North Carolina Nursing History

The following has been reprinted with permission from the American Association for the History of Nursing Bulletin, Fall 2012, pp. 12-15

Mary Rose Batterham: The Second Registered Nurse in the United States

“”Tribute must always be given to the pioneers and leading spirits in any organization. They pave the way and make it easier for those who follow”. Mary Rose Batterham, RN (n.d.)

Mary Rose Batterham spent her first decade as a nurse battling everything from a typhoid epidemic to state legislators . She was a rare woman with the ability to assist in surgeries performed on kitchen tables in Appalachian mountain cabins without benefit of running water or electricity, the gift to write and speak persuasively to any size organization to promote nursing practice and education, the leadership qualities to be elected by her fellow nurses to represent them at state and national meetings and the imagination and resourcefulness to help create the new profession of Registered Nursing (Bullough, Sentz & Stein, 1992; Kaufman, 1988). She was one of the 15 women she characterized in her speeches about the founding of the NC State Nurses Association as : ” all nurses, making history, constructionists, iconoclasts, destroying the old conception of the graduate nurse and raising the trained woman to the dignity of a professional woman.” (Batterham, n.d., Nursing record of “firsts”, 1926)

Mary Rose Batterham was born in Walsoken, Norfolk County, England in 1858. In 1881 her family immigrated to Asheville, NC. Batterham wanted to practice nursing but no nursing schools had been established in NC at that time. In 1893 she graduated from the Brooklyn City Hospital School of Nursing, secured a position as a nurse for the policy holders of the Metropolitan Life Insurance Company and returned to Asheville, becoming the third graduate nurse in the city (“Miss Batterham tenderly buried”, 1927, “Weaver, Brown and Batterham”, 1960).

Almost immediately she was in great demand as a private duty nurse and took many surgical cases. The first hospitals in Asheville were emerging around the time of her return and there was only one operating room in the city. Therefore, most surgeries, both major and minor, were performed in patients’ homes. In one of her speeches, Batterham described the role of the nurse in home surgeries. She described how the nurse often arrived the night prior to surgery to clean the house and the patient. The day of surgery began by boiling instruments and securing a supply of extra water on the wood stove. The bed, dining room table or most often a kitchen table which served as an operating table was layered with blankets and covered with a clean sheet. Nurses performed a variety of tasks including assisting with surgery, giving anesthetics and teaching the family about sanitation, hygiene and nutrition for a quick recuperation. After the doctor left, a nurse often stayed behind to watch over the patient’s recovery. (“Weaver, Brown and Batterham”, 1960).

In 1900, typhoid swept through the student body at North Carolina Women’s College in Greensboro, NC. College officials asked for graduate nurses to help them cope with this epidemic. Graduate nurses from across the state volunteered to help. Many of these nurses stayed on the campus for several weeks as the epidemic ran its course. During their leisure hours they discussed issues related to nursing practice, nursing education and nursing regulation. Mary Rose Batterham and Mary Lewis Wyche were two of these “Greensboro” nurses. In the months after the epidemic Mary Lewis Wyche wrote to all of the “Greensboro” nurses and other nurses she knew in NC asking them to send representatives from their towns to a state wide meeting in Raleigh, the state capitol. This meeting was to ascertain if there was enough interest to organize a state nurse association and work for a nurse registration law (Kaufman, 1988; Wyche, M.L.., 1938).

35 nurses met in Asheville and elected Mary Rose Batterham to represent them at the Raleigh meeting. The group raised $25 to cover her travel expenses. 15 nurses attended the Raleigh meeting. They organized themselves into the NC State Nurse Association (NCSNA) in October, 1902. Mary Lewis Wyche was elected President of the new organization and Batterham was elected first Vice President (Batterham, n.d.).

Their work was not done. The second day of the Raleigh meeting was spent drafting a nursing registration bill. This bill was introduced in the State Legislature in January of 1903. It passed the State House as written by the nurses. However, by the time the bill arrived at the State Senate, some doctors and hospital administrators had organized opposition. A weakened bill, without mandatory registration, passed the Senate and was signed by Governor Aycock on March 3, 1903. This was the first law pertaining to nursing practice in the United States. Legal criteria now existed in order for someone to use the title “Registered Nurse”. The names of nurses who met the criteria and presented documentation to the Clerk of Court in the county in which they wished to practice would be entered in a Nurses Registry kept in each county court house and available to the public (North Carolina Bill, 1907, Wyche, 1938, Pollitt & Miller, 2010).

By prior arrangement, and in honor of the work and dedication that Batterham showed to the people of Asheville and Buncombe County, the Clerk of Court of Buncombe County opened his office an hour early so she could become the first Registered Nurse in North Carolina and therefore the fist Registered Nurse in the United States (“Miss Rose Batterham, 1927; Who’s who, 1926).

Over the next 24 years, until her death in 1927, Batterham continuously proved her dedication to her profession and to the betterment of her fellow citizens. In a speech to the 1922 session of the NCSNA, later printed as a letter to the editor in the Feb 1923 issue of the American Journal of Nursing, she encouraged private duty nurses to volunteer occasionally with public health nurses. She wrote:

“We can enjoy a day with the county nurse, helping with the school or office work, also giving clinical demonstrations and lectures, at the same time learning practical engineering and how to run a car. Why should the private nurses not be educators? What are they doing to interest people in the many homes they enter? Do they ever speak of welfare work or civic needs, of the unnecessary deaths among women and children in the rural districts and of the undernourished school children? Why, no other class of women has so great an opportunity to interest influential people as has the private nurse … the offspring of unborn generations will arise and bless the public health nurse, in the time when perfect health shall cover the world as the waters cover the sea.” (Batterham, 1923).

In a speech to the Federated Women’s Clubs of Asheville in 1920 she advocated for the passage of the Sheppard Towner Act to fund more nurses to work in maternal child health. She explained to her audience:

“I have been in homes where conditions would make an angle weep; a new born baby and a mother attended by a lady whose chief pretention to cleanliness was a clean apron, taken off after the doctor left; a hatchet under the bed or a knife under the pillow to cut the pains; and not a sheet or clean gown in the house. Is it any wonder we lose 18,000 mothers and 300,000 babies every year?”(Batterham, 1920)

In addition to her advocacy for the public’s health she worked to upgrade the nursing profession. She helped craft the first nurse registration bill and several later revisions of it. She lobbied for mandatory registration for nurses (a law that would not pass in NC until 1965); she campaigned for shorter hours, better pay and better working and living conditions for nurses. Not satisfied with asking others to make the changes she envisioned, in 1919, Batterham organized a Nurses Clubhouse in Asheville. Private duty nurses, including Batterham, lived in the Clubhouse between cases and all nurses were welcome to come to social and professional events sponsored by the Clubhouse (Bullough, Stenz & Stein, 1992; Nursing records, 1926, “Weaver, Brown and Batterham, 1960).

Batterham never married. Upon her death, her body lay in state at the Nurses Clubhouse and her pallbearers were her nursing colleagues in full uniform. The Asheville Citizen newspaper carried this eulogy about her:

“For nearly thirty five years Miss Mary Rose Batterham was a ministering angle to the people of this town … for more than a generation, here among us, she stood valiant in the presence of pestilence, and fought to defeat pain and to conquer disease and to cheat death its untimely prey. Hers was the good fight, not for glory or gain, but, with mercy and compassion as her weapons, to disarm grief in its agony and tears” (Miss Batterham tenderly, 1927).

Batterham was honored many times as the first Registered Nurse in the United States. Articles in the American Journal of Nursing and the Asheville Citizen described Batterham in that way (Miss Rose Batterham, 1927; Who’s who, 1926). It was only in 1935 when the County Nursing Registries in North Carolina were sent to the state capitol of Raleigh for central keeping that is was discovered that Josephine Burton of Craven County had registered on June 4th, 1903. Virtually nothing is known about Nurse Burton, the first Registered Nurse in the United State (Wyche, 1938).

Mary Rose Batterham, organizer, writer, speaker, advocate, nurse, died believing she was the first Registered Nurse in the United States. Her tireless work improving the quality of life for her fellow citizens deserves to be remembered and honored.

Reference List

• Batterham, M.R. (n.d.) History of nursing in western North Carolina. Speech given to Asheville, NC Nurse’s Association found in the vertical files of Pack Library, Asheville, NC.
• Batterham, M.R. (1920) “Be a nurse”. Speech given to the Federation of Women’s Clubs, Asheville, NC December 14, 1920, text found in vertical files in the Pack Library, Asheville, NC.
• Batterham, M.R. (1923) How can private duty nurses help public health nurses? American journal of Nursing 23(5) 417-418.
• Bullough, V.L., Sentz, L. & Stein, A.P. (Eds.). (1992). American nursing: A biographical dictionary. Vol. II. New York: Garland.
• Kaufman, M. (Ed.). (1988). Dictionary of American nursing biography. Westport, CT: Greenwood.
• “Miss Batterham tenderly buried” (April 7, 1927) Asheville Citizen Times.
• “Miss Rose Batterham” (1927) Asheville Citizen Times.
• “North Carolina bill: became a law March 2, 1903. (1907) American Journal of Nursing 7(4). 274.
• “Nursing record of “firsts” (September, 5, 1926) Asheville Citizen Times,
• Pollitt, PA & Miller, W.E. (2010) North Carolina, pioneer in American nursing. American Journal of Nursing 110(2) 70-71.
• “Weaver, Brown and Batterham were pioneers in public health nursing” (July, 17, 1960) Asheville Citizen Times.
• “Who’s who in the nursing world: Mary Rose Batterham” (1926) American Journal of Nursing 26(9). 700.
• Wyche, M. L. (1938) The history of nursing in. North Carolina. Chapel Hill: University of North Carolina Press.