Author Question: Nursing 1940's

Anonymous Asks:

First and foremost, I have to say that I am in love with Medical Edge. I've been spending a lot of time on it lately because I enjoy studying medicine and also because I am starting to do research for my novel. It's set in 1939 through to 1943. I have three questions for you.

One of my main characters is a nurse in Sioux Falls, South Dakota. I want to be able to write her doing her job correctly. I was wondering what kind of equipment they used, how they used it, and for what illnesses (No need to be extremely specific here, I think). Also, what would her responsibilities be within the hospital? Would she rotate through all the wards or do/did nurses have particular specialties like physicians?

Jordyn Says:

Thanks for your compliments on my blog! Glad you find it helpful.

Nursing in your time frame of 1939-1943 would have looked a lot different than it does today. They definitely wore uniforms and caps. Doctors would have been formally called "Dr. Smith" versus using first names like we do now (although not in front of patients).

Nursing work was viewed as inferior to the physician meaning—you do what the physician says. Now, a nurse’s input is more respected. Doctors and nurses realize they can't work separate from one another.

Nurses likely didn't specialize then like we do now and there was likely not a lot of physician specialties either as there weren't any intensive care units or emergency departments until the 1970s. Equipment would have been non-existent like the heart monitors and stuff we now use. Read through this info to get a general feel of how the floors or "wards" would have been split up.

This link is from Britain but would probably have some cross-over to the US. Here is a link to some personalized stories from people who nursed during your time frame. I would read through these for the 1930's and 1940's to get a feel for what their jobs were like.

This is also from the UK but should provide some insight. 

Question:

Another one of my main characters goes off to fight in the war. How severe would an injury have to be for him to be discharged? Presently, I have a situation designed where he is aiding a family out of a bomb shelter; there is an unexploded shell nearby, and a child accidentally kicks rubble at it and sets it off. Big boom, main character loses part of his leg and half of his body is burnt. I'm also thinking that he loses his hearing. Would this be plausible?

Jordyn Says:

I would search military discharge related to a medical condition two ways. One—what medical conditions are prohibitive for military service and those conditions that would lead to discharge.

 I found this list, but you could probably find more and if it's the 1939-1942 time frame it may be different than those that cause discharge in these times.

The injuries you list related to the bomb blast are realistic and I think would be enough to cause his discharge from the military as well.

I contacted a cousin of mine who serves in the medical corp of the military and he said to look at AR 40-501 which is the standard of medical fitness. Basically, if you couldn't do what's listed than you could be discharged from service. He did say that there are personnel who are still serving who have amputated limbs.

Question:

Lastly, my nurse has a patient, a woman in her 40s or 50s, who she loves with all her heart. I want this patient to die. What would be a good way to kill this woman off? I need her to have been in the hospital for around four years. I also want to have her weak but able to speak with my other characters. What's a good malady for this situation?

Jordyn Says:

This kind of criteria would mean the character would need a chronic illness that's debilitating. You could look into multiple sclerosis, Lou Gehrig's Disease, Huntington's Chorea or some of the autoimmune disease like Lupus or Sarcoidosis.

These diseases fall on a spectrum (more MS and the autoimmune diseases) but Lou Gehrig's Disease and Huntington's Chorea lead to neuromuscular wasting, etc that does lead to death and there is currently no cure.

In that time frame you're looking at you'd have to determine if they were able to diagnose these diseases. To do that you could Google search "When was Lou Gehrig's Disease discovered?" That should get you in the ballpark to know if the medical community knew about whatever disease you chose for your time frame.

Keep in mind—it would be highly unusual for someone to be hospitalized for four years straight.

Medical Question: 1940's C-Section

Nike asks the following question:

Can you tell me anything about Cesarean section in 1946 in a tiny village hospital. It's in Long Island, NY, only two hours from NYC, so they're not isolated and totally backward.

The woman is a minor character who appears in only one scene, but I want to get it right. It's after a brutal snow storm, a maternity nurse stops by just to check in. Everyone knows everyone in the village and the doctor, a woman doctor, mentions she's been thinking about this patient. The nurse is going home, and says she's been thinking about her too and will probably stop in on her.

I figure the patient was in the hospital about a week and she'll need bed rest for about two weeks. Is that right? I'm thinking the patient might have her mother either living with her or staying w/her for the duration and the mother would be doing all the daily chores and taking care of the infant.



Justawomen/Photobucket

Jordyn says: I've been researching your question and am not quite finding the specifics you're looking for. Right now, a woman who has a C-section would be in the hospital for anywhere from 2-5 days with 2 weeks of light chores at home and no driving so your parameters of a week in the hospital and a couple weeks bedrest--- I think you could have some latitude. I tried to get some first-hand accounts and found one... number three below. That might lend to getting a feel for the culture at the time.

I've included several references/resources for you to look through.

1. General overview of the history of C-section:

http://www.nlm.nih.gov/exhibition/cesarean/part3.html

2. Here's some of the procedures a woman might experience:

"By the 1940's, the standard was set, with hospital birth being thought to be the ideal. The idea was that at the hospital the doctor had all the "tools of the trade" handily available. Unfortunately, this was and continues to be a major downfall of hospital birth, as well. Included in those tools were medications, forceps, surgical instruments, confinement to bed, enemas, pubic shaving, arm and leg restraints, and hospital nurseries with rigid schedules. Birth was seen as an illness that required medical attention."

Here's the reference that was taken from: http://www.naturalchildbirth.org/natural/resources/history/history01.htm

 3. I found a patient experience from the 1940's-- though not a C-section. What she says and the pictures that they include I think will help give you a lot about the culture at the time. Plus, the couple is absolutely adorable!

 http://news.bbc.co.uk/2/hi/uk_news/6159909.stm

4. Some more about the culture of the 1940's. "During the 1940s most women gave birth in an unconscious state, courtesy of drugs such as scopolamine. Women of that time seemed very happy to be numb, and end the "suffering" their mothers experienced in childbirth. They looked at birth without drugs as uncivilized."

http://www.ivillage.com/power-giving-birth-interview-nancy-wainer-cohen/6-a-144604#ixzz18fjYonLe

5. Historical Overview

http://www.mesacc.edu/dept/d46/psy/dev/Spring02/prenatal/history.html  

I found this little snippet that mentioned the length of hospital stay but couldn't pull the reference.  Period 1940-1950, the length of stay in hospital was reduced from 20.5 to 9.8 days per patient.

Any other suggestions for Nike?

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Nike is a wife, mother, and animal lover. She loves living in coastal metro NYC, a short distance from the Atlantic Ocean. Like so many other writers, Nike started writing at a very young age. She still has the Crayola, fully illustrated book she penned as a little girl about her then off-the-chart love of horses. Today, you might call her a crime fictionista. Her passion is crime fiction. She likes her bad guys really bad and her good guys smarter and better.

Nike was a 2010 Inspy Awards judge and writes book reviews for The Christian Pulse on-line magazine. She’s the founding board member of the Grace Awards, a reader driven inspirational fiction award and current  member of the American Christian Fiction Writiers (ACFW), where she serves as a small critique group leader. Also, she’s a member of Edgy Christian Fiction Lovers on Ning, where she coordinates a group summer blog tour and has taught a workshop on proposal writing. You can find Nike at Crime Fictionista: http://www.crimefictionandfaith.blogspot.com/.