Race and Place in Virginia - The Case of Nursing

As we round out the first week of Black History Month 2021, we will be sharing each Friday nursing stories that highlight the influence of Black nurses at UVA, across Virginia, in the U.S., and around the world. We begin with doctoral student Tori Tucker (BSN `12) who, for the past four years, has been gathering and analyzing the oral histories of influential Black nurses at UVA, in Charlottesville, and across the commonwealth for her dissertation "Moving Lines."

The impact of this work has been both expansive and profound, and provides the centerpiece of Tucker's doctoral dissertation, which will be completed and presented later this year.

Tucker's article below, first published in Nursing History Review in 2019, offers a lens on the intersection of race, history, and caregiving through the story of one special and accomplished nurse: Ms. Mavis Claytor (BSN `70, MSN `85), UVA School of Nursing's first African-American graduate. While Claytor may have been called a 'hidden' nurse, her impact, compassion, skill, poise, and inventiveness as a clinician were anything but. We salute her as one of our very finest alumni.

Race and Place in Virginia: The Case of Nursing

This article examines contested meanings of place through a case study of the educational and professional life of Mavis Claytor, the first black woman to graduate from the University of Virginia School of Nursing. It does so within the context of entrenched racialized legislation and geographically-based socio-cultural norms, as academic and healthcare centers in Virginia transitioned from segregation to desegregation in the 1950s through the 1980s. The article seeks to understand how and why Virginia became a national site for the massive resistance movement that countered school desegregation; and how, within this context, Claytor made sense of place as she entered newly-integrated programs and spaces in Virginia. History as place reveals how local nurses’ work connects to where they lived, studied, and practiced, providing a renewed lens for analysis in nursing history.

Virginia: A Place of Analysis

Black nurses’ concept of place in America is manifold, and history provides a lens for illuminating this meaning. Black nurses’ experiences cannot be understood without considering the intricate interworking of American history (colonialization, slavery, Jim Crow laws, massive resistance) and acknowledging Virginia’s central lineage within this narrative. While Virginia shares many features with other states, it also has a distinct identity as the site where slavery began in the United States. Historical context is situated in places such as Jamestown, where enslaved Africans grew tobacco in colonial settlements; in Richmond’s Lumpkin Jail, where enslaved blacks were either held, traded, or severely punished; and in Charlottesville’s Monticello, Thomas Jefferson’s plantation, where he enslaved approximately 400 laborers at this plantation site across his lifespan. Indeed, Jefferson’s Notes on the State of Virginia, written approximately a decade after the Declaration of Independence, made his views known that blacks were intellectually inferior to whites, “in endowments both of body and mind.”

In 1819, Jefferson founded the University of Virginia as a segregated institution for white men. Relevant history is also present in Virginian places such as Hampton, where northern and southern black nurses studied and mastered nursing practice at the segregated Hampton Training School for Nurses, known as Dixie Hospital Training School; in Roanoke, where black nurses learned and cared for black patients in the black-established health infrastructure known as Burrell Memorial Hospital; and in Charlottesville, where black licensed practical nursing students studied at Jackson P. Burley High School and practiced at the University of Virginia Health System. Additionally, Piedmont Sanatorium in Burkeville trained black nurses and provided tuberculosis care for black patients in Virginia from 1918 through the 1960s. Virginia continues to be a physical and intellectual incubator of American political and social movements. A detailed exploration of black nurses in Virginia not only brings a new lens to an underexplored area of nursing history, but it can also help dismantle discriminatory policies and practices from which health disparities arose.

Black Nurses’ Identity in the United States

Black women were caregivers and healers during slavery in America. Yet nursing history records often begin with the development of professional nursing institutions and at the nexus of credentialing, a metric that has often cast the white nurse as the only nurse worthy of historical merit. A deeper understanding of segregationist and exclusionary practices provides context for this gap. Black nurses predominately had three options in the early 1950s: apply to a licensed practical nursing program, a historically black professional nursing program, or apply to a nursing school that accepted black students under the restriction of quotas. Black nurses and nursing students found themselves bolstered between systemic oppression and a generational lineage of civil rights pursuits between the 1950s and 1980s. During this time, black nurses and nursing students sought to advance their professional identity and strategically address the health inequalities in the black community.

>> READ UVA TODAY'S UVA shines light of recognition on African American nurses it trained decades ago

Claytor came of age in the Jim Crow South during the 1950s and 1960s. At that time, discriminatory and segregationist practices in the United States perpetuated disparate health outcomes in the black community. National mortality and morbidity statistical comparisons between black and white citizens in the 1950s unveiled a haunting actuality surrounding the falsehood of “separate but equal”; it was in fact “separate but deadly.” Leslie A. Falk, physician and professor at Meharry Medical College, documented evidence of health disadvantages in the 1966 publication, “The Negro American’s Health and the Medical Committee for Human Rights.” Falk inquires:

"How do health and medical care fit into this scheme of things? First, let us review some of an extensive literature on the Negro’s health status. Mortality statistics are almost universally adverse when Negro and white rates are compared. The average US Negro dies seven years earlier than the average US white. In the South, a Negro male has a particularly short life expectancy—only 50 years, compared with 67 for the white male."

Statistical data use grew expeditiously between 1890 (the first census conducted by the US government) and 1950. Instituted reports such as the Vital Statistics of the United States, a national report that the US Department of Health, Education, and Welfare published, included population data collected during the 60-year period. The 1950 report, for example, included data about fetal, infant, and population mortality, showing lacks with large discrepancies compared to whites. Statistical data revealed numbers and comparison of racial groups over time, yet analysis did not acknowledge segregation or the black community’s unequal access to quality healthcare. Black healthcare professionals and other activists independently and collectively organized to disrupt the segregated medical and education system of the Jim Crow era; and black nurses, in particular, remained at the center of health and community activism.

Virginia’s Recalcitrance to Racial Integration: Massive Resistance

Black women’s fundamental human and civil rights, such as education, survival, privacy, and pleasure predicated upon a sophisticated understanding and adept navigation of the contractual nature of segregated and integrated spaces. Claytor was born into a close-knit family in 1943 to Lucy Smith Claytor. One of seven children, she and her family grew up in Callaway, Virginia, a town located in rural Franklin County. Her roots in this area are both deep and wide; she is the granddaughter of Wyatt Smith, a former enslaved laborer born in 1859. The 1865 passage of the Thirteenth Amendment abolished slavery, and Smith and his family eventually purchased their property in Franklin County. He raised his children and grandchildren on that land. Claytor’s grandfather repeatedly told her: “Do not hate. The heart has no room for hate. The heart works under the all or nothing principle. If you have a little drop of hate, it will come out.” She relied on his words often throughout her life.

Place as a construct is both the foundation and scaffold supporting and reinforcing personal identity. As Claytor negotiated aspects of segregation, she did so within a resurgent southern sectionalism that developed after World War II over divisive racial issues. Claytor attended elementary and high school in the 1950s and 1960s during a time when the law supported segregation of schools, operating under the guise of “separate but equal.” On May 17, 1954, the US Supreme Court affirmed Brown v. Board of Education, supporting education and equality advancement in the United States.

Post the Brown decision, however, white Virginians grew increasingly wary of federal involvement in state affairs. Organizers in Virginia countered the Brown ruling with militant political, social, and economic resistance, led by the Defenders of State Sovereignty and Individual Liberties. Membership in this organization increased within its first year, with 30 chapters and 12,000 members in the state by the fall of 1955. Supported by Virginia’s Governor Thomas B. Stanley, the organization’s influence reached far as it provided economic, social, and legal strategies for barring Virginia’s implementation of racial integration. Led by Senator Harry F. Byrd, Jr., a former governor, conservative lawmakers called upon the state to carry out systematic acts of massive resistance, and Virginians literally closed their schools to prevent integration. This act of resistance across the state further substantiated the unfixed position of place: the classroom symbolized federal rhetoric affirming black students’ access to desegregated public schools while state sovereignty upheld black exclusion.

Virginia government leaders took advantage of the state constitution’s Section 141 and denied funds to schools that complied with the Brown decision. On January 9, 1957, government leaders created addendums to support private school vouchers for white families, which provided an educational alternative for white children whose schools closed. The new option honored the Defenders of State Sovereignty and Individual Liberties’ mission, to deny federally forced racial mixing and learning in public institutions. The organization called upon all its members to act and remain vigilant, affirming:

"There will be no integration in Virginia only so long as the people are willing to stand unafraid and with a determination that is unfaltering. Part of this responsibility rests on your shoulders. Get busy, visit, call, telegraph, or write your representative and urge him to stand on your side, not on the side of the integrationist, NAACP, Virginia Council on Human Relations and others who are trying to force the evils of integration upon us. NOW IS THE TIME FOR ACTION!"

As well, the newly-acquired registered nurse credential did not insulate them from racism and discrimination. Black nurses and nursing students were still black women in America, who navigated shifting geographical and social landscapes. As Darlene Clark Hine asserts, “The end of overt discrimination and segregation . . . did not mean the eradication of more subtle and sophisticated forms of institutionalized racism.” Researchers commend the resiliency of black nurses but rarely acknowledge the other side: that racism and exclusionary practices required black nurses to endure systematic weathering in their academic and professional pursuits.

To the Claytor family, the land held a sacredness, as a place of birth, sacrifice, celebration, and protection. The family land provided Claytor insulation from shame, countering negative representations by reinforcing the positive black identity. Indeed, black identity could be celebrated within the infrastructure of her home, the black community, and in the black classroom.

During massive resistance, Claytor’s school in Franklin County, Virginia remained open and segregated for black students. She and her siblings attended Lee M. Waid, which encompassed grades one through twelve. The classroom provided significant buffering and equipping for navigating racialized discriminatory practices in Virginia through education. Black teachers created healing spaces of pride, safety, accountability, and possibilities for black students. Teachers replaced erroneous mainstream teachings of black inferiority with lessons that placed black men, women, and families at the center of their own worldview. Her love of learning and desire to escape home chores drove her school attendance. She found the classroom to be a welcomed break from canning, farming, and tending to her family’s land.

Claytor admired and respected the black teachers at Lee M. Waid and considered teaching as a suitable career following graduation. This desire changed when her grandmother, Mary E. Smith, became ill. Claytor, a teenager, did not feel adequately equipped to manage her grandmother’s care needs, yet she remained in the caregiver role. She was 16 years old when her grandmother died. Claytor sought a career in nursing, desiring never to feel that helpless again.

After graduating from Lee M. Waid in 1961, Claytor relocated to the neighboring city of Roanoke, Virginia, where she and her sister, Lois Croan, attended the Burrell Memorial Hospital’s Lucy Addison High School of Practical Nursing Program. For many women searching for nursing affiliations, vocational training programs were their only option. Black physicians estab- lished Burrell Memorial Hospital in 1915 to serve the needs of black patients in the Roanoke area, and its program provided formal education for many black nurses. It earned its accreditation in 1925 but later closed in 1934 during the Great Depression. The nurse training program remained closed at Burrell Memorial Hospital for approximately 24 years.

On September 2, 1958, as massive resistance in Virginia was collapsing, Burrell Memorial Hospital partnered with the Roanoke City School System and established Lucy Addison High School of Practical Nursing. Claytor and her sister graduated from this school in 1963 as members of the first graduating class. Having received encouragement to further her educational pursuits, Claytor eventually attended Morgan State University, a historically black college in Baltimore, Maryland, where she took courses in general studies. She then enrolled in the Helene Fuld Provident Hospital’s Registered Nursing Program located in Baltimore.

Black physicians established Provident Hospital in 1894 with a twofold mission: to serve the healthcare needs of the black community and to provide an educational opportunity for black nurses and physicians. Claytor excelled in her coursework and received recognition as “Miss Provident Hospital” in 1965. In historically black places such as Provident Hospital, black women could thrive in a context of mutual support and receive recognition for their accomplishments. Claytor gained valuable experience, confidence, and skills while attending the hospital’s Registered Nursing Program. She graduated with a diploma in nursing in 1967 and continued to seek further opportunities to expand her role in the field of nursing while simultaneously working clinically to gain experience and earn a living.

In 1968, Claytor applied to and received acceptance into Roanoke College’s School of Nursing program, following her aspiration to obtain a Bachelor of Science degree in Nursing. Once she received her acceptance letter, however, she discovered that the National League for Nursing (NLN) had not accredited the program. Claytor expressed to the academic office that she was seeking enrollment in an NLN-accredited program, knowing that, as a black woman, she had to continuously validate her education as one that was equal to her white counterparts. The institution’s accreditation was more than an accolade; it was a means for upward mobility and resistance against racialized social hierarchies. In response, she applied to the NLN-accredited University of Virginia School of Nursing.

Integrating the University of Virginia

The University of Virginia was among many public institutions wrestling, both internally and externally, with enforcing desegregation in the 1950s and 1960s. The University’s School of Nursing remained without admittence of black students following the 1964 Civil Rights Act; but the fall semester of 1968 brought historic change. At that time, Roanoke College contacted the School of Nursing about a prospective transfer student, Claytor.

The first black student, a lawyer named Gregory Swanson of Martinsville, Virginia, enrolled in 1950 in the Law School’s master’s program. Admission occurred only after a prolonged court battle and the support of the NAACP’s Legal Defense Fund. Although he did not graduate, Swanson’s admission paved the way for Walter Ridley to attend. Ridley became the first black student to graduate from the University of Virginia in 1953 with his Doctorate of Education. What remains invisible in history are the other black students who were denied admission. Consequently, in a later interview, Swanson expressed: “Someday in the very near future the law school, as well as the whole university, will point the way to more constructive efforts in effectuating equality in the South. The University of Virginia should be the pivotal point of socio-economic and political changes which would make democracy a living reality.”

The University of Virginia Schools of Nursing and Education provided the only outlets for white women in the all-male student body. By the 1960s, more changes were coming. In 1961, the University admitted a black woman to the School of Education. Dean B.F.D. Runk wrote to the Assistant Dean of Women regarding Constance H (surname redacted on the record). He emphasized, “[S]he must be treated in accordance with the regular policies and procedures affecting all students and that denials of such applications can not [sic] be made on the basis of race.” At the same time, radical student protests gained attention at the University of Virginia, leading President Edgar Shannon to recognize the need for more open admissions policies. According to Historian Barbara Brodie, Dean Mary Lohr and other nursing faculty supported Shannon’s decision to integrate. Yet the School of Nursing did not admit its first black student until 1968.

That year, Claytor completed her transfer application for the University of Virginia’s School of Nursing program. The application did not require an indication of race or ethnicity and the University accepted her for the fall enrollment, approximately 20 years after Swanson’s arrival. Claytor grew up surrounded by the mountains in Franklin County, and as her family drove her into town, she found the mountains of Charlottesville to be a reminder of home. Her family said their goodbyes and dropped her off on the University’s Grounds. After she arrived at McKim Hall, the nursing student dormitory, Claytor attempted registration for her assigned room. She immediately faced direct housing discrimination and isolation. The McKim Hall dormitory staff gave her a list of local hotel options under the auspices of no available space in the nursing dormitory. Clearly, Dean Runk’s 1961 prohibition of any denials “on the basis of race” was not heeded.

Claytor’s family departed home, and the thought of leaving now was not an option. The NLN accredited the University of Virginia’s nursing program, a requirement that Claytor firmly established before her admission. She traveled by foot, stopping at various hotels to inquire about obtaining a room. Although several hotels had vacancy signs in their windows to attract guests, upon her arrival the hotel employers all shared that they had no rooms. She continued walking and located another hotel that did accept her, and she stayed there for the initial weeks of the semester. She exhausted her savings, however, and could not personally sustain this unanticipated financial burden for more than a few weeks. Claytor then contacted the School of Nursing’s Dean Lohr and submitted her formal resignation from the program. At that time, the Dean expressed her unawareness of the housing discrimination and expeditiously secured Claytor’s room in McKim Hall, albeit in a segregated place. Despite living in McKim, Claytor was not fully included in dormitory life as she never had a roommate for the duration of her education.

Claytor entered the bachelor’s program with clinical experience and a well-rounded background, a strength that her peers and professors readily identified. She found the classroom and clinical setting to be a welcoming place, but this did not prevent or protect her against regular periods of loneliness and isolation. She often returned home to be with her family and attend church. As important places of acceptance, safety, and well-being, her home and church provided her with support and peace. She kept her bags packed in the dormitory, engaging the idea of remaining home during her weekend visits and not returning to the program. Claytor’s mother would gently nudge her daughter, saying, “Wait another week; stay another week.” Her mother regularly covered her in prayer with the reminder that she was capable of finishing.

Claytor graduated in 1970 as the first black nurse to be admitted to and graduate from the University of Virginia School of Nursing. She returned to the historically black Burrell Memorial Hospital in Roanoke, Virginia, where she worked as a registered nurse on the general medical–surgical floor. Claytor also worked as a public health nurse. In 1976, she joined the US Department of Veterans Affairs Medical Center in Salem, Virginia, as a mental health nurse. Claytor’s desire to pursue a second degree in nursing grew with continued exposure of new ideas and opportunities. She applied to the University of Virginia’s School of Nursing program in 1983, and once again gained admission—this time into the master’s program in mental health. She graduated in 1985 and continued working at Salem’s Veterans Affairs Medical Center. After 30 years of dedicated and awarded service, Claytor retired as Service Line Chief Nurse for Geriatrics and Extended Care.

On April 7, 2017, School of Nursing Dean Dorrie Fontaine offered a formal apology to Claytor, leading the way for one of the first formal apologies offered on behalf of the University of Virginia. It was an acknowledgment of the discriminatory practices that excluded black students from attending or fully engaging in University enrollment, matriculation, traditions, and student activities. The apology did not correct nor mitigate the past but instead illuminated it, serving as an acknowledgment of the institution’s history.

Conclusion

Claytor and other black students in Virginia grew up during a time when the state led the South’s defiance to racial equality. State leaders fought school desegregation until the federal courts intervened. Consequently, massive resistance delayed desegregation for over a decade, directly influencing and threatening black Virginian students’ public-school access in areas such as Charlottesville, Front Royal, New Kent, Norfolk, and Prince Edward County Schools. In this context, Claytor navigated both segregated and integrated places throughout her educational journey. Her case study illustrates the convergence of historical yet evolving places with socio-political changes in the lived experience of one black woman in Virginia.

Researchers commend the resiliency of black nurses—that they were able to overcome “life on the margins” of an oppressive racial system. However, were they resilient to the effects of these experiences? Researchers rarely acknowledge the other side: that racism and exclusionary practices required black nurses to endure real and anticipated dangers at the expense of desegregating spaces. Place was never “fixed” for them. Still, as they navigated these moving lines, black nurses were central figures in the integration of the US healthcare system. As black women pursued their academic, professional, and personal goals, they traversed a tenuous path to institutional integration, while simultaneously shouldering the compounding burdens of race, gender, and class. Black nurses and nursing students elected to enter newly desegregated spaces, often aware of the unequal demands yet still choosing to pursue advancement in the nursing field.Their narratives elucidate how place shapes, informs, and complicates both personal and group mobility.

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The full text of Tucker's complete 2019 Nursing History Review article is available here: PhD student Tori Tucker's 2019 NURSING HISTORY REVIEW article Race and Place