Gardner, Mary Sewall (1871–1961)

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Gardner, Mary Sewall (1871–1961)

American nurse and social reformer, who was a pioneer in the field of public health nursing and the force behind the founding of the National Organization for Public Health Nursing. Born in Newton, Massachusetts, on February 5, 1871; died on February 20, 1961, in Providence, Rhode Island; daughter of William Sewall Gardner and Mary (Thornton) Gardner; had half-brother, Charles Thornton Davis; never married; no children.

Born in New England in 1871 into a distinguished family (her mother was a descendant of Declaration of Independence signer Matthew Thornton, and her father held a superior court judgeship), Mary Sewall Gardner grew up in an environment that emphasized civic responsibility and methodical thinking. When Mary was four, her mother died, and when her father remarried it was her stepmother Sarah Gardner , a pioneering woman physician, who gave her tangible evidence that whatever career she might choose could in fact be open to her in the future. Her affluent family sent the intelligent Mary to private schools, and for a while she also received instruction at home from a French governess. Having survived a bout with tuberculosis at age 16, she subsequently enrolled at Miss Porter's School, founded by Sarah Porter , in Farmington, Connecticut.

By 1890, her father had died, and, with her stepmother now an invalid, Gardner chose to remain at home to run the household. In her spare time, she became active in community and volunteer work. In 1892, Mary and Sarah Gardner moved to Providence, Rhode Island, and it was during Mary's first years here that she began to consider a career in one branch or another of medicine. In 1901, at age 30, Gardner enrolled at the Newport Hospital Training School for Nurses. Upon her graduation in 1905, she became superintendent of nurses (later director) of the recently created Providence District Nursing Association (PDNA). To Mary Gardner's critical eye, the PDNA revealed more weaknesses than strengths, and she set about to the fortify the organization in as many ways as possible. Fully aware that much progress was taking place in the area of public health and nursing, she visited similar service organizations elsewhere. These included, among others, Lillian Wald 's Henry Street Visiting Nurse Service in New York City. Both face to face and through correspondence, Gardner established lasting and valuable links to other public health nurses.

Many of the reforms initiated by Mary Gardner at her PDNA organization seem obvious to later generations and included such fundamental changes as introducing record systems, scheduling regular meetings, and requiring that nurses wear uniforms while on duty. Realizing that health issues were ultimately linked to broader societal problems, Gardner urged that not only nurses but all members of the health professions become involved in community organization and planning. Under its indefatigable director, the PDNA greatly expanded its services to become a model for other nursing associations not only in Rhode Island but throughout most of the United States. Starting in 1912, Gardner was able to more effectively share her experiences as an administrator because in that year she and her colleague Lillian Wald founded the National Organization of Public Health Nursing (NOPHN). In its first year, Wald served as president of NOPHN and Gardner held the post of secretary, but starting in 1913 Gardner became the organization's president, a position she held until 1916. In 1922, Gardner was named honorary NOPHN president, a distinction she shared with only the equally revered Lillian Wald. Although later generations of women often came to look upon such organizations as NOPHN as lacking in vision and concerned only with piecemeal reforms, in fact this group, in addition to the three others representing the nursing profession on a national basis, was progressive in spirit, advocating votes for women, calling for broader access to health and education, and generally believing in both the possibility and desirability of social improvement.

Of Mary Sewall Gardner's many contributions to American nursing, perhaps her greatest legacy was her classic textbook, Public Health Nursing. First published in 1916, the book was an immediate success, praised by reviewers and nurses alike for being "everywhere concrete, specific, and practical." Public Health Nursing became the Bible of nurses throughout the United States, appearing in revised editions in 1924 and 1936 and going through many printings (the last regular printing was in 1947, but in 1977 a reprint edition was included as part of the "Public Health in America" historical series published by Arno Press). A book that reflected its author's gentle manner as well as her "unusual understanding of, and respect for, human relationships," in time it became a global text, appearing in a number of foreign-language editions.

Global concerns took Gardner away from Rhode Island in 1918, when during World War I she served first as director of the American Red Cross' bureau of public health nursing, and then overseas in war-torn Italy. Here she was posted as chief nurse of the American Red Cross Tuberculosis Commission for Italy, a job she defined as one that stimulated local initiatives, including a rapid expansion of training programs for Italian women as nurses. In 1919, Mary Gardner returned from Italy to the United States, but she retained a strong interest in a continent devastated by four years of war and social upheaval. Believing she could still make a contribution in the European public health environment, in 1921 she returned to study the state of child welfare and public health nursing in France as well as in war-ravaged Eastern Europe. Now enjoying an international reputation, Gardner was chosen in 1925 as chair of the standing committee on public health nursing of the International Council of Nurses, a post she held until 1933.

Mary Sewall Gardner officially retired in 1931, the same year she received the coveted Walter Burns Saunders medal for distinguished service to nursing. As busy as ever during much of her long retirement, she remained on call to give advice, continued her prolific production of journal articles, and supervised a third and final revision of her classic textbook, Public Health Nursing (1936). Gardner also published two works of fiction during her retirement years, So Build We (1942) and Katharine Kent (1946). Both books, obviously based on her many years of administrative experience, are thoughtful examinations of the day-to-day problems of managing a nursing organization.

By the time of Gardner's retirement, the nursing profession had been radically transformed by great social changes in American society. Circumstances that had created the need for public health nurses had largely disappeared with the virtual cessation of mass immigration, the growing role of hospitals, a dramatic decline in the occurrence of infectious diseases, and a significant diminution in public concern over society's poor and weak. By the early 1930s as the nation entered a decade of economic depression, American nurses had not become the highly respected profession they felt they should be regarded as, but instead found themselves suffering from marginalization within the health-care system. Mary Sewall Gardner was concerned by these new challenges in the final years of her life, but she could also look back with pride on a long and remarkable career of service and achievement. She died in Providence, Rhode Island, on February 20, 1961. In 1986, Mary Sewall Gardner was elected to the American Nursing Association's Nursing Hall of Fame.


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——. So Build We. NY: Macmillan, 1942.

Kantrov, Ilene, and Kate Wittenstein. "Gardner, Mary Sewall," in Barbara Sicherman et al., eds. Notable American Women: The Modern Period. A Biographical Dictionary. Cambridge, MA: Belknap Press of Harvard University Press, 1980, pp. 262–264.

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Pennock, Meta Rutter, ed. Makers of Nursing History. NY: Lakeside, 1940.


Mary Sewall Gardner Papers, Schlesinger Library, Radcliffe College.

John Haag , Associate Professor of History, University of Georgia, Athens, Georgia

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Gardner, Mary Sewall (1871–1961)

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