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Welcome to my webpage! Glad you stopped in! As you can tell by my picture, I have chosen to pursue a career in the often stressful, generally unsung, but nevertheless rewarding profession of nursing. Nursing is truly the "science of caring"; since the beginning of time, nurses have left indelible marks on the way healthcare is delivered and the lives of those who receive it.
With such a proud history, it is surprising to me how little we nurses know about our own roots. Being a history buff, I have always been of the firm conviction that knowing our past allows us to plan for and improve our future. As an undergraduate, I had the opportunity to conduct several independent research studies regarding the historical development of professional nursing. From my research, I gained not only increased knowledge but increased pride in my profession, its remarkable past, and its bright future.
Many of nursing's finest hours have been during times of war. From the battlefields of Trenton and Camden to the field hospitals of Gettysburg to the MASH units of Vietnam, nurses have heroically provided care to our wounded men in uniform, jeopardizing their safety and, at times, sacrificing their own lives in carrying out their duties. I urge you to read for yourself about the hardships, heartbreak, and courage encountered by nurses in service to our country. I have included information regarding the American Civil War (both the Union and the Confederate experiences) and the Vietnam Conflict on the homepage; the pages for World Wars I and the Persian Gulf War are still under construction but I hope you will keep "checking in" on the progress!
Also, please stop by the World War II and Daughters of Charity pages, just recently completed!!! |
KSU RN at age 3 |
Nursing’s Role in Selected American Wars
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The nurses' memorial at Arlington National Cemetery |
Want to Learn More? Click here!
I have had men die clutching my dress till it was almost impossible to release their hold. I have often taken young boys in my arms when they were so tired they could not rest in their beds and held them as I would my own little boys. I never went to the ward with a sad face but always had a smile and a cheery word for all. The doctor said that he knew when I was ahead of him, for the patients had such pleasant countenances. -- Lois Dunbar (Our Army Nurses, p. 84)
Following the firing on Fort Sumter and President Lincoln's call for volunteers, patriotic fervor inflamed not only the men of the North but also the women in the spring of 1861. Most Northern women were familiar with the work of Florence Nightingale, the British founder of modern nursing and the "angel" of the Crimean War. Wishing to provide a similar service to their men and the Union, approximately 5600 Northern women signed on to serve as nurses. One Northern journalist states, "Every woman suddenly became a Florence Nightingale." Many of these volunteers had husbands or sons at the front; others were motivated solely by patriotism. Young women in particular were eager to serve as nurses, since they could not join the ranks as soldiers due to their "fairer sex". One spunky young lady, who could not win her father's permission to enter nursing, argued poetically, "Shall I be a baseborn coward, harder hearted than the foe? See, my country, duty calls me. Dearest Father, let me go!" Alas, her father was not swayed by her impassioned plea.
To handle this onslaught of volunteer nurses, the Federal government appointed 60 year old Dorothea Dix of Boston, Massachusetts, as Superintendent of Women Nurses in June 1861. Prior to her apppointment, Dix had made a name for herself as a tireless reformer and whistle-blower, advocating humane treatment and better hospital facilities for the mentally ill. Besides founding 32 hospitals in the United States, Dix also reformed mental institutions in Japan, Great Britain, and Italy. In fact, Dix was even granted an audience with the Pope in recognition of her work; the Pope, it is said, was duly impressed with Dix's devotion to "these cruelly ill-treated members of his flock."
Although personal friends of Dix described her as a sensitive, intellectual, selfless person, the nurses under her supervision were wary -- if not terrified -- of her. Behind her back, they called her "Dragon" Dix for her ironclad rules governing the way Union army nurses should look and behave. According to Dix:
To verify that her volunteers met these criteria, Dix conducted personal interviews with applicants. Prospective nurses dreaded the interview process, as Dix could often be merciless in criticizing inappropriate clothing, giddy behavior, and one's age or appeared age. Eventually, however, it was learned that Dix's bark was worse than her bite; in choosing her nurses, she often relied upon character references moreso than interviews. In fact, Dix was known to have taken on women as young as 25, provided they had glowing recommendations. Although "The Rules" disappointed many of the youngest applicants, the women who were approved as nurses soon discovered the wisdom behind many of Dix's regulations.
In 1863, the War Department issued a statement offering Dix's "rejects" another route for approval as army nurses. Individual surgeons would be allowed to appoint their own nurses, provided the nurses had the recommendation of the Surgeon General, thus skipping over Dix entirely. This, of course, did not sit well with Dix, who felt her position was being usurped. The War Department's motives for the change are unclear. Perhaps Surgeon General Hammond had grown tired of addressing the complaints of the "rejects"; perhaps the War Department was unwilling to give a woman too much power; or perhaps the disorganized War Department was jealous of Dix's tightly run ship.
Union army nurses served on battlefields at the front lines, on troop transport trains, and at numerous field and general hospitals. However, Union nurses were not allowed to assist with surgical procedures. (Strict adherence to this policy is doubted; one nurse, Amanda Farnham, wrote in her memoirs about performing a bullet removal on the battlefield using pocket scissors.) Nurses were to supervise the preparation and serving of the daily diet in general hospitals. Nurses also were expected to oversee the distribution of clothing and supplies from the Christian Commission and the Sanitary Commission. Most importantly, nurses were to provide all physical, emotional, and spiritual care for the patients and families. This was, of course, by far the most challenging aspect of the nurse's role. There remain so many touching anecdotes regarding the nurse / patient relationship that it is impossible to relate them all. One particularly moving story involves Rebecca "Auntie" Pomeroy, one of Miss Dix's most trusted and gifted nurses and a personal friend of Abraham Lincoln. A Union bugle boy, perhaps 13 or 14 years old, lay dying in Mrs. Pomeroy's ward at a Washington hospital. As Mrs. Pomeroy attended him, he whispered pleadingly, "Mother, may I please have my bugle?" Touched by his request, Mrs. Pomeroy found the boy's bugle and gave it to him. The dying boy slowly lifted the bugle, blew two mournful notes, and died with the instrument still at his lips. As Mrs. Pomeroy described, "the final bugle call had sounded!"
Nursing was not only emotionally draining; at times, it also proved life-threatening. One nurse wondered what took more courage: a man stepping onto the field of battle or a nurse about to step onto a smallpox ward. Indeed, communicable diseases took its toll on Union nurses; most were attributed directly to patient contact. Even seemingly minor incidents often led to devastating results. One young nurse accidentally poked herself in the finger while pinning a patient's bandage and contracted the dreaded blood poisoning. The affected arm was subsequently amputated but it was too late; the young nurse succumbed to the disease.
In addition to enlisted nursing staff, there were many informal nurses who served the Union at battlefields and hospitals. Many of these "self-appointed" nurses were the wives, mothers, and sweethearts of injured soldiers; as a result, they were not very well-liked by the regular army nurses. The regular nurses complained that these women were more a hindrance than a help -- demanding special favors for their soldiers, bringing the sick soldiers food that was forbidden by their prescribed diets, using hospital kitchens and laundry facilities for personal needs, and providing unskilled, unauthorized care to the other soldiers on the ward. In some cases, however, these women proved valuable assets to the nursing staff; some even stayed behind and joined the ranks of regular army nurses once their loved ones had either gone home or passed on.
President Lincoln himself was a frequent visitor in the Washington hospitals. Often he would bring gifts of fresh fruit, preserves, or other goodies to the men and would go up and down the rows of beds, shaking hands and speaking encouraging words. The President also shook hands with the nursing staff and often requested to meet the cooking and cleaning staff as well. Many of the cooks and laundresses were former slaves, who were overjoyed to meet "Father Abraham" in the flesh. On one occasion, however, the hospital superintendent worried that the President was insulted at having to shake "colored hands". Lincoln replied, "No indeed! It does my soul good. I'm glad to do them honor."
Other well-known Union nurses include: poet Walt Whitman, author Louisa May Alcott, Red Cross founder Clara Barton, and the indomitable Mary Ann "Mother" Bickerdyke. Barton's courage under fire at the Battle of Antietam is to be commemorated this year, with the dedication of a monument to her services. More information on Mary Ann Bickerdyke's contribution to the Union cause can be found at the link "Mother Bickerdyke" suggested above.
The work of Union army nurses did much to promote the development of nursing as a profession, as well as women's rights. Shortly following the war, the president of the American Medical Association advocated the founding of a nurses' training academy, similar to the St. Thomas School founded by Nightingale in London. Consequently, with the help of Union nurse veterans, the Connecticut and Boston Training Schools for Nurses were opened in the 1870s. Dr. Vesta Swartz, an army nurse who later completed medical school, wrote of Union nurses' contributions to the women's rights movement:
When Fort Sumter was fired upon, the first blows exchanged, and the wounded and dying came pouring in from the battlefields, the South found itself unprepared to care for its casualties. Unlike the North, the South had no Sanitary Commission to oversee the operation of formal military hospitals and no Dorothea "Dragon" Dix to set standards of hiring and practice for volunteer nurses. The first nurses to serve the Confederacy were actually recovering Southern soldiers whose own lingering physical infirmities prevented them from providing adequate nursing care. In addition, many of these men were displeased at being detailed for hospital duty instead of being shipped home and, thus, were less apt to deliver high-quality care.
In response, the women of the South began to organize their own volunteer groups such as the Ladies' Soldiers' Relief Society and the Association for the Relief of Maimed Soldiers; some even set up their own private hospitals in homes and donated buildings. Nursing care was then provided by the members of these societies. It was not until 1862 that the Confederate Congress passed "the act to better provide for the sick and wounded of the army in hospitals", thus bestowing some semblance of formality upon the Southern hospital system.
At the outbreak of the war, the Confederate Congress had appropriated only $50,000 for hospital care of the wounded; as the casualties mounted, private homes, hotels, barns, warehouses, churches, and courthouses were converted into temporary hospitals. Three of the most notable Confederate military hospitals were Chimborazo (Richmond, VA), Pettigrew (Raleigh, NC), and Sally Tomkins's hospital (Richmond, VA). Sally Tomkins was a charitable Richmond lady who paid all hospital expenses from her own pocket. Her hospital accommodated only 22 beds but it boasted of having the lowest death rate among all Confederate hospitals. In fact, Mrs. Tomkins was commissioned a captain by President Jefferson Davis in recognition of her excellent nursing services, thereby becoming the only female officer in the Confederate army. Many private homes were turned into convalescent hospitals and were under the supervision of the young, unmarried girls, who were considered too virginal and too giddy for nursing in the general hospitals. Many of these eager young nurses eventually married their patients.
Each formally appointed military hospital operated according to a similar chain of command. The chief surgeon was in charge of operations, followed by the staff surgeons and their assistants. Next were two head matrons, whose primary duty was to procure food for the hospital at a salary of $40 / month. The assistant matrons were in charge of the hospital laundry and the distribution of hospital clothing to patients. For every 100 patients, there were two ward matrons, who kept the beds clean and ready, served food, administered medications, and did supervisory work. Ward matrons earned approximately $30 / month. At the bottom of the chain were the regular duty nurses, who did day-to-day nursing tasks and janitorial work for only $11 / month.
Deprivation and dirt characterized many Confederate hospitals during the war years. Small, sleepy Southern towns were overwhelmed with the number of wounded coming in from nearby battlefields and were unprepared to meet the demands for their care. Matron Emily Mason of Winder Hospital, near Richmond, wrote, "We were in need of everything -- sheets for beds, shirts for the men. We had not a rag with which to dress wounds, and even paper for spreading poultices and plasters was difficult to obtain."
In addition, sanitation was almost unheard of in Civil War hospitals. In 1863, the Confederate Congress actually ordered all Richmond hospitals to be shut down and fumigated, but the order was never carried out. In the close, cramped quarters, "the smell of human waste, unwashed bodies, and gangrenous wounds was so intolerable as to overpower healthy men." In one Tennessee hospital, the sewage drainage pipes overflowed and fecal matter covered the floors. Often, patients with "Virginia quickstep" resorted to using dishtubs at the ends of the wards for defecation purposes, rather than commodes. Nurses often had to put camphor-soaked cotton balls in their nostrils to avoid being overpowered by the smells. As a result of such filth, hospitals proved breeding grounds of pestilence. Untold numbers of nurses died as a result of exposure to disease and filth.
Nursing in a Southern hospital during the Civil War was not a job for the faint of heart. Each nurse was expected to carry out a long list of nursing and non-nursing duties associated with the care of her patients and the ward where she was employed. The typical nurse : patient ration was 10 : 1, which left little time for idleness during a shift. A nurse's daily duties included: bathing those patients whose conditions permitted, changing dressings, assisting surgeons with treatments, distributing food, administering medications, and beating and airing out straw mattresses. Nurses were also expected to change the straw in the mattresses once per month and to scour the floors in their ward. In addition, nurses wrote letters for illiterate or handicapped patients, read and sang to them, and prayed with and counseled them and their families. Some nurses were even pressed into service as hospital cooks, going as far as grilling rats when the regular cooks refused to do so.
Not all patients were appreciative of their nurses' efforts, however. Phoebe Yates Pember, matron of Chimborazo Hospital at Richmond, recalled one patient who was nursed by none other than Mildred Lee, the 17 year old daughter of General Robert E. Lee. When the patient proceeded to curse at his nurse and bark orders at her, the man in the next bed intervened and told him to behave, that Miss Lee herself was his nurse. "Lee, Lee?" the patient said. "There's some Lees down in Mississippi who keep a tavern there. Is she one of them Lees?"
When tending to an enemy prisoner of war, many Southern nurses found it difficult to remain objective. Although the nurses acknowledged a moral obligation to give impartial, quality care to a sick or injured soldier of either allegiance, regional patriotism occasionally took precedence over moral duty. Nurse Kate Cumming was confronted with this problem following the Battle of Shiloh, when she found two Union POWs in her charge. She wrote, "Before I went in, I thought I would be polite...but when I saw them laughing and apparently indifferent to the woe which they had been instrumental in bringing upon us, I could not help being indignant...I told (the captain) where I wished him and all like him, so that they might not trouble us anymore." However, Miss Cumming reflected, "seeing an enemy wounded and helpless is a different thing from seeing him in health and power." Later that same day, while caring for a dying youth from Illinois, Miss Cumming thought, "Poor child! There will be a terrible day of reckoning for those who sent you on your errand and who are the cause of desolating so many hearts and homes."
As the fighting drew nearer, nurses aided in the evacuation of staff and patients and the movement of hospital facilities to safer regions. Emily Mason, writing of her flight from the burning Richmond, writes, "We led the way through the fire and smoke, our sleeves singed and our faces begrimed with sweat and dirt. My driver had become so unaccountably drunk that I could hardly hold him upon his seat." During Sherman's burning of the hospital at Columbia, South Carolina, nurses served as volunteer firefighters, vainly trying to save the building as their untended patients burned to death inside.
During the Civil War, the nurses who served the Confederacy made great contributions to the care of the sick and injured soldiers, the status of Southern womanhood, and the evolving nursing profession. With little or no formal training, the nurses of the South ventured onto dangerous battlefields and into ill-equipped, often unsanitary environments of military hospitals to provide care to their countrymen. As they endured their hardships, the nurses rapidly dispelled the myth of the fragile, timid, easily disgusted Southern woman. In a society dominated by men, these women carved a niche for themselves in nursing, demonstrating to their male superiors and to their fellow women that a woman's compassion and zeal could be put to greater uses than simply hearth and home. Their dedication to their patients and to their country helped to dispel the myth that only lower class, immoral women were fit to nurse and fostered a growing respect for nursing as a vocation. In the words of Phoebe Pember,
American nurses tended to combat casualties, often within combat zones and, in some instances, under enemy fire. They also cared for Vietnamese prisoners of war and civilians wounded by the fighting, volunteered at Vietnamese orphanages and convents, worked at leper colonies, and flew on aeromedical evacuation missions. In the eleven years of fighting, eight female nurses and three male nurses died in Vietnam. Their names are inscribed upon the Vietnam Veterans Memorial in Washington D.C.
For many nurse veterans, their assignment to Vietnam was, in essence, their first "real job." The average American military nurse on duty in Vietnam was just 23 years old and fresh out of a three-year diploma nursing school. Most nurses were white, working- or middle- class girls whose fathers were World War II veterans. As students, many took advantage of Student Nurse Corps programs, which guaranteed tuition reimbursement, military housing accomodations, travel opportunities, and a monthly stipend while in school. In 1965, 52% of the entire Army Nurse Corps was comprised of student nurses, who were commissioned as second lieutenants in the Corps upon passing their state licensure exams.
When these young nurses finally reported for basic training, many were completely unprepared for the experience of military life. The first weeks of basic training consisted of military protocol classes, battlefield tactics, survival skills, and path finding. In addition, they were taught certain clinical skills that were considered outside the realm of civilian nursing practice. These included suturing, performing tracheotomies, debriding wounds, identifying and tying off bleeding arteries, and triaging incoming wounded.
Once the nurses arrived "in country", life consisted of little more than work. Each nurse's tour of duty was exactly one year long. During that year, they were expected to work 12 hour shifts, 6 days per week; during a "push" (slang for an influx of casualties), they worked 48 and even 72 hours at a stretch with no relief. The patient loads were heavy; the work was exhausting. One nurse recalls being so exhausted that she lay down on a bloody gurney and promptly fell asleep. To cope with the stress, some nurses claim to have shut down emotionally during their tours of duty, viewing patients as wounds rather than as people. Some purposely avoided caring for "expectants" (soldiers who were imminently dying). Occasionally, however, a patient would manage to break through the carefully constructed emotional barrier, triggering a breakdown. One nurse describes her grief at finding a West Point class ring in the satchel of a soldier mangled beyond recognition. Finding photographs of dead or maimed soldiers with their girlfriends or parents at home also proved very difficult for even the most stoic of nurses to handle.
In addition to caring for battlefield casualties, nurses cared for soldiers and Vietnamese civilians who had fallen victim to rare tropical diseases, such as bubonic plague, dengue fever, typhoid, jungle rot, and cholera. Freak accidents and injuries also brought soldiers to U.S. military hospitals; counted among these were "friendly fire" mishaps, attempted suicides, drug overdoses, drownings in deep mud, monkey bites, and maulings by tigers.
Although most damage done was structural, there were incidents of American nurses being wounded, disabled, and in the case of Lieutenant Sharon Lane, even killed during rocket and mortar attacks on hospital facilities. During a rocket attack on the 312th Evac Hospital at Chu Lai on June 8, 1969, flying shrapnel struck Lt. Lane (a native of Canton, Ohio, KSU's hometown) in the neck just as she had finished securing a patient. The fragment severed Lane's carotid artery; the 25 year old Army nurse bled to death within minutes. She was the first and only nurse to die by hostile fire in Vietnam. Her death served as a frightening reminder of the dangers she and her colleagues faced. In Vietnam, the nurses soon learned, there was no such thing as a safe region.
In the midst of daily danger, suffering, and death, nurses were expected to maintain a cheerful outlook, a reassuring presence, and -- when high ranking officers or celebrities came to visit the hospital compounds -- a spotless appearance. Nurses report that, prior to VIP visits, they took on the role of custodian, mopping hospital floors, concealing potentially distasteful sights such as soiled dressings and urinary drainage bags, and even scrubbing bloodstains off the grass. The careful preparation for these VIP visits irritated many nurses, who felt they were being forced to "prettify" the war.
Professionally speaking, the Vietnam experience was, for most nurses, their first taste of professional autonomy. In civilian life, health care was still very much dominated by the physician; in Vietnam, nurses were respected for their knowledge and technical skills and were trusted to make difficult judgment calls. Due to the demands of caring for multiple casualities, the boundaries between the physician's domain and the nurse's blurred even further. Some physicians entrusted the nurses with advanced clinical procedures, considered out of the realm of nursing practice. One nurse recalls how a physician handed her a scalpel and said, "Here you go -- welcome to med school." For most of the nurses, Vietnam was the only period in their professional lives where they would experience such colleagiality with physicians. In addition to acquiring advanced clinical skills, the nurses learned how to think and act quickly in emergency situations, a skill which would prove valuable upon re-entering civilian practice. Nurses also had opportunities to assume supervisory positions in Vietnam, regardless of their limited clinical experience, and thus developed leadership skills and a sense of professional competence. Although the dictionary definition of nursing was familiar to them before serving in Vietnam, their wartime experiences showed them just how great the impact of their care could be. A nurse's ability to detect a subtle change in a patient's condition often proved lifesaving; a nurse's choice of supportive, comforting words to a newly disabled young soldier often played a vital role in the boy's emotional recovery process. The nurses learned they had something special and unique to offer their patients just by virtue of their being nurses. Many nurse veterans report they have never felt more "like a nurse" than they did in Vietnam.
The relationships the nurses forged among themselves further strengthened their emotional resolve and made difficult periods livable. In sense, the nurses formed their own family groups in Vietnam. Unimpeded by the social and cultural barriers of the United States, nurses developed a sisterly sense of love and responsibility for one another. Many nurse veterans describe it as a bond they had never felt before in their lives and that the friendships forged in Vietnam were among the strongest they had ever had.
Nurses also felt a sense of closeness to their young patients. Since the average combat soldier in Vietnam was only 19 years old, the nurses often found striking resemblances between these soldiers and their own younger brothers, cousins, and boyfriends at home. This, coupled with the fact that demonstrators were attempting to rally the people at home against these young men, strengthened the nurses' attachment to their patients.
Upon returning to the States, nurse veterans found themselves in a disturbing, often hostile environment. Nurses report being physically assaulted by antiwar demonstrators while wearing their military uniforms. Others report being followed and verbally harrassed by protesters as they tried to go about their daily business. In addition, the veterans found among their closest family and friends an unwillingness to listen to their stories or accept their expressions of pain.
In recent years, post-traumatic stress disorder (PTSD) has been brought into the media spotlight as a disorder affecting one quarter to one half of all Vietnam veterans -- including nurses. Known as "shell shock" in WWI and "combat fatigue" in WWII, PTSD is defined as "a syndrome that becomes evident in the aftermath of a traumatic event that is outside the usual range of human experience." Signs and symptoms of PTSD include: flashbacks, nightmares, fatigue, irritability, social isolation, substance abuse, and even suicidal thoughts. Nurses who have experienced PTSD speak of the overwhelming emotions the disorder forced them to confront, often several years following their Vietnam experiences. Commonly experienced emotions include: hopelessness, anger at life, guilt for being unable to save all of their patients, and frustration with their inability to publicly express their pain. Nurses cite psychotherapy, support groups for women veterans, involvement in organizations such as the Vietnam Veterans of America, and developing friendships with other nurse veterans as means of coping with PTSD. In 1993, the dedication of the Vietnam Women's Memorial near the Vietnam Wall in Washington D.C. also helped to put closure on this painful period in the nurses' lives. In her book
In addition to their patient care roles, nurses were expected to serve as assistants during evacuaton procedures, in the event of rocket or mortar attacks. Due to the high incidence of guerrilla warfare during the Vietnam conflict, the Geneva Convention provisions for the protection of noncombatants in medical facilities offered little protection. At the sound of the alarms, nurses first donned flak jackets and helmets, then secured their patients. Patients who could not be moved were put under their beds and covered with mattresses, while the rest were moved to bunkers. During such attacks, patients who had use of their arms often requested M-16 rifles to be used in the defense of their nurses and fellow patients.