Nursing today is not just one profession, but a wide array of specialties linked by a common foundation in nursing education and theory. Going back to the early days of nursing, there have always been visionary leaders who saw a need and then worked to fill it, creating a professional niche for others who shared their passion. Some of these visionaries have familiar names: Clara Barton, whose work on the frontlines during the Civil War lead to her founding the American Red Cross; and Margaret Sanger, who opened the first birth control clinic in the U.S. in 1916, resulting in her arrest and the beginning of a movement that continues as Planned Parenthood today. Here are some others who are less well known.
Lillian Wald (1867-1940)
Lillian Wald was a pioneer in public health. After seeing first-hand the unsanitary conditions in Manhattan’s tenement buildings during the 1890s, and the lack of medical care available to the burgeoning immigrant population, she founded a visiting nurse service in 1893 and began caring for the poor. By 1895, she had government support and financing and was able to expand services. She opened Henry Street Settlement House, a community center that provided a wealth of services to families and children, including safe playgrounds, health and hygiene education, and cultural experiences. It exists to this day.
Lillian and her staff essentially became the first public health nurses in New York City, with their focus not just on medical care but on healthful lifestyles and environments as well. In 1902, she used some of her funding to hire a public school nurse to make the rounds of neighborhood schools. This undertaking was so successful that the Board of Education began hiring school nurses. In 1912, Lillian co-founded and became first president of the National Organization for Public Health Nursing—which is why she is credited with creating an entire nursing specialty.
Mary Breckinridge (1881-1965)
Mary Breckinridge was an early pioneer in rural healthcare. In 1925, she founded the Frontier Nursing Service (FNS) to bring professional nursing services to Kentucky’s Appalachian Mountains, where residents were notoriously underserved. The FNS relied on nurse-midwives to bring general and maternal care to an area that was then so isolated that the caregivers traveled on horseback and accepted bartered goods as payment. During its first two decades of service, the area’s infant and maternal mortality rates plunged to well below the national average. The FNS staff founded the first professional association of nurse-midwives in 1929.
By the 1960s, healthcare had become so complex that the FNS expanded its focus to train and hire family nurse practitioners, allowing the organization to provide more comprehensive care to all family members. Today, Mary’s work in rural healthcare is carried on through the Mary Breckinridge Hospital, now owned by Appalachian Regional Healthcare. Rural populations still face many health disparities, but we’ve come a long way, thanks to Mary’s early efforts.
Dorothea Dix (1802-1887)
Dorothea Dix created lasting reforms in America’s mental health system. She was not formally trained as a nurse, due to the era she hailed from, yet she is considered one of the most famous nurses in history. Although she was appointed to superintendent of the Union Army nursing corps during the Civil War, her most important contributions came before that. During the 1840s, Dorothea became interested in the plight of the mentally ill, who were locked up under deplorable conditions. She read everything available about mental illness and the treatments of the day, and she conducted extensive field research, visiting jails and homes for the poor across Massachusetts, documenting everything. She then presented her research to the state legislature and asked for a state-funded mental hospital. After this initial success, she took her reform campaign to other states. As a result of Dorothea’s patient advocacy, many psychiatric hospitals were built or improved upon, and staffed with trained nurses. Dorothea was ahead of her time, a visionary who could see a mental health system of holistic care, rather than imprisonment.
Florence Wald (1917-2008)
Florence Wald is known as the mother of the modern hospice movement. As a nurse, she was troubled by the way terminally patients were treated and became interested in palliative care after hearing a lecture on the topic by a British physician. At that time, Florence was the dean of the Yale School of Nursing, and she reportedly worked to update the program to make students more aware of end-of-life issues. In 1966, Florence stepped down from her position to found the Connecticut Hospice, the first such program in America. Today, of course, hospice programs are ubiquitous, and all nurses are trained to advocate for their patients’ dignity, freedom from pain, and right to make autonomous decisions.
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