Sarah Sundin: WWII Nursing Part 2/3

December 14, 2016December 3, 2016 / Jordyn Redwood / Leave a comment

We’re continuing our three part series with historical author Sarah Sundin about her research into WWII nursing. You can find Part I here.

US Army Nursing in World War II—Part 2

Ruth hugged her knees to her chest, her dark blue cape tented around her against the gray chill.

Where would the money come from? Promotions were meager in the Army Nurse Corps. All the nurses were second lieutenants except the chief nurse, a first lieutenant. At twenty-three, Ruth was too young and inexperienced to become a chief nurse.

She’d always solved her own problems, but now she longed for advice, and she kept thinking about Major Novak.

In my World War II novel, A Memory Between Us, the heroine, Lt. Ruth Doherty serves as a US Army Nurse in England. The amount of research seemed daunting, but I found fantastic resources, read intriguing real-life accounts, and gathered fascinating facts about nursing in World War II.

On November 24th, I covered requirements to serve in the Army Nurse Corps. Today I’ll discuss the training the nurses underwent and rank in the Army Nurse Corps. And on November 29th, I’ll provide some details on uniforms, nursing practices, and a list of my favorite resources.

Recruitment and Training

The American Red Cross served as the traditional reserve for the Army Nurse Corps. On October 9, 1940, the ANC called the reserves to active duty, to volunteer for a one-year commitment. At first there was no formal military training for nurses. On July 19, 1943, the first basic training center for nurses opened. Training centers were located at Fort Devens, MA; Halloran General Hospital, Staten Island, NY; Camp McCoy, WI; and Brooke General Hospital in San Antonio, TX. The nurses trained for four weeks, learning military courtesy and practices, sanitation, ward management, camouflage, the use of gas masks, and map reading. They also drilled and underwent physical training.

To train the increased number of nurses needed during the war, Congress authorized the Cadet Nurse Corps on July 1, 1943. The government paid for women to attend civilian nursing programs in exchange for service in the Army Nurse Corps upon graduation. The women in this accelerated program (two and a half years instead of three) had their own special cadet uniforms.

Rank

Nurses entered the ANC as second lieutenants, and the vast majority of them stayed at that rank. The chief nurse of a hospital was usually a first lieutenant, but sometimes a second lieutenant or a captain. The highest rank in the ANC was held by the superintendent of the ANC, a colonel.

Even so, nurses held “relative rank.” They held the title, wore the insignia, were admitted to officers’ clubs, and had the privilege of the salute, but they had limited authority in the line of duty and initially received less pay than men of similar rank. On December 22, 1942, Congress authorized military nurses to receive pay equivalent to a man of the same rank without dependents, and on June 22, 1944, Congress authorized temporary commissions with full pay and privileges.

One of the main reasons nurses were granted officer status was to “protect” them from the great crowd of enlisted men, and—it was often thought—for male officers to keep the women for themselves. The Army had rules against fraternization between officers and enlisted personnel.

***This blog originally posted 11/26/2010.***

********************************************************************************************* sarahsundin2 Sarah Sundin is the author of the Wings of Glory series from Revell: A Distant Melody (March 2010), A Memory Between Us (September 2010), and Blue Skies Tomorrow (August 2011). She has a doctorate in pharmacy from UC San Francisco and works on-call as a hospital pharmacist.

Sarah Sundin: WWII Nursing Part 1/3

December 12, 2016December 3, 2016 / Jordyn Redwood / Leave a comment

Redwood’s Medical Edge is pleased to host historical author Sarah Sundin who has done extensive research regarding nursing during WWII.

US Army Nursing in World War II—Part 1

“I love this smell, don’t you?” May said.

“Bichloride of mercury?” Ruth laughed and shook water from a pair of gloves. “Only a nurse would like this smell.”

May rolled syringes in a pan of the blue green disinfectant. “In the orphanage I had no control over my life, but with soapy water and a stiff brush, I could scrub away the smells and pretend I lived in a castle.”

Ruth draped the brown latex gloves over a clothesline to dry before being sterilized. “Cleanliness may not be next to godliness, but it beats back the demons of poverty.”

In my World War II novel, A Memory Between Us, the heroine, Lt. Ruth Doherty serves as a US Army Nurse in England. The amount of research seemed daunting at first, but I found fantastic resources, read intriguing real-life accounts, and gathered fascinating facts about nursing in World War II.

Combat produces injuries. Injuries require treatment. If you write a novel set during World War II, you may have to write a medical scene—and you’ll want to get the details right about your nurse characters.

During World War II, 57,000 women served in the US Army Nurse Corps (ANC), 11,000 in the Navy Nurse Corps (NNC), and 6500 in the Army Air Forces. More than two hundred nurses died serving their country.

Today I’ll cover requirements to serve in the Army Nurse Corps. On November 26th, I’ll discuss the training the nurses underwent and rank in the Army Nurse Corps. And on November 29th, I’ll provide some details on uniforms, nursing practices, and a list of my favorite resources.

Requirements

To serve in the Army Nurse Corps, women had to be 21-40 years old (raised to 45 later in the war), unmarried (married nurses were accepted starting in late 1942), a high school graduate, a graduate of a 3-year nursing training program, licensed in at least one state, a US citizen or a citizen of an Allied country, 5’0”-6’0,” have a physician’s certificate of health and a letter testifying to moral and professional excellence.

Pregnancy was the main cause of discharge from the Army Nurse Corps, or as the women called it, PWOP (Pregnant WithOut Permission). To discourage pregnancy, the Army had a cumbersome process to gain approval for marriage. Other methods to prevent pregnancy included careful placement of nurses’ quarters, discouraging drinking, and encouraging the women to socialize in groups. The second main reason for discharge was “neuropsychiatric,” what we call combat fatigue nowadays.

Remember that gender and race discrimination was still rampant in the 1940s. Male nurses were not allowed in the ANC during World War II, and only a limited number of African-American nurses. Despite a large number of black registered nurses in the United States, fewer than five hundred were allowed to serve, and then only to care for black patients or for prisoners of war.

***This post originally published 11/24/2010.***

What Does a Nurse Do? Part 2/3

October 12, 2016October 7, 2016 / Jordyn Redwood / Leave a comment

Let’s continue our discussion of what a nurse’s role really is and how you can use this to increase conflict in your manuscript.

You can find Part I here.

Last post we looked at the nurse as patient advocate. This post, we’ll look at the nurse german-shepherd-puppy as the patient’s safety net. Which dog would you rather have defending your house? The cute, furry puppy or the grown dog with the watchful eye? A strong nurse is the patient’s watchdog. I look out for my patient’s interests when they may not be able to do so.

I am often the last line of defense between everything and the patient. Let’s delve into the medication arena. The nurse gives the patient’s medications. It’s my job to ensure that what the physician orders is the correct medication for the illness, for the right patient at the right dose given the right route (by mouth, intravenously, etc…). One of the challenges in pediatrics is there is no standard dose. Every drug dose is based on the patient’s weight. I’m not going to give the same amount of morphine to a 5kg infant vs. an 80kg teen. If the patient is not weighed or their weight is entered incorrectly, this can have disastrous effects when medications are given.

german-shepherd-578929_1920 Medication errors do happen. I want to reassure you that there are a lot of safeguards in place to prevent such occurrences. Most departments are going to computer based medication ordering. This is beneficial in many ways. One, the order is typed and therefore easily read eliminating mistakes in reading handwriting. Second, most medication based ordering systems have built in safeguards that will check the prescribed dose against the patient’s weight to make sure the dose is not too high. In pediatrics specifically, all high risk medications are double checked by another nurse and co-signed on the chart. But as a good nurse functions as a safety net, so should the parent question what is being given to their child and why.

Let’s take a real life example. During my years in the pediatric ICU, I worked at a teaching hospital. At this particular institution, residents could rotate through the unit their second year. I had a second year resident order potassium, which is a potent electrolyte, at four times the recommended dose. Now, if too much potassium is given, it will cause the heart to stop beating. That’s how big this error could have been.

I approached the resident and questioned the order. He stated, “But the drug book says to give 4meq/kg/day.” I explained that the “per/day” was the key term. That the drug should be divided into four doses given every six hours, no more than 1meq/kg at one time. I told him he could order it that way, but the pharmacy wouldn’t fill it and I certainly wouldn’t give it.

Needless to say he changed the order and the drug was given correctly.

Have you ever had a medication error happen to you? How do you think it could have been prevented?

What Does A Nurse Do? Part 1/3

October 10, 2016October 4, 2016 / Jordyn Redwood / 2 Comments

I still find it interesting that many outside of healthcare don’t truly understand what a nurse does. Television, movies, and fiction all have varying takes on the subject– most of which don’t depict reality.

teen-girl What is your definition of a nurse? When you’re in contact with the medical system, what do you want a nurse to do for you? I would love to know.

My ultimate role as a nurse is to serve as an advocate for my patients. In pediatrics, that means my clients range from a newly born infant to a young adult who is most often accompanied by a parent. How can this be a source of conflict? Let’s take a look at an example of how my advocating for a child can become a source of conflict between me and the parent.

A parent presents with her teen daughter and wants her tested for drugs. The mother has concerns that her child may be experimenting and wants confirmation. Can we run a drug test that covers common drugs of abuse? Yes. Will we in this situation? Depends.

How are we going to obtain the urine specimen if the teen is not a willing participant? We would have to hold her down, pull her legs apart, and insert a catheter into her bladder. Legally, this would likely be considered assault if the teen is not having a medical emergency. A medical emergency would be something dramatic– like no pulse and no breathing. Or, the patient is unconscious and we’re trying to determine why. In this situation, the teen is not experiencing a medical emergency. The teen is awake, alert, and communicating appropriately. As a nurse, I am not going to do that to her regardless of the parent’s demands.

What are the options?

First, the physician will have a conversation with the parent and child to discern the parent’s concern. The child will be interviewed alone and asked pointed questions about their drug use. The parent may also be interviewed alone as well. The first issue is to figure out if there is a legitimate concern. If there is, will the teen willingly submit to the drug test? If so, we’ll run the drug screen. If not, in a non-emergency situation, the approach will likely be to get the family into some counseling.

However, if we do drug test the teen, we may or may not disclose the results to the parent. Whether or not this information would be released depends on the state and the age of the child.

How has a nurse advocated for you?

Author Beware: The Law– HIPAA (3/3)

December 16, 2011March 18, 2019 / Jordyn Redwood / Leave a comment

Today, I’m concluding my three-part series on the HIPAA law. I’m going to focus on how I’ve seen it violated in published works of fiction.

Image by Neven Divkovic from Pixabay

Situation 1: A hard-nosed journalist makes entry into the hospital and begins asking the staff about a current patient. One nurse pulls him aside and gives him the information. This is a clear violation of HIPAA. All media requests will go through the public relations office. For any information to be released, the patient needs to give their permission.

Situation 2: A nurse on duty calls her friend and notifies her that another victim involved in a crime spree, that her sister was a victim of, is an inpatient at her hospital. Again, unless that person has provided direct care to the patient or the patient gives their consent for the information to be released, the nurse is in violation of HIPAA. However, the author of this particular manuscript handled it well. At least she had the character divulge that she could get in “big trouble” if upper management found out what she’d done. Think back to Brittney Spears in Part One of this series.

Situation 3: A small town high school mascot falls ill on the field during a football game and is rushed to the hospital. A paramedic takes him to the ER. When the paramedic’s wife arrives, she inquires about his condition. The paramedic/husband tells her what the doctors found. Again, the wife is not providing direct medical care to the patient. This paramedic has violated the patient’s HIPAA rights by divulging this information to his spouse. Now, I understand, in small towns– this information may “leak out”. A better way for the author to have handled this would have been to have the wife of the fallen mascot tell this woman what his diagnosis was. HIPAA doesn’t apply to family members and they can willingly share information with who they wish. That may not make the patient very happy— ahh . . . another area of conflict!

Have you seen HIPAA violations in works of fiction that you’ve read?