Veterans Day: Nurses on the Battlefield: The Ultimate Sacrifice

I like to believe that every day nurses do something heroic for people, even if that something is trifling. We make small sacrifices every day for our patients, like forgoing a meal, or a trip to the bathroom, staying late to make sure our patient’s care is complete, and spending holidays caring for our sick patients instead of sitting down to dinner with our families. But when I think about the sacrifice our military nurses make, I quickly realize a grumbling stomach, and a full bladder are inconsequential in comparison.

Today is Veterans Day, a day I hold in high esteem. I honor all the men and women who serve this great nation. However, when I think of what it truly means to sacrifice, I am drawn to the battlefield nurses who are not only hungry, and running with full bladders, but are putting their lives in danger to care for the heroes that defend our nation. Battlefield nursing launched our most famous leader, Florence Nightingale, into the history books, during her time in the Crimean War. Her dedication to service, her intellect, and her ability to improve battlefield conditions, while reducing soldier mortality rates in the wounded, changed the face of nursing care not only on the front lines, but in each and every hospital as well.

In America George Washington understood the importance of the battlefield nurse, and in 1775 The Congressional Resolution allotted one nurse for every 10 patients in military hospitals, and provided nurses a salary, though meager, at two dollars per month. Up until that time, nurses positions had traditionally been voluntary. By 1777 George Washington put out a call for more nurses, and the salary was increased to eight dollars per month. Nurse’s time on the battlefield did not end with George Washington. From 1861-1865 over 3000 nurses served in the Union Army during the Civil War. By this time nurses were earning 12 dollars per month and rations, however, nurses were always at risk of contracting contagious diseases, and battlefield injuries.

 In 1917 when WWI raged across Europe, over 12,000 American nurses were ready to serve. They were deployed all over the world. Again in 1941, after the bombing of Pearl Harbor, nurses came forward to serve in the Second World War. For the past nearly seven decades Nurses have served in Korea, Vietnam, Iraq, and Afghanistan. To date, approximately 1000 nurses have lost their lives in the line of duty. A true sacrifice!

Operating Room, MASH unit Korea

Vietnam war memorial with nurse and wounded soldier.

Flight Nurses Today           

I recently came across this article about one of those brave nurses who made the ultimate sacrifice doing her job, caring for the soldiers, and country, she swore to protect. She is the kind of woman, nurse, and human being I would hope all of us aspire to be. Today’s Veterans Day post is dedicated in her honor: Jennifer M. Moreno.

An undated photo provided by the U.S. Army shows Army 1st Lt. Jennifer M. Moreno. Moreno, 25, of San Diego, Calif., an Army nurse from Madigan Army Medical Center at Joint Base Lewis-McChord, was one of four people killed Sunday, Oct. 5, 2013 by an improvised explosive device in Afghanistan. (AP Photo/US Army)

Everyday we have choices to make. Some may be small, some large; others may be easy, while some may be life changing. On October 6, 2013 Captain Jennifer Moreno, an Army Special Operations Command Nurse was on assignment with her comrades in Afghanistan attempting to capture a high value target. Instead of the high value target surrendering, an Afghan woman came out and detonated her suicide vest, wounding six troops. That explosion then set of an IED. As soldiers rushed to help the injured troops, they set off another IED. A second Afghan emerged from the building, detonated his suicide vest, killing Jani a working military dog.

Ground soldiers were ordered to stay in place by their commander, but Moreno heard the cry of help for a wounded soldier. It is in that moment where Moreno’s choice represented duty to serve, and Captain Moreno chose not to stay in place, but to perform her commitment, and follow the Nurses Code of Ethics, as well as the soldiers creed to “never leave a fallen comrade”, to go help save her fellow soldiers. It was a choice that would prove to be fatal.

In over a century of war, we have lost many nurses to the side effects of conflict whether by disease, or injury. I would like to take the time to honor those listed below, and thank them for their service, and their ultimate sacrifice.

Spanish American War: 21 Nurses died of typhoid and malaria.

WW I: 430 Nurses died from the 1918 Influenza outbreak.

WW II: 460 nurses died. Six Army Nurses died in hostile fire at Anzio Beachhead in 1944. Six Army Nurses died when a Japanese suicide plane crashed into the Hospital Ship USS Comfort near the Philippine Islands in 1945.

Korea: 16 Army, Navy, and Airforce Nurses died enroute to the battlefield

Vietnam War: 8 Nurses died in enroute to the battlefield. Army Nurse Lt. Sharon Lane died from hostile fire.

Iraq: Army Nurse Capt. Maria Inez Ortiz was killed by a mortar attack in the Green Zone in Baghdad. Army Nurse Captain Gussie Jones died in Iraq of non-battle related causes.

Ft. Hood Texas: Army Psychiatric Nurse Captain John Gaffney, Army Mental Health Adult Nurse Practitioner Captain Russell Seager, and Army Psychiatric Nurse Practitioner Lt. Colonel Juanita Warman were all killed by hostile fire when Major Nidal Malik Hasan opened fire on them.

Afghanistan: Army Nurse Captain Jennifer Moreno killed in and IED explosion. Army Nurse Practitioner, Lt. Colonel Richard Berrettini died from injuries after his vehicle was hit by an IED. Army Nurse Captain Bruce Clark collapsed, and died during deployment in Afghanistan. Army Certified Nurse Anesthetist Joshua McClimans was killed by indirect rocket or mortar fire from insurgents on his way to work at the Army Hospital in Afghanistan.

God bless all the men and women who have sacrificed their lives for our freedoms!

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Veterans Day: A Tribute to Military Nurses

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     The last time I posted for Veterans Day, I wrote about the special relationship between the nurse and the soldier’s they care for.  But today, on this Veterans Day, I wanted to recognize all the nurses who have courageously gone to the battlefield, risked their own lives, and in some cases lost their lives.  I wanted to delve into the history of the military nurse, their duties, bravery, and unyielding dedication they show to the soldiers in their care.

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Florence Nightingale attending the wounded of the Crimean War.

     Florence Nightingale is the most famous military nurse in history.  Although not a commissioned soldier, her experiences during the Crimean War helped to pave the way, for what would be in America, The Army Nurse Corps.  Florence Nightingale’s presence during wartime led to important changes in hygiene, and sanitary conditions in the hospital wards at the front lines.  Those changes were brought back to Great Britain, and America, and had a global impact on hospital care both on the battlefield, and at home.

     Since that time women have traditionally served in times of war, but mostly in volunteer corps, not as officers.  During the Revolutionary War the Congressional resolution of July, 27, 1775 allowed one nurse for every ten patients in Continental hospitals.  Nurses were paid two dollars per month a salary that increased to eight dollars per month by 1777.  Nurses were in great demand on the battle field to care for the sick and wounded soldiers, and in 1778 George Washington ordered his commanders to hire as many nurses as possible.  Nurses traveling with the army were at risk for injury as well as disease.

The Angels of the Battlefield by William Ludwell Sheppard ushistory.org

     The Civil War brought the attention of Dorothea Dix to the forefront.  Though not a nurse herself, she was federally appointed as Superintendent of female nurses, and in charge of overseeing the entire nursing staff of the Union Army.  From 1861-1865 approximately 3300 nurses served in the Union Army for the grand salary of 12 dollars per month, and food rations.  Nurses during this time were at great risk for contracting contagious diseases, as well as the dangers of being on a battle field. Interestingly Louisa May Alcott, author of Little Women, served as a nurse under Dorothea Dix.

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WWI Nurse

     By 1898, under the request of the Surgeon General,  nurses were contracted for the Spanish-American War, and salaries were increased to 30 dollars per month and one food ration a day.  The Army, around this time, was more selective in the hiring of trained nurses, or graduate nurses approved by their nursing school directors.  These nurses were called contract nurses, and their training improved the quality of the military nurse.  The army later went on to establish the Army Nurse Corps in 1901 which organized nursing under the control of the army, and allotted for three-year terms.  At this time only 220 nurses were on active duty.

First 20 Navy Nurses Corps.

First 20 Navy Nurses Corps.

     In 1908 Congress established the first Navy Nurse Corps, though unofficially, nurses had been sailing on navy ships for nearly a century.

     In 1917, during WWI, nurses ranks had risen again to 12,186, and were stationed all over the world.  The Army opened its own school of nursing in 1918, but then closed it in 1931 due to budget cuts.

     In 1920 nurses in the military were given officer rank from 2nd lieutenant to major.

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     When the Japanese bombed Pearl Harbor on December 7, 1941 the nursing corps had dwindled back down to around 7000.  But with a reserve corps already established, and active recruiting, that number quickly went back up to over 12,000 within six months.  During WWII black nurses had begun to serve in large numbers, however their units remained segregated both at home and overseas.

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Liberated Nurses Feb 12, 1945

     In 1942 66 Army Nurses serving in the Philippines, became prisoners of war to the Japanese with the fall of Corregidor.  Just prior to the fall, 21 nurses escaped and made it safely to Australia by plane and submarine. Those that remained as POW’s did so for three years before they were liberated.  All received the Bronze Star Medal and a promotion of one grade.

Flight Nurses in Training 1943

Flight Nurses in Training 1943

First Navy flight Nurses 1945

First Navy flight Nurses 1945

     In 1943 the first class of Army Nurse Corps flight nurses graduated from the School of Air Evacuation, and basic training camps were established to train nurses for their military experience.

In November  of 1943 a plane carrying 13 nurses and 17 soldiers crash landed in Albania behind Nazi enemy lines.  All members of the plane survived, and after a nine week, 800 mile  journey, managed to escape enemy lines.  This story can be found in the book Albanian Escape, written by Army Nurse Agnes Jensen.

Nurses showing worn out heels after a sixty day hike out of enemy territory!

Nurses showing worn out heels after a sixty day hike out of enemy territory!

     In 1947 Nurses were given the opportunity to take a 56 week course in anesthesiology, and a 24 week course in operating room technique and management.

     In 1950 the Korean war begins, and nurses are sent to set up hospitals, and Mobile Army Surgical Hospitals (MASH)  units.

     By 1955 male nurses were authorized commission to serve in the U.S. Army Reserves for assignment to the Army Nurse Corps.

Operating Room, MASH unit Korea

Operating Room, MASH unit Korea

     1962 sees the first wave of nurses sent to Vietnam, and 1973 sees the last wave of nurses leaving Vietnam.  Nine nurses died in Vietnam during this time period.

Vietnam war memorial with nurse and wounded soldier.

Vietnam war memorial with nurse and wounded soldier.

     In October 1976 a B.S.N. was required for active duty in the Army Nurse Corps.

     1990 Nurses are deployed to support troops in Operation Dessert Shield/Dessert Storm

     September 11, 2001 America is attacked.

     2003 Operation Iraqi Freedom begins.

Flight Nurses Today

Flight Nurses Today

     Nurses on the battlefield, at the front lines, or in route to do their duties put their lives on the line, and as a result over 200 nurses have died in the line of duty.  The nurses presence during combat is indispensable.  Nurse soldiers, like all soldiers, sacrifice their time, their families, and sometimes their lives to protect the soldiers protecting our freedom.  Nurses on the battlefield have always, and will continue to be a voluntary job.  Nurses are not part of the draft, though shortly before the end of WWII there was a bill in congress to have nurses as part of the draft, but at the end of the war it was determined that enough nurses had volunteered that a draft was unnecessary for them.   Military nurses should be proud of their enduring history.  Great women bravely face the darkness of war, carrying with them only their knowledge, skills, and compassion, guided by the light from Florence Nightingale’s lantern.  That light continues to shine within the brave men and women of todays modern-day Army, Navy, Air Force and Marine Nurse Corps.

     I am proud to be a nurse.  I am grateful to all the nurses before me who had the courage to face danger, provide excellent nursing care to our wounded soldiers, and protect the freedoms we hold so dear.  I wish all the military nurse corps a peaceful Veterans Day, and a sincere thank-you from this civilian nurse.  You are all truly special for what you do.  And of course to ALL the Veterans and Active Duty Soldiers a HUGE Thank-you.

God Bless You All!

In Honor of Our Veterans

When I picture the image of a wounded soldier lying bleeding on a battlefield somewhere, I know close by a nurse is waiting in nervous anticipation to come to his aid.  I have always felt that nurses and soldiers go hand in hand throughout the history of war and peace.  They compliment each other in a relationship that cannot be defined.  I have never fought in a war, but I have spent time caring for our Veterans.  They are a unique bunch of people who I have had the privilege of meeting.

Of course it was our founding sister, Florence Nightingale, who rose to stardom through her bravery caring for the wounded of the Crimean war.  She set the stage for the war-time nurse, the lady with the light, going from soldier to soldier in the night caring for their wounds, reading them letters, or holding their hand as they passed from this world.  I know there were plenty of Florence Nightingales before the Crimean War, and plenty after, but it was she, who truly made the soldiers bedside nurse someone to be proud of.

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Florence Nightingale Courtesy of Asli Kutluay aslikutluay.com

I don’t think there’s anyone braver than a U.S. soldier.  When this country goes to war, our men and women never falter.  Time and again we have watched so many go off to war, and only some return.  And even those that return are changed for life; whole on the outside, but somehow broken on the inside.  As it is a soldiers duty to go to war, and obey commands, it must be our duty as citizens to honor their sacrifice and their service.

I spent four years in the early 1990’s working for a big university hospital as a research coordinator.  During this time I was set up with an office in the Veterans Administration Hospital.  The majority of my work would be conducted there.  Upon entering the V.A. hospital I was greeted by security guards and asked to show my I.D., then I was shuffled through a subway turnstile type entrance into the main lobby.  Past that first checkpoint, as I made my way to the elevator banks, I remember so clearly seeing a man with no face, literally a hole where his face should have been.  I wasn’t sure how this person was able to get around, but quite clearly he was, I on the other hand was having some difficulty.

USAAF Flight Nurses in WWII. National Museum of the USAF

USAAF Flight Nurses in WWII. National Museum of the USAF

Russian nurse in a fox hole tending to a wounded soldier

Russian nurse in a fox hole tending to a wounded soldier

My office was on the fourth floor, but my clinic was in the basement, along with all the outpatient clinics that veterans attended; anything from gulf war syndrome to sexual dysfunction.  I felt like a fish out of water.  Not only did I know nothing about conducting research, I knew even less about working and caring for veterans.  As I slowly started to learn my way around this hospital with its rules and protocols, and constant stares, I also slowly started to learn my way around these men.  What I found was a cast of characters more colorful than any rainbow, but as solid as the colors on the flag.  I met men from just about every war, from WWII to Vietnam.  Some were demolitions experts, some were prisoners of war, others had lost their way and ended up in prison, or living in S.R.O.’s (Single Room Occupancy Housing).  But all had captured a piece of my heart.  And as the patient load grew, my best friend came to work with me and soon discovered for herself what a crazy, mixed up world the V.A. hospital was.

Even though we were probably too young for the responsibilities of a research job, we were not lacking in our responsibilities to care for and do anything for our Vets.  Kindness goes a long way, and that was one thing we could give unconditionally.

Like I said, nurses and soldiers go together both on and off the battlefield.  There’s a certain grit that comes off a Veteran, it’s something I trust and admire.  But then again it takes a certain grit to become a soldier in the first place.

So on this Veterans day this one nurse would like to thank all our soldiers who have sacrificed their time, their limbs, and their lives to support the freedoms that this country has provided for all of us!!

Thank You!!

Vietnam war memorial with nurse and wounded soldier.

Vietnam war memorial with nurse and wounded soldier.