Nursing practice and the people who provide care vary from generation to generation depending on society’s needs and situations. The history of nursing in Mississippi may be divided into two large chapters, each covering a century of change.
The initial chapter may be described as the pretraining period for nurses. From the early antebellum period until the 1898 opening of the first nurses’ training program in Natchez, Mississippians had extensive need for nursing care. Nurses fell into two categories, domestic and community. Domestic nurses practiced within families in times of illness, injury, or epidemic. All women were considered nurses. Their cookbooks and marriage and home medical guides were filled with sick diets, cures, and home remedies. Slaves or hired servants might assume the role of sick nurse. Families tended to provide all care when sickness struck. Domestic nurses often remain obscured in the shadows of history because their service was personal. Their practice consisted of following orders when a physician could be summoned or relying on home and folk remedies when a doctor’s care was not available.
Community nurses, conversely, served people outside of the home during times of crisis. Community nurses might list themselves in local business directories or answer calls for volunteers during epidemics. The records of the great epidemics in the 1800s list many nurses who volunteered or were paid to serve during outbreaks of yellow fever and other communicable diseases. Community nursing practices were shaped by current medical practices. For example, in the early years of the century, yellow fever victims were given no fluids but were purged, bled, blistered, and cupped as the fever developed. Nurses were expected to provide all care to patients without removing any of the bedclothes piled high even in summer in an attempt to break the fever. By the end of the century, there was less purging and blistering, and patients were given mustard baths, allowed to drink iced champagne if available, and given other fluids.
Surviving public records reveal that nursing in the community, especially during fever outbreaks, was a field dominated by African Americans, both male and female. Doctors and patients strongly preferred black nurses, believing them better suited for this type of difficult work. In addition, hiring black nurses cost less than hiring white ones.
Training programs for nurses began in the state a full twenty-five years after they were established in the northern states. In the North, the years after the Civil War were marked by movements that called for hospital reform, leading to early training programs for nurses. In Mississippi, however, former hospital matrons were coping with the problems of Reconstruction and crises from annual disease outbreaks. The state had few physicians ready to build hospitals, and limited public resources slowed the growth of a health system that would require nurses. Large family networks, the rural nature of the state, and the home focus of medical care also limited the need for trained nurses.
The second chapter in Mississippi’s nursing history opened with the creation of the nursing program at Natchez Charity Hospital in 1898. Trained nurses had to be brought to the state from other regions to lead the initial efforts. Hospitals and training programs grew rapidly between 1900 and 1920, when more than forty facilities were established. Students learned cooking, sanitary measures, and caring for equipment. They worked twelve-hour days and sporadically attended classes in the evenings. They had a half a day a week off for religious services and another partial day off to deal with personal issues.
The early hospital-trained nurses had vision and courage that came from the difficulties of their educational process. Just ten nurses from this first generation met at the Natchez Hospital in June 1911 to establish the Mississippi State Association of Graduate Nurses. They approved a code of ethics, made organizational plans, and set out to persuade the legislature to require licensing of nurses, a goal that was reached with the creation of the Mississippi Board of Nurse Examiners in 1914. Two years later the first examination was held, and the state had its first registered nurses.
The First World War stimulated interest in the field because of public image of war nursing. During the Great Depression years hospitals reduced student numbers to cut costs and hired graduates who would work for room and board, leading to the development of the idea of the staff nurse. During the Second World War the innovative cadet nursing program again stimulated nursing school enrollments, but a severe shortage followed during the 1950s as nurses left practice to marry and start families. Most of Mississippi’s registered nurses graduated from hospital diploma programs and were competent and hardworking, but the profession continued to advocate the creation of higher education programs in nursing. In 1948 the School of Nursing opened at the University of Mississippi, and the state’s first associate degree nursing program opened nine years later at Northeast Mississippi Junior College in Booneville.
In the final years of the twentieth century the profession’s focus shifted from educational change to the rapidly changing practice environment and expanding roles of the nurse. When the century opened, nurses were not considered skilled enough to manage even clinical thermometers, which remained a tool for doctors alone. By the end of the century nurses were certified to start IVs, administer medications, and resuscitate patients. With the development of nurse practitioners, advanced practice became part of the mainstream in nursing education and practice.
- Reita Keyes, “History of Nursing Education in Mississippi” (PhD dissertation, University of Mississippi, 1984)
- Mississippi Historical Committee, Passing the Flame: The History of the Mississippi Nurses’ Association, 1911–1986 (1986)
- Linda Sabin, “From the Home to the Community: A History of Nursing in Mississippi, 1870–1940” (PhD dissertation, University of Mississippi, 1995)
- Linda Sabin, Struggles and Triumphs: The Story of Mississippi Nurses, 1800–1950 (1998)