V E TE R AN S AFFAI R S & M I LITARY M E D I CI N E O UTLO O K
MILITARY AND VA NURSING HISTORY Caring Across the Years for Those Who Serve By Craig Collins
n U.S. NURSES (mostly males in the first century-and-a-half) have aided sick and wounded warfighters on the battlefield since the Revolutionary War – although not officially part of the military until the 20th century. The Continental Congress, at the request of Gen. George Washington, on July 27, 1775, approved hiring one nurse for every 10 patients in Army hospitals at a pay of $2 per month, $4 for nurse supervisors. The pay per nurse was raised to $4 when the Revolutionary War began a year later and their duties increased with combat casualties. In addition to the care they gave the soldiers, having a female nurse replace a male freed that man to join the fight. Those first nurses were untrained and many the wives of soldiers, who had no way to support themselves and had begun following the Army, doing odd jobs, for food and lodging. When the war ended, female nurses were dismissed. Despite fighting two more wars – the War of 1812 and the Mexican-American War (1846-1848) – female nurses were not employed by the Army again until the Civil War. Still working with no training, more than 6,000 served in both Union and Confederate hospitals and closer to the battle lines. A major step forward was made on June 10, 1861, when the Union named Dorothea Lynde Dix “superintendent of women nurses,” creating the first organized unit of U.S. nurses. As with the Revolution, however, they were civilian hires, not members of the military in either army. As before, the end of that war meant the end of the Army’s perceived need for such support, returning instead to only a small cadre of male nurses. Female nurses were not employed again until the Spanish-American War (1898), when the first contract hires were made to deal primarily with outbreaks of yellow fever, malaria, and other tropical diseases. Although that conflict only lasted four months, 21 of the more than 1,500 nurses who served died, largely from tropical diseases contracted from their patients. Once again, most of the women who applied were untrained, and the War Department had no resources to see if they were medically qualified. The Daughters of the American Revolution offered to serve as an examining board for potential nurses and,
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for the first time, an acceptable applicant had to have graduated from a training school and provide suitable recommendations. Recognizing the value nurses provided – and the need for more than the few male nurses the Army normally employed – the U.S. surgeon general laid out the criteria for a reserve force of nurses in 1899. Two years later, Congress made nurses a full part of the military by creating the Army Nurse Corps (ANC). The Navy Nurse Corps was established seven years later. The Army Reorganization Act of 1901 also created the first Reserve Corps of female nurses, most of whom previously had served at least six months in the Army. For the first time, the U.S. military had an organic corps of military nurses, trained to work close to the battle lines, which proved vital when America entered World War I in 1917. Although there were only 403 Army and 160 Navy nurses on duty at the time, by the end of the war in 1918, more than 22,000 had served, several decorated for their actions, including the Distinguished Service Cross and Medal of Honor. Several hundred of those also died in service, many victims of the 1918 Spanish Flu epidemic, according to the American Society of Registered Nurses®. World War I also saw the creation of the Army School of Nursing, which began courses specific to Army nursing at several military hospitals in 1918.
View of nursing nuns seated in front of tents of the U.S. Army 3rd Division Hospital, 7th Army Corps during the Spanish-American War, 1898.
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Military Nursing History
