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Before the Civil War, most nurses in the United States were male. Women in the U.S. knew of Florence Nightingale, a British nurse who successfully served on the battlefield, but social taboos prevented well-to-do women from working outside the home. A "working woman" was an object of pity or scorn in Victorian America.
At the beginning of the war, Union Army leadership realized that they needed more medical staff and decided to accept women nurses to fill the gap. Dorothea Dix was chosen as the first superintendent of U.S. Army nurses in June 1861. Dix insisted that her nurses be between thirty-five and fifty years old, in good health, of high moral standards, not too attractive, and willing to dress plainly. Over three thousand nurses served the Union through Dix's appointments.
Northern women also found ways to volunteer as nurses without going through Dix. Regional aid societies would certify women as official nurses if they had already proven their worth as volunteers in Union hospitals, regardless of Dix's guidelines. Some experienced female nurses served, such as Catholic nuns, but any matronly, responsible woman could qualify during the Civil War. The escalating war required still more medical staff, and in 1863 the Union Army allowed surgeons to choose their own nurses.
Army surgeons and other male staff were not always happy to see women entering their domain. Without authority over hospitals or other medical staff, women nurses found ways to accomplish their goals despite male resistance. When they could not cajole, reason, or shame Army doctors into improving conditions for the patients, the women worked around them.
In addition to providing medical care, the women nurses comforted and fed patients, wrote letters, read, and prayed. They managed supplies and staffed hospital kitchens and laundries. African-American nurses were often confined to menial labor jobs, ordered to work among the most dangerously ill patients, or assigned to care for African-American soldiers.
Female nurses in the North and South went bravely where few Victorian women had dared tread. Many would consider their experiences to be among the definitive ones of their lives, leading many to further social and political service. Showing a high level of determination, knowledge, and emotional and physical strength, these women succeeded in opening the nursing profession to future women.