Nurses Building a Nation: Healthcare and Policy in the Indian Service, 1924–55

Building on recent scholarship illuminating maternalism in the American West, this study explores relationships between white women and Native Americans.  Functioning much like public health nurses, white field nurses provided healthcare services to native peoples on Indian reservations from 1924-1955.  Endorsing scientific medicine as the treatment of choice, such women formed public health programs and influenced policy.  This paper thus answers, in part, recent calls for studies connecting the American West to policy development. 

To say Native American healthcare under the auspices of the Bureau of Indian Affairs (BIA) by the mid-1920s was substandard would be a gross understatement.  Therefore, in an attempt to meet its obligations, the BIA began to establish a field nursing program.  Federal officials had long championed biomedicine as a means of assimilation, but such policy sometimes conflicted with nursing objectives; hence, nurses confronted choices between enforcing assimilation policy and respecting indigenous value systems as they developed plans of treatment.  Such women responded to Americanization goals in a variety of ways, and a number of white nurses employed creative strategies to bypass policy in favor of more pragmatic, yet equally effective, methods of healthcare delivery.

Often located in rural areas, white field nurses in this study retained a high level of autonomy decades after “civilization” policy gave way to cultural relativism during the 1930s; throughout the forties and fifties, they continued to make policy at the grassroots.  Schooled in biomedicine, such nurses simultaneously promoted western healthcare over native practices while paradoxically finding ways to accommodate indigenous healing.  In this fashion, such white women both observed and reconstructed federal health policies in the American West as they sought positive outcomes for the peoples they served.