The following account of nursing in Washington during the Influenza Pandemic of 1918 is an extract from "Wide Neighborhoods, A Story of the Frontier Nursing Service" by Mary Breckenridge, The University Press of Kentucky, Chapter 9.

I hit Washington at the height of the 1918 influenza epidemic, when the sick numbered several hundred thousand in that congested city.

The United States Public Health Service had charge of the medical and nursing services, with Miss Mary Lent as chief nurse. From her I learned there were almost no nurses so, with Miss Delano's permission, I volunteered. The District of Columbia had been divided into four medical areas, to one of which I was assigned as assistant nurse in charge. The head nurse of my area fell ill soon after I reported for duty so that I was plunged into the direction of nursing care for thousands and thousands of stricken people. I don't recall how many patients we had in my district at the peak of the epidemic, but it could not have been less than forty thousand. Nor do I remember how many nurses I had to help me, but I don't think there were more than five. We used hundreds of aides for day and night care of the patients with pneumonia in the families where everybody had come down with influenza. Many of these aides were clerks turned over to us for the emergency by the government bureaus, and only a few of them had received training in home care of the sick. They were, however, keen young people who had volunteered for the assignment and had a good will. We issued masks to them and gave them special instruction in the care of their hands. Not many caught the infection. We used the token force of nurses to make rounds of the houses, give hypodermics where ordered, and instruct the aides in regard to other treatments and drugs.

Our physicians were mostly elderly men, who had ceased to practice before the war, and Army and Navy doctors loaned us by the Armed Services. At our headquarters in a schoolhouse we had three telephones, all reporting new cases every minute, while a queue of people stretched out into the street from early morning until around midnight. Cars were put at our disposal so that we could get doctors, nurses and the aides off in the quickest possible time. The filing system was a madness of improvisation in which the vital thing, with thousands of patients, was the correct address of each. Some of the reports the aides dictated, after a day or night on duty, would have been comical had they not been so tragic. One said of a pneumonia who had died, "Patient's condition got pretty bad towards the end." Another, who had been in a government bureau handling food rations, reported on a housewife, "She has twenty pounds of sugar salted away"

One of the most awful things about this Washington nightmare was the condition of the houses in which both our white and colored patients lived. They were riddled with bedbugs. We devised a system of disinfecting the beds, then pulling them out from the walls and putting their legs in tin cans of carbolic. But the bedbugs dropped down on the patients from the ceilings. Years later, when I traveled into Washington on the same train as my cousin, John Mason Brown, I told him about my struggle with the bedbugs. He said, "Yes, I see. You lost the cherry blossom approach

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