Angels of the mercy fleet: Nursing the ill and wounded aboard the United States Navy hospital ships in the Pacific during World War II

World War II was a turning point in the evolution of American nursing. Nurses who served in this war represented a microcosm of American nursing. The purpose of this study was to examine the experiences of nurses aboard navy hospital ships in the Pacific during the war. By reconstructing and analyzing their experiences, factors which promoted significant postwar changes in American nursing were identified.; This study was implemented using a retrospective nonexperimental design typical of historical research. Data collection focused on both civilian and military documents, with emphasis on primary data sources. Data sources included published ship logs, personal correspondence and journals, wartime publications, and secondary historical texts. The American Journal of Nursing was frequently used as a source of data, due to its unique roles as the voice of professional American nursing and the liaison between military and civilian during wartime. It published direct reports from nurses on the war front, as well as messages from military leaders. A major source of primary data was the interviews with nurses who served on navy hospital ships in the Pacific during the war. All data were subject to validity and reliability measures typical of historical research.; The findings of this study emphasized the ability of nurses to function effectively under stressful and adverse conditions. Prompted by patriotism, nurses entered the military in large numbers. The reality of war mandated brevity in military orientation. Necessary clinical skills and knowledge were learned through continuous exposure to the ill and wounded. Without a precedent of naval nurses serving aboard hospital ships in wartime, they developed their nursing roles and expanded their scope of practice to meet the needs of their patients. Nurses developed a collaborative relationship with their chief nurse and physicians aboard ship. The close rapport with physicians led to joint learning opportunities, mutual discussions about patients, and a team approach to the clinical management of patients. Nurses became more active in the assessment and therapeutic interventions of their patients, especially during times of physicians unavailability, and learned to practice at a level beyond the traditional realm of nursing. With increased autonomy and less micromanagement from above, they assumed a more active managerial role. As officers in charge of their assigned areas, the nurses acquired skills in supervision, delegation, and instruction. They learned to differentiate nursing skills and tasks, identifying those that could be performed by corpsmen, and relied heavily on these auxiliary personnel for direct patient care.