During the Civil War, an estimated 3,000 untrained women served as nurses caring for wounded soldiers on the battlefield, in makeshift hospitals, even in their own homes (Egenes, n.d., p. 6). The nursing profession of today owes much to the Civil War volunteer nurses, because it was they who laid the groundwork for nursing within the United States and worked to change the overall opinion of women in healthcare (Egenes, n.d., p. 6). In 1872 the first official nursing school was established in the nurse training school of Women's Hospital of Philadelphia (Egenes, n.d., p. 8). Mary Mahoney was the first African American graduate nurse in the United States. She graduated from the nurse training program at the New England Hospital for Women and Children (Egenes, n.d., p. 8). By the end of the 19th century, graduate nurses could find employment as private duty nurses in patient homes, hospitals that provided care to patients with complex conditions, or in the public health arena as school nurses or social workers (Egenes, n.d., pp. 11-12). The first nurse licensure program was initiated by North Carolina in 1903. By 1921, 48 states, along with the District of Columbia and the Hawaiian territory, enforced laws regarding the regulation of nursing practice (Egenes, n.d., p. 13).
After WW2, a shortage of nurses occurred due to many nurses returning from war to act as wives and mothers (Egenes, n.d., p. 18). Most hospital staff nurses gave up their positions once married, and this trend continued until the 1960s (Egenes, n.d., p. 18). The Goldmark Report of 1923 suggested that nursing education should focus primarily on education rather than on patients, and recommended nursing education take place in universities; hospitals, however, resisted this change due to the free labor student nurses supplied in hospital apprenticeship programs (Egenes, n.d., p. 19).
By the 1970s, nurse practitioners, clinical nurse specialists, nusing administrators, and nurse researchers became educated within advanced master's nursing programs (Egenes, n.d., p. 21).
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