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6. The Hospital Labor Dilemma
- University of Virginia Press
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134 the hospital labor dilemma K six K The need for nurses and other attendants to staff Civil War hospitals surpassed expectations. The antebellum practice of detailing able-bodied men or using convalescent soldiers in military hospitals proved inadequate but remained in effect throughout the war. Military officers, loath to lose good men, generally relinquished their undesirables and recalled details when they pleased. Although a handful made good nurses, many convalescents were physically and psychologically unfit to nurse, while others neglected their duties. Training soldiers as nurses presented a further problem, as they could, at any time, be ordered back to the field.1 The Confederate Congress, on August 21, 1861, called for hospitals to hire civilian “nurses and cooks” to be “subject to military control” and receive the same pay as privates. Few civilians, however, willingly stepped forward to serve, and the dearth of good cooks, nurses, and attendants meant that enlisted men filled such positions. Securing laundresses proved equally difficult.2 Finding and retaining competent nurses remained an obstacle to the delivery of quality medical care. The repeated removal of able-bodied men to the front in expectation of battle disrupted well-functioning hospitals.3 Competing priorities created tensions between military and medical officials. Surgeons wanted to retain experienced and competent cooks and nurses and found disabled men wanting as attendants, but able-bodied men were most likely to be ordered into active duty. After September 1862, medical officers could permanently detail soldiers as ward masters and nurses, but the military simply ignored this provision. Pressure from the military and public to release fit white men to the army meant that hospitals too often relied on convalescent labor and suffered the discontinuity of frequent staff changes. Committees composed of surgeons and military officers visited Confederate hospitals to review medical cases, sending some men to the field, discharg- the hospital labor dilemma 135 ing others, and keeping some on as patients and attendants. A severe manpower shortage intensified the hospital labor problem in the South. In July 1863, the Adjutant and Inspector General’s Office for the Confederacy ordered that unfit men replace those who could be returned to the field, and the Surgeon General’s Office began to examine soldiers every month. Of physically fit white men, only stewards could legally avoid active service. At the end of the war, the Army of Northern Virginia was so depleted that General Robert E. Lee asked the secretary of war to sweep the hospitals for more soldiers.4 Detailed and convalescent soldiers and African Americans performed the majority of heavy hospital labor. White soldiers said little about their hospital work, focusing instead on war news. Unlike the middle- and upper-class white women who wrote extensively about their hospital careers, soldiers did not see medical labor as central to their wartime experiences.5 White male and black nurses and hospital attendants outnumbered white women and kept hospitals functioning in both North and South. They are important for this reason alone. An exploration of their work and experiences, however, also highlights the disproportionate importance of white female nursing , particularly in the South. Not only did white women have prewar experience with domestic nursing, housekeeping, and administrative tasks, but soldiers preferred them as caregivers and expected them to provide the highest quality care. Such preferences and expectations imbued white women with a greater level of influence over patients’ psychological health, spiritual health, and morale, which affected physical well-being. Even if and when soldiers and African Americans evinced dedication to and skill as nurses, the white men receiving that care continued to assume white women cared more about their needs. Soldier nurses’ motivations also differed from those of women. Few soldiers appointed as nurses had professional medical aspirations, and most viewed their hospital work as an extension or means of escape from military field service . Those nurses and ward masters attempting to advance themselves in medicine hoped to become doctors, partly because nursing remained associated with feminine traits and duties. Patients preferred female attendants, and, on the whole, women cared more about their work, which reinforced stereotypes regarding their sympathetic nature. African Americans represented a valuable labor source for both Union and Confederate hospitals. The Southern racial order, however, determined duties, experiences, and approaches to nursing, and in many cases undermined the efficacy of black labor. Although slaves and free blacks, especially women, usually had commensurate or greater experience with nursing than white women, [44.200.82.195] Project MUSE (2024-03...