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  • Writer's pictureDale DeBakcsy

Making All Nurses Equal: The Many Battles of Estelle Massey Osborne

In 1923, when Estelle Massey graduated from the City Hospital No. 2 School of Nursing with the highest examination score in the entire state of Missouri, only fourteen of the nation’s 1,300 schools for nursing allowed black people to even apply. The American Nursing Association did not accept black nurses as members, and the US navy categorically refused to employ them. And while it is an oversimplification to attribute the opening of the nursing profession to minorities throughout the 1950s and 1960s to a single person, it was assuredly the multi-front plan formed by Estelle Massey (1901–1981) while president of the National Association of Colored Graduate Nurses that provided the blueprint for overcoming the worst of the profession’s inequalities.

Estelle Massey invented no new medical technique – the time she spent as an actual practising nurse was far outweighed by her time as an administrator and organiser – and because our society is as it is, you have probably never heard of her. We lionise doctors, but tend towards condescension when it comes to nurses; we celebrate researchers but mock administrators. And yet it was this tireless nurse-turned-administrator who did the long, hard work of erecting new educational institutions for black nurses and forging relations with theretofore white-exclusive national organisations that, after persistent decades, at last stamped out one of the great prejudices at the heart of the American health system. For all that, she deserves far more than the smattering of thin articles she has been allotted by historians of science.

She was born the eighth of eleven children in the small town of Palestine, Texas. Her parents believed resolutely in the power of education, and all of Massey’s older sisters became teachers. Her mother had two principles in raising her daughters – that they must complete high school and that they must never, so long as they were children, work for white people. She wanted to shield her daughters from the indignities of prejudice for as long as possible; to let them grow into a confident sense of identity before subjecting them to the self-shattering blows of white objectification.

By and large, she succeeded. With the exception of a white police officer who propositioned her, at the age of 11, to let him buy her a pair of shoes she was looking at in a window in exchange for sexual favours, she grew up without the daily indignities of segregated transportation and dehumanisation at the hands of white employers. She graduated high school and, as had her sisters before her, set out at age 18 to her first teaching position.

She was the only teacher at a school for farmers’ children where all children were piled in one room regardless of age, the sort of set-up we associate with the mid-1800s but that, along the periphery of American education, was still very much in existence into the 1920s.

It was not Massey’s thing. Parents pulled their children from class for most of the year to help with the harvest, and the town itself offered no stimulation for a bright young woman used to the lively intellectual atmosphere of her parent’s home. When a man at the school was mysteriously killed by a gunshot through the classroom window, Massey took it as an unambiguous sign to ‘get out of Dodge’ and resigned her post.

She went to live with her brother, a dentist in St Louis, with the idea of taking up dentistry herself. Her brother, however, did not think it was the right fit for her and conspired with some friends to lure her into the nearby hospital’s new nurse training programme. They were taking Basically Anybody, and when she turned up to get a feel for the place she found to her surprise, and warranted concern, that she was immediately accepted into the programme. Before she quite realised what had happened, she found herself studying nursing and developing a genuine passion for it, particularly obstetrics.

She studied for three years, obtained the highest score on the state-wide final nurse’s exam, and, given her love of obstetrics, was of course immediately placed in a position that had nothing to do with obstetrics. The theory at the time was that, to develop discipline in a new nurse, you had to place them in a position they were actively not passionate about. Massey was stuck at the medical ward, checking patients in and out – routine work that was in no way satisfying – so when an opportunity arose to work in public health, she grabbed it, taking a job with the Municipal Visiting Nurses of St Louis, where she was assigned the cases involving minorities.

Here she came up against the real dead weight of institutional prejudice. When her superiors vacated their positions, their jobs went to other white people of less seniority and training than Massey, and when official calls came in, the callers routinely insisted on talking to the white nurses, even if it was about topics in Massey’s area of experience. As a result, sometimes Massey would answer the phone, be forced to hand it to a nearby white nurse, but then sit close by as that white nurse relayed questions from the caller to her, and her responses back to the caller, in a hurtful farce.

So, she left that position too, heading for work at a joint programme between a Kansas City high school, junior college and a couple of local hospitals to exchange educational opportunities. She taught nursing and hygiene at the high school and college, but felt that, to do her job properly, she ought to have more education herself than three years at the world’s least picky nursing programme. She applied for a Rosenwald Fund scholarship even though one had never been given to a black nursing student before, and boldly resigned her post before hearing that she had won it.

Fortunately, she did, and in 1931, she became the first black nurse ever to earn a master’s degree. She was selected by the Rosenwald Fund to apply her new learning to a project in the deep South, investigating ways to bring better health education and service to rural communities. As might be imagined, a young black professional showing up in the South and advising white townsmen about health initiatives often sparked resentment. One official told her not to appoint any nurses who gave black people too much respect by saying ‘Mr’ or ‘Mrs’ in front of their last names. She learned to navigate prejudice with cool detachment, while at the same time discovering that allies often were found in unlikely places. That knowledge served her well in her next position, as she stepped on to a truly national stage.

She took up the educational directorship of Freedmen’s Hospital in DC (another first for a black woman) and soon the presidency of the National Association of Colored Graduate Nurses (NACGN), a position she held for five years, from 1934 to 1939. During her tenure, she unleashed a two-pronged assault, firstly forming connections with the wider nursing community that paved the way for black nurses to be integrated into the American Nurses Association, and secondly by fostering programmes that developed post-nursing school opportunities for nurses of colour. By 1946, the ANA began its integration, and by 1951 the NACGN dissolved itself as no longer necessary in the face of the ANA’s new inclusivity.

While the NACGN and ANA were working out the details of the project Massey had started, Massey herself had moved on in the early 1940s to a position at the National Nursing Council for War Service (yet another first), where she was tasked with investigating how black nurses could be incorporated at last into the armed services, in anticipation of the Second World War. At the time, in the army black nurses accounted for less than 0.5 per cent of the total, while there were precisely zero serving in the navy. Massey applied pressure on the armed forces to change their policies, and grouped together professional organisations to persuade educational institutions to allow nursing students of colour.

As a direct result, in just two years, the fourteen training schools available during Massey’s youth shot up to thirty-eight, the number of minority army nurses in the army doubled, and the navy began allowing black nurses as well.

Four of them.

You have to start somewhere.

After the war, she joined the Board of Directors of the ANA (yet another first) and was sent to Sweden to represent America at the International Council of Nurses. Four years with the ANA (1948–1952) was followed by a long reign as assistant director of the National League for Nursing (1954–1959) followed by a position as the full Director of Services, where she continued to open the South and expand education.

She lived for twenty-one years after becoming director, but no account of her life during the years 1964–1981 exists, so what she did during that time, including even the circumstances of her death, remains a great unnecessary mystery, created by chroniclers of nursing’s history simply losing interest in her story. The last source to devote more than a few paragraphs to her life came out in 1966, and all historians since have remained content to end their narratives there, in spite of access to records that might fill in those aching blanks.

And so, we say goodbye to Massey in 1965, at the height of her influence, and with the sincere hope that someone who meant so much to an oppressed minority in an under-appreciated profession had a peaceful end, replete with the full knowledge of all she had meant, to nursing, to people of colour, and indeed to the world.


The sources are, as I mentioned, depressing in their abrupt fall-off. The redoubtable Edna Yost gives her thirty-ish pages in American Women of Nursing (1947), and she also shows up for six pages in The Story of Nursing (1954, revised 1965) by Bertha Dodge. Those narratives get combined in your best source overall, the twelve over-sized pages devoted to Osborne in the nursing section of Volume 2 of Profiles of Negro Womanhood (1966), which is a great series by Sylvia Dannett for anybody interested in the history of black women in America.

And if you want to read more stories about astounding women in medicine, you can grab a copy of my History of Women in Medicine and Medical Research, available on Amazon or from Pen & Sword Books.


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