Nursing in Iowa: The Making of a Profession

Anna Knutson had made it just in time. Her neighbor's son was sick—so sick that he might die. Anna wrapped the boy's body in sheets soaked in hot water. This method, combined with rest, helped the boy recover.

In Story County—as in most rural areas in Iowa—women often took care of sick relatives and neighbors. They used home remedies and skills that they had learned from years of experience. This was the Iowa of the mid-19th century. There were few hospitals or clinics. There were also few doctors and no trained nurses.

Civil War Training

Many women and men served as nurses during the Civil War (1861-1865).  Many simply volunteered as nurses. Annie M. Hill, served as a volunteer nurse at the Army Square Hospital in Washington, D.C. from 1863 to 1865. She later moved to Dubuque where she took medical courses and became a doctor. At this time it was very rare for a woman to become a doctor. But nursing was one of the few occupations that welcomed single women. Many women were also becoming teachers at this time. 

Many Iowa women visited their husbands at war and stayed to work as nurses. Rebecca Otis went to Jefferson Barracks, St. Louis, Missouri, to see her husband and then worked as a nurse for the army surgeon.

The Civil War demonstrated a need for trained nurses. Florence Nightingale influenced reform in hospitals in England and reformed the training of nurses. As her writings began to impact nursing in America, the first school in the United States based on Nightingale's principles was established in 1873 at New York's Bellevue Hospital.

Nursing Education Begins

Nuns from the Roman Catholic Church worked at many of Iowa's early hospitals as nurses. Sisters Mary Catherine Slattery and Alexis Crotty learned their nursing skills at the Medical Department in Iowa City in 1873. Sisters at another Iowa City hospital in 1887 took care of rooms, supplied food, gave medicine, and were to "nurse the sick and watch at night when necessary.”

The typical nursing school was part of a hospital. Student nurses' education came from working long hours in the hospital. Most hospitals had limited staffs, so nurses had many responsibilities besides the care of their patients. The typical Iowa nurse worked 12-hour shifts. She or he cared for patients, cleaned rooms and washed dishes. Nurses on special duty cared for very sick patients for 24 hours, and they caught whatever sleep they could.

New Roles for Nurses

During the first decade of the 20th century nurses in Iowa began visiting sick people in their homes. In 1920 this practice became a regular part of state services. Visiting nurses not only cared for poor people; they also provided information and services to Iowans of all backgrounds. Visiting nurses encouraged the public to prevent serious illness by immunization and regular physical examinations. Often they worked with teachers and social workers to encourage health care education.

Nurses also provided services in Iowa factories beginning with meatpacking plants in 1919. These nurses took care of sick or injured employees. Companies soon realized that nurses could play a valuable role in promoting and protecting the health of workers, and in turn, making the labor force more productive.

Modern Nursing

Nursing continues to provide important health care services, from caring for sick people to promoting ways of staying healthy. Both women and men enter the profession after many years of education, including training in special fields of health care.

Nurses work in a wide variety of health care areas. Some nurses assist with surgery. Others have special expertise in treating certain forms of illness, injury, such as severe burns, or mental illness. Some nurses care for newborn babies, while others work with the elderly. Iowa nurses also do research in aging, pain, children's health and many other areas.


  • Victoria Carlson and Etta Rasmussen, “Nursing in Iowa: The Making of a Profession,” The Goldfinch 9, no. 4 (April 1988): 18-20.