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Nursing During World War I: The Importance of the Discipline


During the early 1900s, the world was rapidly experiencing changes. For instance: one, the US economy was growing, while in Europe, Germany was busy arming itself and the rest of Europe seemed to ignore the threat at that time; second, women especially in the US received vote rights and employment on regular basis; and three, advanced medical care and public health systems were being set up. In America, for instance, the primary site of medical care shifted from home to hospital. Surgical and diagnostic mechanisms were also improved. The outbreak of war in 1914, commonly referred to as ‘World War I’ brought with it a desperate requirement of nurses to care for many soldiers injured or suffered from illness infected as a result of trench warfare. The challenges brought about by this war offered nurses the opportunity to advance into new fields of specialization (Cherry, p. 14).

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In the United States of America, the World War I provided an avenue for nursing to discover the importance of professional training and discipline. At the same time, this war posed a threat to the status of nursing (Joel, 57). During the war period, nursing issues were handled by the American Red Cross Nursing Service headed by Jane Delano. Delano is one of the prominent personalities in the American nursing profession. She dedicated a great part of her full time doing volunteer to the American Red Cross. She also successfully agitated for better remuneration and status of nurses serving in the military. Delano was the most beloved nurse in the United States of America during the difficult years of World War I. As director of Red Cross Nursing Service, Delano held the responsibility of meeting the increasing number of nurses required to serve the military as well as meet domestic emergencies (Lynaugh, p. 86).

The American Red Cross began sending medical supplies to Europe as early as 1914 before the United States joined the war in 1917. During this period, the world nursing resources were overstretched to the limits. This happened as more and more countries were drawn into the raging war, and as a result the work of nurses grew stupendously. The deteriorating climate created the sense of urgency for the American Red Cross to establish Red Cross Nursing aide detachment. It should be noted that earlier in 1912, the organized professional nurses led by Delano, had vigorously opposed the plan arguing that it would have amounted to absolute threat to nursing service. According to them, it had taken a lot more effort and resource to establish the standards. The Nursing Professional Leaders had confronted many difficult battles in the intervening years to establish standards for practitioner and training schools. The critical issue for them was to consolidate professional nursing position as the authority over nursing related personnel and related activities at the Red Cross. They felt that establishing aide plan would water down the gains they achieved to that extent (Daly, p. 29).

The American Red Cross was able offer professional training and certification to nurses who completed the course. It issued 273 certificates of course completion in 1914. These number of certificates issued rose to 27942 by 1918. This successful development created a cluster of women who wished for service in the frenzied patriotism of the war years. Delano and her professional colleagues had not foreseen the scope of the challenges that lay a head. During the early years of the war, the Red Cross Nursing Office led by Delano, expanded as the war requirements continued to escalate. The agency a wonderful organizational feat by enrolling many nurses through a process of checking references and schools and writing to superintendents, deploying nurses to attend domestic emergencies, and developing a program aimed at lay volunteers. Delano personally saw of groups of nurses who departed for Europe, taking keen interest in their welfare (Lynaugh, p. 86).

Around 1916, base hospital medical teams were organized by the Red Cross. Some of which were sent to help European countries already involved in the war. The Red Cross, at the request of the war department organize a group of 25 nurse aides to accompany each 100 nurse base hospital unit. However, each aide was required to finish a home care course together with one month training. The escalation of the war, especially the entry of the United States into the war in 1917, led to thousands of women with various levels of training to seek for volunteer nurse positions at the Red Cross offices. The need for more nurses increased threefold as graduate nurses in droves left their positions in training schools to join the Red Cross or military service. This caused alarm bells to ring at the civil hospital authorities as the nursing staff leaving these hospitals consisted of ‘pupil nurses’ in the hospital based training program. They cared for the patients under minimal supervision of a graduate nurse. The departure of graduate nurses to serve in the war threatened the training schools ability to supervise the pupils. There ability was much necessary to the economic and clinical functioning of the hospitals with which the schools were associated. During their training, most pupil nurses were paid a rather minimal allowance. These made conditions in civil hospitals to deteriorate completely due to shortage of staff. As a result, Dr. Goldwater, an administrator of New York’s Sinai Hospital, took advantage of the moment to urge for the use of aides in the civilian hospitals during the crisis. This idea clearly threatened the hard won gains of ‘trained nurses’ (Joel, p. 58).

Professional nurses who had employed a lot of their resources and time to convince the public of the importance of nurse training, were able to witness a return of poorly trained aides to hospitals. Professional nurses were also worried that the interest in nursing school enrollment would be eroded if aides were paid, and those aides with hospital experience would then try to pass on as nurses. These fears were not grounded since the country did not have a national system required for registration. This led the national committee of the Red Cross Nursing Service to recommend in 1917 that Red Cross courses be instituted to help supply base hospital units then being readied for work overseas. By the end of 1917, about 1500 aides had been trained by the Red Cross (Joel, p. 57).

The increased demand for nurses to meet the war needs led to the expansion of the Army Nurse Corps and to a lesser extent the Navy Nurse Corps. The recruitment standards declined as the war continued. All that was required of a nurse was to produce a certificate of moral character and professional qualification by their superintendent of nurses. They also had to be unmarried. Once a gain, untrained women approached the Red Cross offices bidding for volunteer nurse service without knowing the kind of training required. These increased genuine fear that the army would be subjected into untrained hands as it had happened in Europe. Hence, a committee was formed on nursing to find ways of meeting the problems that were connected with the care of the sick and injured in hospitals and homes; and the extraordinary emergencies as they arose. That committee was later given governmental status and limited financial support. Contributions from nursing formed a greater percentage of these funds. The committee was able to document estimates on the number of nurses available and those who were undergoing training. However, the numbers were not sufficient for both military and civilian requirements (Joel, p. 58).

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The American Red Cross played the role of unofficial reserve corps of the Army Nurse Corps. When nurses together with those who were part of the multidisciplinary base units coming from hospitals were taken to serve in Europe, the home situation became desperate. As a result, recruitment efforts were stepped up. The efforts were first of all geared towards attracting educated women into nursing and then encourage schools of nursing to increase their capacity. The male nurses who did volunteer were usually deployed into regular fighting units and their nursing skills went unutilized. It is important to also note that the US army never accepted to choose black nurses. The Red Cross would only accept black nurses in mid 1917 on the approval of the surgeon General. The admission of black nurses is credited to Adah Thom, who was herself a black nurse (Joel, p. 58).

It was not easy to entice young women to join nursing even with the patriotic fervor generated by the world war. Many students were opposed to the life of drudgery, severe discipline, tiresome work, poor education, lack of freedom and entertainment as students, and limited satisfaction options for employment. Despite of these, schools increased there capacities to some 25%. There pressure of the conflict resulted to changes in education. One of the resulting changes was the establishment of the Vassar Training Camp in 1918. The idea was to commence a preparatory course in nursing for women who have passed through college. More than 400 students of age 19 to 40 studied in many professional fields in the spirit of patriotism (Daly, p. 31).

The nursing conditions at the American military camps were reported to be atrocious, hence the Surgeon General appointed Annie Goodrich to evaluate the quality of nursing service in the military camps. Goodrich had experience inspecting training schools in New York State. She was an assistant professor at Teachers College. Goodrich’s report revealed poor conditions much worse than civilian hospitals. The military camps did not have enough nursing personnel to care for the patients. The available nurses found it impossible dealing with disinterested corpsmen (Lynaugh, p. 80). It was recommended that each military hospital should have a nurse training school where students under careful supervision, would provide better service than aides or corpsmen. The Army school of Nursing was to be centralized in the office of the Surgeon General and headed by a Dean. The Army school was eventually approved in 1918, with Goodrich being appointed as Dean. The college provided a 3 year course based on the standard curriculum for schools of nursing. Duty hours were limited to 6 to 8 hours unlike civilian hospitals. The response to the school was overwhelming and it attracted many students than it could accommodate (Joel, p. 59).

Works Cited

  1. Cherry, Jacobs. Contemporary Nursing: Issues Trends and Management. New York: Elsevier Health Sciences, 2005.
  2. Daly, Speedy. Professional Nursing: Concepts, Issues and Challenges. New York: Springer Publishing Company, 2005.
  3. Joel, A. Kelly’s Dimension of Professional Nursing. London: McGraw-Hill Professional, 2003.
  4. Lynaugh, J. Nursing History Review: Pennsylvania: University of Pennsylvania Press, 2007

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