Effects of War
It is a sad, sobering fact that war results in increasing medical knowledge and skills of all medical personnel – physicians, surgeons and nurses. Is so much suffering worth these gains in knowledge? Some answer ‘yes’ as they consider the improvement in care to victims of accidents and disasters a positive result of medical knowledge gained.
In the beginning of the conflict military nurses were intended to work in the rear and not face dangerous conditions near the battlefield. However, the plans had to be discarded when reports of injuries due to “gas” attacks, artillery weapons that left large numbers of soldiers with injuries requiring skilled nursing care. Surgical and gas treatment teams were organized to take specialty care closer to the patients; nurses were key elements of those teams.[i] These female nurses challenged conceptions of how close women could be to battle and how they could face danger. CEUfast Blog[ii]
“Nurses treated patients near or just behind the front lines at field hospitals, evacuation stations, or clearinghouses—even in churches that were turned into hospitals. They could be found at base stations, which were generally far removed from battle; however, they also served in troop transports and transport ships. Some nurses even drove ambulances.” – CEUf fast Blog[i]
Nurses treated numerous types of wounds, as well as infections and mustard gas burns. They were also faced with soldiers suffering from emotional injuries, including shell shock. Some were trained in social work, including psychiatric training, in order to help current soldiers and those returning home deal with their experiences.
“The battlefield conditions presented extreme challenges for nurses. Patients had massive wounds to the face and head incurred as they poked their heads out of trenches, massive wounds to extremities that would require amputations, and also burns from poisonous gases. Injuries from battles on French farm fields featured both shards of shrapnel and embedded soil and manure. Antibiotics were not available, - rubber gloves and wound irrigation solutions were recent innovations. Nurses managed infections with great success under these trying circumstances, especially considering there was no electrical power and bandages from wounds had to be washed by hand and re-used.” [i]
Nurses Work Load and Working Conditions
In May 1917, U.S. medical teams became the first American troops to arrive in the war zone, and many remained through mid-1919.
War nursing’s more common hazards included infected fingers, sickness, and physical strain. “My back is busted in two tonight. Slowly, [moving] down the ward, doing the dressings and making the beds,” Boylston wrote in her diary. This frequent changing of dressings and application of antiseptic, though physically exhausting, served a critical medical function in the pre-antibiotic era: It became the most effective method for healing infected war wounds and prevented many limb amputations. Helen Boylston[i]
From the Journal of [ii] Elizabeth Weaver:
“During Miss Williams absence on Surgical team I had charge of Ward A. At this time the doctors were busy in the Operating Room practically day & night, consequently the nurses had to do the dressings on the ward. All day long from morning until night I went from bed side to bed side doing dressings. I had an orderly to assist me. …strenuous days. These patients were rushed directly from the front. I always dreaded removing bandages for fear of hemorrhage. I never knew what I was going to find, there were many missing limbs, horrible deep wounds.”[iii]
“After June 15 the hospital was well filled & work became more strenuous for the nurses. On Oct 10, 1918 we had 2275 patients & only 49 nurses, some of the nurses being on Emergency teams, several sick & several at Camp # 44 The mail from the States at this time was very irregular. I sometimes would not hear from home for a month, some of the boys had not received mail for 4 or 5 months”.
“Base Hosp #20 was originally planned as a 500 bed hosp. but gradually grew in size until at one time we had 2275 pts. The nursing force however was not increased at any time; consequently the work was extremely heavy at times & certainly most difficult as the patients were housed in so many different buildings.” Elizabeth Weaver
Johns Hopkins nurses joined the American Red Cross in 1914 and were already serving throughout Europe. Base Hospital 18, in France was staffed mainly with Hopkins nurses and physicians. The correspondence from nurses serving in these units, often published in the Johns Hopkins Nurses Alumnae Magazine, poignantly describes the hardships and horrors faced by both soldiers and their caregivers.[i]
Alice Fitzgerald, 1906, served with a base hospital of the British Army in France in 1916. She wrote often to the Alumnae Magazine about her experiences:[ii]
September 30, 1916 Just as I was going to get leave, I received orders to move, and am now at 2/2 London Casualty Clearing Station, the nearest to the front, and the nearest any nurse gets. Let me tell you that we are all but in the trenches: in fact, we are surrounded by trenches, because we are on ground evacuated by the Germans. We are so situated that we have shell fire on three sides and the noise is simply fierce at times; so far the shells have not reached us but bombs have and the other night we were missed by about 30 yards. …Talk of hard work! I have 2 tents holding 70 patients each and they have to lie on stretchers and pretty close, and making dressings practically on the floor, nearly breaks my back, but I get through somehow or other and am not much the worse for wear. … The most comfortable and comforting time of the day or night is when I get into my sleeping bag with a hot water bottle and tuck in for the night with my tent flap well open and try to go to sleep to the music of the bombardment.” - Alice Fitzgerald
Mary Adams, 1911, describes the heavy work and many wounded in an undated letter from the February 1917 edition of the Alumnae Magazine[i].
I had five tents each with eight of these beds but before the evening was over four more were added to each tent so that I had 12 in each. So close were the beds you could not step between. I made dressings until 12 midnight using lantern light. The next day we were up earlier than usual and I found my number of tents increasing so that I soon had 150 patients. As soon as I had finished their dressings I helped in other lines and that day it was 2 a.m. before I got to bed, barely taking time for meals.
The rush lasted for several days, sending patients to England as soon as possible and getting new ones in, so that it was one continuous convoy in and out.” Mary Adams