treatment for children and families. Realizing that nurses had the experience and knowledge to provide further health care assistance, Henry Silver and Loretta Ford developed a training program for nurse practitioners in 1965 at the University of Colorado. This new role required advanced clinical training and practice, allowing nurse practitioners to prescribe treatments, order tests, and diagnose patients. The pediatric nurse practitioner program at Rochester was developed in 1966 by Harriet Kitzman.
While men have provided care to the sick for centuries, nursing throughout much of the 19th and 20th centuries was a female-dominated profession. This was due to several factors, including well-meaning efforts to establish nursing as a respectable job for women, alongside misconceptions of caregiving as “naturally” feminine and stereotypical media portrayals. Since the early 1970s, though, the number of men in nursing has tripled—aided by growing representation and more inclusive recruitment.
A member of the nursing faculty at University of Rochester from 1957 to 1978, Josephine K. Craytor was a leader in oncology nursing and one of the first nurses to implement the clinical nurse specialist role. In 1970, she published the first programmed textbook on cancer care for nurses.
In 1972, the University of Rochester established an independent School of Nursing and named Loretta Ford (1920-2025) as its inaugural dean and director of clinical nursing at the Medical Center. Among many other contributions to the profession, she pioneered the unification model by bringing together education, practice, and research under one academic umbrella.
The nursing profession has a rich history of activism, from credentialing legislation to general healthcare reforms. Beginning in the 1970s, professional nursing associations became increasingly involved in political advocacy and coordinated lobbying. This guide from the political arm of the American Nurses’ Association provides information on political participation, particularly campaigning, to beginners.
Artist Jamie Columbus created this illustration to celebrate the 70-year anniversary of Helen Wood Hall and the advancement of nursing at the University of Rochester.
Throughout much of its existence as a profession, nursing schools and employers have had to actively recruit to keep up with the ever-growing need for nurses. The advertisements and publications displayed here show just some of the ways that nursing was marketed to prospective students and employees.
American Nursing
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American Nursing
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Critical Care Nursing
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Dr. Nurse
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Early Black American Leaders in Nursing
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Enduring Issues in American Nursing
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Hearts of Wisdom
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Linda Richards: Portrait of a Nursing Reformer
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Making Room in the Clinic
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No Place Like Home
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Nurse-Midwifery
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The Path We Tread
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An Address Delivered Before the Members of the Graduating Class of the Rochester State Hospital Training School
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The Hospital Head Nurse: Junior Executive and Clinical Instructor
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Notes on Hospitals
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Nursing and Nurse Education in the United States
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Pediatric Nursing: Its Principles and Practice
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Philadelphia Lying-in Charity, for attending indigent females at their own houses
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Suggestions for the Sick-Room
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