Graphic Graduate pathways after graduation.jpg

Introduction to Early Graduate Nurse Practice Opportunities

In the beginning  - 1872 to 1900 - hospital schools of nursing were few in number;  the class sizes were small resulting in a limited number of graduate  nurses.   After graduation from a school of nursing , the graduate nurse had a limited  choice of where she could practice. Hospitals were staffed by students and provided  nursing care  hospitals did not require the services of graduate nurses to staff the units.  Administrative positions such as supervisors and head nurses were employed by hospitals; graduates from the new hospital schools of nursing  were hired to fill management positions with educated graduate nurses.  Linda  Richards, considered the first ‘trained’ nurse , graduated in September of 1873 from the New England Hospital for Women and Children; her first position in October of 1873 was night supervisor in Bellevue Hospital Training School [i].

As the number of hospital schools of nursing  increased and the number of more educated nurse increased, management positions were scarce. Thus the majority of graduate nurses earned their living as private duty nurses working in the home of their patient . Hospitals realizing the value of an educated graduate nurse began to utilize the ‘most promising’ graduate nurses as head nurses or supervisors.

A Young Lillian Wald in her Nurses Uniform

A Young Lillian Wald in her Nurses Uniform

Developing a New Path for Graduate Nurses

Meeting the the Health and Social Needs of the Public


In 1893 Lillian Wald and Mary Brewster, graduates of the New York Hospital School of Nursing, moved to the Lower East Side of New York city living and working out of a tenement house to become a part of the community which they served.  Lillian Wald, created the term “Public Health Nurse”  as she believed that public health nurses must treat social and economic problems  - not simply take care of sick people”.[i] In 1895 they moved from their original tenement to a house on Henry St which became the Henry Street Settlement Nurses Settlement. They hired nurses to visit the those in need in their  homes leading to the Henry Street Visiting Nurse Association which  eventually became the Visiting Nurse Association of New York.

Alternative paths for graduates nurses

Not all graduate nurses  remained in the work force, Some married soon after graduation  Hospitals  did not hire a married woman. Other graduates were called home to care for a sick relative.

[i] Fee, Elizabeth and Liping Bu,. 2010. “The origins of Public Health Nursing:The henry Street Visiting nurse Service”. .American Journal of Public Health July, Vol 100 No.7. pp 1206 – 1207.

[i] See timeline for Linda Richards r amazing career.