Women in Civil War Changed the Idea of Who Could Be Nurses

The 1850s and 1860s in America saw the rise of the “sentimental domestic idea.” Women were held up as examples of purity, piety, and submissiveness. In the American antebellum period, precise and strict rules were recommended for women’s socially acceptable and appropriate behavior.

But the Civil War would change the social, economic, and political landscape for women from every walk of American life—perhaps nowhere more so than in the field of nursing. In the wartime environment, women showed remarkable resilience and were able to respond to great needs while learning and using skills to alleviate the pain.

“At the beginning of the war, a ‘nurse’ meant a soldier recovering in hospital from a wound or injury, untrained in healing, who aided doctors with miscellaneous duties,” Dr. Robert D. Hicks of the College of Physicians of Philadelphia explained. “The idea of women handling the bodies of men not related by family was unthinkable. By the end of the war, the term meant women who aided doctors by cleaning and feeding patients and occasionally assisting doctors in their surgeries and treatments.”

The governments of divided countries were not ready for the long and difficult Civil War and the resulting deaths. It was not possible to arrange transport and treatment for the thousands of sickened or wounded men. There were no field hospitals or well-organised medical corps in the armies. An officer’s wife might accompany her husband to the battlefield, or a mother attend to care for a wounded son or husband, and either might choose to remain and care for the increasing number of wounded.

Injured soldiers increased in number, which led to epidemic diseases that ravaged troops. Newspaper stories about the shortage of supplies and medical treatment in army hospitals and camps inspired many women to join the ranks of the soldiers and nurses on the battlefields. These women began appearing in cities all over the country to care for wounded and sick soldiers. The doctors did not always accept them. Particularly the Union Army was against women on-site, as they believed that they were disorganized, incompetent, or inexperienced. Southern women considered nursing intimately inappropriate.

It was true that most of the women probably had no prior experience with the kinds of devastating wounds and ailments the men were experiencing, but they were willing to learn and insistent on becoming part of the solution, arguing that the war “was as much a woman’s war as it was a man’s war.” The women of North and South pressed on in areas that had previously been closed to Victorian women, and it is estimated that more than 21,000 women served in Union military hospitals and a comparable number in the Confederacy, where 10% of the nursing women were African American. Over 3,000 of these women were paid to be nurses, while thousands more were unpaid volunteers. The women included Catholic nuns, immigrant, former enslaved, and wives, as well as daughters. This war gave women the opportunity to play an active part in the relief effort outside their homes and families. Women could also assume leadership positions in sanitary commissions, assist in government and business with clerical work, and offer invaluable assistance when caring for injured soldiers.

Studio portrait by Dorothea Dix. She was the superintendent of nurses during the American Civil War.

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In 1861, the Union formalized the arrangement, appointing Dorothea Dix as “Superintendent of Female Nurses of the Army.” Dix was among the American women who had traveled to Britain, Turkey, and Crimea to learn from the legendary Florence Nightingale, who was already transforming nursing in Europe. Dix, 59, was already a prominent advocate and reformer of prisoners and mentally ill. After being horrified at the violence, Dix boarded a train for Washington, D.C., to meet Simon Cameron, U.S. Secretary of War. Cameron offered Dix her services to be a nurse for the Union Army. However, she was impressed by her assertiveness and organizational skills as well as her tenacious nature. She appointed her superintendent of Union Army nurses, which she held until 1865.

Continue reading: The Heroic Work of Nurses today: How Florence Nightingale helped pave the way

Dix was able to overcome resistance in a hostile field and, during WWII, arranged and trained more than 3,000 nurses. Dix was the first woman to ever hold this high-ranking federal appointment. She jumped into the job, setting up aid stations and hospitals in the field. Although she was once thought to have high standards for nurses, she advocated for more formal training for them and greater work opportunities. Her nurses were crucial to the advancement of the nursing profession in wartime and general medicine. She was very kind to them.

In the South, Captain Sally Louisa Tompkins, also known as the “Angel of the Confederacy,” became, at the age of 28, the first woman to be commissioned into the Confederate Army—also the first woman in American history to be formally inducted into the military. In Richmond, she ran the home-turned-hospital. The medical practices of the private Robertson Hospital reflected Tompkins’s compassionate and meticulous dedication to cleanliness and care and its reputation began to spread. According to legend, wounded soldiers from Richmond would seek admission to Robertson Hospital. Commanders also sent their most serious cases to it. Confederate President Jefferson Davis created regulations that all hospitals must be under military control. The private hospitals had to shut down for fear of being accused of dodging military service and malingering. He made a shocking move, breaking military and social traditions by allowing Tompkins to continue with her work. Also, he commissioned her as a Captain in the Confederate States Army. She was then legally able to sustain the hospital’s operation and to obtain her medical supplies from military stores. The Robertson Hospital was operated by Tompkins throughout World War II. It treated 1,334 wounded soldiers and only 73 died in 45 months. This hospital had a survival rate of 94.5 percent, which is the best among Confederate military hospitals during wartime.

Harriet Tubman’s portrait.

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Although commitment and determination to the cause was transcendental to some extent of social class or race, inequality still existed among women. Many unsung African American women contributed enormously to this effort, including former slaves, contrabands and freeborn who risked everything to help staff hospitals and ship hospital beds. Harriet Tubman was born to slavery and is best known as Harriet Tubman’s brave conductor on Underground Railroad. She also served as Union spy and scout. Her influential contribution to nursing in the Civil War are less well known. After the war drew a dark shadow on the nation, she offered her support to the Union Army. She traveled to South Carolina in order to give desperately-needed nursing care to Black soldiers as well as newly liberated slaves. Her ability to heal dysentery with healing herbs medicine was legendary.

Ann Bradford was born in Rutherford County in Tenn. in 1830 into slavery. She fled slavery and risked her life in 1863, fleeing the plantation. She was eventually taken on board the Union ship U.S.S. Red Rover (a captured Confederate vessel turned hospital ship) and was first classified as “contraband,” a term for escaped slaves. The timing of Ann’s escape was fortuitous, as Union President Abraham Lincoln had recently signed the Emancipation Proclamation, and Bradford’s status was upgraded to “free woman.” She could legally leave the ship if she wanted but chose to stay on board, embracing a new life by formally becoming a volunteer with the Sisters of the Holy Cross of Notre Dame. Ann, an African American woman who served on a Union vessel as a crew member and the first female nurse to join the U.S. Navy openly. She was one of five African American women—including Alice Kennedy, Sarah Kinno, Ellen Campbell, and Betsy Young—who served on that ship and were assigned the rank of “first-class boy,” a term usually applied to young men who worked as general-duty sailors. Bradford made the transition from slave to free and paid worker in a relatively short amount of time. They performed various duties including nursing and caring for the injured, washing clothes, as well as cooking and cleaning. They had no formal training in medicine and relied only on traditional remedies found on plantations. However, their unexpected new experience gave them insight and common sense.

The need for professional nurses was more apparent during and after the Civil War. Some hospitals began informal training. For two- or three years, students agreed to volunteer their nursing skills to the hospital. The hospital also offered clinical instruction and lectures. But the attached nurse training was to hospitals and not schools. This encouraged segregation of the health care system. For many years, African American nurse students were denied entry to schools of nursing other than those that had been established by African American hospital. The first formal schools of nursing in the United States opened in the year 1873 and were all based on Florence Nightingale’s model for the education of skilled nurses. There are more than 800 nursing schools in the United States that offer degree programs in care for men and women of any race.

Many women from Northern and Southern, both nuns and laity, were forced to abandon long-held social norms and traditions in order to make a bold move to the front lines of war because of the desperate circumstances created by Civil War. Years of misperceptions about women’s strength and perseverance were overcome by them. Many people who had been expected and encouraged to be passive were now able to make passionate contributions and bring out their iron backbones in war.

Source:A Revolution in Western Medicine: The American Civil War Revisited Western Medicine. Carole Adrienne is now available through Pegasus books. Copyright © 2022 by Carole Adrienne.


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