Highlights in Nursing in North Carolina 1935-1976

 Highlights in Nursing in North Carolina 1935-1976

 
1939
The first headquarters office for the North Carolina State Nurses’ Association was opened in the Commercial Building in Raleigh.  Edna L. Heinzerling was appointed executive secretary.  This same year she was appointed as a special agent of the U.S. Public Health Service.  In this capacity, she made a survey of the nurse manpower in North Carolina available for wartime service.
 
College-credit nursing education courses for graduate nurses were sponsored by NCSNA and offered in the summer at the University of North Carolina in Chapel Hill.
 
Since the majority of the members of the North Carolina State Nurses’ Association were employed as private duty nurses, the responsibility for the functions and standards of the professional registries was an important part of the work of the association and its district companies.
 
1940
Membership in the North Carolina State Nurses’ Association had increased from fourteen persons in 1902 to 2,251 persons by 1940.  Membership percentages in ANA were: 45.4% private duty, 38% institutional, and 9% public health.
 
1941
Marie Brock Noell was appointed executive secretary of the North Carolina State Nurses’ Association.  The Newsletter, official publication of the Association, became the Tar Heel Nurse.  In competitions at the conventions of ANA through the years, the Tar Heel Nurse has won several awards for excellence.
 
Ruth Warwick Hay was appointed Professor of Public Health Nursing at the University of North Carolina at Chapel Hill to establish the Department of Public Health Nursing.
 
September.  World events were moving rapidly toward a crisis.  In the September issue of the Tar Heel Nurse, Katherine Rehder, President of the North Carolina State Nurses’ Association, appealed to the members of the Association to recruit high school and college graduates for enrollment in schools of nursing, to join the military service, or to volunteer for civilian defense.  The Association participated in an national survey of Red Cross enrollment of graduate nurses.  In North Carolina the Nursing Council on National Defense conducted the survey.
 
December 7, 6.00 a.m. The Japanese attacked Pearl Harbor and the United States was at war.
 
1942
The North Carolina State Nurses’ Association pledged to pool its resources to help in the war effort.  The Board of Directors authorized the investment of $3,478 in War Bonds.
 
April.  The 38th Evacuation Hospital (Charlotte) was called to serve in England.  The 65th General Hospital (Duke University Hospital Unit) was called, stationed at Fort Bragg, and then sent to foreign duty.
 
Thirty eight nurses from North Carolina attended the Biennial Convention of the American Nurses’ Association, the National League of Nursing Education, and the National Organization of Public Health Nurses in Chicago.  A total of 10,766 nurses met to discuss the convention’s theme, “Nursing at the Nation’s Service” and to pledge nursing’s support to the national war effort.  An estimated 25,000 persons attended the joint opening session in the coliseum.  The balcony was filled with student nurses in uniform, the United States Navy Training Band played, and there were urgent pleas for the war effort resulting in valiant responses of support.  This was the last national convention until the war was over.
 
1943
A statewide meeting of the North Carolina League of Nursing Education was held to discuss acceleration of basic courses for schools of nursing.  This meeting was significant because it was an attempt to deal with the wartime pressures of graduating nurses in a shorter period of time in order to fulfill the demands for nursing service at home and in foreign areas.
 
The Tar Heel Nurse proclaimed “ALL NURSING IS WAR WARK.” The Battle of the Atlantic was in its fury and nurses were needed everywhere.
 
State headquarters for the nursing Procurement and Assignment Service of the War Manpower Commission were opened in conjunction with NCSNA headquarters to begin classification of all nurses as to availability for military service or essentiality for civilian duty.  The NCSNA executive secretary, Marie B. Noell, who also was serving as executive secretary of the North Carolina Nursing Council for War Service, was appointed chairman of the State Nursing Committee for Procurement and Assignment Service in North Carolina.
 
Congress enacted the Nurse Training Act of 1943 (Public Law 74—the Bolton Act) which authorized the U.S. Public Health Service to create the United States Cadet Nurse Corps.  It also provided for post-graduate preparation for nurses.  The purpose of the Cadet Nurse Corps was to increase the enrollment of students in schools of nursing, and North Carolina’s schools of nursing felt the impact.  The corps offered students free education, attractive uniforms, and stipends for 30 months.  It offered the participation institutions maintenance of students for nine months, tuition, and assistance in securing funds for expansion of residential and educational facilities.
 
NCSNA held an annual business meeting in Winston-Salem jointly with the North Carolina Nursing Council for War Service.  There were no social functions, no luncheons, no dinners, although voting and other business matters were carried out as usual.  This austerity was in keeping with the war effort.
 
1944
 A Division of Nursing Education was established at Duke University.  Helen Nahm was appointed associated professor in charge of the program two years later.
 
The theme for the NCSNA convention in Charlotte this year was “Present and Post-War Planning for Professional Nursing.” Again, the convention was without frills and was focused on nurse manpower to serve a nation at war.
 
1945
The Professional Counseling and Placement Service was established by NCSNA to serve both civilian and returning military nurses.  There was no charge for this service, and it was available to employers, non-members, student nurses, and practical nurses, as well as to members.
 
By 1945, 1,150 nurses from North Carolina were serving in the Armed Forces of World War II.  Efforts were intensified to recruit nurses for military service as an alternative to President Roosevelt’s proposal to draft nurses.
 
The North Carolina Medical Care Commission was created by the General Assembly to make plans for expansion of the University of North Carolina Medical School; establish a supporting teaching hospital; administer a program of state financial support for hospitalized indigent patients; survey the state’s hospital needs; administer federal funds for hospital construction and/or expansion; administer a loan program for students in the health professions, including nursing; and administer a hospital licensing program.  By statutory requirement, the Commission membership included a representative of NCSNA.  Flora Wakefield was appointed by the Governor to the First Commission, which held its organizational meeting in the summer.
 
1946
The American Nurses’ Association embarked on its Economic Security Program.  The goals were:  1)Acceptance of the 40-hour week and established of minimum salaries; 2) Increased participation of nurses in administration of nursing service; 3) Development of nurses’ associations in the role of exclusive spokesmen for nurses in matters affecting their employment; 4) Development of collective bargaining by state nurses’ associations; 5) Restriction of the membership of a nurse to only one organization which could act as a bargaining agent; and 6) Elimination of barriers to the employment of majority groups.
 
North Carolina launched the Good Health Program to improve the health status of the citizens.  NCSNA was among the endorsing organizations.
 
1947
The North Carolina State Nurses’ Association launched the Economic Security Program introduced by ANA.  The first minimum employment standards for nurses developed by NCSNA were circulated in August. An accompanying letter stated the Association’s position that the professional organization should be the official representative of nurses in matters relating to their employment conditions.
 
The North Carolina State Merit System, having established job descriptions, salary brackets, and qualifications for positions for public health workers, held the first oral examinations for employed public health nurses.  Applicants for new positions were required to take both oral and written examinations.
 
The North Carolina Nursing Practice Act was amended to require annual renewal of registered nurse licenses and to include regulations for the training and licensure of practical nurses.  Under this legislation, registration of nurses was moved from the office of the county clerk of court to the state licensing board.
 
The Hill-Burton Act was passed by Congress, and the North Carolina General Assembly appropriated $6,500,000 in matching funds for a program of hospital and health care facility construction in the state, to be administered by the Medical Care Commission.  Loans also were made available to students of dentistry, medicine, nursing, and pharmacy.  There was immediate impact throughout the state, resulting in expansion of health facilities and demand for more nurses.
 
October.  A North Carolina health publication proclaimed: “North Carolina needs 12,500 graduate nurses to bring the state up to the desired standard of one nurse for every 285 people.”  In order to meet this need, as well as projected needs for the proposed new health care facilities, the North Carolina State Nurses’ Association, in conjunction with the North Carolina League for Nursing Education and the Medical Society of North Carolina, sponsored the selection of “Miss North Carolina Student Nurse” as a project of the Good Health Association.  Responsibilities assumed by the winner included touring the state to inform high school and junior college students about nursing as a caret.
 
The NCSNA Board of Directors voted to amend the Association charter to provide for representation of nurses in employment matters and to remove the restriction of membership to white nurses only.  These charter amendments were filed in April, and later that year the Board named a special committee to study admission of black nurses to membership.  This matter had been under consideration for several years.
 
1948
The NCSNA Board of Directors voted to recommend that the Association admit black nurses to membership and issued such an invitation to the members of the North Carolina Association of Negro Registered Nurses, Inc.  Black nurses discussed the invitation of their convention in June of that year and voted to make formal application for membership in NCSNA.  In October the NCSNA House of Delegates approved the Board’s recommendation to admit black members.  In June 1949, the Negro nurses voted unanimously to dissolve the North Carolina Association of Negro Registered Nurses.
 
North Carolina College in Durham (now North Carolina Central University) began a program in public health nursing for registered nurses, the first to be offered in an all-black institution of higher learning in the state.  Ester Henry was appointed director.  Under a segregated system of public higher education, there was little opportunity for black graduate nurses to obtain additional education in this state.  In 1950 North Carolina College offered summer courses for nurses in Public Health Nursing and in Ward Teaching and Administration, and 120 students enrolled.  In 1958 the first non-black student was admitted to the degree program in Public Health Nursing.  By 1963 the school discontinued the specialty in Public Health Nursing and offered the B.S. degree in nursing.
 
Nursing for the Future, by Esther Lucile Brown, was published.  It was a comprehensive study written “to view nursing service and nursing education in terms of what is best for the profession of nursing as a possibly vested interest.”  The nursing world was stunned by the recommendations:  1) That nurses be either professional nurses or practical nurses; and 2) That professional nurses be educated in schools of nursing within colleges or universities.
 
Summer and early fall.  A fearful epidemic of poliomyelitis raged in North Carolina.  The American National Red Cross brought medical equipment and nurses into the state to help with the disaster.  A special hospital was set up in Greensboro to care for the epidemic victims, and many families imposed conditions of quarantine on themselves.
 
By 1948 three schools had been established in North Carolina to prepare practical nurses for licensure.
 
The Maternal and Child Division of the State Board of Health and the United States Children’s Bureau initiated a comprehensive plan for the care of premature babies born at home or in hospitals unequipped for premature care.  Nurses in local health agencies and selected hospitals were instructed in the transportation and emergency care of premature infants.
 
 
 
 
1949
Under the auspices of the University of North Carolina and the North Carolina Medical Care Commission, a study was completed on Nursing Education and Nursing Service.  Its purpose was to determinate needs for nursing and to make recommendations for the future.  The report recommended doubling the number of graduates annually to meet nursing needs of the state by 1960.  The shortage was especially acute, the report stated, in the supply of nurses qualified by education to serve as administrators, supervisors, educators, and public health nurses.  Julia M. Miller, Dean of the School of Nursing, Emory University, undertook the portion of the study which dealt with hospital schools of nursing.  Identifying a major need for better preparation for nurses, she recommended that Duke University and the University of North Carolina at Chapel Hill offer baccalaureate programs in nursing.  She also recommended the planning and implantation of continuing education programs for registered nurses and the development of a master’s program in nursing in the state.  One-half of the state’s 40 hospital schools of nursing were classified in the lower 25 percent in the nation.
 
October.  The North Carolina State Nurses’ Association voted approval of the organization of the North Carolina Student Nurse Association.  The organization was formalized in 1950.
 
The Forty-Seventh Annual Convention of the North Carolina State Nurses’ Association was held in High Point.  Congressional bills proposing to grant funds to the states for nursing education became the major issue at the convention.  Some North Carolina nurses and physicians feared the government might impose controls upon schools of nursing.  Members and non-members came to the convention to battle the issue, storming the meeting room doors.  The opposition wore pink carnations, heckled the speaker, and imported a nurse leader from Georgia to support those against the legislation.  After the issues were debated, many were converted to favor the bills.
 
During the decade of the 1950s the primary concerns in nursing were: preparation for atomic warfare; improvement in nursing education and practice, with an accompanying study of nursing functions, standards and qualifications (FS&Q); legislative activities, nursing research; intergroup relations; and economic security.  It was a period of bold and rapid changes in nursing.
 
1950
NCSNA underwrote the cost of a summer school nurse in Ward Teaching and Administration at North Carolina College in Durham. 
 
June.  The army of North Korea invaded South Korea, and by July 8, the United States was involved in this police action.
 
Dr. Elizabeth L. Kemble was appointed Dean of the School of Nursing, University of North Carolina at Chapel Hill.  This was the first state financed four-year basic baccalaureate degree program of nursing in North Carolina.
 
NCSNA’s nine districts were realigned to form 22 districts.
 
ANA introduced a group professional liability insurance program.
 
1951
“During the year, 1,000 North Carolina nurses had special preparation in the nursing aspects of atomic warfare,” according to the Tar Heel Nurse.
 
Bessie M. Chapman, secretary-treasurer of the North Carolina Board of Nurse Examiners from 1936 to 1946, was the first recipient of honorary membership in NCSNA.
 
The North Carolina Committee on Nursing and Nursing Education was organized.  This committee, formed in responded to the study, Nursing and Nursing Education in North Carolina, had as its main purpose planning for the implementation of the recommendations of the study.
 
The Board of Directors of NCSNA was empowered by the membership to make preliminary plans to promote legislation that would provide a mandatory Nursing Practice Act to replace the existing permissive Nursing Practice Act.
 
1952
The national nursing organizations, meeting in joint session, voted to accept a two-organization structure for nursing.  Study on reorganization of national nursing organizations had begun as early as 1924, when it was decided that each organization should retain its autonomy.  In 1944 another study was undertaken by the organizations.  In 1946 Raymond Rich Associates was employed to make a detailed study of the six participating organizations, their structure, administration, functions, and facilities and to make recommendations.  Two plans were designed by the study group.  Plan I proposed one organization for all nurses and nursing, and Plan II proposed two organizations—one for professional nurses and one for nurses and other interested people and organizations.  From 1946 until 1952 studies were conducted on the state and district levels, as well as on the national level.  Finally, a decision came in 1952, and two national organizations for nursing resulted-The American Nurses’ Association and the National League for Nursing.  In North Carolina, the League for Nursing Education became the North Carolina League for Nursing.
 
The Hypodermic, a news bulletin issued by the Publicity Committee of the North Carolina Student Nurse Association, was the first official publication of that organization.
 
September.  North Carolina Memorial Hospital was opened in Chapel Hill.  The staff, many of whom were imported from other areas, expected patients to be clamoring at the door for service, but there were few.  Then it was discovered that there was no convenient local bus service into the village, and many people preferred “Mr. Duke’s hospital”, for they knew the people there.
 
An income protection accident and sickness insurance plan for nurses went into effect, endorsed by the North Carolina State Nurses’ Association and marketed by the Continental Casualty Company.
 
The North Carolina State Nurses’ Association celebrated its 50th Anniversary. 
 
1953
As a result of legal battles over the authority of the Board of Nurse Examiners to enforce standards for schools of nursing, bill sponsored by disgruntled school authorities was introduced in the General Assembly.  The bill would have weakened the Board, prevented use of National Test Pool Examinations, made no provision for reciprocity, set low standards for accreditation of nursing schools, and prevented the Board from raising those standards.  NCSNA countered with a bill it already had drawn, which would protect the authority of the Board.  Hundreds of nurses and students poured into Raleigh to support NCSNA’s bill.  Compromise was reached, and a “reasonably satisfactory” bill was passed.  The new law provided for a Board of Nurse Registration and Nursing Education consisting of five registered nurses, two physicians, two hospital representatives, and three licensed practical nurses.  Changes were made in licensing procedures and accrediting procedures for programs of practical nursing.
 
October.  In convention, NCSNA endorsed a resolution calling for a 40-hour work week for registered nurses, and immediate implementation of the resolution was begun.  Through its Economic Security Program, the Association studied salary differentials based on race to guide it in acting to eliminate discrimination in employment.
 
1954
The American Nurses’ Association successfully opposed House Joint Resolution 171 offered in Congress by Representative Frances P. Bolton (R. Ohio).  The legislation would have established a commission to define nursing functions, a responsibility that the Association felt belonged to the professional organization.  The North Carolina State Nurses’ Association supported the position of ANA.  This was a painful experience for nursing because Mrs. Bolton had represented the profession well in Congress.
 
The first Lee Parker annual scholarship for a student nurse was awarded at the 1954 NCSNA convention.  At the same convention, honorary membership was conferred on Dr. Robert Burton House, chancellor of the University of North Carolina at Chapel Hill.
 
Mid 1950s.  Team nursing was the most popular topic for discussion.
 
1955
The North Carolina State Nurses’ Association withdrew from the Southern Division of ANA, which reorganized at a meeting in Arkansas to become the Southern States’ Nurses Association.
 
The 53rd annual convention of NCSNA was held in Winston-Salem.  The centerpiece for the banquet table was a replica, in sugar icing, of the recently purchased headquarters building on Clark Avenue in Raleigh.  After extensive renovations, this building was occupied by the staff in April 1956.  Additional adjoining property was purchased in 1963 and 1967.
 
NCSNA received $9,853.80 from the American Nurses’ Foundation, Inc., to help financed a study of patterns of psychiatric nursing in North Carolina hospitals.
 
North Carolina had four schools offering a baccalaureate degree in nursing; UNC in Chapel Hill, Duke University in Durham, A and T College in Greensboro, and Winston-Salem State Teachers College in Winston-Salem.  The School of Nursing at UNC-Chapel Hill was the first baccalaureate program in the state to be accredited by the National League for Nursing.
 
1956
Watts Hospital School of Nursing was the first three-year diploma program in North Carolina to receive full National League for nursing accreditation.
 
1957
The North Carolina Commission on the Improvement of Patient Care was organized as recommended by the National Joint Commission for the Improvement of Care of the Patient.  The major purpose was to stimulate, implement, assist with, and sponsor activities which would contribute to quality care of patients.  Members of NCSNA and the North Carolina League for Nursing served on the North Carolina Commission.  The national commission was dissolved in 1960; the state commission continued.
 
The Board of Directors of NCSNA approved the idea of bringing the book, History of Nursing in North Carolina, up to date.  A committee was appointed to study the feasibility of such a project.  This committee was unable to function because of lack of funds.
 
The first meeting of the Continuing Education Advisory Committee was held in Chapel Hill.  The purpose was to explore ways and means to provide a comprehensive program of continuing education for graduate nurses throughout the state.  This committee also served as the Advisory Committee to the School of Nursing, University of North Carolina at Chapel Hill.
 
1958
Delegates to the 55th annual convention of NCSNA, upon recommendation of the Board of Directors, adopted a resolution authorizing the Committee on Legislation to seek funds for state scholarships for nurses.
 
1959
The North Carolina State Nurses’ Association became a charter member of the North Carolina Council of Women’s Organizations.
 
October.  The 57th annual convention of NCSNA was held in Raleigh.  Nursing history was the subject of a special display at the North Carolina Hall of History.
 
In the decade of the ‘60s, ANA and NCSNA focused on the profession’s responsibility to monitor the quality of practice and on the study of the profession’s educational needs. Numerous committees on state and national levels were studying nursing and nursing education.  The Community College system was established in North Carolina.
 
1960
The American Nurses Foundation launched a campaign to raise $1 million for nursing research.  NCSNA raised nearly $12,000 in this effort.
 
Associate membership was adopted by NCSNA, and procedures for nominating and electing delegates were modified to comply with the Labor Management Reporting and Disclosure Act of 1959.  By the end of the year, 3,479 nurses were members of NCSNA.
 
1961
The NCSNA Board of Directors charged the Committee on Legislation to study laws relative to an all nurse licensing board.  When the study was finished in February of 1962, the Committee reaffirmed its belief in an all nurse board and proposed a long range program to educate its members concerning this belief.
 
1962
The First Health Careers Congress, sponsored by health related organizations was held in Winston-Salem.  The Health Congress offered schools of nursing an opportunity to recruit high school students for their nursing programs.
 
Margaret Baggett Dolan was elected president of the American Nurses’ Association, the only North Carolina nurse to hold that office.
 
An original Florence Nightingale letter, “To All Our Nurses, May 28, 1990”, was acquired by the University of North Carolina’s Division of Health Affairs Library at Chapel Hill.
 
1963
Mildred I. Clark, Colonel, USANC, member of NCSNA, was made Chief of the Army Nurse Corps.  At the NCSNA convention in October, she was honored at the annual banquet.  Also at that convention, the North Carolina League for Nursing’s Committee for Historical Source Materials in Nursing provided a special exhibit.
 
Disaster nursing was the topic for discussion.  The fear of nuclear war was very real.
 
The Board of Directors of NCSNA instructed the Committee on Legislation to continue efforts to educate members of the Association concerning the feasibility of a mandatory Nursing Practice Act and an all nurse licensing board.
 
The Surgeon General’s Consultant Group on Nursing, appointed in 1961, released its report recommending a greatly expanded program of federal aid to nursing education, improved utilization and training of nursing personnel, elimination of deficiencies in economic incentives for nurses, and a study by the profession of the present system of nursing education.  The Consultant Group was composed of representatives of nursing, medicine, higher education, labor, and hospital administration.  One of its members was Mary K. Kneedler, NCSNA member and form Chief of Public Health Nursing, State Board of Health.
 
Delegates to the 1963 convention of NCSNA approved a resolution pledging the Association’s support for Goal III as proposed by the American Nurses’ Association.  Goal III stated: “To ensure that within the next 20-30 years the education basic to the professional practice of nursing, for those who enter the profession, shall be secured in a program that provides for intellectual, technical, and cultural components of both a professional and liberal education.  Toward this end, the ANA shall promote the baccalaureate program, so that in due course it becomes the basic educational foundation for professional nursing.”
 
1964
March.  “Guidelines for Nursing Education in North Carolina” were formulated by an independent group of nurses.  The Guidelines called for two levels of basic nursing preparation with academic institutions, a time allowance of from three to five years for all non-accredited schools to show movement toward National League for Nursing accreditation, and the establishment of a committee to implement the recommendations.  They also recommended that regional planning for graduate education, research, and continuing education be recognized as essential.  These Guidelines were adopted by the Coordinating Council of the NCSNA and NCLN.
 
The report of the Survey of Nursing Education in North Carolina was published, prepared by Ray E. Brown, Director of the Graduate Program in Hospital Administration at Duke University, and sponsored by the North Carolina Board of Higher Education, the North Carolina Medical Care Commission, and the North Carolina State Board of Education.  The chief concern of this study was the need for better education for nurses.  To meet this need, Brown declared that institutions of higher learning, including community colleges, must play a key role in meeting the current and future needs for well-educated nurses.
 
1965
At the annual meeting of the Coordinating Council of NCSNA and NCLN, Dr. Howard Boozer, Assistant Director of the Board of Higher Education, reported that there were eight different committees within the state whose sole purpose was to study nursing education.  These committees, representing both professional and governmental agencies, seemed to have overlapping functions and purposes.
 
A new plan of study for nurses without academic preparation in public health nursing was established and administered by the Public Health Nursing Section, Local Health Division, of the State Board of Health.  It was designed to qualify nurses for the Public Health 1 position as defined by the merit system in North Carolina.
 
Patient sitters invaded the health care delivery system.  This new person in uniform posed a threat to the market for private duty nurses and caused administrative problems for hospital nursing service personnel.
 
The North Carolina Nursing Practice Act was rewritten, in legislation passed by the General Assembly, to include provision for mandatory licensure, new definitions of nursing practice, and flexibility in programs for nursing education.
 
Edna L. Heinzerling, who edited the Mary Lewis Wyche History of Nursing in North Carolina, received honorary recognition from NCSNA.
 
1966
The Board of Directors of the North Carolina State Nurses’ Association authorized the Committee on Legislation to explore the implications for nursing in the Physician’s Assistant Programs, and to act on behalf of the Association if legislation involving this group in relation to the Nursing Practice Act was proposed.  As this new member of the health care team sought to establish functions, nursing had cause, once more, to re-evaluate its scope of practice.
 
The North Carolina Board of Higher Education conducted a study, Projected Patterns in Nursing Education in North Carolina.  The intent of this study was to provide a factual basis for planning new programs and new schools of nursing.
 
1967
Marie B. Noell, Executive Director of NCSNA, retired after 26 years of service, “Marie Noell Recognition Day” was held on June 25, and her portrait, a gift of members, was unveiled and officially presented to the Association.
 
July.  Helen E. Peeler was appointed to the position of executive director.  She served until 1971.
 
Elizabeth S. Holley was the first nurse to receive the Award of Merit of the Southern Branch of the American Public Health Association.
 
NCSNA adopted the pattern of biennial conventions alternating with biennial clinical sessions.  In October 1967 the first Biennial Convention was held in Asheville, and Josephine Kerr received honorary recognition from the Association for her service to nursing as a leader and former president of NCSNA and president for 10 years of the North Carolina Board of Nurse Examiners.
 
The House of Delegates of NCSNA approved the purchase of additional property adjoining the two lots already owned by the Association for the construction of a new building for headquarters.  The Board of Directors voted to establish a special building fund.
 
1968
NCSNA negotiated its first written employment contract, covering nurses at the Veterans Administration Hospital in Fayetteville.  This was six years after President Kennedy’s Executive Order which gave representation and collective bargaining rights to federal employees.
 
Helen S. Miller, Chairman of the Department of Nursing at North Carolina Central University at Durham, received the coveted Mary Mahoney Award at the American Nurses’ Association Convention in Dallas, Texas.  She was the first black nurse to receive gubernatorial appointment as a registered nurse to the North Carolina Board of Nursing and later was elected national president of the Chi Eta Phi Sorority, member organization of registered nurses, and first vice-president of the National League for Nursing.
 
1969
The 1969 session of the General Assembly was a nightmare for NCSNA.  A physician member of the North Carolina Senate introduced 15 bills concerning nursing education and the powers and functions of the North Carolina Board of Nursing.  The bills ranged from vague attempts to instruct the Board on minor matters to a sweeping proposal to abolish the 1965 Nursing Practice Act and reenact the 1953 law.  Nurses packed committee hearings and communicated their concerns by letters, telegrams, and personal interviews with lawmakers.  The most damaging bills were killed.  Those that passed were largely ineffective, except for one which lowered the standard relating to qualifications to teach in a diploma school of nursing.
 
NCSNA launched a fund-raising campaign for a new headquarters building.  The goal was $150,000.  Caroline Singletary was named chairman of the Fund-Raising Committee, and district nurses’ associations began to raise money.  Miss Singletary served as fund-raising chairman for several years until the successful completion of the building project.
 
Fifteen past presidents of the NCSNA were honored at the second Biennial Convention in October.  The official state nurses’ association past president’s pin was presented to each person who had served in this office.
 
Professional Counseling and Placement Service records for North Carolina nurses were transferred to the ANA Professional Credentials and Personnel Service.
 
There is a thin fine line and sometimes not even that between nursing practice and medical practice, and nurses are continuously expanding their role to include activities once considered strictly medical practice.  This process was accelerated in the early 1970s.  Changes in practice required change in nursing education and legal protection for the nurse practicing in an expanded role.  Nurses increased their visibility in the legislative arena and began to have a stronger voice in political affairs, especially those related to the delivery of health care.
 
 
 
 
1970
A pilot course for nurses wishing to function in an expanded role of child health supervision was initiated by the Division of Maternal and Child Health of the North Carolina State Board of Health and offered at the University of North Carolina at Charlotte.
 
A special issue of Newsletter was published by the North Carolina Board of Higher Education describing admission policies and the granting of credit to registered nurses for previous education and professional experience.
 
Margaret Baggett Dolan received an honorary doctoral degree from Duke University for her “contributions to raising the level of health care for the residents of this and many other countries.”  Her many offices and honors include: Consultant in public health for the Department of the Army and Department of HEW, consultant to the President’s Committee on Health Resources, recipient of ANA’s Pearl McIver Award, President of the American Public Health Association, President of the National Health Council, President of the American Journal of Nursing Company.
 
Verna Wilkinson, Director of Nursing Services for the Greater Carolinas Chapter of the American Red Cross, received the ARC Ann Magnussen Award.
 
The James M. Johnston Scholarships and Awards in Nursing Education at the University of North Carolina at Chapel Hill were announced.  This trust provides resources for full time undergraduate and graduate study and for part time study for registered nurses in continuing education.
 
The Regional Medical Program was financing 20 projects in the state.  A registered nurse, Audrey J. Booth, Assistant Professor of the School of Nursing at the University of North Carolina at Chapel Hill, became Director of Professional Services of RMP.
 
An Abstract for Action, the report of the National Commission for the Study of Nursing Education, was published.  The report recommended that nursing education move into colleges and universities.  The report also called for the formation of a Master Planning Committee for Nursing Education in each state and for the formation of national and state Joint Practice Commissions in order to explore the present roles ascribed to both medicine and nursing and to search for ways in which the emerging concepts of role expansion and role extension could be used to provide a high quality of health care to the consumer.
 
October 3.  This date marked what probably will be recorded in Tar Heel history as the largest “junk” sale of all times.  Thirty-two districts of the North Carolina State Nurses’ Association held garage sales to raise money for the new headquarters building. 
 
1971
North Carolina was designated as one of nine target states by the National Commission for Nursing and Nursing Education to demonstrate, in a three-year implementation project, the effectiveness of its recommendations.  A grant of $10,000 was received by a multi-disciplinary North Carolina Steering Committee to finance target state activities.  A North Carolina Joint Practice Committee composed of nurses and physicians, was established in 1972, and the Joint Advisory Committee on Nursing Education (advisory to the Board of Higher Education and the State Board of Education) accepted the role of Master Planning Committee for Nursing Education.  This role was relinquished by the Joint Advisory Committee in 1973.  Educational materials relating to the National Commission report and target state activities were developed by the North Carolina Steering Committee and were adapted by the National Commission for use in other target states.
 
The first Pharmacy-Nursing Conference, a collaborative effort between the North Carolina State Nurses’ Association and the Society of Hospital Pharmacists, was held to acquaint the members with the new role of nurses and pharmacists in health care services and to introduce “Guidelines for Drug Distribution in North Carolina”, a document developed by a joint committee of the two organizations.
 
December.  The last issue of the Tar Heel Nurse as a quarterly magazine was published.  The 1971 issues won three out of four awards given in its classification in the biennial American Journal of Nursing Company competition for state nurses’ association magazines.
 
1972
Tar Heel Nurse appeared in a new form.  Responding to the need for more frequent communications with the membership, NCSNA changed the publication to a newsletter issued 10 times a year.
 
NCSNA participated in the ANA search for the nation’s most involved nurses and selected Margelet Willoughby as “North Carolina’s Number One Be-Involved Nurse.”
 
Lelia Clark received the Selective Service System Meritorious Award at NCSNA headquarters for her service on the North Carolina Medical Advisory Committee as NCSNA representative.
 
Mary Mills became the second North Carolina nurse to receive the Mary Mahoney Award.  She was nominated by District Twenty-Seven and NCSNA.  A graduate of Lincoln School of Nursing in Durham, she has won numerous honors both in the United States and abroad for services to all races in health and human development.  Her honors include awards and citations from several foreign governments where she served with the Agency of International Development and its predecessor health development programs; honorary degrees from Tuskegee Institute and Seton Hall University’ a plaque at New York University’s Department of Nurse Education; the 1971 Rockefeller Public Service Award; and her portrait in the Exhibit of Outstanding Americans of Negro Origin in the Smithsonian Institute.
 
“Operation Input” was launched, sponsored by the North Carolina State Nurses’ Association, the Schools of Nursing at the University of North Carolina at Chapel Hill and Greensboro, and the North Carolina Regional Medical Program, with assistance from the North Carolina Board of Nursing.  More than 19,000 questionnaires were distributed to registered nurses so that “every nurse would have an opportunity to express needs for continuing education, to tell of problems in functioning in today’s health care arena, and to give priorities to various areas in which the professional organization may be of greater service to nurses.”  The report of the study, prepared by Audrey Booth and Rose George, was published in early 1973, financed by a grant from the Regional Medical Program.
 
Mary Tissie Grissom celebrated her 102nd birthday.  She practiced nursing in Wilmington.
 
The appointment of Frances N. Miller as Executive Director of NCSNA became June 1.  She had served as interim administrator since March 1971.
 
The Regional Medical Program announced a project of equivalency and proficiency testing designed to facilitate the movement of licensed practical nurses into associate degree nursing programs.
 
January.  The Legislative Research Commission’s Committee to Study the Lawful Role of the Nurse in Delivery of Comprehensive Health Care held its first meeting.  One nurse, Audrey Booth, was appointed to the Study Committee.  The Joint Practice Committee served as a resource to the Committee.  The Study Committee completed its work in the fall of 1972 and recommended that the role of the nurse be expanded in order to improve the delivery of health care in the state; that an office of continuing education for nursing be established in the general administration of the University system; that associate degree programs be given critical review as to admission criteria, clinical facilities, and adequate funding for establishment of any new program; and that state support to diploma schools be increased.
 
1973
Legislation implementing some of the recommendations of the Legislative Study Committee was passed by the General Assembly.  The new laws provided a mechanism for the development of rules and regulations by a Joint Subcommittee of the Board of Nursing and the Board of Medical Examiners governing the practice of registered nurses in the expanded role.
 
Dr. Eloise R. Lewis, Dean of the School of Nursing at the University of North Carolina at Greensboro, became a charter Fellow of the American Academy of Nursing.  Since that time Dr. Virginia Stone, Dr. Jeanne Margaret McNally, Dr. Katherine Nuckolls, Dr. Laurel Archer Copp, and Dr. Carolyn A. Williams have become Fellows in the Academy.
 
Fifteen meetings were held by the staff of NCSNA in locations throughout the state to inform all nurses about the implications of the Taft-Hartley Act amendments, which are expected to be approved by Congress.
 
NCSNA held three information conferences in the state based on results of the “Operation Input” survey and giving nurses opportunity to express their concerns related to career mobility, credit for previous nursing education, continuing education, availability of courses closer to home, sources of information about educational programs, and availability of educational counseling.
 
As a result of information gained through “Operation Input”, NCSNA was restructured in order to meet the expressed needs of nurses in the state.  The new structure included four commissions to focus on the major program areas of Practice, Education, Health Affairs, and Membership Services.
 
In the “VA Salisbury Case”, a union representing all employees (including registered nurses) charged hospital management with unfair labor practices in granting administrative leave for nurses to attend educational conferences conducted by NCSNA.  The case involved precedent of national importance to nurses.  The decision upheld VA policy of granting administrative leave to nurses to attend educational meetings sponsored by ANA and its affiliates and was a re-affirmation of the multi-purpose nature of ANA and its constituent associations.
 
The Committee of One Hundred was formed to help provide financial support for the NCSNA building project.
 
On May 19, ground was broken for a new headquarters building.  The little white house on Clark Avenue, which had been headquarters for 17 years, was razed.
 
 
1974
The Board of Directors of NCSNA approved a recommendation of  the “Minute-Man” Legislative Committee that the State Board of Health be urged to phase out “granny midwives” and to give recognition to nurse midwives by integrating them into the public health training program, service projects, and planning efforts.
 
The General Assembly passed bills to provide for advance placement programs in selected schools of nursing and appropriated funds for program development.  Another bill was passed providing for appointment of a registered nurse to the Commission on Health Services, Department of Human Resources.  Mrs. Evelyn Farmer Alexander received the first gubernatorial appointment of a registered nurse to the Commission.  This session of the General Assembly also made provision for establishment of Rural Health Clinics in underserved areas, to be staffed by Family Nurse Practitioners and Physicians Assistants.
 
August.  The North Carolina State Nurses’ Association Continuing Education Recognition Program was launched.  The program was designed “to stimulate providers of continuing education to offer programs meeting professional standards and to stimulate registered nurses to seek educational experiences which would maintain and/or improve their professional competence.”  The program also offered a central recording service for individual nurses to maintain their continuing education records, and recognition for those who reached the recommended achievement in continuing education.
 
NCSNA moved in the new headquarters building in September.  The building was named for Marie B. Noell, former Executive Director, to honor her vision and untiring efforts to strengthen NCSNA and its ability to influence the quality of patient care and health care delivery.  Dedication of the building was held several months later.
 
The Taft-Hartley Act was amended by Congress to give employees of private non-profit hospitals the right to collective bargaining.  The American Nurses’ Association reaffirmed its pledge to represent nurses in collective bargaining efforts.  ANA provided NCSNA a one-year grant of $7,500 to support the NCSNA Economic and General Welfare Program.  ANA’s grant support has continued yearly for this program.
 
Dr. Virginia Stone, Professor of Nursing at Duke University, received the Honorary Recognition Award at the Biennial Convention of the American Nurses’ Association.  This award, one of the highest conferred by ANA, was for “contributions of accomplishments of national or international significance to the nursing profession.”  Dr. Stone was cited for her contributions to nursing in gerontology and geriatrics.
 
1975
January.  Katherine Myers of Charlotte received greetings from President Gerald R. Ford, Governor James Holshouser, and many others who honored her on her 100th birthday.  She was acclaimed the oldest retired Red Cross staff person in the United States.
 
Five North Carolina nurses were among the first 99 to be certified by the American Nurses’ Association for excellence in clinical practice.  They were honored in a special and historic ceremony in January at ANA headquarters in Kansas City.
 
The North Carolina State Nurses’ Association became the North Carolina Nurses Association (NCNA) by charter amendments approved by the House of Delegates.
 
Marjorie C. Cole was the first nurse in the state to receive “Notice of Achievement” under NCNA’s Continuing Education Recognition Program.
 
The NCNA Board of Directors recommended that existing traditional nurses’ professional registries take steps toward incorporating as non-profit registries and become community agencies expanding services when appropriate to include a variety of private health care personnel needed by the community and that district nurses’ associations no longer establish private duty fees.
 
The first group of nurses to exercise rights under the Taft-Hartley amendments of 1974 voted for NCNA as their bargaining agent.  Forty-one nurses at Columbus County Hospital signed bargaining rights to the Association.  The National Labor Relations Board certified the bargaining unit.  Eight months of contract negotiations took place.  Participation in the bargaining unit dwindled.  Nurses still alive in the unit voted to strike.  After 11 days they accepted a contract and returned to work and to pressure from the medical staff not to ratify the contract.  More nurses deserted the unit.  Finally, NLRB decided in June 1976 that the hospital was, after all, government-owned and not under NLRB jurisdiction.  Since there was no longer sufficient bargaining-unit support from the nurses for further NCNA efforts on their behalf, NCNA did not appeal the decision.
 
The North Carolina Nurses Association launched a contest among members for a new logo.  The winning entry, selected from 40 designs submitted, was designed by Evelyn Jernigan.
 
The North Carolina Nurses Association negotiated its second contract covering registered nurses employed at the Veterans Administration Hospital in Durham.  This unit of nurses for several years had been represented by a union but in an election in 1974 voted for their professional organization to represent them.
 
At the Biennial Convention of NCNA, a Collective Bargaining Council was created and was delegated the authority for development of policies and administration of the collective bargaining program of the Association.
 
1976
The need for legislation to guarantee availability of liability insurance for health professionals was a major concern.  In a short session of the General Assembly, legislation was passed to facilitate lower cost and availability of malpractice insurance.  A Health Care Excess Liability Insurance Fund was authorized.  The legislation mandated appointment of a representative of NCNA to the Fund’s Board of Governors.  Gaylord Snyder received this appointment in July.
 
NCNA began making plans for observance of its 75th Anniversary in 1977 and appointed Elizabeth S. Holley, Vice-President, as chairman of the Diamond Jubilee project.
 
A memorial donation of $1,000 to the Margaret C. Moore Scholarship Fund at the University of North Carolina at Greensboro was made by NCNA in recognition of Miss Moore’s contributions to the concept and construction of the NCNA headquarters building.  She was chairman of the Building Committee throughout all phases of the project.
 
A grant of $5,000 from the North Carolina Regional Medical Program made possible the publication and distribution of five Task Force Reports approved to date by the North Carolina Joint Practice Committee.  The reports related to the practice of nurses and physicians in psychiatric-mental health, occupational health, maternity and family planning, nurse-manned clinics, and pediatric practice settings.
 
Two registered nurses were the first to gain the approval of the Joint Subcommittee of the Board of Nursing and the Board of Medical Examiners to practice as registered nurse midwives.  Since the approval process was initiated, 88 family nurse practitioner and two pediatric nurse practitioner were approved by mid-1976.  Ongoing consultation to the Joint Subcommittee is provided by the Joint Practice Committee,
 
Dr. Eloise R. Lewis received the Oliver Max Gardner Award presented by the Board of Governors of the University System for services to mankind, the first nurse faculty member in the University system to be so honored.
 
An “Explorer Group” of representatives of the North Carolina Board of Nursing, the North Carolina Nurses Association, the North Carolina League for Nursing, and the North Carolina Licensed Practical Nurse Association began exploration of the implications and issues in relation to mandatory continuing education for relicensure. 
 
The North Carolina Nurses Association established the Elizabeth S. Holley Memorial Fund to honor the memory of its Vice-President and Chairman of the 75th Anniversary Observance.  A few days after his death in September, the 75th Anniversary calendar was completed and went on sale in the district associations throughout the state.
 
The Service Fund of the North Carolina Nurses Association was terminated.  The Fund was established in 1911 to provide financial assistance to disabled nurses.  Inflation and the availability of assistance from other sources decreased the Fund’s effectiveness.  The Service Fund monies were transferred to the Association’s educational funds.
 
The number of diploma schools of nursing had decreased to eight.  There were eleven baccalaureate programs in nursing in the state and 26 associate degree programs.
 
NCNA ended the year with a membership of approximately 3,600, and the number of registered nurses licensed to practice and residing in the state had grown to nearly 30,000.