Federal Security Agency 
U. S., PUBLIC HEALTH SERVICE. 
Division of Nurse Education 
U. S. CADET NURSE CORPS 
Origin and Plan of Operation 
On. June 15, 1943, the President approved the Bolton Act which had been 
passed by the 78th Congress; 8n July 12 funds became available; and within 
a'week, application forms and instructions were being mailed to- some 1,300 
accredited schools of nursing which may be eligible to participate in this 
new nurse education program. At the same time letters describing the rela- 
tionship pf all nursing and hospital groups were being sent to State and 
local nursing councils for war service, State Boards of Horse Examiners, 
Presidents of State.Leagues of Nursing Education, Directors of Schools of 
Nursing, Hospital Administrators, Presidents of Collegiate Schools of Nurs- 
ing, Nurse Associations,’Public Health Nursing Organizations. High schools, 
colleges, hospitals, and nursing organizations are being urged to.give im- 
mediate, active support to the recruitment campaign for the enrollment of 
65.000 new student nurses in the U. S. Cadet Nurse Corps before June 1, 1944. 
PREVIOUS _ The shortage of nurses which has now become acute was fore- 
NURSE seen in 1941 when Congress appropriated #1.2 million to the U, S. 
TRAINING Public Health Service to use in assisting schools of nursing to 
ACT train additional student, nurses and to provide refresher and post- 
. graduate courses. The appropriation was nearly doubled in''1942, 
and altogether a total of #5.3 million was appropriated for the biennium 
1941-43. This year Congress has made available #45 million for a much more 
comprehensive program and more funds will be appropriated as needed to carry 
out the purposes of the Bolton Act. • 
The nurse training recruitment program, initiated-as part of the Na- 
tional Defense health activities, was,successful within the limitations iEx- 
posed by law. Appropriations during the fiscal years 1941 and 1942 aided 
12.000 student nurses in 309 schools of nursing. ,■■ Equipment and supplies 
for libraries and laboratories and salaries for instructors were also pro- 
vided, About 3,800 inactive nurses were given refresher courses and some 
4,800 graduate nurses received postgraduate training in special fields es- 
sential to the; war effort. . .. .. ; 
WAR ’ It became -evident during 1942- that -nurses could not be 
CREATED trained fast-enough to meet the rapidly increasing demands of 
ACUTE both the military and-civilian populations. Graduate nurses, re- 
NURSE spending quickly to the call of the-armed forces, -left the staffs 
SHORTAGE of hospitals, health and welfare agencies, schools and institutions. 
Civilian needs for nurses mounted in war-boom areas. The influx of 
millions of new workers,- both men and women, created, unprecedented health 
problems not only in industrial plants but also,in trailer camps and in 
communities where crowded, insanitary living quarters menaced the health 
of workers and their families. . War' industries more than doubled the hum-■ 
ber of nurses employed for industxsj^^^Lth- work. Hospitals were pressed for additional services at the very time their staffs of doctors, interns, 
and nurses were "being depleted. Wards and sections were closed in many 
hospitals "because of lack of personnel. 
Yet, the demand for hospital care continued to mount as the number of 
maternity cases increased and as more people tended to seek hospitalization 
for minor ailments when home medical services were unavailable. Use of hos- 
pitals also was stimulated "by the growth of membership in Blue Cross plans 
and by the greater ability of people to pay for health and surgical services 
as incomes rose. The greatly increased patient turnover created a great 
strain upon medical and nursing facilities. 
AID OH During the Hall of 1942, the situation grew so much worse 
HBDSRAXj that hospital administrators and nursing leaders consulted 
GOVBEhDHDTT federal agencies to see what could be done. Emphasizing the 
SOLICITED fact that the program then in operation was insufficient to 
meet the requirements of the armed forces and at the same 
time maintain essential civilian services, they urged broadening the scope 
of the nurse training program. 
The need for more substantial Government aid in the recruitment of 
nurses became apparent when the Army and Navy issued a call for 2,500 nurses 
each month during 1943 in addition to the 35,000 already in military service. 
The plan which was eventually implemented by the Bolton Act was developed in 
a series of conferences attended by representatives of the National Nursing 
Council for War Service, the American Hospital Association, the U. S. Public 
Health Service, the Health and Medical Committee, Federal Security Agency, 
and other governmental agencies. 
BOLTON Cut of these deliberations grew the legislation introduced 
ACT in the House (H. R, 2326) by Mrs, Frances P. Bolton, 
INTRODUCED Congresswoman from Ohio. Hearings were held by committees 
of the House and the Senate on May 7-8, 1943. Representatives 
of the Army, Navy, Veterans Administration, Public Health Service, Office of 
Civilian Defense and other Federal agencies concerned with the problem urged 
the passage of the bill as did the representatives of many private groups 
and institutions. 
MAHY Dr. Claude ¥, Monger, Director of St. lake’s Hospital, Hew 
GROUPS York City, representing the American Hospital Association, 
EHD0HS3 presented a resolution of the Board of Trustees of that As- 
MBASUK3 sociation approving the hill and urging 11 favorable action 
with minimum delay.” Dr. Hunger stressed the really desper- 
ate situation in civilian hospitals as a result of the shortage of nursing 
personnel and stated that the administrators of large hospitals were nat a 
loss to know what to.do about this lack of nurses.” 
Other organizations represented at the hearings were: The American 
Red Cross, The Catholic Hospital Association of the United States and 
Canada, the American Protestant Hospital Association, the American Nurses 
Association, the National Association for Colored Graduate Nurses, the • 
National League of Nursing Education, the National Organization for Public 
Health Nursing, the Association of Collegiate Schools of Nursing, and 
the American Psychiatric Association. Prior to, and during the hearings, letters and telegrams were received by governmental officials from hospi- 
tal superintendents in all parts of the country describing their predica- 
ment due to inadequate nursing staffs. Stating that patients were being 
-denied admission and that wards had been closed and could not be reopened 
until more graduate nurses became available, they urged passage of the- . 
Bolton bill and approval of funds for the training program. 
The unanimity of opinion as to the need for nurses, .and the widespread 
approval of the proposed legislation to help meet the need, convinced the 
congressional committees of the. soundness of the proposals. The legisla- 
tion which was quickly passed by both houses without a dissenting vote, au- 
thorizes Federal grants-in-aid to approved nurse training schools meeting 
certain scholastic and curricular requirements. 
ACT Immediately after the passage of the Act, a Division of Nurse 
BEGINS r. Education was established in the Public Health Service 
TO directly responsible to the Surgeon General. Miss Lucile 
JUNCTION Retry was appointed Director. She had been on the nurse edu- 
cation staff of the Public Health Service for the past two 
years and had recently been appointed Dean of the Cornell University-New 
York Hospital School of Nursing, New York City, and then granted leave of 
absence. 
The Federal Security Administrator, as directed by the Bolton Act, ap- 
pointed an Advisory Committee on Training for Nurses to meet with the Surgeon 
General. The Committee is composed of: Chancellor Oliver C. Carmichael, 
Vanderbilt University; James A. Hamilton, New Haven Hospital; Miss Marion G. 
Howell, Western Reserve University; Sister Helen Jarrell, Loyola University; 
Dr, Hyrum Leo Marshall, University of Utah; Rev. Alphonse M. Schwitalla, St. 
Louis University; Miss Isabel M, Stewart, Columbia University; Miss Margaret 
Tracy, University of California; Miss Anna D. Wolf, the Johns Hopkins 
Hospital. 
FIRST On June 25 and 26, Dr. Thomas Parran, Surgeon General of the 
MEETING U. S. Public Health Service, held the first conference with 
CP ADVI- this Committee at which rules and regulations governing the 
SCRY administration of the program were prepared. They were ap- 
COMMITTEE- proved by. the Surgeon General on July 3, 1943, and were pub- 
lished in the Federal Register of July 9, 1943. In issuing 
these regulations the Surgeon General explained that: 
,!The objectives of 'the Public Health Service and 
of .the Advisory Committee in formulating the regula- 
tions were to insure a sound educational program, but 
to leave the responsibility for the administration of 
specific programs to the individual schools and hospi- 
tals . No one. Federal pattern jis to _be_set. ' The 
schools will be free to select their own students, to 
plan their own curricula, and to formulate policies 
consistent with the Act and the traditions of the in- 
stitutions concerned.n ACCELERATED The Bolton Act provides that participating schools must agree 
CURRICULA to accelerate their curricula so that the required program of 
REQUIRED combined study and practice will be completed in from 2A to 
30 months, except that in the case of students admitted prior 
to January 1, 1942, this period may extend to 32 months. The remaining pe- 
riod before graduation is to be devoted to supervised practice either in the 
home hospital, other civilian, hospital, or a Federal hospital or agency. To 
be eligible for participation in the program a school must provide satisfac- 
tory living facilities, adequate student health service, clinical experience 
in medicine, surgery, pediatrics, and obstetrics. In general, the standards 
of the Rational League of Rursing Education are being used as a guide. Any 
institution, such as an accredited school of nursing, a hospital, a univer- 
sity, or a college, operating nurse education facilities and wishing to par- 
ticipate, may apply direct to the U. S. Public Health Service which is the 
Federal agency authorized to administer the Act. It is possible for the 
smaller schools of nursing—those connected with hospitals having a daily 
average patient-population of less than 100—to participate, provided the 
clinical experience available and the educational program meet the regula- 
tions of the Surgeon General, 
ITEMS Application forms for participation in the Federal Nurse 
COVEKSD Training Program, together with instructions for preparing 
BY the required "budgets, may be obtained by writing to the Divi- 
ALLCTMSNT sion of Nurse Education, U. S. Public Health Service, Wash- 
ington, D, C. Funds will be allotted to the participating 
schools in accordance with the plans which they have submitted to the Pub- 
lic Health Service for review and approval. Funds may now be requested for 
the following items: 
(1) Maintenance.— Peasenable maintenance will be paid for 
all students who are members of the U. S. Cadet Nurse Corps for the first 
nine months of their training, provided that the hours of student practice 
in the hospital do not exceed an average of 24 per week, and that the hours 
of combined practice and class work do not exceed 48 in any one week. 
(2) Tuition.— Reasonable tuition and fees for all members of 
the Corps will be paid, it being assumed that existing or already established 
rates are reasonable. 
(3) Uniforms and Insignia.— The cost of outdoor uniforms and 
insignia will be paid for all members of the Corps, provided such uniforms 
conform to the "Regulations for Uniforms for the U. S. Cadet Nurse Corps,” 
as prescribed by the Surgeon General. 
(4) Stipends.— The Public Health Service will pay to each 
cadet during her first 9 months of training (Pre-Cadet period) not less than 
#15 per month and during the next 15 to 21 months (Junior Cadet period.) not 
less than #20 per month. Senior Cadets, who will be engaged in supervised 
practice, will be paid by the hospital or agency employing their services, 
and the stipend shall be not less than #30 per month. The Federal Govern- 
ment does not pay the Senior Cadet stipend. STUDENT The U, S. Public Health Service will pay maintenance costs 
BENEFITS for the first nine months of the study course and full in- 
AND structional costs, as well as cost of uniforms, hooks, lab- 
Q3LIGA- oratory fees, etc., and stipends to first and second year 
TIONS student nurses in schools which have approved plans. This 
, aid is available for students who satisfy the school that 
they are physically and scholastically fit and who, when enrolling in the 
U. S. Cadet Nurse Corps, will sign a statement promising that, upon gradua- 
tion they will be available for the duration of the war in either military 
or essential civilian nursing services. This promise does not preclude 
marriage nor does it imply that a nurse must enter one of the armed serv- 
ices. She may serve in a non-governmental hospital, the Veterans Adminis- 
tration, Public Health Service, Indian Service, a war industry plant, or 
in other essential war service. 
Expansion of School Eacilities 
Expansion of housing and such educational facilities as classrooms 
and libraries, will be necessary in many nursing schools if the required 
number of student nurses are to be enrolled in the U, S. Cadet Nurse Corps. 
Institutions which cannot finance the entire cost of such additions are 
eligible to apply for assistance under the Lanham Act. Channels have been 
cleared to enable prompt consideration of applications. 
Institutions applying for financial aid under the Lanham Act make 
their preliminary request to the Regional Office of the federal Works Agency 
having jurisdiction in the state. New construction will be permitted only 
upon evidence that existing buildings are not available for lease or purchase 
that might be suitably altered or rehabilitated. 
Institutions which do not require assistance from the federal Works 
Agency under the Lanham Act should make application for priorities as- 
sistance directly to the War Production Board, Washington, D. C. 
The Surgeon General, in urging hospitals, nursing schools, and other 
interested groups to give the program full publicity, and to act with all 
possible speed in making their applications, said: 
nThe task of the_ U. $. Cadet Nurse Corps is to 
enroll 65.000 additional students in basic schools 
of nursing during the present fiscal year; to make 
the_ students_ available for full-time nursing duty 
under supervision at an earlier date than ms pos- 
sible under the former plan; and to maintain a con- 
tinuous supply of graduate nurses pledged" to serve 
in essential nursing positions fHr the duration of 
the war. Whether vie accomplish this vital war ob- 
jective depends upon the teamwork which all of us 
apply to our specific tasks in the program."