Caregiving Becomes a Steppingstone for Nursing
The history of women in nursing in the United States began by invitation during the Revolutionary War in 1775. Although tradition dictated that nurses in the military be male, General Horatio Gates requested that women be called upon to care for wounded soldiers. George Washington honored this request, asking Congress for female nurses and matrons to supervise them. Washington’s purpose was two-fold—he supported Gates’s idea, and he also wanted to relegate work to daughters and mothers of soldiers who, out of a lack of support at home, were forced to follow the army. Emerging from these ideas was the first military nursing system and the formation of hospitals. There were advantages to the arrangement. Women proved to be better at caring for the sick, and each nurse that was hired freed up a soldier to fight on the battlefield. The work was hard. To attract and keep talent, Congress raised their compensation several times, from $2 to $4 and eventually to $8 per month (in contrast, surgeons and apothecaries were paid $40 per month).
Most were likely inspired by the work of Florence Nightingale, often referred to as “the Lady with the Lamp,” who after extensive studies abroad, practiced nursing before returning to England to work at a hospital for “gentlewomen” in London. At the beginning of the Crimean War in 1854, Nightingale was asked to manage a group of nurses to treat wounded soldiers. She would continue to spread her medical practices through the establishment of an Army Medical College, her publications, and the Nightingale Training School. Inspired by her work, the International Committee of the Red Cross created the Florence Nightingale Medal, awarded every two years to excellent nurses. Since 1965, International Nurse Day has also been officially celebrated on her birthday.
Another one of the most famous nurses in the history of American medicine was Clara Barton, who was employed by the federal patent office in Washington D.C. when the Civil War broke out in 1861. During the war, she provided nursing care and supplies to soldiers, which earned her the nickname “Angel of the Battlefield.” When the war ended, President Lincoln supported her in opening the Office of Missing Soldiers to help connect more than 20,000 men with their families. But her work as a pioneer within the Red Cross movement is how she earned her fame. After a trip abroad, she founded the American Red Cross to protect war-wounded civilians in conflict zones. Her work and the work of other nurses also culminated in the Army Nurse Corps in 1901.
Black Nurses Clear High Professional Hurdles
Women of African descent were challenged to enter the world of medicine on two fronts: gender and race. Mary Eliza Mahoney, daughter of freed slaves, would receive her education at Phillips School in Boston, which became one of the first integrated schools in the country. She then spent time as a nurse’s aide and went on to apply her knowledge of medicine to graduate from the New England Hospital for Women and Children’s professional graduate school for nursing. In 1908, she became America’s first Black nurse. Later, Martha Minerva Franklin founded the National Association of Colored Graduate Nurses (NACGN) to support the welfare of Black nurses and break down racial discrimination.
Others have followed in breaking down barriers to the medical profession. Most notably, Hazel Winifred Johnson-Brown’s dreams of becoming a nurse culminated in an impressive career as a nurse and educator in the United States Army from 1955 to 1983. In 1979, she became the first Black female general in the United
States Army and the first Black female general of the United States Army Nurse Corps. She also served as Director of Walter Reed Army Institute of Nursing.
Medical School Acceptance Leads to Bigger Achievements
It wasn’t until 1849 that Elizabeth Blackwell, the first female doctor in American history, would earn her medical degree. Blackwell’s desire to practice medicine was borne from a series of life events. After her father’s death, she worked as a schoolteacher (one of the few occupations open to white, middle-class women). While caring for a sick friend, Blackwell was inspired to do more. Before her friend died, she shared her belief with Blackwell that she would have suffered less as a patient under the care of a female physician and encouraged Blackwell to use her talent and education to become a doctor. Upon careful consideration and advice from other physicians within her social circles, Blackwell applied to more than a dozen medical schools before being accepted by Geneva Medical College in upstate New York and is known as the first woman to become a doctor in the United States, followed by Mary Putnam Jacobi, Ann Preston, and two female contemporaries.
In the 1850s, Blackwell partnered with contemporaries Dr. Marie Zakrzewska, and Dr. Emily Blackwell, her younger sister, to establish the New York Infirmary for Indigent Women and Children, which is now New York-Presbyterian Lower Manhattan Hospital. Around the same time, the Women’s Medical College of Pennsylvania opened in 1850, the first of its kind, devoted to the medical education of women. The close of the nineteenth century saw the establishment of nineteen women’s medical colleges and nine women’s hospitals.
The history of women in healthcare, particularly as physicians, was initially clouded by skepticism. Harvard professor Edward H. Clarke, in 1874, presented some backlash to these efforts, declaring that somehow this educational activity was hazardous to women’s health, and by extension, the profession. It was reflective of prevailing attitudes at the time. Given the state of gender equality in the late nineteenth century, these early female doctors graduated after years of study to disapproval and discrimination, sometimes from their own families. Despite this backlash, by the end of the nineteenth century, more than 7,000 female physicians constituted 19% of American physicians.
Female Doctors: Advocates for Change
English physicians like Sophia Louisa Jex-Blake, who pushed for legislation permitting women to access the MD degree and licensing needed to practice medicine and surgery, encouraged more women to pursue medicine. American women like Kate Campbell Hurd-Mead, who, on the advice of Mary Putnam Jacobi, decided to follow in the footsteps of her father and pursue a career in medicine. She is credited for establishing the Evening Dispensary for Working Women and Girls in 1891 in Maryland, the first medical facility to hire female doctors in Baltimore. Hurd-Mead is well-known for her promotion of maternal hygiene and infant welfare and is an early historian of women’s contributions to medicine.
The gains of women doctors during the nineteenth century, though seemingly small by today’s standards, cannot be underestimated. In 1860, Rebecca Lee Crumpler, challenged prevailing attitudes toward “women’s work” and systemic prejudice against African Americans as a whole, as the first African American woman to earn a medical degree in the United States. Before she was admitted to the New England Female Medical College in 1860, Crumpler had worked as a nurse for eight years. After her graduation in 1864, she practiced medicine in Boston, then moved on to Richmond when the Civil war ended to work alongside other Black physicians caring for freed slaves, who would otherwise have no access to medical care.
The Future of Women in Medicine
Today, women continue to serve as trailblazers, advocates, and leaders in medicine like those who have gone before them, including Dr. Virginia Apgar, whose simple, rapid assessment for assessing the viability of newborns, called the Apgar Score, is standard practice in maternity wards today. Despite the accomplishments of Apgar and others, female physicians continue to struggle with gender discrimination in the form of glass ceilings, sexual harassment, and lack of maternity support. Still, things are looking up. According to the American Medical Association (AMA), women now make up 34.7% of physicians in America; however, half of the medical school admissions, and graduates, are women.