Author Question: Nursing 1940’s


Anonymous Asks
:

First and foremost, I have to say that I am in love with Medical Edge. I’ve been spending a lot of time on it lately because I enjoy studying medicine and also because I am starting to do research for my novel. It’s set in 1939 through to 1943. I have three questions for you.

One of my main characters is a nurse in Sioux Falls, South Dakota. I want to be able to write her doing her job correctly. I was wondering what kind of equipment they used, how they used it, and for what illnesses (No need to be extremely specific here, I think). Also, what would her responsibilities be within the hospital? Would she rotate through all the wards or do/did nurses have particular specialties like physicians?

Jordyn Says:


Thanks for your compliments on my blog! Glad you find it helpful.

Nursing in your time frame of 1939-1943 would have looked a lot different than it does today. They definitely wore uniforms and caps. Doctors would have been formally called “Dr. Smith” versus using first names like we do now (although not in front of patients).

Nursing work was viewed as inferior to the physician meaning—you do what the physician says. Now, a nurse’s input is more respected. Doctors and nurses realize they can’t work separate from one another.

Nurses likely didn’t specialize then like we do now and there was likely not a lot of physician specialties either as there weren’t any intensive care units or emergency departments until the 1970s. Equipment would have been non-existent like the heart monitors and stuff we now use. Read through this info to get a general feel of how the floors or “wards” would have been split up.

This link is from Britain but would probably have some cross-over to the US. Here is a linkto some personalized stories from people who nursed during your time frame. I would read through these for the 1930’s and 1940’s to get a feel for what their jobs were like.

Thisis also from the UK but should provide some insight. 

Question
:

Another one of my main characters goes off to fight in the war. How severe would an injury have to be for him to be discharged? Presently, I have a situation designed where he is aiding a family out of a bomb shelter; there is an unexploded shell nearby, and a child accidentally kicks rubble at it and sets it off. Big boom, main character loses part of his leg and half of his body is burnt. I’m also thinking that he loses his hearing. Would this be plausible?


Jordyn Says:

I would search military discharge related to a medical condition two ways. One—what medical conditions are prohibitive for military service and those conditions that would lead to discharge.

 I found this list, but you could probably find more and if it’s the 1939-1942 time frame it may be different than those that cause discharge in these times.

The injuries you list related to the bomb blast are realistic and I think would be enough to cause his discharge from the military as well.

I contacted a cousin of mine who serves in the medical corp of the military and he said to look at AR 40-501 which is the standard of medical fitness. Basically, if you couldn’t do what’s listed than you could be discharged from service. He did say that there are personnel who are still serving who have amputated limbs.

Question:

Lastly, my nurse has a patient, a woman in her 40s or 50s, who she loves with all her heart. I want this patient to die. What would be a good way to kill this woman off? I need her to have been in the hospital for around four years. I also want to have her weak but able to speak with my other characters. What’s a good malady for this situation?

Jordyn Says:

This kind of criteria would mean the character would need a chronic illness that’s debilitating. You could look into multiple sclerosis, Lou Gehrig’s Disease, Huntington’s Chorea or some of the autoimmune disease like Lupus or Sarcoidosis.

These diseases fall on a spectrum (more MS and the autoimmune diseases) but Lou Gehrig’s Disease and Huntington’s Chorea lead to neuromuscular wasting, etc that does lead to death and there is currently no cure.

In that time frame you’re looking at you’d have to determine if they were able to diagnose these diseases. To do that you could Google search “When was Lou Gehrig’s Disease discovered?” That should get you in the ballpark to know if the medical community knew about whatever disease you chose for your time frame.

Keep in mind—it would be highly unusual for someone to be hospitalized for four years straight.

Veterans Die While Waiting . . .

Honestly, I wish this was fiction. As a nurse– I wanted to call attention to this.

Imagine . . . you have served your country faithfully and just need to see a doctor. The VA system requires patients be seen in a timely manner of 14-30 days. Evidently in Phoenix, there was a system in place to hide the fact that 1,500 veterans were waiting months to see a physician and according to this CNN piece— 40 died while waiting.

There were two lists. One that was shown to auditors to prove that they were meeting this appointment criteria. What was really occurring is that a veteran would make a request and would be electronically placed on a “secret list”. When their appt came up under the 14 day mark, it would be registered, when if fact they were waiting several months to be seen.

With the government assuming more control over healthcare I fear more and more of these stories are going to come to pass.  Doctors are leaving traditional practices and opening up concierge services. My own primary care physician did this. We chose not to pay him out of pocket for “access” on top of our normal insurance rates. We had to find a new physician.

The government is also becoming the largest payer to hospitals through Medicaid, Medicare and now the ACA. When you have one primary customer– that customer will dictate how your hospital runs. Right now, hospitals are cutting back staff, staff incentives and such because they are worried about reimbursement from government agencies. My own hospital has done these things.

What about you? How do you feel about the current state of our healthcare system? What changes have you seen take place that you like or don’t like?

You can check out lengthy pieces on this subject here and here.