The History and Organization of the Red Cross Nursing Service

The Development of the Red Cross Nursing Reserve   |   The Peacetime Program of the Red Cross Nursing Service   |   The History of the Nurse Enrollment   |   Nurse Enrollment Program Today

Nursing in the Spanish-American War
When the battleship Maine exploded in the Havana harbor on February 15, 1898, killing 260 Americans, it triggered the Spanish-American War. Clara Barton and her assistants already were working with Cuban insurrectionists imprisoned by Spain when the incident occurred, and she had dined aboard the vessel two days prior to the explosion.

Following America's declaration of war on Spain in April 1898, Barton made the Red Cross available to the U.S. military. For the first time, the American Red Cross provided a nonmedical service for soldiers. Volunteers served as field agents carrying on a limited communications service that handled inquiries from families.

Early in the war, the U.S. Surgeon General permitted only men to work with battlefield casualties; however, public opinion and pressure from his superiors to take better care of the wounded changed his mind. To recruit nurses, Clara Barton and others traveled to various hospitals to find recruits who were screened and contracted to the Army, working for approximately $30.00 per month. Conditions at medical camps in Florida and Cuba were deplorable, and yellow fever and typhoid were rampant.

One American Red Cross nurse waiting in Tampa, Florida, for a ship to take her to Cuba reported that "desperately sick fever patients, United States soldiers on United States soil, were lying on cots between heavy military blankets, no sheets, no pillows, no towels, no mosquito netting although they were being tormented beyond words by mosquitoes, flies, and sand fleas." U.S. Army medical officers stated that their operation would have broken down completely without the aid of the Red Cross. President McKinley expressed America's gratitude to the Red Cross for the feeding of U.S. troops and providing medical aid to the wounded.

The Red Cross Nursing Reserve

After the Red Cross was reorganized in 1905, state and territorial branches were created and the Red Cross expanded its services to include peacetime emergencies. One of the organization's newly assigned responsibilities was "to enroll doctors and nurses for Red Cross service in time of war or great disaster."

An article in the March 1905 issue of the American Journal of Nursing included plans "for some form of affiliation with Red Cross so that the great nursing body of the country might have a recognized place in Red Cross work." A special committee of nurses was appointed from around the country to confer with Mabel T. Boardman, Secretary of the Red Cross Central Committee. Boardman convinced the Surgeon General of the Army that Red Cross nurses should serve as the reserve of the Army Nurse Corps, but discovered several obstacles in setting a nationwide standard for qualified nurses.

There were great variations in requirements for nurses in different states. Laws regulating the practice of nursing were almost unheard of; there was no uniformity in educational requirements for nurses and schools of nursing were owned or controlled almost entirely by groups of doctors who did practically all of the teaching. "Quality must come first, quantity second," Boardman said as she set out to recruit a cadre of Red Cross nurses.

The first missions of the Red Cross Nursing Reserve were a bit bumpy. According to the editor of the American Journal of Nursing, "The question before us is how to bring all forces into cooperation with the Red Cross that prompt and efficient (nursing) service may always be at the command of that society without unnecessary delays." Lengthy negotiations between the nurses, the Red Cross and the War Department resulted in the creation of a special subcommittee of the War Relief Board to be responsible for the Red Cross Nursing Reserve. It was agreed upon that the subcommittee would have 15 members, nine of whom were to be trained nurses. Jane A. Delano, the Superintendent of the Army Nurse Corps, was appointed volunteer chairman of this committee.

As chairman of the committee on Red Cross Nursing Service, Delano immediately began to push a plan of organization which would place the responsibility for recruiting nurses for emergency service with the Red Cross entirely in the hands of the nurses themselves. State and local committees made up of enrolled Red Cross nurses served as volunteer recruiters who mobilized nurses when they were needed for service. The system worked so well that when 20,000 U.S. troops gathered on the Mexican border in anticipation of possible war with Mexico in 1910, Miss Delano proudly announced:

"Should a sudden need for nurses arise, there stand ready to cooperate with the National Committee on Red Cross Nursing Service 141 nurses on 24 state Red Cross committees, and 233 more on local committees. The committees, with nearly 1300 enrolled nurses, are a guarantee to the nation that neither the stress of calamity nor the turmoil of war will ever again find us wholly unprepared."

After three years as head of the Army Nurse Corps, Miss Delano resigned her position in 1912 to devote all of her time to building up the Red Cross Nursing Service. She traveled extensively throughout the United States, speaking before nurses' meetings and to nursing school classes. Nurses were urged to enroll with the Red Cross for emergency duty in time of epidemic, fire, flood, and war. But no one dreamed that the demands of war would so soon put the efficiency of the Red Cross Nursing Service to the test.

The Beginning of the Red Cross Rural Nurse Service
Suddenly conscious of the value of even a little knowledge about how to care for the sick, the women of the country clamored for more classes in Home Hygiene and Care of the Sick. The Red Cross was hard pressed to find enough nurse instructors to teach them. In many rural areas where the need was greatest, there were no nurses available.

Lillian D. Wald, a nurse and pioneer of public health nursing in urban centers, pioneered the concept of a nation-wide rural nursing service. In 1912, when the American Red Cross Rural Nursing Service was established, it was implemented through local Red Cross chapters under the direction of the national office. In 1913, the service was expanded to include large towns and cities with populations up to 25,000. The following year, it became Town and Country Nursing.

The nurse spent most of her time visiting families and providing nursing care at the bedside. The detection and management of infectious diseases, including tuberculosis, typhoid, influenza, and trachoma was another important part of the practice, as were sanitation and immunization programs. The rural nurse and her town and country counterpart spent extensive time traveling by bicycle, horseback, or by car on poor roads in disagreeable climates.

The Beginning of World War I
On the 6th of April, 1917, just after the Red Cross had moved into its new memorial building on 17th Street in Washington, D.C., the United States entered World War I. Following the declaration of war, the whole Red Cross organization flourished. By December there were 22 million members and 3,700 chapters—the greatest mobilization of humanitarian interest the world had ever known. Nurses from all parts of the country volunteered their services. To facilitate administrative work, the national Red Cross executive office was decentralized and 13 divisions were set up, each with a headquarters, a manager, and an office and field staff. A nurse was assigned to each of these divisions to direct the nursing activities.

During the First World War, 18,000 American Red Cross nurses served with the Army and Navy Nurse Corps. Nearly half of the nurses served at home to ensure exemplary health and sanitary conditions. The remainder served at American base hospitals in France, on hospital trains, and in evacuation and field units in the zone of advance. The Red Cross provided two out of every three Navy nurses and four out of five Army nurses, including the first African-American nurses. Nurses worked diligently at home, especially during a deadly influenza epidemic that swept the country in 1918. Responding to a call for help from the Surgeon General of the U.S. Public Health Service, 15,000 Red Cross nurses, dietitians, and others were recruited to work in military camps, hospitals, coal fields, munitions plants, and shipyards, where they remained until the epidemic finally subsided in the spring of 1919.

Red Cross Base Hospitals
One of the major activities of the Red Cross during World War I was the organizing, equipping and staffing of 50 base hospitals for the use of the Army. The personnel for each hospital were usually drawn from the staff of large individual American hospitals who signed up as a unit. Approximately 265 people were required to staff a base hospital; 100 of these, including the chief nurse, were to be Red Cross nurses.

In addition to the large base hospitals, smaller hospitals were authorized to organize units which could be assigned to the Army wherever needed. Nineteen of these were assigned to active service during the war. A staff of 399 Red Cross nurses worked in these units. When hospital units or base hospitals were turned over to the War Department, all Red Cross nursing personnel automatically became members of the Army Nurse Corps.

Nurses for Relief Work in Europe
The Red Cross Nursing Service also contributed significantly to civilians of European countries devastated by the war. The most extensive program was in France, which had been a major battlefield. A Department of Civil Affairs of the American Red Cross in France was organized which developed five different classes of relief activities, namely (1) child welfare work; (2) the establishment and maintenance of homes for refugees; (3) tuberculosis prevention; (4) assistance to civilians returning to devastated areas; and (5) the training of war cripples so that they could take care of themselves and their families.

The problems of the war-ravaged communities seemed insurmountable. Said one report:

"In some of the villages, no house remained intact. Yet among these bleak ruins still existed many old men and women and hundreds of young children, many of them suffering from ringworm, impetigo, scabies and blepharitis.... They looked stunned and sullen, and no smile could be teased from them.... And in all the villages are the old, old people. They are so terrorized, so heartbroken there is nothing more that life can do to them. They do not seem to be asking for a place to live in but a place in which to die undisturbed."

Eventually, American Red Cross Civilian relief commissions were sent to Italy, Romania, Palestine and Siberia, and with them went Red Cross nurses. Nurses were also assigned to the American Committee for Relief in the Near East.

By the signing of the Armistice in November 1918, 8,989 enrolled Red Cross nurses had been assigned to military establishments; 284 to hospitals and cantonment zones for the United States Public Health Service, and 604 to foreign service under the Red Cross commissions to the Allies. Thus, the total number of Red Cross nurses in military service during the European War was 19,877. The total number of American graduate nurses who served in the European War was 23,868.

The Post-War Period
After the war, two Red Cross nursing divisions were developed: the division of Institutional and Student Assignment and the division of Public Health Nursing. All nurses returning from overseas duty passed and were interviewed. By this means, an attempt was made to put them in touch with satisfactory opportunities for civilian employment in the field in which they were most interested.

When the end of the demobilization period drew near and the Red Cross began to make plans for closing the Bureau of Information, it was suggested that a national headquarters for the three nursing organizations be set up, and the Bureau of Information continued under their auspices. The plan met with general approval among the nurses, but the problem of financing such an enterprise seemed a formidable one. Finally, as a result of Miss Noyes' influence, the Red Cross agreed to provide the funds for financing the headquarters for a year, or until sufficient revenue to support it could be assured by the nursing profession. In her dual capacity as president of the American Nurse's Association and director of the Red Cross Nursing Service, Miss Noyes was instrumental in bringing to life a long-cherished dream of the professional nursing organizations.

Government Nursing Services
The Red Cross Nursing Service also played a major part in organizing a nurse corps for the United States Public Health Service. The responsibility of taking care of large numbers of injured and convalescent soldiers and sailors after the war ended was assigned to the Bureau of Marine Hospitals and Relief. Previously assigned to the United States Public Health Service to help staff hospitals maintained around Army cantonments, the Red Cross Nursing Service was asked by the Surgeon General of the United States Public Health Service to provide nurses to veterans' hospitals.

Lucy Minnigrode, who had been a member of Noyle's staff at Red Cross national headquarters, transferred to the Office of the Surgeon General of the United States Public Health Service to direct its new nursing program.

In May 1922, all hospitals caring for ex-service men and women were transferred to the newly created Veterans' Bureau, and another government nursing service was established under the direction of Mrs. Mary Agnes Hickey. Minnigrode continued to serve as Director of Nursing Service in the United States Public Health Service Hospitals.

The Peacetime Program of the Red Cross Nursing Service

Immediately after the war was over, the Red Cross was faced with the enormous problem of deciding what its contribution would be to the reconstruction program in Europe. It was not possible to terminate all activities at once, and it was difficult to decide how much should be done because no one could tell how long the American public would be willing to finance such an extensive undertaking. The reconstruction program involved the services of many nurses and Noyes continued to direct their activities. The transitional period from war to peace required approximately four years. During this time, hundreds of health centers and child welfare stations were set up and staffed by Red Cross doctors, social workers and nurses. To provide leadership for some of these activities after the Red Cross withdrew from Europe, it was decided to help some of the most ravaged countries establish good schools of nursing according to the Florence Nightingale system.

Red Cross subsidies were advanced for schools of nursing in Prague, Czechoslovakia; Constantinople, Turkey; Posen and Warsaw, Poland; and Port-au-Prince, Haiti. Several scholarships were also awarded to a number of leading women and nurses to enable them to come to America, or to King's College in London, to observe modern methods of nursing and public health so that they could go back to their countries as leaders in these fields.

The insular possessions of the United States were given special Red Cross help because of the imperative need to improve health and sanitary conditions. Nurses were assigned in Santo Domingo, Puerto Rico, the Virgin Islands, the Hawaiian Islands and the Philippines. The work in these countries was directed by Ida Butler, one of Noyes' assistants.

Noyes continued to pilot the Red Cross Nursing Service through all the complexities of the post-war period and until her death in 1936. Although her assistant, Ida Butler, was scheduled to retire, she was appointed to succeed Noyes until a new director could be selected.

In 1938, Mary Beard became director of Red Cross Nursing Service and Virginia Dunbar was appointed as her assistant. It was not long after their appointment when the world was again engulfed in war. The Enrollment Division of the nursing service was given a supreme test in procuring much larger numbers of nurses than ever before. Nurse recruitment committees that were developed in 340 chapters organized the enrollment and recruitment system. During the first year of their organization, these committees recruited over 22,000 nurses for the armed forces -- almost as many as served in World War I.

In 1944, Army and Navy nurses were granted full commissions for the duration of the war and six months thereafter, but the American Red Cross was not relieved of its responsibilities for recruitment for war service until May 1945 when the nurse procurement program was terminated. In anticipation of new legislation for permanent commissions for military nurses, the national enrollment of Red Cross nurses was suspended on July 1, 1946.

On April 16, 1947, the President signed the bill establishing a permanent nurse corps for the Army and Navy, which became Public Law 36. The primary purpose of the Red Cross Nursing Reserve as originally constituted was, therefore, removed. According to present records on file, there were approximately 207,000 Red Cross nurses.

The Central Committee of the American National Red Cross, on May 5, 1947, approved a plan for the enrollment of nurses in the Red Cross Nursing Service for the purposes of the Red Cross itself, that is for service to local communities through chapter programs. This plan replaced the type of enrollment in operation from 1905 to 1946, which served primarily as a reserve for the Army and Navy.

History of Nurse Enrollment

Recognizing that the national emergency, which would require the largest number of nurses, was war, a reserve of well-prepared nurses was developed and maintained primarily for the Army and Navy. Nurses enrolled in the reserves were also called upon to assist in cases of local disasters, which was in keeping with the spirit of the charter obligations.

A national roster was established through a system of state and local committees on Red Cross nursing (composed of nurses only), credentials of nurses were evaluated by the nursing staff of the American Red Cross, and nurses meeting the standards of the Army and Navy were certified to the appropriate nurse corps. Professional qualifications were determined by the Army and Navy and by professional organizations such as the American Nurses' Association and the National League of Nursing Education.

In both World War I and World War II, the American Red Cross carried the responsibility of the recruitment of nurses for the Army and Navy. In World War I, 20,000 nurses were recruited by the American Red Cross of the total 25,000 who served; in World War II, practically all of the 77,800 nurses who served were certified to the Army and Navy by the American Red Cross. Over 100,000 nurses were actually certified. This was the largest voluntary response in relation to resources of any professional group.

During World War II, chapter nurse recruitment committees composed of nurse and non-nurse members were organized and their excellent work did much to ensure the successful mobilization of nurses for war service. In addition to military service, the reserve served a valuable purpose throughout the years in supplying nurses for disasters and in Red Cross programs.

In 1944, Army and Navy nurses were granted full commissions for the duration of the war and six months thereafter, but the American Red Cross was not relieved of its responsibilities for recruitment for war service until May 1945 when the nurse procurement program was terminated. In anticipation of new legislation for permanent commissions for military nurses, the national enrollment of Red Cross nurses was suspended as of July 1, 1946.

On April 16, 1947, the President signed the bill establishing a permanent nurse corps for the Army and Navy, which became Public Law 36. The primary purpose of the Red Cross nurse reserve as originally constituted was, therefore, removed. According to present records on file, there were approximately 207,000 Red Cross nurses.

The Central Committee of the American National Red Cross, on May 5, 1947, approved a plan for the enrollment of nurses in the Red Cross Nursing Service for the purposes of the Red Cross itself, that is for service to local communities through chapter programs. This plan replaced the type of enrollment in operation from 1905 to 1946, which served primarily as a reserve for the Army and Navy.

Nurse Enrollment Program Today

Since 1909 the American Red Cross has recognized the important contributions of dedicated volunteer nurses. Today nurses continue to play vital roles in easing human suffering in their own communities and around the world. And you, too, can help.

The Red Cross Nurse Enrollment Program represents a new level of commitment, symbolizing professional status, voluntary service, and dedication to the fundamental humanitarian principles of the Red Cross. As an enrolled nurse in the program, you are honored with a unique badge bearing an individualized, engraved number. By maintaining a roster of volunteer nurses, the Red Cross can

• Quickly locate volunteers who have demonstrated a willingness to provide vital services during local, national, or international emergencies.
• Provide a channel for nurses to participate in Red Cross activities that meet the needs of their community.
• Recognize the commitment of these volunteer nurses by awarding the numbered badge.

Eligibility
To be eligible for enrollment in the program, you must be a registered nurse and

• be a graduate of an accredited school or college of nursing
• currently be licensed as a registered nurse in the state in which you volunteer
• have given at least 20 hours of volunteer service to the American Red Cross

Duplicate Badges
If your original badge is lost, damaged or defective, you may request issuance of a duplicate badge through your local chapter or by sending a letter to: