Nursing field

The women’s role in society has influenced their participation in the nursing field. The indispensable importance of nurses has been proven through the years that have passed. Simultaneous to the professionalisation of nursing, one of the ways to acquire the necessary nursing skills and knowledge is through military service. Australian nurses have been utilized to deal with sicknesses, wounds and deaths in war zones and medical facilities (hospital ships and transports). Australian women serving soldiers during war had cultivated their nursing skills and knowledge that developed into the present nursing standards in Australia.

The formation of Australian Nursing Service of New South Wales began the participation of Australian women as nurses in war. These women have taken up the task as caregivers in different medical settings such as field hospitals and medical ships near battlefields. The 60 women that had signed up to serve the Boer War marked the first step of Australian nurses towards professional development. This also marked the major contribution of Australian nursing to history, both locally and globally. In every war, Australian nurses had participated, and it produced a tremendous effect in their lives profession (Australian Government 2010).

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World War I The presence of Australian nurses during the World War I (WWI) had been integral in the series of events that happened. It brought up opportunities for trained Australian nurses to further enhance not only their nursing skills and knowledge but also their commitment to the profession and their country. When the World War I erupted, both trained Australian nurses and civilian women have enlisted to participate in nursing duties in battlefields. A different world welcomed the nurses on duty.

They were greeted by the danger of weapons, insufficient food and supplies, different unfamiliar diseases, mutilated bodies and deaths. Upon these conditions, the nurses had strive to do their best to adapt to the situation and be competent in their work. Among the first things that these nurses developed during WWI was resourcefulness in the field. During deployment in foreign countries, nurses had encountered primitive settings that were inadequate for the nursing needs of patients. Nurses had to make use of improvised medical equipment made out of boxes and bags.

Nurses even had to use their clothes as substitute for bandages and wash clothes for their patient’s wounds. With all the nursing duties they had to perform, these nurses also learned how to manage and maintain their medical facilities (ward tents) against strong winds and leaks (Harris 2008). Incidences of water shortages also were a problem for nurses assigned in ships. These scenarios had proven to be very much different from the hospital settings in Australia. The nurses worked hard to adjust to their patients’ needs and the working conditions.

Besides developing resourcefulness, Australian nurses had stabilised endurance and flexibility. Nurses that were active faced several gruesome physical environments such as freezing winters. Nurses had to work through this climate, keeping the patients warm and dry and maintaining the viability of liquid medicines. These nurses also dealt with high incidence of frostbite, exhaustion or trench foot during this climate (Gammage 1975). This was a difficult transition for those nurses who worked in a temperate climate. War conditions produced hundreds of wounded and dying soldiers that occupied nursing wards continuously.

Nurses had to perform in the fastest and most efficient way possible, thus creating skills for emergency nursing (Tyquin 1993). In line with this, nurses had fulfilled their role in Casualty Clearing Stations (CCS). Nurses developed surgical skills, ability to assess medical priorities (triage), alleviate pain and suffering and aid in the recovery of patients (Butler 1943). During the WWI, sterility was an important concept during surgical intervention. Nurses had the responsibility to ensure the sterility of surgical equipment and assist physicians in operating on patients.

These were the first responsibilities of nurses in the surgical field. Nursing skills utilised the concept of rehydration; blood transfusion and shock treatment were used to revive patients. Added duties were also given to nurses such as assisting in the removal of smaller pieces from wounds. Nurses also gained knowledge about the common post-operative complications and its management (Harris 2008). Besides managing the wounds of the patients, nurses had to deal with diseases such as dysentery. This disease had made use of the knowledge of nurses in nutrition.

They were the ones who cooked the so-called invalid food to help in soldiers’ recovery (Marlow 1998). World War I had also affected the mental state of soldiers. The tortured images of war, i. e. , mutilated bodies, dead comrades and great exhaustion, produced a condition known as shellshock (Bourke 1995). Nurses worked with this added condition of the patients. They were tasked to provide medicine as well as use alternative methods such as amusing patients to make them forget (Thurstan 1917). Lack of resources during the World War I has given opportunities to Australian nurses to fulfil new roles in the field.

Some nurses were trained as anaesthetists, one occupation not possible for nurses in normal conditions. Nurses were also allowed to perform minor operations on patients suffering from multiple injuries. Physicians allowed nurses to do such tasks due to lack of manpower. This presented a great opportunity for nurses to expand their abilities in healthcare (Harris 2008). With the new acquired skills, Australian nurses were also acquainted in the use of new apparatus during the WWI, such as x-ray. Harris (2008) quoted the statement of Ella Tucker, an Australian nurse, about how impressive the new apparatus was.

Tucker wrote “just wheeled into the X-ray room, the F. B [foreign body] located, & patient wheeled back to the theatre, & operated proceeded with”. Finally, Australian nurses also took the role as dispensers of medicine during the WWI. Harris (2008) wrote in her article that with the WWI, Australia embraced a new system of education in different professions, including Pharmacy. Although this system was recognised in the country, there was no clear purpose of policy regarding the business of medical supply in the Australian army and the existence of pharmaceutical service in the field.

This brought another opportunity for Australian nurses to fulfil the role of dispensers, which according to Harris (2008, p. 3) means “compounding drugs and handing them out”. The useful skill of dispensing was introduced to nursing training schools. In 1899, postgraduate fourth year of training had enlisted dispensing as one of its subject. Nurses received special dispensing certificate after a six-week course which was later reduced into a two-week course for nurses (Harris 2008). The employment of trained nurses improved the flexibility of the skills and knowledge of nurses in varied areas of healthcare.

The lack of qualified personnel in the army produced opportunities for utilising trained nurses as substitute. This situation widened the diversity of knowledge and skills of Australian nurses. The clinical skills of the trained nurses were developed during the WWI. However, the administrative skills of nurses were also cultivated. There were accounts of trained nurses acting as managers in wards. Trained nurses were tasked to manage male nursing orderlies. Women significantly increased in the nursing field. It was said that women replaced male attendants or wardsmen who declined in number in hospitals.

This was a challenge for Australian nurses because these male orderlies at times did not have proper training or valuable knowledge about ward work. Smooth management depended on how these nurses were able to train and supervise their subordinates (Butler 1943). In their supervision over theses male orderlies, nurses were able to practise their teaching skills. This is an early account on how nurses were able to enter the academe for the nursing profession. Harris (2008) quoted Ella Tucker who wrote in her diary that she gave her orderlies “bandaging lessons, & later on pad splints”.

These were the events that developed Australian nurses and their profession through the years. It made a huge impact on the enhancement of the nursing field and the expansion of the roles and responsibilities of nurses. The war produced hardships, illnesses and diseases and deaths among hundreds of people. Throughout history, Australian nurses played a huge part in their service to the army. Military nursing presented more opportunities to trained Australian nurses to experience and learn nursing work different from the usual settings. World War II The role of Australian women in the army continued as World War II (WWII) commenced.

Nurses were among the million Australian men and women deployed outside Australia, in North Africa, Europe, the Mediterranean, the South West Pacific and Southeast Asia (Australian Government-Department of Veterans’ Affair 2010). There is one significant difference between the WWI and the WWII. The WWII had higher incidences and number of Australian troops captured. The fate of nurses was considered more unfortunate since they were included in list of war prisoners. Nurses endured the same torture and terrors in prisons. They were not spared from the brutal massacres and painful conditions in the hands of their captors.

Nursing organisations were formed in coordination with the navy, army and air force. These organisations included Australian Army Medical Women’s Service (AAMWS), Australian Army Nursing Service (AANS), and Voluntary Aid Detachments (VADs) of the Red Cross. Dedication, courage and nationalism were shown by these nurses who served every medical facility of war as they endangered their lives. Besides the constant threat on their lives, these Australian nurses continued to give service to the sick and dying even with through unbearable conditions. Australian nurses deployed in North Africa had to endure instances of inadequate food supply.

They also had to work despite the unpredictable weather and unhygienic medical facilities. In the North Africa desert, nurses had to live and operate in underground bunker that served as an aid post. They provided nursing care in underground tunnels with only air vents. These nurses worked in long shifts just to accommodate the number of injured and sick soldiers. They were images of selflessness as they allowed their patients to sleep in tents while they slept on open grounds. These working conditions could testify the dedication and heroism that Australian nurses had performed during the WWII.

They did not discriminate in times duty, catering to every nationality, enemy or comrades (Skwirk 2010). There were many gruesome stories about the situation of Australian nurses during the WWII. One of the most remembered was the story of Vivian Bullwinkel, the sole survivor of the Bangka Island Massacre. Among the 90 nurses and soldiers that were shot by the Imperial Japanese Army in 1942, she had tried to survive to live on and testify to the unfortunate fate of the other victims of the massacre (Cook 2007). Her courage and patience were tested when she was held as captive in three and half years.

She endured brutality and sufferings in the camp because of her determination to survive for her colleagues. She performed her duties as a cook and nurse. She even had to endure transporting human feces and unclogging toilet drains with just half a coconut shell to earn 80 cents. These were heartbreaking accounts of her camp life during the WWII (Angell 2010). Other Australian nurses also shared their experiences as war prisoners in foreign lands. The Rabaul nurses were also prisoners of war that had been captives for more than three and a half years.

These nurses were transported to Japan where they served in a rural medical facility. This was a very frightening experience since there was no information about the whereabouts of these isolated Rabaul prisoners-of-war. However, despite the circumstances, courage and endurance were continuously shown by these nurses (Deglon Marriott 2009). The tales of the World War II enhanced their image as hardworking, loyal and competent nurses. After the war, they were recognized formally for their war service and nursing skills that had saved lives and alleviated sufferings.

These women in service were a form of refuge and hope for the soldiers. Adam-Smith (1984) quoted Dorothea Skov, an Australian Women’s Auxiliary Service (AWAS) member who wrote: ‘Soon officers said, “The morale and behavior of men have lifted since women joined the Service. ” … Every girl who enlisted expected to release a man for active service. The returned men appreciated this when they got used to seeing us around. ’ Vietnam War Australia was involved in the Vietnam War that erupted in 1962-1973. Australia sent their combat troops as well as Australian nurses in Vietnam.

About 43 Australian nurses were involved as part of the Australian army in Vietnam. There were more than 200 Australian civilian nurses who volunteered. During this war, women expanded their roles to serve their country. They had varied roles such as Red Cross support, Australian Embassy staff and journalists (Australian Government-Department of Veterans’ Affair 2010). The World War I and the World War II had given much pain and sufferings but still they were able to become heroes in the eyes of the sick and dying soldiers. This was also true for Australian nurses who came to Vietnam.

Norman (1990, p. 45) stated that the loneliness, fatigue and fears felt by nurses were rewarded by feelings of appreciation and self-actualization from their nursing work. The main objective of participating in volunteer nursing work was attained. A major number of their patients recovered after being admitted in military hospitals in Vietnam. However, as what had happened in the past wars, Australian nurses also struggled in their work in a foreign land. They mainly had to deal with working with Vietnam nurses who had a different culture and nursing competence.

Jan Bell, an Australian nurse, shared her experience in the battlefield when she was assigned. Bell (1999) wrote about their working relationship with the Vietnamese women. She wrote: ‘Basically we took over the operating theatres and outpatients department of a Vietnamese hospital although we did work alongside some Vietnamese staff. Needless to say, they weren’t terribly happy about having us come and take over their hospital. At the time you felt you were an evangelist showing them the right way to do things. In hindsight we were doing it at the expense of

their values. However, having said that, it was hardly surprising that we tried to instill our methods. We’d come from modern, clean well-ordered Concord to a filthy in our eyes – ill-kempt, badly-maintained hospital. The toilet facilities for patients were to say the least, appalling. ’ Bell, however, managed to adapt to these working conditions. She had even come to admire a fellow Vietnamese nurse named Madam Mop for her dedication and standards. She confessed that her working conditions in Vietnam made her more hardworking and adaptable to chances.

It taught her to be better in her communication skills and be more open minded. She believed that Vietnam made her a better nurse who had greater political and social conscience. Another thing that was new for these Vietnam nurses was the fact that they have been introduced to various uncommon diseases that were widespread to Vietnam during the war. Bell (1999) mentioned that besides the whole medical and surgical conditions known to be present in wars, Australian nurses had to deal with people with tetanus, tuberculosis and occasional leprosy cases.

These nurses also encountered the increase in volume of patients that needed medical attention, ranging from gunshot wounds, burns, head injuries, multiple abdominal wounds to injuries from explosives. Bell (1999) recalled her experience during the Tet offensive in 1968 when she had witnessed the surge of injured people that were mainly children and women. She was shocked from the situation she had encountered. This was indeed an enlightening experience despite the conditions that had to be dealt with and the lack of facilities to be used.

This whole experience may be depressing to others, but Bell stated that given the opportunity, she would do it again. It was indeed clear that experiences of war in foreign lands made nurses strong and adaptable to different conditions. Effect of Military Nursing on Australian Nurses and Nursing The involvement of Australian nurses to the past wars that had happened for the last centuries provided much development in the nursing field. Florence Nightingale introduced the importance of sanitation and infection control in health care settings that severely reduced morbidity and mortality rate.

The Vietnam war experience gave Australian nurses the skills for triage, to do most good for the most number of people. The severity of the situation during these conditions had taught Australian nurses knowledge and skills far different from the normal things in a normal hospital setting at home. The use of triage and even wound care principles are still continued in these modern times of nursing. Areas such as emergency nursing, intensive care nursing and operating room nursing had evolved from the lack of preparation of military nursing during war.

Finucane (2004) described the role of military nurses as ‘nurses triaged, proceeded to intubate, inserted chest tubes, amputated limbs and whatever else was required for their patients to survive’. The need for nurses to acquire these skills can be evidenced by the presence of advanced roles for nurses and specialty areas in modern nursing. During the Vietnam War, the concept of early care and intervention was recognized as it reduced the percentage of mortality than in the past world wars. At war, administrative roles for nurses were introduced.

Nelson and Rabach (2004)believed that during war, matrons (senior nurses) have their own hierarchy that cultivated their administrative skills in nursing. These women were included in administrative training for the army for the first time. These trainings had given military nurses new ideas on how to plan and manage their subordinates. After the war, these senior nurses had been placed on administrative positions in hospitals settings. They have exemplified excellent managing and innovating new policies in the hospital settings such as the case of Annie Sage.

However, conflicts happened as Sage believed that the nursing profession should be recognized equal to the medical profession. Sage envisioned the elevation of the status of Nursing as a profession as well as its development (Nelson and Rabach 2004). These Australian nurses had clearly shown their devotion and courage to the nursing profession and their patients. Different significant figures such as Sister Edith Cavell and Sister Dewer died while protecting their patients during wars. The extraordinary experience of Vivien Bullwinkel as the sole survivor of the Bangka massacre showed her courage and determination to live for her colleagues.

These are only few testimonials of the devotion and courage nurses had shown in the battlefields. Australian nurses had not only shown nursing skills during war, they were also a source of comfort to those injured and dying (Finucane 2004). List of References Australian Government 2010, Women in action- nurses and serving women, Australian Government, viewed 7August 2010,<http://www. cultureandrecreation. gov. au/articles/ womeninaction/> Australian Government-Department of Veterans’ Affair 2010, Australian women in the

Vietnam War (1962-1973), Australian Government- Department of Veterans’ Affair, viewed 7 August 2010, <http://www. dva. gov. au/commems_oawg/commemorations/education/Documents/DVA_Women_in_War_part5. pdf> Australian Government-Department of Veterans’ Affair 2010, Australian women in World War II (1939-1945), Australian Government-Department of Veterans’ Affair, viewed 6 August 2010, <http://www. dva. gov. au/commems_oawg/ commemorations/education/Documents/DVA_Women_in_War_part3. pdf> Adam-Smith, P 1984, Australian Women At War. Nelson, Melbourne. Penguin Books Ltd.

Angell, D 2010, ‘Vivian Bullwinkel’, Angell Productions, viewed 6 August 2010, <http://www. angellpro. com. au/Bullwinkel. htm> Bell, J 1999, ‘1964-Jan Bell- Vietnam War Nurse’. The Lamp, vol. 56, no. 10. Bourke, J 1995, ‘Shell Shock and Australian Soldiers: in the Great War’, Sabretache, vol. 36, no. 3, pp. 3-15. Butler, AG 1943, ‘Official History of the Australian Army Medical Services 1914-1918′, Australian War Memorial, vol. 3, pp. 636-637 Cook, B 2007, Women and war: a historical encyclopedia from antiquity to the present, ABC-Clio, Santa Barbara, CA, viewed 5 August 2010 ;http://books. google. co.

2, pp. 97-110. Gammage, B 1975, The Broken Years: Australian Soldiers in the Great War. Canberra, Penguin. Harris, K 2008, ‘In “the Grey Battalion”: Launceston General Hospital nurses on active service in World War I’, Health and history, vol. 10, no. 1, pp. 21-40. Harris, K 2008, ‘Sister dispenser – Australian trained nurses in pharmacy’, Pharmacy History Australia, vol. 4, no. 34, pp. 3-6. Marlow J, 1998, The Virago Book of Women and the Great War, Virago Press, London. Nelson, S ; Rabach, J 2004, ‘Military experience: the new age of Australian nursing and other failures’, Health and History, vol.

6, no. 2, pp. 79-87. Norman, E 1990, Women at war: the story of fifty military nurses who served in Vietnam, University of Pennsylvania Press, Philadelphia Skwirk 2010, Nurses in the war, Swirk, viewed 6 August 2010, ;http://www. skwirk. com. au/ p-c_s-14_u-91_t-199_c-665/nurses-in-the-war/nsw/nurses- in-the-war/australia-and-world-war-ii/war-time-experiences; Thurstan, V 1917, A Textbook of War Nursing, G. P. Putnam’s Sons, London. Tyquin, M 1993, Gallipoli: The Medical War- the Australian Army Medical Services in the Dardanelles Campaign of 1915. University of New South Wales Press: Sydney.


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