...nurses may be inspired to work towards change by studying nurses in earlier times who persistently challenged unfair laws, policies, and practices. Expectations of nurses working towards social justice are supported by organizations such as the International Council of Nurses, the American Association of Colleges of Nursing, the American Nurses Association, the World Health Organization, and the United States Department of Health and Human Services, and are inherent to the Nurses Code of Ethics (American Nurses Association [ANA], 2015). While concern for equality is currently expected, it has not always been forefront to nursing organizations and institutions of higher education. Studying the eras prior to the Civil Rights Movement, during which time discrimination based on race, gender, and other factors was both legal and accepted as the cultural norm, can inform current efforts to eliminate health disparities. As Stuart (2010) noted, nurses may be inspired to work towards change by studying nurses in earlier times who persistently challenged unfair laws, policies, and practices. Knowledge of nursing history is a vital part of becoming an informed and responsive professional. As Lynaugh explained:

What happens in the present is not an accident. It has a past. In order to understand and change contemporary health system problems, nurse historians examine how these problems emerged, how they influence the present, and how to use that knowledge to design better systems for the future (D'Antonio & Fairman, 2010, p.113).

This story of one courageous, but largely unrecognized, nurse and pioneer Civil Rights advocate, Esther McCready, provides an inspirational example of what nurses are capable of accomplishing if we remain dedicated and true to our principles. More than a ....as an African American teenager... Esther McCready challenged the discriminatory admissions policies of the University of Maryland School of Nursing. decade before the Civil Rights Act of 1964, as an African American teenager from Baltimore, Maryland, Esther McCready challenged the discriminatory admissions policies of the University of Maryland School of Nursing (UMSON). Her actions eventually resulted in the formation of numerous separate schools of nursing for African Americans across the south. This article recounts the powerful impact Esther McCready’s actions had on creating opportunities for nursing education during a time when they were severely limited for African American women. While scholars have given attention to the ways that health advocacy was integrally tied to the work of advancing Civil Rights, Esther McCready’s important contributions have been mostly absent from these narratives (Carnegie & Dolan, 1991; Hine, 1989).

The purposes of this article are to honor the life and work of McCready, hoping her story will inspire nurses today to become social justice advocates, and to describe past struggles of racial segregation and subsequent challenges towards racial integration of nursing schools and healthcare agencies. This article also explores nurse advocacy and how Esther McCready advocated for herself and greater racial equity in nursing education during a time of civil rights turmoil. A review of relevant court cases and policies related to segregation and integration of higher education in the mid-twentieth century is presented, along with the experiences of McCready’s professional life following acceptance into UNMSON. Finally, I will discuss the consequences of McCready’s actions on racial integration of nursing education in the southern states.

Nurse Advocacy

McCready’s pursuit for entrance into the segregated UMSON is reflective of the Canadian Nurses Association’s definition of advocacy as:

… engaging others, exercising voice and mobilizing evidence to influence policy and practice. It means speaking out against inequity and inequality. It involves participating directly and indirectly in political processes and acknowledges the important roles of evidence, power and politics in advancing policy options. (Canadian Nurse, n.d., p.1)

...the current emphasis on nurses as advocates for vulnerable individuals is evolving toward a broader social justice advocacy model. Professional nurses have a long, proud history of advocating for their patients, social justice, and the profession (Mathews, 2012 & Mahlin, 2010). Mathews (2012) notes, “In prior eras, visionary nurses realized the need for associations in order to meet the changes occurring in the social, cultural, and economic sectors of their world” (p.1). Since the late twentieth century, most of the professional literature on advocacy has focused on the role of the nurse as patient advocate (Ball, 2006, Brearly, 2013, Hanks, 2008). However, Paquin (2011) argues that the current emphasis on nurses as advocates for vulnerable individuals is evolving toward a broader social justice advocacy model. After providing several definitions of advocacy, Tomajan (2012) concludes “that the role of an advocate is to work on behalf of self and/or others to raise awareness of a concern and to promote solutions to the issue” (p.1). McCready merged advocacy for self and advocacy for social justice as she sought to pursue her nursing education at UMSON.

Esther McCready’s Early Life Experiences

Esther Elizabeth McCready was born on January 10, 1931 in Baltimore, Maryland. She was one of four children born to Elizabeth McCready, a housekeeper, and John McCready, a laborer (Hobbs, 2004); neither parent was active in political or civil rights issues. McCready remembers a happy childhood and a loving home. She chose a career in nursing as a young child and has recalled, “I knew at age 8 what I wanted to do when I grew up. When I went for my yearly physical examinations, I saw nurses, and I decided I’d like to do what they were doing” (Smith, 2008, p.32). As a child, McCready was independent and remembers entertaining herself for hours with her toys or practicing the piano. She did not need company to be content. This trait would later serve her well (E. McCready, personal communication, June 30, 2014).

McCready was a child during the era of racial segregation (1896-1964), and Maryland and the city of Baltimore enacted laws banning African Americans from tax-supported, Whites-only, public schools, libraries, parks, hospitals and neighborhoods, while providing them with separate, yet inferior, public counterpart institutions. African Americans in Baltimore were legally discriminated against in areas of employment, housing and education. Overall, their health was poorer and lives shorter than Baltimore’s white citizens (Smith, 2008).

...to comply with law to provide separate, but equal, education for African American prospective nursing students, the Baltimore-based UMSON paid tuition for three African American women each year to study nursing at Meharry Medical College in Nashville, Tennessee. McCready was an honors student at the segregated Dunbar High School in Baltimore and also worked as a nurse’s aide at Sinai Hospital. Her work experience solidified her desire to become a Registered Nurse. In the late 1940s, the private Provident Hospital School of Nursing in Baltimore was the only nursing program in the area open to African American students. However, to comply with law to provide separate, but equal, education for African American prospective nursing students, the Baltimore-based UMSON paid tuition for three African American women each year to study nursing at Meharry Medical College in Nashville, Tennessee. This arrangement maintained the exclusively white campus at the UMSON. McCready did not want to attend Provident’s program, nor did she want to move to Tennessee (McCauley, 2005). After graduating from high school in February, 1948, McCready worked full time at Sinai Hospital on the ground floor maternity ward. The Director of Nurses planned to put McCready on the evening shift, but her mother was uncomfortable with her coming home late at night. So McCready found a new day job in the Johns Hopkins Hospital (Hopkins) medical records department (E. McCready, personal communication July 28, 2014).

During a lunch break at Hopkins, she and a co-worker, who was also a former high school classmate, discussed pursuing nursing careers. McCready recalled their conversation:

‘I [McCready] think it is a shame that because of our race, there is only one school in Baltimore that we can attend. Let’s write to the White schools in the area asking for applications.’ My friend said ‘You know what they will say.’ I [McCready] told her I know what they will say but let’s write them anyway.’ My friend asked ‘Where will we get the names of the schools and what will we say?” I [McCready] told her ‘The telephone directory. You take the first half and I will take the second half. Let’s tell them we are Negroes because we were not trying to pull the wool over anyone’s eyes.’ I knew what they were going to say, but I wanted to make them say it (E. McCready, personal communication, July 28, 2014).

The UMSON was the only White school that sent McCready an application. McCready believed that she and her friend were divinely inspired to write to the White schools, disclosing their racial heritage, even though they anticipated a negative response. She resolved that she should not be deprived of the opportunity to study nursing and live close to home as did local White students. Several schools promptly responded by stating they did not accept Negro students. Others referred McCready to religious-based nursing programs located out of state. The UMSON was the only White school that sent McCready an application. She has often wondered if the person who sent the application was terminated from employment (E. McCready, personal communication, July 28, 2014). When McCready received an application from UMSON and discovered her friend had not, McCready suggested her friend apply to the UMSON along with her. The friend declined in order to first observe the consequences of McCready’s application to UMSON.

McCready completed the application and, in order to meet admission requirements, visited her physician, Dr. Rayner Brown, for a mandatory physical examination. After discussing her plans, Dr. Brown inquired if McCready had contacted the National Association for the Advancement of Colored People (NAACP) for support with the application. Since 1909, the NAACP had been in the forefront of the struggle for racial equality and integration. Dr. Brown indicated that McCready would not get accepted to the UMSON without help from the NAACP, despite the fact that UMSON had responded by sending McCready an application. McCready received opposite advice from her dentist, Dr. Oris Walker, a younger man than Dr. Brown, and as naïve as McCready about Civil Rights matters. Dr. Walker believed that since she started the effort on her own, she should continue it on her own without contacting the NAACP (E. McCready, personal communication, July 28, 2014). Shortly after her healthcare visits, she was contacted by NAACP Baltimore Attorney Donald Murray regarding her plan to attend the UMSON (Kelly, 2009). During their meeting, Murray encouraged her to consult NAACP Chief Counsel, renowned Civil Rights attorney and Dean of the Howard University School of Law in Washington, D.C, Charles Hamilton Houston. During McCready’s private meeting with Houston, he asked if anyone “put her up” to trying to integrate the UMSON. McCready recounts the conversation:

After listening to my story of how this all came about, he was satisfied and told me I was very brave. He advised me to continue on my own and to contact the NAACP if I had any problems. Dean Houston advised me to send all of my correspondence to UMSON through Registered Mail to have proof that they received my letters (E. McCready, personal communication, June, 30, 2014).

McCready sent her application to the UMSON admissions office in the winter of 1949 for admission to the August, 1949 class. She waited through the spring and summer of 1949 for their response, during which time White students were receiving their decision letters (Hobbs, 2004). She would periodically contact the admissions office and was repeatedly told the admissions committee was reviewing her credentials. In August, 1949, the UMSON welcomed its new class of nursing students, yet McCready had not been notified of a decision concerning her application. She contacted Attorney Murray, who then contacted Dean Houston, who informed McCready “They had no intention of admitting you. We will take them to court.” Houston then became a co-counsel with Mr. Murray in McCready’s case. (E. McCready, personal communication, June 30, 2014).

A Brief Review of Pertinent Legal Cases

Plessy v. Ferguson

In Plessy v. Ferguson (1896), the U.S. Supreme Court upheld the legality of state laws requiring racial segregation in public facilities as long as the facilities for each race were "separate but equal.” Soon after the decision was reached all the southern states, including Maryland, passed laws excluding African Americans from their public, tax supported colleges and universities.

Gaines v. Canada

Forty-two years later, the United States Supreme Court mandated in the Missouri ex rel. Gaines v. Canada (1938) case that if states provided a graduate or professional school for White students The Supreme Court further ruled that offering scholarships to African American citizens to attend out-of-state graduate and professional schools did not satisfy the intent of Plessy v. Ferguson. they must provide equal in-state education for African Americans. States could satisfy this requirement by allowing African Americans and Whites to attend the same graduate or professional school or by creating an equal graduate or professional school for African Americans. The Supreme Court further ruled that offering scholarships to African American citizens to attend out-of-state graduate and professional schools did not satisfy the intent of Plessy v. Ferguson (Bluford, 1959). Until the decision in McCready’s case against the UMSON, southern states generally ignored or circumvented the Gaines decision.

Educational Options for African American Students

Meharry Medical College (MMC) in Nashville, Tennessee was founded as a private, Methodist school for newly freed slaves in 1876 and later became one of the most distinguished institutions for educating African American healthcare providers in the South (Summerville, 2002). However, by the 1940s, the cost of educating physicians, dentists, pharmacists, and nurses at MMC was outstripping the revenues brought in by tuition and donations. Beginning in the early 1940s, several southern states made arrangements to pay the tuition, room, and board for a limited number of African American students from their respective states to study health professions at MCC (Reid, 1951). These states sought to meet the requirements of recent Supreme Court decisions while maintaining segregation at the all-White campuses within their borders. In 1949, 16 southern states and MCC agreed to form the Southern Regional Educational Board (SREB) making MCC a publicly-owned and publicly-funded, multi-state institution. Esther McCready was the first person to challenge the SREB multistate compact when she legally challenged the UMSON admissions policies that same year (Reid, 1951).

Esther McCready’s Day in Court: McCready v. Byrd, 73 A.2d 8

McCready’s case was heard in the Baltimore City Courts in October of 1949. Before the court date, the University of Maryland sent Dr. Maurice Pincoffs, Chairman of the University of Maryland Medical School and chief physician at the University Hospital, to visit and observe the MMC campus. He testified at trial that MCC was a fine school and comparable to the UMSON. However, under cross examination by McCready’s attorneys, Dr. Pincoffs indicated, when asked how much time he had spent on the MCC campus, that he visited for only 6 hours (E. McCready, personal communication, June 30, 2014).The Dean of the UMSON, Florence M. Gipe, RN, also testified at the trial on behalf of the university system. She was asked if other African American students had sought to attend the UMSON and replied that none had applied. McCready’s attorneys pointed out that since McCready lost the first round of her legal battle in the Baltimore City Courts. racial data was not collected on the application form it was impossible to know if other African American students had ever applied to UMSON.

Despite inconsistencies in Drs. Pincoffs’ and Gipe’s testimony, McCready lost the first round of her legal battle in the Baltimore City Courts. The news of the court’s decision received national attention when an article written by reporter Joe Lewis appeared in the New York Age. He reflected the opinion of the African American community and its White allies when he wrote:

I ran across a piece in the papers recently about an ambitious young lady who wishes to enter the nursing profession but she is prevented from attending a school in Baltimore where she lives because she is a Negro. Now that is bad. Recently there was an epidemic of polio going around and there was a cry for more nurses. Hospitals were understaffed and the sick did not get sufficient care because there was a lack of nurses. The young lady, one Esther Elizabeth McCready, was born in Baltimore reared in Baltimore and went to school in Baltimore and now they want to send her to Nashville. The Baltimore Supreme Court Judge Smith dismissed a suit which would have compelled the University of Maryland, a nursing school, to accept the young 18 year old. Can you beat that! A man who is supposed to see that the Constitution of the United States is carried out to the letter took that un-American attitude! The young lady is fighting her case. (Lewis, 1949, p.14).

Houston immediately appealed the decision. Due the potential length of time until the appeal was heard, the NAACP and McCready’s lawyers suggested McCready continue her education by enrolling in classes at Morgan State College, a nearby African American public college (E. McCready, personal communication, July 28, 2014). Shortly after the Baltimore City court’s decision, Houston suffered a myocardial infarction and was confined to a Washington, D.C. hospital. As the date of the appeal neared, Houston remained hospitalized. The NAACP suggested that local Baltimore Attorney Murray should accept co-counsel from NAACP Attorney Thurgood Marshall, a future Supreme Court Justice, to assist with the appeal. deShazo, Guinn, Riley and Winter (2013) provide details of what happened next:

She was rejected and simultaneously offered state support to attend Meharry School of Nursing. Unexpectedly, McCready sued the state and Governor William Preston Lane Jr. of Maryland for admission to the University of Maryland on a claim of discrimination. Maryland replied that provisions for the education of African American Maryland residents in nursing existed in a contract between the SREB and Meharry Medical College and that should suffice, as it was separate but equal … Maryland won the McCready suit in Baltimore City Court but lost in the Maryland Court of Appeals in April of 1950.

The Maryland Court of Appeals ruled in favor of McCready on April 14, 1950. The UMSON was ordered to accept her as a student in the class beginning in the fall of 1950. A portion of that ruling reads:

A Negro petitioner, who had all the educational and character requirements for admission to the school of nursing at the University of Maryland, and who was denied admission solely because of the her race, was denied equal protection of the laws, notwithstanding that the University had offered the petitioner an equally good course of nursing in another state at no more expense pursuant to an interstate compact.

McCready and Attorney Murray went to Houston’s hospital room to share the good news. Unfortunately, this was Houston’s last civil rights victory as he died eight days later on April 22, 1950 (Brent, 2009).

Consequences of McCready v. Byrd, 73 A.2d 8

...the Civil Rights Act of 1964 forced segregated nursing programs to open their doors to all qualified applicants regardless of race. The ruling in the McCready v. Byrd, 73 A.2d 8 case nullified the MMC-SERB agreement and had far-reaching effects towards the ending of racial segregation in higher education. In 1950, Kentucky integrated its state-supported schools of nursing and hospitals; West Virginia followed in 1954. States practicing segregation could no longer use the MCC–SERB agreement to satisfy the “separate but equal” doctrine. The North Carolina Legislature chose, in 1953, to open two Bachelor of Science in Nursing (BSN) programs for African Americans, at Winston-Salem State University and at the Agricultural and Technical College in Greensboro, rather than integrate the University of North Carolina at Chapel Hill’s existing BSN program (Pollitt, 2014). Other southern states followed North Carolina’s example for another decade until the Civil Rights Act of 1964 forced segregated nursing programs to open their doors to all qualified applicants regardless of race.

Esther McCready’s Student Days at UMSON

Although Esther McCready’s court battle was behind her... Although Esther McCready’s court battle was behind her, difficulties lay ahead for her in the newly-integrated UMSON. McCready’s lawsuit and its outcome received a significant amount of local press, and all officials and students at the UMSON knew she would be attending the university. There was a tradition at the UMSON for junior and senior students to choose a “little sister” from the entering class to mentor during their first year in the program. The summer before arriving on campus McCready received a letter from Virginia Mathews, saying she chose to be McCready’s “big sister.” However, Mathews was married, lived off campus, and had several health problems, so she was not available much of the time (Brent, 2009). In her note to McCready dated August 25, 1950, Mathews wrote:

I’m sure the difficulties you’re going to encounter have been thoroughly pointed out to you so I’ll just say that I greatly admire your courage and you may count on me to do everything in my power to help you. (Pioneers of diversity, n.d.)

She recalled, “I went by myself to the first day … Nobody spoke. Nobody said ‘Hi. Come and join us’” (Kelly, 2009). She entered the classroom, and all of the 40 or so white students were already seated. McCready introduced herself to the instructor and was told to take a seat. No one spoke to her, sat near her, or walked with her as they toured the hospital and school of nursing facilities. McCready was standing by an elevator on Orientation Day when an instructor said to her “If you don’t pray to God, you won’t get out of here, because nobody here is for you.” McCready replied “If God intends for me to get out of here, nobody here can stop me.” That same day she became the first African American to eat in the formerly white cafeteria. She remembers the negro dietary aides were proud of her and smiled encouragingly as she passed through the line (E. McCready personal communication, July, 28, 2014).

Despite the fact that the UMSON traditionally provided housing for its students, McCready was informed in the summer of 1950 that she would have to commute since there were not enough dormitory rooms available for all students entering in the fall. In addition to social shunning from students and faculty, McCready’s lack of university housing further isolated her from the campus community. Two Jewish students were also informed there were not enough dormitory rooms and they would also have to commute to school. McCready believed “this was done to make it seem legitimate, that I was not the only one being denied a room in the nurse’s dormitory” (E. McCready personal communication, July, 28, 2014). Several months later, McCready asked one of the Jewish students how her parents felt about her commuting; she replied that the Jewish students had been given rooms in the dorm.

McCready then called NAACP Attorney Murray who inquired about the situation with Dean Gipe. Gipe indicated McCready could move into the dorm after the capping ceremony signifying the end of the probationary period. Those students, including McCready, who had nurse’s aide or candy-striper experience were allowed to start working on the wards after a three-month probationary period, an honor that the less experienced students earned several months later. McCready did indeed move into the nurse’s dormitory after the capping ceremony. The Dean lived in a suite on the 2^nd floor and students lived on higher floors in the dormitory. McCready, however, was assigned to a second floor space that had formerly been an office and was the only student sharing a floor with the Dean. Consequently, McCready was denied social interaction among the students.

Life was not much better in the classroom than in the dormitory for McCready. She recalled a physician lecturer who turned his body to the opposite side of the room in order to avoid any contact with her. He never once looked at her except to locate her seat in the classroom. She reacted to his behavior by saying “I can still hear you and I am taking notes to prepare for the exam” (E. McCready, personal communication, June 30, 2014).

McCready’s ability to enjoy time alone served her well as a student at the UMSON. The Maryland Women’s Hall of Fame entry for McCready summarizes her nursing school experiences this way:

During her years at the UM School of Nursing, Ms. McCready faced students who were hostile to her, professors who ignored her, and supervisors who attempted to sabotage her work. Through it all, she maintained a quiet dignity and determination that could not be defeated (Hobbs, 2004).

McCready drew strength from many sources in order to survive this tumultuous time in her life. McCready drew strength from many sources in order to survive this tumultuous time in her life. Her faith and family, especially her mother, provided unwavering support. Her legal team was always interested and ready to respond to any untoward problems she experienced in nursing school. McCready did note that commencement of classes and clinical work brought friendship and support from students and hospital staff. The next year, 1951, the UMSON admitted three African American students who roomed together and had a much easier time with their classmates and instructors. Also in that same year, the UM Hospital hired African American Registered Nurses for the first time in history.

McCready never quite escaped discrimination at the UMSON. The final instance occurred at the dinner dance for the graduating class in the spring of 1953. All seniors were invited to attend and any who had received scholarships or other awards were publicly honored for their achievements. McCready’s mother was a housekeeper for a group of Catholic priests and a visiting priest learned about McCready’s story and decided she should receive a reward for her struggle and determination to complete her education. He coordinated a scholarship fund donated by physicians at his local hospital for McCready to continue her education. The amount of money raised was enough to cover travel expenses and tuition and fees for two years at an institution of her choice. McCready’s scholarship was written into the draft of the awards program, but her name and honor were not publicly announced the night of the ceremony (E. McCready personal communication, July, 28, 2014).

McCready’s Journey After Nursing School

McCready’s experiences of racial discrimination continued after her graduation in 1953. McCready took her state board of nursing examinations shortly after graduation, and the building in which the exams were given did not have an open dining room. White test takers had their choice of a variety of local restaurants at which to eat a quick lunch. McCready and several other African American test takers were required to travel for lunch at the Pennsylvania Station lunch counter since it was the only local place they would be served. Despite this challenge, she passed the examination on her first attempt.

Once licensed, McCready considered a career in the U.S. Navy. In the early 1950s, there were racial quotas in the Navy Nurse Corps with a limited number of openings for African American nurses. McCready completed all the steps towards becoming a Navy nurse. She recalls that during her physical examination, the last step in the process, the physician who examined her said “It looks like everything is in order” (E. McCready, personal communication, June, 30, 2014). A short while later, she was notified that her application was denied because she wore eyeglasses. McCready believes she was denied entry because the Navy met the quota for African American nurses that year. A year later, the Navy recruiter offered her a position in the Navy Nurse Corps but she did not accept the offer (E. McCready, personal communication, June 30, 2014). Instead, she accepted a position as a Registered Nurse with the Baltimore City Health Department. McCready had a varied career in nursing, including working three years in post-operative recovery with subsequent promotion to Head Nurse of an OB-GYN recovery unit at New York Hospital – Cornell Medical Center.

McCready’s Continued Education and Advocacy

In her personal life, McCready has always enjoyed using her vocal talent and singing. She studied voice for two years as a special student at the Peabody Conservatory of Music in Baltimore and then earned a Bachelors and a Master's degree in music at the Manhattan College of Music in New York City. Subsequently, this led to an educator position in the New York City school system for 17 years, including time spent as the “teacher in charge” of a newly created junior high school of performing arts. However, McCready never lost touch with the nursing profession, working per diem jobs until her retirement from nursing in 1986. For many years she taught first grade full time, worked per diem as a Registered Nurse in the Harlem Hospital Emergency Department, and sang professionally as part of the choral ensemble at the Metropolitan Opera in New York City. One of their productions was the folk opera Porgy and Bess. An opportunity to travel through Europe and the United States singing in the chorus of Porgy and Bess with the Metropolitan hastened her retirement from the school system in 1996. In the 1990s, McCready was hired as the first academic tutor for Raven Symone, the actress who played Olivia on the Cosby Show. (E. McCready personal communication, July, 28, 2014).

McCready remained an advocate for Civil Rights primarily through her work in electoral politics. McCready remained an advocate for Civil Rights primarily through her work in electoral politics. Her pastor, Reverend Adam Clayton Powell, Jr., of the Abyssinian Baptist Church, was the first African American from New York to serve in the U.S. Congress. He served for 26 years and had 13 successful campaigns to keep his seat. McCready worked on many of his reelection campaigns during the years she lived in New York City. In April of 1959, McCready attended the “Youth March for Integrated Schools” in Washington, D.C. and sat next to Reverend Dr. Martin Luther King, Jr. on the train heading north after the march. He had a planned speaking engagement in Delaware and she was returning home to New York City (E. McCready personal communication, July, 28, 2014).

McCready returned to her hometown of Baltimore in 1996 after her retirements from nursing and teaching. She has received numerous honors for her courage in fighting segregation and creating opportunities for others seeking a nursing education. McCready has remained in contact with the UMSON. For eight years, she served on the Board of Visitors, a group of professional and community leaders who contribute time, knowledge, and philanthropy to sustaining excellence in undergraduate and graduate nursing education. McCready has donated artifacts to the UMSON Museums, the Reginald F. Lewis Museum, the Maryland Women’s Heritage Museum, and the Maryland Historical Society. In 2004, McCready was inducted into the Maryland Women’s Hall of Fame. Esther McCready is an unsung heroine of the nursing profession. The courage and dignity she displayed while standing up for her rights against discriminatory laws and institutions is an inspiration to all nurses seeking a just and fair society. McCready offered several pieces of advice for nurses today:

Don’t be discouraged because life doesn’t happen the way you thought it would … maybe the Lord has other plans. Set goals and never let anyone tell you that you cannot achieve your goals. Hold onto your dreams, if you work hard and stay focused your dream today, it can become your reality (E. McCready, personal communication, June 30, 2014).

McCready’s words and actions serve to inspire nurses today to continue our collective struggle to create equity and fairness in our profession, our workplaces and in our lives.

Conclusion

Racial discrimination persists despite the fact that the United States ended legal segregation with the enactment of the Civil Rights Act of 1964. Integration of higher education, healthcare agencies, and state constituencies of the American Nurse Association was accomplished by the mid-1960s (Baldwin, 2003). According to recent analyses of Healthy People 2010 objectives, the leading health indicators have demonstrated little improvement in disparities over the past decades. Significant racial and ethnic health inequities permeate the major dimensions of healthcare, the healthcare workforce, population health, and data collection and research (National Center, 2012)

...advocacy from each and every professional nurse is required to end racism and discrimination in health and healthcare. As nurses identify and implement plans working towards a more equitable society, the words of Florence Nightingale ring true, “Let us run the race where all may win – rejoicing in their successes - as our own – and mourning their failures, wherever they are – as our own. We are all one nurse” (Dossey & Kegan, 2013, p.40). Acknowledgement of the problem, and plans to eliminate racial inequalities, in health indicators, higher education, and healthcare employment have been mandated by governmental and national health professional associations. Yet, advocacy from each and every professional nurse is required to end racism and discrimination in health and healthcare.

Acknowledgement

I offer my sincere appreciation to Ms. Esther McCready, RN, who served as an invaluable resource in preparing this article. Through numerous conversations and draft revisions she has enabled me to tell her story to a wide nursing audience. Her bravery in the face of dire circumstances is exemplary. I take responsibility for any errors in this article.

Author

Phoebe A. Pollitt, PhD, RN
Email: pollittpa@appstate.edu

Phoebe Pollitt practiced public health nursing in Appalachia for over 20 years before teaching nursing at Appalachian State University. She is currently an Associate Professor and teaches community health, nursing research and concepts of professional nursing. Her research interests are nursing history and health disparities.

McCauley, M.C. (2005, June 22). Bridges to the past. The Baltimore Sun. Retrieved from http://articles.baltimoresun.com/2005-06-22/features/0506220262_1_mccready-nursing-school-permanent-collection. < /p>

Missouri ex rel. Gaines v. Canada, 305 U.S. 337 (1938)