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
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.
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”