STATEMENT OF DR. THOMAS PARRAN, SURGEON GENERAL, UNITED STATES PUBLIC HEALTH SERVICE The CHAIRMAN. Doctor, will you state for the record what you want to appear about you? Dr. PARRAN. Dr. Thomas Parran, Surgeon General, United States. Public Health Service. Mr. Chairman, I appear in support of H. R. 2277. All of us agree, I am sure, that the needs of our armed forces for nurses must be met at once. Our wounded must have all required nursing care. The record as presented by Surgeon General Kirk indicates that these needs are not being met quickly enough through voluntary methods of recruitment. In the face of this record, it does not appear that enough volunteers can be secured within the next 2 months to reach the Army quota of 60,000 nurses by June 1. Moreover, the needs of the military are bound to continue beyond the close of the war. The number of wounded needing care is cumulative. It will not reach its peak until the fighting stops. We must take into consideration, also, the fact that as the war progresses toward victory, the public will assume that peace is closer at hand than it actually may prove to be. We had such an experience last autump, and on Christmas Day, the tragedy of overoptimism hung heavily over the Nation. Indeed, in my opinion, this false peace psychology is largely responsible for the accumulated military nurse shortage. We cannot afford to risk the repetition of a similar disaster. It is for these reasons that I favor applying the selectiveservice principle to graduate nurses up to the age of 45. I am convinced this is the only way to meet the military needs as quickly as they must be met. The CHAIRMAN. Doctor, all nurses are commissioned at the present time in the Army, are they not? Dr. PARRAN. They are, Mr. Chairman. The CHAIRMAN. Is there any other service in the Army or Navy for commissioned officers that is on a selective-service basis? Dr. PARRAN. There is not, so far as I am aware, except for physicians and dentists and, I believe, veterinarians; that is, all doctors, dentists, and veterinarians were registered under Selective Service, but so far as I know, all of them in the Army have commissions. The CHAIRMAN. I see. Dr. PARRAN. It has been said, Mr. Chairman, that this bill is discriminatory in singling out this one profession for selective service. On the contrary, I think it gives merited recognition to the essentiality of the profession of nursing. We should recall that for a many years no woman was entitled to a commission in the armed forces of the United States except that she be a nurse. A draft of nurses is further evidence of the vital part nursing plays in the national health picture. I realize, Mr. Chairman, that in a democracy we are loath to place any additional compulsions upon any group of citizens unless the actual requirements of war clearly demonstrate the need for such ac group are those who do not want to come in immediately, but at some date they have set. Some 30 percent project their time of coming into the service up to 60 days. Senator REVERCOMB. It would seem to me, General, you would much prefer a volunteer nurse than one compelled by order to enter the service. General KIRK. That was thought about the soldiers, that a selectiveservice man would not be as good as a volunteer. Senator REVERCOMB. Do you believe that would apply to the nurses as well? General KIRK. We are all human and come from the same stock. Senator REVERCOMB. You want the nurses, whether drafted or volunteer? General KIRK. We want them to take care of the soldiers shot, sick, and wounded. Senator REVERCOMB. Would you close the door to volunteering even if the draft was passed? General KIRK. No, sir; we will take all we can by volunteering and hope no one is drafted.. Senator GURNEY. How attractive is a nursing job in the Army? Would you explain the rate of promotion and whether or not the rate in the Army Nurse Corps is as rapid as in the Navy, or if you dovetail the policy of promotion? General KIRK. I do not know what the rate of promotion in the Navy is, or the grades. We have certain T. O.'s tables of grades in all that go overseas. In other words, for the chief nurse in a hospital of a hundred or more, it is put down whether she will be a captain or a major. Senator GURNEY. Does that 18 months overseas' duty apply to nurses, where they are promoted from second lieutenant to first lieutenant? General KIRK. Yes. Senator GURNEY. It has changed things? General KIRK. Yes. That is regardless of T. O. That improved promotions in the Nurse Corps very much. I had seen very many nurses in the Southwest Pacific who had been there for 3 years and who were still second lieutenants, and I did not hestitate to try to get them promoted at once. I saw most of the hospitals there. Senator GURNEY. That is the only blanket promotion you have had in the last 3 years, is it not? General KIRK. That is correct. Senator GURNEY. Are we going along now and wait until we see a similar condition 18 or 20 months from now, or are we going to step up the rate of promotions for nurses and state how high they can expect to go in rank? General KIRK. I would like to step that up, Senator. That is done by the War Department. Senator GURNEY. Do you think there is a need for inducement to get them to volunteer? General KIRK. I do not think the question of grade has anything to do with volunteering. I do not think the average nurse understands grades in the service, and I know 80 percent of the civilian group do not. Senator GURNEY. You do not believe the fact they would be commissioned as second lieutenants and not as first lieutenants would hurt in the volunteering? General KIRK. You mean if they came in as first lieutenants instead of second lieutenants we would get more? Senator GURNEY. The nurse with 10 years' experience may be. better than one who has just graduated; at least she would have some reason to feel that way. General KIRK. There are so many factors. The girl with 10 years' service is going to be better than the one with 1 year's service, and she will be picked for a leader and put on jobs she is competent to do. Senator MAYBANK. I would like to ask if you have any idea of the approximate proportion of the number of volunteers who were rejected. Of some 10,000, some 4,000 were still to go through examinations, and so on. I wonder what that proportion is. General KIRK. We have a study on that. May I read this? General KIRK. As of March 10 the Army had 915 completed applications; that is, physically fit and approved by the Red Cross, and all we needed was the nurse's signature to put her on duty. Senator MAYBANK. What I mean is how many were rejected before they reached that point; how many were eliminated because of physical or mental reasons or because of not graduating from a recognized hospital or because of age? General KIRK. I have the figures here, sir. We get actually to duty about 58 percent of those who apply. Five percent are disqualified professionally; 20 percent are physically disqualified; 17 percent fail to accept the appointment after they have met all of the requirements and have put in their application. That is our experience up until now. Senator MAYBANK. Seventeen percent failed to accept? General KIRK. Before the President's message, those who failed to accept their commission when it was tendered was 7 percent; now it is 17. Senator MAYBANK. How do you account for that, General? Senator MAYBANK. I can understand that, that is common sense, but I wonder what caused her to change her mind. Would it be perhaps she might get a better job or because she had been promoted in the local hospital? General KIRK. I would be going into theory on that, sir. Senator MAYBANK. It seems to me a large proportion of people who take examinations to have 17 percent fail to take commissions. You say 17 percent of them did not? General KIRK. That is right. That is one trouble with voluntary recruitment. Senator REVERCOMB. Let me ask you this question, sir: The bill, as you advocate it, applies only to the group of registered nurses? General KIRK. Yes, sir. Senator REVERCOMB. Was there any provision for one usually classed as a practical nurse? General KIRK. We are using nurses' aides. Senator REVERCOMB. Sir? General KIRK. We are using people as nurse aides on a civilian status to supplement our nursing service. Senator REVERCOMB. Is that the practical nurse, one who has had practical experience for going into your work? General KIRK. If she will come in as nurse's aide, we have general authority to hire under civil service if she will accept the pay, which amounts to $1,450 or $1,570 a year. It amounts to about $75 & month after she gets her board and lodging. Senator REVERCOMB. Do you furnish the board and lodging for that employee? General KIRK. Yes. Senator REVERCOMB. Do you have any of those people in hospitals abroad? General KIRK. Only at home. Senator REVERCOMB. Only in this country? General KIRK. Except they are in the Philippines now. They are getting what nurses they can that are graduate nurses in the Philippines and are training Filipino girls as nurse aides there. That is going on there to take care of the civilian group who will have to be taken care of. It is in the lap of the Army and the Navy now. Senator REVERCOMB. For information, I ask you could not the socalled practical nurse serve a good purpose in a hospital abroad; would they be helpful? General KIRK. I think we can use all we have here, sir. It would complicate things overseas. Senator REVERCOMB. What would the complications be? General KIRK. We could better get along without nurses here and give them to the people over there. Senator REVERCOMB. Is the complication between the registered nurse and the practical nurse? General KIRK. No; it is an administrative problem and has nothing to do with that. Senator REVERCOMB. How is that? General KIRK. It is an administrative problem and not a question of conflict, as I see it, between the registered nurse and the practical nurse. Senator O'MAHONEY. General, do you have a statement showing the number of nurses in each separate grade? General KIRK. No, sir, I do not. Maybe I can get it. Senator O'MAHONEY. I wonder if you could do that, please, and then have a table made up showing the comparison between the compensation of the nurses in the Army with the compensation of the nurses in the Veterans' Administration. (The information requested was subsequently furnished in a letter, as follows:) WAR DEPARTMENT, SERVICES OF SUPPLY, Chairman, Committee on Military Affairs, Hon. ELBERT D. THOMAS, United States Senate, Washington, D. C. DEAR SENATOR THOMAS: At the hearing before your committee on March 19, request was made that we furnish you with a statement of the number of nurses in each grade in the Army Nurse Corps, and a comparison between the compensation paid to nurses in the Army and those in the Veterans' Administration. As of January 31, 1945, the Army Nurse Corps consisted of the following personnel: Colonel.. Lieutenant colonel__ Major.. Captain. 179 -1, 074 Total____ 42, 914 Since that date there have of course been a substantial number of promotions and additions, but the figure for January 31, is the last one which has been published by The Adjutant General of the Army. Recently there have been a large number of promotions. In the period February 3-March 16, 1945, there were 4,291 promotions. The pay and allowances (rental and subsistence) of Army nurses are as follows: Nurses in Veterans' Administration facilities are civil-service employees and begin with a classification of SP-5, which carries an annual salary of $1,800, and as a wartime measure they are being paid $2,190 for a 48-hour week. Every 18 months the nurses receive a promotion of $60, until they reach a total salary of $1,980 plus overtime. Then if the efficiency rating is "Excellent" they receive a salary of $2,160 plus overtime. The position of head nurse is classified as SP-6 with a salary range of $2,000 to $2,600, or SP-7 with a salary range of $2,300 to $2,900, or SP-8 with a salary range of $2,600 to $3,200, depending upon the responsibility of the assignment. These classifications are reached in a period approximately 10%1⁄2 years. The total number in each classification at the present time are: SP-5, 4,457; SP-6, 440; SP-7, 90; SP-8, 20. In considering the relative compensation of Army nurses and Veterans' Administration nurses, it should be borne in mind that Army nurses do not pay Federal income tax on the money received as rental and subsistence allowances and, like all other military personnel, are entitled to an additional deduction of $1,500 for income-tax purposes. It should also be noted that Veterans' Administration nurses, like all civil-service employees, contribute 5 percent of their income for retirement purposes, whereas there is no similar obligation on Army nurses. In addition, an Army nurse has the privileges granted under the G. I. bill of rights, including veterans' preference. Sincerely yours, GEORGE F. LULL, General KIRK. May I make this statement before General KIRK. Since World War I until our nurses were given a commission by the kindness of this body, the Veterans' Bureau nurse received more pay as a civilian employee than did the Army nurse. Now, at the present time, when the Army nurse is commissioned, it tops her in her pay rate over the veterans' nurse. So, to level that off, legislation or something is necessary to increase that particular grade in civil service, to increase the pay of the civilian nurse that the Veterans' Bureau hires. Senator O'MAHONEY. I wonder if you would be good enough to look into this problem and make whatever suggestions you may care to make to the committee as to whether or not it would be desirable to amend this bill in such form as to up the grade of every nurse now in the Nursing Corps, a blanket increase all of the way up |