A Brief History of the Beginnings of the
Florida Nurses’ Association
History of Florida Nurses Association
CHAPTER ONE
LAYING THE FOUNDATION 1909-1929
By 1909, the State of Florida approached a new chapter of major growth and change, yet it remained a sprawling rural state
with cities separated by miles of wilderness. The total population of Florida in 1910 amounted to just over 750,000 people,
with Jacksonville, the largest city, boasting a population of 28,000 residents. The smaller cities dispersed throughout the
state continued to exist in isolation due to limited transportation services. Jacksonville had several hospitals in 1909 and
two training schools for white nurses: DeSoto Sanatorium and St. Luke’s.
Both of the hospitals had northern-trained registered nurses as superintendents, who had brought the ideas and programs of
northern hospitals with them. The person who urged nurses in Jacksonville to come together may never be known. What
we do know however, is how they came together and what happened once they did. Graduates from the two Jacksonville
schools, led by those registered nurses from the north, met at the home of Mrs. W.W. Cummer on March 1, 1909. This
meeting opened a new chapter in the history of nursing in Florida. Mrs. Cummer hosted the meeting, although she was not
a nurse herself. As a member of a wealthy Jacksonville family, who has strongly supported St. Luke’s Hospital, she had
considerable knowledge of nurses and hospital issues. Mary Alberta Baker, the Superintendent at St. Luke’s had come to
Jacksonville from New York and Ethel P. Clarke, Superintendent at DeSoto had come from Maryland. These three women
alone gave the charter group considerable input from broad experience.
Like many first meetings, friends tend to sit with friends. Nurses, with their twelve-hour workday, had little time to
socialize and hence the people they knew came from their own institutions. So, as Miss Clarke of DeSoto called the
meeting to order, the DeSoto nurses sat on one side of the room and the St. Lukes’s nurse sat on the other.
The objectives of the new association in Jacksonville mirrored those of Alumnae Associations which had merged to form
the American Nurses association several years earlier: to promote unity among nurses, to keep abreast of progress and to
unite for greater control of nursing (educational, legal, practice). Early meetings had to focus on the structure and policies
of the group, as well as accomplishing their chief goal described in the American Journal of Nursing:
“Jacksonville, - The Florida Association of Graduate Nurses effected a permanent organization in May and all
efforts are tending to make state registration an accomplished fact in the near future.
Florida’s growth meant new hospitals, more training schools and a critical need for standards within the nursing profession.
The first Nurse Practice Acts had been passed in 1903, in North Carolina, New Jersey, New York and Virginia. Other states
had followed and theses early Florida leaders recognized their responsibility to gain control of nursing standards in such a
rapidly growing state.
There is a major gap in the minutes of the Association from June, 1910 to March 15, 1912 and no additional notices
appeared in the American Journal of Nursing.
Working throughout 1912, the Association completed the arduous task of recruiting members through Superintendents,
organizing nurses in the state, preparing for the first convention, and beginning work on the first Nurse Practice Act. That
same year, Miss Nettie Flanagan represented the Florida Association at the American Nurses Association Convention in
Chicago. The minutes of subsequent meetings describe Miss Flanagan’s valuable leadership on national issues following
her convention experience. The Association began a long tradition of selling projects by offering ANA Calendars for $.50
at St. Luke’s and DeSoto Sanatorium in order to raise money for the ANA Relief Fund. This fund helped nurses in financial
need.
In order to finance the expenses of the first state convention, each member of the executive committee paid $5 and each
association member paid $2. These were significant sums in an era when either a dress or oil stove cost $5 and $2 would
purchase a good skirt.
The first convention took place on January 29, 30, and 31, 1913, at the Board of Trade Building in Jacksonville.
During 1912, Mr. J.M. Barrs, a Jacksonville attorney became the legal counsel to the Florida Association of Graduate
Nurses. He assisted the group with work on the structure and organization of a bill providing for registration of nurses.
Following the convention, the newly appointed Legislative Committee and Association officers met with representatives
from various areas of the state to discuss the bill, section by section. The modified bill received approval. Mr. Barrs then
put the bill in proper legal form for presentation. Miss Baker represented the Association in Tallahassee as lobbyist for the
bill.
The state legislature met in April and May of 1913. In this era before women could vote in Florida, one can only wonder
how this female nurse lobbyist affected the male legislator. Whatever her reception may have been the Florida Association
of Graduate Nurses, represented by the Nursing Superintendent of Florida’s first Hospital, succeeded in the attempt to gain
legislative support. The first practice act passed the Florida Legislature and Governor Trammell signed it into law on June
7, 1913. Nursing had received recognition as a profession deserving standards for public protection.
The outbreak of World War I had less immediate impact on Florida trained nurses than other, since the American Red Cross
required nurses to have graduated from hospitals with at least 50 beds. Only St. Luke’s in Jacksonville had enough beds and
only a few of its graduates joined the Army. Later, in 1918, the bed requirement had to be dropped making other graduate
nurses eligible. By 1918 and 1919, the Association experienced the loss of some members and leaders due to military
service. Continuing work on bylaws, nurses’ relief, and participation in national efforts, occupied much of the time for the
Association’s leadership. Remember, these nurses frequently had only two half-days off each week and worked a 12-hour
day.
In 1915, a woman, who later became a living legend in American nursing, addressed the third annual meeting of the Florida
State Association of Graduate Nurses. Miss Annie Goodrich, President of the ANA, 1915-1918, remains one of the
profession’s outstanding orators and writers. She had yet to direct the Army Training School for Nurses or assume the
Deanship at Yale, but she already had the force of a dynamic leader. One excerpt from her speech:
“Again our attention is called to the fact that our calling knows neither day nor night, neither creed, sex color or
nation, war or peace, again we recognize the fact that service so weighted with opportunity and responsibility
cannot be fitly rendered to humanity unless all avenues whereby a thorough Technical and Theoretical preparation
may be acquired by those seeking to prepare themselves for this service. In the face of needless crippling and
waste of life (referring to World war I) that has made our efforts to preserve life seem futile and puny and all
together unavailing, our courage has not faltered and our enthusiasm has not diminished. We face the future full of
hope and courage and again bend our energies to leave a sound educational foundation for the generations of nurses
whose services will never be more greatly needed then in the years which will follow this great war. We believe
that the state and even the nation should assume some responsibility in the preparation of this servant whose
services are so wide and if a healthy people is her greatest resource she would be justified in placing at the disposal
of our students of nursing every educational opportunity. We shall not rest until the institutions of learning and the
institutions for the sick have opened their doors to our profession, and until there is required for every nurse a
definite evidence through a licensing examination that she is equipped with a thorough which only she can render a
complete service.”
Miss Goodrich believed strongly in the value of educated nurses and societal standards. She inspired nurses for over forty
years with her dynamic vision of what nurses could be.
The efforts of the Relief Committee need to be noted here since nurse in this period had very little job security or retirement
protection. The membership voted monthly payments to specific members throughout the early years. They also supported
the ANA Relief fund which attempted to do an even larger job at the national level frequently the Association would vote $5
per month to a member for one year.
Another major committee called Credentials had to deal with the tricky issue of eligibility for members. In this time, before
universal registration and highly variable standards in educational institutions, screening members played a large role in
organizing the membership. At each of the regular meetings the most important business was voting in new members.
Drafting the first constitution, members found this issue of eligibility very cumbersome and confusing. The original
document read:
“Membership – Any nurse in good standing in Florida who has graduated from a Florida school, or any nurse, even
though living elsewhere, having a diploma from a well established hospital giving a general course of training and
instruction in nursing, of at least two years, or any nurse having obtained an equivalent training from two or more
training schools before June, 1912 or any nurse of good standing, resident of Florida, having graduated prior to
1912 from a general hospital giving two years training, shall be eligible for membership, provided her application
is approved by the Board of Directors.”
Reading the above paragraph shows the confusion and struggle created when the members tried to organize nurse without
adequate standards in the profession. When the group amended this section if finally read:
“Membership – An applicant must be a graduate in good standing from a well equipped and properly organized
general training course, which offers not less than a two year course. She must give a satisfactory endorsement
from a former Superintendent of the Training School, together with such evidence of skillful and acceptable work,
proof of professional ability and morality as the Committee on Credentials may demand.”
These early years allowed the membership to establish a strong organization, which weathered the disruption of World War
I without major problems. Their work also provided the impetus to enter the twenties with a sense of accomplishment and
self-confidence. As the twenties opened, the Florida State Association of Graduate Nurses became the Florida State Nurse
Association. One can detect the exuberance and enthusiasm, which pervaded the annual conventions as the programs
expanded, and the membership grew. The districts identified in the 1917 convention became more organized and interest
sections began their activities. Identification with their Association grew to be a major aspect of the registered nurse’s
responsibility.
The Florida State Nurses Association gained recognition as a state resource for nursing and health issue standard.
Affiliations between FSNA and other major health or welfare organizations began during this period. By 1929, the structure
and policies of the association had matured significantly; FSNA had become closely related to every aspect of nursing
practice and health care in the state. The depression in Florida actually began in some sections of the economy in 1926
when a hurricane struck Miami destroying the land boom. Another aspect of the impending national depression unique to
Florida and the south in general, was the absence of the extreme prosperity, which had been experienced in the northeast
during the twenties. Maybe these realities explain in some way why the nurse coped so admirably with the stresses of 1929
and the lean years that followed.
In the pre-convention Board meeting in 1929, Miss Rowe announced that the bank in which the Association’s funds were
kept had failed. She said it would therefore be necessary to cut the budget for the coming year. Banks closed, businesses
failed, and what started in 1926 in one sector of the economy became a general problem. Many nurses who did private duty
soon found themselves unemployed since workers could not find jobs. In spite of the pending difficulties in the economy,
the membership voted to embark on two major ventures, which would require time, effort and great financial expense by
supporting an active legislative program.
Mill Lillian Clayton, ANA President, addressed the convention in 1929 in order to explain the work and current problems of
the ANA Grading Committee. This Committee on Grading of Nursing Schools began an ambitious program of studies in
1926. These studies focused on three separate areas of inquiry: the supply and demand for graduate nurses, a “job analysis”
of what nurses did and the actual grading of nursing schools. The study on the supply of nurses had been completed in
1928. Miss Clayton discussed the difficulties the committee was having trying to determine uniform terminology for
classifying positions. She informed the Florida Board of Directors that the ANA Board had decided to finance the work of
the Grading Committee by assessing each Association on a per capita basis. With a membership of 892, Florida’s share
would come to $1402.50. The Board decided to assess each member $.50 per year for three years, payable with dues. One
can only admire the aplomb with which these dedicated women attacked their problems in the fact of mounting financial
difficulties. The goal of standardized, organized and respected profession remained with them throughout the depression
years.