From New York City Industrial First Aid Rooms to Southern Cotton Mill Villages: Lillian Wald and the Development of the Industrial Nursing Specialty, 1895-1925

The purpose of this study is to describe and analyze the origins of industrial nursing, as envisioned by nurse Lillian D. Wald and other Progressive Era leaders. Building on prior research of industrial reform and corporate welfare work, this study follows the progress of the development of the industrial nursing role from Wald’s inception and vision of industrial nursing practices to the experiences of rank and file industrial nurses in the South, and examines the influences that shaped those practices. This research also incorporates a case study to analyze the development of the industrial nursing role in a southern textile mill in Greensboro, North Carolina between 1895 and 1925.

The researcher used historical methods with a social history framework for the development of research questions, data collection, and data synthesis. Research questions included: (1) What are the origins of the industrial nursing specialty? (2) How did Lillian Wald envision the role of the visiting nurse in industry? (3) How did industrial nursing develop in the post-Reconstruction South, within the context of race, class, politics, and economic renewal?(4) How was the industrial nursing role applied at Cone Mills, a textile mill company in Greensboro, North Carolina? (5) How did industrial nurses operate within the corporate welfare system at Cone Mills?
Primary sources included archival data from: the New York Public Library Archives; the Smithsonian Historical Collections Lewis W. Hines Child Labor Photograph Collection; the Wirtz Labor Library at the U.S. Department of Labor; the National Archives College Park, Maryland; the University of North Carolina Southern Historical Collection, Cone Mills Corporation Records; East Carolina University Archives; and the Baltimore Museum of Art Claribel and Etta Cone Papers. Secondary sources included published and unpublished manuscripts, books, and dissertations.

At the opening of the twentieth century, explosive growth of American industry changed how people lived and worked. Individual health suffered due to the transition to urban life and the effects of industrial work. Throughout the Progressive Era stakeholders battled over public versus private responsibility for workers’ health and safety, often putting the companies at odds with state and federal government programs. Workers and reformers demanded that the employer take on the burden of providing a safe work environment. These economic changes, societal shifts, and political movements affected nurses’ work. Industrial nursing’s identity and agency were intricately tied to industrialization and economic growth. Nurses, led by Lillian Wald, positioned themselves to play a key role in improving the workplace. The dissertation’s significance lies in the study of historical antecedents to current occupational health issues in the United States and developing countries.