Hospital based ambulance service began in May 1896 when Dr. Henry T. Williams presented the Hospital with its first ambulance. Competition developed between Rochester's four hospitals for patients. Within the first seven months, there were 433 ambulance calls, 48% of which were "hurry" calls. In the early years all hospital ambulances answered hurry calls, meaning that drivers raced to get to the patient. The first, to arrive hurried back to their hospital with their charge. This high-speed competition resulted in a number of collisions with trolleys, bicyclists and pedestrians. One local paper reported:
"The (ambulance) team passed the Four Corners at a dangerous rate of speed and there was considerable scampering on the part of persons waiting for trolleys. Directly after the ambulance passed, a number of bicyclists started in hot pursuit and they in turn endangered the lives of those who had gotten out of the way of the ambulance."
Private ambulance company service did not begin until 1950.
Sophia Palmer became Superintendent of Rochester City Hospital and the nursing school in 1896. She came to an institution in turmoil. Her predecessor had been removed for "the good of the hospital," the Nursing School was in disarray, and the hospital was running at a deficit. Through her leadership conditions improved steadily.
Miss Palmer was in the forefront of nursing reform. She became editor of the American Journal of Nursing and produced the first issue in October 1900 in her quarters at the Hospital. Her monthly editorials become a strong force for nursing and helped lead to the passage of the Armstrong Bill, which placed all New York State nursing schools under the SUNY system and arranged for examination and registration of nurses graduating from accredited schools.