In the early 20th century, the legacy of slavery in the United States led to the segregation of African American and White nurses. They attended separate training schools and worked in segregated hospitals. The George A. Brewster Hospital, established in 1901 in Jacksonville, FL, aimed to address the healthcare needs of African Americans, particularly those affected by the Great Fire of Jacksonville in 1901. During this time, societal reformers, influenced by notions of White, middle-class respectability, advocated for an "ideal" nurse based on these ideals. In regions where missionary women served as teachers and nurses, hierarchies of class and race became entrenched, resulting in segregation and second-class status for certain groups of people.