The Birth of an Occupation: Professional Nursing in the Era of Public Health

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Over the past century, nursing was transformed from untrained menial labor into a professional, credentialed occupation. This paper studies the role of hospital-provided training in this transformation. In the early 20th century, hospitals founded training schools for nurses to meet the growing demand for medical care. Using linked census records and school openings as a source of variation, I find that white women who were geographically close to an opening in adolescence were more likely to become nurses in their twenties. Effects are largest for women from professional backgrounds, consistent with the standards that schools used to select students. Proximity to nurse training did not raise labor force participation or improve occupation-based measures of economic status. Furthermore, by their thirties, women proximate to training schools were less likely to work as physicians. These results paint a mixed picture: Nurse training elevated the status of nursing by changing the composition of nursing students, however, it also reinforced gender segregation within the medical field.