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The CHAIRMAN. Those estimates have been made by the Army itself?

Dr. PARRAN. Yes, sir; the Army and Navy have kept us and the Red Cross and the other related agencies informed fully as to their quota and needs from time to time.

The committee may be interested also in a spot check made during the past 2 weeks. The Public Health Service queried more than 5,000 cadet nurses in all areas of the country to determine the present intentions about serving where most needed upon graduation. They were asked these two questions:

1. Three months ago what did you plan to do upon graduation? 2. What do you now plan to do?

The analysis of replies shows that 3 months ago, 66 percent planned to go into the military, whereas today that percentage has risen to 85 percent. The rest expressed a deep consciousness of their obligation to remain in essential civilian service. It is apparent, therefore, that these young women are imbued with a seriousness of purpose and a realization of their moral obligation to their Government in consideration of the Federal money spent in their behalf.

This nurse-training program represents a substantial investment in Federal funds, the appropriation being some $63,000,000 during the current fiscal year. In my opinion the country is receiving and increasingly, will receive returns on this investment which will be important not only in wartime but will reach beyond the war and far into the future. Moreover, we cannot measure what the loss to the country would have been if civilian health services had collapsed in its hour of crisis, but I do believe it would have been comparable with defeat in a major military campaign, because nursing is the backbone of our whole civilian health service. As I have said, we cannot measure the cost of failure, but we can measure the important contribution which has been made and will continue to be made by these thousands of loyal, energetic young student nurses. By their phenomenal enrollment in schools of nursing they have created a reservoir from which the military will draw in ever-increasing numbers.

In my opinion, Mr. Chairman, H. R. 2277 is essentially a good bill. It is my hope that the true principles of Selective Service will be followed with utmost care in its administration, in order that both the military and minimum essential civilian needs may be met. Unless this be done, there are many nurses with special training for key positions in public health and in nurse education who will be forced out of their positions as a result of social pressures. Already there is 22- to 30-percent vacancy in public health departments, visitingnurse associations and on the staffs of nursing schools. If more key nurses were to be removed or were to leave their posts suddenly, our entire nurse structure would collapse. This cannot be permitted to happen at a time when we are training the largest number of student nurses in history, and when the major civilian health problems of a long and hard war are still ahead of us.

By applying the true principles of Selective Service, as was done so successfully with the doctors of the country with the advice of Procurement and Assignment of the War Manpower Commission, we should be able to budget our limited nursing resources to cover minimum needs. This is a precious national health asset which must be conserved.

The Public Health Service is concerned with any situation which threatens the national health. After current military quotas are filled by Selective Service, there still will be needed some effective controls over the remaining nurse power of the country. In proportion to military vacancies, this will represent a very large number of nurses. An important effect of this law on civilian health, therefore, is that a mechanism can be set up to insure that these remaining nurses engage in essential work. This seems to be provided by section 22 (b) (1), which says:

In order to assure that the Nation's limited nursing skills are wisely utilized and that the national health and safety is protected against unwarranted depletion of essential nursing services, in the classification, reclassification, or deferment of any individual under this act, the selective-service local board shall give consideration to the recommendations, if any, with respect to whether such individual is engaged in essential nursing services, filed with such board by the Nursing Division of the Procurement and Assignment Service of the War Manpower Commission * * *

I think that is a very important provision because as the war progresses, we shall see the cumulative effects of fatigue, long hours of work, worry, anxiety, and grief. In other words, there is bound to be a lower level of civilian health and greater susceptibility to disease. We have been fortunate up to now in not having had any serious epidemics. It is well within the realm of possibility that we may have a repetition of the 1918 infiuenza pandemic before this war is over. If this or any other disaster were to occur, there would be no time to pass a law which would mobilize doctors, nurses, and other personnel to meet the critical health and medical care problems created thereby.

It is for these reasons that I favor the selective-service principle for professional nurses which considers essential civilian service as well as total military needs.

This is total war. We must mobilize fully to guard against collapse on any front, military or civilian.

The measure before your committee is a very much better bill than the one which was reported to the House of Representatives.

In an earlier question, Mr. Chairman, you have indicated an amendment which in my opinion should accomplish the general purposes I have attempted to outline. Your proposal is more effective than the present blanket exemption of all married women. As a result of discussions on the floor of the House, a number of amendments were adopted which, in my opinion, makes this bill a workable measure and one which seems reasonably adapted to meet the ends in view.

The CHAIRMAN. If the bill provided for nothing else than the registration of nurses, that in and of itself would be a contribution to our present situation, would it not?

Dr. PARRAN. Yes; at least we would know-such action would enable us to know what our nursing resources are. I do not think such action, however, would do much more than that.

The CHAIRMAN. Would that not be something worth while?

Dr. PARRAN. It would be worth while to have the facts. Just to have the fact, however, that a well-trained nurse is working in a candy factory because she gets higher wages there than she would get as a

nurse does not do much good in getting such a nurse into the military service or essential civilian service. The CHAIRMAN. Senator Austin? Senator AUSTIN. No questions. The CHAIRMAN. Senator Gurney? Senator GURNEY. No; thank you. The CHAIRMAN. Thank you, Doctor.

Mrs. Bolton.

STATEMENT OF HON. FRANCES P. BOLTON, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF OHIO

Mrs. BOLTON. Mr. Chairman, it is not my desire or purpose to take up too much time of this committee, particularly since you can refer to my testimony before the House, but there are certain matters that I do wish to speak of in order that the actual record of these, hearings may be clear.

I was very happy to hear the Under Secretary of War, Judge Patterson, and the Surgeon General express such sincere praise of the nursing profession and of the work the nurses are now doing. Too much cannot be said about both, and I am sure it has been a sincere pleasure to these gentlemen to have the opportunity to express their appreciation, both as individuals and as officials of the War Department and of the Army. It is a great pleasure for me to add a few words to theirs, as a Member of Congress, as the mother of two service sons, and as a civilian, to say nothing of just as a woman. In all four of these categories, my gratitude and appreciation is boundless.

Working closely with nurses over a long period of years, I know how keenly they feel their responsibilities to the whole structure of the care of the sick; they know the needs of the civilian hospitals, of the public health fields very thoroughly. So many thousands of them are currently carrying the truly intolerable loads on every side of the civilian picture. They are so keenly aware that the flow of students must continue if there is to be a continuing nursing force, and they have come forward for the arduous duty with the Army and the Navy with a patriotic zeal equaled by no other professional group save perhaps the doctors.

We have listened to Admiral Agnew's very fine testimony that so far as the Navy is concerned it feels it has no need to draft nurses but that the Navy, in order to back up the Army, as they always do, speaks for the draft if it be necessary.

I want to remind you that in 1940 the Army Nurse Corps numbered under a thousand persons. In April 1944 it numbered 40,000. I am speaking only of the Army. In those 4 years something over 80,000 nurses had volunteered for service. In testimony previously given this committee, the number 90,000 was used, which I assume included the Navy.

I want to emphasize that every quota asked for by the Army was met in spite of the rigid adherence to regulations which refused service to many young women because they were a fraction too short or too tall, too light or too heavy, or had not 100-percent dental occlusions. Senator KILGORE. May I interrupt right there, Mrs. Bolton?

Mrs. BOLTON. Yes, indeed, Senator.

Senator KILGORE. I have had a number of letters on that point; that the fact those who volunteer must qualify as a commissioned officer, with all the necessary formalities, has been a hardship on the volunteers. Have you had that complaint?

Mrs. BOLTON. No, sir.

Senator KILGORE. In other words, in traveling to the place where they take their Army examination and waiting until they were commissioned, at which time they might find themselves with a very serious case, at the time they were suddenly called, and could not get relief. In some cases that have been brought to me, that has caused hardships in getting nurses.

Mrs. BOLTON. I have not heard that.
Senator KILGORE. You have not?

Mrs. BOLTON. No, sir. There may be isolated cases.

Senator KILGORE. They do have to go through the same formalities as any other officer getting a commission.

Mrs. BOLTON. The Army Nurse Corps is made up solely of officers. That was found necessary in the last war. Unfortunately, at that time only relative rank was given. Last year, that very serious maladjustment was corrected and a commissioned rank has been given to the nurses who are now in the Army of the United States, and it is very necessary, sir.

Senator KILGORE. I agree with you, but I am wondering if it would assist if some of the necessary steps we find in commissioning officers for other duties in the Army could be eliminated or modified or smoothed out and whether it would speed up the increment of nurses coming in and whether they do find it a hardship to go through that.

Mrs. BOLTON. I could not answer that question.

Senator KILGOR. We get them because they are registered nurses? Mrs. BOLTON. Yes.

Senator KILGORE. Then we have additional qualifications which sometimes make it hard for the nurse who wants to volunteer to come in.

Mrs. BOLTON. She must be qualified, of course.

Senator KILGORE. But she must also have certain physical qualifications and go through certain steps in order to get that commission. Mrs. BOLTON. Otherwise, she would be a possible detriment. Senator KILGORE. That is right, she might be.

Go ahead; pardon me.

Mrs. BOLTON. I do want to emphasize very much the fact that every quota asked for by the Army was met in spite of the rigid adherence to regulations which, in many cases, have been very much changed.

If, as was suggested the other day, the numbers asked for were not adequate, that can hardly be blamed upon the nurses. I repeat, if one can use the round figure of 250,000 active nurses in the countrythat number has varied from 250,000 to 285,000; even to 300,000-but the general feeling seems to be that we can count approximately 250,000 as being active nurses. Then one-third of their number have asked for service. That approximately 25 percent of these did not qualify under the existing regulations cannot be considered their

fault. The fact remains that every announced quota between 1940 and 1944 was filled. It is a magnificent record.

If I may speak a little of the background of the circumstances that led to the Nurse Cadet Corps and the money that was appropriated to help the inactive nurses get special courses and refresher courses, to get them back into the active field: Back in 1940 I went personally with five top nurses to the then Surgeon General, asking that the Army School of Nursing be reopened. We went supposing it would be reopened because war was imminent, and we went to offer out services in the securing of the necessary staff, teaching staff's for those schools. We were told very clearly that the Army did not propose to reopen the school of nursing again, it did not intend to do any teaching. Civilian hospitals would have to supply the nurses.

Senator KILGORE. Could I ask another question?
Mr. BOLTON. Yes, sir.

Senator KILGORE. Civilian hospitals run nurse training schools in the hospitals where, as the students progress, they are given more and more duties to assist the graduate nurses on duty. Could that be done in selected types of Army hospitals in the United States satisfactorily?

Mrs. BOLTON. It is done, sir.

Senator KILGORE. It is?

Mrs. BOLTON. The Army School of Nursing was activated in 1918 as being necessary to a prolonged war at that time. Its record in the first 18 months was quite extraordinary, both in the number of applications and the way it was administered. The school ran for 10 or 12 years and was shrunken- then was closed down by units until it was active only in Walter Reed Hospital. Finally even that unit was closed, after which it was advisable to keep only the skeleton organization of it as the possible framework for future need.

Senator KILGORE. That has not been used?

Mrs. BOLTON. No. It was deemed advisable by the Army that the civilian hospitals of the country should be called upon to produce the necessary nurses.

Senator KILGORE. I have noted that in civilian hospitals students who have had a full year and a half, do quite a bit of work of the nurses, within certain limitations; in other words, they help the graduate nurses in their tours of duty. Would that help relieve any situation we have in the hospitals if we carried on that program in our service hospitals? The 2-year students now in the Cadet Corps are now in the civilian hospitals and that service is being rendered in civilian hospitals. Would it be of value to the Government?

Mrs. BOLTON. It is available to the Government.

Senator KILGORE. But the girl cannot complete her course.

Mrs. BOLTON. Her last 6 months, when she is a senior cadet, may be spent in either civilian or Army hospitals, and practically all of the senior cadets the Army has wanted have gone to the Army and they have been useful. In fact, the Army has said that 40 nurses can be replaced by 50 cadets; the proportion is like that.

Senator KILGORE. That is, those who have been trained up to the last 6 months?

Mrs. BOLTON. Yes; the Senior Cadets. In an ordinary civilian hospital a student almost immediately becomes of use to the hospital.

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