Black women wanted to be nurses long before World War II. Aside from teaching, nursing was the only professional career available to African American women after the Civil War. The first black woman to work as a professionally trained nurse in the United States was Mary Eliza Mahoney, who earned a diploma from the New England Hospital for Women and Children in 1879. The hospital was founded in 1862 and stipulated in its charter that only “one Negro and one Jew” would be accepted as students each year. Given this school was located in the Northeast and considered progressive in its policies, the situation for southern African American women who wanted to be nurses was almost hopeless.14

The dire health care conditions for southern blacks caught the attention of white philanthropists. In particular, John D. Rockefeller and his wife, Laura Spelman Rockefeller, whose family had deep roots in the antislavery movement, decided to finance a southern institution for black women, the Atlanta Baptist Female Seminary, founded in 1881 and later renamed Spelman College. The Rockefellers funded a nurse-training department in 1886, but the program was dissolved in 1927 given the limited resources of the small campus hospital, MacVicar, and because Spelman had since become a liberal arts institution.15 But a string of nursing programs at black hospitals and historically black colleges and universities were subsequently created, including the Dixie Hospital Training School in Hampton, Virginia, in 1891, the Tuskegee Institute nursing training course in 1892, and the Freedmen’s Hospital Nursing School in Washington D.C. in 1894. By the mid-1920s, more than twenty-five new nursing schools had been established, along with two hundred black hospitals, in the South, Midwest, and Northeast. Most of these institutions were privately owned and were funded by white philanthropists.16

Despite the emergence of black nursing schools, access to health care for African Americans in the South remained quite limited. The 1896 landmark Supreme Court case Plessy v. Ferguson, which legalized the doctrine of separate but equal, had a devastating effect on blacks. Although the Supreme Court mandated equal facilities, states rarely cooperated. Blacks were excluded from publicly supported municipal hospitals, and black doctors were denied access to internships, residencies, and hospital staff appointments. The consequences of these segregationist policies included high morbidity and mortality rates in black communities.17

As more black women became nurses in the early 1900s, there was a growing interest among them in joining the U.S. Army Nurse Corps. But they were not successful because they lacked the necessary medical affiliations the military required, which were granted solely by the American Nursing Association, an organization that mostly excluded black women. In response, a black nurse named Adah Thoms cofounded with Mary Eliza Mahoney the National Association of Colored Graduate Nurses (NACGN) in 1908. Their main purpose was to provide black registered nurses (RNs) with an accredited organization that would advocate on their behalf for hospital staff jobs, professional nursing associations, and military enlistments.