Care of recruited nurses and how they were trained, stationed and provisioned

The need for nurses to assist doctors, dentists, medics, stretcher bearers and ambulance drivers was immediate after Congress declared war in April 1917.

Since at that time, the United States had a very small standing army, expanding the current base to a fighting force of more than 1 million meant the development of a huge and almost instant medical assistance group.

Furthermore, recruiting women meant an entirely separate set of arrangements for training, transport, domicile and services had to be built into the organization of a mobile fighting army, navy and marine corps. Providing our fighting forces and medical support unit with barracks—or some similar accommodations—required either appropriation of current homes, chateaux, public buildings such as hotels, etc., or building them.

In France, many donated the use of their homes and chateaux. Many towns and cities offered their public buildings, such as city halls or old factories. The result was that nurses, in particular, those back of the line, might sleep in very nice surroundings—and others find themselves in tents.
Here are a few examples:

Base Hospital #3, Vauclaire, France

Tents used by Evacuation Hospital #1

Accommodating one million men as well as approximately 40,000 medical professionals (including 22,00+ nurses was a huge task, necessary to care of the American fighting man. But it was also a difficult one, made more complex by the fact that women were still considered to be the "weaker sex." Separation of them from their male counterparts implied not only sequestered housing accommodations but also dining, bathing (if possible considering field conditions) and latrine facilities. In the early days of the American war effort, the women even had separate common rooms where they spent their off-duty hours. However, as the frequency and intensity of battles increased, many of these social constraints bowed to the need for efficient responses by medical personnel. As mobile units, immediately behind the lines, became overwhelmed with casualties and as allied hospital units (particularly the French) were destroyed in German advances, social strictures of separating women from the men fell.

Male officers mess, Vichy Hospital Center

What these nurses did not have was rank within the Army.

To quote the Army official history of nursing service (from http://www.army.mil/women/nurses.html ):
"Army nurses during World War I did not have officer status. They were not commissioned, but appointed into the ANC. Medics sometimes refused to accept nurses’ authority on the wards. After the war, Congress, to show their appreciation, gave nurses officer status by allotting them “Relative Rank,” meaning that an Army nurse first lieutenant, for example, received less pay and status than a male first lieutenant."

Other challenges of supply and demand caused controversy within the Nurse Corps command and among other leaders within the greater Army. The most vital need was, of course, to recruit as many qualified, well-trained nurses as possible as quickly as possible. When that number lagged behind quotas, the Army decided to recruit unqualified women to serve abroad. Many of these women worked in other professions or had none at all, joining out of national pride and compassion for wounded Americans. For these women, they were sent to training camps for what we would call a crash course in medical emergency care. Many of them had no idea how to use a hypodermic needle or change a dressing. To train many of these women quickly, the Army established its Army Nursing School and pushed through many aides toward the front.

Another controversial issue was the "separate but equal" status of African-Americans. Black men were enlisted as soldiers and Marines, but were assigned to units separate from white troops. This meant that they would also receive medical care apart from their white brothers in arms. Hence, black women who volunteered to join the nursing corps were also enlisted and served black combat units in "separate but equal" facilities.

Planning transport into France of soldiers and wounded from front lines to home

Photo Copyright, Jo-Ann Power.
Exhibit:
Fort Sam Houston Medical Museum,
San Antonio, Texas.

Transporting all Americans, both military personnel and medical staff, into France to the front lines was a huge logistical problem.
This is one reason why arrival of American fighting force levels took nearly a full year from the date of declaration of war.
The flow of personnel in presented one challenge. However removing wounded American soldiers from the A.E.F. front lines back through French countryside to base hospitals, rehabilitation sites, onward to the French Atlantic coast and home to the United States was an immensely more complex logistical challenge.
Planning routes was the first task, but in fact, the simplest. Drawing lines on a map seems easy, yet the best routes were not the ones which could be used. The front lines of British and French troops meant a southwest exit from American lines northeast and east of Paris was necessary. But huge problems existed.

Most American soldiers did not speak French. Secondly, they served in a terrain new to them.  Still more confounding was the fact that French rail lines were badly in need of repair and without synchronized gauges to lock one train route/system to another. (French trains transporting nurses from their embarkation point in St. Nazaire often stopped at the end of a line for hours awaiting the next train east. Nurses recount stories of waiting, tired, hungry and often bitterly cold.)
Here are a few pictures of the types of transport and machinery needed to ensure adequate transport home for wounded American soldiers.

Horse-drawn ambulance
Photo, Copyright Jo-Ann Power.
Exhibit: Fort Sam Houston Medical Museum,
San Antonio, Texas

Interior of motorized ambulance, U.S. Army Ambulance Service

Transport by boat and barge was also necessary. These, like ambulance trains, had nursing staff to aid wounded during their journey across country and on the Atlantic Ocean.

Hospital barge, stretcher bearers and nurse on board.

Interior of hospital train ward car, shown from attendant's compartment.

Nurses served as attendants on these transports because the nature of many soldiers' conditions were precarious. Doctors were needed at the front, as were male stretcher bearers. Nurses on board responded to the immediate needs of wounded men whose physical needs could change in an instant.

Here is the photograph of the interior of an operating room on board a hospital train.

Recruiting posters of World War I are stirring, blunt appeals to enlist

Here are only a few of the hundreds of posters the United States government printed to encourage citizens to enlist as soldiers and Marines. Hundreds of other posters encouraged others to enlist as nurses, medical personnel, ambulance drivers, merchant marine and longshoremen. The rhetoric is a mix of appeals to patriotism and a sense of wonderment that the realities of war quickly negated.

The most well-knownAmerican recruitment poster is Uncle Sam pointing to the viewer. This "I Want You" image has been used and adapted over the past 9 decades to recruit for other wars. Adaptations even discouraged enlistment in such wars as the Vietnam conflict.  Here is the original version and its famous British counterpart and predecessor featuring General Kitchener recruiting for the British Army in 1914.

Public domain in U.S. Archives

Public domain in UK, EU and U.S.

After U.S. Marines won the battle of Belleau Wood, their German opponents nicknamed them Devil Dogs, Teufel Hunden. To this day, the U.S. Marines use this name and their museum in Belleau Wood, France bears the title.

Types of services women volunteered to perform

Recruiting poster,
Red Cross nurse shown with wounded solider.

While nurses were a vital component of any medical department for the United States Army, women served in other groups and other capacities.

The Navy also developed a Navy Nurse Corps during the war.

In addition, the Red Cross is perhaps the most well-known of these other groups. These volunteers wore what we now know as traditional uniforms of white with a red cross donning the front of their caps.

To assist nurses and doctors working behind the lines, women enlisted in the ambulance corps. They, along with many men, drove cars and trucks, designed by Ford Motor Company and by the precursor of General Motors.  (Having had a look at these myself in the Fort Sam Houston Medical Museum in San Antonio, Texas, I must say they look like the most uncomfortable transport I have ever seen.)

Women also volunteered to serve as secretaries in General Pershing's headquarters staff. He, in fact, asked for women to serve in this capacity after he decided he could not and should not spare anyone from his Staff to do this work.

Signal Corps accepted female volunteers to work the telephones for communications all over the front, inter-Army and with American allied forces. These women had to be fluent in French and English, and were known as "The Hello Girls."

http://signal.army.mil/history/history-hello_girls.html#

Then, too, many women traveled abroad to serve in many civilian capacities. Some worked in make-shift canteens making sandwiches and brewing coffee to serve to convalescent soldiers on their way home in mobile hospital trains. Others worked with displaced French populations. A few rescued orphans from temporary shelters and served as teachers in schools and convents.

Expectations of women who volunteered for nursing soldiers abroad

An American nurse on the front lines.

Most nurses who volunteered to serve during the First World War had experience serving Stateside in hospitals, local sanitariums for tubercular patients or in private homes. They served in various capacities—on wards, in maternity units and in private duty to wealthier patients who had the funds to engage a private nurse for home duty.
While a few had specialties, as we now think of them, most engaged in general duty.
Before going abroad, very few nurses ever saw the types of wounds, disease or shell shock that men incurred from living and fighting in trenches, or from shrapnel fragments or the newest inventions of warfare--tanks and machine guns.

How women joined the World War One nursing effort

Nurses marching together during training.

When Congress declared war in April 1917, the United States had no sizable standing army. While volunteers were accepted, most men joined the military via a new draft.
To fulfill the need for a medical contingent, military officials knew they would need a huge number of doctors and nurses.
Many hospital staffs responded by forming their own volunteer groups. Without depriving the home front of medical personnel, these professionals called for their own in-house staffs to volunteer to serve abroad.
Among those who volunteered were nurses, many of them newly graduated from in-house hospital training schools.
Here, above, we see them marching together in their day uniforms.

Women's heroism, A story never before told

Army Nurse in Ward Uniform.

More than three decades ago when I first began to write fiction, I became enamored of a story I yearned to tell about a young American woman who broke all conventions to answer the call for nurses to save the wounded and sick soldiers fighting in the Great War.
Living in Washington D.C., with one husband and three young children, plus working nine to five (or more) on Capitol Hill, I wrote my novel riding on the Metro as I went to and from work. I wrote on Saturday mornings, before carpools for soccer and ballet. I finished it. Gave it to my critique group to help me tear apart and put back together again.  I sent it out to editors in New York.
And I almost sold it.
But no one wanted to buy it.
"Too depressing," said so many editors who nonetheless loved the prose and theme. "World War One is not up-lifting."
I kept my research. My note cards and xerox copies of pictures. My interviews with museum directors. And over the years, I did more research.  Traditional publishers might not wish to buy such a story about a "depressing" subject, but I adored the concept and kept reading and thinking about my interpretation of an American woman's experience on the front lines.
Today, I am astonished at how much more primary documentation is available.
And so at the urging of my husband, who is a proud veteran of the First Army (or the Big Red One, as it came to be called during World War One) and at the insistence of many of my family who read the manuscript then and love it still, plus my former critique partners who loved the book, I will bring HEROIC MEASURES (much edited) to the reading public.
What you will read here will not be that tale.
But what you can read here will be similar stories, all of the heroism of women who served when it was not fashionable, socially acceptable, financially rewarding, career-enhancing, nor even wise.
I hope you will return!