of the conditions within the United States, with over 30,000 wounded returned from overseas a month, and he has only 1 nurse for 25 beds as against a recommended ratio of 1 to 15 beds within the United States, the best civilian standards being, as I understand it, 1 nurse to less than 15 beds.

That shows the work load and how thinly our Army Nurse Corps is spread now and how heavily overworked that Nurse Corps is. Conditions like that do not prevail in civilian hospitals and yet, overseas, they have to work under the most emergency conditions, tents in zero weather in the winter, and things of that sort, and there is no way of the sister or mother or daughter being available to pinch-hit and do work for them the way they are doing here on the home front.

Senator BURTON. Mr. Secretary, are you satisfied that under this bill you could fill your requirement of 60,000 nurses?

Secretary PATTERSON. Yes, sir.

Senator BURTON. How long would it take?

Secretary PATTERSON. I think it could be done before the last day that the Surgeon General has set for his target, May 31. As a matter of fact if this bill is passed, I doubt if you will have to resort to induction to any considerable extent. But if the bill fails it will be interpreted by a great many people that there is not any need and that Congress does not believe there is any need. Therefore in my opinion there will not be very much volunteering.

Senator GURNEY. I have one question, Mr. Chairman: Mr. Secretary, this bill does not provide for induction of nurses for service other than in the Army and Navy; is that right?

Secretary PATTERSON. That is right, land and naval forces. I do not know why they left out the air, but they mean Army and Navy, there is no doubt of that.

Senator GURNEY. Is it not a fact that many wounded and sick soldiers are being discharged from Army and Navy hospitals right into the veterans' hospitals at present?

Secretary PATTERSON. Yes, sir.

Senator GURNEY. Are we not going to have some shortage in the veterans' hospitals?

Secretary PATTERSON. General Hines claims he has, and I have no doubt he is right. But there is an exemption under this act to exclude nurses employed in the Veterans, Administration.

Senator GURNEY. In other words, you cannot induct them out of a veterans' hospital into the Army or Navy?

Secretary PATTERSON. That is right.

Senator GURNEY. The point I want to make is, What is the War Department's recommendation on the advisability of inducting nurses to serve in veterans' hospitals?

Secretary PATTERSON. I think that ought to be the subject of a separate proposal, Senator. I do not know enough about the trend in the veterans' hospitals, whether it is getting less acute or more acute. I think it is a subject for a separate measure and it should not be covered in one for the armed forces because, of course, they do not enter military service when they go into the Veterans' Administration hospitals, not in general.

Senator GURNEY. The Nation is obligated to give complete care to a soldier even after he is discharged, and for that reason we have set up the veterans' hospitals. If we are going to train hospital nurses

and put them into the Army and the Navy, the veterans' hospitals certainly are going to have a harder time securing new nurses for their facilities.

I believe, Mr. Chairman, we should have someone from the Veterans Bureau to advise us on this.

The CHAIRMAN. Is there testimony in the House hearings?

Secretary PATTERSON. I believe the Veterans' Administration has supported this bill as it stands, without their needs being included. The CHAIRMAN. Are there any other questions?

(No response.)

Thank you, Mr. Secretary.

General Kirk, please.

STATEMENT OF MAJ. GEN. NORMAN T. KIRK, THE SURGEON GENERAL, UNITED STATES ARMY

The CHAIRMAN. For the record, General, will you state what you wish to say about this?

General KIRK. I have a formal statement here on this bill, sir, if you care to hear it.

The CHAIRMAN. We will be glad to have it. Just be seated.
General KIRK. Thank you.

Mr. Chairman and members of the Senate Military Affairs Committee, for the record, my name is Maj. Gen. Norman T. Kirk, United States Army. I am Surgeon General of the Army. In that capacity, I am responsible for providing adequate medical and nursing care for the personnel of the United States Army.

I favor the passage of this bill, H. R. 2277, which provides for the application of selective service principles to the procurement of nurses at this time. The drafting of nurses was proposed in the President's message of January 6, and the Medical Department is supporting it heartily.

I favor this bill because we need 60,000 nurses urgently and because we cannot risk the failure to get them through voluntary recruitment. With the enactment of this bill, I know, and the soldiers in our Army will know, that they will get the nursing care necessary for the wounded and sick.

NEED FOR 60,000 NURSES

Let me tell you why we need 60,000 nurses. As of March 7, 1945, the number of our soldiers wounded in battle in this war reached 450,000. Since the beginning of this year over 116,000 soldiers have been wounded, or at the rate of over 1,750 each day. The chart before you, which is called Cumulative Army Casualties, and the supporting data attached to it show the total of the wounded in action from August 1944. You will note that the number of wounded soldiers has increased during that period about 400 percent.

Our Army hospitals, according to most recent data, have about 520,000 patients who are either sick or wounded. Approximately 244,000 are in hospitals in the United States, and the rest are in hospitals overseas. The total number of patients has of course been continuously increasing. If you will examine the chart labeled "Patients in Army Hospitals Since May 1, 1944" and the supporting

data, you will see that the number of patients has increased by 260,000 since May 1, 1944.

We are evacuating battle casualties and seriously sick soldiers to hospitals in this country at an ever-increasing rate. In July 1944 the the number of such evacuees was about 10,500. In February 1945 it was approximately 37,700, or about 1,350 per day.

The need for increased nurses for our wounded and sick soldiers is apparent from the figures I have just given you. The American soldiers are entitled to the best medical care which we are capable of giving. The nursing personnel must be made available for them.

The Army nurse is doing one of the truly great jobs in this war. With supreme loyalty and high devotion to duty, over 90,000 American women have voluntarily applied to the Red Cross since Pearl Harbor for service as nurses with the Army and Navy. Over 10,000 nurses have been separated from the services during the war. The need for the application of the principle of Selective Service to nurses is therefore no reflection on the nurses of the country. The demands of this war are simply too great to rely upon voluntary recruitment. At the present time Army hospitals in this country are understaffed with nurses. Over 60 percent of all Army nurses are assigned to overseas units.

The requirement of 60,000 nurses is based upon a minimum of 1 nurse to 12 beds in overseas hospitals and 1 nurse to 15 beds in the zone of interior. These requirements are necessary to provide minimum adequate nursing care. In addition, nurses are assigned to hospital trains, to training centers, technical schools, separation centers, and to dispensaries, and there are always a number who are sick, in reserve pools, or traveling to their duty stations.

In December 1944 the nurse shortage was so acute that we found it necessary to send 11 general hospitals to overseas service wither

In overseas theaters a great many of the fixed hospitals have erpanded their bed capserty from 50 to 100 percent over normal with out additional personnel.

Many nurses have been on continuous duty for 18 hours attending the critically wounded who have been brought in. While in the Southwest Factfie I saw many nurses who had been overseas for more These nurses need relief.

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NURSE ASSIGNMENT IN A GENERAL HOSPITAL IN THE UNITED STATES

Let me explain briefly the nursing set-up in a general hospital in the United States. Here is a chart entitled, "Army Nurse Corps in Zone of Interior Hospitals." It shows the normal assignment of 1 nurse to 15 beds in a 1,000-bed general hospital in this country. If not at present, then in the near future, 80 percent of the patients in these hospitals will be bed patients. Forty-seven nurses on day duty in wards on an 8-hour shift are able to give each patient one-half hour of professional nursing care. At night, with 7 nurses on duty, each patient can receive 6 minutes of nursing care. Surely we cannot spread our nursing service any thinner.

INADEQUACY OF VOLUNTARY RECRUITMENT

The issue now is whether we are to meet these needs by voluntary recruitment or under the amendment to the Selective Service Act which is embodied in H. R. 2277. I give it as my carefully considered judgment that the passage of the bill is absolutely necessary. Recruitment methods have been aggressively tried but will not produce the required number of nurses in time to meet our pressing needs. The American Red Cross has more than 350 recruitment committees throughout the United States. The Recruitment Publicity Bureau of The Adjutant General's Office, has had many national agencies working on the procurement program. The American Legion, the Girl Scouts, and several private advertising and publicity agencies have been contributing their efforts toward this campaign. Some 818 radio stations throughout the Nation have been carrying transcriptions on Army nurse recruitment. In addition, newspapers, periodicals, and posters have been utilized.

The results of this intensive and vigorous program for voluntary recruitment are shown on the chart bearing the legend, "Actual and required number of nurses, Army Nurse Corps, 1944-45." It took us many months to reach the 40,000-nurse ceiling which existed until the end of April 1944. In the 8 months from April 1944 to January 1945 some 27,000 new nurses graduated from nursing schools. Nevertheless, in the same period, the strength of the Army Nurse Corps increased by only 2,584, or a net gain of only 323 a month..

In September 1944, 27,000 letters were mailed over the signature of the superintendent of the Army Nurse Corps to prospective nurse appointees, who were classified 1-A by the War Manpower Commission. Only 710 replies to those letters were received, and approximately 200 applications resulted in appointments in the Army Nurse Corps.

The President's message to the Congress on January 6, 1945, greatly stimulated applications by nurses for service in the armed forces. Unfortunately, however, the number of these applications promptly and sharply declined and is now approaching the trend which existed during 1944. The chart headed "Applications for Army and Navy Nurse Corps Received Weekly by American Red Cross Committees Since January 6, 1945," and the supporting data. show how rapidly the applications have been declining. Within 4 weeks after the President spoke, applications fell from 5,115 per week to 1,130. In the 2 weeks in March they averaged 733 per week.

In the other chart, which is called Applications for Army Nurse Corps received since January 1, 1944, by American Red Cross at national headquarters, you can see how the present trend is now approaching our experience in 1944. In the first week of January 1944 there were 453 such applications for the Army Nurse Corps. In the week just ended, on March 10, 1945, there were 471 such applications. The effect of the President's appeal has apparently been spent.

NEED FOR DRAFT OF NURSES

Compare for a moment the relative increase in the number of patients in Army hospitals and the number of nurses in the Army. It is shown by the chart entitled "Percentage Increase in Patients and Army Nurse Corps Since May 1, 1944." At that time the Nurse Corps had just about reached its ceiling as it then existed. You will see that the patient load increased about 100 percent whereas the number of nurses increased about 17 percent. In my opinion, this comparison proves conclusively how completely voluntary recruitment has failed to meet our needs despite the most intensive and aggressive campaign on a Nation-wide scale.

Since the beginning of this year and under the stimulus of the President's message and intensified recruitment efforts, we have succeeded in increasing the strength of the Army Nurse Corps from 42,255 at the end of 1944 to an estimated 47,500-a net increase of approximately 5,250. Both the Army and the Red Cross have expedited their procedures for handling applications. After a careful study of the backlog of applications now being processed by the Army and by the Red Cross and making our best estimate of further voluntary recruitment until June 1, 1945, it is our judgment that we will be about 9,000 short of our need of 60,000 nurses at that time.

If the proposal for selective service of nurses, which has had a good deal of publicity, is now rejected, it is recognized that voluntary recruitment will be much less effective than it was before the President's message. The psychological factor involved is that the draft proposal is to meet an emergency, and if it is rejected the normal assumption on the part of nurses will be that the emergency does not in fact exist and that they are not badly needed. This would play havoc with the voluntary recruitment program, which, even without this handicap, has failed to bring forth sufficient volunteers during the last year. Obviously then, if this legislation is not quickly passed, we are going to fail our stricken combat soldiers.

NECESSITY OF PROMPT ACTION

Speed is the essence of the problem. Our wounded and sick cannot afford the luxury of "too little and too late." It is right now that intensive fighting is going on in the European and in the Pacific theaters. Each day large numbers of American soldiers are being wounded and become ill. Each day our hospitals overseas and at home are becoming more crowded. Each day more American soldiers require the care of nurses. The need is real and the need is now.

The CHAIRMAN. General, the quotas have always been met up to 1944, have they not?