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Breaking Barriers: A History of Mary Eliza Mahoney

Mary Eliza Mahoney wide

By Heather Kays

There is a long and storied history to the emergence of the nurse practitioner (NP) role, which includes many women of color who were at the forefront of the movement.

During National Minority Health Month this April, the American Association of Nurse Practitioners® (AANP) would like to reflect on the significant contributions made by nursing pioneer Mary Eliza Mahoney.

Although there were Black women who worked as nurses before her, Mahoney became the first Black woman to graduate from a nursing program and the first to earn a professional nursing license. She was one of 42 students admitted into the New England Hospital for Women and Children Training School for Nurses in Boston, Massachusetts. Mahoney is believed to be one of only three people in her class to complete the challenging 16-month program in 1878. After graduation, Mahoney remained in Boston and became a private-duty nurse. She was known for her strict professionalism and kind demeanor.

When she was in her teens, Mahoney knew that she wanted to become a nurse. To work towards that goal, Mahoney began working at the New England Hospital for Women and Children. The hospital provided health care only to women and their children. The facility was also noteworthy because it had an all-female staff of physicians. Mahoney worked there for 15 years in several roles. She worked at the hospital as a janitor, a cook and a washer woman. She also had the opportunity to work as a nurse’s aide, which gave her the chance to learn a great deal about the nursing profession.

Mahoney was five feet tall and less than a hundred pounds, but the slight woman was known for her tenacity and work ethic.

Mary Ella Chayer, a former professor of nursing at the Teachers College at Columbia University, wrote of Mahoney in 1954: “This nurse was an outstanding student of her time, an expert and tender practitioner, an exemplary citizen, and an untiring worker in both local and national organizations. She was a sound builder for the future, a builder of foundations on which others to follow may safely depend.”

In addition to Mahoney’s extraordinary personal career, she is also remembered for her contributions to professional organizations. She was an early member of what would later become the American Nurses Association (ANA). In 1908, Mahoney co-founded the National Association of Colored Graduate Nurses (NACGN) with Adah B. Thoms. Mahoney was a prominent advocate for equality in nursing education, as well as a passionate supporter of women’s suffrage. When the 19th Amendment passed in 1920, Mahoney became one of the first women in Boston to register to vote at the age of 76.

Ten years after Mahoney’s death, NACGN established the Mary Mahoney Award in 1936. The award continued to be given after NACGN merged with ANA in 1951. Today, the Mary Mahoney Award is presented biennially for significant contributions to the opening and advancement of equal opportunities in nursing for members of minority groups. Mahoney was inducted into the Nursing Hall of Fame and the National Women’s Hall of Fame.

Mahoney’s grave in Everett, Massachusetts, now serves as a memorial site. In 1973, Helen S. Miller, winner of the Mahoney Award in 1968, led a fundraising drive to erect a monument in honor of Mahoney at the gravesite. Miller’s efforts were supported by the national sorority for professional and student nurses, Chi Eta Phi, and ANA. The memorial was completed in 1973, and it still stands as a tribute to Mahoney’s legacy.

Efforts to champion equity and diversity within the health care community continue to this day. Thanks to pioneers like Mahoney, opportunities have been increased for Black and female nurses — increasing representation and access to quality care for all patients. Yet, work remains to be done. Diversifying the health care workforce is one way to help “destruct the systemic biases and racial inequities that persist in health care.”

According to Hernandez-Cancio in a 2019 study, patients are more likely to utilize preventive care services and report care satisfaction when treated by a health care professional who shares their own racial or ethnic background. Studies such as this show how it is possible for Black nurses to bolster patients’ trust in the health care system and increase the likelihood that patients will receive culturally competent care. Importantly, all NPs are encouraged to increase their knowledge about culturally competent care and best practices to ensure you build trust and rapport with your patients. This will increase their level of comfort and ensure the provision of accessible, person-centered, equitable, high-quality health care for diverse communities.

AANP is committed to improving health equity and seeing that diversity, equity and inclusion (DEI) are present within the association and represented throughout the NP community. There are many opportunities to learn more about AANP’s DEI activities and how you can become a champion for the patients you serve. Attend the 2022 AANP National Conference to hear closing general session keynote speaker Martin Luther King III deliver an inspirational message on equality and peace, encouraging NPs to continue leading efforts to address social determinants of health — especially those related to racism, poverty and violence. Consider joining the Health Equity, Diversity and Inclusion AANP Community to engage in conversations with other NPs who share a passion for all aspects of DEI, and be sure to visit the AANP CE Center to access more than a dozen continuing education (CE) courses on the topic. By learning more about ways historical and current barriers impact health care, you will be better equipped to advance DEI within the NP role and increase health equity for patients.

The image of Mary Eliza Mahoney used in this article was sourced from: Schomburg Center for Research in Black Culture, Photographs and Prints Division, The New York Public Library.