Pearl Harbor's Impact on the Nursing Profession in WWII

Introduction: Pearl Harbor and the Nursing Profession

Pearl Harbor, and the United States' subsequent involvement in World War II, had a lasting impact on the country, much as the events of September 11, 2001, had and will continue to have a lasting impact on this nation. In particular, this paper focuses on the impact that Pearl Harbor and World War II had on the nursing profession. The events at Pearl Harbor, and other events during the course of World War II, played a large role in helping to change the country's perception of nurses. These dedicated women were now taken more seriously and, as a result, the environment in which nurses learned and worked changed significantly.

At the time Pearl Harbor was attacked, the United States was facing a serious shortage of nurses. President Franklin Roosevelt issued a call for more nurses, and the military, in an effort to help fulfill the country's need, responded by offering programs designed to recruit women into nursing service. One of the most successful programs — though not a strictly military program — was the United States Cadet Nurse Corps. Women who completed the Corps often went on to join the military as nurses and served with great distinction.

World War II also ushered in changes to the technology employed in the nursing profession. New techniques were developed in anesthesia and prosthetics, and patients' psychiatric health was studied more seriously, with training provided accordingly. This was especially vital as war-ravaged veterans returned from World War II only to face a society that, while appreciative of their wartime service, had little idea how to address their complex needs. The country — and the nursing profession — also underwent changes at an ethical and legal level.

One of the darkest periods in this nation's history was the forced internment of thousands of Japanese Americans. Prejudice and hysteria combined to create an atmosphere in which an entire group of people was punished in one country for the actions of those in another. As a result, many Japanese American women entered the nursing profession as a means of escaping the internment camps and demonstrating their loyalty as American citizens.

Economic and Social Changes for Wartime Nurses

This paper examines each of these areas in turn — the economy, politics and legislation, technology and education, the nursing environment, and the ethical and legal issues the nursing community had to address as a result of Pearl Harbor and World War II — and argues that these events played a pivotal role in creating the nursing profession as we know it today.

Prior to World War II, the United States economy was in a poor state. The country was in the throes of the Great Depression, and thousands of people had lost their jobs, their homes, and their way of life. World War II served as a stimulus to the economy, with jobs being created in factories where workers built airplanes, tanks, parachutes, ammunition, and more. However, the war did more than stimulate the basic economy — it also brought about a profound change in the status of women. Prior to the war, women largely remained in the home, working as homemakers and mothers. When hundreds of thousands of men went overseas to fight, factories and offices were left understaffed, and women stepped in to fill the vacancies.

The nursing profession felt these economic changes acutely. There was a substantial shortage of nurses in the country, particularly in the military. At the time Japan attacked Pearl Harbor, there were only 7,000 active-duty nurses in the military; six months later, there were 12,000 (Feller, 1997, p. 13). Part of the impetus came from a sense of nationalism and patriotic duty. The country was reeling from the attack, and many women saw the Army and Navy Nurse Corps as a place where they could serve their country.

For other women, however, the motivation went further. Given the poor economic conditions in the United States before World War II, there was little opportunity for young adults — especially women — to pursue higher education. The critical shortage of nurses, however, meant that the United States was willing to take extraordinary measures to address that gap. As a result, the U.S. Cadet Nurse Corps was established, allowing women to train as nurses free of charge. Provided they were willing to serve in the Corps for the duration of the war, women could receive free education, including tuition, books, uniforms, and monthly stipends.

Politics, Legislation, and the Army Nurse Corps

Politically and legislatively, nursing was also of great importance during this period. As previously noted, the country faced a severe shortage of nurses when it entered World War II. President Roosevelt issued a special appeal for women to join the Army and Navy Nurse Corps. The Army Nurse Corps had existed since the time of the Revolutionary War and had participated in every major military action since, becoming a permanent part of the War Department in 1901 (Feller, 1997, p. 7).

Like the soldiers they supported, the women who joined the Army Nurse Corps and went overseas initially expected a swift victory. The reality of the battlefield, however, came as a shock. According to Lieutenant Colonel Margaret E. Aaron, an Army Nurse Corps representative:

"Mostly young and new to the Army, the women found themselves bewildered and homesick in a strange country. Wearing uniforms and work dresses ill-adapted to the cold, damp climate and minimally heated buildings, they suffered a high rate of colds, flu, and pneumonia" (Cosmas and Cowdrey, 1992, p. 119).

In June 1940, there were only 942 women in the U.S. Army Nurse Corps (Roman, 2002, p. 58). According to Marlene Roman, president of the Academy of Medical-Surgical Nurses (2002), this situation led to the creation of the Nursing Council for National Defense, which emphasized the urgent need to train additional nurses. During World War II, Army and Navy nurses served in Europe, Asia, Africa, and the Pacific, as well as in military hospitals throughout the United States (p. 58).

The ranks of Army and Navy nurses continued to grow, but it was not enough. In late 1944, the Secretary of War formally recommended to the president that nurses be drafted into service. The House of Representatives passed the measure — known as HR 2277 — and the Nurses Selective Service Act was signed into law in March 1945. As it happened, however, the Act was never implemented. Less than a month later, Allied forces entered Berlin and the war in Europe ended. The War Department notified the Senate that the legislation was no longer necessary. Public opinion polls taken at the time showed that 73% of Americans supported drafting female nurses, and by the summer of 1945, nearly 57,000 Army nurses and 11,000 Navy nurses were on active duty (Roman, 2002, p. 58).

Nurses Under Fire: Pearl Harbor and the Pacific Theater

The Cadet Nurse Corps was not a military branch in the same sense as the Army and Navy Nurse Corps. It was administered by the U.S. Public Health Services Department, and its members were considered civilians, although many went on to join the Army or Navy Nurse Corps upon completing their training. The two-year program combined classroom instruction with practical service work. As Morris (2002) explains, "the cadets worked at homeland hospitals, filling the positions left by nurses sent overseas to serve in military hospitals. The government paid for their training and in return, the cadets promised to work wherever they were needed."

Kathleen Sullivan, a member of the Cadet Nurse Corps, recalled in an interview (Morris, 2002) that "nursing was very different in those days...nothing was disposable...penicillin was just coming into use although most of the allotments were reserved for military casualties. It had to be administered precisely every three hours. Often...it took so long to complete their rounds that within minutes of finishing, it would be time to start again."

The women who chose to become nurses, whether civilian or military, demonstrated remarkable strength, fortitude, and grace under pressure, and nowhere was this more evident than during the attack on Pearl Harbor. On December 7, 1941, a Japanese strike force from the Imperial Navy dropped bombs on the harbor and its ships anchored in Battleship Row, on Hickam, Wheeler, and Bellows airfields, and on the Kaneohe Bay Naval Air Station on Oahu's north shore. The surprise was total, as was the devastation. According to Condon-Rall and Cowdrey (1998), "among the ruins, 2,327 American officers and enlisted men lay dead, of whom 2,000 belonged to the Navy, 98 to the Marines, and 229 to the Army; some 270 civilians perished. Another 1,143, among them 439 soldiers, were wounded."

Prior to the attack, life at Pearl Harbor Naval Station had been casual and relaxed, with little urgency toward war preparation. The lack of nurses and medical supplies had seemed inconsequential — until the attack made the shortage a devastating liability. As Hughes (2003) notes, the nurses involved in the chaos at Pearl Harbor "worked under tremendous pressure." Hughes (2000) describes the scene:

"As hundreds of casualties suffering from burns and shock began to arrive...the staff was overwhelmed. The blood-spattered entrances led to hallways where wounded men lay on the floor waiting for surgery....Medical personnel faced shortages of instruments, suture materials, and sterile supplies. Doctors performing surgery were forced to pass scissors back and forth from one table to another. Doctors and nurses used cleaning rags as face masks and operated without gloves."

Despite these conditions, the nurses performed extraordinarily. According to Hughes (2000), "their skill and dedication contributed to the low post-injury mortality rate among American forces in every theater of World War II. Overall, fewer than four percent of the American soldiers who received medical care in the field or underwent emergency evacuation died from wounds or disease." Their contributions did not go unrecognized. According to Army Nurse Corps records (ANC, 2003), the chief nurse at Hickam Field, 1st Lt. Annie G. Fox, was the first of many Army nurses to receive the Purple Heart, awarded for "her fine example of calmness, courage, and leadership, which was of great benefit to the morale of all she came in contact with."

A further dimension of nurses' wartime service was less widely known at the time: some were captured and held as prisoners of war for several years. Elizabeth Norman's book We Band of Angels (1999) tells the story of 77 Army and Navy nurses taken prisoner by the Japanese following attacks on American installations in the Philippine Islands on the same day as the Pearl Harbor strike. These women were the first group of American military women ever taken captive and imprisoned in the nation's history. In total, 201 Army nurses died during World War II, and more than 1,600 were decorated for "meritorious service and bravery under fire" (Feller and Moore, 1996, p. 16). Army and Navy nurses suffered the highest casualty rate of any group of military women (Roman, 2002).