Charity Collins Miles
First Black School Nurse
Note: Credit to The Relentless School Nurse blog for teaching us about Charity Collins Miles. We intend to further Robin Cogan’s initial work and research.
Charity Collins Miles graduated from nursing school at Spelman College in Atlanta, Georgia in 1906. At the turn of the twentieth century, the role of school nursing had spread to other cities across the country after showing success in New York City in 1902. She was hired as an Atlanta school nurse in 1911 to care for all the Black students in the city’s segregated schools. To better address the broader needs of the community who lacked access to healthcare, she created additional services such as infant welfare, prenatal care, oral hygiene, and health education and ultimately served as the Assistant Supervisor of Public Schools. In 1903 states began to adopt the Nurse Practice Act to standardize the nursing profession and education. To implement the act, Georgia’s Board of Nursing was formed in 1907. The Board subsequently refused to permit Black nursing school graduates to even apply for their nursing license registration. The nursing board examination was established by 1912 and by 1916, it had mandated eight nursing categories to be included on the test and for practical skill demonstration. The test took two days to complete and was only administered in Atlanta once a year. It was in this restrictive climate that Miles’ nursing career began.
To change these licensing barriers, Miles supported her fellow classmate Ludie Andrews, who, with her own money, initiated legal action against the State Board of Nurse Examiners. As a direct result, Black nursing graduates obtained their right to apply for a professional license in Georgia by 1919 or 1920 (sources differ). During this same period, the need for healthcare workers during the 1918 Flu Pandemic motivated Congress to pass legislation that permitted non-physicians to be hired by the U.S. Public Health Service hospital reserve corps. Miles was hired in 1919 as its first Black nurse and thus created future opportunities for subsequent Black nurses to serve in the U.S. Public Health Service.
Historical Background: The first known nursing diploma schools were founded in 1873 in New York, Connecticut, and Massachusetts. Spelman College was the first diploma program established for Black nurses (known during that time as Atlanta Baptist Female Seminary). From its founding in 1886 until it closed in 1924, the program graduated 181 nurses (Cannon, 2002).
According to Mary Elizabeth Carnegie (1999): “At the beginning of the century, hospitals were employing the barest minimum of graduate nurses in administrative positions, with students providing the nursing service. The vast majority of those that operated schools of nursing had a daily average of less than 50 patients. Plus there was no standard curriculum for schools of nursing to follow. To raise standards, nurses, who had organized by then, pushed for the passage of Nurse Practice Acts, the first of which was passed in 1903 in North Carolina, followed by New York, New Jersey, and Virginia. This meant that a nurse would have to pass an examination for a license to prove that she was safe to practice” (p. 128).
While otherwise beneficial to establish professional curriculum and norms, the story of Charity Collins Miles and Ludie Andrews reveals how the guise of licenses, exams, and standardization also permitted discriminatory policies at the state level to became part of professional nursing culture.
Sources
We sourced the above information from Spelman College, the History of the Georgia Board of Nursing, Chapter Three of Nursing Issues in the 21st Century: Perspectives from the Literature (page 125), the book The Path We Tread: Blacks in Nursing Worldwide 1854–1994 (page 191) by M. Elizabeth Carnegie, the book American Nursing by Patricia D’Antonio (page 119), as well as the following journal articles (open access does not seem to be available):
Cannon, R. B. (2002). Enduring echoes. Georgia Nursing, 62(1), 20.
Carnegie, M. E. (1999). Honoring the past, treasuring the present, and anticipating the future of nursing and health care for black Americans. ABNF Journal, 10(6), 126–30.
Hawkins, J., Hayes, E., & Corliss, C. (1994). School Nursing in America — 1902‐1994: A Return to Public Health Nursing. Public Health Nursing (Boston, Mass.), 11(6), 416–425.
Learn More
To learn more about inclusion in nursing and be part of the national discussion to address racism in nursing, check out and share the following resources:
Know Your History
- American Association for the History of Nursing to attend monthly webinars on topics of nursing history, view the calendar here.
- Nursing CLIO to engage with historians and scholars committed to deep work around historical accuracy in healthcare and nursing.
Examine Bias
- NurseManifest to attend live zoom sessions with fellow nurses on nursing’s overdue reckoning on racism or to sign their pledge.
- Breaking Bias in Healthcare, an online course created by scientist Anu Gupta, to learn how bias is related to our brain’s neurobiology and can be mitigated with mindfulness.
Support & Advocate
- National Coalition for Ethnic Minority Nurse Association to stay engaged with topics relevant to nurses of color.
Help us paint the internet with nursing’s diverse origin stories. Follow this Medium publication, NursesYouShouldKnow on Instagram, LinkedIn, or Facebook, or @KnowNurses on Twitter to share and re-post our articles far and wide.
If you wish to be involved in the project, provide feedback, submit past or present day nurses to be featured, or to receive a monthly calendar in advance of which nurses will be featured each month, please sign up here.
