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Militarization of the PHS Commissioned Corps

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  • Militarization of the PHS Commissioned Corps

    Militarization of the PHS Commissioned Corps

    The Commissioned Corps of the United States Public Health Service has played a role in supporting wartime health requirements throughout its history. Soon after the formal establishment of the Corps in 1889, it was called upon to assist the military in the Spanish-American War of 1898. All of the Service's Marine Hospitals were made available for the care of the sick and wounded of the Army and Navy. The Corps also was given the major responsibility for the prevention of the introduction of yellow fever into the United States by troops returning from Cuba and Puerto Rico. Medical officers of the Service were assigned to Cuban and Puerto Rican ports, and some Service officers were assigned to transports carrying troops home. The Service also operated a temporary quarantine station for returning troops. A medical officer of the Service was also on duty aboard the Revenue Cutter McCullough with the fleet of Commodore Dewy at the battle of Manila Bay.

    The Spanish-American War emphasized the need for defining the functions and status of the Service in wartime. As a consequence, the act reorganizing the Service that was approved on July 1, 1902 contained the following provision:
    "That the President is authorized in his discretion to utilize the Public Health and Marine Hospital Service in times of threatened or actual war to such extent and in such manner as shall in his judgement promote the public interest without, however, in any wise impairing the efficiency of the Service for the purposes for which the same was created and is maintained."

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    Using the authority of this 1902 Act, President Wilson militarized the PHS in anticipation of America's entry into World War I by an Executive Order issued on April 3, 1917. This order allowed the PHS to detail officers or other employees at the request of the Secretary of War or the Secretary of the Navy to the military and made PHS stations available for treating sick and wounded military personnel and related purposes in times of war or threatened war. With the issuance of this order, the Service was considered to be a part of the military forces. In addition, Congress passed a joint resolution approved July 9, 1917 fixing the rights and status of PHS officers when serving in the Coast Guard, Army, or Navy.

    The Executive Order of April 3, 1917 by which President Wilson militarized the PHS was later overturned. An opinion issued by the Attorney General on October 29, 1921, held that the power to create a military force out of a civilian one was a duty residing in Congress alone. The opinion stated that under the existing law of 1902, the President could utilize but not convert the Service to a military force within the meaning of the definition "military or naval forces of the United States."

    During World War II, however, the President was given legislative authority for militarizing the PHS Commissioned Corps. The Act of Congress of November 11, 1943 that authorized military benefits for the commissioned officers of the PHS also gave the President the authority to declare the PHS Corps to be a military service in times of war. The Public Health Service Act of July 1, 1944, which repealed the 1943 Act, contained the same provision for militarization of the PHS Corps. On June 21, 1945, President Truman issued Executive order No. 9575 which declared "the commissioned corps of the Public Health Service to be a military service and a branch of the land and naval forces of the United States during the period of the present war."

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    The official end of World War II did not take place until the coming into effect of the treaty with Japan on April 28, 1952, by which time the United States was already involved in the Korean conflict. The official end of the war would have returned the PHS Corps, which was involved in supporting the military action in Korea, to a non-military status, but by interim legislation the Congress on April 14, 1952 continued certain wartime powers of the President, including the authority to declare the PHS Corps to be a military service. By Executive Order No. 10349, dated April 26, 1952, President Truman maintained the status of the PHS Corps as a part of the country's land and naval forces. By Public Law 450, approved July 3, 1952, the Congress again extended certain wartime powers of the President, but did not continue his authority to declare the PHS Corps to be a military service. In the absence of such authority, and in the absence of a formal state of war, the PHS Corps was no longer a military service. The Public Health Service Act was later amended to state that the President might declare the PHS Corps to be a military service not only in time of threatened or actual war, but also in "an emergency involving the national defense proclaimed by the President."

    The PHS Commissioned Corps has also contributed support to more recent military operations of the United States, such as in Vietnam and the Persian Gulf. For example, the PHS organized surgical teams in Vietnam, consisting of both Corps and civilian personnel. PHS staff were also involved in efforts to control malaria and other infectious diseases in Vietnam. The Office of the PHS Historian, however, does not have any information on whether or not the President used his authority to declare the PHS Corps a military service during these conflicts. On July 6, 1988, the Department of Health and Human Services and the Department of Defense signed for the first time a Memorandum of Agreement which established a contingency planning relationship between the departments "for the mobilization and employment of U. S. Public Health Service (USPHS) Commissioned Corps Officers in DoD health care activities."

    Prepared by John Parascandola, PHS Historian, September, 2001

  • #2
    Re: Militarization of the PHS Commissioned Corps

    The Cadet Nurse Corps, 1943-48

    In 1943, facing a shortage of nurses that had been exacerbated by World War II, the Federal Government established the Cadet Nurse Corps within the Public Health Service (PHS). Between the years 1943 and 1948, 124,065 nurses were graduated from the Cadet Nurse Corps, making the Corps one of the largest and most fruitful Federal nursing programs in history. In addition, the Corps allocated subsidies to nursing schools that resulted in improved school facilities and curriculums, enlarged nursing faculties, and enriched post-graduate nursing education.

    Creation of the Cadet Nurse Corps.
    When the United States entered World War II, American nursing leaders began to debate what measures were needed to supply nurses for the war. With pressure from nursing organizations and other interest groups, Congress passed the Labor-Security Agency Appropriation Act of 1942, which appropriated funds to nursing schools and assigned the responsibility for allocating these funds to the Public Health Service. However, funding for scholarships and courses was insufficient to the needs, and there were no centralized recruiting efforts. As the war progressed, the demand for nurses increased, but other more attractive, higher-paying jobs for women were usurping the pool of prospective nursing candidates.

    Working with nursing groups, Representative Frances Payne Bolton of Ohio, a long-time champion of nursing education, introduced a bill that would establish the Cadet Nurse Corps (originally designated the Victory Nurse Corps) to persuade more young women to join the ranks of the nursing profession. The Corps proposed to grant scholarships and stipends to qualified applicants in exchange for providing "military or other Federal governmental or essential civilian (nursing) services for the duration of the present war." It would also provide certain funds to participating state-accredited nursing schools.

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    The Nurse Training Act (or the Bolton Act) passed both the House and the Senate and was ready for the President's signature on June 15. The Act became Public Law 74 on July 1, 1943, with an appropriation for the first year of $65 million.

    Operation of the Corps.
    The Public Health Service, under Surgeon General Thomas Parran, was responsible for administration of the Cadet Nurse Corps and accompanying postgraduate programs. In June 1943, the PHS established the Division of Nurse Education to allocate aid to participating nursing schools. Parran appointed Lucile Petry Director of the Division. She thus became the first woman to head a major PHS division.

    Women regardless of color qualified for the Cadet Nurse Corps if they were between the ages of 17 and 35, had been graduated from an accredited high school, had earned good grades, and were in good health. After acceptance by a participating nursing school, qualified applicants were given scholarships that covered tuition and fees, as well as a small monthly stipend. The Corps also paid $35-$45 for room and board during the first 9 months of training.

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    Cadets were expected to graduate in thirty-months and to provide essential nursing services for the duration of the war, either in the military or in civilian life. Most Senior Cadets rendered nursing services on the home front, where many positions were vacated during the war by nurses who went overseas to care for the wounded. Postgraduate scholarships and refresher courses for nurse graduates were also offered by the Cadet Nurse Corps to remedy the shortage of nursing school instructors, public health nurses, industrial nurses, and psychiatric nurses.

    For a school of nursing to qualify for the Cadet Nurse program several requirements had to be fulfilled. The school was required to be accredited and to be affiliated with a hospital approved by the American College of Surgeons. The school also had to have adequate staff and facilities. Congress had mandated that all schools, regardless of size, would have to be eligible for aid through the Cadet Nurse program, even though some schools had lower educational standards. As a result, substandard conditions in the weaker schools were improved by funding from the Corps and advice given by field consultants.

    Recruitment Campaign.
    Many organizations and institutions were involved in the active recruitment campaign of the Corps. Corporate, cinema, radio, and magazine promotion of the Corps were the most influential and visible elements of the recruitment campaign. Millions of newspaper and magazine readers, radio listeners, and movie-goers were exposed to the Cadet Nurse Corps through ads, articles, shows, and films. More than 300 national radio programs broadcast information about the Corps. Film stars posed with "pretty Cadets in Hollywood" and "Cadets in Washington were photographed with notables." Companies such as the Eastman Kodak, Pond's Cold Cream, Kotex, Pepsi-Cola, Old Spice, Sanka Coffee and National Biscuit Company ran ads featuring Cadet Nurses.

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    Vanguard Films produced a 10-minute film, "Reward Unlimited," starring Dorothy McGuire as Cadet Nurse Peggy Adams, and co-starring popular screen artists, Aline MacMahon, Spring Byington, and James Brown. The film was distributed to 16,000 theaters and viewed by an estimated audience of 90 million. Actresses donning Cadet Nurse uniforms were also featured in other films such as Shirley Temple's "Kiss and Tell," "Lady on a Train," and "The Blonde from Brooklyn."

    The Office of War Information distributed several million leaflets and 2,800,000 car cards to towns and cities across the country. Thousands of department stores, post offices, pharmacies, hospitals, and schools prominently displayed Cadet Nurse Corps posters. Articles and ads about the Cadet Nurse Corps appeared in Collier's, Harper's Bazaar, The Ladies Home Journal, Vogue, and hundreds of other magazines. Cadet Nurses were on hand at the launching of liberty ships and at war-bond rallies and marched in patriotic parades.

    The Cadet uniforms were an important element of the recruitment campaign. The uniforms were an obvious sign of the Cadets' commitment to the war effort. Leading fashion designers brought fashion models to a special luncheon in August 1943 to show their renditions of the Cadet Nurse uniform. The Corps had enlisted the help of fashion editors to choose the most attractive summer and winter uniforms. Fashion editors choose a summer uniform of gray and white stripped cotton including a jacket suit with red epaulets and large pockets, a simple round neck white blouse, and a gored skirt. The winter uniform was a guard's coat of gray velour belted in the back with pockets and red epaulets, a single-breasted gray suit with button pockets, and a white round neck blouse.

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    The recruitment campaign was an immense success. For 3 years, the Cadet Nurse Corps fulfilled its yearly quota for 65,000 nurse recruits. In 1943, the Corps actually surpassed the quota and was forced to circumscribe the campaign plans for 1944. With assistance from the National Association of Colored Graduate Nurses, the Corps enrolled 3,000 African Americans.

    Lasting Legacy of the Cadet Nurse Corps.
    The end of the war brought with it a decision to terminate the Cadet Nurse Corps program. October 15, 1945, was established as the final date for new admissions to the Corps, and the last Cadets were graduated in 1948. Although the Corps lasted only five years, its legacy is still being felt.

    In addition to training 124,000 nurses, the Corps led to significant improvements in nursing education. The Corps fostered a more academic approach to nursing rather than an apprenticeship-type training. Expansion of course offerings and increases in faculty size can be attributed to the influence of the Corps. Further, the Corps and circumstances created by the war helped to introduce nurse instructors as lecturers on disease subjects which had previously been taught by physicians. The Corps also prompted widespread attention and Federal aid to postgraduate studies for nurses.

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    Funds provided through the Corps helped to improve and enlarge classrooms, housing quarters, and libraries of nursing schools across the country. Cadet Nurse Corps scholarships enabled more women to attend university nursing schools than ever before. In addition, the Corps and the exigencies of the war helped to integrate some nursing programs that had previously accepted only white students. The Corps also encouraged more varied training for nurses in such fields as convalescent care, public health, pediatrics, tuberculosis, and psychiatric care.

    The Cadet Nurse Corps also established a prominent niche for nursing in the Public Health Service. During the period 1944-46, an amazing 46 percent of the Public Health Service's budget was devoted to the Corps. The visibility of nursing both within and outside the PHS was greatly enhanced by the publicity surrounding the Cadet Nurse Corps and its successes.

    This essay was published in Public Health Reports, vol. 109, May-June, 1994, pp. 455-457. For further information on the subject, see Beatrice J. Kalisch and Philip A. Kalisch, "Nurses in American History: The Cadet Nurse Corps in World War II," American Journal of Nursing, vol. 76, February, 1976, pp. 240-244; Philip A. Kalisch and Beatrice J. Kalisch, The Advance of American Nursing (Little, Brown and Company, Boston, 1978), pp. 473-489; Thelma M. Robinson and Paulie M. Perry, Cadet Nurse Stories: The Call for and Response of Women During World War II (Center Nursing Press, Indianapolis, 2001).