Black students considering a career in nursing can draw inspiration from the struggles, successes, educational achievements and advances made by black nurses in our country. History books have mostly omitted the rich history of blacks in nursing, but their contributions are no longer being overlooked. Here, we offer a perspective on the achievements of black nurses in the United States.

Early History of Blacks in Nursing
Black women have nursed our nation during slavery, war and peace. While nurturing their own families and fellow slaves, they cared for the sick and breast-fed white babies within the families that owned them. Though the term "nurse" was not used, their activities were clearly within the scope of nursing.

Prior to the Civil War, there were also nurses among free blacks. Mary Williams and Frances Rose were two such nurses whose names were listed in the city of Baltimore's 1840 directory.

Black men also worked as nurses. In 1783, James Derham, a black nurse from New Orleans, saved enough money to buy his freedom from slavery. He later became a prominent physician in Philadelphia, where he practiced medicine and won the highest respect from his medical colleagues. Derham is credited with becoming the first black physician in America.

Educating Black Nurses
In 1879 Mary Eliza Mahoney became the first black graduate from an American school of nursing -- the New England Hospital for Women and Children in Boston -- thereby becoming the first professional black nurse in the United States.

Formal education exclusively for black nurses started in 1886 with the establishment of a nursing program at Spelman Seminary (now Spelman College) in Atlanta. In 1891 the first hospital school of nursing for black women was established at Provident Hospital in Chicago by pioneer black surgeon Dr. Daniel Hale Williams. Subsequently, many more schools for blacks were founded out of the sheer necessity to train black nurses to take care of black patients.

The first baccalaureate program at a black school was established in 1936 at Florida A&M University in Tallahassee. Associate degree programs emerged in the early fifties, with the first to be offered at a black institution -- Norfolk State University in Virginia -- in 1955. Today, historically black colleges and universities continue to play a major role in training blacks for the nursing profession. Twenty-four of these universities offer nursing programs leading to baccalaureate degrees, 12 offer master's degrees and two offer doctoral degrees.

Black nursing students have also made inroads at some of the nation's most prestigious nursing schools, including the University of Maryland at Baltimore School of Nursing, which has the highest percentage of black students and faculty, and Johns Hopkins University.

Banding Together
In 1908 black nurses banded together to form their own organization, the National Association of Colored Graduate Nurses (NACGN), to fight discrimination in education, employment and within the American Nurses Association (ANA). After fighting for equal rights and gaining ANA's assurance that black nurses would be accepted as members on an equal basis, the NACGN disbanded in 1951. Since then, two black nurses have served as two-term ANA presidents.

Twenty years after integrating the ANA, black nurses identified the need to focus on the health of the black community and its access to the health care system. As a result, in 1971 the National Black Nurses Association (NBNA) was formed. While the ANA is still considered the premier professional nursing organization, the NBNA pays close attention to minority concerns and serves as a national resource of black nurse recruitment, retention and education.

Nurses in the Military
Beginning with the Revolutionary War, black nurses have served in every conflict in which our nation has been involved. Harriet Tubman, Sojourner Truth and Susie King Taylor played significant roles as nurses in the Civil War. Black nurses also served honorably in the Spanish-American War.

During World War I and World War II, black nurses fought for the right to participate as nurses. They were finally accepted into the Army Nurse Corps after the armistice was signed signaling the end of World War I, and hundreds of black nurses served during World War II, although assigned mostly to segregated units.

Four black nurses were finally accepted into the Navy Nurse Corps during the last months of World War II; and by the time the Air Force Medical Service was established in 1949, with the Air Force Nurse Corps an integral part of it, integration was policy. Black nurses distinguished themselves in the Korean War, the Vietnam War and the Persian Gulf War. They are now serving in all branches of the armed services, being assigned without discrimination.

Addressing the Shortage
For the second time in the last 20 years, our country is experiencing a shortage of registered nurses. With blacks making up only 4.9 percent of all registered nurses in the United States, recruitment and retention are particularly critical within black communities.

In July 2002, Congress adopted The Nurse Reinvestment Act to address the shortage by providing scholarships to nursing students, encouraging careers as nursing faculty, assisting in nurse education, and supporting career ladder partnerships between nursing schools and practice settings. President George W. Bush signed the bill into law in August 2002.

Blacks in Nursing Today
Today, black nurses work at all professional levels: as an elected official in Congress, in appointed positions within the military and government, as university presidents and as hospital executives.

In nursing, you can be anything you want to be -- practitioner, educator, administrator, executive, researcher, journalist, consultant, congressional leader, policy-maker, health advocate -- to name a few of many career possibilities. Nursing is an evolving and growing profession thanks in part to the significant contributions made by black nurses every day.

Dr. M. Elizabeth Carnegie is editor emerita, Nursing Research, and author, The Path We Tread: Blacks in Nursing Worldwide, 1854-1994.