Nurses as Formal Leaders in United States Civilian Hospitals: 1891-1991

Nursing leadership has evolved since the 1890s and has taken different forms throughout nursing history for the sake of preserving the nursing profession against the headwinds of competing medical and hospital administrator professions. Through the examination of the professional lives of Isabel Hampton Robb, Belva Overton, Sister Mary Maurita Sengelaub, and Anne Zimmerman, the evidence demonstrates that nursing leaders adapted to internal (hospitals and health systems) and external (insurance reimbursements) factors. Starting with the initial strong position of nursing in superintendent roles in hospitals, to their forcible removal from leadership roles, and later the reemergence of influential nursing leaders.