The history of nursing has been frequently discussed and studied. Many people could tell you about the amazing contributions of people like Clara Barton or Florence Nightingale. Both of these nurses were major advocates of medical change that brought about profound results inside the hospital. But what about nurses who brought about change outside the hospital?
Here are five nurses who changed not just nursing, but society through their efforts.
Born in 1802, Dorothea Dix’ life did not get off to a good start. Born to alcoholic parents in New England, she was forced to flee from home at 12, taking refuge with her grandmother. She became a school teacher, initially educating the children of well off families, but eventually focusing her work on indigent children.
Dorothea suffered from poor health, which eventually drove her to move to England to seek a cure. There she became friendly with the philanthropic Rathbone family. They shared their beliefs in societal reform and governmental engagement with social needs, a position she herself came to embrace.
Upon return to the states in the 1840s she began systematic investigations of the treatment of the mentally ill throughout several states, delivering scathing reports to the state legislatures. Her efforts bore fruit in 1845 when New Jersey passed legislation based on her recommendations establishing the first state established and run mental hospital. By 1854 several other states had followed suit after her investigations. The U.S. Congress voted for a bill authorizing a federal fund to support mental hospitals, but this was vetoed by President Franklin Pierce as a federal overreach.
Dorothea would continue to act as a nurse-advocate for the mentally ill until her death in 1881. Her efforts on their behalf radically changed society’s views and treatment of the mentally ill for the better, a legacy that lives on to this day.
The daughter of Ashkenazi immigrants, Lillian Wald graduated from the New York Hospital’s School of Nursing in 1891. Her first job as a nurse was at an orphanage. Conditions there appalled her. She was moved to begin teaching classes on nursing to poor immigrants in Manhattan’s Lower East Side in the hopes of promoting better health conditions.
Though raised middle class, Lillian chose to move into the slums of the Lower East Side to be closer to her patients, adopting the title of “Public Health Nurse” as reflecting her community oriented nursing practice. With the backing of several well to do socialites and philanthropists she founded the Henry Street Settlement in 1893. Shocked by earlier incidents where doctors had abandoned patients who could not pay for their services, the Henry Street Settlement provided subsidized health care to the needy.
Lillian would spend her life as an advocate for equal health care for all, regardless of income. Thanks to her efforts New York became home to the first public nursing system in the world. Her ideas also led to the introduction of school nurses and promoted further interest in a national health insurance plan amongst people like Theodore Roosevelt, his niece Eleanor Roosevelt, and his fifth cousin, Franklin D. Roosevelt. Her classes on home healthcare would eventually lead her to help found the Columbia University School of Nursing.
Margaret Sanger was a dangerous woman. Her father had been a feminist before the term even existed, advocating for suffrage and public education. Her mother had died at 49 after being pregnant 18 times in 22 years, leaving Margaret completely convinced that women’s reproductive rights were being completely neglected, and with a drive to see this changed.
Margaret enrolled in nursing school in 1900, completing two years before marrying in 1902. Her husband was a leftist advocate who fully supported her entry into bohemian politics and activism. In 1912 she published a column on sex education for the socialist magazine New York Call. Her writing quickly expanded to many different publications, advocating for contraceptive education and access for women as the first step to freeing poor women from a lifetime of poverty and health problems while simultaneously giving them the freedom to enjoy their sexualities.
These writings directly challenged the Comstock Law and a number of similar state laws. These laws declared any discussion of sex education and birth control as obscene. Margaret was indicted under these laws in 1914, but fled to England. By 1916 she was back in the U.S. illegally smuggling birth control devices into the country and running an illegal family planning clinic in Brooklyn. She was again indicted, this time resulting in her arrest and standing trial. Initially found guilty and sentenced to 30 days in a work house, an appeals court reversed the conviction and ruled that birth control could be discussed with and distributed by doctors.
Margaret would continue to use civil disobedience to overturn laws limiting women’s reproductive and health rights until her death in 1966. One of her lasting legacies was an organization she helped found called the Birth Control Federation of America. Today it is known as Planned Parenthood.
A contemporary of Margaret, Mary Breckinridge had a very different approach to women’s reproductive health. The daughter of the only Vice President of the United States to be convicted of treason (for joining the Confederate army during the Civil War), Mary belonged to a family of government movers and shakers. Despite of her mother’s disapproval of working women, Mary received her degree in nursing from St. Luke’s Hospital in NYC.
Mary’s home life was an unhappy one. She had married twice, her first husband dying after two years of marriage, and the second one proving to be unfaithful. She had two children, one of whom died only hours after birth, and the second at the age of four. Devastated by these deaths and her husband’s cheating, she divorced and moved to France to care for American wounded during WWI.
While in France she became familiar with French and British midwives. Reflecting on her own childbirth woes, she realized that trained midwives with nursing credentials could provide far better care for poor rural women and infants than she herself had received. She returned to the U.S. and rode horseback to the most remote areas of the Appalachians in order to learn more about the healthcare problems of extremely rural women.
Armed with this knowledge Mary then spent time in England and Scotland, becoming a certified nurse-midwife and studying community based midwifery. In 1925 she returned to the U.S. to found the Frontier Nursing Service in Kentucky. Supported by donations, English trained and certified nurse-midwives road horseback to provide prenatal and childbirth care throughout the region. Payment for services was income based, with repayment possible in goods and services when money was unavailable.
Since its inception, the FNS has been accredited with a drastic reduction in pregnancy related death rates. To help provide the necessary trained personnel the FNS helped found the first midwifery schools in the U.S. Mary continued to run the FNS until her death in 1965. The FNS continues to serve rural Kentucky women to this day.
While Mother Teresa is a famous figure, known for her compassion, many people forget that she was a certified nurse. Born in the Ottoman Empire in 1910 as Anjeze Gonxhe Bojaxhiu, she dedicated herself to life as a nun at 18. Initially she was sent to Ireland in order to learn English before being sent to India at her own request. She learned Bengali as a novitiate in Darjeeling, and finally took her vows in 1931 as Sister Teresa.
Sister Teresa was horrified by the Bengal Famine of 1943 and the following religious violence between Hindus and Muslims in 1946. Desperate to aid those most harmed by the extreme poverty of India, she traded a traditional nurses habit for the white and blue sari that would become her iconic outfit for the rest of her life. She became an Indian citizen and left the convent in 1948 to live amongst the slums of Calcutta.
Her ministering to Calcutta’s poor soon won widespread attention. Women flocked to her to join in providing food and supplies to the needy and healthcare to the sick. Even the prime minister expressed his appreciation and admiration. By 1950 the Vatican itself had taken notice, allowing her to start the Missionaries of Charity. Under Sister Teresa’s guidance the organization created orphanages, medical clinics, emergency relief centers, and brought particular attention to the needs of lepers, a group that previously had received little attention.
Despite its Catholic connections, the Missionaries of Charity quickly proved to be non-denominational in its care for the needy. Nurses working with the terminally ill provided not just physical care, but spiritual care according to the patient’s own faith. While Catholic patience would receive Last Rights on their death bed, Muslim patients would be read to from the Quran and Hindus receive water from the Blessed Ganges.
The Missionaries of Charity continue their non-denominational work today, even after the 1997 death of Mother Teresa. It’s most famous efforts continue to be on the lepers of Calcutta, however it has branched out over the past sixty-five years. It is active in 133 countries, with over 4,500 sisters working to provide care to the poorest of all nations and faiths.
The Next Name on the List
Nurses continue to advance not just the medical wellbeing of patients in hospitals, but the social wellbeing of the disadvantaged throughout the world. The current challenges facing nursing, with a growing shortage of trained and certified people is forcing today’s nurse to innovate and challenge the current social structures on their treatment of people’s health needs. Whether it is the ongoing HIV crisis worldwide or the risks of the spread of diseases from poor access to drinking water and growing urbanization in an overpopulated world, there are nurses out there today who are seeking to change society for the better. In time they too will end up being added to the lists that are populated by these five women and the many, many others like them.