Army Nursing in World War II - Nursing Practice

Since my new World War II novel, With Every Letter (Wings of the Nightingale book 1), features nurses, I'm conducting a blog series on Army Nursing during the war. Previous posts looked at requirements to serve in the Army Nurse Corps, training and rank, and uniforms. Today we'll look at general nursing practices.

The Ward
On the ward, the nurse was in charge, under the authority of the physician. She was assisted by male medics, enlisted men. In stateside hospitals, female Red Cross nurses’ aides also served. Physicians entered the Medical Corps with the rank of captain and only male physicians were admitted to the Corps.

As was typical in the 1940s, physicians expected unquestioning, speedy obedience from nurses. However, the war shook things up. The necessities of combat meant nurses were often asked to perform new tasks and given more authority, especially in combat zones. For example, flight nurses, were completely in charge during flight and had authorization to treat many medical emergencies. To learn more about WWII flight nursing, please see my guest posts on Redwood's Medical Edge.

Flight nurse conducting air evacuation in Sicily, July 1943
Nursing Duties

The nurse was responsible for keeping the ward properly heated and ventilated, and for cleanliness, orderliness, and quiet - often quite difficult in combat theaters. She and the medics changed linens and helped the patients bathe, shave, brush teeth, change clothes, and use the bedpan or urinal. They served food and helped the sicker patients eat. Alcohol rubs were given to relax patients and prevent bed sores.

Nurses took careful notes, stored by the bedside, to monitor patient health. TPR's (Temperature, Pulse, and Respiration) were recorded at regular intervals, at least twice daily. A glass mercury oral thermometer was used. Blood pressure was measured in certain patients as well.

Physicians relied on the nurse's assessment of patient symptoms - signs of bleeding or infection, weakness, restlessness, anxiety, coloring, mental condition, speech, condition of the eyes and tongue, appetite, bowel and urinary functions, coughing, and pain.

Nurses were vital members of the Operating Room team, and in combat theaters, they often learned to administer anesthesia, close wounds, and other tasks.

Medication Administration

Medications were stored in the ward in a locked cabinet. The nurse was responsible for the key, but medics were allowed to access and administer medications in most instances. Nurses were trained to give medicine by mouth, hypodermic (now called subcutaneous), intramuscular, topical (on the skin), and by enema. Intravenous medications were to be given only under the direct supervision of a physician; however, exceptions were made in the combat theaters and for flight nurses.
This was long before our disposable, single-use, "universal precautions" era. Syringes were made of glass and were sterilized in bichloride of mercury before reuse. Gloves were washed and reused—and holes were even patched.
Improvisation was the rule, especially in combat areas, and nurses used their creativity and imagination to turn trash into useful items.
Tomblin, Barbara Brooks. G.I. Nightingales: the Army Nurse Corps in World War II. Lexington: University Press of Kentucky, 1996. (A wonderful history, including all theaters, full of personal stories).
Technical Manual TM 8-220: Medical Department Soldier's Handbook. Washington DC: War Department, 5 March 1941. (The official Army handbook used by medics, which contains a lot of information on nursing duties).

Labels: , ,