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North Carolina Nursing Timeline 1861-1946
As the Civil War begins, North Carolina has neither hospitals nor trained nurses. Many Southern women volunteer their services as nurses due to the shocking number of casualties. Florence Nightingale's "Notes on Nursing," published in 1860, becomes the inspiration and only instruction manual for many.
Wilmington, which wasn't captured until 1865, is one of the only remaining entry points for food and medicine into the South due to the Union blockade. Drugs had to be smuggled throughout the state. Southern nurses resort to homemade remedies: cucumbers or balsam for burns, jimson weed for fever, rose geranium for diarrhea, wild yam for scurvy, and blackberry root for dysentery.
Prior to the War, the lives of most American women had been restricted to domestic duties. By the War's end, women have established fifteen military hospitals in NC, and helped create the new career of professional nursing.
Formal training for nurses begins in the U.S. with schools in New York, Connecticut and Boston. By 1900, there are 432 nursing schools throughout the country.
St. Peter's Hospital in Charlotte, the first civilian hospital in the state, begins seeing patients. The leading force behind its creation is Jane Wilkes. (photo courtesy of UNC Charlotte Special Collections)
NC's state board of health is organized as part of the effort to cope with the typhoid epidemics sweeping the country.
Through the efforts of Jane Wilkes, the Good Samaritan Hospital opens in Charlotte. It is the first privately-funded, independent hospital in NC exclusively for the treatment of African-Americans.
The state's first nursing school opens at Rex Hospital in Raleigh. Mary Lewis Wyche, a Vance County native and nursing graduate of Philadelphia General Hospital, started the school shortly after becoming head nurse at Rex. Watts Hospital School of Nursing opens in Durham in 1895, and is the oldest school of nursing still in operation in the state. (photo courtesy of NC Division of Archives and History)
St. Agnes School of Nursing in Raleigh becomes the first professional nursing school for African-Americans in NC Additional schools of nursing for African-Americans open in 1902 at Charlotte's Good Samaritan Hospital, and at Lincoln Hospital in Durham.
The newly formed American Nurses Association, the first women's professional group in the U.S., calls for laws establishing professional standards, the regulation of nurse training schools, and the registration of nurses.
Nursing school graduates are given their first opportunity for military service during the Spanish-American War. As a result, mortality in the army is less than in any previous war.
Lydia Holman, a nurse from Philadelphia, arrives in Mitchell County in the NC mountains to care for a wealthy woman who is ill with typhoid fever at her vacation home. Traveling mountain trails by horseback, Holman begins providing the only health care available to the citizens of this remote area, staying until her death in 1960 at age 92. (photo courtesy of Shannon Holman Gurley)
Mary Lewis Wyche organizes and becomes the first president of the NC Nurses Association, which frames a bill to provide for the registration of trained nurses. On March 3, 1903, NC becomes the first state in the nation to pass a nurse registration law. New York and Virginia follow North Carolina later that year. By 1923, all 48 states have legislation regulating nursing.
Developing exams and issuing licenses is entrusted to the new Board of Nursing, composed of three registered nurses from the NC Nurses Association and two physicians from the NC Medical Society. Mary Lewis Wyche is one of the first nurses on the Board. Annie Lowe Rutherford of Fayetteville becomes the first African-American nurse to receive a license.
Hoke County opens the first public tuberculosis sanatorium in NC, where patients suffering from the disease stayed for months or years until they either recovered or died.
The Guilford County Department of Public Health becomes the first full-time county health agency in NC and the second oldest in the country. Robeson County opens the first strictly rural health department in the country in 1912.
The National Organization for Public Health Nursing is established, with the legendary Lillian Wald of New York's Henry Street Settlement as president and Lydia Holman a member of its first board of directors. Inspired by Holman's work in Mitchell County, the organization convinces the American Red Cross to establish nursing services for rural areas nationwide. Between 1915 and 1935, the Red Cross supervises public health nurses in 52 of NC's 100 counties. These nurses provide the only health care available to many North Carolinians for years.
A NC Board of Health survey of school children reveals shocking rates of tuberculosis, malaria, malnutrition, impaired vision and hearing, diseased throats and poor teeth. In 1919, the NC legislature appropriates funds for six full-time nurses to travel statewide to provide services for all students under the seventh grade, regardless of race. Within two years, the six nurses see 92,566 students and educate countless teachers and parents on health care issues. All six nurses remain in their jobs for over 18 years. (photo: 1922 school nurse, courtesy of NC Division Of Archives and History)
NC passes a law establishing a training school inspector appointed by the NCNA. The next year, the NC League of Nursing Education is formed as a section of the NCNA. The next two decades see an increased interest in nursing education, with more carefully planned curricula, higher entrance requirements, and better classrooms and instructors.
Women win the right to vote.
Congress passes the Sheppard-Towner Maternity and Infant Protection Act, making funds available for visiting nurses, maternity centers, and clinics for infants and mothers. Sheppard-Towner has an enormous impact on public health nursing in NC By the end of the decade, there are 94 public health nurses employed by county health departments statewide.
Carrie Early Broadfoot of Fayetteville organizes a professional association for African-American nurses. In 1948, the NCNA votes to open its membership to all registered nurses in NC, and the "Colored Nurses Association" votes itself out of existence. (photo courtesy of NCNA)
NC adopts the Model County Midwife Regulations, requiring that all midwives receive instruction from doctors or nurses in order to receive a permit to practice. Public health nurses' work with lay midwives contributes more than any other factor to lowering NC's infant mortality rate.
Duke University Hospital begins a three-year nursing diploma program. Nursing students can get a baccalaureate degree with two additional years at Duke University. (photo: Duke grads '31, courtesy of Duke University Medical Archives)
UNC-CH establishes a Department of Public Health, the first training center in the South for public health workers. The department becomes the School of Public Health in 1939, the fourth such school in the nation and the first at a state university.
During World War II, demand for nurses was acute, both in military service and at home. A 1941 issue of the NCNA's Tar Heel Nurse magazine appeals to its members to encourage inactive nurses to take refresher courses, help recruit high school and college graduates to nursing schools, and join the military service or volunteer for civilian defense.
Ruth Hay, a national leader in public health nursing education, is appointed to establish the UNC Department of Public Health Nursing at the School of Public Health. Hay is the first female professor appointed to the University's faculty. In 1946, the department institutes a cooperative program with NC Central in Durham, whose African-American students were denied admission to UNC. Under the leadership of Lincoln School of Nursing graduate Mary Mills, registered nurses can earn a public health certificate after one year of study at NC Central. (photo: Ruth Hay, courtesy of UNC School of Public Health. Mary Mills, courtesy of NCNA)
The U.S. Cadet Nurse Corps, a federally funded training program, is created. By 1945, over 1,000 nurses from NC are serving in the Armed Forces.
During WWII, NC leads the nation in the rate of rejection of its draftees for medical reasons. In response, a commission recommends creating what would become the UNC Division of Health Affairs by expanding the medical school at Chapel Hill from two years to four, building a teaching hospital, and establishing schools of nursing and dentistry to join those of public health and pharmacy.
NC launches the Good Health Program. Promoted by NC native Kay Kyser, the most popular big band leader in America at the time, and endorsed strongly by the NCNA, the campaign includes a song by Kyser, Frank Sinatra and Dinah Shore called "It's All Up To You."