The Inhospitable Hosptial: Gender and Professionalism in Civil War Medicine, Jane E. Schultz, Signs: Journal of Women in Culture and History, 17:2 [1992], pp. 363-392.The enthusiastic embrace by women of the benevolent organization, especially those focusing upon the health concerns of soldiers, was remarkable during the American Civil War. In the hospitals of the Union and the Confederacy, 20,000 women served. Enslaved and free black women, upper class white widows, farm women, and others served as nurses, matrons, cooks and laundresses provided paid, forced, and unpaid labor. Schultz's review of several hundred published and archived diaries, memoirs and letter collection reveals that female nursing evolved during a trend of increasing medical professionalism which was guided by men. (364-365)
In military hospitals, personal interactions of brought forth coping strategies by women. Their avoidance of the 'medical models of professionalism was a protest against male authority' that after the war were embraced. After the war in hospital training schools placed nurses at the bottom of the hierarchy. Obedience and discipline were principles were emphasized in the curriculum. Dissent and protest was not encourage among nursing students. Schultz focuses not on the post-war emerging professionalism of nursing, but the behavior of nurses that emerged as conflicts arose between male surgeons and female attendants regarding corruption, bureaucratic inhumanity and morality in Civil War hospitals. (365-366).
Between June 1861 and October 1863, Dorothea Dix appointed 3,200 women to nursing positions. In October 1863, the surgeon general allowed surgeons to appoint nurses. Frequently chosen by surgeons were Catholic nuns who would not be paid and required very little in regard to housing. Vows of poverty and self-sacrifice along with experience in asylums and orphanages seemed to suit the nature of nursing as it was recognized by doctors. Female U.S. Sanitary Commission agents at time assumed nursing duties on hospital transport boats and ships. The Union paid female nurses 40 cents a day and one ration. Cooks and laundresses earned between six and ten dollars a month. (336-367)
Untypical but noteworthy are Esther Hill Hawks and Mary Edwards Walker, both educated by medical colleges. It was inconcievable for a women to have military rank yet both performed service. Hawks tended to black federal soldiers in South Carolina and Walker performed emergency medical services at Fredericksburg in December 1862 and later Chickamauga in September 1863. The Confederacy established a pay scale for female nurses, yet it appears that most Confederate nurses provided temporary and unpaid services. (368-369)
Nurses' duties consisted of keeping clean patients with their beds and clothes, preparing and serving food and perscriptions ordered by the surgeon, and writing for and pass time with them. Military hospitals were plagued by cascading issues. Chief among was the issue of relating the early 18th century mindset of allopathic medicine to the emerging mid-19th century mindset of homeopathic medicine. Additional issues included military rank, hospital inspectors, medical competency examinations and graft among vendors and quartermasters. (370-373)
Women entered situations in which 'status anxious' poorly supplied and trained surgeons. These doctors declared that the best service to be done by women be at the bottom of the chain of command. Ratios of doctors to patients, nurses to surgeons, male nurses to female nurses created difficult situations particular to the size of the hospital. Schultz believes the small hospital homes of Richmond held fewer bureaucratic dilemmas than the larger general and pavilion hospitals like Chimborazo in Richmond. The post-war memoir by Phoebe Yates Pember reveal this. Jane Stuart Woolsey, a nurse at Washington DC hospital offered a similar reflection on her experience. (373-374)
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