Dyson College of Arts and Sciences
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from the moving train in torrential rain so that they would be able to find their way to those in need (Kernodle, 1949). The Flu Pandemic of 1918 The "Spanish flu" pandemic began at the height of World War I, with the first wave striking early March 1918 (Watanabe & Kawaoka, 2011). During the 1920s, the death toll was estimated at 21.5 million people, but later global mortality estimates rest between 30 and 50 million, with 675,000 Americans among the dead (United States Department of Health and Human Services, n.d., par.6). At the time the pandemic struck, many nurses and physicians were deployed to aid the war effort and the country had a shortage of front-line responders. The following account depicts how individuals involved, such as Paul Lewis, a virologist, were caught off guard by the ferocity of the illness: The clinicians now looked to him to explain the violent symptoms these sailors presented. The blood that covered so many of them did not come from wounds… Most of the blood had come from nosebleeds. A few sailors had coughed the blood up. Others had bled from their ears. Some coughed so hard that autopsies would later show they had torn apart abdominal muscles and rib cartilage (Barry, 2004, p.2). As scientists worked to determine the causative agent of the catastrophic illness, others dealt with how to provide care for those stricken, often outside the controlled hospital environment. It was noted that the virus attached in cycles, from the appearance of the first case, to the peak, and then abatement. The American Red Cross and the Public Health Service attempted to concentrate nurses and doctors in areas when the disease was peaking, when a community was in most need. As noted earlier, there was a shortage of nurses, yet nursing care was critical. "What could help, more than doctors, were nurses… Nursing could give a victim of disease the best possible chance to survive. Nursing could save lives… But nurses were harder to find than doctors" (Barry, 2004, p. 319). The demand for nurses was so urgent that massive recruitment drives took place. "…[R]ecruiters had a list of all nurses in the country... Those recruiters now pressured nurses to quit jobs…doctors to let office nurses go, made wealthy patients who retained private nurses feel unpatriotic, pushed private hospitals to release nurses" (Barry, 2004, p. 320). Those nurses active during the pandemic again found travel to be a significant obstacle to providing care. Nurses called to the lumber camps in northern Michigan, for example, would travel 20 to 30 miles at night through deep woods only to find that they then had to employ handcars to reach their patients (Kernodle, 1949). They would find 30 or 40 cases of influenza, as many as 10 men with a high fever huddled together in one log cabin. In this region, one person out of every 50 died. Moving Forward These two historical examples portray nurses as front-line responders attempting to provide care to its victims. Reflecting on how nurses conducted themselves, within the larger context of the disaster and alongside other providers, offers information for the development and implementation of improved practices in a contemporary world that has greater needs and greater complexities. For example, reflections on past practice have informed the profession about the need to develop specific competencies so that nurses are better prepared to respond during disasters. These will be highlighted later in this paper. To be able to look back, reflect, learn, and apply these lessons will assist all planners and responders as we move forward collectively in the development 46