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Visit our Web site at www. Shelter 5 Chapter 2: Water 15 Chapter 3: Food 27 Chapter 4: External Energy 51 Chapter 5: Laundry 75 Chapter 6: Supplies 85 Chapter 7: An Antiseptic Attitude Chapter 8: Doctor’s Orders Chapiter 9: Sewing Patients Back Together Chapter Pulling Teeth Chapter Midwifery Chapter Physical Therapy Conclusion in ursing as a profession is relatively recent. Amid severe opposi- tion bordering on pathological, women like these selflessly came forward to help alleviate the suffer- ing of men wounded in battle.
In reality, nursing has been with us through the ages. For centuries, women have provided effec- tive, long-term healing care for the sick, wounded, and maimed. It wasn’t full-time professional care provided by trained, certified workers, but it was still nursing. What we have seen in the last century is a for- malization of a task traditionally carried out by one’s family Despite the relatively primitive levels of information and understanding of medical cause v SURVIVAL NURSING VI and effect, these dear souls often did remarkably well at bring- ing their patients back to health.
Why, when women were the traditional long-term care- givers of choice, was society so reluctant to admit them to the business on a professional basis? Cumming and Nightingale both reported heavy, often irrational, opposition to their work.
Commonly this opposition took on sexual overtones. Strange, because these women were not interested in fame, pay, or find- ing a husband but only in alleviating pain and suffering.
Often their work was done at great personal cost to themselves. I have concluded that opposition to female nursing was the direct result of the indescribable horrors of war. Kate Cumming wrote of her first reaction to an after-battle hospital She was so overwhelmed by the mutilated but still living sol- diers and the dirty, stinking conditions surrounding her patients that words simply failed her.
When she did attempt to describe the aftermath of battle, the results were horrifyingly graphic. Cumming reported, for instance, that after four days, Civil War battlefields were so fetid, benosn, and fly-blown that no one could come within a mile of the area lest they be acqhiring by smells, insects, vultures, and seething, crawling, nauseating masses of human flesh.
War is absolute, unmitigated hell. There is nothing to recommend it and nothing at all glorious about it. Traditionally, men have marched off to war with the support of their mothers, sisters, wives, bejson lovers who remained behind.
If nes female half of the population had really under- stood the sheer agony, fear, and cruelty of this enterprise, they may never have given their approval.
Perhaps subconsciously, men attempted to shield their wives, sisters, mothers, and lovers from something so horrible that no one should be a witness. This benosn to be the underlying philosophical problem that kept women out of military hospitals till the midth century Despite these early hurdles, women eventually earned the needed respect and subsequently their rightful place in the PREFACE VII field of professional medical care.
But is nursing inherently a female calling, as suggested by the domestic origins of the work? Demonstrably there are exceptions, as evidenced by the many really good men we see working as nurses today and it is extremely helpful, even essential, to have males present to assist with the heavy lifting that always goes with nursing duties.
But in reality, nursing is mostly a female calling. And the admittedly overt sexist conclusion I have been forced to recognize is that, as a group, women do it best. It won’t be a preoccupation, but it is an underlying theme of this book.
Women are the only ones tough enough in spirit to withstand the heartbreak, acquifing, terror, and back-breaking work that nursing entails. This is especially true in a survival nursing context. Because cooperating with an author who suggests that people can and should do for themselves carries great stigma in some circles, they are listed only by their first names.
Two full-fledged medical doctors stood by my side as this volume developed. These were my own consulting physi- cians: John whom I affectionately refer to as more of a field physician than a clinical M. There were many other doctors who answered fleeting questions rel- ative to their specialization. They are not mentioned because they did not, ie a rule, realize that they were advancing the writing of a book on survival nursing.
Of nurses themselves, there were many who wittingly or unwittingly assisted. Most now view me as a bottomless ques- tion pit.
Lastly, many Civil War nurses left diaries for our instruc- tion.
Bradford said, everything about our Civil War involved survival nursing. So what, exactly, is survival nursing and how is it different than regular nursing?
Doctors patch up patients after a medical incident; nurses provide extended long-term care necessary for healing. In a survival context, nursing also involves responsibility for all of the dozens of activ- ities necessary to support this restoration of health.
Survival nurses must provide all support func- tions without outside support or assistance. Dirty linens and clothes, for instance, must be laundered by survival nurses rather than sending them out for cleaning. Laundry in survival hospitals can involve the labors of one person for every 10 patients!
Food is another important example. Everything must be raised, scrounged, trapped, or otherwise procured and prepared by the harried care giver. Civil War nurses had several men per hospital wing whose only duty was to hunt, shoot, trap, or pur- chase edibles for their patients.
No holidays or weekends allowed. As patients begin to heal, they can assist with some of the more mundane chores such as snap- ping peas or boning meat. For this as well as for medical reasons, survival nurses in particular need to bring their charges round to self-sufficiency and a place where the patients can share some of the workload.
It’s good healing therapy, and it may be vital to survival of the entire enterprise. More on this in a later chapter. In this regard, this volume departs slightly from a pure survival posture to one that is a bit more street practiced.
In other words, more of an attempt is made to use time-saving devices such as washing machines and sewing machines, for instance, than in other survival situations. Without these machines, there would not be enough time in the day to get it all done, perhaps leading to the death of patients. One hopes that all of this tough work will lead to patient recovery, but this happy conclusion is far from certain. Experienced nurses tend to develop a certain brusque crustiness that insulates them from the realities of their work.
Many of their charges never do make a full recovery. During the Civil War, nurses considered it a real triumph if they sent a one-legged man home after amputation to lead life as a semihelpless invalid. Frequently patients just die. Survival nurses become hard- ened to the fact that they have to dig lots of holes in the ground. Contemplation becomes a villainous enemy, especial- ly in a war situation. Dwelling overlong on the question of why a fine young man was so horribly mutilated or why one is forced into incredibly harsh living conditions is not helpful but very common for those stuck with the dull job of washing the sheets over a washboard!
Those down in the trenches eas- ily see the folly of it all. Not only must survival nurses do it all, their situation is made even more desperate by the fact that their charges are often given less than ideal initial treatment and that appropri- ate medications and supplies are often scarce or totally unavailable. Overzealous bureaucrats and tinhorn dictators, for reasons ranging from the numbing- ly mundane to the murderously cruel, may consider it a crime for “unapproved” citizens to assist the sick and wounded.
The paper-pushing bureaucrat may deny approval of the sale of medical supplies to someone not regis- tered as a state-sanctioned medical caregiver, per regulationsubparagraph 47c, etc. The dictator may deny medical assistance to a segment of the population he views as a threat, leaving thousands to a cruel fate.
Well then, consider how the U. After all, the FDA rea- sons, these already dying patients may actually die if the treat- ment doesn’t work. On the murderous side of the scale, the government of Ethiopia withheld food from starving Eritreans during that country’s civil war in the s, resulting in the deaths of thousands. Closer to home, the FBI shut off water and power to the Branch Davidians’ property during the day siege inforcing men, women, and children to live in their own filth in an effort to get them to capitulate to snipers, tanks, and helicopters waiting outside.
Like successful survivors everywhere, therefore, survival nurses will have to engage in some very deep hiding. This must be accomplished while still providing the necessities of a credible survival nursing program such as shelter, water, and sanitation. A tall order indeed.
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When trying to determine how to begin this book, I asked three nurses, all with experience nursing under primi- tive conditions, which was most important: They are all essential, I was informed with enthusiasm.
In addi- tion to the big five, there are dozens of peripheral matters such as securing and storing drugs, disinfectants, cleaning sup- plies, sickroom linens, bandages, dressings, and clean clothes; tending to patients’ nutrition; and keeping insects and vermin at bay. On the bright side, today’s average citizen knows far, far more about the causes and effects of disease and infection, pharmaceuticals, wound-dressing procedures, cleanliness, nutrition, and many other medical procedures than did learned physicians of the Civil War era.
If we don’t know this stuff already, there is a huge amount of easily acquired litera- ture on the subject that can be stored away until the day of cri- sis. In Civil War terms, all of this knowledge would be seen as nothing short of pure magic. The road ahead is arduous, but examples of those who have actually succeeded at this business are many. The moti- vation to assist a friend, relative, loved one, comrade, or fel- low human is high among free people.
This is how we proceed.