RAINING OF NURSES 
HEARINGS 
BEFORE THE 
COMMITTEE ON EDUCATION AND LABOR 
UNITED STATES SENATE 
SEVENTY-EIGHTH CONGRESS 
FIRST SESSION 
ON 
S. 983 
A BILL TO PROVIDE FOR THE TRAINING OF NURSES 
FOR THE ARMED FORCES, GOVERNMENTAL AND 
CIVILIAN HOSPITALS, HEALTH AGENCIES, AND 
WAR INDUSTRIES, THROUGH GRANTS TO 
INSTITUTIONS PROVIDING SUCH TRAIN- 
ING, AND FOR OTHER PURPOSES 
MAY 6 AND 7, 1943 
Printed for the use of the Committee on Education and Labor 
UNITED STATES 
GOVERNMENT PRINTING OFFICE 
WASHINGTON : 1943 
86411 COMMITTEE ON EDUCATION AND LABOR 
ELBERT D. THOMAS, Utah, Chairman 
DAVID I. WALSH, Massachusetts 
JAMES E. MURRAY, Montana 
CLAUDE PEPPER, Florida 
ALLEN J. BLLBNDER, Louisiana 
LISTER HILL, Alabama 
DENNIS CHAVEZ, New Mexico 
JAMES M. TUNNELL, Delaware 
JAMBS O. EASTLAND, Mississippi 
HOMER T. BONE, Washington 
JOSEPH F. GUFFEY, Pennsylvania 
ROBERT M. LA FOLLETTE, Je., Wisconsin 
ROBERT A. TAFT, Ohio 
STYLES BRIDGES, New Hampshire 
GEORGE I). AIKEN, Vermont 
JOSEPH II. BALL, Minnesota 
ALBERT W. HAWKES, New Jersey 
KENNETH S. WHERRY, Nebraska 
Paul L. Badger, Clerk 
II CONTENTS 
Statement of— 
Mclntire, Roar Admiral Ross T 2 
Draper, Dr. Warren F 4 
McAfee, Brig. Gen. Larry 9 
Clark, James Russell 10 
Davison, Dr. W. C 12 
Sheahan, Miss Marian 13 
I jams, Col. George E 22 
Baehr, Dr. George 27 
Stimson, Maj. Julia C 29 
Dent, A. W 31 
Martin, Rev. John G 33 
Stewart, Miss Isabel 34 
Stauphers, Mrs. Mabel Keaton 37 
Parran, Dr. Thomas 39 
Goostray, Miss Stella 41 
Tydings, Mrs. Eleanor Davies 44 
Bolton, Hon, Frances P 46 
Eliot, Dr. Martha 50 
Beard, Miss Alary 54 
Harvey, Dr. Verne K 57 
Faville, Miss Katherine 59 
Butler, Mr. Eugene 63 
Gowan, Sister M. Olivia 73 
Wolf, Miss Anna D 79 
Jacobson, Miss Marguerite 87 
Overholser, Dr. Winfred 88 
Page 
III TRAINING OF NURSES 
THURSDAY, MAY 6, 1943 
Committee on Education and Labor, 
United States Senate. 
The committee met, pursuant to call, at 10 a, m., in room 45T, 
Senate Office Building, Senator Elbert D. Thomas (chairman) 
presiding. 
Present: Senators Thomas (chairman), Tunnell, Eastland, and 
Ball. 
Washington, D. C. 
The Chairman. We have under consideration S. 983, a bill to pro- 
vide for the training of nurses for the armed forces, governmental and 
civilian hospitals, health agencies, and war industries, through grants 
to institutions providing such training, and for other purposes. I 
will ask the reporter to insert the bill in the record at this point. 
(S. 983 is as follows:) 
[S. 983, 78th Cong., 1st sess.] 
A BILL To provide for the training of nurses for the armed forces, governmental and 
civilian hospitals, health agencies, and war industries, through grants to institutions 
providing such training, and for other purposes 
Be it enacted by the Senate and House of Representatives of the United States 
of America in Congress assembled. That for the purpose of assuring a supply of 
nurses for the armed forces, governmental and civilian hospitals, health agencies, 
and war industries, there is hereby authorized to be appropriated for the fiscal 
year ending June 30, 1943, and for each fiscal year thereafter, sums sufficient to 
carry out the purposes of this Act. Such sums shall he used for making payments 
to schools of nursing or other institutions which have submitted, and had ap- 
proved by the Surgeon General of the Public Health Service (hereinafter referred 
to as the Surgeon General), plans for nurses’ training, and for all necessary 
expenses of the Public Health Service in administering the provisions of this Act. 
Sec. 2. A plan for training of nurses may be limited to student-nurse training, 
or to postgraduate or refresher nursing courses, or may include both. A plan 
submitted by any institution may be approved only if it provides— 
(a) that no student or graduate nurse will be included under the plan 
unless in the judgment of the head of the institution such nurse will be 
available for military or essential civilian services for the duration of the 
present war, and such nurse so states in her application for inclusion under 
the plan; 
(b) that nurses under the plan will be provided courses of study and 
training meeting standards prescribed by the Surgeon General; 
(c) that the institution will furnish student nurses under the plan (with- 
out charge for tuition, fees, or other expenses), courses of study and train- 
ing, uniforms, including street uniforms, and maintenance in accordance 
with regulations of the Surgeon General; 
(d) that the institution will pay student nurses under the plan a stipend 
at not less than the following monthly rates; $15 for the first nine months 
of study; $20 for the following 15 to 21 months of combined study and 
practice, depending upon the curriculum of such institution ; and 
1 2 
TRAINING OF NURSES 
(e) that the institution will either afford student nurses under the plan 
an opportunity to complete their course of training until graduation at such 
institution and will pay such student nurse a stipend at a monthly rate not 
less than $30 for the period following the period of combined study and 
practice and prior to graduation, or will transfer such student, after com- 
pletion of the period of combined study and practice and prior to graduation, 
for training in some other institution, but only if such training may be 
credited toward graduation, and the institution to which the nurse is trans- 
ferred agrees to pay her a stipend at a monthly rate of not less than $30 
until graduation. 
Sec. 3. (a) From the sums appropriated therefor the Secretary of the Treasury 
shall pay each institution, with a plan approved under section 2— 
(11 with respect to items furnished student nurses thereunder, amounts 
determined by the Surgeon General to compensate such institutions for— 
(A) reasonable tuition and fees for the courses of study and training; 
(B) reasonable maintenance provided pursuant to section 2 for the 
first nine months of their course of study and training; 
(C) uniforms and insignia, provided in accordance with section 2; 
and 
(D) the minimum rate of stipend specified in section 2 for periods 
prior to completion of the course of combined study and training re- 
ferred to in such section; and 
(2) with respect to items furnished graduate nurses thereunder, amounts 
determined by the Surgeon General to compensate such institution for rea- 
sonable tuition and fees for postgraduate and refresher course of study, and 
reasonable maintenance for graduate nurses undertaking postgraduate 
courses, or such portion of such amounts as may be determined in accordance 
with regulations of the Surgeon General. 
(b) Determinations by the Surgeon General under this section of amounts 
which any institution shall receive shall be conclusive upon such institution and 
upon the General Accounting Office. 
Sec. 4. The method of computing and paying the amounts referred to in section 
3 shall be as follows: 
(a) The Surgeon General shall, from time to time, on a prepayment of reim- 
bursement basis, estimate or make determination of, the amount for each insti- 
tution, which amount shall be reduced or increased as the case may be by any 
sum by which he finds that unadjusted payments with respect to any prior period 
were greater or less than the amount which should have been paid to such insti- 
tution pursuant to section 3 for such prior period, and shall certify the amount 
so estimated or determined and so reduced or increased to the Secretary of the 
Treasury. 
(b) The Secretary of the Treasury shall thereupon, through the Division of 
Disbursement of the Treasury Department and prior to audit or settlement by 
the General Accounting Office, pay the institution at the time or times fixed by 
the Surgeon General the amount so certified. 
Seo. 5. In lieu of payment therefor under section 3 (a), the Surgeon General 
is authorized to procure and provide insignia for student nurses under a plan 
approved under section 2. 
Seo. 6. The Surgeon General with the approval of the Federal Security Admin- 
istrator is hereby authorized to promulgate such rules and regulations as may 
be necessary to carry out the purposes of this Act. 
The Chairman. Admiral McTntire, please. 
STATEMENT OF REAR ADMIRAL ROSS T McINTIRE, MEDICAL CORPS, 
UNITED STATES NAVY, SURGEON GENERAL OF THE NAVY 
The Chairman. Admiral, for the record, will you state your name, 
please, and title, and whatever other information you want to give 
about yourself ? 
Admiral MoInttre. Roar Admiral Ross T Mclntire, Medical Corps, 
United States Navy, Surgeon General of the Navy. TRAINING OF NURSES 
3 
The Chairman. Admiral, will you proceed, then, as you wish? 
Admiral McIntire. Mr. Chairman, the Navy is very decidedly in- 
terested in this bill. I am coming this morning to support the bill 
and speak more on my own personal interest in the matter than from 
the Department’s side, for this reason: We received the bill rather 
recently, and the Department has not been able to clear through the 
Budget a short amendment that we feel should be attached to this bill 
to make it an enabling one, from our standpoint, so that we may pay 
for the services, uniforms, messing, and so on, of student nurses that 
might be transferred to us during their last 6 months of training. 
We hope to be able to hand to the committee, in a very short time, 
our views and an amendment which we hope you will consider. I am 
sorry that that can’t be done at this time, this morning. 
I would like to comment, though, on the need for nurses. I am 
sure that that is superfluous, but for the record I would like to say that 
the need for at least 65,000 more student nurses in this coming year is 
imperative. 
Now to do this, the Government will need to help, and the Public 
Health Service, I believe, is the oroper organ to carry this out. I think 
the preparations that they have made to do this will be adequate, and 
that we can get results. I know that all the civil institutions are in 
accord, that we will get cooperation. 
Then I would like to add, also, that not only do we, in the armed 
services, need more nurses, and will continue to need more, but that 
in the long view, the civil needs of this country will be such, through 
the rest of this war and in the post-war period, that we will not have 
anywhere near enough graduate nurses to supply those needs. 
And when we consider what will happen when this war is over—and 
the change in population that must again come about, for war indus- 
tries have certainly dislocated population—health conditions will be 
of even greater importance to the future of this country following the 
war than they even are today. 
And so we should have a very thorough and workable plan for all 
the health needs, and I hope that that will be forthcoming in the very 
near future, and this is a constructive step. I believe the small amount 
of money that the Government will need to put up to activate this plan 
will be very well spent. It will be something that will pay dividends 
for many, many years to come. 
And so I can say from my own experience in this first year and a half 
of war that this program will help definitely in the war effort. The 
Navy will need every nurse that can be spared from the civilian set-up. 
The Chairman. Senator Tunnell? 
Senator Tunnell. Admiral, I was interested in your statement that 
after the war, you thought there would be a great shortage of nurses— 
is that what you said ? 
Admiral McIntire. That is perfectly true. 
Senator Tunnell. How do you explain that? 
Admiral McIntire. Well, I will explain that in this way: We are, 
of course, during this year, and the next year, and we hope not more 
than the following year, as far as the armed services are concerned, 
will still need to take nurses from our civil institutions; that is, the 
graduate nurses. Now we might feel that we, then, when the war is 
over, could return these nurses to civil life. I don’t believe we are 4 
TRAINING OF NURSES 
going to be able to do that anywhere near in the percentages that we 
would expect, because, whether we like it or not, we are going to have 
a great responsibility in seeing that there are not epidemics in certain 
other parts of the world; and so, the armed forces will need, for a time 
at least, to keep up the strength of their medical departments, and that 
will mean that we will need to keep a great many of these reserve 
nurses on active duty in the services for some period following the 
war; and for that reason we will not give the help then that we should 
give to the civil communities immediately following, and the Public 
Health Service will then have the responsibility of the over-all plan 
of seeing that epidemics do not break out in continental limits. 
Senator Tunnell. That is what I was interested in. 
Admiral McIntire, Yes, sir. 
The Chairman, Admiral, there is one more question. We have 
heard, in considering rehabilitation bills and things of that kind, that 
more men are being saved in this war who will need rehabilitation, 
than in the past wars—thank goodness. But at the same time, it opens 
up a governmental problem, because our Government will have on its 
hands hundreds and probably thousands of persons who have to be put 
back into life, who are injured and who will need nursing care. 
Now is it proper to use that as an argument in favor of this bill ? 
Admiral McIntire. I believe that that is an argument. There is 
no question in my mind, but what our rehabilitation program will be 
a very large one, and I believe that if we start now—and we have 
started, I can tell you that—making plans for sane rehabilitation of 
our wounded, that we will not make the same mistake that was made 
in the last war, of waiting until a great many could not be rehabilitated. 
But it will mean that our institutions will need additional nurses, well- 
trained in this field of rehabilitation. 
So I think it is a just argument to use in this case. 
The Chairman. Thank you, Admiral. 
Admiral McIntire. Thank you, Mr. Chairman. 
The Chairman. Dr. Draper, please. 
STATEMENT OF DR. WARREN F. DRAPER, ASSISTANT TO THE 
SURGEON GENERAL, PUBLIC HEALTH SERVICE, REPRESENTING 
SURGEON GENERAL PARRAN 
The Chairman. Dr. Draper, for the record will you state your name 
and what other facts you want to appear about yourself? 
Dr. Draper. Dr. Warren F. Draper, assistant to the Surgeon Gen- 
eral, Public Health Service, representing Surgeon General Parran. 
The Chairman. Proceed as you wish, Doctor. 
Dr. Draper. Mr. Chairman, as is generally known, the Public Health 
Service has had a plan for increasing the number of nurses for the 
past 22 months- During the fiscal year 1942 the Congress made avail- 
able an appropriation of $1,800,000 to assist schools of nursing in 
increasing the number of student nurses. In 1943 the appropriation 
was increased to $3,500,000. And we have been operating under this 
plan. 
The main purpose was to increase the number of student nurses, and 
no consideration was paid to the number of student nurses already 
enrolled in the schools. As a result of the program already under way, TRAINING OF NURSES 
5 
the number of student nurses has been increased by some 12,000. Now 
that program was considered or developed when we expected to have 
an Army of about 3,000,000 men. Since the beginning or the program 
the situation has, of course, changed very much, and now we have a 
great demand for the services of women in many lines of work. 
The uniformed services, of course, are taking a great many women. 
Some 15,000,000 women, 16,000,000 women, are going into industry, 
and war services of other sorts are taking many more women. So that 
it is very difficult to increase or even to maintain the enrollments of 
student nurses, to say nothing of increasing it under the present condi- 
tions. 
The new proposed legislation is a radical departure from that that 
we have had in operation heretofore- It provides new incentives for 
women to enter the nursing profession, and new inducements; but it 
seems to us that if we are to get the requisite number of nurses, that 
new provisions of some sort to induce young women to enter the school 
of nursing are necessary. 
By June 1944 we understand that some 372,000 graduate nurses 
will be needed in this country. The nurse inventory, which is the 
best evidence that we have, taken in 1941, indicated that there were 
about 180,000 nurses available in the country. Since 1941, up to the 
present time, about—I have forgotten the exact number 
The Chairman (interposing). Are you going to leave that state- 
ment for the record, Doctor ? 
Dr. Draper. I will have it in just a moment. 
Well, since that time, through graduations and additions to the 
nurses, the number has increased to about 259,000. Now, we will need 
the difference between 372,000 and 259,000, which is the largest num- 
ber we have available, by 1944, or a difference of about 115,000. 
I am very glad that representatives of the different institutions for 
the training of nurses, and of the hospitals, where the needs are very 
acute, are here today to give testimony to your committee. From their 
knowledge and experience I hope it may be possible to get the best 
kind of legislation that can be drawn for the solution of this problem- 
I don't think that anybody claims the legislation, as introduced, is 
perfect. It represents "the best thinking that those of us who have 
been concerned with it have up to the present time, but any changes 
that those with knowledge and experience feel should be made to make 
the plan more workable and more helpful, I am sure that everybody 
wants to hear and to give favorable consideration to. 
Mr. Chairman, I have one very brief amendment that I would like 
the privilege of offering at this time, if I may. 
The Chairman. That will be fine, Doctor, if you will leave it for 
the record or state it, whichever one you wish. 
Dr. Draper. I will state it, if I may, sir. 
At the end of section 1, line 5, insert the following : 
The Surgeon General is authorized to enter into contracts with private, non- 
profit corporations or organizations for the recruitment of student nurses. 
Mr. Chairman, the Public Health Service 
The Chairman (interposing). May I ask you there at that point, 
why the use of “private” in that amendment? Do you not want to 
be able to do that with public, too ? 6 
TRAINING OF NURSES 
Dr. Draper (continuing). “Enter into contracts with private, non- 
profit corporations or organizations”—yes, sir; of course public would 
be included also. 
The Chairman. Will you look into that amendment, and see if not 
including the word “public” there might put a limitation on the 
amendment which might bring about a bad interpretation? 
Dr. Draper. We will consider that. 
The Chairman. I have not read the whole paragraph and I do not 
know, but the amendment, as it sounds to me today, is definitely a 
limitation which I am sure you do not want, because you want the 
cooperation of all public institutions. 
Dr. Draper. That is correct, sir. We will look into' that. 
Senator Tunnell. Either by striking out the word “private” or by 
adding “public.” 
The Chairman. Yes; just as long as the limitation does not keep you 
from doing exactly what you want to do, that is my thought. 
Dr. Draper. Thank you for the suggestion, sir. 
May I make just one other statement? There have been received 
a number of telegrams that refer to this legislation, all favorable, and 
I would like the privilege of inserting these in the record, if there is no 
objection, Mr. Chairman. 
The Chairman. We would like to have them for the record. 
(The communications referred to are as follows:) 
[Excerpt] 
Utah Valley Hospital, 
Provo, Utah, February 21, 1943. 
Miss Pearl McIver, R. N., 
Senior Public Health Nursing Consultant, 
States Relations Division, 
United States Public Health Service, Washington, D. C. 
Dear Miss McIver: I am writing to lay before you the desperate situation 
which is facing this hospital in trying to provide nursing care—not adequate 
care—but care of a kind to the patients referred to us. Due to the development 
of a iarge steel industry for the war effort, the influx of new population and 
industrial accident cases has placed a demand for care beyond the hospital’s 
capacity. Likewise the obstetrical service has doubled. On the other side of 
the picture, from a staff of 17 nurses we are reduced to 7, with no nurse available 
after this week for the operating suite. 
In the course of the last 15 months three of our supervisors have left for the 
armed services and numerous general duty nui’ses have married and gone with 
their husbands to the coast or to other parts of the country. The solution for us 
does not lie in short-cuts or in aids, for we have long ago cut x’outines to the 
minimuixx and added both a large staff of paid aids and Red Cross volunteer aides. 
However, we do not have sufficient nurses to supervise the aids we now have 
or to cover one nurse to a floor on the various shifts. 
Our salaries are above or eqxxal to those paid in adjoining territories and we 
are willing to pay whatever is necessax’y for the positions to be filled. 
We woxxld welcome any assistance from you in finding nui'ses for our staff 
or any suggestions you xxxay have as to source of supply. 
We purposefully bring oxxr situation to your particxxlar attention in that you 
may be informed of the seriousness of the situation that will face our civilian 
health if measures ax'e not soon taken to find nxxrses for hospitals such as this. 
Sincerely yours, 
Mildred F. Walker, 
Superintendent. TRAINING OF NURSES 
7 
[ Excerpt 
Mr. Paul Y. McNutt, 
War Manpower Commission, 
Washington, D. C.: 
Long Beach. Calif., April 23, 19^3. 
Most of our hospital beds are occupied by injured defense workers from the 
Long Beach-Los Angeles Harbor area or Army dependents and Navy dispensary 
cases. We are now caring for 350 patients with the same number of nurses that 
we formerly used for 150 patients. Our nurses are not physically able to do 
tiny more work than they are now carrying. 
We need today 24 graduate nurses and in 3 weeks 17 obstetrical nurses, 7 of 
whom should be nursery nurses, 7 general floor nurses, and 3 delivery room nurses. 
We are opening a wing for the exclusive use of the local Navy dispensary 
patients and must staff it with nurses as explained above. 
Irmela M. Witke, 
Superintendent, Seaside Memorial Hospital 
Miss Alma Haupt. 
Director, Nurses Supply Board Procurement and Assignment Services, 
War Manpower Commission: 
Are faced with closing the 30-bed floor May 3. Unless you can assist us to get 
some general-duty floor nurses. Answer collect. 
S. W. Rice. 
Acting Administrator, Miami Valley Hospital. 
Dayton, Ohio, April 30, 1943. 
Baltimore, Mil, May 3, 19/fS. 
Miss Alma Haupt, 
Executive Secretary Subcommittee on Nursing, 
Washington, D. C.: 
We are interested and would urge the passage of the war reserve bill. The 
young graduates finishing school are attracted by the high salaries paid by the 
defense plants and are not applying to schools of nursing as heretofore. Some- 
thing must be done to make nursing financially attractive. 
Sister Mary Helen, 
Director of Nurses, Mercy Hospital. 
Miss Alma Haupt. 
Washington, D. C.: 
New Orleans. La., May Jh 19J/3. 
New Orleans Charity Hospital suffering keenly from nurse shortage. Unable to 
replace 2G0 graduate nurses resigned last 36 months. Nursing staff unavailable to 
reopen closed hospital wards. Many patients denied admission. Urge legislative 
Approval of funds for training additional students as best means of meeting nurse 
shortage. 
Sister Henrietta. 
Hartford, Conn., May 4, 1943. 
Miss Alma Haupt, 
Washington, D. C.: 
Urge support bill for student nurse fund. Connecticut unable to meet quota 
assigned. 
Marion H. Douglas. 
Chairman, Nursing Council for War Service. 8 
TRAINING OF NURSES 
St.. Paul, Minn., May 4,1043. 
Miss Alma Haupt, 
Washington!, D. C.: 
Shortage of nurses makes it imperative that H. ,R. 2326 and S. 983 have favorable 
consideration of Congress. 
Dr. Peter D. Ward, 
Medical Superintendent, Charles T. Miller Hospital. 
Albany N. Y., May 4, 1943. 
Miss Alma Haupt, 
Washington, D. C.: 
Graduate general staff nurses, Albany Hospital, now 70; were 180 January 
1942; lost over 60 percent in spite of valuable assistance men and women 
volunteers. Necessary to close one private ward last week because of nurse 
shortage. Appeal for help sent War Council of America Hospital Association 
last week. Association promises early investigation and assistance if possible. 
Federal aid enabled 20 students to enroll past 2 years; without continuing aid 
they will have to withdraw from school. If anticipated aid fails, candidates 
already enrolled for next class will be unable to take course. Continuing losses 
of general staff nurses must be offset by steadily increasing student enrolliment 
if this hospital is to maintain full service to community. 
K. G. Ambebson, 
Director of Russel Sage College, 
Albany Hospital School of Nursing. 
Detroit, Mich., May 5,1943. 
Miss Ada Belle McCleery, 
Washington, D. C.: 
Our daily average patients is 100 less than a year ago due to shortage of nurses 
and other personnel. We are short of pupil nurses because our school of nursing 
has been recently reestablished. In March 1942 we employed 221 graduate nurses 
and in March 1943 only 103 were employed; 40 relief nurses employed daily 
in 1942 and 60 in 1943. Vacant 40-bed ward floor being used for teaching nurses 
aids, which I believe is more important than opening it for patients. Nurses 
aids now give us service equal to 25 nurses. Greatest problem if shortage of 
nurses for nights and weekends. Situation in other Detroit hospitals is that 
they are short of all personnel but have not closed any space so far. Herman 
Kiefer Hospital reports they could care for additional tubercular patients if 
they had more nurses and if shortage becomes more acute may have to reduce 
present number. All hospitals report definite shortage of nurses and personnel. 
Five of our nurses go into the Army this week. Our loss has been to industry 
as well as to armed forces. 
Stewart Hamilton Harper Hospital. 
Senator Tunnell. Doctor, you have used the expression “nurses 
available.” Do you mean that that is the total number that there are 
in the United States ? 
Dr. Draper. There are, of course, married nurses and nurses who, 
for physical reasons, would not be eligible for this kind of service, 
active service. 
Senator Tunnell. But married nurses might be useful? 
Dr. Draper. Married nurses are being used to a very considerable 
extent, but there are nurses with families and children, and so forth, 
who wouldn’t be able to be used. And we figured that the 181,000 was 
the number of nurses who could actually get out on the job and do 
active work. 
Senator Tunnell. Thank you. TRAINING OF NURSES 
9 
The Chairman. Thank you very much, Doctor. 
Dr. Draper. Thank you. 
The Chairman. General McAfee, please. 
STATEMENT OF BRIG. GEN. LARRY McAFEE, MEDICAL CORPS, 
ASSISTANT TO THE SURGEON GENERAL, UNITED STATES ARMY 
The Chairman. General, for the record will you state your name 
and your title, and whom you represent? 
General McAfee. Larry McAfee, brigadier general, Medical Corps, 
assistant to the Surgeon General, United States Army. 
Mr, Chairman, I am representing the Surgeon General this morn- 
ing, who is out of the city. I am authorized to state that the Surgeon 
General and the War Department are in favor of the enactment of 
this bill. 
This bill provides for the continuation of the flow of young women 
into the nursing profession. At this time we appreciate that there 
is very keen competition for young women in various war activities, 
and many of the positions that they may have possess more glamor 
and are more lucrative than a study of nursing. Consequently, young 
women graduating from the high schools are being taken away from 
the study of nursing. 
Under the present system of recruiting, we are obtaining a very- 
satisfactory number of nurses. This has been in effect for 3 months. 
However, we appreciate that the nurses that we are getting come to 
us at the expense of the civil communities. 
We feel that this bill will encourage a study of nursing and provide 
a pool that is available to satisfy the Federal services and the civil 
hospitals, post-war. We feel that there will be an unusual number 
of nurses required, both in Public Health Service and for the care 
of the disabled of this war. 
Our estimate, based upon a troop basis, is 51,000 nurses by the 
1st of July 1944. 
The Chairman. That is for the Army needs? 
General McAfee. That is for the Army ,♦ yes, sir. 
We realize that as recruiting goes on, it will be getting more difficult 
and more difficult. Of course, the women trained under this program 
will not be available to us sooner than 2 years. However, they, in 
their training, will be helpful and will relieve the registered nurse 
in many respects. 
I think I can add nothing more to the statements of the Surgeon 
General of the Public Health Service and the Navy. 
Senator Tunnell. How many nurses are there in the Army now?' 
General McAfee. We have at this time 27,000 nurses. 
Senator Tunnell. And you would want 51,000 more, did you say ? 
General McAfee. No; a total of 51,000 
Senator Tunnell. I was not clear as to that. 
General McAfee. Yes, sir. 
I he ( hairman. I hank you, General. We appreciate your comine: 
General McAfee. Thank you. Senator. 
The Chairman. Mr. Clark, please. 10 
TRAINING OF NURSES 
STATEMENT OF JAMES RUSSELL CLARK, REPRESENTING THE 
AMERICAN HOSPITAL ASSOCIATION, SECRETARY OF THE 
COUNCIL ON GOVERNMENT RELATIONS 
Mr. Clark. Mr. James Russel] Clark, representing the American 
Hospital Association, secretary of the council on Government relations. 
The Chairman. What is the American Hospital Association? 
Mr. Clark. It represents 3,200 voluntary hospitals in the country, 
including some Federal, State, and county hospitals. 
The Chairman. That is, your organization represents all kinds of 
hospitals, public, private, church, endowed, and everything? 
Mr. Clark. Yes. In other words, out of a total number of hospitals 
of about 0,500, there are 3,250 in our membership. 
The Chairman. That is about half of the hospitals in your mem- 
bership? 
Mr. Clark. Yes; and the number of beds is much more than that. 
The Chairman. What about geographical distribution? 
Mr. Clark. All over the United States and Canada; we do take in 
some Canadian associate hospitals. 
The Chairman. Does it include the Territories? 
Mr. Clark. Yes, sir; Puerto Rico and Alaska. 
The Chairman. What is the aim of the association ? 
Mr. Clark. To further the interests of hospitals and to keep high 
the standards and to keep the public informed about hospitals. 
The Chairman. What has been the record of your association in 
regard to hospitals, has it been to curb the growth or to encourage the 
growth ? 
Mr. Clark. To encourage the growth wherever it seems necessary, 
and to encourage the 
The Chairman (interposing). You recognize the fact that the coun- 
try as a whole is backward as far as hospitals are concerned ? 
Mr. Clark. I wouldn’t say the country as a whole, but in sections of 
the country I believe there is great need for increased space, hospital 
beds. 
The Chairman. There are some parts of the country that desperately 
need this increase. 
Mr. Clark. Yes, sir. 
The Chairman. All right. Mr. Clark. 
Mr. Clark. I would like to preface my remarks with a resolution 
of the board of trustees in connection with S. 983: 
Whereas the present supply of graduate nurses for military and civilian hos- 
pitals is inadequate to meet basic needs; 
Whereas this shortage will tend to increase because of the heavy demand by 
both the military and civilian populations for graduate nurses; 
Whereas the competition of other war activities is likely to reduce rather than 
permit the necessary increase in normal recruitment of young women for the 
nursing profession ; 
Whereas every effort must he made to increase the enrollment of schools of 
nursing in order that the present shortage may he met before there occurs a 
serious break down in the health and hospital services of the Nation; 
Whereas the American Hospital Association considers this to be one of (he 
most critical problems facing the hospitals of this country: therefore be it 
Resolved. That the board of trustees of the American Hospital Association ap- 
proves in principle Senate bill 983 which provides for the training of nurses for TRAINING OF NURSES 
11 
the armed forces, governmental and civilian hospitals, health agencies, and war 
industries, and urges your favorable action with minimum delay. 
May 4, 1943. 
In addition to that, we feel that the problem today is most acute, 
and that unless the nursepower of the Nation is reinforced very ma- 
terially in the schools of nursing during 1943, that America will face 
a real threat to civilian health. Nurses are absolutely vital in keep- 
ing civilians and soldiers alike healthy to carry on the war. 
In the industrial boom towns, defense plants, and public-health 
services are demanding thousands of nurses. Hospitals are frequently 
nonexistent, and sometimes even doctors are not available. Nurses 
must be available to prevent the needless suffering and loss of life, flu 
epidemics, disaster, sabotage, or enemy action. 
The average number of patients under treatment in hospitals at 
any one time has increased 8 percent over 1941, and this figure is 
mounting steadily. In Government and civilian institutions alone, 
there are already thousands of vacancies, and this situation is becom- 
ing more acute daily. Even with the luxury nursing reduced to a 
minimum, many civilian hospitals have been forced to close some of 
their wings because of the nursing shortage. 
The goal of G5,000 student nurses is actually more than 40,000 short 
of the need, but is so great a strain on existing facilities that no more 
can be trained at this time. So that the aid of this bill would be 
very helpful in furthering this program. 
I would like to add one amendment that the association is inter- 
ested in. 
Section 6 of the bill, line 18, page 5, the entire section to be deleted 
and rewritten as follows: 
The Surgeon General, upon recommendation of an advisory committee of not 
less than five members appointed by the Federal Security Agency, consisting of 
representatives of the nursing profession, hospitals, and educational institutions 
concerned, is hereby authorized to promulgate such standards, rules, and regu- 
lations as may be necessary to carry out the purposes of this act. 
We feel that the hospitals who actually train nurses have a logical 
interest in all these things, and that that is a proper amendment. 
Relationship of School Nursing to Hospitals 
Although a very few schools of nursing are independent of hospital control, 
such as Yale, Western Reserve, and Cook County, all use hospital facilities for 
their students’ clinical experience. 
In each of these institutions there is a separate financial arrangement from 
which neither the institution nor the school receives any profit. In most in- 
stances, it is merely an accounting arrangement. 
The great majority, however, are a part of the hospital itself and consequently 
receive from the hospital not only facilities for clinical experience but also all 
financial support over and above those fees paid by the student. 
In other words, an education program is coordinated with the service program. 
One of the principles of nursing education is learning by doing. This principle 
is used by engineering and other technical schools. Under this plan neither 
school nor hospital is actuated by the profit motive. 
May we explain why there was an apparent discrepancy in the figures used 
at the hearing on the total number of nurses now enrolling; One witness used 
calendar year figures; one witness used fiscal year figures; one witness used 
school year figures. 
We would srrggest that the school year figures he used as published by the 
American Journal of Nursing, Apr il, 1943, pages 883, 384. 385. 12 
TRAINING OF NURSES 
Student admissions—school year of June 1, 19Jf2-May IS, 19Jf3 
Totals for United States: 
Students admitted 49,169 
Quota for year 55, €00 
Percentage of quota reached 89 
Total students enrolled in United States, January 1, 1943 - 100, 480 
Quota of 65,000 incoming students for the school year, June 1, 1943, through 
May 31, 1944, was set by the subcommittee on nursing, health, and medical com- 
mittee, Federal Security Agency. 
In connection with the reimbursement of hospitals as provided for in the bill, 
one of the reasons hospitals have been willing to contribute maintenance to 
students from the day of admission is that the cost of the maintenance was offset 
by the nursing service given its patients during the latter period of the nurses’ 
training. 
Under the provisions of the bill the accelerated course of study will keep the 
nurses from doing ward duty as early as before. Also, in view of the Federal 
demand for nurses, the hospitals, in all probability, will not receive only a limited 
amount of service from the student during the last 6 or 12 months. 
Because hospitals are nonprofit, the majority being relatively poor, they are in 
no position to assume all of the expense of an accelerated program. The hospitals 
of the country are earnestly concerned about the military needs as well as their 
own urgent local needs in this time of great emergency. 
The Chairman. We will give consideration to yonr amendment, and 
thank you, Mr. Clark, for coming, 
Mr. Clark. Thank you. 
The Chairman. Dr. Davison, please. 
STATEMENT OF DR. W. C. DAVISON, DEAN, DUKE UNIVERSITY 
SCHOOL OF MEDICINE, DURHAM, N. C. 
The Chairman. Doctor, for the record will you state your name 
and your position ? 
Dr. Davison, W. C. Davison, dean, Duke University School of 
Medicine, Durham, N. C. 
The Chairman. Will you proceed as you wish? 
Dr. Davison. I have read this bill, sir, and think that it would do a 
great deal toward recruiting student nurses, who are very badly needed 
throughout the country. 
At the present time, it has been brought forth by the preceding 
speakers that there is a tremendous shortage, not only in civilian 
activities and hospitals, but also in the Army and Navy, and it is be- 
coming increasingly difficult because of the large number of women 
who are being recruited to other activities. I believe that this bill will 
make a study of nursing so much more attractive than it has been in 
the past, that more women will join up in these schools of nursing. 
The Chairman. Duke now has a nursing course, has it not? 
Dr. Davison. Yes, sir. 
The Chairman. About how many nurses do you train ? 
Dr. Davison. We can train 90 every 9 months, but it has been prac- 
tically impossible to obtain that number of recruits. We have been 
assisted by appropriations from the Public Health Service, and we, 
at the present time, are building an additional nurses’ dormitory so 
we can accommodate more nurses, but it still isn’t possible to obtain as 
many recruits as we can train. 
The Chairman. Your relation is as an endowed institution, is it 
not? Your relations are such with the other institutions and the TRAINING OF NURSES 
13 
public-health institutions so that it is working out to the advantage 
of everybody, are they ? 
Dr. Davison. They have been exceedingly cordial and cooperative. 
The Chairman. And the trustees of your institution support your 
nursing activities, do they ? 
Dr. DavTson. Yes, sir. 
The Chairman. And the faculty does, too? 
Dr. Davison. Yes. It was in Air. Duke’s original gift that a school 
for nursing should be established along with the school of medicine. 
The Chairman. Do you have any trouble in the school of medicine 
in having a nursing school attached to it? 
Dr. Davison. I think it is rather a great advantage. 
The Chairman. I think so, too. I am glad to hear it. 
Senator Tunnell. I would like to ask the doctor if he thinks that 
the inducement offered in this bill would bring results? 
Dr, Davison. Yes, sir; I do. 
Senator Tunnell. There has been nothing said along that line thus 
far. There has been more a discussion of the needs than the likelihood 
of the increase. I wonder whether you coidd express yourself as to 
why you think there would be any great change? Fifteen dollars a 
month or $20 a month does not seem so large as an inducement wage. 
Dr. Davison. I don’t think the $15 or $20 a month is the major in- 
ducement, but during the war everybody wants to get into some service 
sponsored by the Government for war activity, and I think that is 
the great inducement, that these women will have uniforms and they 
will feel they are part of the general war effort, much more so than 
they would if they were students in a civilian hospital, though they 
may wffien they graduate go into the armed services. But pledging 
themselves beforehand to go into the armed services gives them a con- 
sciousness that they are cooperating with the war effort, and I believe 
that will be a greater inducement than the salaries themselves. 
The Chairman. Thank you. Dr. Davison. 
Dr. Davison. Thank you, Senator. 
The Chairman. Miss Sheahan, please? 
STATEMENT 0E MISS MARIAN SHEAHAN, REPRESENTING THE 
NATIONAL NURSING COUNCIL FOR WAR SERVICE AND THE SUB- 
COMMITTEE ON NURSING OF THE OFFICE OF HEALTH, DEFENSE, 
AND WELFARE; PUBLIC HEALTH NURSING IN NEW YORK STATE, 
ALBANY, N. Y. 
The Chairman. Please state for the record your name and your 
title, Miss Sheahan ? 
Miss Sheahan. Miss Marian Sheahan, formally representing the Na- 
tional Nursing Council for War Service, and the subcommittee on 
nursing of the office of health, defense, and welfare. May I say that 
informally I am representing the opinion at least of one director of 
public-health nursing in New York State, because that is the work 
that I do and I earn my living from. That seems important, because 
I speak from first-hand knowledge of local needs, and can speak 
quite feelingly from that point. 
It seemed as though my contribution might be to give a brief pic- 
ture of all of the steps that have been taken by the organization which 
86411—43 2 14 
TRAINING OF NURSES 
the professional nursing services have developed in order to indicate 
why we feel justified in appealing to a Government that we know is 
pretty well pressed from all sides for help, because we feel we have 
really taken every opportunity and followed every step to take care 
of the big job of meeting the needs for nursing throughout the country, 
and it almost seems as though we have come to the point where we 
can’t do the job unless we get a considerable amount of help which is 
not available and probably never could be within the profession itself 
at a period when the country is at war. 
Now, very briefly, the nursing organizations number five on the 
national level, representing different services and different branches of 
nursing. When the war broke out, and a year or more before it, it 
seemed as though if we were going to coordinate all our efforts and 
make the very best plan that could be made, that we should have some 
machinery for pooling all of the experience that was available, pooling 
all of the plans that had been made, and making a concerted effort to 
do the job. 
Therefore, the National Nursing Council for War Service was the 
device, and essentially it is just what is described, a council whereby 
all of the representatives of the nursing profession, with liaison repre- 
sentatives from the governmental nursing services, and the Hospital 
Association, and laymen who utilize the service, could be brought 
around the table to think together, plan together, decide what to do, 
and then lend all their efforts toward a coordinated program. 
That has worked out very well, and we feel that it is quite an effective 
type of organization to do the job. 
Then the subcommittee on nursing was a small committee appointed 
as a governmental committee to serve as a channel for the profession 
to utilize all the governmental resources, and to get back to the council, 
which is the professional group, the thinking and the needs of the 
Government. That, too, seems to work very well, because it has 
brought about very close planning on the basis of information which 
is accurate and first hand. It has certainly brought about a great 
deal of mutual understanding and a good deal of compromise and 
give and take, so that we can say that nursing—when 1 say nursing, 
I mean the profession of nursing—and the agencies utilizing nursing 
in the Government, are truly in accord. 
That, briefly, is the organization through which we have worked. 
At the State level there are State councils comparable to the national; 
and at the local level, cities and counties throughout the country, there 
are local councils organized in much the same way. So that we can 
route back through the National Council and to the subcommittee on 
nursing, the actual needs and the thinking and the feeling of the 
smallest parts of this whole country. 
Now, the problem can be simply stated, and then broken down into 
smaller parts. It is the constantly increasing demands for nursing 
service from all sides, the military being one, and the supply lagging. 
We have been thinking of the future as well as the present, because we 
have to think of how this large group of nurses, this large group of 
young women who are being invited into the nursing profession, how 
they might earn their living when the war is over, and what the future 
has to offer. So we have been very much aware of that, and have taken 
it into consideration, and feel on the basis of that consideration that TRAINING OF NURSES 
15 
we are perfectly justified in continuing the expansion of the student- 
nurse program. 
Now the two component parts of this big problem really deal with 
the supply of nursing with all of the aids to nursing which can be 
secured, and the distribution of the available supply. 
The council, working through these various channels—I won’t 
attempt to give credit, because it truly has been pooled thinking and 
pooled effort—so that I will say the council, representing the whole 
group thinking, the steps to date were, first, the taking of an inventory 
so we would know what the supply was. That inventory was first 
taken in 1941, and was repeated this year, so that we do base our facts 
upon as good an estimate of the nurses in the country who are available 
or will make themselves available for service, as possible. 
That inventory in 1941, and the last one in 1943, included every 
inactive nurse who could be reached, with the thought of getting every 
inactive nurse back into some kind of nursing service, even if it were 
for only 2 or 3 hours a day in her own small area, according to her 
residence and her own personal situation. 
In one State at least, New York State, the practical nurses were 
included, because we have a license law that licenses practical nurses, 
and therefore we had some 25,000 nurses who were listed and could 
be reached because they were on a roster. 
The next step was the decision, based upon the studies and the 
inventory, and so forth, and such studies as the American Medical 
Association have made, which they print in their journal every so 
often, the facts about nursing, which is published by the American 
Nurses Association every year, the experience in England, which has 
been summarized, and other data of that kind. I won’t attempt to go 
into all the figures, because they are many and sort of a little bit too 
complicated to read off. But all of the evidence is here if you would 
like more than possibly you have already received. 
Now the next step was to develop a recruitment program for student 
nurses, to increase the number over normal times, and roughly speak- 
ing. the number the first year, 1941, was increased by 15,000, making 
the goal 55,000, That goal was not reached, although excellent work 
went into it, and we were quite satisfied that it was partly reached. 
The next point was to develop a plan, which was developed with the 
League of Nursing Education, to aid the schools of nursing in the 
country to accelerate their programs of study, so that instead of gradu- 
ating so many nurses in 36 months that program might be accelerated 
down to 30 months or 24 months, so that there would be more turn- 
over, leaving the facilities in the hospitals for these newer students 
who were coming in. 
There was an education unit developed within the council, the 
salaries for part-time people were paid, and they are now going right 
out into the schools and holding institutes in regions to help the schools 
with their plans for acceleration. 
The next point was one of quite widespread public information, 
including information to the professions so that they would know 
what was going on and could follow along the program. Also, that 
the public would be informed and would give their support. 
The sixth was quite an intensive effort to return every inactive nurse 
by actually going out after her if she were known to exist, and by a 16 
TRAINING OF NURSES 
little interpretation helping a nurse who had been out of active prac- 
tice for a good many years to realize that even though she was a bit 
rusty there were refresher courses being organized and she could do 
something if she would arrange her time. That was done largely by 
the local councils, because they were at the spot where the hospitals 
needed nurses and where the nurses lived. 
The next point was the use of supplementary assistants to stretch 
nursing as far as it would go, and that was through the program of 
the American Eed Cross and through a large number of other 
volunteers who could give minor services which did not require the 
training which the nurses required. That has been very successful, 
and without a doubt has been a lifesaver for the country. The Council 
on Nursing, through its local branches, certainly did a great deal to 
encourage the utilization of those aides, and I don’t believe there is 
any hospital, probably, in the whole country, or any public health 
nursing agency, that isn’t making use of a large number of auxiliary 
workers, most of them volunteers, a good many of them being paid 
either for part-time or full-time service. 
The next step was a rather intensive study of the supply of nursing 
in relation to the distribution, on the basis of priority needs, and the 
Council got out first a pamphlet like this, which has to do with the 
distribution of nursing service during war. Then they followed this 
up with a little bit more dramatic copy, decorated in red and white, 
which gave the same information in different form, and that was de- 
signed to help the agencies throughout the country and the nurses to 
decide whether they should stay in their home jobs because they were 
essentia], whether they should go into the military service, and also 
was designed to help the hospitals and the agencies utilizing nursing 
to really do some pretty good study of the work they were assigning 
nurses to, in order to short-cut and to turn over to nonnursing per- 
sonnel the things that really didn’t require nursing skills. We know, 
for instance, in the old days that nurses cleaned all the hypodermic 
needles. Well, by teaching a volunteer or an attendant to clean 
those needles, it will be quite possible to release a nurse to give a 
treatment or to take care of a sick patient. We feel that that has 
been done pretty well, and that it should go on and more should be 
done, but nevertheless it was a pretty important step in the program. 
Then the last step was to do pretty good teamwork, and that has been 
demonstrated with the American Eed Cross in recruiting nurses for 
the military seryices, all of these steps being a very important part of 
this last, rather ma'for objective. 
Then we have worked very closely with the United States Public 
Health Service in helping the hospitals utilize the funds which were 
available from that first fund for education, which Dr. Draper 
mentioned. 
Now the estimates of the needs upon which this bill which we are 
discussing was drawn, came from all of these sources, and really 
seemed to point very definitely to the fact that we do need a larger 
number of students even than the 65,000 which is the goal which has 
been made public. Because when you assemble all of these facts, 
based upon the patients in the hospitals, the Public Health nursing 
agency need for nurses, the need for nurses in industry, they actually 
add up to about a shortage of 94,000 student nurses, if you interpret 
student service in term of graduate service; and we know, again TRAINING OF NURSES 
17 
through the studies of the nursing agencies and the hospital associa- 
tion, that usually, say roughly, that three students will take the place 
of two graduates after the first period of intensive instruction is over. 
So that those estimates truly have been based upon the very best 
statistics that are available. Therefore, we have said that we will 
publicize 65,000, but if we can get as many as 90,000 students into the 
schools in the country, we could utilize them very well, because that 
still doesn’t meet this numerical shortage which has been developed 
through all of these data. 
Therefore, we have felt that we have done all we can in the profes- 
sion, because we are competing with all of the other very spectacular 
and dramatic appeals to women of the country. Now we don’t want 
the young women who will just yield to a dramatic appeal and go 
into a school of nursing and drop out in 6 months. Therefore, we 
haven’t proposed a very, shall we say, lucrative sum of money which 
will attract a young woman who isn’t going to really consider the 
values in nursing. But we do feel, nevertheless, that in order to com- 
pete with all of the other attractions for young women, through in- 
dustry paying large salaries, through the other women’s activities 
of the Government—the WAAC’s and the AVAVES and the SPARS— 
that there must be some evidence that the Government considers nurs- 
ing an essential in this war effort, and gives more than just the 
statement (and to date it has just been the statement) that nursing 
is essential. AVe have had no governmental support other than the 
U. S. Public Health Service educational unit, which has been help- 
ful, but it hasn’t provided this appeal which will help the young 
women to consider nursing when they consider some of these other 
things. 
Therefore, we consider that this bill offers a small stipend which 
will make it possible for young women to enter school and maintain 
themselves, and their personal needs; it offers the appeal that it is a 
governmental service with an insignia and with a wartime implication; 
and it also offers the help to the schools of the country whch will make 
it possible for them to admit the students. 
Lastly, we feel that opening up the governmental hospitals and 
the hospitals under the Army and the Navy, it will provide the clinical 
facilities so that anywhere, from 65,000 students and over, they can 
actually be given reasonably sound nursing education. That wouldn’t 
be possible if just the present schools of nursing were utilized. It 
means opening up these other facilities, and the bill provides for 
these. 
It is for this reason that we feel we have truly demonstrated the 
willingness to go just as far as we can as a profession, that the money 
has been found within the profession and from voluntary sources 
to do the work up to date. We feel we have done an excellent job 
(.n recruiting, we have an excellent clearance bureau which is working 
and which has answered many, many thousands of letters, and a brief 
summary of that will be offered in testimony later. 
We have now come to the point that we feel justified in asking for 
this aid, because without it we just don’t see that we could do the 
job. 
Senator Tunnelu. I would like to ask a question. Before 1941, 
for instance, what was the usual number of student nurses taken on? 
Miss Sheahan. About 30,000. 18 
TRAINING OF NURSES 
Senator Tunnell. Is it the thought of those of you who make a 
study of this situation, that if there should be an annual increase or 
an annual addition of 65,000, that there would long be a requirement 
for that many? 
Miss Sheaiian. We rather feel so, because we know that even in 
normal times, the hospitals were understaffed, we know that public 
health nursing agencies were understaffed, and we know that there 
is a considerable loss in the field of nursing due to the fact that the 
bulk of the group are women; they have a high marriage rate, and 
there is a lot of turn-over in nursing. 
We also are feeling quite confident that while we don't know exactly 
what is going to happen in the future, that there are going to be many 
years of more work through the governmental hospitals, because they 
will have many more patients to take care of through the rehabilita- 
tion of the soldiers, and we know that there probably will be an increas- 
ing demand for hospitalization because of the popularity of the group- 
hospital plans, like the Blue Cross, and so forth. There already has 
been an indication of that. So we really feel quite justified, and I 
think we have thought it over very carefully because we have an obli- 
gation to the young women whom we go out to recruit and invite into 
nursing, we have an obligation to see to it that something is offered 
them later, but we really feel that they will be employed. 
Senator Tunnell. Taking into consideration the various ways by 
which you lose nurses from the activity of the nursing profession, as 
I understand, through perhaps loss of health or marriage or maybe 
death, have you any idea of the nursing life, the average nursing life? 
I don’t mean the lives, but the time that they continue in the work. 
Miss Sheaiian. I wish I could remember it; it is in this book [indi- 
cating]. 
Senator Tunnell. You do have such information? 
Miss Sheaiian. Yes; and the turn-over has been figured out. 
A Voice. Seventeen-plus years of nursing. 
Miss Sheaiian. It is 17-plus years. 
Senator Ball. Maybe these facts have been developed; I got here 
late. 
Can you tell me approximately how many nurses are in service now? 
Miss Sheahan. According to the 194i inventory, approximately 
almost 300.000 answered the questionnaire. Now, if 20 percent didn’t 
answer—there are 280,000, I think—a certain number might not have 
answered, but you could at least count on that number as actively 
engaged in nursing. We usually say around 300,000. 
Senator Ball. Those are 1941 figures ? 
Miss Sheahan. Yes. That doesn’t mean, remember, that all of those 
nurses are doing full-time work. Maybe between 40 and 50 percent 
are in private duty, and they may take only one case a month, or work 
20 days a month. So when yon figure on that group of nurses through 
an inventory, we really have very little way of knowing how many of 
that group are in full-time nursing practice, because I think. Senator, 
you asked the question. How many inactive nurses or married nurses 
could work? We know many of them can work, but maybe not all the 
time. 
Senator Ball. So there woud be a considerable deduction from that 
figure for full-time nurses? TRAINING ( 
NURS 
19 
iss Sheahan. Yes. 
Senator Ball. Does your 1943 survey show much of an increase? 
Miss Sheahan. The 1948 survey lias only been tabulated for 30 
States, and those 30 States have been tabulated and can be provided 
now, and very shortly more will be ready. But it shows an increase 
in the number of inactive nurses who have come back into some form 
of nursing, so that we have quite a bit of evidence that some of these 
steps which I enumerated have been successful. It does not show an 
increase in the actual number of nurses in those 30 States, but I believe 
Miss Dunn will verify this: Those 30 States did not include some of 
the larger States. 
Miss Dunn. Not all of them. 
Miss Sheahan. It included about 175,000 nurses. 
Senator Ball. And you estimate the current shortage at 65,000 full- 
time nurses? 
Miss Sheehan. Actually, the actual shortage comes out nearer to 
90 000—94,000, I think. 
Senator Ball. That is full-time nurses? 
Miss Sheahan. Yes; 90.000 student nurses, because we were in- 
terpreting graduate nurse service 
Senator Ball (interposing). Three student nurses can replace two 
graduate nurses after this initial 9 months’ training? 
Miss Sheahan. That is right: and this estimate also takes into con- 
sideration that the utilization of auxiliary workers should keep up at 
the present pace plus, and the “plus” would go through to a couple of 
double plusses, because they are very much needed. 
Senator Ball. Is that the current figure that you estimate yon need, 
95,000 in training now, is that figure going to increase or is that based 
on future needs? 
Miss Sheahan. No. sir; it is based upon present needs. 
Senator Ball. Has it been projected on the basis of future needs? 
Miss Sheahan. It Avas projected to a certain extent, but those ratios 
were really developed on the basis of the present practice in nursing 
in hospitals throughout the country: the number of nurses employed in 
public health agencies: pins an estimate of the number who are now 
going into industry, and that has been doubled or trebled. 
Senator Ball. Well, that figure, then, might increase? 
Miss Sheahan. The needs might increase, it is true, but the increase 
woidd be purely hypothetical, and we couldn’t determine it. That is 
why Ave feel that this is a conservati\re estimate, because it is not based 
upon unknown quantities, it is based upon the actual current practices 
in the country, plus the estimate which the military sendees gave, 
which is a new need, of course. 
You might ask why 65.000 was determined as the goal when we 
needed more. It seemed as though yon had to set a quota to be 
publicized that would seem reasonable, and it also represents approxi- 
mately the group of young Avomen that might be easily attracted into 
the schools of nursing. Then Ave can do the digging for the rest and 
get as many as we can. 
Senator Ball. How many student nurses are there in the country 
now? 
Miss Sheahan. The last figure, I believe, Avas about 100,000 students 
in the schools of nursing in the country. 20 
TRAINING OF NURSES 
Senator Ball. Then you want to approximately double that figure 
of 100,000? 
Miss Sheahan. Yes, sir; we would like surely 165,000 plus. 
Senator Ball. How does the stipend provided in this bill compare 
with what student nurses generally receive now, or do they receive any ? 
Miss Sheahan, For the most part, and there again one of these 
nursing educators in the back might have the number right on the tip 
of their tongue, for the most part the students receive nothing. If they 
receive anything from their parent hospitals, they pay for their own 
tuition. So that the students receive practically nothing for stipends 
now. This would be something that would be a deliberate effort to ap- 
proximate the benefits which are coming to the other women’s services 
being called essential by the Government. 
Now I am sure that one of this group back here would know the num- 
bers, and would know that more accurately than I. 
Senator Ball. Well, the general practice is that they get their tui- 
tion, their board and lodgings, and uniforms, but very little stipend? 
Miss Sheahan. No stipend, practically, and in many, many hospitals 
the student pays for her own tuition for her nursing education. 
(At this point the 'chairman left the room, and Senator Tunnell 
assumed the Chair.) 
Senator Ball. So that actually, this would be a considerable change 
from the present policy ? 
Miss Sheahan. It would be a considerable change from the present 
policy, which has been based upon a growing philosophy that nursing 
is an education, that the preparation for nursing is an educational 
procedure which should be based upon educational principles, and 
that the students should pay for their tuition, that the hospitals should 
evaluate the service the student gives and pay her for that so that she 
has something from which to pay for her tuition, and that practice has 
been growing in the schools of nursing throughout the country. 
Senator Ball. Under this bill, of course, the Government would pay 
both the tuition and the stipend, and for uniforms and all the rest? 
Miss Sheahan. Yes, sir. 
Senator Ball. Do you anticipate that all the present schools of nurs- 
ing would come under this plan ? 
Miss Sheahan. I couldn’t say, because 
Senator Ball (interposing). They could apply, and if they were 
approved their schools would then come under this plan, and I would 
take it that most of them would apply. 
Miss Sheahan. Yes. 
Senator Ball. It would take quite an expense off their shoulders. 
Miss Sheahan. We would assume that certainly any hospital that 
would meet the requirements approved by the Surgeon General would 
certainly apply, and there seems a great deal of evidence that the 
hospitals are interested and will apply. 
Senator Ball. And actually, it is going to relieve the hospitals of 
quite a financial burden, isn’t it ? 
Miss Sheahan. I wouldn’t believe so. I believe it will help them so 
that they will have no additional burden in return for the pressure 
which they are yielding to take more students than they ordinarily 
would take. I wouldn’t want to speak to that, because I don’t believe 
that I am prepared to, but I think either Mr. Clark or someone from TRAINING OF NURSES 
21 
the United States Public Health Service have figured that out, and I 
believe I am right in saying that it is not going to make the hospitals 
wealthy by any means, but it will help them to take on this extra 
student load. 
Senator Ball. Well, they now provide the maintenance and uni- 
forms generally, don’t they? They don’t charge the students for that? 
Miss Sheahan. It is a little bit hard to generalize in answer to that 
question, because the practice in hospitals varies so in various parts of 
the country, and we have small-, middle-, and large-sized hospitals, 
and the practice is very spotty along the way. So that in some hos- 
pitals, the answer to your question might be yes, and in others, no. 
The general philosophy, however, has been to encourage placing 
nursing education on an educational basis. Separating the costs of 
nursing education, so that it pays for itself, the service to the hospital 
can be evaluated and the two related so that neither the student suffers 
nor the hospital suffers. 
If you would like more figures on that, they can be provided, because 
the actual number of hospitals and the practice throughout the country 
has been summarized and could be provided. I am sorry that that 
isn’t my specialized field, so that I haven’t all those facts on the tip of 
my tongue. 
Senator Tunnell. I might ask this: Is there, from the survey that 
you have made in the 30 States that you spoke of. any indication as to 
whether, without this inducement, there has been an increase in the 
student nurses? 
Miss Sheahan. There has been an increase; yes. The survey, by 
the way, includes graduate nurses, the available supply immediately, 
and was carried on all over the country, but only 30 States have been 
tabulated. There has been an increase over and above 1941, and that 
increase, I believe, has reached 49,000. Again, I would like one of these 
people to correct me if that is wrong. So that without this, there has 
been an increase from between thirty and thirty-five thousand to forty- 
nine thousand. That is what makes us believe, based upon many inter- 
views and thousands of letters from the young women who are inter- 
ested in nursing, there was growing evidence that they wanted these 
assurances, that they were thinking of these other women’s occupations, 
and that many of them said they needed help if they were to go into 
schools of nursing, and that they do get such help from these other 
women’s occupations, like the WAVES and the WAAC’s. 
Now there is abundance of proof that that is the reaction of the 
young women of the country, based upon many thousands of letters, 
and I think the chairman of that recruitment committee is going to 
give testimony tomorrow morning, and will give you more of the 
details for the record. 
Senator Tunnell. I understood you to say that prior to 1941 there 
were a number of student nurses, aggregating about 30,000 per year, 
and now you say that it has increased to about 49,000; is that correct? 
Miss Sheahan. Yes, sir. Sometimes you will find a little difference 
in your figures, because some of the statisticians base their figures on 
the calendar year, and others base them on the school year, from June 
1941 to June 1942. Now the estimates which were used in presenting 
this brief to you were the school year, July of any year to July of the 
next year. 22 
TRAINING OF NURSES 
There lias been a satisfactory interest in nursing, and an increased 
interest on the basis of the war, which again gives us the feeling that if 
we go out after this additional group, up to 65,000, with these incen- 
tives to aid us, that we probably can reach the goal. 
Senator Tunnell. All right, thank you. 
Miss Sheahan, Thank you, gentlemen. 
Senator Tunnell. Next on the list is Col. George E. Ijams. 
Colonel, will you give your name and official position to the reporter. 
STATEMENT OF COL. GEORGE E. IJAMS, ASSISTANT ADMINISTRA- 
TOR OF VETERANS’ AFFAIRS, VETERANS’ ADMINISTRATION, 
WASHINGTON, D. C. 
Colonel Ijams. Col. George E. Ijams, Assistant Administrator of 
Veterans’ Affairs, Veterans’ Administration. 
Mr. Chairman, unfortunately General Hines had to leave the city 
to attend a meeting of the American Legion in Indianapolis and on 
the request of Senator Thomas he prepared a letter which he has asked 
me to come up and read. So with your permission I will read the 
General’s letter. 
Hon. Elbekt D. Thomas, 
Chairman, Committee on Education and Labor, 
United States Senate, Washington, D. C. 
May 5, 1943. 
My Dear Senator Thomas : This will supplement my letter of May 1, 1943, 
pertaining to your telegram of April 30, 1943, and your letter of April 30, 1943, 
requesting a report on S. 983, Seventy-eighth Congress, a bill to provide for the 
training of nurses for the armed forces, governmental and civilian hospitals, 
health agencies, and war industries, through grants to institutions providing such 
training, and for other purposes. 
This letter may be considered as a report on the bill, but it should be stated 
that due to the limited time the report has not been coordinated with the Bureau 
of the Budget to ascertain the relationship of the proposed legislation to the 
program of the President. 
The bill has for its general purpose authorization of funds to be appropriated 
for the fiscal year ending June 30, 1943, and for each fiscal year thereafter, to 
provide for the training of nurses for military or essental civilian servces for 
the duration of the war. The plan may he limited to student nurse training, or 
to postgraduate or refresher nursing courses, or may include both. The bill 
makes provision for certain monthly rates of pay to student nurses and also 
provides for payment to each institution with a plan approved by the Surgeon 
General, Public Health Service, under section 2 of the hill. The hill further 
provides that the Surgeon General, with the approval of the Federal Security 
Administrator, is authorized to promulgate such rules and regulations as may 
be necessary to carry out the purposes of the act. 
It should be stated at the outset that while the Veterans’ Administration is in 
accord with the general purposes of the proposed legislation, it is suggested that 
the bill be amended to specifically provide for the needs of the Veterans’ Admin- 
istration. 
As a background to the present and prospective needs of the Veterans’ Admin- 
istration for hospital personnel, including nurses, there are 93 facilities of the 
Veterans’ Administration furnishing hospitalization and domiciliary care, with 
a total of 80,170 beds presently operated. Construction to increase existing 
facilities to provide 1,379 beds is under way and plans for further construction 
to provide 2,419 additional beds has been approved. The Federal Board of 
Hospitalization has made, and is making, a continued study of governmental 
hospital needs. The Federal Board of Hospitalization includes representa- 
tives of the Veterans’ Administration, Army, Navy, and Public Health Service, 
and the studies are conducted under the President’s order envisaging complete 
correlation of the Government building program. In addition to veterans of 
prior wars, and veterans of World War II not now in active service but TRAINING OF NUR8E.S 
23 
eligible under existing laws, the existing agreement made in pursuance with 
law. requires that the Veterans’ Administration afford needed hospitalization 
to all veterans of the present war released by the Army and Navy as soon as it 
is determined that they cannot be returned to active service. Several thousand 
have already been given this care and the load is being increased. 
The personnel shortage at the Veterans’ Administration hospital facilities in- 
cludes physicians, nurses, technical personnel, attendants, utility, and supply 
personnel, etc., and this condition has become acute. If the service is to be 
maintained, drastic steps must be taken to secure the needed personnel. This 
bill seems to offer an approach to future, not present, solution of the problem 
as to nurses. 
During the past year the nursing service of the Veterans’ Administration has 
been faced with increased difficulty in filling vacancies with qualified nurses. 
Many of the nurses who are being recruited are beyond 55 years of age and have 
either been engaged in private duty or have been entirely out of the field of 
nursing for the last 5, 10, or 15 years. These nurses are unable to stand the 
hard grind of institutional work; they are slower and less apt to meet the 
emergency load with calm clear thinking, even though they may be willing. The 
work is beyond their physical capacity. We are also getting nurses who have not 
been actively engaged in nursing for the last 5 years. This group, though 
younger, presents a similar problem in institutional nursing. 
At the present time our hospitals require a total of 4,474 nurses, and the 
expanded program will add to tins need. With almost 500 vacant jwsitions at 
the present time, it can be easily seen what will result unless the Veterans’ 
Administration can have access to the pool of trained nurses, including those 
newly trained under the contemplated plan. Between May 1, 1942, and May 
1, 1943, 1,394 nurses resigned from the Veterans’ Administration. Only 101 
gave as their reason for resigning the fact that they were entering the military 
service. To fill these vacancies it has been necessary to give the managers 
authority to recruit nurses locally as the United States Civil Service Com- 
mission is unable to certify enough applicants to meet the demand. The situa- 
tion has been gradually becoming worse until today, from the United States 
Civil Service Certificate of 328 names, only 7 have been assigned. Managers are 
unable to recruit locally enough nurses to fill vacancies. Some indication of 
the gravity of the situation may be indicated by the fact that for 1943 it is 
expected that 2,000 nurses will be required to fill vacancies: for 1944, based on 
increased utilization, it is expected that approximately an additional 1,190 over 
and above the number needed for filling vacancies, will be required. 
The Veterans’ Administration, under the existing laws and under present con- 
ditions, cannot employ and retain an adequate number of qualified physicians, 
dentists, nurses," attendants, utility and supply personnel, etc., to operate its hos- 
pital facilities. The functions of treatment and care cannot be discharged on a 
proper basis because of such conditions and the impracticability of adapting new 
employees to the particular work involved, even with continued supervision. Due 
to the fact that such appointments as can be made are made under wartime con- 
ditions, where the Veterans’ Administration cannot compete with the salaries 
paid in private industry, there is a large turn-over incompatible with sound prin- 
ciples of personnel management and serious impairment of medical and hospital 
services to our war disabled. The sources of supply of nurses—and this is gen- 
erally true with reference to medical and other personnel—which before the 
national emergency were generally suitable to meet the needs, have been removed, 
and those sources, by virtue of war conditions, have been absorbed into the 
Military and Naval Establishments, 
In considering the facts contained in this explanatory letter, it should be borne 
in mind that the Veterans’ Administration facilities are utilized not only for the 
discharged disabled of the present war and prior wars but are also utilized where- 
ever necessary for persons disabled and while still in active service. It is obvious 
that further impairment of the functions of Veterans’ Administration facilities 
should not under any circumstances be permitted. It is a recognized principle that 
a major obligation of the Federal Government is to care for its war disabled, and 
nothing short of the most efficient medical care of these persons can be contem- 
plated. The responsibility of the Veterans’ Administration is fixed under the 
statutes and it is in the conscientious discharge of this responsibility that I have 
made, and am continuing to make, every effort to insure the accomplishment of 
the purposes of those laws. 
It is my desire to impress upon the committee what I consider to be not only 
the appropriate but necessary place the Veterans’ Administration should occupy 
in a sequency of priority on a supply of nurses. Considering the Federal obliga- 24 
TRAINING OF NURSES 
tion to the war-disabled veterans and the other veterans whose rights to hos- 
pitalization have been provided by law, it is believed that the position of the Vet- 
erans’ Administration should be second only to the War and Navy Departments in 
such priority. Recognizing my full responsibility in the matter, it is believed pref- 
erable that this sequence of priority for the Veterans’ Administration be made a 
matter of law. This statement is made without prejudice to any program involv- 
ing civilian needs. In my opinion, the civilian problem should be treated sep- 
arately, so that under no conditions will the needs of the War and Navy Depart- 
ments and the Veterans’ Administration be impaired. 
For the foregoing reasons, it is the recommendation of the Veterans’ Adminis- 
tration that your committee give favorable consideration to the amendments to 
the hill as outlined herein. 
Very truly yours, 
Frank T. Hines. Administrator. 
Senator Ball. Section 2 of the bill provides, as I read it, that each 
nurse trained under this program will be available for military or 
essential civilian services, and it does not attempt to set up any prior- 
ities. It seems to me that that is a pretty tough assignment to try to 
take on in legislation, to set up rigid priorities for nurses. 
Obviously the Public Health Service might do something like that, 
but I question the wisdom of trying to write a rigid priority into 
legislation. 
Colonel I jams. We have had some experience, Senator, with regard 
to the securing of physicians. We were supposed to secure, through 
the organization set up for that purpose, certain physicians for our 
service. To date we have not received one physician through that 
channel, and it was our thought that if—and I might read, if I may, 
the proposed amendment, as we have written it, on page 2, line 12, 
or I might read that paragraph (a) under section 2, which begins at 
line 10—I will read the whole thing with the inclusion of the proposed 
amendment: 
that no student or graduate nurse will be included under the plan unless in the 
judgment of the head of the institution such nurse will be available for military, 
Veterans’ Administration, and essential civilian services in the order named— 
That was the only suggestion we had to make, sir. 
Senator Ball. That would require a nurse, then, taking training 
under this; if the Army or Navy asked for her, she would have no 
alternative but to go; if they didn’t ask for her but the Veterans’ 
Administration did, she would have to accept employment with the 
Veterans’ Administration. I mean, you have got a rigid priority 
system there. 
And so forth. 
Colonel Liams. It was not our thought, Senator, that we would 
establish any priority as to numbers, because we realize that no one 
knows how many nurses this bill will produce. We hope it will pro- 
duce the 65,000. 
Senator Ball. I think that would be the sense of that kind of amend- 
ment, if you had it “in the order named.” I wouldn’t be averse to 
including the Veterans’ Administration, but it seems to me if the 
Army and Navy grabbed all the nurses, your Veterans’ Administration 
and essential civilian sendees would have none. 
Colonel Ijams. That is exactly what has happened insofar as the 
physicians are concerned, Senator, and that is what we hope to avoid 
by this amendment. 
Senator Ball. Then that is very unfortunate; but by an overriding 
priority that is what you run into. TRAINING OF NURSES 
25 
Colonel Ijams. Yes. 
Senator Bali.. It is perfectly all right to include Veterans’ Admin- 
istration, but I doubt if you want to set up a priorities system. It 
seems to me that that is something that the Public Health Service 
has to work out and see to it. I have heard too many reports, as you 
say, where the Army and the Navy have just grabbed all the active 
physicians out of a certain area and left it in bad shape. 
Colonel Ijams. Naturally, we are not objecting to the Army and 
the Navy getting all the physicians and nurses and attendants and 
everything else they need to do their job, but we have a job to do our- 
selves which is one that must be done under enactments of Congress. 
We are required to keep these hospitals operating; we are required to 
give hospitalization to these disabled men. To do that we must have 
personnel, and our sole objective is to secure, through this bill, if 
enacted, some benefit in the way of trained nurses for our service. 
Senator Ball. It seems to me that the proper answer to that, just 
as in the task of splitting up scarce materials for war production, is 
to survey your available pool of medical and nursing people available, 
set down the absolute minimum requirements of each essential service, 
satisfy those first, and then any surplus the Army and Navy have 
first call on. But it doesn’t do any good to give the Army and Navy 
all the physicians and all the nurses it can possibly use and leave the 
whole civilian population at home in bad shape, and in the long run 
that is going to hurt more than help the war effort. 
Colonel Ijams. I quite agree with you. 
Senator Ball. That is why I object to setting up rigid priorities in 
the bill. 
Colonel Ijams. Well, Senator, what you have stated is exactly what 
we would like to have. We would like to get some benefits from this 
bill, because we haven’t received any benefit from the physician allo- 
cation. 
Senator Ball. Do the veterans’ hospitals run nursing schools? 
Colonel Ijams. No, sir; we do not. 
Senator Ball. Are you prohibited from doing it under the law ? 
Colonel Ijams. You are getting a little far afield from my knowl- 
edge. I am a layman, Senator. But the nursing school, as I under- 
stand it, to operate a nursing school you must be able to give certain 
courses that we could not give, because practically all of our patients 
are men, we do not have gynecology and things of that kind which 
we can teach. 
Senator Ball. That will be changed after the war. 
Colonel Ijams, I am afraid it will. 
Senator Ball. You mean you have no maternity wards? 
Colonel Ijams, Exactly. We are asking, Senator, to take the people 
who will be produced in this bill in their third year. Also, we have 
approached nursing schools in at least two localities and requested 
them to cooperate with us and let us have some of their nurses for 
training purposes in the part of the training that we can furnish, and 
I am glad to say that that is going to work out. 
Senator Ball. I didn’t get your figure on the number of beds that 
the veterans’ hospitals are now operating and now have available in 
their operating facilities. It was in the first paragraph, I think, of 
the letter you read. 26 
TRAINING OF NURSES 
Colonel Ijams. We have a total of hospital and domiciliary beds of 
80,176, and construction to increase existing facilities to provide 1,379 
beds is under way, and we have also authorized for additional beds, 
2,4!9. 
I might say that in those figures I have quoted only authorized beds. 
Naturally we are working on quite a large program in the Federal 
Board of Hospitalization, which has not yet been authorized, but I 
have no doubt will be authorized when it gets to the President. 
Senator Ball. Do you anticipate that the Veterans’ Administration, 
in the years ahead, will be able, in lieu of building new facilities, to 
take over some of the Army and Navy base hospitals? After the war 
is over, the casualties will gradually move from those base hospitals 
over to the Veterans’ Administration, I should think. 
Colonel Ijams. Senator, the casualties are going to move before the 
war is over. 
Senator Ball. Yes? 
Colonel Ijams. Months ago, in the Federal Board of Hospitalization, 
we passed a resolution, which was approved by the President, under 
which when a man is disabled he will go into his service hospital, Army 
or Navy. They will look the man over, diagnose his condition, and 
prognose him; and if he is curable, if he is what I would term a mili- 
tary asset, can be cured and sent back as a fighting man within a reason- 
able time, we do not enter the picture. If, however, that man is what 
I would term a military liability, if he has a condition requiring con- 
tinued hospitalization for a long period of time, and can be of no earthly 
use in the war effort as a member of the armed forces, then the Army or 
Navy will discharge that man to our care, and they are the cases that 
are coming in to us very, very fast now. 
When this war is over, the Veterans’ Administration will acquire 
from the Army and Navy a large number of beds which they are now 
building and using in the war effort. The present law requires vet- 
erans to be maintained in fireproof construction. Many of these hos- 
pitals that the Army and Navy are putting up are to meet a tempo- 
rary need, and they are in isolated communities because of the avail- 
ability of open spaces for maneuvering of troops, and so forth, and 
they are of temporary construction. However, through the coordina- 
tion of the Federal Board of Hospitalizatin, the Army and the Navy 
are now building more beds of a permanent nature than heretofore, 
with the object of turning them over after the war to the Veterans’ 
Administration, so that the beds will not have to be built twice to take 
care of these men. 
Senator Ball. That is the point I was getting at. It seems to me 
that that would be sensible. I know that the hospitals in most of these 
camps are very flimsy, of temporary construction. 
Colonel Ijams. You will find in the future that certain construction 
will be part temporary and part permanent, the idea being that we 
have figured that a certain number of those beds would be required by 
the Veterans’ Administration after the war. They will be the ones 
that will be of permanent construction, and the temporary beds are the 
ones that will not be needed, in our opinion, after the war. 
Senator Ball. I am glad to hear that. It seems to be a sensible way 
of planning it. 
Senator Tunnell, Thank von very much. Colonel. TRAINING OF NURSES 
27 
Colonel Ijams. Thank you, sir. 
Senator Tunnell. 1 understand Dr. Draper wanted to make an addi- 
tional statement ? 
Dr. Draper. Mr. Chairman, I wanted to ask if it might be satisfac- 
tory to all who are interested if, instead of Veterans’ Administration, 
as suggested by Colonel Ijams, we might say “other governmental or 
essential military services.” I wouldn’t like to exclude other agencies 
of the Government. 
Senator Tunnell. You understand that the number of Senators 
present here is a very small proportion of the committee, so any sug- 
gestion you have, if you will leave it with the reporter, we will be glad 
to go over it. 
Dr. Draper. Thank you. 
Senator Tunnell. The next witness is Dr. George Baehr. 
Just state your name and position for the record, please, Doctor. 
STATEMENT 0E DR. GEORGE BAEHR, CHIEF MEDICAL OFFICER, 
OFFICE OF CIVILIAN DEFENSE 
Dr. Baeiir. Dr. George Baehr, chief medical officer in the Office of 
Civilian Defense. 
Senator Tunnell. All right. 
Dr. Baehr. The Office of Civilian Defense has long been concerned 
with the steady depletion of the nursing services of the country due 
to the war effort. In the summer of 1941 steps were taken to do some- 
thing about it. 
At that time, even before the rest of the country or even the hos- 
pitals of the country were fully aware of the future trend in nursing 
circles, the Office of Civilian Defense proposed to the American Red 
Cross the organization of a training program for volunteer nurses’ 
aides. This has been carried on very successfully by the Red Cross in 
collaboration with the Medical Division of the Office of Civilian De- 
fense, and throughout the country today there are 72,000 volunteer 
nurses’s aides trained to assist in hospitals, and an additional 20,000 are 
in training. 
This has been a source of considerable assistance to the hospitals, 
but it is far from adequate. The use of volunteers in this capacity, of 
course, is far from adequate. 
The depletion of nursing services in civilian hospitals has been due 
not alone to the needs of the armed forces, but in very large part to 
the needs of the war industries. 
(At this point Chairman Thomas returned to the room and assumed 
the chair.) 
Dr. Baehr. There are no figures available to indicate how many 
nurses have gone into the war industrial plants, but in one group of 
60 industrial plants, making munitions, which were built by the Ord- 
nance Department, there were, in the last year, 1,800 nurses employed 
for these 60 plants. 
They are needed. I have looked into the matter as to whether they 
could be spared. They are used on each assembly line. They are 
needed because of the great hazards in the war industries, and it is the 
opinion of the medical officers in charge that they cannot be spared. 28 
TRAINING OF NURSES 
In many parts of the country the hospitals have given up their gen- 
eral duty nurses from wards to the armed forces, and to the war in- 
dustries, so that in some parts of the country hospital wards have 
had to be closed. 
Two days ago I was in Buffalo and inquired at the Buffalo General 
Hospital as to their nursing situation, and was informed that the 
genera] duty nurses in the wards of that hospital were now down to 
one-third of the previous figure. 
In the city of New York, the municipal hospitals alone have 1,800 
vacancies in war nurses which they have been unable to fill. 
On the west coast we have had appeals to intervene with the repre- 
sentatives of the War Department in order to reduce the recruiting 
of nurses on the west coast, because of the nursing situation in civilian 
hospitals. 
I bring this out in order to emphasize the fact that the supply of 
nurses for the Army and for the war industries and for the Veterans’ 
Bureau and other governmental agencies, will become increasingly 
difficult to meet because the hospitals are forced, the civilian hospitals 
are forced today, because of the present deduction in general nursing 
services, to attempt to persuade nurses to remain, in order that the 
civilian hospital work should not suffer too severely. 
Civilian hospitals in many parts of the country are being given over 
by their trustees, or offers are being made to give them over, to the 
Army, because they cannot maintain them much longer if the supply 
of nurses and other personnel should continue to fall. 
In mental hospitals, the picture is really depressing. A large hos- 
pital for mental cases on Staten Island, built by the State of New 
York, has not been opened and has been taken over by the Army, be- 
cause the State could not administer it in the present situation. 
Several thousand beds, constructed at the Pilgrim Hospital on Long 
Island for mental cases, and urgently needed for these cases, have been 
given over to the Army because it was impossible to staff them. 
And this is the situation in many parts of the country. 
The Office of of Civilian Defense is severely concerned not alone 
with the fact that the present trend will make it increasingly difficult, 
unless something is done about it, to provide the armed forces and the 
other governmental agencies and war industries with nursing serv- 
ices, but that the protection of the civilian population is in serious 
jeopardy or will be in serious jeopardy if the supply of nurses in 
hospitals falls below the present figure. 
We have given careful study to this bill, and it is our opinion that 
the provisions in the bill would go a long way toward correcting the 
deficiencies, and would do so promptly. 
I should like to point out that if this bill were enacted, relief would 
come both to the armed forces and to the governmental agencies, as 
well as to the civilian hospitals, within a very short time, because those 
who have completed 2 years or more, or 30 months of service, of train- 
ing rather, could be placed then in this group of cadet nurses, and as 
these cadet nurses increase, the third-year nurses increase in number, 
they are free to take over the duties of general duty nurses in the wards 
of hospitals. 
As a result of that, the civilian hospitals will have less excuse for 
retaining even their present number of graduate nurses on ward duty, TRAINING OF NURSES 
29 
but will require a sufficient number to supervise the activities of the 
cadet nurses. But these third-year cadet nurses would carry the load. 
And since the hospitals would be paying for the maintenance of these 
nurses outside of the training schools, outside of the nursing service 
dormitories, they would probably not need, would certainly not need 
all of them, and some of these cadet nurses would be available for 
service in governmental institutions such as the Veterans’ Bureau and 
in military hospitals, station hospitals in this country. 
The Chairman. Are there any questions ? 
Senator Ball.. I am wondering, Doctor, if you have a tremendous 
expansion in the number of nursing schools, where you are going to 
get the staff of instructors to instruct them in the schools? I know 
in a number of communities the supply of doctors is extremely limited, 
they are terribly busy, and you need some doctors as instructors in 
nursing schools. Has any thought been given to that picture ? 
Dr. Baehr. Well, we are faced with the same problem in the acceler- 
ated program for medical students. As you know, medical students 
are now being trained in 3 years instead of 4, they are given no vaca- 
tions; and that instruction is given by a reduced teaching staff who 
just work twice as much as they previously did. And for the dura- 
tion of the war, as long as they can carry on, they will do so; and the 
same thing must be done, will be done, in the training schools for 
nurses. There is no other way out. 
Senator Tunnell. There is a shortage in every line of activity, is 
there not ? 
Dr. Baehr. There is a shortage in every line of activity, but in the 
nursing services it has become so critical, and the need for the future 
is so great, that unless we do something now we may be faced with a 
situation, and very likely will be faced with a situation, which will be 
extremely hazardous. 
Senator Tunnell. Medicine and nursing care does really have to 
be met. 
Dr. Baehr. Yes, sir. 
The Chairman. Thank you very much, Doctor. 
Dr. Baehr. Thank you. 
The Chairman. Maj. Julia C. Stimson, please. 
STATEMENT OF MAJ. JULIA C. STIMSON, PRESIDENT OF THE 
AMERICAN NURSES’ ASOCIATION, NEW YORK CITY, N. Y. 
Major Stimson. Julia C. Stimson, president of the American 
Nurses’ Association; and for 18 years I was superintendent of the 
Army Nurses Corps, and was recently called back into active duty for 
6 months, for recruiting duty. That is the reason for the uniform. 
Mr. Chairman, Miss Sheahan has told you very clearly of the work 
of our nursing professions organized in the council, the National Nurs- 
ing Council for War Service. I will speak for the American Nurses’ 
Association, which was one of those groups and was really the initiator 
of the council more than 2 years ago. 
The American Nurses’ Association has for its aims in general the 
advancement of the professional and educational welfare of nurses, 
to assist in the proper and adequate care of patients, and moreover to 
cooperate in every way—may I go back just one moment—in the care 
86411—43—3 30 
TRAINING OF NURSES 
of patients and the prevention of disease, and to cooperate with our 
sisters in the nursing profession all over the world in carrying out all 
these measures. 
Now the American Nurses’ Association is a professional member- 
ship of graduate, registered nurses in the United States, with over 
183,000 members, and with constituent State associations located in all 
the States in the United States, including the District of Columbia, 
Puerto Rico, and Hawaii. 
The association has gone on record as offering support and 
strength in any nursing activity in which the association can be of 
service to the country. But now we believe that global war has 
created unprecedented demands for qualified nurses for service with 
the armed forces and for industrial nursing positions. We believe 
that the needs of the armed forces, or we have demonstrated that the 
needs of the armed forces have rightly been given priority by the 
nursing profession, but at the cost of very grave depletion of nursing 
services for the civilian population. 
We also feel that the most liberal use of voluntary and other aux- 
iliary nursing personnel, of which you have heard, cannot balance 
the loss of qualified nurses. 
So the American Nurses’ Association, recognizing its grave respon- 
sibility for providing adequate nursing care wherever needed, has 
used its utmost, lias taken the maximum use of all of its resources, 
including its publication—and may I pause for a moment to state 
that our publications are the American Journal of Nursing, with a 
subscription list of nearly 71,000, and a Nursing Information Bulle- 
tin, which is issued monthly now, with a circulation of from 12,000 
to 20,000. So that we are using all our facilities to secure the coopera- 
tion of nurses and laymen all over the United States, in all that we, 
as an association, are doing. 
We have used all our facilities, and are continuing to do so, in 
support of a comprehensive utilization of the existing nursepower; 
the sum-total of all our efforts to meet both the military and civil 
demands for nursing we feel is still inadequate and there is urgent 
need for the enrollment of larger numbers of students in schools of 
nursing, since such students, under supervision, supply us full nursing 
service, and when graduated will contribute to essential national and 
international health programs. 
For these reasons, the American Nurses’ Association goes on record 
as approving in principle this bill. 
Now there is one argument—you have heard many arguments this 
morning, and I am going to be very brief—but there is one argument 
that hasn’t been brought forth that seems important. 
The Government has found it important to provide for essential 
services, both now and after the war, in making provision for the 
training in colleges of many thousands of young men in the pre- 
medical, predental schools, also for veterinary doctors, and they are 
given both basic and advanced courses. And it is also providing 
education for engineers, who are needed now amTwill be needed after 
the war. 
We feel that that is a precedent which should be followed in the 
case of this essential service, professional service, the need of nurses, TRAINING OF NURSES 
31 
and that Government help should be afforded for the absolute need 
at the present time, and the need that will occur after the war. 
Now you have asked a number of questions about needs, and I 
know that that interests you, and you may be interested just to hear 
a telegram that we received yesterday from the Nurse Placement 
Service of the midwest division, which is in Chicago, which is really 
a placement service, which we manage entirely by the professional 
service, in which the American Nurses’ Association is very much 
interested and have cooperated with for many, many years. This 
service reports this: 
Reporting shortages of nurses indicated by statistical comparison of 1942 with 
1940 that there are 70 percent fewer available nurses to fill positions. Nineteen 
hundred and forty was the peak year for registrants in the history of the 
service. Also 100-percent increase in vacant positions in 1942 as compared with 
1938 and 20-percent increase in 1942 over 1940, making a gap in 1942 between 
available jobs and available nurses of 120 percent. Figures for the first 3 months 
of 1943 (this year) show a 20-percent increase in jobs over the same period 
(that is, opportunities for nurses) in 1942 and a 30-percent decrease in applicants, 
95 percent of whom are in present positions and wanting to change. The urgent 
need for nurses for all levels of positions is shown constantly, especially staff 
nurses. This tragic need in rural hospitals and rural public health agencies, 
also hospitals in industrial centers. These figures represent the country as a 
whole as the nurse placement service functions nationally under our professional 
auspices. 
I think there is nothing more I can add to what Miss Sheahan ha 
so ably presented to yon. 
The Chairman. Thank yon very much. 
Major Stimson. Thank you, Mr. Chairman. 
The Chairman. Mr. Dent, please. 
STATEMENT OF A. W. DENT, PRESIDENT, DILLARD UNIVERSITY, 
NEW ORLEANS, LA. 
Mr. Dent. I am A. W. Dent, president, Dillard University, New 
Orleans; President of the National Student Health Association, 
which is an organization of the student health workers in the Negro 
colleges of the United States. 
I might also say that for 10 years prior to becoming a university 
president, I served as superintendent of Flint Goodridge Hospital in 
New Orleans, and for 6 years was chairman of the National Confer- 
ence of Hospital Administrators, which is an organization of ad- 
ministrators of the Negro hospitals in the United States, approved by 
the American College of Surgeons. 
I want to say that I, and members of these organizations which I 
have referred to, endorse thoroughly in principle the bill. 
We should like to call attention to the need for Negro nurses, and 
something of the problem involved. At the present time there are 
approximately only TOO Negro student nurses in the United States. 
The statement has been made here this morning that there are ap- 
proximately 70,000 student nurses in the country. Seven hundred 
Negro students would indicate that only 1 percent of these student 
nurses are Negroes, where in our total population Negroes represent 
about 10' percent, and in the Southern States the percentage varies 
from about 50 percent in Mississippi to approximately 25 percent in a 
State like North Carolina, 32 
TRAINING OF NURSES 
In my own area, the area surrounding New Orleans, where I am now 
working, Mississippi, Louisiana, Texas, Oklahoma, and Arkansas, there 
are approximately Sy2 million Negroes, according to the 1940 census. 
In this entire area there is only one school of nursing for Negroes 
which can now meet the accrediting requirements. That school is at 
Dillard University. We started it only last September with assistance 
of Federal funds. 
There is only one other school in the area, and that is in Texas, a 
school operated in the State School for Negroes in Texas, but which 
does not meet the requirements for State accrediting. 
There are some hospitals in the area and some schools which could 
conduct good nursing schools if they were stimulated, possibly, through 
making Federal funds available to them to assist in the cost of operat- 
ing these schools. 
I speak of this particular area because I know it best, but the prob- 
lem is approximately the same throughout the country. 
I would like to speak of the need for nurses in the post-war world, 
Negro1 nurses particularly, in addition to the obvious need for them 
at the present moment. 
About 65 percent of the Negro babies born in the entire United States 
are delivered without the presence of a doctor. There is some feeling 
that postgraduate courses for nurses in midwifery might be developed 
for the purpose of improving this condition until such time as there 
are sufficient numbers of physicians to serve the needs. 
The demand for Negro public-health nurses has been much greater 
than could be supplied for at least 10 years in almost the entire country, 
and the need has been very acute in the Southern States wdiere there is 
a large Negro population. 
Furthermore, our recognition of the need for the development of 
greater food crops in the post-war world is going to cause us to be- 
come more concerned about the rural areas, where our health problems 
are worse, and more health workers, including nurses, will be needed 
for these areas during the post-war period. 
I spoke of my connection with the National Student Health Asso- 
ciation. We are very much concerned about the lack of health educa- 
tion in our colleges. Well-trainect nurses are needed, and they could 
be very helpful in preventing illness, in preventing disease, if we had 
well-qualified teachers in our colleges and schools throughout the 
country. 
The last thing which I should like to mention is the need for main- 
taining an adequate nursing staff in our civilian hospitals, and in our 
Government hospitals. The veterans’ facilities which have been re- 
ferred to here today, which are in some areas of the country segregated 
as to race, use Negro nurses; and the ability to supply nurses for these 
hospitals is seriously lacking now, probably more acute than it is in 
other areas of the population. This condition will continue to increase, 
and I believe that the provisions of this bill will enable us to recruit 
more students in nursing in order to meet these needs now, the present 
needs, and to prepare to meet the needs which will confront us in the 
post-war era. 
The Chairman. Thank you. 
Mr. Dent. Thank you, sir. 
The Chairman. The Reverend John Martin, please. TRAINING OF NURSES 
33 
STATEMENT OF REV. JOHN G. MARTIN, SUPERINTENDENT OF THE 
HOSPITAL OF ST. BARNABAS, NEWARK, N. J.; PRESIDENT-ELECT 
OF THE AMERICAN PROTESTANT HOSPITAL ASSOCIATION 
The Chairman. For the record, will you state your name, please? 
Dr. Martin. Rev. John G. Martin, superintendent of the Hospital of 
St. Barnabas, Newark, N. J., and president-elect of the American 
Protestant Hospital Association. 
The Chairman. Proceed, Dr. Martin. 
Dr. Martin. I do not wish to repeat many of the arguments that 
have been presented, Mr. Chairman. I would like to present, however, 
a resolution that was adopted by the officers and trustees of the Ameri- 
can Protestant Hospital Association: 
Whereas there is a critical shortage of nursing service in military, other Gov- 
ernment, and civilian hospitals and health agencies, which shortage is rapidly 
being aggravated by the increasing competition for womanpower by the armed 
services and industry, thus threatening a collapse of nursing care for the civilian 
population, and 
Whereas the health and medical committee of the Office of Defense, Health and 
Welfare Services has formally endorsed a plan to establish a student War Nurse 
Reserve in the Public Health Service: Now, therefore, be it 
Resolved, That the officers and trustees of the American Protestant Hospital 
Association go on record as favoring the Student War Nurse Reserve as the 
most adequate means of combating the serious shortage of nurses; and be it 
further 
Resolved, That the support of our association be given to Senate bill No. 983: 
Be it further 
Resolved, That Rev. John G. Martin, president-elect of our association, be ap- 
pointed to appear before the Senate Committee on Education and Labor and en- 
dorse Senate bill No. 983 on our behalf. 
Hospitals throughout the country have found themselves in the posi- 
tion of having an increased business. An increased number of patients 
go to hospitals for various reasons—first, the general prosperity is en- 
abling more people to attend to their ills than was so previously. Then 
there is a great increase in industrial accidents because of the speed-up 
of industry. Third, there is the increase in maternity work, more 
babies are brought into the world, and more and more of them are be- 
ing born in hospitals. 
Then again, the hospital insurance plans that have been developed 
within the last decade, the Blue Cross plans which are very successful, 
have increased the work of hospitals. 
These and other reasons have made it imperative that hospitals give 
adequate nursing care, and yet they are handicapped 
The Chairman (interposing). May I break in and ask you one ques- 
tion? Is the prejudice against those organizations breaking down 
gradually throughout the country? 
Dr. Martin. I don’t think there is any prejudice against them. You 
mean against the hospital associations? 
The Chairman. No; against the joint associations for hospital serv- 
ice. We have cases here in Washington in the courts trying to break 
them up. 
Dr. Martin. Yes; I think that has been an exception to the rule, 
however. In general the work of the hospital insurance plans has 
increased tremendously, so that there are now something over 10,000,- 
000 people insured throughout the country, in a plan that is not more 
than about 10 years old. 34 
TRAINING OF NURSES 
The Chairman. Then the prejudice is breaking down. 
Dr. Martin. Yes, if there has been a prejudice it is breaking down; 
yes, sir. 
There is competition, of course, for students, as has been brought out, 
which I will not go into. The larger pay of industry has a bearing on 
it, and young women have a financial aspect to their work as well as 
the desire to help in the war work. 
The hospitals are sending their nurses into the war service, and that 
leads to a shortage of nurses. Moreover, the nurses are gradually 
taking on more heavy responsibilities that formerly were the responsi- 
bilities of the medical services, the interns, and so on. 
These are some of the difficulties that the hospitals are facing, and 
we feel that this bill will enable the hospitals to face these responsi- 
bilities and difficulties, and help to solve them. 
The need for financial aid is apparent, and the fact that since the 
enrollment programs have been installed during the last several months 
and help has been secured from the Government, we have an indication 
of a speed-up and an increase in the enrollment of student nurses, we 
feel is an indication of what will happen with this bill. This will 
further speed up the enrollment of nurses. 
For these reasons, our association is heartily in favor of this bill, 
and would like to endorse it. 
The Chairman. Thank you, Doctor. 
Dr. Martin. Thank you, Senator- 
The Chairman. Mr. Eugene Butler, please. 
Is Mr. Butler present ? (No response.) 
Miss Isabel Stewart, please. 
STATEMENT OF MISS ISABEL STEWABT, DIRECTOR OF THE DIVI- 
SION OF NURSING EDUCATION, TEACHERS COLLEGE, COLUMBIA 
UNIVERSITY 
The Chairman. Please state your name and connection for the 
record, Miss Stewart? 
Miss Stewart. Isabel M. Stewart, director of the division of nursing 
education, teachers college, Columbia University. 
I have been asked to say a word about the need for an increased 
faculty to train these nurses, and I would just like to say that I think 
everybody agrees that we do need more nurses; and that this means 
that we must have more in training; and this means that nursing 
schools must be expanded to take care of this added load; and that 
again means that as we expand nursing schools we must increase the 
training personnel. And that group of personnel that we need for the 
training of nurses is already very low. 
We have never had anything like enough in that group, and with 
the increased load that is one of the places where the great shortage 
is being felt. 
If we are going to prepare this added group of nurses, we must 
have a greatly increased group of training personnel, and we can’t 
wait for those young women to voluntarily go and get the additional 
training they need, we have got to help them to get that training just 
as we have got to help in preparing the personnel for the training of 
the soldier and of all the other people who are needed in the war effort. TRAINING OF NURSES 
35 
I think this will be quite obvious to anybody who has had to deal 
with the need for personnel in industry or in military affairs, in the 
armed services, or in any other field of work. 
I would like to just simply say a word about the size of the job. We 
had—and may I say that I think these are the last figures, and I happen 
to have them at hand so that I can give them to you—in the first place, 
we had in 1940,85,000, roughly, students in schools of nursing. I think 
that some of the figures which have been given to you previously have 
confused a little the admissions and the actual number of students in 
training, but in 1940 we had 85,000 in training. 
In 1943 we had 100,000. That is, we have increased by 18 percent 
since 1940, the number of students in nursing schools. 
We expect in 1944, if our plans go through, to add to this 100,000 
students in training, 10,000 more. So that we would expect, in 1944, 
to have at least 110,000 students in nursing schools. 
Now in order to prepare these young women we have—and if you 
would like to have the figures for admissions, that is a different figure, 
again—we had in 1939, just before the war, before we started our in- 
ventory—I will give you 1940, we had 38,000 students being admitted 
that year, in 1940. We now have, this last year, 47,500 students being 
admitted. That means new students who are to be prepared, who are 
just coming right into nursing schools. 
I can give you these figures if you want them. 
The thing is, then, that we do have a big job, and we know that we 
will have to increase substantially the number of people that are going 
to train these nurses. 
Now we have had approximately 25,000 of such people. They range 
from head nurses, supervisors, to instructors who give their entire time 
to teaching, and those who direct these nursing schools. 
We can increase our nursing schools, expand our schools, only to 
the extent that we can expand our training personnel, and it is very 
difficult because many of these young women are of the age when they 
can go into military service, and a good many of them have gone al- 
ready into military service, and we can’t keep them from going into 
military service. 
Of course, there are other sources of depletion, as have been men- 
tioned. Moreover, they carry a much heavier load than they have ever 
carried before. I don’t know any group in the nursing profession that 
is at the present time carrying a heavier load than is this group, because 
they have extra patients, they have extra students, these students are 
coming in. Instead of having one class a year, they are now putting 
in two, three, or four classes in some places, that is, having new students 
coming in in successive groups. 
There are other workers in the institution that have to be taught, all 
these auxiliaries, these aides, have to be taught; all of these women who 
are coming in for refresher courses have to be taught, and supervised. 
So there is that extra load. 
Moreover, there are fewer doctors, and the doctors have always 
shared in the teaching, and we are finding it extremely difficult now to 
get enough teaching by the doctors, so that the nurses are again having 
to take over a good deal of that teaching. 
In addition to all of this, we are being asked to accelerate the pro- 
grams, and the schools are making a great effort to do that; they are 36 
TRAINING OF NURSES 
carrying not only heavier loads, but carrying them through more 
rapidly. 
All of this means, then, a tremendous burden on those who are re- 
sponsible for the training. 
Now the schools are doing their best. They are working overtime, 
they are carrying much heavier loads of teaching than they have ever 
done, and they are still short, and they say—we have had a recent 
inquiry, it has gone out to all the 1,300 schools in the country—and 
1,000 of those schools replied to the questionnaire. And of the thou- 
sand schools that were asked whether they could take in more students, 
and what their main difficulties were in relation to taking in more 
students, one-third of them said that they were short of supervisors 
and head nurses; and one-fifth of them said that they were short of 
instructors. That means a rather serious shortage. 
Now then, if this shortage cannot be relieved, then our whole scheme 
breaks down, I mean, we can go only so far as we can supply the 
people who are training these young women. It breaks down in that 
we will have a poorer product to begin with; it breaks down in that 
we simply cannot take in more students than we can train, and so it 
is very necessary to have Federal aid to make it possible to increase 
the supply of instructors and of the training personnel. 
Now so far as the money that has been given by the Government 
to help nursing schools, those sums that have been given have aided 
substantially in the training of more of these workers for the training 
of the rest of the students. In this country we have 20 or more centers 
where such young women can be prepared for advanced work in teach- 
ing and supervision, and so forth, in nursing schools, and most of 
those schools have had scholarships, have been able to offer scholar- 
ships to deserving students who are willing to pledge themselves that 
they will remain in service, that when they have had this extra training 
they will be able to give their service definitely in these fields of work. 
I may say that I can’t give you the exact amount that has been spent 
on this, but I do know, as director of one of the schools—and probably 
the one that has the largest number of students in the country—we 
have about 600 young nurses who are in preparation for just such 
positions—I can say that it has been a big help. In other words, 
whereas other divisions of the college have slumped, particularly dur- 
ing this war period, it has been possible—our group has been main- 
tained, and the reason why it has been maintained is that scholarships 
were available, and these scholarships have helped particularly the 
young nurses who could not otherwise—I mean who haven’t saved 
enough to take the preparation themselves, and a number of part-time 
students who could afford to come to college only if they were earning 
at the same time. It has been possible to help some of those to drop 
their jobs, and to come in and get their preparation and then to be 
available for full-time positions later. 
I simply want to say, in addition to that we have had some special 
projects in the country as a whole, for instance in the preparation of 
head nurses, the junior executives in nursing schools who teach and 
supervise students, and we have the assurance of the hospitals that 
that plan, which is part-time work in the hospital and part-time study 
in the college, has not only helped to increase the number of teachers 37 
TRAINING OF NURSES 
and training personnel, but has been an actual help to the hospitals 
during this period. 
I might say that the delay, I mean the fact that we have not any 
assurance at the present time, any positive assurance of scholarship 
assistance for this summer and for next year, has been a matter of 
great anxiety to many schools and to many young women who want 
to com£ in and get such training. 
We thus have inquiries every day asking us, “Is it going to be possible 
for us to get some scholarship aid this summer, because if we do not 
get it, we don’t see any way by which we can come and get ready for 
these positions.” 
So if such aid is not available, I think there is going to be a definite 
slump in the number of students, young nurses who are coming in to 
be prepared for training others. And that will be felt at once in the 
summer session, and it will be felt in the fall session. 
The schools are waiting anxiously to know whether they can send 
us some of their promising younger people, and I think I may just 
simply say that they know that they simply cannot swing the extra 
load of nurse production that the country expects them to carry 
unless they are going to have some such scholarship aid as will be 
provided in this bill. 
The Chairman. Thank you very much, Miss Stewart. 
Miss Stewart. Thank you. 
The Chairman. Mrs. Stauphers, please. 
STATEMENT OF MRS. MABEL KEATON STAUPHERS, EXECUTIVE 
SECRETARY OF THE NATIONAL ASSOCIATION FOR COLORED 
GRADUATE NURSES 
Mrs. Stauphers. Mabel Keaton Stauphers, executive secretary, Na- 
tional Association for Colored Graduate Nurses, an organization of 
professional registered Negro nurses, many of whom are members of 
the American Nurses’ Association, the National Organization for 
Public Health Nursing, and the National League of Nursing Edu- 
cation. 
Our association is a member of the National Nursing Council for 
War Service, and we endorse in principle what Miss Sheahan has 
said and what Miss Stimson has said. 
Mr. Dent failed to tell you that he was a member of the advisory 
council of our national association, and in order to expedite time I 
would like to endorse his statements regarding the need for more 
opportunities for education, especially in that area. 
I would like to bring to you some other situations which would indi- 
cate that a bill of this type is needed at this time. 
Our office is at this time being swamped with calls for Negro nurses, 
not only to Negro hospitals but to some of the largest hospitals in 
this country in the North, the Middle West, the Far West, and the 
Northeast. For that reason, there is a definite need for more educa- 
tional opportunities for Negro nurses, and this bill would help those 
opportunities. 
The Chairman. That statement, Mrs, Stauphers, means that the 
Negro nurses are working in what may be termed white hospitals? 38 
TRAINING OF NURSES 
Mrs. Stauphers. Yes. In New York City we have about 1,250 
Negro nurses serving on an interracial basis in the city hospitals, 
and in the public health agencies, too, of this country. 
For instance, the Henry Street Visiting Nurse Service integrates 
its nurses into all of its services. 
And also, although we feel that at this time we are limited in our 
service for the United States Army, we are only being called on to 
serve and are serving in four Army camps at this time, we know there 
will be a need for us; we have that feeling about it, and we want to 
be ready. 
We are being used in the veterans’ facilities, and we can again not 
fill the need. Only yesterday a call came to us from the Japanese 
Relocation Centers, for nurses, and we would have to borrow those 
nurses. 
Now another point that I would like to bring out is that the sponsors 
of the bill have not at this moment, perhaps, thought of any safe- 
guards for minorities in the bill, especially the Negro. We are not 
unmindful of the very fine administration which the present United 
States Surgeon General’s office has given in relation to Negro schools, 
but we feel that some safeguards in this bill would strengthen his 
administration and would help future administrations. 
We endorse the bill in principle, and we do hope that a considera- 
tion will be given to safeguards to minorities. 
The Chairman. Thank you. 
Mrs. Stauphers. Thank you, Mr. Chairman. 
The Chairman. The hearing will stand in recess until tomorrow 
morning at 10 o’clock. 
Mr. Brown. Mr. Chairman, I am preparing a statement which I 
would like to submit to the committee with respect to this bill. 
The Chairman. We will be glad to receive it, Mr. Brown. 
(Whereupon, at 12:20 p. m., the committee recessed until 10 a. m., 
Friday, May 7, 1943.) TRAINING OF NURSES 
FRIDAY, MAY 7, 1943 
United States Senate, 
Committee on Education and Labor, 
Washington, D. C. 
The committee met, pursuant to recess, at 10 a. m., in room 457, 
Senate Office Building, Senator Elbert D. Thomas (chairman) pre- 
siding. 
Present: Senators Thomas (chairman), Murray, Ellender, Tunnell, 
Eastland, Ball, and Hawkes. 
Also present: Representative Frances P. Bolton. 
The Chairman. The hearing will be in order. 
Dr. Parran, please. 
STATEMENT OF DR. THOMAS PARRAN, SURGEON GENERAL, PUBLIC 
HEALTH SERVICE 
The Chairman. Dr. Parran, we would appreciate a statement from 
you about the bill, for our record. 
Dr. Parran. Mr. Chairman, I appear in support of S. 983, to pro- 
vide for the training of nurses. This bill has been drafted after much 
care and after extended consultation with the nurse-training institu- 
tions of the country and their associations, with the hospital groups 
in the country. In fact, I should like to say for the record that there 
has been the closest possible cooperation between the Public Health 
Service and the professional groups who are concerned equally with 
us in connection with this important problem. 
During the past 2 years the nurse-training institutions have done a 
magnificent work in trying to expand their training programs so as to 
supply the urgent needs of the military forces and the civil population 
with registered nurses. 
The Public Health Service has been aiding in the training of nurses. 
The current appropriation for that purpose is now being expended, 
amounting to some Sy2 million dollars. 
This present program, however, is based on the incentive principle; 
that is, we have compensated training schools in part for the cost of 
training the additional nurses over and above the number which they 
had admitted pre-war. With the increasing competition for woman- 
power, we are confident that the current program will not produce 
the number of nurses needed for military and civilian purposes. 
I believe that yesterday you had testimony from my first assistant, 
Dr. Draper, concerning the bill. I merely wanted to appear and make 
this brief statement, and should be glad to answer any questions which 
the committee may have to ask. 40 
TRAINING OF NURSES 
Senator Tunnell. Doctor, there was some suggestion yesterday that 
possibly one of the effects, if not one of the objects of this bill, might 
be to relieve the hospitals o| their present expenditures along the line 
of training. Do you think that it either has that purpose or that effect, 
or would have? 
Dr. Parkan. It certainly has not that purpose, and in my opinion 
does not have that effect. As the plans have been drafted, with the 
cooperation of the hospitals of the country, they have shown every 
willingness to bear their part of the cost. 
The major costs incident to the carrying out of the provisions of this 
bill will be in paying the tuition of girls who wish to study nursing, 
which tuition heretofore has been paid by these girls themselves. Also, 
this bill will pay a small amount each month to the nurses who desire 
to enroll and thereby make their services available for war service 
during this emergency. 
As we have estimated the break-down of costs, it appears that the 
training schools and hospitals will be paying about as much on behalf 
of the training of each nurse as will the Federal Government. 
Senator Tunnell. And that whatever is obtained by this bill or 
through this bill, according to your theory, would be more largely 
used for the additional nurses than for the present training program ? 
Dr. Parran. That is the purpose, and the purpose also is to relieve 
the prospective student nurse from much of the cost which she now 
bears. That seems necessary, because war industries are offering 
positions to girls and are paying them from the time they start train- 
ing. The same is true of the uniformed auxiliaries of the military 
services. 
This program will cost between $60,000,000 and $70,000,000, depend- 
ing upon the number of students who will agree to continue in nursing 
work for the duration of the present war and 6 months thereafter. A 
little less than one-half the amount will probably be spent for stipends 
to individual students; about one-quarter will be used to pay for 
tuitions, other fees, and uniforms, which heretofore have been paid 
by the students themselves; the remainder will cover maintenance for 
the students during the preliminary training period when students 
are not contributing nursing service to the hospitals. 
I should like to emphasize that under the terms of the pending 
measure neither the nursing school nor the hospital will benefit unduly 
from Federal aid. The largest part of the expenditure is for the pur- 
pose of paying stipends, tuition, and other fees heretofore paid by the 
students, with the remainder utilized to provide maintenance only 
during the first 9 months of the course. 
In return for this the nursing school will accelerate its program by 
condensing the required instruction into a total of 24 or 30 months 
instead of the usual full 3-year period. 
In the table which I will submit herewith there is a break-down of 
the amount it is proposed that the Government will spend and the 
amount which it is estimated the school or hospital will expend on 
behalf of the nurses training. It should be emphasized that the mili- 
tary services, other governmental medical agencies, and civilian hos- 
pitals will have a call on the services of the students in the proposed 
student war nursing reserve during the last 12 or 6 months of their 
training prior to graduation. By calling out these students from the TRAINING OF NURSES 
41 
home hospital that hospital is completely deprived of their services at 
their most efficient period. 
In a 24 months’ accelerated program, for example, it appears that 
the hospital and nursing school will expend on behalf of each nurse 
$1,940. If these students are withdrawn in the senior year for military 
and other services, for example, the hospital will have only 15 months 
of part-time service of such students, for which they will be paying 
about $65 per month. In fact, in making an estimate of from $1,200 
to $1,300 per nurse trained, many of us have felt that we were squeezing 
the hospital and the nurse-training school too hard. 
(The table referred to by Dr. Parran is as follows:) 
Exhibit D.—Estimated cost of preparation of 10 student nurses, hy years 
Total 
Total 
Public 
Health 
Service 
School 
or 
hospital 
Public 
Health 
Service 
School 
or 
hospital 
24-month curriculum: 
30-month curriculum: 
Maintenance at $4ii per 
Maintenance at $45 per 
month (Public Health 
month (Public Health 
Service first 9 months) _ 
$40, 500 
$121,500 
Service first 9 months)^ 
$10,500 
$121, 500 
25,000 
Instructional costs ... 
20,000 
' 
21,500 
Clinical supervision 
21, 500 
14,000 
Uniforms, books, etc 
9,000 
6,000 
4,900 
Clerical services, etc 
4, 900 
10,000 
Classroom facilities - 
10. 000 
Stipends to students 
43,500 
36,000 
Stipends to students 
55,500 
18,000 
Total 
123,000 
193,900 
Total . 
125,000 
180, 900 
The Chairman. Thank you, Dr. Parran. 
I should say this, that the committee has had Dr. Parran with us in 
executive session on this bill, so that we have been pretty well informed 
about the provisions from Dr. Parran. 
Miss Stella Goostray, please. 
STATEMENT OF MISS STELLA GOOSTRAY, PRESIDENT, NATIONAL 
LEAGUE OF NURSING EDUCATION, CHAIRMAN, NATIONAL NURS- 
ING COUNCIL FOR WAR SERVICE, SUPERINTENDENT OF NURSES, 
CHILDREN’S HOSPITAL. BOSTON 
The Chairman. For the record, will you state your name and your 
address and official position ? 
Miss Goostray. Stella Goostray, president of the National League 
of Nursing Education, and chairman of the National Nursing Council 
for War Service, and superintendent of nurses at the Children’s 
Hospital, Boston. 
The Chairman. You may be seated if it is more comfortable. 
Miss Goostray. The National League of Nursing Education is a 
membership organization composed of the nurses who are engaged in 
various forms of advisory and executive and teaching positions in 
schools of nursing, in public health agencies, and in the Government 
nursing services; and its chief concern is the preparation of nurses for 
the various branches of nursing, and in the promotion of better nursing 
service to the public. 42 
TRAINING OF NURSES 
Last fall the board of directors of this league, realizing the unprece- 
dented demand for graduate nurses, both for the military and civilian 
services, recommended to its membership and to the 1,300 accredited 
schools of nursing in the country that they should give immediate 
consideration to making adjustments in their educational programs. 
Now we could not accelerate our courses, as have the colleges and 
medical schools, because we have had no long vacations during the 
summer which we could take advantage of, but we believe that the 
course could be so adjusted that the essential services and the educa- 
tional program could be completed in 30 months. 
So tiiat the league started on that work in the fall, and I am very 
glad to say that many schools have made a start toward getting their 
courses accelerated. 
In finding out what was being done in the schools, we found that 
there were several difficulties in the way of this acceleration, one of 
them being the lack of teachers, housing facilities, and clinical 
facilities. 
Now, we believe that this new bill will, if the plan is followed, help 
us in getting teachers and in finding more clinical facilities. 
I have a resolution from the National League of Nursing Education, 
board of directors, asking to go on record as approving the bill S. 983 
in principle. I shall be glad to read it, if you wish. 
The Chairman. The resolution can be printed in the record. It is 
much like the other resolutions, is it not ? 
Miss Goostray. Yes; it is. 
(The resolution of the National League of Nursing Education is 
as follows:) 
National League of Nursing Education, 
1790 Broadway, New York, N. Y. 
Whereas the National League of Nursing Education recognized that conditions 
are unusual because of the war; and 
Whereas more students are needed in schools of nursing to meet the military and 
civilian demands; and 
Whereas the National League of Nursing Education recognizes that many 
opportunities have been opened to high-school and college graduates to aid the 
war effort, thus creating competition; and 
Whereas many desirable applicants may lack funds to finance the course in 
nursing and for that reason are diverted to other fields; and 
Whereas the National League of Nursing Education believes that everything 
should he done to increase the number of desirable applicants for schools of 
nursing; and 
Whereas the National League of Nursing Education is of the opinion that the 
course should he adjusted wherever State laws permit so that basic preparation 
may be accelerated in order to free students for service during the last 6 
months. Therefore, be it 
Resolved, That the board of directors of the National League of Nursing 
Education go on record as approving bill S. 983 in principle. 
May 3, 1943. 
Miss Goostray. There are approximately 1,300 schools of nursing 
in the United States meeting the minimum requirements set by law 
in the State in which they are located, which makes their graduates 
eligible to be licensed as registered nurses. In these schools of nurs- 
ing on January 1, 1943, there were approximately 100,000 students. 
The great majority of these schools of nursing are operated by non- 
profit hospital organizations. Approximately 80 schools of nursing 
are collegiate schools. They are established as constituent parts of a 
college or university or maintain educational and organizational rela- TRAINING OF NURSES 
43 
tionships with such institutions. All of these university schools must 
also have educational or organizational relationships with one or more 
hospitals for the clinical experience portion of their program. 
In increasing numbers schools of nursing have eliminated the pay- 
ment of stipends and are charging tuition fees. The latest pro- 
fessional study made in 1939 showed that approximately one half 
of the schools charged tuition.1 The average tuition in a hospital 
school is $75 for the total 3-year program which does not meet the 
cost of instruction. Larger tuition fees are paid by students in uni- 
versity schools of nursing. In addition, there are fees for books, 
uniforms, special student activities, and for the use of the laboratories. 
The hospital provides the student with food, room, and laundry 
without charge, in return for the service she renders in the process 
of learning nursing. In hospital schools of nursing of good grade 
the student spends very little time on the wards of the hospital during 
at least the first 6 months. She may have supervised practice periods 
during that time but no hospital could depend for any appreciable 
part of the nursing care of its patients on these students. As the 
student goes on in her course she spends an increasingly larger part 
of her time on the hospital wards. She may, however, be sent away 
from the particular hospital in order to broaden her professional 
experience as all hospitals do not provide for care of all types of pa- 
tients, such as maternity patients, the care of children, the care of 
psychiatric patients, etc. 
Whether a hospital profits financially by the presence of a school of 
nursing has been debated for many years. Studies have been made 
on the annual cost per student to the hospital which shows that the 
annual costs range from $459 to $1,285.2 One of the difficulties in 
getting accurate figures is that hospitals in their accounting systems 
do not always separate the cost of nursing education from nursing 
service, and do not determine and assign a monetary value to the 
services of the student. Whether the present system of economics in 
relation to nursing education can be justified may be disputed, but the 
plan proposed under the terms of bill S. 983 will place upon hospitals 
charges which they do not now have, extra classes will have to be 
admitted, teaching costs will be increased for that reason, and the 
accelerated program will further decrease service to the hospital dur- 
ing the period of the student training. It is also to be noted that the 
hospital which has assumed the cost of the student’s education may 
not have her services at the time when she is most valuable to the 
institution since she may be transferred to another institution or to 
the military service. The payment of a stipend to students in the last 
6 months or year, as the case may be, will in many instances cause 
the hospital to revert to a practice which has not been in effect since 
before the last war. The last professional study made in 1939 showed 
that approximately a third of the hospitals paid student stipends, the 
average stipend paid being $8 monthly.3 This may not be interpreted 
that a third of all student nurses received stipends. Many of the 
1 Facts About Nursing, p. 20, The Nursing Information Bureau of the American Nurses 
Association, New York 
2 Administrative Cost Analyses for Nursing Service and Nursing Education, p. 3, 
Pfefferkorn and Rovetta, published by American Hospital Association, National League for 
Nursing Education, 1940. 
8 Facts About Nursing, p. 20, The Nursing Information Bureau of the American Nurses 
Association, New York. 44 
TRAINING OF NURISES 
institutions which pay stipends graduate small numbers of nurses. 
Government supported institutions are more likely to pay stipends 
than the voluntary organizations. 
It is true that the hospitals need more student nurses. The number 
of graduate nurses which supplement their student nurses has been 
greatly reduced and will be still further reduced. But in addition the 
schools of nursing must undertake the responsibility of maintaining a 
supply of graduate nurses to be available for the military and civilian 
needs of the country. We must frankly admit that if we are to meet 
the minimum needs for nursing service in this country we must find 
a plan which will attract more young women to nursing than would 
normally come into our schools. The number of young women 
admitted to our schools of nursing in 1935 was 30,000; by 1938 it had 
increased to 35,000, and in 1942 it was approximately 49,000. We 
wanted 55,000 and we estimate that the minimum number that we 
should admit during the year beginning July 1 is 65,000. All young 
women who come into our schools of nursing will not wish to be en- 
rolled in this plan and some will continue fo pay their own expenses 
and the hospital school of nursing will assume the cost of their nursing 
education in return for the service which they render, which will not 
be on an equal basis in every institution. We believe, however, that 
there are young women who cannot pay any of the costs involved and 
who must have some help toward their personal expenses. The pres- 
sure of the demand for the essential service of nurses seems to justify 
asking the Government to share with the hospitals in meeting these 
demands and to assume financial responsibility in this emergency for 
students of nursing just as they are for students of medicine, dentistry, 
pharmacy, and so forth, who under normal conditions pay for their 
own education. 
AMENDMENT TO SENATE BILL S. 983 1 
This Act shall cease to be ineffect upon the date of the termination of hostilities 
in the present war as determined by the President, or upon such earlier date as 
the Congress by concurrent resolution or the President may designate, except for 
purposes of (a) making computations, payments, and adjustments in payments 
with respect to recruitment, training, and courses prior to such date, and (b) 
making computations, payments, and adjustments in payments so as to permit 
continuance, after such date, of training and courses by graduate or student nurses 
who were receiving training or courses ninety days prior to such date. 
The Chairman. Are there any questions? (No response.) 
Thank you very much. 
Miss Goostray. Thank you, Senator. 
The Chairman. Mrs. Tydings, please. 
STATEMENT 0E MRS. ELEANOR DAVIES TYDINGS, VOLUNTEER RED 
CROSS AIDE 
The Chairman. Mrs. Tydings, be seated, please, and for the record 
will you state your name and what you are doing, and why you have 
come to testify on this bill ? 
Mrs. Tydings. Eleanor Davies Tydings. I am a volunteer Bed Cross 
aide, and I have come because I think there is a crying need for more 
nurses. In fact, I know there is a crying need for more nurses. 
1 This amendment is filed at the suggestion and with the full approval of Surgeon 
General Parran. TRAINING OF NURSES 
45 
We of the volunteer Red Cross aides are trained for only 3y2 weeks, 
4 hours a day training, and that does not qualify us to give medication 
or hypodermics or any of the things that the nurses do. We really are 
the workers that do the little jobs and make beds and try to help out 
as much as we can with the actual physical labor, which isn't so im- 
portant as the medication, and so forth. 
I believe the Red Cross has done a wonderful job training young 
women to do this sort of work, but there is a constant drain upon the 
nurses, and it is the nurses that we must have, particularly if this war 
is going to go on for any length of time; and we are going to have 
enormous numbers of men who are going to be wounded and who are 
going to need nurses. 
One of the heads of the nurses training at Garfield Hospital tells me 
that out of 39 graduating last year in the class that she taught, there 
are only 12 left in the hospital, and some of them are leaving. Well, 
that is an enormous drain on the civilian hospitals, and the civilian 
hospitals are sutfering today for a lack of trained nurses. 
For example, in a ward with 26 patients in private rooms, not in the 
big ward, but in private rooms, there will be only one nurse from 11 
to 7 every day for 26 patients. Well, it is physically impossible for 
one nurse to take care of 26 patients, even though she may have one 
Red Cross nurse’s aide to help her. You just run your legs off; I 
know that. I have been going every day to Garfield Hospital and 
working in the open wards, where there are any number from 18 to 
20 patients, average, in the ward, and there will be one nurse there 
and sometimes two nurses but usually only one. There will be two 
Red Cross volunteer aides and there will be one paid aide. And we 
are just running our legs off; we can’t get from one patient to the 
other. And these patients are paying, mind you, $5 a day for their 
beds, and they are not getting the sort of service that they ought to 
get for that. That is a lot of money for people to pay to go to a hos- 
pital, and they are not getting the proper bedding; they are not get- 
ting—we can’t get enough sheets, and what sheets we have are in dread- 
ful condition. The hospitals in Washington—will you stop me when 
I have worn you out, because I could go on indefinitely. 
Of course, the major need is for nurses. That is what you are going 
to have to have. 
Now, talk about manpower needs, you are going to need some woman- 
power, too, in these hospitals when you get all these wounded, not to 
mention the civilian sick, who are going to be neglected even greater 
than they are now, because, as Miss Wilson at Garfield said to me, we 
can just barely manage to stagger along now with the help we have 
got, and what we are afraid of is that it is getting worse and worse, and 
we will have less and less. That means that people are going to be 
suffering in agony, and there isn’t going to be anybody to bring them 
a glass of water when they are dying for a glass of water; there isn’t 
going to be anybody to come and help them when they need a hypo- 
dermic, because the one nurse, or the half a nurse, is just not going to 
be able to get around to all those patients. 
I don’t know what the situation is in the Army hospitals, but cer- 
tainly any war is going to bring about a great many more people need- 
ing the care of nurses. 
86411—43 4 46 
TRAINING OF NURSES 
Senator Tunnell. As a matter of curiosity, Mrs. Tydings, how many 
hours do those people, the nurses who are attempting to handle 26 beds, 
how many hours do they keep that up ? 
Mrs. Tydings. I am not absolutely positive about that; I am rather 
new at Garfield; I have only worked there 3 weeks; I have worked 
there every day for 3 weeks; I mean 5 days a week. But I think those 
nurses—some of them work longer hours than others—I believe that 
all night long in ward H the other night, with 15 patients, there was 
only one nurse. 
Senator Tunnell. For the whole night? 
Mrs. Tydings. That is what I understand, sir, but 1 am not abso- 
lutely positive about that. I am not an expert on Garfield. 
Senator Tunnell. That is pretty important. It seems to me that 
you are right; that it is absolutely impossible for them to do that work 
and keep it up for a long time. 
Mrs. Tydings. It is going to be even worse, you see, with the addi- 
tional draw of nurses from the hospitals, the civilian hospitals. They 
are all flocking into the Army and Navy Nursing Corps. Naturally, 
I would want to do that, too, if I were a nurse- But the dreadful 
part is that whereas many young girls used to elect nursing as a pro- 
fession, and go and study for a long period of time as student nurses 
before they graduated to the point where they could make money and 
support themselves, nowadays they can get so many jobs, in fact they 
are crying for people, which will pay them immediately what they 
would earn after the long, arduous training of a nurse, so that you 
have that to contend with, too. There are less and less young girls who 
want to go and take this long, difficult nursing course when they can 
get jobs right away that will pay them as much as they would earn 
when they have graduated. 
It is a very difficult situation; it is a part of the manpower problem, 
I suppose. 
The Chairman. Thank you very much for coming, Mrs. Tydings, 
we appreciate it. 
Mrs. Tydings. Thank you. 
The Chairman. We have with us Mrs. Bolton, the author of the 
bill in the House; and, Mrs. Bolton, will you please make a statement 
for our record ? 
STATEMENT OF HON. FRANCES P. BOLTON, REPRESENTATIVE FROM 
THE TWENTY-SECOND DISTRICT OF OHIO, HOUSE OF REPRESEN- 
TATIVES 
Mrs. Bolton. I would be very happy to make a statement, Mr. 
Chairman. 
I am Mrs. Bolton, Congresswoman from the twenty-second district 
of Ohio, and for a great many years a member of the nursing groups of 
the country; and I am interested in nursing, in nursing education, and 
in the general care of the sick. 
It has been my work, until I came to the Congress. 
Senator Tunnell, Where is the twenty-second district? 
Mrs- Bolton. It is Cleveland and the vicinity. 
I know you have had a great deal of very interesting evidence, and 
I do not know that I can contribute anything new to what you have TRAINING OF NURSES 
47 
accumulated, but for so many years I have represented the public on 
the nursing groups that I am sure that perhaps some of my comments 
will be very interesting to you. 
I have also sat for the past year and a half, by invitation, with the 
nursing and other groups of the Health and Medical Committee, and 
those interested in the nursing care of our troops and of our civilian 
population, at most of their meetings. So that I have been very con- 
versant with the problem, and very eager to see it handled more 
efficiently. 
In the First World War there was established the Army School of 
Nursing, which I had the honor to be associated with, and at that time 
the same problem appeared, that of having enough nurses for a long 
war. And the only way that we could at that time see a progressive 
number of students rolling otf the schools, was to have the Army take 
over an educational program, which they did, and it was a magnificent 
piece of work. 
The Army school continued, finally only at the Walter Reed Hos- 
pital, having been all over the country, until about 1931. And when 
it was closed, the framework was continued. It exists still, the frame- 
work of that. 
But when this war came, there was a so much larger responsibility 
on the Army and the Navy for technicians, for chemists, for all 
of those people, that it seemed unwise to the powers there to reopen 
the Army school. Therefore, it became very necessary to do some- 
thing to have the same flow, in greater numbers, than we had been able 
to start during the previous war. 
In 1941 there was an appropriation of $1,200,000, and a deficiency 
appropriation of $600,000, which went to the Public Health Service 
for the subsidy of nursing schools which could increase the number of 
their students; and in 1942—July—there was appropriated $3,500,000. 
We therefore feel that there has been a very fine piece of work done, 
from which a larger work can go forward. 
There were 309 schools of nursing that received aid during this 
time; 12,000 student nurses were helped; 4,000 graduate nurses have 
taken graduate courses in special fields; 4,000 retired nurses have been 
brought back into active service through refresher courses. 
But, you see, the picture is so different this year from what it was 
a year ago. There is such competition for the manpower, and par- 
ticularly for the womanpower of the country, that the girls, as Mrs. 
Tydings has said, are being drawn into other agencies of Government 
and other war work. 
I think you will be interested, if you have not had these facts, to 
know' that normally about 35,000 young w omen go into nursing each 
year, they have a call to nursing. But we need 65,000, and we need 
them so desperately that I do feel very eager to thank this committee 
for its prompt hearing of this bill, because the need is emergent, it 
is not a thing that can be put away or put off for any length of time, 
you have heard, of course, a great many figures, probably, and a great 
many of the reasons why, so I will not go into that, I won’t repeat, 
but I do want to express something which I think has need to be ex- 
pressed, if it has not been said, and that is that my bill—and I feel 
sure that Senator Bailey has the same feeling about it—that this is 
not permanent legislation; that this is established for the emergency 48 
TRAINING OF NURSES 
of the war in order to have a continuing student body, which, of course, 
makes a graduate body. 
We hope, too, that the eventual bill will be so written that it will 
contain a clause which will express this thought, that no student will 
be accepted after the finish of the war. That definitely limits the 
period, but it tapers off so that the girls who have entered perhaps 
the spring or the fall before the end of the war, will not be left high 
and dry without the ability to finish their course. 
The new plan does ask that the students get aid, it provides aid 
for them, it provides a shorter period of training which we feel to be 
imperative; but we also feel this, gentlemen, and if I may speak from 
the experience of a good deal over 30 years of work with nurses, the 
standard of nursing education is a very necessary thing to uphold. 
We are all eager to have the course made as short as possible, but the 
very fact that due to the dearth of nurses we are using subsidiary 
groups, trained in only a small way, supervised by the nurse, it means 
that we must have a supervising nurse particularly well trained, of 
particularly good quality. s 
It is for that reason that some of the restrictions are put in in the 
standards, and so on, of the schools. I want to bring that point out. 
because I think sometimes it is forgotten by those who are not par- 
ticularly versed in hospital procedure and in public health procedure, 
and so on. 
We are hoping that this method of the Student Nurse Reserve, War 
Reserve, will bring a little drama into the picture so that the recruit- 
ment will be facilitated. We have found it difficult because of the 
more dramatic services that are opening for women, and of course 
the higher pay makes it very necessary, the higher pay of industry 
makes it very necessary, that we have some kind of payment going 
to the student while she is in training so that she does not need to be 
a burden to her family and to herself, she doesn’t have to assume the 
debts that girls very often do assume. 
The question of what will be done with nurses after the war, if 
we produce so many, has been brought to me so often I wonder if I 
may take just one moment to that. 
We feel that the nurse will be of such great use—we are developing 
a public-health conscience, we are developing an international con- 
science, we are developing many things that will take up the supply 
of graduate nurses after the war; and many of those nurses who have 
married, who have their homes, will just long to get back to their 
homes. But at the same time, the services are being so developed— 
you take the need that there will be in Veterans’ hospitals, in our 
general hospital situation, and I feel sure that such a situation as 
prevailed after the last war does not need to be feared at this time. 
I want very definitely to have that a part of the contribution I make 
to your knowledge of the subject, 
I want to thank you exceedingly, Senator Thomas, for the privilege 
of coming before this committee. 
Senator Tunnell,. See if I am clear on this: My understanding 
from the testimony, particularly of yesterday when we did go into 
figures somewhat, is that there are more nurses now than prior to the TRAINING OF NURSES 
49 
war, that there are more student nurses now than prior to the war, 
but that there is a greater demand for nurses? 
Mrs. Bolton, That is true, sir. 
Senator Tunnell. And the testimony was, yesterday, as you sug- 
gest, that even though there should be many more nurses than usual 
taken in each year, or student nurses, that the witnesses didn’t believe 
there would be a surplus after the war, and that is your thought ? 
Mrs. Bolton. That is definitely my thought. 
Senator Ball. You spoke, Mrs. Bolton, about the situation that 
developed after the last war. I am not too familiar with that. What 
was it? , 
Mrs. Bolton. Well, we accelerated the numbers of nurses as much 
as it was possible to do, and then when the war was over some of those 
nurses were unable to get positions and work, and they felt very badly 
treated by the public, they felt they had given everything and that 
the least they should have was work when they came home. 
My own feeling has been rather strong in the matter, that it was 
largely a matter of nurse distribution. 1 will cite a fact for you to 
demonstrate that. 
In the very heavy flu epidemic, we took a census of patients and doc- 
tors and nurses; and we found the percentage of patients who couldn’t 
be nursed, and nurses who couldn't get jobs, to be almost the same; 
and it was quite definitely a distribution problem. We now have 
so much more machinery for distribution. 
Senator Ball. Did that situation develop immediately after the 
war, or was it after the depression ? 
Mrs. Bolton. Immediately, and for some years following, right 
after the war. 
Senator Ball. I know that during the depression our hospitals had 
a terrific time, and then they introduced this hospital association, 
which pretty much solved the problem. 
Mrs. Bolton. It is a very, very serious situation for all hospitals, 
because the nurses are patriotic, they have gone from all areas, just 
as fast as they could get into the Army. Naturally that is their first 
desire, although we have tried to keep teaching nurses, and nurses in 
responsible positions in hospitals, to keep their jobs and stay home, 
but that is very hard when the pressure is great at the front. 
Senator Ball. What do you think of the schedule for pay in the 
bill? The WAVES and the WACC’s go in at the regular Army and 
Navy pay. 
Mrs. Bolton. Yes. 
Senator Ball. Do you think this will do the job? 
Mrs. Bolton. We have thought so as we have studied it through 
these long months. I have been in accord with the findings of the 
various committees at each point. We are very reluctant to go into 
too much money. 
The Chairman. Mrs. Bolton, may I ask, did any witnesses appear? 
against the bill in the House ? 
Mrs. Bolton. No, sir. 
The Chairman. Thank you for coming over. 
Mrs. Bolton. Thank you for permitting it. 
The Chairman. Dr. Martha Eliot, please. 50 
TRAINING OF NURSES 
STATEMENT OF DR. MARTHA ELIOT, ASSOCIATE CHIEF OF THE 
CHILDREN’S BUREAU, DEPARTMENT OF LABOR 
The Chairman. Dr. Eliot, we are glad to see you again. 
For the record, will you state your name and your position, please ? 
Dr. Eliot. I am Dr. Martha M. Eliot, Associate Chief of the Chil- 
dren’s Bureau of the Department of Labor. 
The Chairman. Proceed as you wish. 
Dr. Eliot. I am very glad, Senator Thomas, to have an opportunity 
to appear before this committee in support of Senate bill 983, which 
provides for the training of nurses for the armed forces, governmental 
and civilian hospitals, health agencies, and war industries, through 
grants to institutions providing such training. I am particularly 
anxious to emphasize the need for postgraduate courses that prepare 
nurses for work in maternity care and care of children. 
In the work carried on by the State health departments under title V 
of the Social Security Act providing maternity care, child-health 
services, and medical and hospital care for crippled children, it has 
become increasingly apparent during the last 2 years that the shortage 
of nurses, both in the public health field and in hospitals, is having, 
and will have, an increasingly serious effect on the health and well- 
being of mothers and children. J ust as the withdrawal of doctors from 
communities for the armed forces is creating critical situations in many 
communities, so the withdrawal of nurses to the armed forces is cre- 
ating extremely serious situations, especially in the maternity wards 
of hospitals and in the nurseries for newborn infants. The effect on 
the health of babies and children and on mothers during the prenatal 
period, of the withdrawal of public-health nurses may well be reflected 
in increased infant mortality rates. The recent new program provid- 
ing for maternity and infant care of the wives and infants of men 
in the military service is showing the shortage of nurses in hospitals 
to be serious. 
The public-health nurse has become the chief reliance of health de- 
partments and of physicians wTho are concerned with providing health 
services for infants and young children with respect to their job of 
instructing mothers in the care of themselves during pregnancy and 
in the care of their infants during the first year of life. One of the 
outstanding factors bringing about the reduction of infant mortality 
during the past 2 decades has been the increase in the educational 
program carried out by visiting nurses and public-health nurses with 
mothers and families in cities. During the past 7 years, since the 
passage of the Social Security Act, the number of public-health nurses 
in rural areas has increased materially. With this increase, there has 
gone forward with increasing effectiveness the educational program in 
the fields of infant and child care and maternity care. More than 50 
percent of the State and Federal funds spent under the maternal and 
child-health program provided for in title V of the Social Security 
Act is spent for the employment of public-health nurses to serve the 
rural areas of this country. Today some 5,000 nurses are assisting 
mothers in the care of their children through these funds. Many of 
them are giving bedside care to mothers in childbirth when the mother 
must be delivered in her own home. 
There are, however, 789 counties that do not have a single public- 
health nurse to perform this service, and 31 percent of the counties that TRAINING OF NURSES 
51 
claim to have nursing service must share a nurse with another county. 
Relatively few counties are able to employ an adequate number of 
nurses. 
The Chairman. How many counties are there in the United States; 
what does that 789 counties mean? 
Dr. Eliot. There are 3,073 counties in the United States, so that 
approximately one-fourth of the counties do not have a public-health 
nurse. 
Relatively few counties are able to employ an adequate number of 
nurses. This is due both to a shortage of public-health nurses and to a 
shortage of funds for this purpose. 
Before the war there were sufficient public-health nurses employed 
to provide 1 nurse for every 6,562 persons. This ratio falls far short 
of the desirable ratio of 1 nurse to every 2,500 persons. With the with- 
drawal of some 1,800 public-health nurses to the armed forces, this 
ratio has been made wTorse rather than better, since there has been no 
pool of reserve nurses that could be called on by the States to fill their 
places. 
The need to give public-health nursing training to many thousanl 
graduate nurses is apparent. That this cannot be done in a very large 
way, perhaps, until after the war, is apparent, but postgraduate train- 
ing for nurses in the public-health field must be continued even now 
during the war if the health of mothers and children is to be protected. 
Also, what must be done now is to give the necessary hospital training 
to nurses who, when the war is over, will wish to enter the public- 
health field. I am told that the Public Health Service estimates that, 
during the next fiscal year, 65,000 nurses should enter the schools of 
nursing. 
(At this point Chairman Thomas left the room, and Senator Tunnell 
assumed the chair.) 
In order to partially compensate for withdrawal of public-health 
nurses for the armed forces, State and local health departments are 
employing nurses who are graduates of hospitals, but who have had no 
public-health-nursing training. In some cases health departments are 
employing untrained workers to assist public-health nurses with some 
of their duties that such untrained persons can perform acceptably. 
This is clearly a temporary measure until an appropriate number of 
nurses can be given the basic hospital training and the additional prep- 
aration in public-health nursing. To make it possible to use such 
nurses who are not trained in public health and nonprofessional assist- 
ance for the maternal and child-health program, it is essential that an 
increased number of supervisory staff specially trained in maternity 
care and care of children be employed. 
Special postgraduate courses for nurses in maternity care and in 
pediatric nursing should be established at selected medical centers. 
These specially trained supervisory nurses are needed by State health 
departments, and in many local health departments where several staff 
nurses are employed. Such graduate courses could be established un- 
der the provisions of Senate bill 983. They are greatly needed. A 
plan for this postgraduate work in maternity care and nursing care of 
sick children has been worked out by the National Organization of 
Public Health Nursing and the curricula have been outlined. What is 
needed is the funds to develop the courses in appropriate medical 
centers. 52 
TRAINING OF NURSES 
The need for nurses trained in maternity care and care of newborn 
babies is very great. The shortage of nurses in maternity wards of 
hospitals is critical, especially in many cities where the population has 
increased in an unprecedented manner due to the establishment of 
war industries. The tendency for doctors to wish to deliver women 
in hospitals has increased during the past few years in many parts of 
the country. The number of hospital deliveries has increased from 
37 percent in 1937 to 61 percent in 1941. 
In the cities where crowding has followed war industries, the con- 
ditions in homes are such that most women wish to go to hospitals for 
confinement. The result is that maternity wards and private rooms 
of most hospitals are crowded far beyond the limits of safety for either 
mother or child. Some hospitals have been forced to place beds for 
the mothers in corridors. Inspections of nurseries for newborn babies 
have shown that sometimes twice as many babies are being cared for 
as should be in the space provided. Not only is there this overcrowd- 
ing, but the number of nurses provided to caji:e of the women and 
their babies is in many cases less than the number provided in normal 
times. The result is that epidemics of diarrhea among the newborn 
babies are being reported with increasing frequency. 
For instance, a report comes from one large western city that the 
total infant mortality rate increased 22 percent in 1942 over 1941. 
There were in all 150 infant deaths; of these infants, 105 died during 
the first month of life. In this same city in the first 2y2 months of 
1943, there were 135 cases of diarrhea in babies under one year of age, 
with 25 deaths among infants under three months of age. Reports 
from four hospitals in a midwestern city show that of 112 newborn 
infants affected with diarrhea, 47 died. From another small city, of 
18 cases of diarrhea among newborn infants, 11 resulted in death. 
Similar reports of epidemics of diarrhea have reached us from eastern 
cities. 
To ease the crowding in maternity wards and nurseries for newborn 
babies, many maternity hospitals are sending mothers and babies 
home on the second, third, or fourth day after the birth of the baby, 
when physicians know that they should be kept for not less than 10 
days if the mother is to return to normal condition promptly. 
Obviously, many more nurses are needed in these maternity wards if 
present conditions continue. 
An increase in staff nurses is not all that is needed. Supervisors 
specially trained in maternity care and the care of sick children must 
be made available to oversee the work of staff nurses and help in 
educating student nurses. The infant mortality rate among newborn 
infants will undoubtedly rise. There are already some indications 
that the vital statistics for 1942 will show an increase in mortality 
among newborn infants. 
There is a need for nurses trained in the care of sick children. To 
care for sick children in the wards of general hospitals or in children’s 
hospitals requires specially trained, highly skilled nurses. Children 
are more frequently ill than adults, and although fewer children than 
adults are admitted to hospitals, the care needed by those who are 
admitted requires special training of the nurses if lives of children 
are to be saved. As a rule only the sickest children are admitted to 
hospitals. More time of nurses is required to care for them than for 
adults. Graduate nurses highly trained in the care of children are TRAINING OF NURSES 
53 
needed to supervise the work of staff nurses and to participate in the 
education of student nurses in the care of sick infants and children. 
Special training must also be given in the care of children with 
communicable diseases. 
The success of many surgical operations on children, especially 
orthopedic operations or operations for harelip and cleft palate, de- 
pends on the skill of the nurse who takes care of the child during the 
period of convalescence. Special courses, therefore, for the training 
of graduate nurses in the care of sick children, are greatly needed and 
could be started under the provisions of Senate bill 983. 
The need for expansion of training courses for nurse midwives is 
very great. The shortage of doctors to serve civilians resulting from 
the war situation has made it apparent that a much larger number 
of trained-nurse midwives could be effectively used in certain areas to 
supplement the maternity service rendered by physicians. The train- 
ing of nurse midwives and their employment to assist physicians in 
the practice of obstetrics has not been developed in this country to 
the extent that it has abroad. There are but four schools where grad- 
uate nurses may be trained in midwifery in this country, only one 
of which is equipped to train more than a few midwives each year. 
And I would like to say that help is given to three of these through the 
program now administered by the Public Health Service. 
A well-trained nurse midwife working under the direction of a 
physician could supervise the delivery of many normal cases, with the 
assistance of the physician when necessary. She could also work on 
the obstetric service of small hospitals as an assistant to the physicians 
serving the hospital. A trained nurse midwife may also act as super- 
visor of maternity nursing services in State and local health depart- 
ments, Under the provisions of Senate bill 983 additional schools of 
midwifery could be established and the facilities of existing schools 
could be expanded. 
Industrial nursing service for women in industry: The enormous 
increase in the number of married women entering industry as the 
result of the war has increased the responsibility of industrial nurses 
for the supervision of pregnant women while at work. A sound indus- 
trial maternity policy should include nursing consultation service to 
both employers and employees. Many married women wish to continue 
work during pregnancy. In a majority of instances there is no physical 
reason why they should not. For their protection and the protection 
of the employer, a well-trained industrial nurse should be available 
in all factories employing women, to give the necessary service. Spe- 
cial training in relation to supervision of pregnant women at work 
should be a part of a postgraduate course for industrial nurses. 
Public-health nursing service in day-care centers for children of 
working mothers: Public-health nurses are needed in day-care centers 
for children of working mothers to assist with the health supervision of 
the children. Public-health nurses are needed not only to inspect the 
children daily, but also to advise the teacher and other members of 
the staff in health services for young children. 
With the shortage of physicians, nublic-health nurses, if available, 
can carry much of the health service needed for these children. When 
infants under 2 years of age must be cared for during the day when 
their mothers go to work, the need for the assistance of public-health 
nurses is even greater. With the shortage of public-health nurses, 54 
TRAINING OF NURSES 
graduate nurses without public-health training can be employed to 
assist in this program under the general supervision of a public-health 
nurse. The shortage of nurses is making it very difficult for those 
responsible for these day-care centers to provide the necessary health 
services for children. Nurses who work in this program should have 
had special training in nursing care of children. 
In conclusion, it would appear that all available evidence points 
to the very great need for (1) primary training of a large number of 
nurses in hospitals; (2) postgraduate training for hospital and public 
health nurses in maternity care and care of sick children, to equip 
them to be supervisors of staff nurses; (3) postgraduate courses in 
public health nursing for a steadily increasing number of graduate 
nurses in order to provide for the needs of mothers and children in 
the civilian population. 
Senator Tunnell. Did I understand you to say, Doctor, that in 
some particular location there was an increase in the infant mortality 
of 22 percent? 
Dr. Eliot. We had a report from one city that during 1 year there 
was an increase in infant mortality of 22 percent. 
Senator Tunnell. Do you think that that prevails generally ? 
Dr. Eliot. I think it probably does not prevail generally, but it is 
an indication that there may be an increase in many other areas. 
Senator Murray. Was there an epidemic on in that particular 
place ? 
Dr. Eliot, There was an epidemic of diarrhea among the babies 
in the hospitals. 
Senator Tunnell. Do you think that that can be attributed to the 
shortage of nurses? 
Dr. Eliot. I think it can be attributed to two things: The shortage 
of nurses, which means that the care of those new-born babies is de- 
ficient; and the great overcrowding in the hospitals, with the ma- 
ternity patients, and therefore in the nurseries for the new babies. 
Senator Murray. Could bad water or food conditions have any- 
thing to do with it ? 
Dr. Eliot. Probably not either bad water or the food itself, but 
the handling of the food would account for some of it. 
For instance, when twice as many babies have to be taken care of 
as is normal, and wffien the number of nurses is short even for the 
normal number of babies, the amount of time that can be given to 
the care of the baby is obviously much too little; and the care of the 
milk, when babies are artificially fed, may be defective. 
Senator Tunnell. Thank you very much, Doctor. 
Dr. Eliot, Thank you. 
Senator Tunnell. Miss Mary Beard. 
STATEMENT OF MISS MARY BEARD, DIRECTOR OF NURSING 
SERVICE OF THE AMERICAN NATIONAL RED CROSS 
Miss Beard. Mary Beard, director of nursing service of the Ameri- 
can National Red Cross. 
We are very deeply concerned in this matter of enough good nurses, 
because we have accepted the responsibility of providing qualified 
nurses for the military. Recently there has been a directive from the 
Army which really makes us the door-in for all the nurses they need, TRAINING OF NURSES 
55 
and with the Navy the proportionate percentage of nurses coming in 
through the Red Cross is very high. 
We are very sorry to have to say that now, nearly 25 years since 
the last war, we haven’t been able to make those qualifications much 
higher than we did before. We must have nurses of a certain quality. 
In this war, more than in any other, the nurses who have to go must 
be awfully good people, they are going to very strange places, and a 
great variety of them, and on the whole I can say that they are very 
good people. 
The necessity, then, for the Red Cross to find out whether the nurses 
who will go to the armed forces are up to the standards set has given 
us a very intimate understanding of the situation of schools which 
are producing those nurses all over the country. 
My associate, who is head of the recruitment-enrollment service, 
tells me that she believes the most serious fact for me to bring to you 
this morning is that one-third of all the eligibles are now with the 
forces. That leaves a small number for all that has to be done at 
home, in addition to all the further job that has to be carried through 
for the military forces. 
Roughly—and these figures are rough—we will say that there are 
30,000 such nurses with the military forces now, and that by Christ- 
mas, roughly again, we must have 20,000 more. 
We are proud of those nurses; yes, sir. In the midst of a meeting 
where the Pacific area, the Midwest area, the Southern States, and 
the New England States were all together, considering recruitment 
methods, we had word that one of the chief nurses from Africa was 
unexpectedly there; and she came over—she had come here on a 
special mission, and she would go back again as soon as she could— 
she came over again to see us. I was so glad she came right then. 
She represents the very best, she is a girl with excellent training, 
sent over by the Red Cross on the Harvard Red Cross unit to England, 
the communicable disease unit, before we were in it, and going right 
into the Army from there as soon as she could, and very, very close 
to the fighting now. 
I questioned her to find out how good the nursing is, and the one 
thing I could get—I got no criticism, she is a very effective person 
and she is taking the good with the bad, and she is an awfully good 
nurse—the one thing I got was “Not enough, not enough to do the 
very skillful surgical things that are being done to meet the very 
serious medical needs that have to be met.” 
I said, “What about using the male nurses, who are there and who 
are doing something else, perhaps?” 
She said, “Oh, of course we would give anything to have them, 
and they are being used.” I have a letter from one of them now. 
But they are not in the same group with the women nurses. 
Now our anxieties are great, and we have reason to feel exceedingly 
anxious, lest we should not get enough for the armed forces, and I am 
speaking now of them. We are getting down closer and closer to the 
place where they won’t be. We must release, then, the graduate 
nurses who are working in this country, in every legitimate way that 
we can find to release them. 
We are trying—the Red Cross nursing service has a responsibility 
toward the volunteer nurse’s aides, and I was delighted that you had 
that testimony this morning, I thought it was so good—and I would 56 
TRAINING OF NURSES 
like to add to that, that a change has been made in enrolling a short 
time ago which said that those young women had to be nonpaid. 
They do until they have worked off their 150 hours of practice, but 
then, if the hospital wants them terribly and if their children at home 
have to have them and they have got to hire somebody to take care of 
the children, the hospital may employ them, there is nothing in the 
Red Cross prohibition to prevent their being paid. 
The other thing that the Red Cross is doing to try to supplement 
at home the loss of nurses, is the training of all kinds of women, and 
some men, too. I heard of a group of firemen taking it the other 
day. In home nursing there are more than 700,000, this last year, 
women, persons who have taken that home nursing course, and that 
will help. It is very short, but it deals with the principles of the 
prevention of illness and the care of common illness in your own 
family. Those two things can be done. 
I think you were not told by Mrs. Tydings that there were 100,000 
of these volunteer nurse’s aides, and that that number is growing. I 
know you were told by Dr. Eliot that you can’t have a nurse’s aide 
without a nurse; you have got to have somebody for her to help. 
So the reasons for our great concern—and we are for this bill 100 
percent; we think this would help very much—are: Shortage of 
nurses, and there was a shortage during the depression. That situation 
made a shortage of nurses before the war. The contrasting conditions 
in preparing these essential women nurses for the essential national 
job to be done, the contrasting conditions with other women that are 
now being prepared, that is a terrible handicap. You can’t go to your 
family and say, “Give me money to go through this training of many 
months,” with the same amount of assurance that you could if there 
were not other women—in my opinion, less needed than these women 
are—who are having so much better, fairer a start in the thing. So 
there is that competition. 
Then in itself it is a selective group. When I was a girl I knew I 
wanted to be a nurse, but my sisters didn’t want to be nurses; they 
wanted to be something else, perhaps equally useful. But it isn’t all 
girls who want to be nurses. It is different; there is a good deal that 
is disagreeable about it; and your appeal is not to the same people 
exactly. 
There is very much too low a financial standing for nurses, anyway; 
that is another handicap we have to think of. To keep on being a 
nurse you have to want to a good deal. And that is an element in it. 
The requirements of the Red Cross—and I say “the requirements of 
the Red Cross” simply because the armed forces have put that responsi- 
bility on us—are, as I said, hardly any higher than they were before. 
The number of schools which do not meet those very low require- 
ments is shocking. About 1,000 a year—these are the nurses them- 
selves—graduate from schools which cannot meet those low require- 
ments. There are on duty now about 30 percent—I said that before 
when I said one-third—of all who are eligible. There are 97 schools 
with which we have been dealing, which do not meet the require- 
ments—and I think some of the others could be more accurate about 
this—I think there are about 1,300 schools, and 97 of them do not meet 
our requirements. 
There is another statement. Although these schools are approved 
locally by the boards which must approve them, there are 149 others TRAINING OF NURSES 
57 
which are so near the edge of disapproval that we have had to say, 
‘‘We will give you a year; we will let your nurses in now because we 
need them and because we have faith that you will correct those condi- 
tions,” but there are 149 of them. And during this great call for 
nurses, there have been 11 of these schools closed, which is, of course, 
good. 
This bill seems to us to answer ever so many of these questions. The 
one thing about nursing, learning to be a professional nurse right now 
in the world, as contrasted with when I went into it, is that no man 
is going to want to compete with us when he comes back. You can 
make a good case to the girl who really wants to be a nurse today about 
her future life, and if we, the people of the United States, give the 
same help to these women to go into this profession now, because of 
the need for them—and I have said very little about the need for them 
here, both here and there—we are going to have something which ,will 
be very strong to help build up the future that is before us. 
I think almost everything else about this has been said. 
Senator Tunnell. My understanding from you is that we have left 
for civil life about two-thirds of the nurses ? 
Miss Beard. Not for civil life, because we have got to try to get 
them into the armed forces, too. That is all we have left for anything. 
Senator Tunnell. And those two-thirds, if you have them, have to 
look after all of the women, all of the children, and seven-eighths 
of the men ? 
Miss Beard. You are right. 
Senator Tunnell. Of the country ? 
Miss Beard. Yes. 
Senator Tunnell. Thank you very much. 
Miss Beard. Thank you, Senator. 
Senator Tunnell. Dr. Verne K. Harvey. 
STATEMENT OF DR. VERNE K. HARVEY, MEDICAL DIRECTOR OF 
THE UNITED STATES CIVIL SERVICE COMMISSION 
Dr. Harvey. Dr. Yerne K. Harvey, Medical Director of the United 
States Civil Service Commission. 
I am here to let the committee know the responsibility that the Civil 
Service Commission lias in recruiting for the Federal agencies, the 
Federal civilian agencies that use nurses. 
The recruiting problems have become increasingly difficult in the 
past year to the extent where, since January 1, we are approximately 
800 behind the demand for filling vacancies in the various Federal 
agencies for which we do recruit. 
Those Federal agencies include, of course, the Veterans’ Adminis- 
tration, the Public Health Service, the Indian Service, the Panama 
Canal, St. Elizabeths Hospital, some of the District of Columbia 
institutions. 
We believe that this bill will go a long way in helping satisfy the 
needs and furnishing resources and a reservoir from which the recruit- 
ing can be done in the future. 
I have one suggestion in regard to the bill. In section 2 (a), line 12, 
I understand that since this came out, somebody has offered an amend- 
ment, a suggested amendment; and I believe such an amendment would 
strengthen the bill insofar as the Federal Government’s interests are 58 
TRAINING OF NURSE'S 
concerned, and that would be to include some sort of wording, after 
“miltary”—“other Government hospitals, including the Public Health 
Service, Veterans’ Administration.” I believe that that would safe- 
guard the needs of the Federal institutions. 
Senator Tunnell. You don’t have the amendment suggesting that ? 
Dr. Harvey. No. I understand that somebody made a suggestion 
yesterday. 
Senator Tunnell. Senator Murray suggests that you repeat it again, 
so that it can be generally understood. 
Dr. Harvey. That in line 12, section 2(a), following the word “mili- 
tary,” the words “other Government institutions, such as the Public 
Health Service, the Veterans’ Administration, and other Government 
hospitals,” be added. 
I believe that would safeguard the interests of the Federal institu- 
tions. 
Senator Tunnell. Have you anything further? 
Dr. Harvey. That is about all I had to offer. 
I am here in support of it, and if there are anjr questions I could 
answer, I would be very glad to. 
Senator Ellender. You say that the shortage in nurses today is 
only 800? 
Dr. Harvey. No. Since January 1, of the requests that we have had 
from the Federal hospitals, Federal agencies, we have lacked 800 in 
filling them. 
Senator Ellender. What does that indicate? 
Dr. Harvey. That indicates that there is a shortage in the reservoir 
from which we have to recruit, and that reservoir is the nurses through- 
out the country. 
Senator Ellender. Well, does that not in effect reflect a shortage of 
nurses at this moment? 
Dr. Harvey. Yes. 
Senator Ellender. Do you know how many nurses this bill con- 
templates graduating each year, or providing for? 
Dr. Harvey. I don’t recall specifically now. 
Senator Tunnell. I might say, for Senator Ellender’s benefit, yes- 
terday I think they said they are 15,000 short of the hoped-for goal in 
student nurses for this year, that they were hoping for 65,000 and 
they have only 50,000 in sight. 
Senator Ellender. You mean as students? 
Senator Tunnell. As students. I think that is correct. If I am 
wrong, somebody can correct me. 
Miss Goostray. The number asked for this year was 55.000. We 
figured that we got about 49,000. If we have 65,000 students enter, 
presumably we will lose, if our figures continue as they have in the 
past, somewhere between 25 and 30 percent, of students dropping out 
before they graduate, in normal times. 
Senator Hawkes. How many do you feel you need at the present 
time under present conditions; I mean after the 25 percent have 
dropped out? 
Miss Goostray. We believe that we need more than 65,000, but we 
feel that we will only have a chance, probably, of getting 65.000. We 
shall have to supplement the nursing service in some other way. 
Senator Ellender. Is that in addition to the number of nurses that 
are now employed ? TRAINING OF NURSES 
59 
Miss Goostray. That is student nurses, new students coming in this 
next year. On January 1, we had 100,000 students in our schools of 
nursing, and presumably we admitted about 10,000 more in the 
spring classes. 
Senator Ellender. I notice under section 2, subsection (d), there 
is to be paid to students the stipend of $15 for the first 9 months, and 
$20 for the following 15 to 21 months. How does that compare with 
what student nurses are now obtaining from the schools; does any- 
body know? 
Miss Goostray. The figures we have show the median at $8 a month 
for student nurses, but there are not very many schools at the present 
time which pay students an allowance. But we have got to compete 
now with the WAAC’s and WAVES, who are being paid, and I am 
sure some of the testimony that will come out later from the chairman 
of our recruiting committee will bring out some of the facts that w« 
have learned through our clearing bureau. 
Senator Ellender. AVill she testify today? 
Miss Goostray. Yes. 
Senator Tcnnell. Thank you, Dr. Harvey, 
Dr. Harvey, Thank you. 
Senator Tunnell. Miss Katharine Faville. 
STATEMENT OF MISS KATHARINE FAVILLE, CHAIRMAN, COM- 
MITTEE ON RECRUITMENT OF STUDENT NURSES, NATIONAL 
NURSING COUNCIL FOR WAR SERVICE; DIRECTOR OF THE HENRY 
STREET VISITING NURSE SERVICE IN NEW YORK CITY 
Senator Tunnell. Will yon state your name and your work? 
Miss Faville. Katharine Faville. I am the chairman of the na- 
tional committee on recruitment of student nurses. National Nursing 
Council for War Service, and am director of the Henry Street Visiting 
Nurse Service in New York City. 
We have been trying quite a long while as nurses to recruit student 
nurses sufficient so that we wouldn’t have to come and ask for this 
kind of a bill. The thing you want to keep in mind when you listen to 
all this talk about supplying nurses for the various branches is that 
the only way you get to be a graduate nurse is to go into a school of 
nursing as a student nurse. Every graduate nurse has to be gradu- 
ated from a school of nursing. 
So this bill is to try to induce more students to come into schools 
of nursing so they can be available to supply the civilian and the 
military needs. 
In the fall of 1941 the nursing profession set up a national commit- 
tee on recruitment of student nurses, and we have employed trained 
promotion people that we thought were very good and understood 
the nursing profession and our needs, and we have tried as hard as 
we know how to increase the number of nurses coming into our schools, 
and at the same time maintain the right quality, because of course we 
could go out and get numbers but we wouldn’t secure the numbers and 
the quality to take care of our sick people. 
We have used the usual methods; we have had a great deal of help 
from the radio companies. The O. W. I. at the present time is help- 
ing us with a very extensive national radio campaign. We have had 60 
TRAINING OF NURSES 
those campaigns over the past 2 years in the newspapers, the maga- 
zines and all of the usual promotion media have been open to us. 
Then we have gone to the special groups, the high schools and 
colleges, the vocational training people, the special groups like the 
Federation of Women’s Clubs, the various women’s fraternal orders, 
the Moose and all of those, and the Legion Auxiliary, and the national 
sororities. 
We have a recruiting committee in each State that is getting speak- 
ers right out into the rural high schools, and until we had gasoline 
rationing we had had pretty good luck in getting out there into the 
schools, because in the rural areas there isn’t quite as much other 
recruiting for other services going on, and the industries aren’t quite 
as active there. 
We found, after a bit, that what it looked like was this, that the 
profession as a whole can count on somewhere between thirty and 
thirty-five thousand girls coming in a year that are career girls. They 
are the kind like Miss Beard who said she had always wanted to be 
a nurse, and about that many seem to want to be. If we are going to 
get more than that we have to get into this common pool which are 
going to go into some kind of war job because their brothers are over- 
seas. 
Everybody is fishing in that same pond and it is getting a lot 
harder because our bait isn’t very good any more. 
The military services up to the present time have had an admission 
age of 21, so they have been going into the colleges and into the more 
mature groups like the girl in business now, and we have had terrible 
competition from them there. 
Now they are talking about lowering the age limit, and then it is 
going to be everybody get what they can, because that will take them 
down into the high schools. We have been the one war service that 
did admit girls out of high school, and so, from 18 to 21 has been 
where the bulk of our people have come from. 
Industry, however, has gone in and is perfectly willing to take those 
youngsters. Another group we used to draw from was the college 
girls with a good science preparation, and now every industry in 
the country is trying to get them and they are getting them because 
they are coming in ajnd paying them an awful lot while they are 
learning. 
We are the only women’s war job at the present time where she 
has to pay her way while she is training, and that is certainly a handi- 
cap when you go out to recruit. 
Now the parents write in and say to us, “You say that this is a war 
need and the Government needs nurses. Well, the Government is 
willing to pay for absolutely everything else it needs, what is wrong 
with you that it won’t pay for the nurses’ training?” 
And we are having at the present time very much poorer luck with 
our radio campaign than we had 6 months ago. 
The girls that are coming in are a younger group and a great many 
more of them are asking in terms of Federal aid. I was talking yes- 
terday to the director of one of our large schools of nursing in the 
country, a very conservative school that has been connected with 
a church, so they have always had all the students they wanted, of a 
very nice type, and they have never had to worry about recruiting. 61 
rRAINiESTG OF KUR£E 
She lias never had scholarships and has never been able to under- 
stand why we needed scholarships. 
Yesterday she came to me and said, “I am trying to get a class of 
25 for the summer, and I can’t get them, and the horrible part of it is 
that every application on my desk needs scholarship aid.” She said, 
“I have never built up scholarship funds for this school and I can’t 
even get 25 for the summer.” 
She wanted us to see what we could do to help her. 
In addition to the money that the Federal Government did give 
through the United States Public Health Service the last couple of 
years, we have tried to go out and get some scholarship funds on our 
own that would have no strings tied to them, and we have been able 
to get something over $100,000, which helps maybe three or four hun- 
dred girls. We got that from the Auxiliary of the Legion and from 
the Federation of Women’s Clubs. I guess it was about $150,000 be- 
cause the federation raised $100,000 itself. But that doesn’t begin 
to touch it 
Senator Ellender (interposing). What is the total amount you 
are now receiving? 
Miss Favelle. We have gotten about $100,000 from the Federation of 
Women’s Clubs and about $50,000 from the Auxiliary of the American 
Legion. 
Senator Ellenuer. You don’t get anything from the Government, 
do you ? 
Miss Faville. Not us directly, but Dr. Pari an’s fund does do that, 
but we have had this for other girls, for their personal allowances. 
The Federal money up to date has not paid for their personal allow- 
ances and every girl needs hairnets and stockings and shoes and what- 
not—she has to have a little allowance. The only way we have been 
able to supply that, because the Government doesn’t do that, was to go 
out and get these independent funds. 
Now the girls are saying, “My family is saying that it doesn’t just 
make sense, I can earn my way in something else and who is to tell me 
that I am needed more as a nurse or in one of those other war jobs?” 
We frankly don't know any other way to fish in the pond except 
to use the same bait, and you haven’t given us that bait; you have 
given it to every other women’s group but us. 
Senator Ellender. If this is already in the record, Mr. Chairman, 
I am sorry, because I haven’t been able to be at the meetings, and if I 
ask questions that have been answered before, please tell me. 
Have you any idea how much the Government would be called upon 
to put up for each student under this bill? 
Miss Faville. I think Miss Mclvor knows the details better than I. 
It is something like $1,000,1 believe. 
Senator Ellender. In other words, how much would it cost the 
Government for each student to enroll in a designated school of 
nursing ? 
Miss McIvgr. The maximum, as we are contemplating it at the 
present time, is about $1,250 for the full 3 years, for the full period 
of training. 
Senator Tunnell. Mrs. Bolton is here. I wonder if she could give 
us any ideas on that. 
£6 HI—43 5 62 
TRAINING OF NURSES 
Mrs. Bolton. I haven’t my papers with me, Senator, but I am quite 
sure that Miss Mclvor has given you accurate figures on that. 
Senator Ellender. That would be about $400 a year? 
Mrs. Bolton. Yes; roughly. 
Senator Ellender. And do you think that this will act as an in- 
centive to increase it to such an extent that you can meet the present 
demands ? 
Mrs. Bolton. We are certainly hoping so, Senator, 
Senator Ellender. To what extent has the enrollment of student 
nurses increased or decreased since the war, in contrast to normal 
times ? 
Mrs. Bolton. I think there are, under normal conditions, about 
thirty-four or thirty-five thousand girls throughout the country who 
have a “call” for nursing; they go into nursing. 
Senator Ellender. Per year? 
Mrs, Bolton. Yes. 
Senator Ellender. Well, now, has the war created an incentive? 
Mrs. Bolton. Yes; we have been able to get, I think it was 49,000 
that actually came into nursing last year, but we need the 65,000. 
Senator Ellender. To what extent does, let us say, a hospital that 
is recognized—and we have several in Louisiana, such as the Charity 
Hospital at New Orleans—to what extent does the hospital aid the 
students, do you know ? 
Mrs. Bolton. I couldn’t give you those figures. 
Senator Ellender. In other words, don’t they furnish everything 
except the tuition that you are seeking? 
Mrs. Bolton. You mean the hospital itself? 
Senator Ellender. Yes. 
Mrs. Bolton. That varies in different hospitals. We have been 
working as a profession endeavoring to have the girl pay for her own 
training, but that doesn’t work in wartimes. 
Senator Ellender. Well, do you have any hospitals, such as the 
Charity Hospital in New Orleans, or in any other section of the coun- 
try, which utilizes the services of these young women as they enter, and 
forces them to pay ? 
Mrs. Bolton. It isn't just that, Senator, the forcing them to pay. 
They are paying for their training and part of their training is their 
bedside care of the patients, and that in turn is of service to the 
hospital. 
Senator Ellender. What I had in mind is—do they put up any 
money ? 
Mrs. Bolton. In many hospitals, yes. 
Senator Ellender. They do ? 
Mrs. Bolton. Oh, yes; just as a medical student pays for his train- 
ing, a nurse has been paying for hers. 
Senator Ellender. Are there many schools in the country which 
teach nursing as a separate school; that is, not in conjunction with a 
hospital ? 
Mrs. Bolton. It has to be in conjunction with a hospital because you 
have to have the clinical field. 
Senator Hawkes. When you talk about $1,200 as the cost to the Gov- 
ernment for this course, does that include this $15 or $20 a month? 
Miss Faville. Yes. TRAINING OF NURSES 
63 
Senator Hawkes. It includes that in addition to the living and so 
forth ? 
Miss Faville. Yes. 
Senator Hawkes. Thank you very much. 
Senator Tunnell. Thank you, Miss Faville. 
Miss Faville. Thank you for the opportunity of letting me appear 
before you. 
Senator Tunnell. Mr. Eugene Butler. 
STATEMENT OF EUGENE BUTLER, APPEARING ON BEHALF OF THE 
REV. ALPHONSE M. SCHWITALLA, PRESIDENT OF THE CATHOLIC 
HOSPITAL ASSOCIATION OF THE UNITED STATES AND CANADA, 
ST. LOUIS, MO. 
Mr, Butler. I am Eugene J. Butler, and I am here on behalf of the 
Rev, Alphonse M. Schwitalla, the president of the Catholic Hospital 
Association. 
Senator Murray. Let me ask you. is Father Schwitalla going to ap- 
pear at these hearings ? 
Mr. Butler. No; Father Schwitalla asked me to express his regrets. 
He is in Chicago today at a meeting of the joint committee on hospitals, 
and he sent this statement to me, and asked if I would present it to the 
committee in his place. So if the committee wishes, I shall read the 
statement, or I shall be happy to leave it here and have it incorporated 
in the record. 
Senator Tunnell. I think you had better read it. 
Mr. Butler. Yes, sir. [Reading:] 
The Catholic Hospital Association of the United States and Canada wishes 
hereby to record its endorsement of Senate hill 983 to provide for the training of 
nurses for the armed forces, governmental and civilian hospitals, health agencies, 
and war industries through grants to institutions providing such training, and for 
other purposes. The association respectfully requests the approval of this bill by 
the Senate Committee on Education and Labor and its subsequent passage by the 
Senate. 
(At this point Chairman Thomas returned to the room and assumed 
the Chair.) 
Mr. Butler (continues reading) : 
The Catholic Hospital Association of the United States and Canada is an asso- 
ciation of Catholic hospitals, 710 in number in the United States, and of the 
schools of nursing, 391 in number in the United States. This association, repre- 
senting as it does in its organization and administration the viewpoints of both 
the hospital administrator and of school executives and faculties, considers itself 
particularly well qualified to express an opinion upon this bill, since the national 
need which this bill has been planned to meet, and the method contemplated in 
the bill for meeting that need, are of particular concern to both the hospital 
administrator and the nurse educator. The bill, not in its present form but in its 
principles and provisions, has been studied, first of all, by the council on nursing 
education of this association and by two of its committees, the committee of 
examiners and the committee on institutional counseling, as well as by the execu- 
tive board of the association. In each of these committees and in the board 
there is representation from the various sections of the country, as well as from 
the various sisterhoods conducting Catholic hospitals and schools of nursing in 
this country. 
The various committees and the board have taken the position that, as is said 
in one of their resolutions, “The winning of the war is our first concern, and 
that therefore the partial sacrifice of the individual’s professional development 
is a justifiable sacrifice in the face of the national need.” The various com- 64 
TRAILING OF NURSES 
mittees and the board are of the opinion that the acceleration of the educational 
processes contemplated in the bill, as well as the partial segregation of the 
periods of study and practice, would be difficult to justify under conditions exist- 
ing in peacetime when educational and training processes can be pursued with 
leisure and with full attention to the demands of the soundest achievable educa- 
tional policies. Under conditions existing today, however, it is recognized that 
the need for nurses available for national service, either with our military or 
civilian people, is so great that the profession of nursing must be ready to make 
a temporary sacrifice in order that our national welfare may be safeguarded. 
The committees and the board of the Catholic Hospital have, therefore, given 
con iderable attention and study to the possibility of maintaining satisfactory 
professional standards, even though the time-honored educational procedures 
must be set aside for the time being. These committees and the board are con- 
vinced that with careful planning and with increased emphasis upon student 
personnel practice, many of the threatened disadvantages which would otherwise 
result from premature professional practice can be successfully forestalled. In 
the official opinion of the Catholic Hospital Association of the United States and 
Canada, Senate bill 9S3 effectively meets many of the difficulties which the 
nursing groups have encountered in increasing their enrollment and in intensi- 
fying their recruitment procedures. It has long been recognized that competi- 
tion and rivalry between the nursing professions and the branches of the 
military forces open to Women have done much to impede the enrollment of young 
women in the schools of nursing. The establishment of a Victory Corps with 
its quasi-military organization, with its uniforms, insignia, rank, and remunera- 
tion, will go far to reduce the effectiveness of that rivalry in impeding recruitment 
for nursng education. It is hoped, moreover, that the judicious and wise utiliza- 
tion of techniques necessarily connected with the Victory Nurse Corps, might 
result in an increase in professional morale which should also prove greatly 
effective in keeping at a minimum the disadvantages which might otherwise 
result from a too hasty acceleration of the educative processes. 
Finally, if the project of increasing the enrollment of our schools of nursing 
were placed upon the hospitals without the aid of the Federal Government, it is 
readily conceivable that an intolerable burden might result for the hospitals 
which, for the most part, have borne the burden of the financial costs of nursing 
education. With the aid of the funds contemplated in Senate bill 983, the hos- 
pitals of the country should be able to assume the larger educational responsi- 
bilities implied in meeting the national needs. It is true that many of the hos- 
pitals will still feel a great burden to meet the obligation of paying the $30 a 
month to the Victory nurse cadet in her third year. It may be confidently hoped, 
however, that both as a contribution to the national war effort and as a partial 
compensation to the Government for payments made to the Victory student nurses 
of junior and of senior grades the hospitals will probably make every effort to 
meet this obligation. 
In view of the foregoing and on behalf of the exQcutive board of the Catholic 
Hospital Association of the United States and Canada, I wish herewith to present 
the resolution which has been formulated by the association's executive committee 
as expressing the mind of the association ; 
“The executive committee of the Catholic Hospital Association of the United 
States and Canada, speaking for the < xecutive board, wishes hereby heartily 
to endorse Senate bTl 983 and to urge upon 11m Committee on Education and 
Labor the favorable recommendation of this legislation to the Senate. In the 
opinion of the executive committee, this bill makes provision for effectively meet- 
ing many of the nursing problems, especially the nursing shortage in the Nation, 
and should go far towards enab'ing the schools of nursing to relieve the critical 
need for nurses in both the military and civil population. The executive board 
urges all the Catholic hospitals to which schools of nursing are attached to accept 
the responsibilities implied in an endorsement of this bill.” 
Furthermore, I wish here to present as relevant to the present discussion the 
resolution adopted by the council on nursing education and its committee on 
February 7, with reference to the Victory Nurse Corps. The resolution reads as 
follows: 
“Whereas the planning of the Victory Student Nurse Corps represents an 
achievement of the combined wisdom of official nurse groups in response to the 
national need of nurses for both military and civil purposes in the present war 
emergency; and TRAINING OF NURSES 
65 
“Whereas this plan in the mind of all those responsible for it gives well-founded 
hope of effectively achieving the purposes for which it was planned; and 
“Whereas the Council on Nursing Education of the Catholic Hospital Associa- 
tion with its committee of examiners and its committee on institutional counseling 
has carefully studied the plan and has convinced itself of the plan’s adaptability 
to the promoting of national purposes in our Catholic schools of nursing: There- 
fore be it unanimously 
“Resolved hy the Council on Nursing Education of the Catholic Hospital Associ- 
ation and hy the committee of examiners and the committee on institutional 
counseling. as follows: 
“1. That the plan as now proposed for the effective organization of the Victory 
Student Nurse Corps be endorsed in its principles. 
“2. That the same plan he endorsed as a practical program in the emergency 
even though it is recognized that it may carry with it certain educational and 
professional disadvantages to our schools of nursing. 
“3. That the difficulties which may he encountered in introducing the program 
are to be regarded as relatively unimportant in the face of the emergency which 
the program was designed to meet. 
“4. That with reference to the two plans; that is, the basic professional cur- 
riculum extending through 24 or through 30 months, this council and its commit- 
tees recognize that the 24-month plan will favor the recruitment of nurses, will 
offer more effective and speedy help in the national emergency to both the military 
and the civilian interests, and will prove more immediately effective in accelerat- 
ing the progress of the student nurse toward professional usefulness, while the 
30-month plan represents a minimal concession to the emergency as compared 
with present standards, guarantees a safer educational procedure and will de- 
mand fewer compromises with existing legislation and the policies of State boards. 
“5. That while it encourages the Catholic schools of nursing to adopt one or 
the other of these plans as each school may deem proper and practical and while 
it recognizes that the conflict between educational considerations and the Nation’s 
need are probably to some extent inevitable, nevertheless it recommends to the 
Catholic schools of nursing the adoption of the 24-month program to increase the 
contribution of nursing education and nursing to the war effort. 
“6. That this recommendation is hereby made with the approval of the principle 
which permeates American life today, that the winning of the war is our first 
concern, and that, therefore, the partial sacrifice of the individual’s professional 
development is a justifiable sacrifice in the face of the national need. 
“7. That this council and its committees have assured themselves that effective 
educational influences can be introduced into the third, that is, the apprenticeship 
year, of the student’s basic professional curriculum, such as seminars, confer- 
ences, journal clubs, clinical conferences, and similar educational helps, and that 
thus many of the disadvantages otherwise resulting from premature professional 
practice can he successfully forestalled. 
8. That the schools should he urged to make the necessary curricular adjust- 
ments for the 24 months’ program only after the most careful consideration and 
with the advice of competent consultors, thus to achieve to the fullest practical 
extent the purposes for which the program was instituted. 
9. That the Catholic schools of nursing are insistently urged to remit in no 
way in the accelerated program their emphasis upon their teaching of religion 
and their religious practice; rather to strengthen their teaching of religion and 
to intensify their religious practice at this time when sound and supernatural 
attitudes toward life are so indispensable in meeting the needs of the world and 
in protecting the ideals of a liberty-loving civilization. 
10. That finally, the differences in educational effectiveness between the two 
plans, great as they are, do not seem to justify deferral of service to the country 
for a period of 6 months on the part of approximately 27,000 nurses annually. 
That concludes my testimony. 
Now Father Schwitalla also sent me a pamphlet, which is a reprint 
from the March 1943 issue of Hospital Progress. The pamphlet is 
entitled “Wartime Problems of the Catholic Schools of Nursing,” and 
I think it contains some very valuable statistical data which the com- 
mittee might want. I do not know whether you want to include it in 
the record. 66 
TRAINING OF NURSES 
The Charman. We would like to have it in the record. It will be 
put in the record. 
(The pamphlet referred to is as follows:) 
Wartime Problems of the Catholic Schools of Nursing 
A meeting of the Council on Nursing Education of the United States, as well 
as of the committee of examiners and the commitee on institutional counseling, 
was held at the St. Louis University School of Medicine on Saturday and Sun- 
day, February 6 and 7. All the members of the council and the various commit- 
tees, except one, were present. 
(Alphonse M. Sehwitalla, S. J.) 
A. THE EVALUATION PROGRAM 
The first order of business was the discussion of the present status of the 
evaluation program. Due to the prolonged illness of the director and the many 
difficulties arising from war conditions, progress in the evaluation program has 
been somewhat delayed. Nevertheless, in certain areas noteworthy advances 
have taken place. As a result of the discussions, it was determined as follows: 
1. That the council continue its visiting program, particularly of those schools 
which for one reason or another were omitted from the first list published in 
January 1942. 
2. That the new schools which have applied for evaluation should be visited 
as soon as possible. 
3. That the counseling service to certain schools be undertaken immediately. 
In accordance with these decisions, the council developed its plans for visits 
to approximately 30 schools which are to be visited by the five Sister examiners 
during the months of February and March. Plans were also made for con- 
tacting the schools which had requested the services of the committee on 
institutional counseling. 
It was pointed out that the estimated number of registered nurses available by 
next October will total approximately 273,907 nurses. Estimating the number 
needed for military service to be about 60,000, there will be left for civilian needs 
a total of 213,907 nurses. The civilian needs are considerably in excess of this 
number. The general hospitals in the country, with a daily average of 500,000 
patients and a nursing need of 1 nurse for 2.4 patients—that is, 7.2 patients per 
nurse at any one time—need 208,000 nurses. The mental hospitals, with a daily 
average census of 603,179 patients, will need 8,000 nurses, using the present nursing 
service standards. Tuberculosis hospitals, with a daily average of 70,577 patients, 
will need 7,000 nurses. Thirty thousand nurses are on private duty, 25,000 are 
engaged in public health work, and 12,000 in industrial nursing. The total civilian 
need is thus estimated to be 290,000, leaving a nursing personnel deficit of needed 
but nonavailable nurses of 76,000. 
B. THE NEED FOB INCREASING THE NUMBER OF NURSES 
To meet this need there must be found 114,000 student nurses, assuming that 
3 student nurses are approximately equal in their utilization to 2 graduate nurses. 
It is estimated that in November 1942 there were 110,000 student nurses in our 
schools. Allowing for the usual defections of 30 percent each year, that is, approxi- 
mately 33,000, and for the number who will graduate before next October, approxi- 
mately 26,000, there will be in the schools of nursing before the fall classes are 
admitted about 51.000 student nurses. Since 114,000 student nurses are required 
to meet the civilian needs, as pointed out above, and since there will be 51.000 in 
the schools, there is a student nurse deficit of 63.000 student nurses. Basing the 
estimate upon previous experience, a total of 84,000 student nurses must be admit- 
ted in order to meet this civilian student nurse deficit. The gravity of the situation 
is apparent to anyone who gives serious study to these statistics. The council on 
nursing education, after extensive discussion, adopted the following resolution: 
“increase in the number of student nurses 
“Whereas the council on nursing education and the committee of examiners and 
the committee on institutional counseling of the Catholic Hospital Association are 
deeply impressed with the recently compiled statistics concerning the national 67 
TRAINING OF NURSES 
need of an increase in the number of student nurses, it is hereby unanimously 
resolved as follows: 
“1. That all the Catholic schools of nursing are hereby strongly urged to 
intensify their recruitment activities. To this end the council and these com- 
mittees suggest; 
“(u) The development of close relationships between the Catholic schools of 
nursing and the high schools in each locality ; 
“(ft) The scheduling of recruitment addresses to the students of both the 
Catholic and nou-Catholic high schools of each locality by representatives of the 
Catholic schools of nursing; 
“(c) The development of vocational conferences in which a representative of 
the school of nursing will interview and encourage prospective applicants for 
admission to the school of nursing; 
“(d) The participation by the authorities of the school of nursing in Career 
Week, Vocation Week, and similar activities of their local high schools, and the 
further development of entertainments and receptions to high-school seniors by 
the schools of nursing, invitations to high-school seniors to attending capping 
exercises being regarded as one of the more effective procedures ; 
“(e) The distribution of vocational literature, the offering of movies, and 
frequent contacts between high-school seniors with the Sister officials of the school 
of nursing, as well as with graduate and student lay nurses. 
“2. That the temptation to weaken or relent in the processes of selecting students 
in order to increase enrollment may defeat its own purpose as such procedures 
may result in increasing student mortality. 
“3. That the admission of more than one class a year by each school should be 
encouraged for the period of the emergency, provided that too great -a disparity 
in numbers be not allowed to develop between the various classes of each session, 
and provided further that the school assure itself of its competence to offer as 
sound an educational program to subsequent classes as it offers to the first class 
of each session. 
“4. That the development of relationships for strengthening the educational 
program of the school of nursing between the Catholic schools of nursing and 
Catholic women’s colleges be fostered and greatly encouraged. 
“5. That for the duration of the war the admission of married applicants and 
the retention in the school of students who marry during their attendance at 
school be considered on an individual basis without prejudice, however, to the 
applicant or the student by reason of her marital status. 
“6. That the admission practices of schools of nursing and the regulations 
governing admission to schools of nursing of the State boards be harmonized with 
the present emergency admission practice of our colleges, particularly with refer- 
ence to the level of high-school achievement from which the student may be 
admitted to the school of nursing, thus lowering to a prudent extent the age of 
admission. 
“7. That this council and its committees view with particular concern as affect- 
ing enrollments in our schools of nursing the gap between the high-school program 
and the admission to the school of nursing. 
“8. That this council and its committees recommend to the schools the exercise 
of the utmost caution in the readmission to the school of previously discharged 
students, a policy which in general is opposed to sound educational procedure, 
but which in particular cases may still salvage a desirable nurse and retain her 
services in the profession of nursing.” 
This resolution gives evidence of the serious attitude which the council on 
nursing education has adopted toward the problem of student need. All our 
Catholic schools of nursing are urgently and insistently requested by the council 
to put into practice as many of the recommendations contained in this resolution 
as possible. It is recognized that several recommendations are here made which 
must be looked upon as definite responses to the emergency. If it is borne in 
mind, however, that our first concern at the present time cannot but be to aid 
to the fullest extent in our power in the war effort, these concessions in educa- 
tional procedure are amply justified. 
The recommendations concerning recruitment procedures will probably appeal 
to all nursing-school administrators and will be relatively easy of execution. The 
great interest which has been created in the problem of the supply of nurses in 
our press, in public utterances, and in school activities will make it relatively 
a simple matter to intensify the promotional and recruiting activities of our 
Catholic schools. Our Sister administrators might even suggest that from time 
to time as occasion may offer, the members of the reverend clergy be asked to 68 
TRAINING OF NURSES 
interest themselves actively in the matter of calling the attention of our high- 
school graduates to the needs of the nursing profession and to the great oppor- 
tunity which nursing offers of giving valuable aid to humanity in this hour of 
the world’s great need. 
Considerable discussion was centered in the problem of maintaining professional 
standards under the pressures of the day. The temptation is great to relent in 
selection procedures when the need for increasing enrollments is so urgent. Per- 
haps it is precisely on this point that the wisdom of the school administrator will 
be chiefly taxed. It was pointed out that the emphasis in recruitment procedures 
should be primarily upon increasing the number of applicants than upon increas- 
ing the number of registrants in the school. If the number of registrants is in- 
creased at the sacrifice of excellence in the applicant, we may be sacrificing not 
only professional standards but we may do actual harm in the deterioration in the 
health care which may result. 
Particular emphasis was laid by the council on the closer relationships be- 
tween Catholic schools of nursing and the high schools in each locality. If, 
moreover, an even better understanding can be secured between the Catholic 
high schools and the Catholic schools of nursing conducted by the same sister- 
hoods, it would seem that much might be done to increase enrollment. 
The council gave considerable time to a review of the question of the admis- 
sion of married applicants and the retention in the school of students who marry 
during their school years. The implications in making a recommendation were 
fully realized. It was thought best to recommend to our Catholic schools that 
each instance should be dealt with on an individual basis but that the marital 
status of the student nurse, as such, should not he regarded as prejudicial to 
the admission to or retention in the school of the student nurse. 
Another problem which engaged the council for a considerable period of time was 
the procedures which should be followed by the schools of nursing to obviate the 
loss of interest of possible applicants during the period between the ending of 
the high school and the opening date of the school of nursing. While no single 
recommendation was made with reference to this period, it is still recommended 
that each school of nursing should familiarize itself with the graduation dates 
or closing dates of the high schools in its locality. In some instances the time 
gap will be found to he very short, so that virtually no problem exists. In other 
instances the time gap may be a piolonged one. even 8 to 6 months. In those 
cases, it will he difficult to sustain the interest of a potential applicant for the 
school unless the school of nursing devise a special program. It was suggested, 
for example, that the use of accepted applicants in the nurse-aide program might 
meet the need in many localities. In other places, the accepted applicant for the 
school of nursing might he given temporary employment as a clerk, for example, 
on a part-time or even a full-time salary. The important thing obviously is to 
keep the accepted applicant interested in the profession of nursing and in the 
school that has accepted her. 
While the council fully realized the importance of securing for the profession 
as many well-qualified nurses as possible, it nevertheless, adopted a cautious 
attitude toward the readmission to the school of previously discharged students. 
Needless to say. if the discharge took place for technical or formal reasons, there 
can be no serious objection to the readmission of a previously discharged student, 
especially if ample guarantees are given by her concerning the sincerity of her 
intentions. To admit discharged students, however, whose discharge was based 
upon more serious reasons, is a procedure which the school should employ only 
with the greatest possible caution. 
C. THE VICTORY STUDENT NURSE CORPS 
The second question to which the council on nursing education and its com- 
mittees devoted the larger part of their attention during their sessions was the 
Victory Student Nurse Corps. The basis of the discussion was the following 
statement released on December 28, 1942, as a suggested plan for a Student Nurse 
Reserve to be administered by the United States Public Health Service. 
“Purpose of the plan. 
“1. To aid in the recruitment of well-qualified women for schools of nursing in 
order to meet the increasing needs of the Army and Navy for graduate nurses. 
The competition for womanpower is becoming very acute. War industries and 
the women’s auxiliary military services are attracting large numbers of the women 
needed in nursing. This plan will provide financial assistance to the student TRAINING OF NURSES 
69 
throughout her training period and in addition will give recognition to the student 
nurse as one who has been summoned by the Government for essential wartime 
service. 
“2. To provide a pool of “cadet” nurses (third-year students) wrho may be em- 
ployed by governmental and civilian hospitals to replace the large number of paid 
general staff nurses who have gone or wall go to w7ar. Acute shortages in the 
number of graduate nurses available for general staff nursing are evident in all 
of the coastal States and in many inland industrial centers. In the event of 
enemy action or a severe epidemic the civilian nurse shortage will be increasingly 
critical. 
“3. To enable the third-year students (who will be known as cadet nurses) 
to vacate the dormitory facilities in order to meet the housing shortage which is 
one of the most serious handicaps to a further expansion of our schools of 
nursing. 
“4. To increase clinical facilities for student practice by assigning a propor- 
tion of the third-year students (cadet nurses) to governmental or civilian institu- 
tions not now operating schools of nursing. 
“Requirements for participation. 
“All schools of nursing which meet the requirements outlined in the Regulations 
of the Surgeon General. Training for Nurses (national defense), may participate 
in the plan. Any student who enrolled in one of these schools after January 1, 
1941, may elect to become a member of the Victory Nui'se Corps. It is conceivable 
that every student entering a school next year might elect to join the corps, hut 
enrollment in the corps should be voluntary and any school might have a per- 
centage of its students who preferred to pay their own way. 
“Each student applicant must agree to serve wherever needed throughout the 
year. As evidence that she is in training for war service with the military forces, 
the war industries, civilian hospitals, and agencies in wartime, she shall he au- 
thorized to wear an appropriate insigne on the left sleeve during her period of 
training. The arm band will bear the insigne of the corps and will designate 
her class rank. 
“The schools wishing to participate in this plan must make some adjustment in 
their curricula which is in accord with the suggestions for acceleration made by 
the subcommittee on nursing of the health and medical committee, Office of De- 
fense Health and Welfare Services, and the National Nursing Council for War 
Service. These are: 
“1. A curriculum which provides that all required courses shall he completed 
in 24 months and the entire next year shall he devoted to supervised experience in 
the home hospital or in an affiliating institution. 
“2. A curriculum in which all required courses shall he completed in 30 months. 
The next 6 months will consist of supervised clinical experience during which 
time the student will be paid a salary by the institution utilizing be>- services. 
“Schools offering either curriculum may participate in the Victory Nurse Corps 
plan. Schools will have authority for selection, promotion, and graduation of 
students according to their own policies. 
“Description of plan for the 24-month curriculum. 
“1. During the first year of training students enrolled in the Victory Nurse 
Corps will receive complete maintenance (including laundry), scholarships (in- 
cluding tuition and other fees), and $20 per month for personal expenses. Daring 
this period the students shall he known as members of the Victory Nurse Corps— 
Junior Grage (VNC-j. g.) and shall wear the appropriate insigne on the left 
sleeve. 
“2. During the second year the students will receive complete maintenance, 
tuition, and a monthly stipend of $20 for personal expenses. During this period 
they shall wear the insignia of the Victory Nurse Corps—Senior Grade (VNC— 
s. g.) 
“3. Upon competition of the second year the students (cadet nurses) will be 
employed by the home hospital, an affiliated civilian hospital, or a military 
hospital within the confines of the United States, or other Federal hospital. These 
hospitals must provide supervised practice acceptable to the school of nursing 
and the State board of nurse examiners as a satisfactory educational experience. 
“During this year these cadet nurses will be paid at three-quarters of the 
prevailing rate for general staff nurses by the institutions utilizing their services. 
The insignia for this year will be VNC-CN (Victory Nurse Corps-Cadet Nurse). 70 
TRAINING OF NURSES 
“4. Under this plan, the participating schools may expect from the Public 
Health Service: 
“(a) Funds for scholarships including tuition and other fees for any or all 
members of the Victory Nurse Corps. Schools which do not charge tuition 
or whose tuition is inadequate to cover instructional costs should adjust these 
charges prior to applying for Federal funds. 
“(ft) Reimbursement for maintenance of all members of the corps for the first 
12 months. In the past reimbursement for maintenance has been limited to 6 
months, but in an accelerated program of this type, it is recognized that the 
student service to the hospital will be extremely limited while the expenses 
connected with this accelerated program will be greater. 
“(c) Stipends for all members of the corps for the first 2 years. (Salaries 
for the cadet nurses will be paid by the institutions or agencies utilizing their 
services.) 
“Description of plan for the 30-month curriculum. 
“1. During the first year students will receive complete maintenance (includ- 
ing laundry), scholarships (including tuition and other fees), and $20 per month 
for personal expenses. During this period the students shall be known as 
members of the Victory Nurse Corps—Junior Grade (VNC—j. g.) and shall wear 
the appropriate insignia on the left sleeve. 
“2. During the second year and during the first 6 months of the third year 
the students will receive complete maintenance, tuition, and a monthly stipend 
of $20 for personal expenses. During this entire 18-month period the students 
shall be known as members of the Victory Nurse Corps—Senior Grade (VNC— 
s. g.) and they shall wear the appropriate insignia. 
“3. Upon completion of the 30-month curriculum, the students (cadet nurses) 
will be employed by the home hospital, and affiliated civilian hospital, a military 
hospital within the confines of the United States, or other Federal hospital. 
These hospitals must provide supervised practice acceptable to the school of nurs- 
ing and the State board of nurse examiners as a satisfactory educational experi- 
ence. During this 6 months’ period, the cadet nurses will be paid at three- 
quarters of the prevailing rate for general staff nurses by the institutions utiliz- 
ing their services. The insignia for this period will be VNC-CN (Victory 
Nurse Corps—Cadet Nurse). 
“4. Under this plan the schools of nursing may expect from the Public Health 
Service: 
“(a) Funds for scholarships including tuition and other fees for any or all 
members of the Victory Nurse Corps. Schools which do not charge tuition 
or whose tuition is inadequate to cover instructional costs should adjust these 
charges prior to applying for Federal funds. 
“(b) Reimbursement for the maintenance of all members of the corps for 
the first G months. 
“(c) Stipends for all members of the corps for the first 30 months (salaries 
for cadet nurses will be paid by the institutions or agencies utilizing their 
services). 
“Graduate status. 
“Upon completion of the cadet year and registration in their respective States, 
the nurses either will enter the armed forces with the full rank and pay of a 
second lieutenant or ensign, or will be assigned by the appropriate government 
agency to civilian nursing services essential to the war effort. 
“A smart street uniform shall be worn by students enrolling in the Victory 
Nurse Corps.” 
The objectives of the plan as suggested by the United States Public Health 
Service were accepted without much question or criticism. The difficulties in 
the recruitment of nurses were recognized. The influence upon recruitment of 
nurses of the competition with Army and Navy units open to young women was 
regarded as a serious obstacle in the recruitment procedures. The salaries 
offered to young women at the present time by industry both in civilian and in 
defense operations were also regarded as influencing nurse recruitment. Any 
plan, therefore, which could meet on the one hand the urge of the young women 
toward auxiliary military service and on the other hand provide her financial 
assistance would seem to increase the effectiveness of the appeal for nursing 
service. 
It is recognized also that there must be available within as short a period of 
time as possible a pool of nurses from which the needed personnel could be drawn 71 
TRAINING OF NURSES 
by both governmental and civilian agencies to meet whatever emergencies might 
arise. In some sections of the country, particularly in the coastal States, the 
need of graduate nurses has become critical. If this is true of present-day condi- 
tions, it is apt to become still more true in the case of foreseeable results of enemy 
action or in case of epidemics. It is also recognized that in order to give experi- 
ence opportunities to such large additional numbers of nurses as are demanded 
at present, more hospitals could well be used, more supervisors must be appointed, 
and more faculty members of our schools must be enlisted in educational activity 
than is the case at present. 
In view of the recognized validity of the objectives of the Victory Nurse Corps 
program, the council on nursing education and its committees expressed them- 
selves as heartily endorsing the program and as being eager to urge all the 
Catholic schools to lend their cooperation with the undertaking to the very best 
of their ability. The council, therefore, and its committees pledge their own 
support to the undertaking and will labor to assist Catholic institutions in the 
development of their respective programs. Endorsement was also given to the 
following: 
(a) The voluntary character of the plan enabling schools to enroll both Victory 
nurse and civilian nurse students. 
(b) The provision that the Victory nurse must agree to serve wherever needed 
for the duration of the war. 
(c) The development of appropriate insignia to be worn with the nurse’s uni- 
form while on duty and of an appropriate uniform to be used when not on duty. 
(d) The provision that schools should continue responsible for the selection, 
promotion, and graduation of students according to their own policies. 
The council gave extensive consideration to details of the curriculum, basing 
its study upon Bulletin No. 1, November 19, 1942, of the National League of Nurs- 
ing Education. The adjustments proposed in the general plan of courses for the 
accelerated program were in general deemed feasible and wise. It was pointed 
out. however, that in details schools could be encouraged rather to make their own 
individual adjustments than to conform to a general or preestablished pattern. 
The questions were faced with complete sincerity: 
(a) Whether the clinical preparation of the nurse can be reduced to the extent 
demanded by the 24-month program without serious impairment of professional 
development and 
(b) Whether the necessary separation between theoretical instruction and 
more limited clinical experience could be educationally justified. 
It is recognized that the “apprenticeship” year should give to the cadet nurse 
a broad outlook which can be made more educationally valuable by the strong 
motivations arising out of nursing practice in wartime. On the other hand, the 
fear was quite generally expressed that such disassociated clinical experience 
would be very difficult to supervise, and would necessitate the introduction of 
effective educational safeguards. Under competent direction, the accelerated 
programs should prove not too serious a detriment to the professional develop- 
ment of the student nurse. 
The evaluation of the advantages and disadvantages of the 30-month and the 24- 
month programs demands an understanding not merely of the broad aspects of 
professional education in nursing, but particularly an understanding of local con- 
ditions in each school. The determining factor in the choice between the two 
programs in any particular situation was thought to be the character of the 
student body. Susceptibility of the student nurse to intensified direction and to 
high motivation and capacity for reacting cooperatively with such direction would, 
of course, make it possible for a school to concentrate its teaching program into a 
relatively shorter period of time than any wdiich has been thus far suggested. On 
the other hand, it was thought that the 24-month program should be accepted 
as a national program, though it was fully recognized that a 30-month program 
is educationally more defensible. In view of the urgency in the need of nurses, 
however, it was thought best to recognize existing conditions and to attach serious 
weight to the presentation of the national need which has been made by the sub- 
committee on nursing. 
Finally, much attention was given to the ability of the hospital to pay part- 
time salaries to the cadet nurse. During the apprenticeship year it was thought 
wise to keep this question open not merely because the burden of such payment 
for some hospitals might be an intolerable one, but also because it was feared 
that the educational value of this year of clinical experience might suffer through 
such payment. 72 
TRAINING OF NURSES 
The council was of the opinion that the Victory Nurse Corps program demands 
some form of aid to students and schools to achieve the purposes for which it is 
being developed. Funds must be provided for scholarships including tuition pay- 
ments and the payment of fees for all the members of the corps. Provision must 
also he made for maintenance costs, so that the hospital may not be burdened 
with the obligation of maintaing its students during the period when it can re- 
ceive from them no compensating service. The conclusions of the council and its 
committees were embodied in the following resolution: 
“the victory student nurse corps 
“Whereas the planning of the Victory Student Nurse Corps represents an 
achievement of the combined wisdom of official nurse groups in response to the 
national need of nurses for both military and civil purposes in the present war 
emergency; and 
“Whereas this plan in the mind of all those responsible for it gives well-founded 
hope of effectively achieving the purposes for which it was planned; and 
“Whereas the Council on Nursing Education of the Catholic Hospital Association 
with its committee of examiners and its committee on institutional counseling has 
carefully studied the plan and has convinced itself of the plan’s adaptability to 
the promoting of national purposes in our Catholic schools of nursing : Therefore 
be it unanimously 
“Resolved by the Council on Nursing Education of the Catholic Hospital 
Association and by the committee of examiners and the committee on institu- 
tional counseling as follows: 
“1. That the plan as now proposed for the effective organization of the Victory 
Student Nurse Corps be endorsed in its principles. 
“2. That the same plan be endorsed as a practical program in the emergency 
even though it is recognized that it may carry with it certain educational and 
professional disadvantages to our schools of nursing. 
“3. That the difficulties which may be encountered in introducing the program 
are to be regarded as relatively unimportant in the face of the emergency which 
the program was designed to meet. 
“4. That with reference to the two plans; that is, the basic professional cur- 
riculum extending through 24 or through 30 months, this council and its com- 
mittees recognize that the 24-month plan will favor the recruitment of nurses, 
will offer more effective and speedy help in the national emergency to both the 
military and the civilian interests, and will prove more immediately effective in 
accelerating the progress of the student nurse toward professional usefulness, 
while the 30-month plan represents a minimal concession to the emergency as 
compared with present standards, guarantees a safer educational procedure and 
will demand fewer compromises with existing legislation and the policies of State 
boards. 
“5. That while it encourages the Catholic schools of nursing to adopt one or 
the other of these plans as each school may deem proper and practical, and while 
it recognizes that the conflict between educational considerations and the Na- 
tion’s need are probably to some extent inevitable, nevertheless, it recommends to 
the Catholic schools of nursing the adoption of the 24-month program to increase 
the contribution of nursing education and nursing to the war effort. 
“6. That this recommendation is hereby made with the approval of the principle 
which permeates American life today, that the winning of the war is our first 
concern, and that therefore, the partial sacrifice of the individual’s professional 
development is a justifiable sacrifice in the face of the national need. 
“7. That this council and its committees have assured themselves that effective 
educational influences can be introduced into the third, that is, the apprenticeship 
year, of the student’s basic professional curriculum, such as seminars, confer- 
ences, journal clubs, clinical conferences, and similar educational helps, and that 
thus many of the disadvantages otherwise resulting from premature professional 
practice can be successfully forestalled. 
“8. That the schools should be urged to make the necessary curricular adjust- 
ments for the 24-month program only after the most careful consideration and 
with the advice of competent consultors, thus to achieve to the fullest practical 
extent the purposes for which the program was instituted. 
“9. That the Catholic schools of nursing are insistently urged to remit in 
no way in the accelerated program their emphasis upon their teaching of religion 
and their religious practice; rather to strengthen their teaching of religion and 
to intensify their religious practice at this time when sound and supernatural TRAINING OF NURSES 
73 
attitudes toward life are so indispensable in meeting the needs of the world and 
in protecting the ideals of a liberty-loving civilization. 
“10. That finally the difference in educational effectiveness between the two 
Plans, great as they are, do not seem to justify deferral of service to the country 
for a period of 0 mouths on the part of approximately 27,000 nurses annually.” 
D. COOPERATION WITH THE NURSE RELOCATION NURSING SERVICE 
A third topic on which the council on nursing education and its committees 
formulated a resolution to be sent to the Catholic schools of nursing was Coopera- 
tion with the Nurse Relocation Nursing Service. The problems of the relocation 
service were discussed with great sympathy and understanding. The objectives 
and efforts of the relocation service were viewed with commendation and were 
thought to merit the endorsement of all persons interested in the final objectives 
of our present war. On the other hand, no prudent person, so it was thought, 
could be unmindful of the serious problems which may arise in certain sections 
of the country and in particular schools from the presence of relocated nursing 
students. It was thought, however, that with prudent and intelligent sympathy 
many of these problems might readily be made to vanish. With diplomacy and 
with tact, no less than with Christian charity, opportunities can well be developed 
in some of our schools which would enable these student nurses to make a really 
valuable, contribution to that post-war international understanding for which, 
after all, we are making such indescribably great sacrifices. Accordingly, the 
following resolution was adopted : 
‘‘Whereas the present plight of the relocated student nurses who are loyal 
American citizens and who by reason of military necessity are confined in reloca- 
tion centers deprives these citizens of certain opportunities for education ; and 
“Whereas among these American citizens of foreign parentage it is reported 
that there are students of nursing who have partly completed their professional 
educational preparation : Therefore be it hereby unanimously 
“Resolved— 
“1. That this council and its committees endorse the efforts of the recruitment 
committee of the nursing war council relative to these student nurses; 
“2. That it encourage those of our schools which are located in areas in which 
such a practice is possible, to accept these students as transfer students from their 
former schools of nursing even though such acceptance he not in accord with the 
previously developed policies governing transfer students; 
“3. That the personal problems of these students, if they are accepted by a 
particular school, he given intensified attention with special reference to their 
spiritual and religious interests.” 
The Chairman. Thank you, Mr. Butler. 
Mr. Butler. Thank you. sir. 
The Chairman. Sister M. Olivia Gowan, please. 
STATEMENT OF SISTER M. OLIVIA GOWAN, PRESIDENT, ASSOCIA- 
TION OF COLLEGIATE SCHOOLS OF NURSING, AND DEAN OF THE 
SCHOOL OF NURSING EDUCATION. THE CATHOLIC UNIVERSITY 
OF AMERICA, WASHINGTON, D. C. 
Sister Olivia. Sister M. Olivia Gowan, president of the Associa- 
tion of Collegiate Schools of Nursing, and dean of the School of 
Nursing Education, Catholic University, Washington, I). C. 
I have a very short statement, because our association stands back 
of all that has been said in the previous testimony. 
The Association of Collegiate Schools of Nursing is an organization 
composed of 31 colleges and universities conducting schools or depart- 
ments of nursing. It educates on a college level young women for the 
general practice of nursing and graduate nurses for teaching, public- 
health nursing, and administration of schools and nursing services. 
There are approximately 10,000 students enrolled in the collegiate 
programs. 74 
TRAINING OF NURSES 
This association recognizes— 
That there is an acute shortage of nurses for the supply of nurses 
necessary to the military and civilian populations; 
That more graduate nurses must become available to the armed 
forces; and 
That schools of nursing have found it necessary to accelerate their 
curricula so that students may become available to the military hos- 
pitals, public health agencies, war industrial plants, and hospitals 
that in the past have depended upon graduate nurse service. 
Furthermore, hospitals conducting schools of nursing are rapidly 
becoming dependent on student nurses to nurse their patients and 
That the competition to secure young women in the age groups from 
which nurses have been recruited is daily becoming more acute. 
Therefore, the Association of Collegiate Schools of Nursing recog- 
nizes that schools of nursing are no longer able to carry the responsi- 
bility of meeting this wartime supply of nurse power, and endorses 
bill S. 983. 
It wasn’t possible to hold a meeting of the association, but I have 
telegrams from a majority of the schools in this association. 
The Chairman. We would like to have the telegrams in the record, 
Sister. 
Sister Olivia. Yes. 
(The telegrams referred to are as follows:) 
Sister Olivia : 
Catholic University Deportment of Nursing, 
Washington, D. C. 
Minneapolis, Minn., May 5, 1943. 
Hospital superintendent, dean of medical sciences, and director and faculty, 
school of nursing, all approve student nurse bill, though it has not been possible 
to take up the bill with university administration. Please notify Houpt. 
Katharne J. Densfobd. 
New Haven, Conn., May 4, 1943. 
Sister Olivia : 
Dean, Catholic University Department of Nursing. 
Am personally favorable to association collegiate schools supporting bill. 
Effie J. Taylor. 
Helena, Mont., May 4, 1943. 
Sister M. Olivia: 
President, Association of Collegiate Schools of Nursing, 
Catholic University, Washington, D. C. 
University of Cincinnati College of Nursing and Health approves and supports 
nurse bill S. 983. 
Helen G. Schwarz. 
Sister M. Olivia, 
Catholic University, 
Washington, D. C.: 
Approve bill 983 but have taken no action. 
Brookline, Mass., May 3, 1943. 
Helen Wood. 
Sister M. Olivia Gowans. 
Catholic University of America, 
Washington, D. O.: 
Detroit, Mich., May 3, 1943. 
Wayne University now cooperating with Detroit and Michigan nursing schools 
in Federal programs and will continue programs according to terms of legisla- TRAINING OF NURSES 
75 
tion and needs of nursing schools. We feel Federal aid absolutely essential to 
recruitment of numbers of student nurses needed. 
Eleanor King, 
Department of Nursing, Wayne University. 
Duluth, Minn., May 3, 19^3. 
Sister Olivia, 
Department of Nursing, Catholic University, 
Washington, D. C.: 
In favor if you think it advisable. 
Sister Mona. 
Cleveland, Ohio, May 3, 1943. 
Sister M. Olivia, 
Catholic University of America, 
Washington, D. C.: 
School will cooperate with bill S. 983. 
Marion G. Howell. 
Nashville, Tenn., May 3, 19Jf3. 
Sister M. Olivia Gowan, 
President, Association of Collegiate Schools of Nursing, 
Catholic University of America: 
Consider passage student nurse bill, S. 983, imperative in light of war needs. 
Aurelia B. Potts, 
Director, Division of Nursing Education, Peahody College, and Secretary, 
Association of Collegiate Schools of Nursing. 
Sister M. Olivia Gowan. 
President, Association of Collegiate Schools of Nursing, 
Catholic University, Washington, D. C.: 
Faculty nursing, education division, Teachers College, Columbia University, 
endorses student nurse bill. 
Isabel M. Stewart, Director. 
New York, N. Y., May 3,1943. 
Ann Arbor, Mich., May 3,1943. 
Sister M. Olivia, 
Catholic University, Washington, D. C.: 
University of Michigan School of Nursing approves of student nurse bill, S. 983, 
as it has been presented. 
Hhoda F. Reddig. 
St. Louis, Mo., May 3,1943. 
Sister M. Olivia, 
President, Association Collegiate Schools of Nursing, 
Catholic University of America, Washington, D. C. : 
Unqualified approval of student nurse bill with urgent request in the interest of 
national welfare that it be passed without delay. This school sees no other way 
by which present needs in nursing can be met. 
Sister Mary Geraldine. 
Executive Dean. 
Sister M. Olivia, 
Catholic University, Washington, D. C.: 
Marquette University College of Nursing indorses proposed student nurse bill. 
Sister M. Augusta. 
Milwaukee, Wis., May 3, 1943. 
Sister M. Olivia, 
Catholic University, Washington, D. C.: 
Have wired Senators Guffey, Davis, and Bailey our interests in the passage of 
nurse bill, S. 983. 
Mary W. Tobin, 
Dean, Duquesne University School of Nursing. 
Pittsburgh, Pa., May 3,1943. 76 
TRAINING OF NURSES 
Rochester, N. Y., May 3, 1943. 
Sister M. Olivia, 
Catholic University, Washington, D. C.: 
No copy bill sent this school. Presume this refers to student war nursing 
reserve. This school of nursing will not oppose the bill. 
Clare Dennison. 
Sister M. Olivia. 
Catholic University, Washington. D. C.: 
Consider passage Senate bill S. 983 imperative if wartime need for nurses is 
to be met. Will wire Senators directly if you send names and wish this. 
Frances Helen Zeigleb, 
Dean, School of Nursing, Vanderbilt University. 
Nashville, Tenn., May 3, UU/S. 
Sister Olivia. 
Catholic University, Washington, D. C.: 
Student nurse bill, S. 983, indorsed by Dean Weiskotten and me. 
Ellen Buell, 
Director, Public Health Nursing. 
Syracuse, N. Y., May 3, 1943. 
Chicago, III., May 3, 1043. 
Sister M. Olivia, 
Catholic University, Washington, D. C.: 
Approve nurse bill if suggested amendment incorporated. 
Nellie X. Hawkinson. 
Department of Nursing Education, University of California. 
Sister Olivia, 
Catholic University, Washington, D. C.: 
Approve student nurse bill, S. 983, provided amendments are adopted. 
Sister Mart Therese. 
Chicago, III., May 3, 1943. 
Sister M. Olivia. 
Catholic University, Washington., D. C.: 
Approve bill. Will participate in program if passed. Can consicleialien be 
given to aid for students in preliminary university program? 
Elizabeth S. Soule. 
Seattle, Wash., May 3, 1943. 
Senator Ellender. Sister, may I ask a few questions, please? 
Sister Olivia. Certainly. 
Senator Ellender. Are you connected in anywise with a nursing 
school in Washington? 
Sister Olivia. Yes; I am. 
Senator Ellender. How much pay, if any, does a student nurse 
receive from the institution with which you are familiar? 
Sister Olivia. The school that I am connected with charges tuition 
for the education of the nurse. That is the Providence division of 
the Catholic University School, in the Providence Hospital here. 
Senator Ellender. Does the student have to furnish her own cloth- 
ing and must she pay for board at the hospital? 
Sister Olivia. In the college program, the student pays for her full 
tuition, her board, and all her necessary fees, books, and so on, at 
the university, and during the clinical period she pays further tuition, 
which is small—it amounts to about $150—and the hospital furnishes 
her with board and room. TRAIXIXG OF NURSES 
77 
Senator Ellender. Well, does she perform any services to the hos- 
pital ? 
Sister Olivia. Yes, certainly. 
Senator Ellender. And for that service she gets board and lodging? 
Sister Olivia. Yes. In learning, the student gives patient care and 
that in turn pays. It is a work arrangement. 
Senator Ellender. Would you be able to tell us what the cost of 
tuition and other costs that must be paid by the student nurse amount 
to per year? 
Sister Olivia. It amounts to about — per year? 
Senator Ellender. Or per month. 
Sister Olivia. I am afraid I don’t have that. You mean in the 
clinical period? 
Senator Ellender. Yes. 
Sister Olivia. The total cost for the collegiate program is about 
$2,200. 
Senator Ellender. I just wanted to get into the record, if possible, 
these facts. So far as 1 understand, there are 49,000 student nurses 
that are now taking training? 
Sister Olivia. That came in last year. 
Miss Faville. 100,000 altogether. 
Senator Ellender. I wonder if it would be possible to determine 
how many of these don’t have to pay any tuition, don’t have to pay 
for their uniform, but get training in return for the services rendered 
to the hospital, or whatever institution they are connected with? 
Sister Olivia. I think that would be possible, but I don’t think I 
am the one to give you the figure. I think there must be somebody 
else in the group who would give it. 
The Chairman. We had those figures given to us yesterday by one 
of the nurses’ associations. 
Sister Olivia. I would be willing to say that it is probably costing a 
student in the Providence division, that I know most about, about 
$400, not costing the student, the total cost, the cost of the instruction 
is $400 for board and room and tuition. 
Senator Ellender. Under this bill, as I understand it, the Govern- 
ment would be required to put up sufficient money to train not only 
these career nurses but all that may come in because of this incentive. 
Sister Olivia. I could say this, Senator, which may help you: The 
director of the Providence division, who is mainly responsible for this 
in our schools, is very much concerned about the amount of money, 
liecause we don’t think that it will pay entirely what it is costing to 
educate our students now. 
Senator Ellender. Well, of course, that is where they are getting a 
college training, but what I had in mind in particular were the hos- 
pitals throughout the country that are now begging, as it were, for 
student nurses in order to help them during this emergency. I do 
know that quite a few hospitals throughout the country are now short 
of nurses; they have left the hospitals and have gone to other fields, 
and you can’t blame them for that. But I am informed that quite a 
few hospitals even go so far as to pay some of the student nurses dur- 
ing training. Of course, that is all due to the shortage. 
Sister Olivia. Somebody just handed me a book entitled ‘'Facts 
About Nursing, 1942.” It is published by the nursing information 
8G411—43 6 78 
TRAINING OF NURSES 
bureau of the American .Nurses’ Association. It states here that the 
median tuition fee charged in 1939 was $75, and that in 1939, 38 percent 
of the schools paid allowances to students. 
Senator Ellender. Now, the point that I desire to make, of course, 
is that if this bill is enacted and it is carried out to its full intent, it 
will mean that all of these career nurses that are now willing and able 
to pay for their uniforms and pay for their tuition, and other expenses, 
will, of course, get the same stipend and the same everything else as 
those who wouldn’t come except for the things that are being furnished 
to her. 
Sister Olivia. I think that is true. 
Senator Ellender. As I figure it out here, it would cost as much as 
$400 per year for each nurse 
Sister Olivia. That is a collegiate program. 
Senator Ellender. But I understood that the information given to 
us a while ago, and if I am wrong I would like to know it, is that for 
the 3-year course it would cost about $1,200, or $400 per year; and if 
you need as many as 65,000, as has been said here, that means that it 
would cost the Government in the neighborhood of $25,000,000 to 
$26,000,000. 
Now, the question may come up, Senator Thomas, as to those who are 
able to pay, and I am just wondering if we should make a difference 
between those who are able to pay and who want to make a career out 
of nursing, and those that would come in because of the war emer- 
gency? In other words, I think it would probably have a better 
chance of going through the Senate if the amount involved were maybe 
a little less than what you are asking for. 
The Chairman. I thing we ought to consider that question in com- 
mittee, Senator Ellender, when the time comes. 
Senator Ellender. Well, what I wanted to do, Senator, was to 
develop those facts, if they are not already in the record. If they are 
all in the record, I am not going to ask any more questions. I am 
very sorry that I was unable to attend all these meetings. I am very 
much interested. 
Mrs. Bolton. Would you permit me to intrude myself at this point ? 
I think we could clear the confusion in your mind, Senator. 
There are comparatively few schools where the nurses can really 
cover their tuition. If there is a difference made between those who 
can pay and those who cannot, it immediately sets up a curious bar- 
rier; and in these days when there is such an increasing demand for 
girls everywhere, that is our vital problem today. And we are feeling- 
very strongly that only by some way of meeting the competition with 
these other groups can we really get in not only the girls who can pay, 
but the vast number of girls who can’t. 
Senator Ellender. Well, now, this, of course, also comes into the 
picture: For instance, as I indicated awhile ago, you have a lot of 
hospitals that are vying with each other for student nurses. 
Mrs. Bolton. Yes, sir. 
Senator Ellender. They are short of a nursing staff, and they are 
willing to take them in, teach them free of charge, and furnish them 
with their board and even tuition, in compensation for the work they 
perform in the hospitals. 
Mrs. Bolton. Yes, sir. 79 
TRAINING OF NURSES 
Senator Ellender. Now are we going to appropriate funds to pay 
these student nurses, and at the same time they will perform this serv- 
ice for these hospitals? What are the hospitals going to do for the 
services performed ? 
Mrs. Bolton. May I suggest this, Senator. I think that there has 
been no real discussion of the amount involved in this bill, and I do 
know that Dr. Parran has submitted the statement that we assume that 
it will reach a sum of some $60,000,000 and possibly $70,000,000, de- 
pending upon the number of girls who agree, when they go into train- 
ing, to sign on for these services. No girl who doesn’t sign on for the 
services in the Government and the civilian services of Public Health, 
and so on, of course, is included in this, and it depends on how many 
there are. 
There will be girls go into nursing who don’t want to sign on, who 
will pay their way, still, and who will come into the group that you 
speak of. 
I might suggest that Miss Mclvor is here, and she has those figures, 
if they could be put into the record, if they are not already there, I 
think a good many of them you would find in the record already given 
you. 
Senator Ellender. Of course, if they are already in the record; as I 
have just indicated I am truly sorry that I was unable to attend all 
these hearings 
Mrs. Bolton. I haven’t been here, either, so I am in the same boat. 
Senator Ellender (continuing). Owing to other engagements. 
But what I am trying to do is to put such facts in the record as to be 
able to answer questions if and when the bill comes on the Senate 
floor. 
Mrs. Bolton. I appreciate that. 
Senator Ellender. And, of course, if we can devise some way so as 
to take care principally of this additional load because of the war, the 
possibility of the passage of the bill will be enhanced. 
Mrs. Bolton, Certainly; I am quite aware of that. 
The Chairman. We appreciate your coming, Sister. 
Sister Olivia. Thank you, Senator. 
The Chairman, Dr. Paullin? [No response.] 
Miss Anna D, Wolf, please. 
STATEMENT OF MISS ANNA D. WOLF, DIRECTOR OF THE JOHNS 
HOPKINS HOSPITAL SCHOOL OF NURSING SERVICE, BALTIMORE 
The Chairman, Miss Wolf, for the record will you state your name 
and your position ? 
Miss Wolf. Anna D. Wolf, director of the Johns Hopkins Hospital 
School of Nursing Service, Baltimore, Md. 
As one of the schools of nursing, representing one of the schools of 
nursing and nursing services of the country, I should like to testify 
in favor of S. 983, particularly on the following points: 
First, as one of the schools that saw the handwriting on the wall 
fairly early, because of the large distribution of our graduates all 
over the country, we began, in 1941, before Pearl Harbor, to increase 
the number of students whom we had in our school. 
We furthermore decided to admit three classes a year in order that 
we could meet the ever-demanding call for nurses. 80 
TRAINING OF NURSES 
We also decided that we would make our matriculation require- 
ments as reasonable as possible so that we could retain married women 
in the nursing school; and we would take in young women who would 
come in directly from high school, a bit younger than we ordinarily 
admit. Our admitting age is 20. We also have made exceptions as 
to the age over 30. So that we have made it possible for just as many 
women to come into the school as we can possibly accept on the basis 
of the credentials which they offer. 
In 1942, with the fine publicity which was established by the National 
Nursing Council for War Service, and with the publicity which we, 
as a school, promoted, we were able to increase our students by over 
100 percent over peacetime admissions. 
We maintained a very careful evaluation of all credentials, because 
we feel, as a school, that this is no time to reduce the admission re- 
quirements as far as intelligence and capabilities of individuals are 
concerned. 
Very heavy responsibilities are placed upon these young women as 
they go out from the schools, and we felt it was highly desirable to 
keep our group very well qualified. 
It is very significant that in that group, that very large group of 
students admitted, we had over 30 percent of college graduates, and 
all except about 15 percent had had 1 or more years of college, which 
indicated a mature, well-qualified group of students, quite well selected. 
There has been an evident decrease in the number of applications 
for the year 1943. We had, in 1942. support from the United States 
Federal services—the United States Public Health Service, I should 
say—and our students benefited from not only scholarship aid from 
that agency, but also through private sources, of which Miss Faville 
has spoken. It is very significant that in order to increase our student 
group in 1942 to more than 100 percent over what we ordinarily have, 
over 50 percent of those students required financial aid; and I should 
like to say that we have studied the requirements of financial aid of 
each student individually so that we know that they are needful of 
this help. 
The financial aid has been limited to these students from $100 to 
$200. We have one or two students who have received private scholar- 
ships of $350. 
I should like to answer a bit the question which was raised a mo- 
ment ago regarding the cost of education of the student nurse. 
In our own school, our students must pay out over $350 for the 
expenses which are incurred. 
Senator Ellender. Per year? 
Miss Wolf. That is for the 3-year program. 
Senator Ellender. What is that for ? 
Miss Wolf. That is for tuition fees, uniforms, books, and educa- 
tional supplies, and things of that sort. 
In addition to that, we have to figure that the student must have at 
least a small stipend for spending money, and we tell the girls about 
$10 a month ought to be able to see them through on minor expenses. 
That brings the student’s cost to go through such a school as ours 
to about $650, depending upon her own personal expenditures. 
We have to remember that the girl’s earning capacity through those 
3 years has been entirely reduced, other than through the value she TRAINING OF NURSES 
81 
receives from her educational work; that most of our students would 
be able to carry good jobs right now at around $150 a mouth or 
more—many of them come in from other positions, and could receive 
much more. So that actually the cost to the student is far higher 
than the actual money which she pays out to the school of nursing, 
and I would like that borne in mind, because that is part of this whole 
problem of securing students for schools. 
Senator Murray. A large part of the training they receive is away 
from the bedside ? 
Miss Wolf. A great deal of the training is away from the bedside. 
There are classes held continuously through the 3-year program, which 
is a very important thing to remember, and faculties have to be 
appointed for that. • 
Senator Murray. That is at a considerable expense ? 
Miss Woif. At a considerable expense to the institution. 
The hospital, in the meantime, does pay the maintenance in full 
of the students while they are in the school of nursing, and it pays 
for medical care in case of illness, and that sort of thing. 
In regard to the diminishing applications for the year, I think this 
is exceedingly important: We made a study of all applications and 
letters to the school for the first 4 months of this year, as compared 
with the first 4 months following Pearl Harbor, and we have found 
that we have only 78 percent of the applications to the school within 
those first 4 months, which I think is extremely significant, because 
our recruitment program has been far more accelerated during this 
past year than it was immediately after Pearl Harbor, although un- 
doubtedly Pearl Harbor did much to increase the applications at 
that time. 
A very significant factor is that the qualifications of our applicants 
at the moment, although they are very fine young women, are not 
showing as great maturity or anything like as high educational quali- 
fications. In the first 4 months of 1942, in the applicants to our school, 
we had over 2G percent college graduates. This year we only have 
15 percent, which shows that those college women are going off into 
other fields. 
Now, that is an extremely serious thing in any school of nursing, 
where at the moment tremendous responsibilities are going to be 
placed upon those women immediately upon their graduation. It is 
highly important that we retain the facilities and the measures which 
will keep coming into our schools women of that caliber. 
We are still receiving many requests for financial aid, and I have 
here a lot of notations from students, which I don’t think are neces- 
sary for the file, but it is also significant that parents write in to 
us and cannot understand why our Government hasn’t done some- 
thing more to stimulate student recruitment through the offering 
of some such plan of a reserve as we have in this bill, S. 983. 
I should like to speak for just a moment upon the subject of nurs- 
ing service, because I happen to be in a position where I am fairly 
Avell acquainted with that in a large institution 
Senator Ellender (interposing). Before you go into that subject, 
would you mind answering a few questions? 
Miss Wolf. I would be glad to, if I can. 
Senator Ellender. Where is your institution located? 82 
TRAINING OF NURSES 
Miss Wolf. In Baltimore, Md. 
Senator Ellender. How many students do you normally have? 
Miss Wolf. We admitted, in 1940, 79 students; we admitted 195 
students in 1942. We were working for 200 students this year, and 
we will not be able to get them unless we have something happen 
very soon. 
Senator Ellender. Well, now, these 192 students—did they pay the 
regular tuition ? 
Miss Wolf. Every student had to pay all the requirements of the 
school, and they may have received financial aid. I said that 50 per- 
cent of our group had to have financial aid, which came through 
either public or private sources. 
Senator Ellender. And that amount for each student as I under- 
stand it is $100 per year, or $300 for the entire course? 
Miss Wolf. No; we figure on $250 for the first year, because that 
is where the bulk of our didactic training is, and $100 for the second 
and third years. 
Senator Ellender. Now your school of course is operated in connec- 
tion with a hospital, I presume? 
Miss Wolf. The Johns Hopkins Hospital. 
Senator Ellender. What does Johns Hopkins furnish to the stu- 
dents toward helping to pay the expenses of these girls? 
Miss Wolf. These students are given their full maintenance from 
the day they are admitted to the school throughout the period up 
to their graduation, and in addition they are taken care of in case 
of illness. 
Senator Ellender. When you say “full maintenance” what does 
that include ? 
Miss Wolf, That means room, board, and laundry. 
Senator Ellender. It doesn’t include 
Miss Wolf (interposing). And then of course the educational plan 
is made for them. 
Senator Ellender. Now under this bill, if passed, Johns Hopkins 
could be paid for whatever service it renders to these students; is 
that right ? 
Miss Wolf. Well, Johns Hopkins wouldn’t be paid; the student 
is being paid in this bill. 
Senator Ellender. I mean that Johns Hopkins would be paid com- 
pensation for their board 
Miss Wolf (interposing). Only for a limited period of time, ac- 
cording to this bill. The bill states that the institution would be reim- 
bursed for the first 9 months of maintenance for the student in the 
first year, and following that time the institution would have to carry 
all the expenses of maintenance. That is within the bill. 
The Chairman. This is an incentive bill to drag the girls in? 
Miss Wolf. Yes; quite. It really is not set up to subsidize the insti- 
tutions and I do not believe that the institutions will be subsidized by 
it. 
Senator Murray. In other words, you don’t constitute a pressure 
group here trying to get something out of the Treasury? 
Miss Wolf. No; we are here as a pressure group to try to get in 
more students to try to take care of our civilian needs and the needs 
of the military forces. TRAINING OF NURSES 
83 
Senator Ellender. That isn’t in my mind at all. All I am trying 
to do is to find out the extent to which Johns Hopkins will keep on 
doing what it now is doing for these student nurses. Certainly the 
hospital receives quite a lot from these student nurses? 
Miss Wolf. You must remember that this bill allows for a so-called 
accelerated program whereby the senior students in their last 6 months 
may be assigned, if they are members of this corps, wherever they are 
most needed, which may be in some other civilian institution or iii the 
military. 
Therefore the institution does not receive very much service from 
that student after her first 9 months, which is a very concentrated 
period of training, during which period they get practically nothing 
from the student. That maintenance which the hospital receives for 
tiie students in this corps for the first 9 months 
Senator Ellender (interposing). Is it your view, then, that should 
this bill pass and you should work along the same lines that you are 
now working, that Johns Hopkins would not be paid anything out of 
this bill, that is, for the work that would be done by any of these student 
nurses ? 
Miss Wolf. I am afraid I don’t quite get your question. 
Senator Ellender. What I have in mind is this: I don’t know 
whether or not you ladies are familiar with the way legislation is 
handled on the Senate floor, but quite a few questions are asked and 
sometimes if we don’t have the answer at the proper time there may 
be a vote against the bill. 
Now, the thing I had in mind was this: At the moment your students, 
the 192 students that you are now training, do bedside work at Johns 
Hopkins, don’t they ? 
Miss Wolf For a period of time. 
Senator Ellender. Now, for that service Johns Hopkins gives them 
their sustenance, that is, room and board ? 
Miss Wolf. Yes, 
Senator Ellender. Now, will Johns Hopkins keep on doing that? 
Miss Wolf. Yes. 
Senator Ellender. Without compensation? 
Miss Wolf. If this bill passes and students are admitted to our 
school under this bill, according to this measure, Johns Hopkins would 
receive maintenance for the first 9 months only for those students. 
Senator Ellender. In other words, Johns Hopkins would re- 
ceive— 
Miss Wolf (interposing). Maintenance for the first 9 months. 
Senator Ellender. And Johns Hopkins will also receive the services 
of these girls ? 
Miss Wolf. But for the first 9 months they receive practically no 
services from these girls as far as we are concerned. We count on 
very little service from them for the first 9 months. You must remem- 
ber that the measure is up to increase the number of students 
Senator Ellender (interposing). It strikes me that Johns Hopkins, 
though, as well as any other hospital in the country, will certainly have 
to pay out of its treasury for the services that are now being performed 
by those girls for this 9 months’ work ? 
Miss Wolf. They would not pay for the services by those girls. The 
Johns Hopkins Hospital would only take care of those students as 84 
TRAINING OF NURSES 
they are admitted to the school, but remember our admissions were 
from 79 
Senator Ellender (interposing). I don’t know whether I have made 
myself plain or not. 
Miss Wolf. The purpose of the bill, of course, is to increase the num- 
ber of students. The benefit is to the student. 
Senator Ellender. Let me ask you this: Does Johns Hopkins receive 
any benefit at all from these girls for the first 9 months that they are 
in the hospital ? 
Miss Wolf. I indicated that we charge tuition fees. Is that an 
answer? Do you mean benefit for services—benefit from the stand- 
point of service ? 
Senator Ellender. As I understand it, these young student nurses 
are trained in the hospital at Johns Hopkins? 
Miss Wolf. Yes. 
Senator Ellender. Does Johns Hopkins benefit by that ? 
Miss Wolf. Insofar as the amount of service which the students 
render at whatever period begin their service. 
Senator Ellender. And for that service Johns Hopkins gives this 
young lady board and a place to sleep; is that correct ? 
Miss Wolf. Yes. 
Senator Ellender. Now, if this bill goes through, as I understand 
it, Johns Hopkins will get that service free of charge ? 
Miss Faville. May I speak on that, please? 
Senator Ellender. If you will. 
Miss Faville. The way it is now the students stay in the school for 
3 years, and in the beginning when they come in they don’t know very 
much about anything, and the instruction is very intensive in that first 
9 months. So the hospital starts in boarding them from the time they 
come in, and they are not much of any good to them in the beginning. 
Now, as they go along they get more and more proficient in skills 
and they are of more help to the hospital. Now, under normal times 
the last 6 months of training is the time when they will really pay 
back to the hospital, in work, the value of much of the board and room 
that they got in the beginning. But under your bill now that last 
6 months the Government can assign them to military hospitals, to 
Veterans’ Bureau hospitals, or wherever they are most needed. So 
the hospital probably will not break even under the new plan because 
they will be available for outside assignment during the period that 
they would be most useful to the hospital. 
Senator Ellender. Because of the Government being able to trans- 
fer this girl for the last 6 months? 
Miss Faville. Yes. You haven’t read the bill right, Senator; 
excuse me. 
Senator Ellender. That is all right. I don’t claim to know anything 
about the bill. I have just read it casually, and I am not an expert in 
bill writing. I don’t know much about it. But I want to be frank, and 
the only way I can find out is for you ladies to tell us. 
Miss Faville. We are awfully glad to tell you. They are going to 
pay the hospital in the beginning when the student isn’t much good; 
the Government is going to reimburse them for their board and room 
during that 9 months. 
Senator Ellender. If you answer the questions I ask. we might be 
able to get somewhere. Let us take this lady’s school. Let’s assume TRAINING OF NURSES 
85 
that she lias 100 students. These students get training both at her 
school as well as at the hospital; am I right? 
Miss Wolf. The school is within the hospital. 
Senator Ellender. Now, these students do bedside work from the 
day they enter the hospital 
Miss Wolf (interposing). That is where you are off. 
Senator Ellender. This is not in the bill. I am just trying to learn. 
Miss Favtlle. That is what we are trying to explain to you. 
Senator Ellender. How long do they attend school? Let’s put it 
that way. 
M iss Wolf. We consider them in the school for 2 years and a half, 
as this bill is written. They are in the classroom without giving service 
to the institution at all 
Senator Ellender (interposing). When do they start doing bedside 
work ? 
Miss Wolf. In our school they do a little bedside work at about the 
sixth month. 
Miss Faville. But it doesn’t pay their board and room, They aren’t 
any good in the beginning, and when they get better the hospital boards 
them at the same rate. They let them eat three meals a day just 
the same. 
Senator Murray. Well, in the early part of her training the student 
is more in the way of the hospital, the hospital doesn’t get any benefit 
at all, and it is a burden on the hospital? 
M iss Wolf. Yes. 
Miss Faville. But you are proposing to take her away at the end 
when she is more than paying her way. So you are going to pay money 
to the hospital while she is a loss and take her away when she is good, 
and most everybody feels that the hospital isn’t going to make anything 
out of it because you are pushing all the classes back into that earlier 
period so you can have her the last 6 months. 
Senator Ellender. What I was trying to make it understandable 
for was in order to make it a little easier to probably pass this bill. 
That is what I was trying to do. In these large institutions through- 
out the country where they do obtain services from these student 
nurses, I would like to see it so that the Government will not have to 
pay those institutions during the training period of these girls. It 
strikes me that it ought to remain as much as possible the same as it 
is now. 
Miss Faville. Then you ought not to take them away during the 
last 6 months. 
Senator Ellender. Then let's strike that out. 
Miss Wolf. Of course the whole purpose is to get the students 
through the schools of nursing as promptly as possible. Therefore 
there is the acceleration of cutting this course of study down to 30 
months or to 24 months. 
Senator Ellender. There is no doubt in my mind that it is a noble 
bill, that its purposes are noble—we need nurses and all of that, but 
when you go to Congress—I have been here for 7 years now and during 
that 7 years Senator Thomas can tell you that we have been trying all 
we know how to help public schools throughout the Nation, and up to 
the moment we haven’t succeeded very well. I don’t know what this 
bill will cost. I understand that it might cost as much as $60,000,000. 
Am I right, Dr. Parran? 86 
TRAINING OF NURSES 
Dr. Parran. That is the estimate. 
Senator Ellender. And that it may be $70,000,000. If you think 
that it is an easy matter to push that through Congress I wish some 
of you ladies would try it. With all of the money that is now being 
spent, billions of dollars for guns and things like that, it is pretty 
difficult to get good things through Congress now, 
I would like to see a lot of money appropriated for our public 
schools and colleges, but try to do it and you will get what Paddy got. 
Miss Wolf. I would like to speak to the point of the need for nurses 
in the community, because that is one of the most serious things we 
are facing. 
In our particular community, Baltimore, which is a defense indus- 
trial area, we are meeting a very serious shortage, especially in our 
public service institutions, our city institutions, and our public health 
services, and our own institution. 
On our own service we should have employed around 350 graduate 
nurses in peacetime. We are now about 95 nurses short. You asked 
a little while ago if nurses were working longer hours, or what their 
hours were. It is quite significant that just this last week, because 
we could not get enough nurses to take care of patients in our institu- 
tion, in certain units of our institution, we had to ask graduates to 
work as much as 10 hours a day in order to cover the service adequately 
so that our patients could be cared for. Fortunately that was only in 
one or two locations, and we hope it will be relieved quite soon. 
That is, of course, one of the most serious things we have to face, 
the fact that if we do not have enough graduates coming out we will 
have to do something to either reduce the quality of care the patients 
get, which is, of course, a serious thing to which Dr. Eliot spoke so 
well this morning, or else we will have to add even far beyond the 
usual service time for most of these people. 
One other thing that I would like to say before leaving the witness 
stand is that the immediacy of this is very serious. We are attempt- 
ing now to have a summer program, beginning early in June. We 
want 50 students in that summer program. We are working with 
other schools. Our applications for that summer program are not 
sufficient to meet the need and we feel certain that unless something 
is done, such schools as ours and others will not be able to get the 
number of students that are needed in order to produce the number 
of graduates that we must have for our services. 
The Chairman. Do you mean by that that your actual peacetime 
needs are not going to be adequately filled ? 
Miss Wolf. They are going to drop beyond that. I think, if we don’t 
do something soon. 
Senator Ellender. Do you think that with the present number of 
nursing schools throughout the country, and the present facilities, 
you can take care of this additional amount of nurses that you think 
is necessary? 
Miss Wolf. I think so. 
Senator Ellender. Yon don’t think it will be necessary to establish 
new ones? 
Miss Wolf. New schools? 
Senator Ellender. Yes. 
Miss Wolf. I think that perhaps some new schools will have to be 
established in order to increase the facilities through both the educa- 87 
TRAINING OF NURSES 
tional and clinical phases. We have had some evidence of that 
already. 
Senator Murray. A very large number of the highly trained nurses 
that come from institutions like yours and Mayo’s are already in the 
armed services, are they not ? 
Miss Wolf. Yes. 
Senator Murray. And many of them are abroad right now? 
Miss Wolf. Right. 
Senator Murray. And it is very difficult for you to maintain the very 
high standards that your institution has maintained in the past? 
Miss Wolf. That is the argument for having the funds available to 
bring the nurses back into service, to train them for the service of 
today, and also to help train the teachers and the supervisors to teach 
these nurses. 
Senator Murray. And none of these hospitals are great money- 
making institutions, making enormous profits and paying dividends 
or bonuses to the presidents or head nurses ? 
Miss Wolf. Our institutions are nonprofit organizations, for the 
most part. 
Senator Ellender. Is this the first attempt to get aid from Congress 
by your organization ? 
Miss Wolf. We have already received funds from the United States 
Public Health Service. 
Senator Ellender. I mean along these lines? 
Miss Wolf. This particular bill comes up now for the first time. 
Senator Ellender. Was any such effort made during the First 
World War? 
Miss Wolf. At that time we had the Army School of Nursing of 
which Mrs. Bolton spoke a few moments ago, which was subsidized by 
Congress. 
The Chairman. You put in nursing courses in practically all of the 
great universities, also, at that time, did you not? 
Miss Wolf, Yes. We had a very large program at Vassar College. 
Senator Murray. You don’t consider this as an effort on your part to 
secure aid from the Government, but you are trying to aid the Govern- 
ment? 
Miss Wolf. We are trying to aid the Government to cover the ser- 
vices needed in the military and civilian population, and to get enough 
nurses to take care of the sick of our country. 
The Chairman. Thank you, Miss Wolf. 
Miss Jacobson, please? For the record, Miss Jacobson, your name 
and position ? 
STATEMENT OF MISS MARGUERITE JACOBSON, ASSISTANT EXECU- 
TIVE SECRETARY, AMERICAN NURSES’ ASSOCIATION, NEW YORK 
CITY 
Miss Jacobson. Marguerite Jacobson, assistant executive secretary 
of the American Nurses’ Association. 
All of the States in the United States, the District of Columbia, 
Puerto Rico, and Hawaii, have a nurse practice act, and 30 of these 
acts require that applicants for a license to practice nursing as a regis- 
tered nurse must have had a 3-year course in nursing. 88 
TRAINING OF NURSES 
From information that has been obtained from the boards of nurse 
examiners in these States it is indicated that the clauses in their laws 
regarding the requirements for a license to practice are so worded that 
the schools of nursing within their States can participate in the plan 
that is set forth in Senate bill 988, and that in many of these States 
they are already Avorking on plans, or have already accelerated their 
course of instruction so that the theoretical instruction is completed in 
30 months, so that the students can be released to serve in governmental 
or other hospitals for the last 6 months, and that will be counted as a 
part of their training. 
The Chairman. Are there any questions? Thank you, Miss Jacob- 
son. 
Dr. Winfred Overholser? 
Dr. Overholser. Mr. Chairman, the committee was kind enough to 
ask Dr. Ruggles, the president of the American Psychiatric Associa- 
tion, to come, and I am here at his request. I am the secretary of the 
American Psychiatric Association. 
The Chairman. For the record will you give your name, your title, 
and position, please ? 
STATEMENT OF DR. WINFRED OVERHOLSER, SECRETARY OF THE 
AMERICAN PSYCHIATRIC ASSOCIATION 
Dr, Overholser. My name is Dr. Winfred Overholser, and I am 
secretary of the American Psychiatric Association. I live in Washing- 
ton, D. C.., and happen to be connected with St. Elizabeths Hospital. 
I come here, sir, on behalf of the oldest national medical association, 
a group which has long been interested in the care of a very substantial 
portion of our population, namely, the inmates of the mental hospitals 
of the country. 
There are at the present time altogether in the mental hospitals of 
the United States, public and private, nearly 600,000 patients. In the 
State hospitals alone there are well over 400,000 of them. 
Those men and women are sick. Nurses are needed for their care as 
well as less well-trained persons like attendants. 
A fair number of the hospitals have operated training schools for 
nurses in the past, and some still do. They have had various difficulties 
in keeping those in operation, and within the last year or two we know 
of at least 13 that have closed their training schools for various reasons. 
There is a very substantial shortage of nurses. Probably there is a 
shortage of about 4,500 graduate nurses in the mental hospitals of this 
country, and it is simply to underscore the need of this bill that I 
come here, sir, at this time. 
There is no question that the operation of a training school reflects 
itself favorably in the care of the patients in a hospital. It is a good 
deal of work to operate a training school. It would be far easier, 
perhaps, not to bother, but every progressive hospital feels that it has 
a duty to keep up the flow of properly trained people, and at this time 
that is particularly urgent with the advancing needs of the military 
services particularly. 
Now, it may interest you to know that the Federal Government 
operates just one training school for these nurses, and that is at St, 
Elizabeths Hospital. We pay $24 a month with full maintenance. 
The girls buy their books and their uniforms. 89 
TRAINING OF NURSES 
We draw from the entire country. It is a Nation-wide civil-service 
examination. We hoped last month to take in about 50 in our training 
school and we managed to get about 20 that met the standards. 
I think that illustrates the difficulties in recruiting even when you 
are paying a pretty substantial stipend, probably as much as any 
hospital in the country does. 
The Chairman. In normal times how do the applicants run? 
Dr. Overholser. There is not much difficulty then; we have all we 
can take care of. 
Senator Ellender raised one question about the necessity of addi- 
tional schools. I think it quite likely that others might be needed. 
There are, however, ample facilities available. There are institutions 
which have operated schools, as I have said, both mental hospitals and 
general hospitals, for that matter, and it would be a relatively easy 
matter to get them going again if the girls could be provided. 
That is one of the principal difficulties, and if some reimbursement 
could be made to the institutions for the expense, because the expense 
is considerable and many hospitals have been unable to afford it, 1 
think it would be a very desirable thing. 
Senator Ellender. What expense do you have in mind there, 
Doctor ? 
Dr. Overholser. It takes a good deal of supervision, Senator, 
These girls spend, for the first 6 months or so, almost all of their time 
in class. That means nurses and physicians, too, to give their time 
to lecturing to them, and then they need very close supervision on the 
wards, supervision over and above what can be given by the average 
ward supervisor. It takes additional personnel to run a training 
school. 
Senator Ellender. While that might be true where the school is not 
operated in connection with the hospital, the testimony a moment ago 
had to do with a school that was operated in connection with a hospital 
and for which tuition is paid. 
Dr. Overholser. In most instances the hospital itself does operate 
it, Senator. I think the number in which there is a university con- 
nection is perhaps not the majority, but some of the ladies can tell that 
far better than I can. 
Senator Ellender. Well, are you able to tell us to what extent the 
hospital benefits from these student nurses if they should remain there, 
say,3 years ? 
Dr. Overholser. During the early part of their stay they are more 
of a liability than an asset. 
Senator Ellender. I have indicated 3 years. 
Dr. Overholser. Yes. For instance in our case for 1 year these 
girls are in affiliation at Jersey City and we get no benefit that second 
year from them at all. When they come back that third year each 
one is probably the equivalent of at least two-thirds of an employee. 
She has to still spend a good deal of her time in classes, and so on, and 
she doesn’t count as a full-time employee. But the hospital does get 
some benefit from her services. 
However, the hospitals in general have been interested in the wider 
problem, not of how many nurses that hospital is going to get when 
it graduates them, but the hospitals and the medical profession have 
been interested in seeing the number of properly trained graduate 
nurses increase in order that better care might be given the country 90 
TRAINING OF NURSES 
over in hospital and out to the sick. There is a certain amount of 
altruism in the operation of a hospital. 
Senator Ellender. Well, there are very few hospitals that do not 
allow at least room and board for their student nurses, are there not ? 
Dr. Overholser. As far as I know they all do that, sir. 
Senator Ellender. Evidently, if all of them do it they must have in 
mind that if the student nurse remains for 3 years there is adequate 
compensation ? 
Dr. Overholser. There is some return, unquestionably, yes, some. 
I am not sure that “adequate” is the proper adjective to use, Senator. 
Senator Ellender. Well, I imagine that if it weren’t for those stu- 
dent nurses doing a lot of wTork around there that the hospital probably 
would have to hire graduate nurses which no doubt would cost a good 
deal more than the work performed, I mean the amount that they 
would pay for the room and board of these student nurses. 
Dr. Overholser. I think the chances are, if they didn’t have these 
student nurses, that they would employ more relatively untrained per- 
sons, ward maids, orderlies, and attendants, and the like. 
Senator Ellender. All of which might cost more than the board 
and lodging for these student nurses ? 
Dr. Overholser. I am not at all sure that that is the case, and I am 
sure that the patients would not get such good care, which is the 
important thing. 
The Chairman. Thank you, Dr. Overholser, 
Dr. Zook. (No response.) 
I have a communication here from the Alpha Kappa Alpha sorority, 
which may be placed in the record at this point. 
(The document referred to is as follows:) 
Statement of Mbs. Thomasina Walker Johnson, Legislative Representative, 
National Non-Partisan Council on Public Affairs of the Alpha Kappa 
Alpha Sorority 
Gentlemen : I am representing the 6,000 women of the Alpha Kappa Alpha 
Sorority, the oldest sorority of Negro college women. There are 153 chapters 
in 46 States. Most of the women are professional women and are active in civic 
and community affairs. The question of health has long been of extreme in- 
terest to us. For several years we have maintained a mobile clinic in the rural 
areas of Mississippi which Dr. Thomas Parran has described as “one of the 
best jobs of volunteer public health work he has ever seen.” This project has 
cost us thousands of dollars to say nothing of the time expended by the members 
of our sorority on a volunteer basis to try to do something about some of the 
great health needs of Negroes. 
There is great need for more physicians, hospitals, and nurses. For this 
reason we are supporting this bill that will increase the number of Negro 
nurses that are so badly needed. 
We should like to urge upon the committee, however, the importance of adding 
specific provisions to this bill to safeguard the interest of minority groups in. 
the population. We should like to state that our experience with a good deal 
of existing legislation shows that when the inclusion of Negroes is not specifi- 
cally required by the act, they are often left out. Examination of the present 
administration of medical service to eradicate venereal disease would provide 
numerous examples of this nullification of purpose of the act for certain groups. 
One of the most eminent surgeons, Dr. Louis T. Wright, said that “When the 
figures for venereal disease remain high, do not look at the Negro—look at 
the act and its administration.” 
The amendments that we offer will strengthen the hand of those persons 
who must administer the act. It will be easier for fair-minded officials to TRAINING OF NURSE,S 
91 
administer the program while it makes it more difficult for persons who might 
not be inclined to administer the program fairly, to do so with discrimination. 
The need for any health program to be administered fairly cannot be over- 
emphasized. The population is too mobile. Even in sections where the most 
rigid type of segregation is practiced, epidemics start in the alleys but they 
always wind up on the boulevards. Germs know no color line and no person 
is safe from an epidemic In his community. 
In places where training for Negro nurses is planned on a fair and equitable 
basis, these amendments may be disregarded. 
We should like to call attention to section 6, page 5, where the Surgeon 
General with the approval of the Federal Security Administrator is authorized 
to promulgate such rules and regulations as may be necessary to carry out 
the purposes of this act. We should like to urge that consideration be given 
to the number of Negro nurses who will be able to take this training and that 
every facility at the command of both the Surgeon General and the Federal 
Security Administrator be used to see that the proportionate number of Negro 
nurses be trained under this program. We should like to see that a floor be 
placed under the Negro nursing situation. We urge this, no matter where the 
possible training facilities might be located. 
We should like to offer amendments as follows: 
After “graduation,” line 17, page 3, another subsection, (f), be added, the 
text as follows: 
“(f) That the Institution provide substantial and equal training opportunities 
to nurses, student, graduate, or both, who belong to minority groups.” 
We should like to add further subsection (g) : 
“(g) That the Institution will afford graduate nurses under the plan an op- 
portunity to take nurse-teacher-training courses until graduation and will pay 
each such graduate nurse a stipend at a monthly rate to be set by the Surgeon 
General, plus tuition for such courses.” 
No part of these amendments, we hope, will be interpreted as an effort to change 
human nature, but we hope it will represent to you our desire to join our efforts 
with yours to meet a pressing human need, around a common basis of humani- 
tarian motives, which every citizen, regardless of race, color, religion, or tradi- 
tional belief, can support without restraint. 
May we reiterate and reemphasize the fact that the health of America cannot 
be safeguarded as long as one segment is neglected. 
The Chairman. Are there any further witnesses who desire to be 
heard? [No response.] The hearing will then come to an end. 
(Whereupon, at 12: 35 p. m., the hearing was closed.) 
Statement Regarding Senate Bill 983, to Provide for the Training of Nurses 
1. The American Council on Education.—The American Council on Education 
was founded ijo 1918. Included in its membership are representatives from 
national and regional educational associations. There are approximately 100 of 
these representatives. More than 500 colleges and universities have membership 
including such professional associations as the Association of American Univer- 
sities, the Association of American Colleges, the National Catholic Educational 
Association, the American Association of Teachers Colleges, and all types of 
colleges and universities, both large and small. It is therefore a representative 
body particularly in the field of higher education. 
2. Committee on College Women Students and the War.—In the fall of 1941 the 
council appointed a special committee to concern itself with the problems of college 
women students. Miss Meta Glass, of Sweet Briar College, was chairman of this 
earlier committee. With the growing manpower demand of war, the Committee 
on College Women Students and the War was appointed in September 1942. Dean 
Margaret Morriss, of Pembroke College, is chairman of this committee. These 
committees from their inception have given serious consideration to the nursing 
field, and have met with representatives of nursing associations. At its meeting 
on October 9 and 10 the committee urged: 
(a) That immediate steps be taken to introduce legislation to provide Federal 
appropriation in order to insure an adequate supply of trained nurses for both 
military and civilian needs. 92 
TRAINING OF NURSES 
(ft) That a letter be immediately sent to colleges and universities having col- 
legiate schools of nursing, encouraging them to provide larger portions of 
scholarship funds to be given to prenursing students. 
(c) To prepare a statement for publication in the bulletin, “Higher Education 
and the National Defense,” calling attention to the increasing seriousness of the 
shortage in the nursing field, and urging colleges and universities to encourage 
young women to consider nursing as a profession. 
At the November meeting the committee met with representatives of the nursing 
associations and discussed specific recommendations regarding proposed legis- 
lation. 
On January 28, a special issue of the bulletin was distributed to all colleges and 
universities including the following statement: 
“The Government has declared that 55,(XX) student nurses are needed this year 
to meet the demand of the armed forces and of the community. The already 
existing schools have the facilities for educating this number of student nurses 
but on December 1, 19d2, the quota was still short by 18,000 candidates. The 
Government quota for the year is 05,000. 
“The National Nursing Council for War Service rightly describes the work of 
the nurse as the ‘war work with a future.’ . The nursing profession is one worthy 
of the best ability of the college woman. Many of the college women who entered 
nursing to meet the demand for nurses in World War No. 1 are now lenders in 
the nursing profession. The young college woman with the spirit of adventure 
and a desire to serve her country in a great woman’s profession is now needed in 
the far greater health emergency created by World War II. She is needed in 
the armed forces, civilian hospitals, industry, and the public-health field where 
positions in administration, in teaching, in community Organization, and in re- 
habilitation challenge her abilities. In the post-war period an important national 
service will be found in the establishment in Europe, South America, and Asia 
of systems of nursing education and public-health-nursing programs. There will 
be need for nurses with language ability, with special background training in 
nutrition, bacteriology, and epidemiology, in psychology, and sociology—for the 
nurse with college training. 
“Many young people have hesitated about nursing because they think that the 
war will be over before their education as a nurse can be completed. They should 
be reminded that they are rendering an essential service while in training and 
that whether the war is long or short, the reconstruction period is going to be 
long. There are now 25,000 positions in nursing schools and hospitals in teaching 
and administration and over 25,000 public-health positions. 
“It will be helpful if college and university administrators will present this 
profession, its opportunities, and its present emergency, to the students on their 
campuses. This may be done by vocational conferences, by urging publicity in 
student newspapers, and most helpful of all, by individual counseling. An espe- 
cially selected speaker is now available upon request to the National Nursing 
Council for War Service (1790 Broadway, New York City), and colleges and uni- 
versities are urged to make arrangements to have her talk to their students.” 
On February 23 the committee in a letter to the War Manpower Commission 
urged the adoption of a subsidized training program on the technical and profes- 
sional level especially for nursing. Such programs to be comparable with those 
provided for men who are serving in the armed forces. 
It is the considered judgment of this committee that Federal subsidy for nursing 
is vital to the war effort. With the auxiliary services of the armed forces and 
with the new and increasing opportunities in employment it is mandatory to 
provide such assistance. 
Proposed legislation will accomplish two purposes: 
1. It will make it possible for young women to study and remain in the nursing 
training who would not otherwise be able to do so, including the retraining of 
those who have been out of the profession for some time. 
2. It will be a strong inducement to students in that it provides public recogni- 
tion of the vital importance of the nursing profession to the successful promulga- 
tion of the war. 
Greenville, S. C., May 7, 19-iS. 
Senator Burnett Maybank. 
Washington, D. C.: 
We will appreciate support in the passage of bill S. 983. 
St. Francis Hospital. TRAINING OF NURSES 
93 
Columbia, S. C., May 0, 
Senator Burnett R. Maybank, 
Washington. D. C.: 
Request that you urge passage S. 983. bill designed to aid nursing schools. We 
are graduating 3a nurses this month. Quite a number will immediately enter the 
armed services. We can enroll 50 white and 25 colored student nurses before 
September if funds are available. 
Columbia Hospital. 
J. B. K. Deloach. 
Senator Burnett R. Maybank. 
Washington. D. V.: 
Request that you support passage of bill S. 983. 
Sister M. Reda, 
Superintendent of St. Francis Infirmary. 
Charleston, S. C., May 7, 1943. 
Honorable Burnett R. Math an k. 
United States Senate. Washington. D. C.: 
We highly recommend Senate bill S. 983 with which hospitals and nursing 
schools are in complete accord as worthy your full support and influence. 
Byrd B. Holmes, 
Superintendent. Greenville General Hospital. 
Greenville,> S. C., May 6. 1943. 
Spartanburg, S. C„ May 7. 1943. 
Senator Burnett R. Maybank, 
Senate Office Building. Washington. D. C.: 
Would request that you consider favorably the passage of S. 983, student nurses 
bill, which is urgently needed to promote enrollment and expedite training of 
nurses now needed for military and civilian hospitals. 
J. B, Norman, 
Superintendent. Spartanburg General Hospital. 
Statement of Edgar G. Brown, President. United Government Employees and 
Director. National Negro Council. Proposing an Antidiscrimination Amend- 
ment to Senate 983. to Provide for Additional Nurse Training, to Meet 
Complete War Needs 
Supplementing my brief statement during the hearings, requesting consideration 
by tlie committee, may I suggest the following language to fully protect and 
Include equal nurse training facilities and opportunities for all American women, 
regardless of race, creed, or color. 
On line 8, after the word “act”, strike out the period and insert a comma, and 
add the following language: “Provided. That there shall be no discrimination in 
the administration of the benefits and appropriations made under the respective 
provisions of this act, on account of race, creed, or color.” 
The widespread discriminations so prevalent in private hospitals, schools, and 
such national organizations, employing thousands of nurses, such as the American 
Red Cross, based on race or color make imperative such definite language pro- 
hibiting such injustices in legislation, authorizing the expenditure of Federal 
funds, supplied by American taxpayers, regardless of class, race, or other 
distinction. 
We urge, therefore, that the subcommittee of the Senate Education and Labor 
Committee will approve the inclusion of an antidiscrimination amendment in 
the bill, which is favorably recommended to the full committee and the Senate 
for immediate passage, in order to advance these protective and welfare staffs, 
so vital to the health and security of the total military and civilian population 
of the Nation, regardless of race, creed, or color. 
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