1. Professionalizing Nursing
1893-1918

2. A. Professional Organizations

3. Organizations (Education)
 Chicago World’s Fair, 1893
 Congress of Charities, Correction, and Philosophy
 Paper by Florence Nightingale presented, on need for scientific
training of nurses
 1893: American Society of Superintendents of Training
Schools for Nurses (ASSTSN)
 Goal: Improving nursing education
 Becomes National League of Nursing Education (1912)
 1896: Nurses’ Associated Alumnae of the U.S. & Canada
 Goal: Enhancing collaboration among practicing nurses and
educators
 Becomes American Nurses Association (1911)

4. Organizations (Registration)
 1899, International Council of Nurses
 First meeting September 1901, at World Exposition in Buffalo,
New York
 Passed resolution in favor of nurse registration
 1900: American Journal of Nursing
 Editor, Sophia French Palmer, was one of the first nurses to
campaign for state licensing
 Palmer assisted in formulating much of nursing registration
legislation

5. Organizations (Support)
 1901: State Nursing Associations (Illinois, New Jersey,
New York, and Virginia )
 33 state associations by 1909 (out of 36 states)
 ANA urged nurses to join ANA and state associations
• High membership but low participation in state organizations
• Many did not want to belong
 1908 National Association for Colored Graduate Nurses
(New York)
 Achieve higher professional standards
 Break down discrimination
 Develop leadership

6. B. Regulatory Laws

7. Nurse Registration
 1891, First nurse registration law (South Africa)
 1899, Natal
 1901, New Zealand
 1902, Great Britain
 1901, International Congress of Nurses resolution in favor
of nurse registration
 1903, first American registration laws

8. State Registration Laws (1903)
 North Carolina first state legislature to pass
registration law
 Lobbying by the state medical society weakened bill
 Only requirement for registration was passing exam
administered by state board (comprised of 2 physicians
& 3 nurses)
 New Jersey, New York, and Virginia sign nurse
registration laws

9. New York Nurse Registration
 NY State Nurses’ Association held meeting to discuss
potential Act (1902)
 100 nurses from across state
 William S. Ely, president of Academy of Medicine of Rochester
(note: SUNY) attended
 Susan B. Anthony attended, and spoke in favor
 Support assured from Senator William Armstrong

10. What’s in a Name?
 “Registered nurse” (Rochester contingent, able to vote)
 Only for graduates of gen’l hospitals and mental hospitals
 “Trained nurse” (Buffalo contingent)
 Public was familiar with that term
 Available for “all nurses,” not just prestigious institutions
 Other suggested terms: “nurse” and “registered graduate
nurse”

11. NY Nurse Registration Act (1903)
 To be designated "registered nurse," applicant needed to
prove her graduation from an approved school
 Minimum standards (type & length of training)
 Not a restrictive law -- nurses could practice without this
certification
 Changes across East Coast in practical & theoretical training
so schools’ graduates could meet NY requirements
 For example: Led to new obstetric courses being offered
throughout East

12. State Registration laws
 All states by mid-1920s
 Not rigidly enforced
 No licensing laws
 First mandatory licensing law passed in 1938 (New York);
most laws would remain weak until after WWII.

13. C. Education Reform

14. State of Nursing Education
 In 1900, ~3500 graduates from nurse training programs
 Nightingale-style training schools 2-3 years training
 Other schools unregulated & nonstandard
 1900, Philadelphia County Medical Society & College of
Physicians of Philadelphia announced plans for 10-week
school of nursing.
 Correspondence courses available

15. Flexner Report for Nursing?
 1911, American Society of Superintendents of Training
Schools request funding from Carnegie Foundation
 Request was denied
 Legal, dental, and teacher education received funding
from Carnegie Foundation for Flexner-like studies
 1918, Adelaide Nutting (Johns Hopkins School of
Nursing) approached Rockefeller Foundation
 Established Committee for the Study of Nursing
Education
 Goal: Investigate “the proper training of the public
health nurse”
 Would lead to 1923 Goldmark Report, “Nursing and
Nursing Education in the United States”