A Brief History of Wartime Nurses in the US

Throughout history nurses have played an integral part in armies across the world. From nuns praying next to the injured to individuals going through rigorous online RN-BSN programs, their training and roles have changed over time.The history of wartime nurses must begin with Florence Nightingale who was a British heroine credited with not only reforming nursing as it existed in England, but for engineering the beginnings of nursing as a profession.  Nightingale traveled abroad to learn to care for hospital patients.   In 1854, the Crimean War brought about many British casualties but there were no nurses to care for them.  Using her political influence, she was able to bring a volunteer group to Crimea to help the British soldiers.  

Nightingale practiced cleanliness, letting sunshine and fresh air augment her healing.  The death toll decreased substantially, and using statistical documentation, Nightingale led the movement for a modern, evidence-based practice.  Upon her return to England, she created the Nightingale School for Nursing to educate professional nurses. 

Nursing in the Civil War in the United States

Within the decade, the United States broke out in Civil War, but neither for the Union nor the Confederacy, were there professionally trained nurses.  Instead, the vague title of "nurse" was given to any person, mostly female, who cared for a wounded person with only their homegrown knowledge of patient care.  It is estimated that 3000 such women served as volunteer nursing personnel in the Civil War, but the volunteer nurses were a far cry from the professional services that were needed.

However, these volunteer women served as the foundation of professional nursing in the United States.  Many of the volunteers left husbands and families and plunged themselves into dangerous situations, not considered "proper" for ladies.  Many people realized the value of formal medical education and changed public opinion about women's medical work.  Some of these women, influenced by Nightingale's school, became instrumental in founding early schools of nursing.

The First Permanent School of Nursing

After the Civil War, populations in US cities rose dramatically with increased immigration and diseases spread rapidly as a result of overcrowding and poverty.  But hospital care for those needing help was scarce and inadequate.  Social reformists began to lobby for formalized medical training for workers of these massive hospitals and almshouses.  In 1872, the first permanent school of nursing was established at the Women's Hospital of Philadelphia.  By 1883, the number of nursing schools in the US had grown to 35, and by 1900, the number had increased to 432. 

Evolving from the traditional hospital nursing, care for the underprivileged came about in the form of district nursing and settlement house nursing in 1893.  In 1896, an association which would later become the American Nurses' Association (ANA) was formed with the intent of formalizing licensure, and states began to pass acts awarding licensed nurses the title "Registered Nurse."

Army Nurses

In 1898, in the Spanish-American war, educated nurses first served as army nurses, approved by the Surgeon General, and came to be a recognized asset to army surgeons.  In 1917, the US entered World War I with fewer than 500 army nurses.  By the end of the war, there were over 21,000 army nurses, aided by the Red Cross reserve. In 1918, the Army School of Nursing was founded.  During World War II, more than 77,000 nurses served in the armed forces.  But after the war, an acute shortage of nurses followed, which lead to the creation of the Associate Degree in Nursing (ADN) program, offering a shorter program period, enabling many more nurses to become qualified. 

In the 1970s, with the advancement of medicine came an increase in graduate programs with clinical specialties in nursing.  In present day, the advancement of nursing education continues to grow with the advent of online RN-BSN programs, offering aspiring nursing practitioners a greater range of educational opportunities.  

Egenes, K. J. (n.d.). Chapter 1: History of Nursing.

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