North Carolina Nursing History

The first 50 years of professional nursing in North Carolina were marred by racial exclusion, prejudice and segregation. From education to employment to membership in professional associations, African-American nurses in North Carolina, indeed in all the states of the old Confederacy as well as some other parts of the nation, faced legal, social and professional discrimination. In 1949 the nurses of North Carolina became the first professional organization in the state to integrate.

When the North Carolina State Nurses Association (NCSNA) formed in 1902, the bylaws stated that membership was open exclusively to white nurses. As the NCSNA drafted and lobbied for legislation, worked to increase standards in nursing education and offered continuing education opportunities for its members, African American nurses could not participate in any of these activities. In order to profit from a professional organization, African American nurses in North Carolina formed the North Carolina Association of Colored Graduate Nurses (NCACGN). Five North Carolina nurses attended the 1920 National Association of Colored Graduate Nurses (NACGN) annual convention in Washington, D.C. Carrie Early Broadfoot, of Fayetteville, called the North Carolina nurses together during the conference and suggested they establish a state chapter of the NACGN. Upon their return to North Carolina, they wrote and spoke to as many nurses as possible about the benefits of having an organization. Their hard work paid off. The first meeting of the NCCGNA, (name later changed to North Carolina Association of Negro Registered Nurses, Inc. –NCANRI) was held in January 1923 in Winston-Salem, North Carolina.. A second meeting was held in Raleigh later the same year with 35 nurses participating. By 1938, there were 150 active members of the group and by 1949, 269 African-American nurses were involved in the organization.

The first professional nursing organization in North America, the Nurses Associated Alumnae of the United States and Canada (NAAUSC) formed in 1896 as a federation of nursing school alumni associations. The organization welcomed graduate nurses of all races as long as they were members of constituent alumna groups. In 1911, the NAAUSC became the American Nurse Association (ANA). Membership in state nursing associations replaced membership in nursing school alumni organizations as the criteria for joining the ANA. Until the late 1940s, many southern state nursing associations, including North Carolina, accepted only white nurses. Therefore, North Carolina African American nurses were denied membership not only in the North Carolina State Nurses Association (NCSNA) but also the ANA.

World War II created a significant shift in race relations in the US and in the nursing profession. In January, 1945, President Roosevelt issued an order desegregating the Army and Navy Nurse Corps. In 1946, the ANA House of Delegates passed two important resolutions to fully integrate the organization. The first resolution recommended that state nurse associations eliminate racial barriers to membership as quickly as possible. The delegates further voted to amend the ANA constitution and bylaws so that by 1948 individuals could be admitted directly into the ANA if they were denied membership in a state nurse association.

In 1944 the President of the NCANRNI wrote the president of the NCSNA asking that African American nurses be allowed into the NCSNA. Their request was denied because the NCSNA bylaws limited membership to white nurses. After WWII, the NCSNA leadership wanted to represent nurses in collective bargaining agreements. In order to comply with federal labor regulations, the ‘white only” clause in the bylaws had to be removed. Some nurses in NCSNA thought it would be embarrassing and unwieldy to have African American nurses from North Carolina be members of the ANA but not allowed in the NCSNA. Many nurses in both organizations believed in racial equality and that one integrated nursing organization in the state would best represent nursing interests to the state legislature and the general public.

Leaders of the NCANRNI and the NCSNA met in 1947 and 1948 to plan consolidating the organizations. There was some resistance inside each organization. Some members of the NCANRNI feared they would be subsumed and marginalized in the much larger NCSNA. The NCANRNI had 269 members in 1949 while the NCSNA had almost 3,000 members. The minutes of the 1947 NCSNA convention reflect some nurses’ hesitancy to socialize with African Americans on an equal basis. However, a majority in each organization voted to unite.

On June 25th, 1949 the NCANRNI voted itself out of existence and the NCSNA voted to open its membership to all registered nurses in the state of North Carolina. Maria B. Noell, executive secretary of the NCSNA, praised the actions of the NCCGNA by saying:

“Since all citizens of North Carolina need adequate nursing care and since the professional nursing organizations are to a great degree responsible for such care. I believe the action taken this morning by the N.C. Association of Negro Registered Nurses, Inc. to dissolve its organization of 27 years standing and to associate itself wholly with the NC State Nurses’ Association will be a great asset in promoting nursing service for all North Carolinians.’’

Elizabeth M. Thomson, President of NCANRNI in 1949 closed the last meeting of the organization with these words:

The final chapter has been written by the North Carolina Association of Negro Registered Nurses, Inc., but the activities of nurses and nursing must go on. As professional women, we all have a great part to play in furthering the progress and elevating the standards of this work. The integrating of the associations gives opportunity for great service, and by so doing, humanity will be better served.

In the first year after integration, African American nurses were serving in leadership positions on the state and district level.

In a piece in American Journal of Nursing in 1963, Marie Noell reflected on the 14 years since the NCSNA integrated its membership this way:

In facing integration in this southern state, the North Carolina State Nurses' Association has been "way ahead" of the communities in which we live. For 15 years, Negro nurses in North Carolina have been members of the NCSNA, but it is only within recent months that Negro members have been able to obtain full acceptance at hotels where we meet. When NCSNA and the North Carolina Association of Negro Registered Nurses, Inc. combined in 1948, it was not without opposition-from some members of both organizations-and as a result, we lost some members. How-ever, the merger was completed. District associations also fully accepted Negro members. From the first, NCSNA has refused to hold conventions or meetings unless the facility permitted all members to attend meetings and association lunch-eons and banquets. On only one occasion did we have to reschedule a meeting. One hotel, being picketed just prior to the NCSNA convention, notified us that Negro nurses could attend all scheduled meetings but not the banquet. We moved our annual banquet from this hotel to a hospital. Today, in at least four major cities in North Carolina, several leading hotels accept all our members for all accommodations, even with civil rights demonstrations going on. We have let it be known that we will not hold a convention at a hotel that does not accept Negro members for housing. Recently one hotel was notified that the 1963 convention would be moved to another city unless we were assured that Negro members would be fully accepted. We have received this assurance. NCSNA's Negro members have not pushed the public for this acceptance. It has been the association itself-its membership and leadership-that has insisted on their acceptance. NCSNA was among the first organizations in this state to include Negroes in its membership. Our action has, I believe, led others to follow our example: first, including Negroes as members, then moving toward their full acceptance at public facilities as rapidly as community conditions will allow. NCSNA has been cited in the press as an example on how all people can work together.