STATEMENT OF THE HONORABLE ROBERT P. PATTERSON, UNDER SECRETARY OF WAR

The CHAIRMAN. Judge, for the record, I have already had inserted a summary of the House testimony, prepared by General Smith. If you can bring us up to date, it will be very valuable to the committee. You may be seated.

Secretary PATTERSON. Mr. Chairman, I have a letter from the Secretary of War. He had to leave town this morning, and he asked me to present it and, if you like, I will read it now.

Then I have a short statement of my own, and then, of course, I will be very glad to answer inquiries.

This letter is dated March 17 and is signed by Henry L. Stimson, Secretary of War:

Dear Senator Thomas: I have asked Judge Patterson to tell the committee of my strong interest in the bill to insure adequate nursing care for the men in the armed forces. The bill (H. R. 2277) makes provision for induction of nurses into the armed forces by Selective Service.

The Nation owes many obligations to the soldiers and sailors fighting in this war, but no obligation is more compelling than the obligation to provide them with the most thorough medical care when they become disabled and helpless by wounds or by disease. The paramount character of this duty is so evident that adequate nursing must be provided at all cost.

There is now a serious shortage of Army nurses. I personally found and witnessed a very considerable shortage in the theaters which I visited in July 1944. This became very much more serious in the latter part of 1944, with the great increase in the number of wounded soldiers from the hard fighting which then took place. We were unable to obtain the additional nurses needed, despite the utmost efforts of the Surgeon General and the American Red Cross. The result was that the nurses on duty in Army hospitals were obliged to work an inordinate number of hours every day to give the necessary care to casualities from the field of battle.

On January 6 the President, as you know, called attention in his message on the state of the Union to the critical shortage of Army nurses and urged the passage of an act to provide the additional nurses by Selective Service. While his message brought forth a somewhat greater number of volunteers in the next 3 weeks, the rate of applications quickly fell off, and it is down again now to the lower levels that were prevalent last year. It is the judgment of the Surgeon General that in the absence of legislation the requirements for Army nurses will not be filled.

Under the conditions that face us, it is of the most urgent importance that favorable action on this bill be taken promptly. We cannot ask the wounded and sick soldiers to wait for relief.

In behalf of the War Department I also urge prompt passage of H. R. 2277.

The bill declares that to provide adequate nursing care for the armed forces it is imperative to secure immediately the services of additional

nurses.

The bill, as passed by the House, provides that nurses between 20 and 44, inclusive, with certain exceptions, shall be liable for selection and induction into the military service.

It is a simple, direct measure. It will meet the need. Without it there is real risk that the need will not be met. We cannot ask our soldiers to take that risk.

The one and only consideration with us in secking passage of this bill is to assure the highest standard of nursing care for our wounded and sick soldiers. This legislation was proposed only when it had become probable that such care could not be provided without it.

You will recall that it was on January 6 that the President called. attention to the urgent need for more Army nurses and asked for this legislation. Nothing has occurred since January 6 to make this need less pressing. The Surgeon General is here to give you the detailed facts, but there are two prime features in the situation that I fell bound to mention.

1. Since May 1, 1944-a period of 10 months-the patients in Army hospitals have doubled in number, while the increase in the Nurse Corps has been less than 20 percent. That is why we cannot give the standard of nursing care that we owe the soldiers unless we have

more nurses.

2. Four hundred and fifty thousand soldiers have already been wounded in this war. Since the President's message on January 6, in which he urged the induction of nurses under the Selective Service Act, an additional 107,000 soldiers have been added to the list of wounded. That 107,000 is part of, and not in addition to, the 450,000. Our Army hospitals, at home and overseas, now have 520,000 patients. Those soldiers now wounded and sick, and those others who will fall wounded and sick before this bitter war is finished, have the first claim on this country. The care of these wounded and sick men is the No. 1 nursing job of the Nation.

In January the President called for 60,000 nurses for the Army, or an additional 18,000 nurses. That figure represents the Surgeon General's considered judgment. As of March 10 the Army Nurse Corps numbered 47,500, an increase of 5,250 since the President's message. We are still, however, far short of our goal, despite the President's message and a vigorously stepped-up recruitment campaign. The Army and the Red Cross have streamlined their procedures and have speeded the processing of applications. Nevertheless, as nearly as can be fairly estimated from all available facts, we will on June 1, 1945 still be 9,000 short of Army needs unless this bill is enacted. While it is true that there was a sharp upswing in applications of nurses to the Red Cross immediately following January 6, it is also true that an equally great decline has since set in. The volume of applications is now almost down again to that inadequate number that prevailed in 1944. We owe our wounded and ill soldiers something more than a 50-percent result.

This bill will not only benefit the wounded and sick soldiers who have the first priority on the Nation, but will also benefit those devoted women. who have voluntarily become Army nurses serving in this country and wherever our soldiers are fighting overseas. Unless the Army needs are filled, these nurses will be called on to work beyond the limit of their endurance. They are close to that limit now. I have seen nurses overseas who have been on continuous duty for over 18 hours, attending to the critically wounded that have been brought in.

Of course, when nurses are short, those on duty will continue to carry the load. They will continue until they break down, and the strain on those devoted women is beyond their power to bear. They need and deserve relief.

After such

Many of these nurses have been overseas for 3 years. long and arduous service they are entitled to a tour of duty in this country, but they cannot be returned in the face of the existing critical shortage of nurses. Fairness compels some measure of relief for these brave, patient, hard-working women.

The drafting of nurses is no reflection upon the nursing profession in this country. The nursing profession can well be proud of the large number of nurses who have volunteered. The fact is that an allout war makes heavy demands, demands that cannot be filled by volunteer recruitment, and that is as true of nurses for military service as it is of men for military service. At the end of April 1944 additional efforts were made to raise the number of Army nurses from 40,000 to 50,000. A net gain of 2,584 additional nurses was secured by the end of 1944.

I am sure we all agree that with the armed forces of 12,000,000 men in the Army and Navy now, it would have been utterly impossible to reach that strength by pure voluntarism. It was brought about by the Selective Service Act. That is true in every war if it is long enough and on a large enough scale; you always have to resort to induction by selective service, and if it has not been done at the outset it has to be done in the course of the war, because there comes a time when the demands are such that those who do cheerfully go have gone and recruiting dries up. So I say the measure here recommended is no reflection upon anybody.

That net gain of 2,584 was out of the target of 10,000 additional nurses set for those 8 months.

The wounded cannot wait to see whether the needs may be filled by voluntary recruitment. In the President's words, "the need is too pressing to await the outcome of further efforts at recruitment."

Except for registration, nurses engaged in essential civilian nursing will not be affected by the passage of this bill. Since nurses engaged in nonessential civilian nursing will first be inducted, it is obvious that there will result a more even distribution of nursing in essential civilian nursing. There are now ample nurses available to fill the needs of the armed forces without impairment of civilian nursing service.

Above all, I urge prompt action. There is no time to lose. The hard fighting now taking place means more casualties, and more casualties call for more hospital and nursing care. Delay in obtaining the additional nurses needed may result in tragedy to thousands of wounded soldiers.

In conclusion, I may sum up the case by saying:

First, the Nation is bound to give the most adequate and thorough nursing care to the soldiers who fall wounded and sick in its defense. No one has challenged that proposition. No one can.

Second, that standard of nursing care will not be met unless we have legislation for induction of nurses into the military service. The risks of failure are too great to rely on volunteer recruiting alone. For that we have the word of the President, and we have the word of the Surgeon General of the Army, who has the responsibility for the medical care of our soldiers. The same view on inadequacy of volunteering has been given by the Surgeon General of the Public Health Service, by the Administrator of Veterans' Affairs, and by the Procurement and Assignment Service of the War Manpower Commission. We cannot afford a policy of "wait and see."

Prompt passage of this bill will be the guaranty of Congress to the stricken soldiers that their nursing care will be adequate.

The CHAIRMAN. Mr. Secretary, I do not think it need be said here, especially to this committee, that we ought to be prepared for all

things. We have attempted to anticipate as best we could how the drafting of nurses could be accomplished, and if we cannot get over the real lesson of preparedness to the people of our great country we will probably fail in accomplishing any lasting worth.

You have a shortage of nurses, you say. What is being done to make up that shortage now? I do not think, in the light of what has been done in nurse training and what has been done in doctors' training, to cut down the need, and the changing of mind from time to time about the worth of this nurse training, that it is quite right to bring us to a situation where quick action on the part of the legislative branch of the Government is the prime necessity. That is no way to accomplish things. Now, what are you doing for the recruitment of nurses at the present time?

Secretary PATTERSON. As the committee knows, Senator, we have always worked with the American Red Cross to get volunteers.

Since the date of the President's message they have greatly shortened, with the American Red Cross, the processing of applications. They have also with the American Red Cross sent out to all Red Cross chapters and bodies, appeals in the strongest terms to get the nurses to volunteer. They have used the National War Advertising Council, the Boy Scouts, the Girl Scouts, and the American Legion; I think they have used every means of bringing the need home.

It is interesting to note that by the Gallup poll, the report is that 78 percent of the people of the country reported that they were aware there was a shortage of Army nurses. So there has been no effort spared, certainly not in the last 3 months, to make the need known. The need is known and thoroughly known.

That does not mean efforts were not taken before that time. The Surgeon General is here and he can tell in more detail what he has done. But in the last 8 months of 1944, in order to try to fill the need of 10,000 more nurses, the Surgeon General's office and the Red Cross have tried to canvass the field and bring in volunteers.

Some 27,000 names were turned over by the Procurement and Assignment Service of the War Manpower Commission of nurses available for Army duty, and a letter was sent to every one of them by the Army Nurse Corps. I believe they had 700 answers and they got something like 200 volunteers out of that effort, and that was, as I say, the result of letters sent personally to each one of the 27,000 people certified to be available for Army nursing.

The CHAIRMAN. Of course, where you have a selective group to begin with, such as you have among nurses, professionally trained persons, the problem is a little different. But in one city that I know of since we have the War Department on the stand, we will be able to talk about the Navy, I suppose-in the recruitment of WAVES there have been in the city, to my knowledge, three commissioned officers with a great staff. Have you anything comparable to that in regard to the recruitment of nurses? Or, to put it this way: You have recruitment organizations for WAC's from one end of the country to the other; why can they not be given the nursing task, too?

Secretary PATTERSON. The regular channels have always been for the stimulation of volunteering, through the American Red Cross. They reach many more communities-I suppose they reach every county in the United States. They reach many more communities than any direct recruiting effort of ours could do.

The CHAIRMAN. Do you assume the Red Cross is doing a bigger job than the Army is doing for the WAC's and the Navy for the WAVES? Secretary PATTERSON. We have not had great success in the recruiting of WAC's. We have 93,000 after 3 years of effort, while the objective has always been 150,000. The recruiting of WAC's has come in very slowly. I would not say that the method used in recruiting WAC's was any better than the method used for recruiting nurses or that the results were any more successful. In fact, we have come far closer to the quota on nurses than on WAC's.

The CHAIRMAN. The great difficulty in recruiting nurses comes back to the one point, and that is finding available trained nurses in the country. So we have very probably found that there is a shortage in education and training. I think that is where we have fallen down in everything, is it not, Mr. Secretary?

Secretary PATTERSON. They can correct me if I am wrong, but I have understood that the figure on the number of registered qualified nurses in the country was around 260,000. So that there is no over-all shortage of a severe character, at any rate, in the people qualified in the country to be nurses.

The CHAIRMAN. But hardly even those figures will hold in a recruitment program where you take one selective group from another selective group; that is, your Army qualifications and your Navy qualifications are such you are going to limit it naturally to a small percentage of all of the people that offer themselves.

Secretary PATTERSON. I think it is the view of all who have studied it that the quota of Army nurses set at 60,000, is by no means one beyond the capacity of the registered trained nurses of this country, even those who can qualify by age bracket and physical standards, to fill.

The CHAIRMAN. There are something like 280,000 registered nurses in the country?

Secretary PATTERSON. I had heard there are between 250,000 and 280,000.

The CHAIRMAN. Somewhere under 300,000?
Secretary PATTERSON. Yes.

The CHAIRMAN. And 50,000 is one-sixth.

Secretary PATTERSON. Sixty thousand would be something less than one-fifth.

The CHAIRMAN. So that if you go into the other provisions, or into the branch of life where you have a particular need, you find it likely the failure of supplying the need is something very basic to the whole situation. That has been discovered in selective service; for instance, that poor eyes have accounted for many of our rejections for military service. I think we should be prepared on all these things. That is the view of all of us.

Secretary PATTERSON. I agree with you, Senator, but I remain of the opinion, after a war has continued for 3 years on the scale of this one and the need grows, that you cannot safely rely on further volunteering in face of the way the volunteering has dried up. Of course, it gets a shot in the arm occasionally, like the President's message gave it one, but that peters out again and the needs are too vast to be filled by pure volunteering. The urgency of adequate nursing and medical care is something we cannot fail on. The urgency is so pressing we cannot afford to ask our soldiers to take the risk.