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 20th century, hospitals founded training schools for nurses to meet the growing demand for medical care. Training schools increased overall nurse supply and soon became the primary pathway for young women to receive a professional nursing credential. I estimate how the availability of nurse training affected labor market outcomes. Using linked census records and training school openings as a source of variation, I show that white women who were geographically close to an opening in adolescence were more likely to become trained nurses. Effects are largest for women from well-off families, as proxied using father's occupation. Availability of nurse training caused women to substitute away from other occupations and had little effect on labor force participation or occupation-based measures of income. Furthermore, by their thirties, women who were geographically close to an opening were less likely to become physicians. These results paint a mixed picture: Nurse training provided new opportunities for women in the workforce, reinforcing existing gender segregation in medicine. Over the course of the 20th century, nursing would grow to become the largest majority-female occupation in the United States.