Looking back: Black nurses struggle for admission to professional schools.

HISTORICAL OVERVIEW

Historically, African American nurses have had three strikes against them. They were Black, female and in a profession still striving for equality and respect within the medical community. The quest for respect and acceptance has been an uphill battle all the way, but fortunately things are moving in the right direction.

The history of nursing in America as taught in our schools usually begins with the story of Florence Nightingale and her assistants during the Crimean War. But women of all cultures have nursed the sick from time immemorial. Nursing was simply another aspect of family life. If by chance one became particularly adept at the task, word of these skills became known throughout the community and that person was called upon in special circumstances.

When I attended nursing school during the 1950's, the history and struggles of Black nurses were accorded a few pages, if any at all, in most texts. According to Althea Davis in her book, Early Black American Leaders in Nursing: (2)

           Nursing history as presented in the past taught only selected
       aspects of nursing history while excluding Black nursing leaders
       and Black nurses experience, as evidenced in nursing history
       texts. On rare occasions these texts included fleeting attention
       to or inaccurate information about Black nurses. But nurse
       historians and historians have begun to fill the void.

Over time as values changed and legislation was enacted, nursing texts began to include a broader and more enlightened scope of information about the Black nurse and her struggle for acceptance into the larger professional medical community.

Nevertheless, the history of Black nurses cannot be told in isolation, since cultural values of the time heavily impacted the struggle. In 1776, the statement by our founding fathers, "all men are created equal," did not apply to women. For most of the 19th century wives were considered little more than property. Women were considered unsuitable for intellectual pursuits, thus marriage and childbearing were deemed their primary function. Females of the time had few options, and were denied the right to vote until passage of the 19th Amendment to the U.S. Constitution in 1920. (3)

LEGISLATION AND BLACK AMERICANS

The Black population of slaves, however, had no rights at all. Indeed in the Dred-Scott decision of 1857, the Supreme Court held that Blacks were not citizens of the United States and thus were not entitled to enjoy constitutional rights. Later, for purposes of determining the number of legislators each state could send to the House of Representatives, the Constitution in 1787, declared a slave as 3/5 a person. (4) During Reconstruction, however, the Fourteenth Amendment (1868) extended citizenship to African Americans with governmental protection. But that promise was negated with the Supreme Court decision of Plessy v. Ferguson, which stated the principle of "separate but equal" did not violate the Constitution.

           This decision forced African Americans to remain second-class
       citizens by allowing the South to continue to enforce segregation
       by law in schools, housing, jobs, transportation, public parks,
       and public hospitals. After Plessy, the rights of Blacks were
       placed at the mercy of state governments for the next fifty
       years. (5)

CARE OF THE SICK

Nursing during early times was simply the care of the sick by family members, or by slaves in the South. Some religious orders assumed that burden as their calling, specifically the Sisters of Mercy, who had charge of Illinois' first hospital in 1849. (6) By and large, however, before the turn of the century "nurses," both Black and White, were untrained. Their care consisted of comfort measures, poultices and wraps of heat and cold plus the compounding of herbs and potions to help their patients.

Most Blacks, and many poor whites, could not afford a physician at the time of birth, hence the extensive use of midwives, especially throughout the southern states. Midwives subsequently attained a modicum of prestige that lasted well into the twentieth century, when obstetricians began to improve childbirth practices.

We credit Florence Nightingale with the beginning of "modern" nursing, in that she advocated "an organized system for the training of nurses." Hospitals rose to the occasion, and the hospital training system was born. But as the schools proliferated, few accepted Black students. Responding to this dilemma, Black educators, "colored women's clubs" and several prominent philanthropic organizations worked together to establish Black nursing schools in the eastern and southern United States.

A national survey was commissioned by the Rockefeller Foundation in 1925; its purpose was to determine the admission policies of nursing schools throughout the country regarding Black students. The resulting report simply documented what was already well known; that of the American Nurses Association's list of 1696 accredited schools, 1588 schools did not admit Black students.

The majority of the schools accepting minority students were in the South, and nineteen had a bed capacity of fifty beds or less. Twenty-five of the schools admitting Black students were connected with hospitals for Black patients, or had a department or wings for Black patients maintained by city institutions. (7)

PROFESSIONAL ORGANIZATIONS

As a profession grows and matures, each seeks to upgrade the educational standards of their schools, improve working conditions, and provide continuing education for their practitioners. Professional organizations have traditionally provided these services, thus at the turn of the century (1905-1912) four major associations were formed to serve the several specialty groups that had emerged: (8)

       The American Nurses Association was organized in 1911. Its
       purpose was to promote the welfare of the profession, foster high
       standards of nursing practice and deliver better care to the
       public.
       The National League for Nursing's chief objective in 1912 was to
       develop educational standards for nurses and foster the
       educational progress of nursing schools.
       The Red Cross Nursing Service was a branch of the American Red
       Cross, evolving from a collaborative meeting of the Red Cross and
       the American Nurses Association. Their task was to develop a
       reserve body of nurses to be prepared for service in time of war,
       and in 1905, they established a uniform basis for a nursing
       service.
       The National Organization for Public Health Nursing (NOPHN);
       founded in 1912, this is the only organization that accepted
       Black nurses since membership could be gained by directly joining
       the national body. Other associations required state membership
       as a condition of participation, but black nurses were denied
       membership in the states' associations.

Finding closed doors in most areas of society, the road to professionalism was especially difficult for the Black nurse. According to Kalisch and Kalisch; (9)

       "Advancement for the Black nurse came slowly, because she was a
       member of an emerging group that had not been fully recognized on
       a merit basis by other groups; professionally, she was part of an
       emerging group whose worth to society also had not been fully
       recognized."

With few alternatives remaining, in 1908 Black nurses formed their own professional organization, The National Association of Colored Graduate Nurses (NACGN), to advance the standards of their nurses, break down discrimination in the profession and develop leadership within the ranks. However, it was not until 1951 that the NACGN was dissolved and membership was granted in the American Nurses Association. But a similar situation existed within the armed forces.

WARTIME ADVANCEMENTS

           "It is an extreme irony that nursing's fortune is so often
       connected to war. Florence Nightingale's experiences in the
       Crimean War, the appalling casualties during the American Civil
       War, the death and destruction of World War I all influenced the
       emergence and development of nurse training and practice. In the
       wake of these episodes of massive carnage, nursing reaped
       increased status and greater public esteem." (10)

All branches of the service rejected the direct admission of Black nurses. Of the small number accepted into the Army Nurse Corps through the Red Cross Nursing Service, few were called to active duty during WWI. These nurses were permitted to care only for Black soldiers, and their quarters and activities were as segregated as those of their patients.

It took the Bolton Bill of 1943, also known as The Nurse Training Act, to significantly expand and improve the educational opportunities for the Black nurse. Finally, in 1948, by President Truman's Executive Order the armed forces began to desegregate. This paved the way for minorities to move into the ranks of the various services (supposedly) without bias and prejudice. Nevertheless, the admission policies of most nursing schools changed little or not at all. The status of women by this time had also taken a great leap forward, thanks to each worldwide conflict, the woman's suffrage movement with subsequent passage of the 19th amendment and the advent of the flapper era.

It is a truism that when men are not available to do the job, women step in, and in most cases do it as well, or in some cases, better. World War II was the major factor that moved women from the home and into the war plants to supplant the men who had gone to war. They were personified by "Rosie the Riveter," but there were also clerks, line workers, truck drivers and maintenance workers. After the War, there was no turning back. It is into this cultural stew of the 1950's that we take you; to look back as we describe events and experiences that reflected the tenor of the times. The four narratives that follow will illustrate the struggle by Black high school graduates as they sought entrance into the nursing profession during the 1950s. The stories describe experiences in Buffalo, New York; Flint, Michigan; Chicago, Illinois; and New York, New York.

       Our parents told us, "Go to school, get an education, depend
       only upon yourself." We listened and attempted to follow their
       advice. But the white world was not ready for us.

Georgia (Mackie) Burnette, RN, MSN. MS ED

Buffalo, New York

I am an old Buffalonian, having resided in the Western New York area for the past 74 years. There was a short five-year "excursion" to Chicago during the early 1960's, but illness and death brought me home again, and I've remained happily amongst family, friends and colleagues.

Following graduation from high school in 1946, I worked briefly at unskilled jobs, married in 1947 and shortly thereafter gave birth to a son, Dale. However, my goal of becoming a registered nurse surfaced again and I sought admission to three nursing schools within the city.

At this time, to become a graduate nurse one was required to complete a three-year educational program at a hospital school of nursing. The graduate was then qualified to sit for the licensing examination leading to state registration. In several parts of the country, a few colleges offered a baccalaureate degree in nursing, but I certainly could not afford the tuition. The fact that I was married also became a deterrent, as I was soon to discover. At the time of inquiry to three or four schools of nursing, I might have been accepted into the County hospital's program, but their policy excluded married applicants.

The remaining schools simply did not admit Black students. Their policy of rejection was common knowledge within the Black community, however, I was brave enough to speak to the admissions clerk in the school-office of the hospital where I was employed as a nursing aide. I will NEVER forget her smile as she shook her head to indicate that I could not expect to be admitted to their school of nursing. Undaunted, I began to search for a school as close to Buffalo, New York as possible.

Although I was married and mother of a four-year old, my commitment to becoming a registered nurse did not falter. That my marriage was floundering badly only moved me to increase my efforts to locate a school. My parents were supportive and not only offered to cover my tuition, but also agreed to care for my son while I was in school. I soon discovered that 400 miles away, the Lincoln Hospital School for Nurses, Bronx, New York was the nearest school to Buffalo. Founded in 1896, it was an all-Black school with tuition of $278 including room and board for the three years. This was a princely sum of money at the time for a working class family in a blue-collar town. But I'd be required to relocate, and this was to be my first time away from home except for short vacations. Nevertheless, I applied and was accepted. I closed my apartment, my parents assumed care of my son and I entered school in New York City, September 1950.

The Bronx wasn't Manhattan, but for me, this was the big city! Yet I was to see little of the outside world due to the demanding curriculum. The classes in anatomy/physiology, microbiology and chemistry were rigorous; nevertheless, there was also a requirement to learn the hands-on aspect of nursing. Three months later, newly outfitted in blue and white uniforms and black stockings, we began providing basic care for patients in the adjacent hospital. A major problem for me, however, was being away from home. I missed my family and the transition from home to school and dormitory living proved difficult.

As the academic period drew to a close, but prior to capping ceremonies, I learned from my mother that a new collegiate program in nursing had begun at the University of Buffalo, (now SUNY, Buffalo).

Despite the fact that four years seemed a lifetime as compared to the twenty-eight months remaining in the current program, I never hesitated. I went home and shortly thereafter was accepted into the school of nursing, September 1951. This was absolutely the very best decision I've made in my entire lifetime.

Racial overtones still prevailed in Buffalo. Nevertheless, during student affiliations to the very hospitals that denied me admission, I was warmly welcomed as a student! One overt act of racism did occur, however, when I was denied an affiliation to a small community hospital located in a town north of Buffalo.

Much later I learned that this lumber town, had, at one time been a seat of major Ku Klux Klan activity; hence their views on minorities. The affiliation was completed, however, in a similar hospital thirty miles away where everyone was friendly and helpful. I truly enjoyed the experience.

Upon completion of the university program in 1955, I entered the (subtly) segregated nursing community with a Bachelor's degree in Nursing, a rarity in the 1950's. The adage, for all the wrong reasons, the right thing was done, was certainly true in my case. By denying me admission to their schools, I stumbled into a collegiate program providing a foundation that assisted in my rise through the ranks of the nursing profession achieving lifetime goals. Things do change over time. I've been a participant in the cardiac rehabilitation exercise program of this hospital for the past three years. As I related the story of discrimination to the young exercise physiologists and nurses, they shook their heads with surprise and disbelief. Yet today, few Black Americans live in this town, there are few minority employees in the hospital, and I am the lone African American patient in the cardiac rehabilitation program. Some things just take longer to change.

Looking back, my career has been enjoyable for the most part, and I was fortunate to have been selected for the majority of positions I sought to attain. I enjoyed stints in all the "fast services" (emergency and operating rooms, labor and delivery suites, and the newborn nursery) before returning to graduate school for Master's degrees in education and nursing. I was appointed assistant professor of nursing at Niagara University, Assistant Administrator for Nursing at one of the prestigious cancer hospitals in the country (Roswell Park Memorial Institute), and retired as director of nursing from a New York State Mental Health facility in 1993.

Retirement is fulfilling and I have embarked upon a second career as a freelance writer.

Willye Tillman, RN, BS, CRNA

Chicago, Illinois

Willye, a native of Chicago was a 1951 graduate from that city's Provident Hospital School of Nursing, an all-Black hospital founded in 1891. Her applications to White hospital schools had been denied, although she was advised to apply at a later time. This was because their quota of two Black students per class (to share bathroom and sleeping facilities) had been filled. She later learned the skin color of those accepted was "light, bright and almost white. Following graduation and licensure, Willye moved to New York City to work in the recovery room of a large New York hospital. In 1956 she applied to three Chicago schools for training as a nurse anesthetist. At one facility as she headed for the operating room for an interview, she was asked, "Where are you going?" Upon hearing her reply, (and discerning her color), she was told forthwith, "We have no openings."

Willye was denied admission to several other schools of anesthesia before acceptance into St. Francis Hospital's School of Anesthesia in Peoria, Illinois. When her Black roommate from the south failed to attend, she shared facilities with the white female students in the convent. For the time, the composition of the class was a major departure from the norm. Willye was the oldest and only Black student in her class, while a female Chinese student further integrated the small group of eight aspiring scholars.

Incidents of racism were few in the school setting, although physicians were often biased in their comments and actions. Movement throughout the city of Peoria was, however, another matter. Restaurants were not opened to Blacks and once when crossing the street she was told "Nigger, go back to Mississippi."

Willye graduated in 1957 from St. Francis Hospital's School of Anesthesia in Peoria, Illinois. Upon her return to Chicago she applied to three hospitals, but all reported they had no openings. However, race was definitely a factor at a private dental office where she was denied employment. This area of the city was an all-White upper class neighborhood where Blacks were permitted to enter only as domestics, maintenance workers or laborers. While she was cordially received for the interview, it soon became clear that she would not obtain the position. She recalls, "The interviewer exhibited a very condescending demeanor which spoke volumes and seemed to imply, 'How dare you come here for an interview!'" He indicated he was looking for a more experienced professional, and that other applicants were being considered. Willye was not requested to call back, and was not told that notification would be forthcoming about the position.

Shortly thereafter, Willye secured positions at two Gary, Indiana hospitals where she remained from 1957-77 (St. Francis 1957-67 and later, Gary Methodist Hospital from 1967-77). But over the years, the 30-45 minute commute to Gary, Indiana from Chicago, Illinois proved exhausting, and in 1977 she sought a position closer to home. While being interviewed at an Oak Lawn, Illinois facility, Willye was advised that a prominent, local Catholic hospital might offer a position more suited to her needs.

Her employment at Holy Cross Hospital in 1977 began during Chicago's violent civil rights struggle for social equality. The facility was located in Marquette Park, another all-White neighborhood from which Dr. Martin Luther King had been evicted on numerous occasions as he and his supporters campaigned for minority rights. To enter that neighborhood, Black folk understood they risked life and limb. But Willye accepted the challenge and the position, remaining at the hospital without incident until her retirement in 1984.

During those years Willye became active in her professional organization, and was elected President of the Illinois Association of Nurse Anethetists from 1978-79, the first and only Black professional to hold that position. Too young and active to retire, Willye served a nurse surveyor for the State of Illinois for ten years, leaving the position in 1991.

Regarding retirement she comments, "Retirement is just a word. My days are spent volunteering with the Zonta Club and an outstanding organization called Soroptimist. These groups are worldwide service organizations of professionals and executives in business working to improve the legal, political, economic and professional status of women.

But a day of relaxation will include water aerobics, lawn bowling and perhaps reading a chapter or two of a good book, when time permits. I've had a good life, an interesting career and am enjoying a satisfying and rewarding retirement."

Wilma (Brady) Watts, RN, MSN

Flint, Michigan

Wilma, a native of Flint, Michigan graduated from high school in 1953. She developed an interest in nursing after her sister, Mary, entered nurses training in 1950. At that time, Mary, aware that hospitals in Flint would not admit Black students to their schools of nursing, simply applied to an all-Black school in St. Louis, MO. In the meantime, however, the Flint Urban League had worked diligently and successfully towards paving the way for an open admissions policy at the various schools of nursing. By 1953 when Wilma and her cousin, Sharon Simpson, sought admission to Hurley Hospital's School of nursing, both were quietly accepted. Nevertheless, they were aware that one factor weighing heavily towards their acceptance was the two could share bathroom and sleeping facilities in the student dormitory.

The nursing school experience was unmarred by overt racism; however, many of their classmates from the upper peninsula of Michigan had never met a black person, and asked, "Do Blacks run so fast because they have narrower heels?" or, "We've always been told that Blacks have tails. Is that true?" Wilma commented, "My classmates were friendly and cooperative, yet some were more 'standoffish' than others. I soon became involved in student nurse activities, was elected class secretary and later class president. When we attended regional conferences we shared rooms without any problems whatsoever."

Wilma and Sharon graduated from Hurley Hospital's School of Nursing in 1956. Following graduation, Wilma remained at the hospital as an operating room nurse before moving to San Francisco. In 1958, Wilma entered Michigan State University in East Lansing, to obtain a Bachelor of Science degree in Nursing. It was during this period she experienced an appalling episode of discrimination while working part-time in the operating room of a local hospital. Her assignment to scrub one morning moved along smoothly until the surgeon arrived. When he saw Wilma, he asked, "What is she doing here? I don't want her to scrub for me." He continued this tirade by throwing instruments on the floor, loudly voicing his displeasure. Staff from adjacent rooms slipped quietly in to watch his display of ill humor and bad taste. When the O.R supervisor arrived, she listened, then quietly remarked to the surgeon, "She's your scrub nurse today," turned and left the room. And that was the end of that! But it was a most disturbing incident Wilma recalls with emotion; one that she will never forget.

After receiving her undergraduate degree in 1960, Wilma assumed the position of director of in-service education at Hurley Hospital until 1962 when she entered graduate school at Wayne State University. Upon receiving her Masters of Science in Nursing, Wilma joined the faculty of the school of nursing of Wayne State University. It was there she met Henry Watts, a professor of Sociology. They were married and eventually settled in Buffalo, where both joined the faculty of their respective disciplines at the State University of New York at Buffalo (Wilma) and Buffalo State College (Hank).

During her twenty years on the faculty of the School of Nursing at SUNY/Buffalo, Wilma held the positions of Assistant Professor of Nursing and Assistant to the Dean. From 1980-1984, she established and directed a $522,000 federally funded program for the recruitment and retention of disadvantaged students. Several articles were published which describe the program. Wilma retired in 1991 and continues her travels throughout the United States and abroad. She remains active as a volunteer in church and community wide programs.

Bronte Blenman Mostiller, RN, BSN

Bronte was a 1949 graduate of a local Buffalo, New York high school, but soon discovered employment for unskilled high school graduates was difficult to obtain. She commented, "I couldn't find work anyplace although I scoured the entire downtown area seeking positions in the retail clothing field. "But I was told each time, 'Sorry, there's nothing available.'"

Bronte was successful, however, in finding employment at Sister's Hospital in the maintenance department. The assignment to the work-room of the operating room was interesting, but she was soon asked to replace a worker on maternity leave. Mopping the operating room floors was not the work Bronte envisioned, and within the week she resigned. She recalls, "Finally, I found work as a domestic for a dentist's family for a short period of time. But my goal was to become a nurse, and I sent applications (with photograph) to nursing schools within the city.

I guess I must have led a sheltered life, because I'd somehow missed the fact that Black students were not accepted to most local hospital schools of nursing. The exception was the City Hospital, if their quota had not been filled. I really felt bad. I thought I was not bright enough, or smart enough." An older friend and registered nurse said to me, "Forget it. Apply to a black school. Apply to Lincoln, where I trained."

I took her advice, all the while praying, "Dear Lord, just let me get into school and you'll never see me in this city again." In 1950 Bronte entered Lincoln Hospital School of Nursing and graduated three years later. She found employment immediately and specialized in maternity and pediatric nursing for her entire career.

Bronte received her Bachelor of Science degree Nursing from St. Johns University in 1971. She remained in New York City for the next thirty-three years, retiring in 1986 from Maimonides Medical Center, New York City. Later that year, Bronte returned home to Buffalo, New York and in June married a native Buffalonian, Carl Mostiller.

Since retirement, Bronte has remained active by volunteering for the blind, as secretary for the recently defunct Nu-Buff Sportsmen's Club, and secretary for her "Mostiller Family Affairs club." She is an avid genealogist and has identified family back to 1848.

Looking back, Bronte smiles as she says, "I loved and enjoyed my career in nursing, mainly because I was fortunate to work with a group that were like family. I was not denied promotions or raises, and moved easily into nursing supervision as positions became available in maternity and pediatrics. But retirement is great. It has afforded me the time and pleasure of exploring a variety of interests I never had time for while employed."

SOCIAL EQUALITY TODAY

There is absolutely no doubt we've come a long way toward righting the wrongs of racism, sexism, and the low status of the nursing profession, but we still have a long way to go.

Race still counts, and will probably continue to do so for many generations. On August 1963, speaking on the steps of the memorial of the president who had abolished slavery a century before, Martin Luther King described his vision of a society in which barriers to Black equality were removed. "I have a dream that my four children will one day live in a nation where they will not be judged by the color of their skin but by the content of their character." (11)

Due to legislation, minority nurses cannot be refused admission to a school of nursing. One problem now is whether the applicant is educationally qualified. Obtaining an adequate elementary and high school education in most inner cities is one of the Black communities' greatest challenges. Students graduate from inner-city high school ill equipped to enter college. One has only to witness the plethora of remedial courses in the freshman curriculum to see that we are not educating our children to enter the mainstream of society. While our President mouths the slogan, "No Child Will Be Left Behind," he has cut educational funding and is currently attempting to revamp the Head Start Programs (translate: push funding cost off to the already financially strapped states).

The problems facing minority nurses today are not the overt denials to recognize, honor and promote, but the subtle, covert actions more difficult to document and quantify. Sometimes racial attitudes are so embedded that perhaps the person is not totally aware of core beliefs that influence his/her decisions.

Nursing organizations created to promote professionalism within the field mirrored the workplace. After the American Nurses Association began accepting Black nurses in 1951, it took only twenty years for the latter group to again form their own professional organization. Feeling their needs were not being addressed, and noting the lack of minority nurses in leadership positions within the Association, a small group formed the National Black Nurses Association in 1971 which continues to flourish today.

Having been retired for ten years, I discontinued memberships in the local, state and national nursing organizations. I am unable therefore to comment on the various professional organizations. However, as in the larger society, I believe improvements continue to be made. During my last years in the workforce (later 1980's), I was the president of the local nursing district organization, and a colleague, President of the New York State Nurses Association.

Minorities in the United States continue to overcome the barriers in our path to equal employment, housing and education. It has been a long, difficult struggle, yet we continue to fight the good fight. Our healthcare system is in shambles, yet remains one of the best the world has to offer. We must not forget that the United States is a great country; it's problems not withstanding. Therefore we should continue to work within established systems to promote social equality, or, emulate our early leaders by initiating and developing alternative alliances to better meet our needs.

           The value of knowing one's history, its context within
       American history, and the leaders that shaped the profession
       inclusively as it grew, instills a pride about the leaders who
       made it possible for Black women to have access to success. WE
       DID NOT MERELY ARRIVE ON OUR OWN.
       Althea Davis, (12)

(2) Davis, Althea T. Early Black American Leaders In Nursing. Sudbury, MA.; Jones and Bartlett Publishers, 1999. Preface vii.

(3) World Book Encyclopedia, 2003, Vol. 4, 1015.

(4) Encyclopedia of Multiculturalism. 1994, Vol. 2, 445.

(5) Ibid., 445.

(6) Frank, Sister Charles Marie. The Historical Development of Nursing. Philadelphia: W.B. Saunders Company, 1953. 187.

(7) Davis, Althea T. Early Black American Leaders In Nursing. 21

(8) Ibid., 91.

(9) Kalisch, Philip A. and Beatrice, J. The Advance of American Nursing, Third Edition. Philadelphia: J. B. Lippincott Company, 1995, 389.

(10) Hine, Darlene Clark. Black Women In White. Bloomington & Indianapolis: Indiana University Press, 1989. 162.

(11) U.S.A. Today. "A Still-Vibrant Dream." Editorial Page. (August 28, 2003)

(12) Davis, Althea T., Early Black American Leaders In Nursing, vii.

Georgia Burnette, RN, MSN, MS Ed. (1)

(1) Georgia Burnette is a retired nurse and an active freelance writer.