JANUARY 2001, VOL 73, NO I P R E S I D E N T ’ S M E S S A U E

Army Nurse Corps celebrates 7 00th annjversaty

0 n Feb 2,2001, the Army Nurse Corps will celebrate its 100th anniversary. It is a

milestone for the army, as well as for professional nursing. The development of professional nurs- ing and perioperative nursing is aligned closely with that of army nursing. Let us all join the army to salute those who have served both nursing and our country and to celebrate our mutual profes- sional progress. We only need to take a look back at the beginning of nursing in the armed forces to get a sense of just how far we have come.

ARMY NURSING HISTORY The history of nurses in the

army can be traced to 1775 when Maj Gen Horatio Gates reported to George Washington that the sick suffered from a lack of good female nursing care. Washington then asked Congress for a matron to supervise the nurses as they attended the sick. It was not, how- ever, until after the War of 1812 with the passage of the Army Reorganization Act of 1818 that the Medical Department of the United States Army was formed. ‘

DOROTHEA DIX The Civil War saw many

women serve as nurses in Union and Confederate hospitals. Noted for her work with the mentally ill, Dorothea Dix became the Union’s superintendent of female nurses during the Civil War? A week after the attack on Ft Sumter, Charles- ton, SC, Dix, at age 59, volunteered

to work in the Union Amy. She received the appointment to super- intendent of female nurses in June 186 1, placing her in charge of the more than 3,000 women nurses working in Union Army hospitals. Dix served without pay throughout the war. She defined what had been vague duties and convinced skepti- cal military officials, who were not used to working with female nurs- es, that her nurses could perform the work acceptably. Battling the prevailing stereotypes and accept- ing many of the common preju- dices herself, Dix sought to ensure that her ranks not be inundated with flighty and marriage-minded young women. She only accepted applicants who were plain looking and older than age 30. The nurses of ax’s day were bound by a dress code of modest black or brown skirts, and they could not wear hoops or jewelry.

the superintendent was stem and frequently clashed with the mili- tary bureaucracy, but army nurs- ing care improved under her lead- ership. Dix looked after the wel- fare of her nurses, who labored in an often brutal environment. When medical supplies were not available from the government, Dix worked to acquire them from private sources. At the end of the war, Dix returned to her work on behalf of the mentally ill.3

Called “Dragon Dix” by some,

OFFICIAL RECOGNITION The Spanish-American War

started in 1898, at which time, Congress gave authority to

appoint women nurses under contract at the rate of $30 per month and one daily ration. That same summery almost BRENDA C. ULMER 1,200 nurses volunteered. During the war, nurses served in the United States, Cuba, herto Rico, the Philippine Islands, Hawaii, China, and Japan and on the hospital ship Relief. It was during this period that the first army regulations governing the Nurse Corps were published. The regulations governed the appoint- ment of nurses and defined their duties, pay, and privileges. In 1901, a bill came before Congress to establish a permanent Army Nurse Corps, and on Feb 2, 1901, it became a permanent corps of the medical department under the Army Reorganization Act?

THE WORLD WAR ERA The United States entered

World War I on April 6, 1917. There were approximately 403 nurses on duty. One year later, there were 12,186 nurses on active duty serving in 198 stations around the world. The Army Nurse Corps reached its peak in November 19 18 when 2 1,480 nurses served in overseas areas, including France, Belgium, England, Italy, Serbia, Hawaii, Puerto Rico, and the Philippines. Several nurses were wounded, but none died as a result of enemy

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action. The Distinguished Service Medal was awarded to 23 army nurses? A letter to the editor of the American Journal of Nursing in 1919 gives a glimpse of how life was for nurses of that era.

Several weeks ago, I went with other nurses to help out where the wounded were pouring in by the thousands fiom Argonne; it was the most depressing experience I ever had. Afer 10 days, we were recalled to care for hundreds and hundreds pouring in here fiom another sector suffer- ing with influenza and pneumonia. With the excep- tion of blankets and cots, we were equipped for less than one-half the number admitted and were neces- sarily obliged to compro- mise everything in order to cope with the situation . . . The diflculties we worked under were many, the laun- dry work was appalling, all drinking water had to be chlorinated. The water here has been contaminated for some time, and, therefore, on arrival, I explained to the boys just what an epi- demic of cholera means. One of the nurses said to me, “You certainly put the fear of God into them.” However, we had no dysen- tery in my huildinx, for- which I was thankful. . . Intermittent Boche planes are over us day and night, with constant firing from anti-aircraji guns . . . We have become so accus- tomed to air raids that they cease to be thrilling. I sel- dom watch them now. l pity

the night nurse with her sick patients and no lights under any circumstances, most of the time . . . How grateful our boys are for the little nursing care we can give them! Their patience and appreciation are most pathetic. To warm them as quickly as possible on arrival, and to keep them so with hot drinks, hot food, and a pair of woolen socks, is most essential. Our results were splendid with all but those seriously ill with pneumonia on arrival. I never want to see another case of pneumonia following influenza; it is this dreaded disease that is filling our A. E. I? cemetery fast. A. S. R., France, March 1919.6

Nurses also played an impor- tant role in World War II. On Dec 8,1941, as Pearl Harbor was being bombed in Hawaii, the Japanese launched an attack on the Philippines. In Baguio at the Camp John Hay Hospital, Ruby Bradley, RN, a 34-year-old career army nurse, was sterilizing instru- ments for her first case of the day-a hysterectomy. There would be no routine surgery that day, and soon bombs began to fall. The bombs were so close that Ruby’s ears rang, and as she looked out the windows at the planes above, she could see big red circles on them. Ruby looked at her watch, noting that the time was 8: 19 AM when war came to the Philippines.’

Until April 1942, the fighting forces, which included physicians, nurses, and corpsmen, endured relentless hardships. On the evening of April 8, 1942, as

Bataan was falling, forces were ordered to withdraw to Corregidor. Corregidor fell to the Japanese on May 6, 1942, and 66 army nurses remained in the Philippines as prisoners of war. In World War 11,201 army nurses died-I 6 as a result of enemy action. More than 1,600 nurses were decorated for meritorious service and bravery under fire.$

KOREA AND VlETNAM When hostilities broke out in

Korea in June of 1950, Capt Viola B. McConnell, RN, was the only army nurse on duty. Capt McConnell escorted nearly 700 American evacuees, mostly women and children, from the besieged Seoul to Japan aboard the Norwegian freighter Rheinhold. The ship had accommodations for only 12 passengers. McConnell used her nursing skills to prioritize care. She was awarded the Bronze Star for her heroic performance.

During the Korean conflict, army nurses were moved to the perimeter of battle lines to estab- lish mobile army surgical hospi- tals. Army nurses supported com- bat troops throughout the ground fighting and during prolonged peace negotiations?

in the Korean War. He is one of the patients cared for by army nurses. He still talks about the care he received and the month he spent in a hospital in Japan.

In 1956, the Army Student Nurse Program (ASNP) was established to help solve the acute shortage of nurses in the army. The ASNP provided financial assistance, pay, and rank to male and female nursing students. Schools of nursing were approved by the Department of the Army and accredited by the National

My father, Berlie Cole, served

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League for Nursing. In 1957, the Department of Nursing was estab- lished at the Walter Reed Army Institute of Research, Walter Reed Army Medical Center, Washing- ton, DC. Its primary mission was to provide education and conduct research in clinical nursing prac- tice. In June 1958, a 22-week course in basic OR nursing was started at Letterman General Hospital, San Francisco, and the US Army Hospital I, Ft Benning, Ga.Io This kind of attention to the nursing shortage is an excellent example of how the work of the army contributed to the greater social good.

first war of which I have deep- seated memories. I remember dis- tinctly the sadness and sorrow when young men from my home- town were killed. Ten army nurses were the first sent to the Republic of Vietnam in March 1962. During the next 11 years, more than 5,000 nurses served in Vietnam-nine died while serving there, and two were killed as the result of hostile fire."

While I was not yet a nurse during the Vietnam War, I remember well its effect on the entire country. One of my most poignant memories relating to Vietnam is of an AORN Congress in Atlanta. One of our speakers was Max Cleland, now a US Senator from Georgia. Sen CleIand is a triple amputee who has excelled and exceeded all expectations of one so seriously wounded during the war. As Sen Cleland told of the horrors of his experiences in Vietnam, the result of which was the loss of both legs and one arm, the entire auditori- um was enthralled and engaged

The conflict in Vietnam is the

with his story. Many of us were in tears as we listened to what he had endured both before and after his injury.

At the conclusion of Sen Cleland's presentation, a periopera- tive nurse who had served in Vietnam walked up to a micro- phone. She tearfully thanked Sen Cleland for telling his story. She said that she had often been haunt- ed by her memories of the severely wounded soldiers under her care and frequently wondered whether some would not have been better off dead than sentenced to live with the aftereffects of those injuries. This nurse, whose name I do not know, said that she now knew that all that she and others had done was not in vain. Sen Cleland by this time also was in tears. It was one of the most touch- ing and moving memories I have of an AORN Congress. Those memories were rekindled on Nov 11, 1993, when I was fortunate enough to be in Washington, DC, when the Vietnam Women's Memorial was dedicated. Many of the women who served in Vietnam were m y nurses.

In October 1972, the Army Nurse Corps established the stan- dard that a bachelor's degree with a major in nursing was required for an appointment to the regular army. It was not until 1978 that the same standard was called into being for civilian nursing. It is hoped that professional nursing will someday achieve the same standard that the army has so suc- cessfully achieved."

AORN PRESIDENTS Two army nurses have served

as president of AORN-Mark L. Phippen, RN, MN, CNOR,

(1990-1991) and Jean Reeder,

Phippen is well-known and beloved by AORN members and was given the Award for Excellence in Perioperative Nursing in 1993. Phippen credits his experiences as an army nurse for helping him achieve excel- lence in his career in periopera- tive nu~sing.'~

Reeder spent 24 years in the military and achieved the rank of Lieutenant Colonel. She received the AORN Award for Excellence in Perioperative Nursing in 1998; she was the 12th recipient of the award. Reeder stated that her world view of nursing is ground- ed in her years of experience as a perioperative nurse.'+ AORN greatly benefited from having these two outstanding examples of army perioperative nurses serve as AORN Presidents-the highest office in perioperative nursing.

RN, PhD, FAAN (1991-1992).

CEl B R A TlNG ARMY NURSES The preceding is just an

overview of the long and distin- guished contributions that army nurses have made to the United States and to professional and perioperative nursing. Undoubt- edly, each of you could add to this overview and to the accom- plishments of army nurses. As we join the Army Nurse Corps in celebrating its 100th anniversary, I hope you will thank those who you know personally for the time and effort they have dedicated to our country and to our profes- sion. Happy 100th Anniversary to the Army Nurse Corps.

BRENDA C. ULMER RN, MN, CNOR

PRESIDENT

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NOTES

the Army Nurse Corps (Washington, DC: US Army Center of Military History, 1995).

2. L L Dock, I M Stewart, A Short History of Nursing From the Earliest Times to Present Day (New York G P Putnam’s Sons, 1937).

3. Dorothea Dix Biography. Available from http://civil warhome.com/dixbio.htm. Accessed 16 Nov 2000.

4. Feller, Moore, Highlights in the History of the Army Nurse Corps.

5 . Ibid. 6 . D J Mason, “Letters: A century of feedback,”

American Journal of Nursing 100 (October 2000) 15-25. 7. E M Norman, We Band of Angels: The Untold

1. C M Feller, C J Moore, Highlights in the History of Story of American Nurses Trapped on Bataan by the Japanese (New York Random House, 1999).

8. Feller, Moore, Highlights in the History of the Army Nurse Corps.

9. Ibid. 10. Ibid. 11. Ibid. 12. Ibid. 13. M Phippen, “Award for excellence in perioperative

nursing recipient advises nurses to strive for excellence, not perfection,” AORN Journal 59 (June 1994) 1157- 1164.

14. L Castle, “AORN members and chapters honored at awards dinner,” AORN Journal 69 (June 1999) 1109- 1116.

New Surgical Method To Remove Varicose Veins Debuts A new system for removing varicose veins has been introduced according to a June 22,2000, news release. Until now, the removal of varicose veins has been painful for most patients. Treatment is impor- tant to prevent dilated, twisted veins; episodes of aching pain: and leg ulcers on the skin’s surface.

The system is designed for use during transillu- minated powered phlebectomy. During this clinical- ly tested procedure, the surgeon views the vein using a transilluminating light and then removes it with a small surgical powered device.

With traditional methods of removal, surgeons cannot always see the vein or verify removal. This system makes vein removal less traumatic for the patient by reducing the number of incisions required, reducing surgical time, and reducing pain experienced with traditional removal methods.

According to the release, approximately 25% of

women and 15% of men in the United States suffer from varicose veins. The condition results from problems with valves in the veins of the leg. When valves do not close properly, blood is sent back into the leg instead of to the heart. As it accumulates, the pressure dilates the vein causing it to bulge and become visible.

Initial treatment for varicose veins usually is a compression stocking worn while the patient is not in bed. This may relieve symptoms and delay pro- gression of the condition, but it is not a cure. Blood flow back to the leg must be stopped surgically.

Americans Now Have Access to Innovative Treatment for Varicose Veins (news release, Andover, Moss: Smilh & Nephew, Inc, June 22, 2000) 1-4. Available from h @ : / ! . individual. comR. ./story shiml?=p0622080.10 3&leve13=596&date=Z~62. Accessed 23 June 2000.

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