The Army Nurse . . . The Army Nurse is the Army Doctor’s right hand. Without her, the present high standard of health among our soldiers, and the gratifying percentage of recovery of battle casualties, would be impossible. NORMAN T. KIRK, MAJOR GENERAL, U. S. ARMY, THE SURGEON GENERAL. Nursing Began — With the First Heartbeat of Man time immemorial, woman has sought to heal man’s hurts. The development from super- stition and witchcraft to the medical miracles of today represents not only the advance of healing to the position of both an art and a science, but the constant and ever more effective oper- ation of an age-old human instinct. Concurrent with that growth has been the emergence of a ready ally of doctor and patient alike in the battle against pain and death — the nurse. The origins of nursing lie deep in the unrecorded past. Among even the most ancient peoples there is a persisting tradition of hospitality, of care for the sick wayfarer, while the earliest organized care of the sick is apparently connected with the shrines and temples of the pre-Christian era. The advent of Christianity gave impetus to the growth of those conceptions of charity and mercy whereby ladies undertook the care of the sick as a religious duty, and its development is marked by the rise of religions orders primarily devoted to the care of the poor and sick, such as the Beguines, an order of nursing sisters originating in Flanders, and the Sisters of St. Vincent de Paul, an order founded in Paris in 1655, By the mid- nineteenth century there were active on the Continent twelve thousand members of the latter order alone. The beginning of scientific training of nurses must he viewed as an aspect of nineteenth century liberal reform, an early manifestation of which was the activity of Theodor Fliedner, a German Protestant divine, whose interest in social reform had been stimulated through his familiarity with the work of Elizabeth Fry, known for her efforts in behalf of prison reform in England. FliedneFs concern for the care of the sick poor led to his founding, in 1836, of a hospital and training center for nurses at Kaiserwerth, an institution which Florence Nightingale was to study with much profit. This was the first of those institutions which, with those in England and elsewhere, were to banish forever from the scene the ignorant, slovenly, and drunken type of so-called nurse immortalized by Dickens in Sairey Gamp. In 1840, Mrs. Fry’s organization of nursing sisters was founded, and in 1872, a Boston hospital offered the first training course for nurses in America. Nursing as a profession had been born. Hospital, about 1500, from an old drawing Hospital in Paris, about 1660 Elizabeth Fry An eighteenth century hospital 3 The Birth of Military Nursing No sketch, however cursory, of either military or civilian nursing could overlook the titanic achievements of Florence Nightingale. Here is a romantic and heroic story, but perhaps more significant than any of the scores of fascinating and dramatic incidents with which her career abounds, are the simple ungarnished statistics: The death rate in military hospitals of the Crimean War in February, 1855, was forty-two percent. Four months later it was two percent. That was the work of the Lady with the Lamp. To her self-appointed task of revolutionary re- form in the field of nursing, Florence Nightingale brought a background of knowledge of the best institutional and nursing practice then available. She had studied both the work of the Sisters of St. Vincent de Paul and that of Fliedner’s Institute at Kaiserwerth. During the year 1854 all England became aroused by the reported state of care — The Nightingale Pledge I SOLEMNLY PLEDGE MYSELF BE- FORE GOD AND IN THE PRESENCE OF THIS ASSEMBLY: TO pass my life in purity and to practice my profession faithfully. I WILL abstain from whatever is delete- rious and mischievous, and will not take or knowingly administer any harmful drug. I WILL do all in my power to maintain and elevate the standard of my profession, and will hold in confidence all personal matters committed to my keeping, and all family affairs coming to my knowledge in the practice of my profession. WITH loyalty will I endeavor to aid the physician in his work, and devote myself to the welfare of those committed to my care. This pledge was formulated in 1893 by a committee of which Mrs. Lystra E. Gretter, R.N., was chairman or rather, lack of it — accorded the sick and wounded in the Crimea, and Florence Nightingale, then superintendent of a London hospital, offered her services. Proceeding to the Crimea with a staff of nurses, she embarked on a program of systematic care of the wounded. Regarded as a revolutionary innovator, she was obliged to battle tradition and entrenched military obduracy, hut to such good effect that the statistical miracle mentioned above became a reality. The traditional figure of the Lady with the Lamp, the angel of mercy, though quite accurate, is perhaps a representation of less ultimate im- portance than the equally accurate one of a tireless and hard-headed fighter, battling for efficient organization. To Florence Nightingale must go the credit for replacing doubtless well- meaning, but haphazard individual effort, with the carefully organized system that alone can save lives. Her reforms both in military nursing and in nursing education have had far-reaching effect. Every nurse and every soldier from that day to this has been greatly in her debt. Nursing in a military hospital of the Crimean War Women as Army nurses — Florence Nightingale’s innovation American Military Nursing .Although organized military nursing as we know it today stems only from the middle of the last century, women were caring for soldiers as far back as the time of the Knights Hospitallers of the Order of St. John, and American women have cared for our soldiers in every war in which this Nation has been engaged. In 1775, at the recommendation of General Washington, a bill was adopted by Congress which created a hospital department for the Army, and called for, among others, a matron “to supervise the nurses, bedding, and so forth,*’ and nurses “to attend the sick and obey the matron’s orders.” Further allusions to nurses of this period are to be found in sections of a plan of regulation for the general hospital, prepared for General Washington and submitted by him to Congress: “12. That a matron be allowed to every hun- dred sick or wounded, who shall take care that the provisions are properly prepared; that the wards, beds, and utensils be kept in neat order; and that the most exact (economy be observed in her department. “13. That a nurse be allowed for every ten sick or wounded, who shall he under the direction of the matron.” Provision was made for payment for matrons, one-half dollar a day and one ration, and for “nurses, each, twenty-four-ninetieths of a dollar a day, and one ration.’* This modest emolument was princely when compared to an earlier hill which specified only “one-fifteenth of a dollar per day, or $2 a month.” When General Gates reported on conditions on the northern frontier, one of his major points was that “the sick suffered much for want of good female nurses,” while the record of the Council of Safety for the New York Convention, November 29, 1776, notes payment to one Esther Burke “for ten weeks nursing sick soldiers, £5, 10s.” These brief official allusions tell only part of the story of nursing in the Revolutionary Army, since much of it was done by the women who simply followed their men to war. There are many stories of wives who dressed their husbands’ wounds on the field of battle itself. Of these women we have only a few names. The many others must remain unknown — unknown, hut not unhonored. 7 Nursing in the Civil War reputation as an effective crusader for better conditions in the care and treatment of the insane, was appointed superintendent of women nurses, “to select and assign women nurses to general or permanent military hospitals, they not to be employed in such hospitals without her sanction and approval, except in cases of urgent need.” Miss Dix, a woman of the highest integrity, found herself in the difficult position of having great personal authority, hut with no function- ing organization behind her. She had been assigned an impossible task, and her accompish- ments are the more remarkable in the face of it. Due to the lack of a single unified corps with official status, policy was determined by the individual medical officers on the spot, and their attitude ranged from grateful co-operation in some cases to indifference or downright hostility in others. The administrative picture is further confused by the fact that, in addition to those nurses who had been approved by Miss Dix or the medical authorities, there were other groups doing similar or related work: the Sisters of Charity; casual Dorothea Dix The story of the women nurses in the Civil War is one of great individual devotion and heroism on the one hand, and a deplorable lack of unified administrative organization on the other. At the very outbreak of the war, Miss Dorothea Dix, who already had achieved a Nation-wide 8 employees; women who simply accompanied regi- ments without any official standing whatever; and employees of the U. S. Sanitary and other Com- missions which were semiprivate welfare agencies. If nursing in the Civil War was an organizational failure, and it must be so conceded (though valu- able lessons were ultimately learned from the chaotic picture it presented), the record is one of blazing individual sacrifice and achievement against great odds. We have some contemporary accounts — such as the hasty notes scribbled on scrap paper by Miss Georgey Woolsey to her sister from Fairfax Seminary Hospital in Alexandria: “All right. Hard work, dirt and death every- where . . . Men are continually brought in and stowed away in filthy warehouses called distribu- tion stations . . . They are frightfully wounded and die in numbers in the stations. No provision whatever for feeding them is made by the Gov- ernment, beyond hardtack and coffee. We go about among them and feed them. I have a room of special cases near by, besides the general station. Three of these died last night. Care came too late. They had been several days on the field after being shot.” Women of the Civil War period sought the same opportunity to serve then as our Army nurses find today A newspaper correspondent gives the following account of these nurses, which, albeit in the rather purple prose fancied in that era, bears the mark of sincerity: ‘■‘’Hundreds of volunteer nurses, many of them wives, sisters, and mothers, came from every walk of life to join in the work of mercy. Hands hardened with toil, and hands that leisure and luxury left white and soft, were bathing fevered brows, supporting wearied heads, washing repul- sive wounds, combing matted and bloody locks. 9 “Patient forms kept nightly vigils beside the couches; gentle tones dropped priceless words of sympathy; and, when all was over, tender hands closed the fixed eyes, and smoothed the hair upon the white foreheads. Thousands of poor fellows carried to their homes, both North and South, grateful memories of those heroic women . . . ” The touching gratitude of the men was evi- denced then as it is today. As one Civil War nurse wrote: “Appreciation is grateful to all, and the Army nurse received it without measure from those to whom she daily ministered. To hear a soldier say as he bade her goodbye to join his regiment, after having been nursed back to health, 4You have saved my life,’ was the richest compensation she could have received.” And Louisa May Alcott tells of a grateful patient, whom the author of Little Women had cared for when she was working at the Union Hotel Hospital in Georgetown, D. C. He was a little old man, and spoke to her in a rich Irish brogue: “May your bed above be aisy darlin’, for the day’s work ye are doom” Our own Civil War brought to the attention of the Nation the need for a systematized form of nursing such as we now have in the Army Nurse Corps \ iirsing in |ho S|Kiiiisli-.\morieiin War that w ar. which hore out the findings of observers of the ( Tvil War experience, that unified direction and control within the Army framew ork itself was the only way to avoid administrative confusion and assure maximum efficiency in the care of the sick and wounded. At the outbreak of the war Dr. Anita Newcomb McGee, director of the Hospital Corps of the Daughters of the American Revolution, was en- trusted with the responsibility of passing on the qualifications of nurses who sought appointment as nurses under contract to the Army, a role not unlike that of Dorothea Dix in the Civil War. Only graduate nurses endorsed by their schools were accepted, assuring a high standard of professional competence. These nurses received thirty dollars a month, plus rations, and Dr. McGee’s efforts were so successful that within about two weeks of taking office, she had a force of twelve hundred nurses. However, a considerable volume of nursing assistance was forthcoming from private sources. Ihe fact that “contract” nurses were subject to Army control and regulation, while the others Dr. Anita Newcomb McGee, Acting Assistant Surgeon, under whose able guidance the ANC teas founded The record of the nurses in the Spanish- American War was such as to convince the last of the skeptics, if such remained, of not only the propriety hut the necessity of w omen in military nursing. The organization of the Army Nurse Corps as an integral part of the Army was the direct outgrowth of the lessons learned during 11 were paid by private sources and were subject to orders from private individuals, did not make for the utmost in harmony and efficiency, to say the least. This, coupled with the recognition of the indisputable value of women nurses, made it imperative that the status of the Army nurse he clarified and officially regulated. Dr. McGee, who had been appointed Acting Assistant Surgeon, herself wrote the section dealing with the Nurse Corps of the Army organization bill, passed in February 1901, which established the Nurse Corps as a definite component of the Army. The confused administrative picture, and the frictions inevitably arising between rival groups, should not be permitted to obscure the picture of devoted and heroic service, both at home and abroad, created by the nurses of "98. Contract nurses served in Cuba, Puerto Rico, Hawaii, and the Philippines, as well as on the hospital ship “Relief.” Thirteen nurses died in the service, one of whom had allowed herself to be infected in the interest of yellow fever research, and died a martyr to science and to humanity. A nurse’s notes attached to a faded picture of the Field Hospital at Coamo, Puerto Rico, give an impression of the conditions in the field which the nurses of ‘98 had to cope with: In the ward tents, Sternberg Hospital, Manila, Philippine Islands Fortress Monroe, Virginia, general and field hospital 12 “The nurses quartered in an old Spanish house in Coamo, located in a banana grove. We drove to camp in mule ambulances, put in long hours and chased lizards which dropped into our beds, and fleas, and had to watch for tarantulas at night. Sick men from 3rd Wisconsin, 16th Pennsylvania, and 3rd Kentucky Regiments cared for by Army Nurses. All water for any purpose hauled in barrels from a spring more than a mile away. Tents crowded, typhoid fever, dysentery and diarrhea, conditions bad, no ice, no diet kitchen/’ Ward in an Army hospital at San Juan, Puerto Rico Military General Hospital and its staff, Santiago, Cuba The U.S.S. Cartago carried these Army nurses to France in 1918 Army nurses in France were trained in gas defense A comfort then, as now, boiling water was eagerly sought by these nurses at the former race-track stable serving as their kitchen in France 14 Wo phi War I irmy nurses en route to hospital unit in France At Base Hospital 52, in France. Army nurses hid smiling farewell to patient Julia C. Stirnson, Director, Nursing Service, AEF, and subseepient Superintendent, ANC When the United States declared war on Germany in 1917 there were only 403 nurses in the Corps, and even this small number repre- sented an increase of 100% brought about by the Mexican Border crisis. Within eighteen months the number had increased to 21,480. These hare statistics indicate an undertaking of unprecedented proportions, and one which would have been almost impossible without the unified control provided by the comparatively recently organized Corps. Only graduate nurses were accepted, and they were assigned to cantonment, general and special military hospitals located in all parts of the United States. Of these nurses, 10,400 were sent overseas, and served in England, France, Italy, Belgium, and Siberia. They were assigned to base, evacuation, mobile, camp and convalescent hospitals, and to casualty clearing stations. They also served on hospital trains, transports, and with surgical teams in field hospitals. Ear, eye, nose, and throat clinic at a base hospital, Savenay, France Operating room in a hospital unit, Aulnois-sur-Vertuzy, France Stretcher bearers load wounded soldiers in hospital train American soldier, wounded in the Argonne, is cared for by Army nurses General Pershing conversing with nurses in France Army nurses’ graves at Mars-sur-Allier, Nievre, France Surgery and modern medicine have worked wonders for our H ounded men at the front. But the Army nurse understands too, the miracle of the little things that help, the smile, the pat of encouragement, the letter she writes for her patient 18 World Wair II Corps, even though the pay and allowances were not the same as for the men. Thus, the position of the Army nurse, which from its beginning had been one of dignity, was improved by definitely fixing the status of the nurse and giving formal recognition to the place of the Corps in the military establishment. All nurses with the Army are now Army nurses — members of the Army Nurse Corps. Even as recently as the last war there were some Red Cross nurses on duty with the Army. These nurses were under the jurisdiction of the Red Cross rather than the Army. The Red Cross continues, however, its valuable function as the procurement agency for Army nurses. By act of Congress, retirement for length of service and disability is now granted to Army nurses, and on June 22, 1944, President Roosevelt signed a bill giving real instead of rela- tive rank to officers of the Corps for the duration of the war. This became effective July 10, 1944. Following World War I, the Nurse Corps, like the rest of the Army, gradually decreased in size, until in 1939 the membership had dropped to 625. When the National Emergency Colonel Florence Blanchfield, Superintendent, ANC Mn recognition of their outstanding work in World War I, relative rank for members of the Army Nurse Corps was provided by Congress in an amendment to the National Defense Act on June 4. 1920, placing them on the status of officers and adding much to the prestige of the 19 was declared in 1939, the Nurse Corps was authorized to increase to 949 but in 1940 it became necessary to appoint reserve nurses once more. The subsequent growth of the Corps has been phenomenal: 1940 . . 1,657 1941 . . 7,262 1942 . . 21,257 1943 . . 36,607 1944 . . 39,500 — (As of May 31) The U. S. Army nurse in World War II is at work in every quarter of the globe. In Nissen huts in Iceland, in tents in the jungles of South Pacific islands, at every battle front, and on the beachheads where our troops have established themselves only hours previously, she is saving precious lives. She serves on land, on the sea in hospital ships, and in the air, evacuating the wounded by plane. For her duties in this war she has trained under battle conditions, she has learned new front-line techniques, and has at her disposal methods and equipment undreamed of in pre- vious wars. The unbelievably high rate of recovery of battle casualties is the measure of her success. The story of the Army nurse in this war is one of devotion, of heroism and sacrifice, of compassion, and of cheerfulness. More than this, it is the story of glorious achievement beyond the limits of the most sanguine expectation. A Nurse at the Front An Army nurse on the fighting front writes as follows: “I wish every nurse at home could see some of those boys, refusing to be disheartened no matter how badly wounded, having only one interest — to get hack in the fight, knock out the enemy, and get home to a peaceful America. I remem- ber particularly one hoy with a femoral artery severed, terribly anemic, with danger of gan- grene and ultimate amputation. ‘Take care of my buddy first,’ he said when he was brought in. ‘He’s worse off than I am.’ We knew differently. “Don’t let anyone back home tell you that the combat zone is no place for nurses. It is, defi- nitely. Just see what a bedside nurse can do to boost the morale of any injured GI Joe. Just a pat on the head, blankets smoothed, and a woman’s smiling face for a man to look up into — sometimes it’s almost better than plasma. “A badly wounded infantryman said to me the other day, ‘How can you nurses be so cheerful when you have so much to put up with?' We looked at him in amazement. ‘Men like you, soldier,’ we thought, ‘you’re the reason. No Army nurse could look you in the eye if she weren’t able to take it, just the way you do*." Water purification in the field Nurses bivouac in field Fox holes provide cover Gas defense Army nurses are inured to battlefield conditions A major in the Army Nurse Corps delivers a classroom lecture Members of the ANC learn how the Army makes beds Malaria control and discipline are illustrated jor Army nurses Army nurses learn military first aid The field ration is explained to Army nurses Army nurses boiling water in the field, Anzio beachhead, Italy Army flight nurses on bivouac hike in the Hawaiian mountains Army nurses admire necklace made by native in North Africa Army nurses in China bargain for rickshaw ride Army nurses find walking muddy in Aleutian Army nurses pass in review “somewhere” in Wales Army nurses were among the first to land in France Three days in Australia and mail from home! The Army nurse in Iceland works in a modern, well-equipped ward Protected by its distinctive markings, this Army hospital ship brings wounded safely home This view of a ward on an Army hospital ship is typical of the interiors of such vessels Hospital Ship Wounded are evacuated speedily to hospitals in the United States aboard Army transport planes An Army flight nurse accompanies the wounded as they are evacuated by plane to hospitals at home Flying Aiiikiilsinee 26 Equipped for every type of surgery, hospital trains like this speed the wounded home by rail An Army nurse and an enlisted man attend a soldier in a typical ward car aboard a hospital train Hospital Train First medical aid to wounded men is given in the field An ambulance collects and carries wounded to the rear The clearing station — emergency surgery At the field hospital. Army nurses help surgeons prepare for operation Surgical tent at evacuation hospital, where wounded receive further treatment Homeward bound — Army nurses care for the wounded on this hospital ship Army flight nurses attend wounded who are evacuated by plane The end of the long chain of evacuation! At the left is an Army station hospital. A big Army general hospital is shown at the right. At such hospitals as these, here in the United States, wounded receive expert medical care until they are ready to return to duty or are given medical discharges and sent back home Roll of Honor Jt is impossible to draw up an honor roll of Army nurses. Their acts of heroism and of courage are the unwritten history of every day of war. Official decorations and citations there are, hut these are only part of the story. In World War I, three members of the Army Nurse Corps received the Distinguished Service Cross; twenty-three the Distinguished Service Medal; twenty-eight the Croix de Guerre; sixty- nine the British Royal Red Cross and two the British Military Medal. Many were cited for meritorious service in the United States Army orders and a number were mentioned in British Army Dispatches. In World War II, for the first time in the history of the U. S. Army, women have been decorated with the Silver Star. They were nurses of the Army Nurse Corps serving on the Anzio beach- head with the Fifth Army in Italy. Others have received the Legion of Merit, the Purple Heart, the Soldier s Medal, and the Air Medal, the latter two being the first such awards ever made to women. Bronze Stars have also been awarded to Army nurses. They have given their lives in this war. Six nurses were killed in the bombing of a hospital on the Anzio beachhead, and an Army hospital ship, the first of six similar vessels, has been named after one of these nurses, Blanche F, Sigman. An Army general hospital in Chicago has been named in honor of the first nurse to meet her death in a theater of operations in this war, Second Lieutenant Ruth M. Gardiner, killed in a plane crash in Alaska, while serving as an air evacuation nurse. In the early hours of the invasion of the Con- tinent from England, U. S. Army nurses were already on the beachheads, preparing casualties for evacuation. They will continue to follow our fighting men, sharing their peril as well as healing their hurts. General Pershing decorating Julia C. Stimson in France Army Nurse Corps Superintendents Dita H. Kinney . . . 1901-1909 Jane A. Delano . . . 1909-1912 Isabel McIsaac . . . 1912-1914 Dora E. Thompson . . 1914-1919 Julia C. Stimson . . 1919-1937 Julia O. Flikke . . . 1937-1943 30 TTniforins of the Army Nurse Corps Some of the uniforms worn by Army nurses. At the top,left to right: Brown-und-white-striped seersucker hospital uniform; flight nurse’s high altitude suit; flight nurse’s uniform; field hospital uniform; olive-drab service uniform. Bottom: Beige summer service uniform; white hospital uniform; blue dress uniform; beige one-piece off-duty dress. "I am Iho Nurse” I am the nurse. I ivalk with him In his world of pain. He is the warrior become a boy again Returned to us in the backwash of war. By God, given back to us, to make whole. I am the nurse. But I am so few and he .. . your wounded man . . . is legion ! Women, mothers of men, stand ivith me in the dark of night . . . and listen. Do you hear the murmur of a million lips? Do you hear . . . the call for help, rising in pitch Above the death-belch of cannon . . . Calling from the heavens, through the whine of crushed wings . . . Bubbling through the ocean s swell. . . touching at every shore? Yes, you hear it.. . the call of hurt. You are a woman and, hearing, you must heed. When his teeth are clenched in pain . . . upon a womans name . . . Mine is the hand that soothes. When his eyes are set upon a woman s face, cherished image plucked through space, Mine are the words that calm. I am the nurse. Stricken in heart with the single fear That against the growing need my numbers cannot prevail. For I am so few and he .. . is legion tvho asks our aid. Add your hands to mine women, mothers of men. Lest I he too few, lest victory hang like a mocking mask Upon our Nation's honor ! Registered nurses who are not yet forty-five may be eligible for membership in the U. S. Army Nurse Corps. Application should he made to the Surgeon General. U. S. Army, Washington 25, D. C., or to a Red Cross Procurement Office. Senior Cadet nurses of the U. S. Cadet Nurse Corps are eligible for transfer to Army hospi- tals for the completion of their training, and for subsequent appointment, if they desire, as second lieutenants in the Army Nurse Corps. Qualified nurses’ aides, graduates of Red Cross training classes, who have had at least 150 hours of subsequent hospital experience, may he employed in Army hospitals. This is full-time, paid employment, with Civil Service status. 32 Pledge of the Army Nurse As an Army nurse, I accept the responsibilities of an officer in the Army Nurse Corps I shall give faithful care to the men who fight for the freedom of this Country and to the women who stand behind them I shall bring to the American soldier wherever he may be the best of my knowledge and professional skill I shall approach him cheerfully at all times under any conditions I may find I shall endeavor to maintain the highest nursing standards possible in the performance of my duties I shall appear fearless in the presence of danger and quiet the fears of others to the best of my ability My only criticism shall be constructive. The reputation and good name of the Army Nurse Corps and of the nursing profession shall be uppermost in my thoughts, second only to the care of my patients I shall endeavor to be a credit to my Country and to the uniform I wear ; * «T*TI » WM« LX—1 4 5—RPB—7—20—44—25M