Although the position of Army Nurses was first mentioned in the Journals of the Continental Congress on July 27, 1775—the traditional anniversary date of the establishment of the Army Medical Corps—it wasn’t until nearly two years later their roles became more clearly defined. On April 7, 1777, Congress specified that each military hospital it authorized for construction would have at least one Matron “to every hundred sick or wounded, who shall take that the provisions are properly prepared; that the wards, beds, and utensils be kept in neat order, and that the most exact economy be observed in her department.” Congress also mandated that there should be one Nurse, operating under the direction of the Matron, for every ten patients. Matrons were to be paid $4 per month, Nurses $2.
Creating these positions was accomplished with the stroke of a pen, but filling them was another matter indeed. Part of the reason was the low pay—the pay for Nurses was eventually quadrupled in an attempt to make the job more attractive—but just as much of a disincentive was the unsanitary conditions and the chances of falling prey to diseases such as smallpox or dysentery. As fervently as Congressional and military leaders sought female nurses, however, there remained a shortage of them throughout the war.
By the time of the Civil War, the Army had established requirements and standards for male hospital stewards. Working in tandem with Army surgeons, the stewards’ main focal points were on cleanliness and sanitation. But as the war grew in its scope and the Army’s manpower began to expand almost exponentially, there simply were not enough stewards to handle the demand for nursing care, and the Army turned to the private sector for a solution. Some 15,000 women sponsored by the U.S. Sanitary Commission served as Nurses in the Union Army, where they worked as surgeon’s assistants, administered medicine, dressed wounds, delivered meals and assisted in feeding, maintained cleanliness, and provided comfort to the wounded and dying.
The end of the Civil War eliminated the need for nurses, as their jobs could be handled by hospital stewards in the much-smaller Army. At the same time, however, advances in medical science had proven the incredible importance of sanitation and sterilization in preventing disease and limiting its spread—and nurses were instrumental into putting these principles to work in hospitals. By the time the Spanish-American War erupted in 1898, the Army understood the importance of the duties being performed by Nurses but, just as in the Civil War, they had to turn to the private sector to find them in the numbers they needed.
Dr. Anita McGee, a physician who was also a member of the Daughters of the American Revolution, volunteered to assist the Army in acquiring Nurses to service at home and abroad; she selected almost 1,000 of the 1,158 nurses who signed contracts with the Army and served not only in the United States but also in Cuba, Puerto Rico, the Philippines, Hawaii, Japan, China, and on hospital ships during the conflict. And while American troops suffered from extraordinarily high rates of malaria and yellow fever in the tropical environments where they were deployed, the care they received from these highly trained, professional nurses inspired Congress to establish a permanent Nurse Corps in the Army.