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Nurses were crucial during 1918 flu pandemic

By KATE MOSTACCIO

Our world today is very different than it was at the end of 2019.

As we navigate the changes brought on by the COVID-19 virus – hundreds of thousands infected,  businesses and schools closed, stay-at-home orders, and social distancing – the critical role of nurses caring for the sick and risking their own health comes to the forefront.

Rewind more than 100 years ago and you’ll find that nurses were also vital during another health crisis – the 1918 flu pandemic.

In 1918, the main treatment for the rapidly spreading flu was supportive nursing care as there were no antiviral medications to slow the progression of the flu and no antibiotics to treat the pneumonia that followed for many patients.

Trained graduate nurses were the best offense against the flu. Armed with the most commonly prescribed treatments of Vapo Rub, aspirin, bed rest, sponge baths, whiskey, cough medicines, clean bedding and hot soups, these dedicated professionals were on the frontlines of the pandemic.

“Thousands of patients reported the classic symptoms of influenza — fever, aches, sore throat, and headache. However, this strain struck more severely and soon some patients turned blue at the fingers, arms or face, had trouble breathing, and even bled. More shocking was these were young men and women suffering from these terrible symptoms,” according to a University of Pennsylvania School of Nursing publication. “Doctors had few resources and few medicines to assist at the time though they did their best. Nurses could help. Nursing care was critical in the day-to-day battle against influenza. Nurses were overwhelmed with numbers of patients, either at the hospital, at home, or in the field, yet they continued to do their job in the face of overwhelming numbers.”

Then, like now, nurses were stretched incredibly thin as patients flooded hospitals and the need for visiting nurses skyrocketed.

“Indeed, when the epidemic arrived in the United States in the fall of 1918, professional nurses were stretched thin,” stated an article by Arlene W. Keeling, RN, PhD, in the 2010 Public Health Reports. “Hospitals were deluged with flu victims; wards overflowed and graduate nurses had to use both medical students and ‘pupil nurses’ to help. In the community, there were simply not enough Visiting, Public Health, Red Cross and Blue Circle nurses to provide care.”

Nurses in 1918 were in high demand, but the profession was still relatively new, with nursing schools opening only about 45 years earlier. The war in Europe also pulled nurses away from the home front, leaving hospitals and nursing programs short staffed.

“In the fall of 1918, the United States experienced a severe shortage of professional nurses during the flu pandemic because large numbers of them were deployed to military camps in the United States and abroad. This shortage was made worse by the failure to use trained African American nurses,” according to a Centers for Disease Control and Prevention blog.

Scenes from 1918 are eerily similar to 2020. Some hospital flu wards with 20 beds were caring for upwards of 40 patients. Nurses were working 12-hour shifts trying to accommodate the patient load. Elective surgeries were canceled. Visiting nurses were welcomed and often swamped by communities desperate for their assistance.

“Local governments closed theaters, schools, churches, and saloons to prevent the disease from spreading. Telegraph and telephone services collapsed as operators took to their beds. Trash filled the streets as garbage men reported sick. Mail piled up as postal carriers failed to come to work. Some cities, including San Francisco, Philadelphia, New York, and Seattle, required all citizens to wear gauze masks in public,” according to an article in CARING magazine in June 2013.

Visiting nurses were repeatedly overwhelmed by families in New York City, where the flu took 30,000 lives. “Desperate people watched from windows and doorways for a nurse,” the CARING article stated. “They surrounded her on the street, begging her to go in six directions as once. The ragged chorus of pleas rang loudest in the city’s teeming slums…”

The flu sickened and sometimes took the lives of nurses. As defense against the illness, they resorted to masks. Unfortunately, the gauze masks were largely ineffective. Combatting COVID-19, nurses across the world risk infection and put their own safety on the line as they continue to provide care every day. Protecting themselves is just as important now as it was 100 years ago and personal protective equipment like masks, gowns, face shields and gloves are vital to their work.