Crossing Borders of Care: The Professionalization of Women in Nursing and China–US Collaboration at Xiangya, 1909–1926

This article examines the development of modern nursing education in China through a case study of the Xiangya School of Nursing in Changsha between 1909 and 1926. Founded in 1911 by the Yale-in-China Association, a non-denominational mission, Xiangya was among the earliest nursing schools in China to promote undergraduate nursing education and public health nursing. Drawing on archival materials, published primary sources, and Chinese and English historiography, we analyze the cultural, political, and gendered challenges that shaped the school's development under the leadership of American nurse Nina Gage. While Gage initially sought to implement an Americanized model of nursing education, she and her colleagues adapted admission policies, educational goals, and curricula to local social and cultural conditions. Recognizing the need for Chinese nursing leadership, they prioritized the establishment of a Bachelor of Science degree to prepare nurses for teaching, administration, and public health roles. By 1926, Xiangya had trained approximately 16% of China's qualified nurses and had become one of only two schools in China offering university-level nursing education. This history highlights the interplay of transnational influence, cultural adaptation, and gendered reform in the professionalization of nursing in early 20th-century China.