The woman who defied the odds as the first Black nurse in the U.S.
At a time when Black women were largely excluded from formal training, Mary Eliza Mahoney set a new standard for who could serve in American hospitals.
Sixteen-hour days, seven days a week, scrubbing floors, emptying bedpans, and eventually assisting nurses and doctors. For 15 years, Mary Eliza Mahoney toiled at Boston’s New England Hospital for Women and Children as a maid, cook, and washerwoman. These were the only jobs open to Black women during an era historians now darkly recall as “the nadir of American race relations.”
Despite how limited her options were, Mahoney dreamed of being at the forefront of patient care. In 1878, a 33-year-old Mahoney applied to nursing school at the hospital where she worked. Although she was two years older than the program permitted, the administrators waived the age requirement, as they'd seen years of her work.
Mahoney became the first Black professionally trained nurse in the United States and also went on to raise nursing’s standards and open its doors to other Black women, insisting that professional excellence and racial justice were inseparable.
Mahoney’s early life
Her parents, Charles and May Jane Stewart Mahoney, were born enslaved in North Carolina, and although the record is incomplete, it’s believed they self-emancipated in the early 19th century. The couple relocated to Massachusetts, which had abolished slavery in 1783 and was a hotbed of abolitionism in the lead-up to the Civil War.
(It took more than 200 years to end slavery. Juneteenth honors that fight.)
Mahoney was born in 1845 in Boston, the eldest of three children. In 1855, tireless protests by Black equal-schools activists compelled the Massachusetts legislature to outlaw school segregation. At age 10, Mahoney enrolled in first grade at the Phillips School, one of the first schools to desegregate under the new legislation.
Mahoney showed an early interest in nursing, working as an untrained practical nurse for Boston families in her late teens. The work was poorly paid and often indistinguishable from domestic service, particularly for Black women, encompassing many of the same duties as a maid.
But the women would soon gain legitimacy in the healthcare field with the outbreak of global wars. Florence Nightingale’s work during the Crimean War in the 1850s earned her the title of the founder of modern nursing and bolstered nursing’s reputation internationally. Sojourner Truth and Harriet Tubman’s service during the Civil War further expanded notions about patriotic caretaking even as their own citizenship as Black Americans was denied. By the time Mahoney was 16, the outset of the Civil War had increased the visibility, legitimacy, and recognition of nursing as a profession.
Breaking barriers in Boston and beyond
In 1862, German-born doctor Marie Zakrzewska founded the New England Hospital for Women and Children in Boston. One of only two hospitals in the country staffed solely by women, it was rare in accepting both Black and white patients. The 1863 founding charter made explicit Zakrewska’s intent “to provide for women medical aid by competent physicians of their own sex; to assist educated women in the practical study of medicine; to train nurses for the care of the sick.”
When the hospital launched the first professional nursing school in Boston 1872—and the second in the entire country—Mahoney had worked there for years, having been hired as a teen. Forty-two candidates applied. Nine were admitted. And after 16 grueling months—daily shifts from 5:30 a.m. to 9:30 p.m., caretaking entire wards of six patients at once, earning meager wages of which 25 percent was paid back to the financially strapped hospital—only three students graduated. Mahoney was one of them.
She graduated in 1879 at age 34, as Reconstruction was being dismantled and the white supremacist order hardened in both North and South. Mahoney had been the only member of her cohort who did not miss a single day of training—a telling detail in a country that has long demanded Black Americans be twice as good to get half as far.
(Reconstruction offered a glimpse of equality for Black Americans. Why did it fail?)
Although licensed at a time when few white nurses were credentialed, hospitals refused to hire Black nurses. Mahoney instead became the first Black nurse to register with the Nurses’ Directory at the Massachusetts Medical Library, spending most of her career as a private nurse for wealthy white Boston families. In 1954, one of Mahoney’s patients told an interviewer, "I owe my life to that dear soul.” Alongside her sister, Mahoney listed that same patient as her “next of kin” when she entered the hospital before her death.
Black nurses were routinely treated as domestics, but Mahoney—having long since paid those dues as a hospital maid—resisted with quiet, calculated dignity. One biographer notes that Mahoney’s “way of distinguishing herself in protest was by refusing to eat in the kitchen with the household help, separating herself and choosing to eat alone.”
Mahoney’s legacy and impact on healthcare
In 1896, Mahoney joined what is now the American Nurses Association, becoming one of its first Black members. In 1908, she became a founding member of the National Association of Colored Graduate Nurses (NACGN), which spent four decades dismantling racist barriers and raising standards across the profession. Mahoney personally brought in many of its earliest members.
For a brief stint from 1911 to 1912, Mahoney was director of the Howard Colored Orphan Asylum for Black children in Long Island, New York. There, she oversaw the farm school’s efforts to care for and educate the children in its care. She would later return to Boston. On August 18, 1920—the day the 19th Amendment was ratified—Mahoney became one of the first women to register to vote in Boston at age 76. She died of breast cancer on January 4, 1926, at the New England Hospital for Women and Children, known today as the Dimock Center, where she had labored, learned and made history.
Mahoney’s impact was felt throughout her lifetime as the number of Black nurses in America doubled between 1910 and 1930 due in part to her recruitment and organizing efforts.
She also became the namesake for one of the highest honors in American nursing. The Mary Eliza Mahoney Medal, first awarded by the National Association of Colored Graduate Nurses in 1936, continued to be distributed after the organization merged with the American Nurses Association in 1951. Mahoney was inducted into the American Nurses Association Hall of Fame in 1976, and the National Women’s Hall of Fame in 1993. In 2006, the U.S. House passed a resolution honoring Mahoney as America's first professionally trained African-American nurse. The City of Boston’s Archives and Records Management division honored Mahoney’s memory by naming its project to transcribe early women’s voter registrations the Mary Eliza Project.
Perhaps Mahoney’s ultimate legacy is how she changed patient care in a country where research has consistently demonstrated that healthcare professionals are more likely to dismiss or ignore Black patients’ reports of pain. Multiple studies show Black patients experience improved health outcomes, lower mortality rates, and increased trust with Black nurses and doctors. These professionals, studies confirm, are more likely to take black patients’ pain seriously, communicate with greater cultural competency, and provide care that recognizes racial harms and prior discrimination. Mahoney’s legacy proves representation not only matters—but can be lifesaving.
(Maternal mortality is high in the U.S.—especially if you’re Black.)
