G.I. Nightingales: The Army Nurse Corps in World War II

Military Medicine, Jun 2004 by McCormick, Kathleen A

G.I. Nightingales: The Army Nurse Corps in World War II

Barbara Brooks Tomblin

The University Press of Kentucky

It was bold to send a historical book to a nurse physiologist and informatician to review, but I really enjoyed reading this book for Military Medicine. The book follows the War in the Pacific, in Europe, and Asia, and the minor theater environments where nurses served during World War II. As I was reading the first chapters, I reflected on the stories I was told as a child about my uncle John Hargreaves who was a marine and died in the war in the Pacific and is buried in the Philippines. I found myself rummaging through family history documents and pulling up the paperwork on his death and what battle he fought in. I wondered if any of the nurses mentioned in this book dated him, knew him, or was involved in preparing his body for forensics and burial. I pulled his flag out of storage, his purple heart, his picture, and bought a frame to immortalize his memories in my home, the way the author immortalizes the actions of the our troops and the nurses and other medical professionals who cared for them. he was one of the young heroes that the author describes in the Pacific.

The author discusses not only the types of illnesses that the nurses encountered, but also the environment they lived in, the cultural issues, and the social life that kept them in balance. What was striking to me was the history of getting the volume of nurses prepared for this massive undertaking, the policies and politics of putting a predominantly women's profession in with the combat troops, and the prejudices of the society of integrating nurses.

Reading about the Pacific was timely in that I reflected on the amount of public health, infectious disease, and emergency medicine that the nurses were engaged in. The author described the challenges of taking civilian nurses into areas of combat, building hospital-type facilities, triage, operating theaters, evacuation, and rehabilitative care to soldiers and civilians with acute and chronic illness. I considered the types of emergency preparedness responses that are currently being developed in the United States to combat bioterrorism from chemical, biological, or other types of exposures. How could any current environment build a response to house 1 800 soldiers within one week? How did they cope without an information technology (IT) infrastructure? She says patients got better with "good nursing care." What nursing language tools did they use at the time, since they didn't have NANDA, NIC, NOC, Home Health Classifications? What could we capture in today's war in the Middle East compared to the volumes of data we lost in World War II because of inadequate documentation systems? What we have are nurses' diaries to help us gain a picture on the nursing care, culture, and practices.

While I was reading the chapters on the European, Italian, and North African operations, I attended parties with octogenarians in the Washington, DC area. This book was new conversation with them about the campaigns that they were in, what nurses they worked with, and what they recalled about their contributions to medicine and nursing at the time. "Did she talk about the trains in Europe?" I was asked. I found myself quickly reading ahead in the book for the descriptions of the trains that these medical personnel served on. They too remembered specific nurses who were helpful in the work on the trains.

I found it fascinating that out of 33,128 patients treated in one European operation, 10,809 care issues resulted from battle related injuries, but the majority of care was given to illness and injuries in the troops and civilians. The author highlights nurses' roles in evacuation and transport. Barbara Tomblin describes the kind of nursing care given to victims of artillery shock, hemorrhage, amputations, bullet wounds, and head injuries. There are a lot more references to numbers in the book and they are very well documented in the24 pages annotated per chapter. In addition, this book is a cumulative review of other literature and the oral histories of almost 100 people.

The majority of care, however, appeared to be from environmental exposure to the elements and accidents. Orthopaedic post-operative care and rehabilitation, and fever relief from malaria and dysentery were worldwide. These chapters as well as the Pacific chapters made me cognizant of all the work that I have been engaged in developing for the Bioinformatics Infrastructure to the identify the genes, genomes, and proteomes associated with malaria. Here we are, more than 50 years after World War II and we still do not have a vaccine or preventive prescription for malaria in the troops. How important with global warming that we know will increase malaria and cholera worldwide, for the US to focus increased resources and development to fund problems of malaria and cholera that exist today and will continue in our wars to come.

Another major concept that this book highlighted was the volume of training needed for the specialized type of nursing care to the troops during the war. Again I pondered, how did they do this without distance learning, telehealth, evidenced based practice, decision support systems, and the integrated hospital information system? If these GT's had microchips embedded on a "smart card," would we have been able to prevent some of the casualties that occurred during this devastating war?