The Bolton Act
Making the Nursing Profession More Accessible to Everyone
It’s been called “the most significant nursing legislation in our time” and played a significant role in supporting the U.S. war effort during the final years of World War II. The Bolton Act of 1943, sponsored by FPB’s namesake and benefactor Frances Payne Bolton, introduced the nation’s U.S. Nurse Cadet Corps and at the time was considered the largest experiment in federally subsidized education in the history of the United States.
The year 2008 saw the sixty-fifth anniversary of the passage of the Bolton Act. Last August, U.S. Representatives Steven C. LaTourette and the late Stephanie Tubbs-Jones introduced legislation to Congress to recognize the significance of that historical measure. “It was a wonderful idea to honor the Bolton Act on its 65th anniversary because it has done so much to improve nursing education in this country,” Rep. LaTourette said. “Frances Payne Bolton single-handedly made sure we had enough nurses at home and overseas during World War II and helped elevate nursing as an important profession for women.” On May 7, 2009, Rep. LaTourette took to the floor of the U.S. House of Representatives to recognize Mrs. Bolton's acheivements officially.
Yet as the congresswoman from Cleveland's 22nd District for 29 years, Frances Payne Bolton was a vigorous advocate for not only nurses but also for women, African Americans, and other minorities. Born in 1885 into an affluent family on Cleveland’s former “Millionaires’ Row,” as a young woman Mrs. Bolton volunteered for the Visiting Nurse Association to accompany nurses—seen at the time as little more than second-class citizens—on their rounds throughout the city’s poor and ethnic neighborhoods. It was an experience that awakened her to the struggles of the less fortunate and served as the impetus for her passionate efforts on their behalf throughout her lifetime.
Mrs. Bolton assumed her position as congresswoman—the first in the state of Ohio and the seventh in the U.S. House of Representatives—after her husband, Chester C. Bolton, died in office in 1939. Despite having never held political office herself, Mrs. Bolton was already well-versed in civic affairs. Promotion of “nursing, nursing education, and the general care of the sick” was one of her chief political causes, and after winning a special 1940 election in her own right, she soon saw the need to boost the ranks of nurses for the war. The Bolton Act, enacted on June 15, 1943, accomplished this by appropriating $160 million in federal funds ($65 million in the first year alone) to 1,125 nursing schools all over the country, including those that educated African Americans. It created the U.S. Cadet Nurse Corps, which over the next five years produced 124,065 graduates out of 169,443 enrollees. The Corps united American nurses from diverse backgrounds to work for a common purpose. By 1945, 85% of all nursing students in the country were Cadet Nurses, and the Corps’ funding “represented more than half of the entire U.S. Public Health Service budget.”
Nursing, Mrs. Bolton declared, was the “number one service for women, not only in a time of war when hundreds of thousands of men’s lives depend upon nursing care, but also in peace time—for the nurse is not only caring for the sick but also teaching health.” Introducing an unprecedented non-discriminatory clause, the Bolton Act opened up the nursing profession to all women between the ages of 17 to 35 who had completed high school and were in good health. For minority women in particular, the Act was their best opportunity to not only receive a nursing education but also to respond to their country’s patriotic call to service at an urgent time in history. With assistance from the National Association of Colored Graduate Nurses, more than 3,000 African American women answered that call, in addition to 350 Japanese Americans and forty Native Americans.
All members of the U.S. Cadet Nurse Corps received tuition scholarships, monthly stipends, and payment of all other education fees, including the cost of books and uniforms. The Act “designate[d] student nurses as having answered the call of their country for this vital work” by stipulating only that they complete their education within thirty months and pledge themselves to serve in “military or essential civilian nursing throughout the war.”
The Corps inspired an ubiquitous national marketing campaign that made use of all available media formats of the day, including newspapers, magazines, radio, and cinema. Well-known corporations such as Pepsi Cola, Eastman Kodak, Sanka Coffee, Nabisco, and Pond’s Cold Cream juxtaposed images of attractive and confident Cadets with their own products; Hollywood personalities like Shirley Temple and Dorothy McGuire appeared in photographs and films featuring recruits in their fashionable uniforms. Such efforts helped to make nursing among the hippest, most promising career paths for tens of thousands of women who until that time were more likely to be limited to domestic or office work.
Although the Corps’ last cadets graduated in 1948, the Bolton Act had a profound effect on nursing education. The Corps’ emphasis on an academic approach over apprentice-style training led to increases in course offerings and faculty sizes in the ensuing years. The respect and authority that nurses gained via their wartime experiences gave women more opportunities for both undergraduate and postgraduate education, integrated previously white-only institutions, and diversified nursing into areas such as convalescent care, public health, pediatrics, tuberculosis, and psychiatric care.
As Mrs. Bolton declared in a radio speech for the announcement of the Bolton Act, the program that it created would bring nurse education from “crude apprenticeship to scientific preparation for a broad and contributive professional career.” To her, nurses were the individuals who brought “light, easement, intelligence, and understanding where there was darkness.”