BLOG: Training Nurses in Wartime America

Greetings, friends!

I have some exciting things to share on Brook's Journal in the near future... more awesome books to choose from for your reading pleasure, a review of a marvelous book that is upcoming, and my end of the year favorite picks with reviews for each.

This week, we have a truly fascinating blog, written by Marilee Aufdenkamp, author of SPARROW'S SONG. When WWI broke out, the United States was caught in an instant crisis, as the need for nurses suddenly skyrocketed. How they handled this emergency would forever open the vocation to women, who were mostly homemakers in those days.

Aufdenkamp's blog post discusses the shortage and how America provided nurses during the 20th century's two worst wartimes. Do scroll down and take a look at this well-written and researched article. Nurses are still in demand today, and with the soaring costs of healthcare, they are often awarded sign-on bonuses. And more and more men are answering the call for nurses, as well. But in the early 20th century, women were the ones who responded.

Marilee, welcome to Brook's Journal. I hope you'll join us again sometime! Read ON, everyone!

ALL ABOUT THE BOOK

Shortly after Kathryn Scheibel leaves her cigar‑making job in 1917, she enters the Army School of Nursing, a pioneering WWI nurse‑training program that offers the education she’s longed for but couldn’t afford. More than two decades later, her career carries her, as an instructor, into the Cadet Nurse Corps, the federal WWII nursing‑education initiative created to support the war effort. There she sees the same pressures she once felt now directed at students with even fewer protections. When two Black students are treated unfairly, Kathryn must decide how to respond.

Sparrow’s Song is a sweeping, intimate novel about resilience and belonging, rooted in the real history of wartime federal nursing education and the evolving landscape of modern American nursing. At its heart is a young immigrant woman pushing herself toward the advantages she’s convinced education will unlock, even as that drive pulls her away from the people and heritage she loves.

Training Nurses in Wartime America: From the Army School of Nursing to the

Cadet Nurse Corps

By: Marilee Aufdenkamp

When the United States entered the world wars of the twentieth century, the country faced nursing shortages so severe that both military and civilian hospitals struggled to stay staffed. In World War I, the Army Nurse Corps had fewer than six hundred nurses available for duty, even though the military estimated it would need tens of thousands. Civilian hospitals were losing staff to military service at the same time, and nursing leaders fought hard to prevent the Army from filling gaps with untrained aides. Their insistence on maintaining professional standards helped shape the creation of the Army School of Nursing in 1918, a federal program designed not as a rapid‑deployment pipeline but as a strategic workforce solution. Students were never intended to be sent overseas. Instead, they staffed stateside Army hospitals so fully trained graduate nurses could be released for service abroad. By the end of 1918, more than fifteen hundred students were enrolled across multiple Army hospitals, all following the same rigorous curriculum. Their work kept military hospitals functioning during the influenza pandemic and the final months of the war.

The Army School of Nursing adopted the brand‑new Standard Curriculum for Schools of Nursing, issued by the National League of Nursing Education in 1917–1918. It was the profession’s first national course of study, emphasizing sciences like chemistry, bacteriology, hygiene, and nutrition—exactly the subjects my fictional student Kathryn studies in Sparrow’s Song. Students trained at military hospitals such as Walter Reed in Washington, D.C., and Letterman in San Francisco, rotating through day, evening, and night shifts with classes scheduled around hospital needs. The program charged no tuition, and students received free room and board plus a modest stipend of fifteen dollars a month, enough to cover books and laundry and sometimes to send money home. Before arriving, they were instructed to purchase Butterick pattern 9530 and sew their own blue chambray uniform, worn with detachable white collars, tall cuffs, and a white apron. Chambray was chosen because it was durable, washable, and clearly distinguishable from the white uniforms worn by fully trained Army nurses. Although the Adjutant General authorized a military‑style insignia—the bronze lamp superimposed on the caduceus—students remained civilians, and the chambray dress reinforced that distinction.

The armistice came only months after the school opened, creating immediate uncertainty. Students were asked whether they intended to complete the full nursing diploma, because only those who planned to finish would be retained. Many chose to stay. Even though the fighting had stopped, military hospitals remained full, troop transports continued bringing home sick and wounded soldiers, and the influenza epidemic still strained the medical service. Students who remained continued full training while staffing the wards, and some died in service. Those who completed the program graduated with a diploma in nursing, not a college degree. At the time, diploma programs were the standard pathway into the profession, and graduates were eligible for state licensure and could enter civilian practice or join the Army Nurse Corps as trained nurses.

By the time the United States entered World War II, the nursing shortage had reached a critical point again. Hospitals were crowded, public health programs were expanding, and higher‑paying wartime industry jobs attracted young women who might otherwise have entered nursing. The country faced an estimated seventeen thousand nursing vacancies. Rather than return to the World War I approach of establishing federal nursing schools, the government chose a more efficient path: subsidize existing schools of nursing that met federal standards and were willing to reorganize their programs into a thirty‑month structure. The Nurse Training Act of 1943, better known as the Bolton Act, created the Cadet Nurse Corps, administered by the U.S. Public Health Service. It became the largest federally supported nursing education program in American history.

One of the most impactful provisions of the act was its nondiscrimination clause, which prohibited participating schools from excluding qualified applicants on the basis of race, color, or creed. As a result, nearly three thousand African American, Japanese American, and Native American women entered the Corps, and several previously segregated nursing schools admitted minority students for the first time. The plan that emerged was both practical and visionary. Schools adapted their curricula from thirty‑six months to thirty, freeing students for a final six‑month period of full‑time clinical service known as the senior cadetship. The federal government paid tuition, fees, room and board, textbooks, laundry, and uniforms. Cadets received monthly stipends—fifteen dollars during the pre‑cadet period, twenty during the junior period, and thirty during the senior cadetship, or sixty if serving in a federal hospital. In return, students pledged to remain in essential nursing service for the duration of the war, though the pledge was a gentleman’s agreement and carried no penalties for those who left.

Participation was enormous. Of the 1,312 nursing schools that met federal standards, 1,125 joined the program. Between 1943 and 1945, 179,294 students enrolled, representing eighty‑three percent of all students admitted to participating schools during that period. Nearly seventy percent completed their training. At the height of the war, student nurses were providing eighty percent of the country’s nursing care in more than a thousand civilian hospitals. Senior cadets served in Army hospitals, Navy hospitals, Veterans Administration hospitals, Indian Service hospitals, Public Health Service hospitals, and civilian hospitals across the country. Those serving in Army facilities held officer privileges, including access to officers’ clubs and recreational facilities. After graduation, cadets who entered the Army Nurse Corps did so as second lieutenants. Like their World War I predecessors, Cadet Nurses graduated with a diploma in nursing, not a college degree, but their training met federal standards and prepared them for licensure and professional practice.

The Cadet Nurse Corps also launched one of the most ambitious recruitment campaigns in American nursing history. The federal government spent nearly thirteen million dollars on recruiting—an extraordinary sum for a nursing program. Posters, pamphlets, radio spots, newsreels, and magazine features promoted nursing as modern, patriotic, and essential to the war effort. The outdoor uniform became a central part of that campaign. Designed by top fashion designers and chosen in a competition at the Waldorf‑Astoria in New York City, each cadet received summer and winter suits, a winter coat, raincoat, beret, handbag, and sleeve insignias portraying the Maltese cross. The colors carried symbolic meaning: gray for mercy and serenity, scarlet for strength and courage, and the fouled anchor for wounded sailors. Cadets received a booklet titled Figuratively Speaking, which instructed them on posture, grooming, and how to wear the uniform properly and with pride. Hollywood joined in with Reward Unlimited, a short film starring Dorothy McGuire as a heroic cadet nurse, and radio spots aired on more than three hundred programs, including the memorable line, “Do You Want to Be a Girl with a Future?” The campaign exceeded its ambitious first‑year recruitment goal by more than five hundred students.

Although the Army School of Nursing and the Cadet Nurse Corps were separated by twenty‑five years, they shared a common purpose: expand the nursing workforce during wartime without sacrificing educational standards. Their structures differed—one was a federal military school, the other a massive civilian‑school subsidy—but both opened doors for women who needed financial support, both provided structured clinical training, and both kept hospitals functioning during national crises. And graduates from both programs earned a nursing diploma, which allowed them to sit for state board examinations for registration and licensure.

  All About Marilee

Marilee Aufdenkamp is a retired nurse educator who taught undergraduate nursing for twenty‑six years before turning her full‑time focus to historical fiction. She writes early to mid‑twentieth‑century stories grounded in immigrant experience and working‑class life.

Her debut novel, Sparrow’s Song, was inspired by her early nursing career in Nebraska, where she came to admire the Germans from Russia she cared for at the end of their lives.

Originally from Southern California, she has spent her adult life in Nebraska.

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