CHAPTER III
RELATIONSHIP OF AMERICAN RED CROSS HEADQUARTERS IN PARIS
AND ARMY NURSE CORPS
BUREAU OF NURSING
The Paris Bureau of Nursing of the American Red Cross was instituted in the summer of 1917, after the arrival there of two American Red Cross nurses, who reported at the headquarters of the Red Cross Commission in France, the one with orders to be chief nurse of the American Red Cross in France and the other to be director of the children 's bureau in Paris.1
In assuming her duties the chief nurse had her own pathway to hew, since the adventure was an unprecedented one. One of the first things she did was to attempt to secure for the American Red Cross the services, as nurses, of all American nurses who were at that time independently in France or in England.1 Then, with the view of establishing a closer relationship between the American Red Cross in France and the Army Nurse Corps there, so that the American Red Cross could at all times be in a better position to know such needs of the Army nurses as could be fulfilled by the Red Cross, the chief nurseof that organization, in October, 1917, initiated arrangements for a conference of Army chief nurses.1 Fifteen nurses attended the conference, which was held in Paris at the time referred to. Among other things, questions of housing for nurses, their uniform, nurses' aides, diet kitchens in hospitals, the care of sick and convalescent nurses, and pay were included in the problems in which the Red Cross was asked to lend its assistance.1
In April, 1918, an Army reserve nurse who had been chief nurse of Base Hospital No. 21 for a year was ordered, at the request of the American Red Cross Commission in France, to the Paris office and was assigned to duty as chief nurse of the American Red Cross in France.1 This appointment took place just as the former Red Cross chief nurse departed for the United States. Her duties were the supervision and control of all activities which might be assigned by the Army to the Red Cross, which included assistance to nurses, both on leave and under orders to return to the United States, the supply of American Red Cross equipment, and the establishment and control of a bureau of American Red Cross nurses who were in the Army. It was also planned to enlarge the activities by the establishment of an authoritative information bureau for nurses and also of a Red Cross nurses' aide service for France. 2
Soon after the chief nurse of the American Red Cross began her duties as such, the work of the nursing bureau became almost entirely an emergency service for the sick and wounded of the American Expeditionary Forces. Groups of Red Cross nurses and nurses' aides had been assigned to headquarters of the American Red Cross Commission in Paris for work in connection with the civilian population, and in April, 1918, there were 800 of these women on duty in France with the Red Cross. 1 At about this time many American
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Red Cross nurses who had been sent to Europe at their own request for other than Army work in France requested and received assignment to active service in the Army Nurse Corps.1
Having an Army nurse in the position of chief nurse of the American Red Cross was especially desirable, not only because a closer cooperation concerning problems of the Army nurses between the Army and the American Red Cross could be effected but also because it frequently was possible for the Red Cross nursing bureau to supply nurses at places where they were badly needed by the Army during emergencies.
Among other institutions which the Red Cross had established for the service of the French was the "American Ambulance" in Paris. This was turned over to the American Expeditionary Forces on July 20, 1917, and was designated American Red Cross Military Hospital No. 1, though it continued at first to receive only French casualties.3 As General Pershing would not permit American military hospitals in Paris at that time,4 and hospital facilities were needed there, the American Red Cross then established a number of hospitals whose collective capacity was rapidly increased to 10,000 beds.5 The association also established other hospitals in the field, where they operated as evacuation hospitals in the rear of the various divisions. These Red Cross hospitals were used in the zone of the armies only through urgent necessity; they were organized at the request of the chief surgeon, A. E. F. Personnel for them came largely from the Army, but their equipment was supplied by the Red Cross. The nursing personnel for these hospitals was made up in all instances as a result of emergency methods and comprised both American Red Cross nurses and members of the Army Nurse Corps. 6
To facilitate supplying adequate nurse personnel to these hospitals, a special meeting was held at the office of the general manager of the Red Cross in Paris on May 29, 1918.7 After discussion of the need for nurses to take care of American soldiers not only in Paris but in hospitals nearer the front, it was determined that the Red Cross department of civil affairs should call in at least 40 nurses and put them into the hands of the chief nurse of the American Red Cross in France for reassignment under the Red Cross department of military affairs. Later this number was changed to 60. In addition it was possible for the chief nurse of the American Red Cross, because of her connection with the Army, to secure the loan of 50 Army nurses whom it was possible to transfer to the hospitals referred to above much more easily than Red Cross nurses.8 Information that nurses were available was sent out to the hospitals and, as was expected, urgent calls came for them and they were sent away in groups of 10or 15 with often not more than an hour's notice to meet emergencies in front-line hospitals. These nurses who formed a reserve force were housed temporarily in a hotel in Paris, and were divided into groups, the head nurse of each of which had to report at Red Cross headquarters every two hours.
The following experience gives a good picture of the way that Red Cross military hospitals were supplied with nurses throughout the summer months of1918: 9 When the first of such nurses were called from their civilian activities and within a few hours' notice were placed in trucks and conducted in person by the chief nurse to the American Red Cross Military Hospital, Beauvais, inquiry
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was made on the way regarding the special experiences of these 20 nurses which would fit them for the work ahead of them in an improvised military hospital. Lists were made of those who would be best fitted for operating-room work and executive positions, etc., but when the group arrived in utter darkness during a raid by airplanes they were told as they were hurried from the trucks to the comparative safety of the building that eight of them were needed immediately for night duty. The entire group volunteered, although they had been traveling for hours and were very much fatigued. Because of the impossibility of having a light by the aid of which lists of qualifications could be consulted, the choice was made by taking the first eight who could be touched, as they happened to stand nearest the door. Since they all were Red Cross nurses, they were all fitted for any kind of work in the hospital, and they soon forgot that they were baby specialists or public-health workers in the crowded surgical hours that were ahead of them.9 When members of the Army Nurse Corps were available, they were added to groups already functioning in these hurriedly improvised hospitals.
The fact that these emergency detachments were authorized to move on French military papers obtained by the Red Cross added greatly to the efficiency of this service; moving them on authority obtained through our Army channels would have caused greater delay. When emergency calls for nurses were urgent and the distance not too great, nurses were sent in camionettes, as in all cases the saving of time was considered a most important factor.10 Later, because of the necessity of individual identification cards and orders for all persons not in the Army proper, the chief nurse was able to move emergency detachments of nurses on Army orders with great saving of time.1
In order that administration might be simplified, the Red Cross personne of these hospitals were made part of the Military Establishment as soon as possible. The chief nurse was made a member of the Army Nurse Corps, and the opportunity was given to members of her staff who were not already in the corps to take the oath of office as reserve nurses.1 There were some nurses who did not wish to transfer to the Army, and they continued to be paid by the American Red Cross. At the time that the military situation demanded that all these Red Cross nurses occupied in civilian work be sent to hospitals filled with wounded men it was not known in the office of the Red Cross in Paris that these nurses had been sent to France under the Red Cross with the distinct understanding that they were to be employed in civilian work only. It was learned later that this arrangement had been made because of the refusal on the part of many of these nurses to enter the Army Nurse Corps in the United States for fear they would be sent to military posts in the United States for periods of service before transfer to the American Expeditionary Forces.1 The office in Paris had no means of knowing this fact or of the institution of this policy on the part of the American Red Cross in Washington, but even if it had been known it is not probable that any other action could have been taken than that which was taken when these nurses were called from their civilian work and placed upon active duty with the Army.
A number of the hospitals which were established by the American Red Cross, as outlined above, had been functioning for many months as civilian
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hospitals, having American and English nurses on their staffs. When it was necessary because of the military situation to transform these hospitals into military hospitals and to reorganize the personnel into a military one, it was almost invariably the rule that all of the nursing personnel wished to remain as part of the nursing personnel of the newly formed organization. In so transforming the nursing personnel it became essential sometimes, in order to meet an emergent situation, to waive the ordinary requirements not only for enrollment in the Red Cross nursing service but also for assignment to duty as reserve nurses of the Army Nurse Corps. In this way nurses who would not under ordinary circumstances be eligible were sworn in as members of the staff under a chief nurse, functioning as a chief nurse of the Army Nurse Corps, paid by the Army and controlled by the Army. In most instances such nurses requested relief from active service after the termination of hostilities and became separated from the corps in France.1 As stated above, the magnitude and uncertainties of the task ahead were sensed early, and it seemed very desirable to assign to the Red Cross certain appropriations for emergencies while the Army Medical Corps was building a large program of permanent hospitalization. In this plan of appropriation the freedom of the chief nurse, American Red Cross, who at the same time was a chief nurse of the Army Nurse Corps and thus functioned in a dual capacity, made it possible for her to meet emergencies with both American Red Cross and Army Nurse Corps personnel in a way that prevented loss of time and duplication of effort.1
Inspection trips were made by the chief nurse, American Red Cross, who was thus better enabled to make plans for her work and to see at first hand the conditions under which the nurses were living and working.1
Shortly before the signing of the armistice, the chief nurse was ordered to the office of the chief surgeon, A. E. F., to become the director of the nursing service, A. E. F. She was succeeded by the Army nurse who had formerly been the chief nurse of Base Hospital No. 5, who for a number of months had been her assistant at Red Cross headquarters in Paris.1
AMERICAN RED CROSS EQUIPMENT BUREAU
Within a very few months after the arrival of the American nurses in France it was found that there were great discrepancies in their equipment and also that many of their needs could be supplied from local sources. The nursing bureau of the American Red Cross in Paris undertook to deal with this difficulty and all requests for nurses' equipment were referred to them. It is not surprising that certain problems presented themselves in this project. In the first place it was most difficult for local firms to obtain the necessary labor and materials, and then, too, even when these were procurable, frequently the railroad companies refused to carry the materials because of the quantities of military supplies to be shipped. In the summer of 1918 a nurse who had reported at American Red Cross headquarters in Paris was assigned to duty as an Army reserve nurse and put in charge of the question of equipment. She organized the equipment bureau, taking up the work at a time when notification had been given that in the near future equipment would be needed for 10,000 nurses, including the nursing staffs of 40 mobile hospitals. This
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necessitated a great increase in contracts as well as an enlargement of the equipment bureau quarters. To these new quarters came from 50 to 100nurses daily for various articles of clothing; many came for their own personal equipment but many others came with large orders for their hospitals. Such articles as trench coats and hats, jersey uniforms, rubber aprons, rain hats, rubber boots, sweaters, mittens and wristlets, woolen underwear, tights, eating utensils, cot pillows, mattresses and cots, rubber sheets, blankets, bedding rolls, bed socks, wash cloths, hand towels, and duffle bags were issued to those who needed them.11
By the spring of 1919 the equipment bureau had made purchases of equipment which amounted to 3,000,000 francs.4 The nurse in charge of this bureau frequently found it necessary to make delivery of supplies in all sorts of extraordinary ways. It was no unusual occurrence for a medical officer who had come to Paris on leave and who had visited the American Red Cross headquarters there to be asked to carry some supplies back to his hospital. In other cases the nurse in charge of the equipment bureau went by motor, not only to deliver supplies but also to find out from various mobile medical units, which never remained long in the same place, what their needs were, and often she had with her sufficient supplies to furnish them with the needed articles on the spot. On these trips she frequently carried supplies to as many as 300 nurses who needed equipment for various reasons. Some were on temporary duty away from their proper stations; others' trunks had been lost en route from the United States, or, as happened to a small group of nurses, their equipment had been burned.12
By the time notification was received that the Army would supply nurses' equipment the Red Cross equipment bureau was utilizing the services of 10 persons in an efficient manner. A cash-sales department for extra equipment was functioning, as well as a trucking service. When information was received that the Government would handle nurses' equipment, it was necessary to cancel many contracts which had been made by the American Red Cross and no longer to supply nurses with the articles which could be obtained through the Quartermaster Department of the Army.11
REST AND CONVALESCENT HOMES
The maintenance of rest and convalescent homes was one of the important lines of work of the Red Cross nursing bureau, and its cooperation in providing these facilities for members of the Army Nurse Corps was of value to the corps.11 Because of her close association with the work of the chief nurses at Red Cross headquarters, the director of the women's bureau of hospital service was able to be of great assistance in this matter as well as in many other activities of the nursing services.11
Two convalescent homes were maintained by the American Red Cross—one at Le Croisic, near St. Nazaire, and one at Cap d'Antibes, near Cannes.11 The convalescent house at Le Croisic was a hotel on the Brittany coast where guests might stay for 10 francs a day. It was designated American Red Cross Convalescent Home No. 6, and was open from July to November, 1918. It offered accommodations for 100 women—either nurses or civilian workers—
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who were on leave or convalescing. The home at Cap d'Antibes, designated American Red Cross Convalescent Home No. 11, functioned from January 6,1919, to May 10, 1919, and accepted Army, Navy, and Red Cross nurses and American women civilian personnel who were on sick or convalescent leave. Two hundred women could be housed in this hotel.11
REFERENCES
(1) History of American Red Cross Nursing Bureau. On file, Army Nurse Corps Section, Personnel Division, S. G. O.
(2) Scheme for the position of chief nurse of the American Red Cross. On file, Army Nurse Corps Section, Personnel Division, S. G. O.
(3) Report on activities of G-4-B, medical group, fourth section, general staff, general headquarters, A. E. F., for the period embracing the beginning and end of American participation in hostilities, prepared by Col. S. H. Wadhams, M. C., chief of G-4-B, December 31, 1918, 35. On file, Historical Division, S. G. O.
(4) Ibid., 35.
(5) Ibid., 53.
(6) American Red Cross military hospitals. On file, Army Nurse Corps Section, Personnel Division, S. G. O.
(7) Letter from Julia C. Stimson to Jane A. Delano, June 1, 1918. Copy on file, Army Nurse Corps Section, Personnel Division, S. G. O.
(8) Letter from Bessie S. Bell to Dora E. Thompson, July 25, 1918. On file, Army Nurse Corps Section, Personnel Division, S. G. O.
(9) Inspection reports of the nursing service, American Expeditionary Forces, 1918-19. On file, Army Nurse Corps Section, Personnel Division, S. G. O.
(10) Military history of the American Red Cross in France, by Lieut. Col. C. C. Burlingame, M. C. On file, Historical Division, S. G. O.
(11) History of Nursing Activities, American Expeditionary Forces, on the Western Front During War Period May 8, 1917, to May 31, 1919. By Julia C. Stimson, director, nursing service, American Expeditionary Forces. On file, Army Nurse Corps Section, Personnel Division, S. G. O.
(12) History of American Red Cross Nursing. The Macmillan Co., 1922, 577.
