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

This paper studies the origins of nursing as a professional occupation. In the early 20thcentury, hospitals founded training schools for nurses to meet the growing demand formedical care. Training schools increased overall nurse supply and soon became theprimary pathway for young women to receive a professional nursing credential. Iestimate how the availability of nurse training affected labor market outcomes. Usinglinked census records and training school openings as a source of variation, I show thatwhite women who were geographically close to an opening in adolescence were morelikely to become trained nurses. Effects are largest for women from well-off families, asproxied using father's occupation. Availability of nurse training caused women tosubstitute away from other occupations and had little effect on labor force participationor occupation-based measures of income. Furthermore, by their thirties, women whowere geographically close to an opening were less likely to become physicians. Theseresults paint a mixed picture: Nurse training provided new opportunities for women inthe workforce, reinforcing existing gender segregation in medicine. Over the course ofthe 20th century, nursing would grow to become the largest majority-female occupationin the United States.