'When the city is a great field hospital': the influenza pandemic of 1918 and the New York city nursing response.

AIMS AND

OBJECTIVES

To describe and analyse the nurses' role in responding to the influenza epidemic in New York City in 1918.

BACKGROUND

Today the world is facing the threat of pandemic avian influenza and there is renewed interest in lessons learned from the influenza pandemic of 1918, one of the deadliest disease outbreaks recorded in history. Much of the published history has been written from a medical or military perspective. No comprehensive account of nursing's role has been written.

DESIGN

A social history framework was used.

METHODS

Traditional historical methods were used for data collection, data immersion, the development of a chronology and themes. Critical analysis of social, political and economic context was also done. Primary sources included the Lillian D. Wald papers at the New York Public Library, newspapers, journal articles and other archival data.

RESULTS

In 1918, New York City nurses provided care to thousands of patients. They did so with minimal federal support, relying on local community agencies to establish makeshift hospitals and provide soup kitchens. The Henry Street Visiting Nurses, assisted by numerous social agencies and Red Cross volunteers, visited patients in their homes and provided them with the only treatment there was: nursing care.

CONCLUSIONS

In 1918, immediate cooperation among a previously established network of nursing and other social organisations and prompt cooperation with the American Red Cross and the United States Public Health Service was essential to New York City's response to the crisis.

RELEVANCE TO CLINICAL PRACTICE: Should an influenza pandemic occur today, as many as a billion people could fall ill. Shortages of antiviral drugs, the speed with which the pandemic could occur and its widespread effects are such that nursing, public health and medical professionals will need to rely on local personnel and supplies. Immediate cooperation and collaboration among federal, state and local organizations will be essential to the response.