Before the American Civil War, the majority of hospital nurses鈥攐r 鈥攚ere men. But the war created a medical crisis that demanded more volunteers, and a lot of the people who took up the call were women.

Of the estimated 620,000 military deaths during the Civil War, were due to disease. If a bullet didn鈥檛 kill a soldier, the infection that developed from a wound might; and the infectious diseases that spread in war hospitals ravaged soldiers and medical workers alike. Amid this desperate need for medical workers, women began to volunteer as nurses for wounded soldiers. After the war, women continued to work in medicine; and by 1900, they represented of U.S. nurses.

Women Volunteer as Nurses

When the Civil War began in 1861, medical jobs weren鈥檛 yet professionalized as they are today, says , a surgeon, historian and founder of .

鈥淪urgery was not part of medical training for many people,鈥 he says. To become a doctor, 鈥渢he only requirement was an apprenticeship with a doctor and some courses.鈥 Many of the people who volunteered as surgeons during the Civil War essentially learned to operate on the job.

Similarly, there was no required training for the nurses who volunteered in war hospitals; so most of their training happened on the job, too. Although both Union and Confederate military medical departments using men in war hospitals, the need for more nurses became obvious in the first few months of the war. Many of the men who ended up working as nurses in these hospitals who had been asked to help care for even more wounded soldiers.

Both white women and free Black women sought to fill this need by volunteering as nurses, though they had very different experiences. Free Black women were frequently assigned tasks viewed as more menial, and often could only treat Black soldiers or other nurses. In the Confederacy, slaveowners forced enslaved Black women and then slaveowners for the work.

Florence Nightingale,  Dorothea Dix Shape Nursing

American nurses working during the Civil War may have heard about the British nurse Florence Nightingale, who had emphasized the benefits of training for nurses during the 1850s Crimean War. She helped establish nursing as a profession in Britain, and influenced the way that some Americans began to think about nursing during the Civil War.

In 1861, the U.S. Army appointed Dorothea Dix as its first superintendent of nurses. Dix implemented a system for women to volunteer for three-month nursing assignments during the war. In addition to establishing standards of care for nurses who volunteered with the Army, she also helped shape the image of what a nurse should look like. To volunteer as a nurse under Dix, women had to be between the ages of 35 and 50, healthy and

Dorothea Dix, 1868. (Photo by Heritage Art/Heritage Images via Getty Images)

Another influential Civil War nurse was the abolitionist Clara Barton, who became known as 鈥淎ngel of the Battlefield鈥 and went on to found the American Red Cross. In 1862, she made a harrowing journey by wagon to to the war hospital near Virginia鈥檚 Cedar Mountain battlefield.

鈥淔ive days and nights with three hours鈥 sleep鈥攁 narrow escape from capture鈥攁nd some days of getting the wounded into hospitals at Washington,鈥 . 鈥淎nd if you chance to feel that the positions I occupied were rough and unseemly for a woman鈥擨 can only reply that they were rough and unseemly for men.鈥

Nursing Becomes Professionalized鈥擜nd Female

Thousands of women served as nurses during the Civil War, which served as a catalyst for more women entering the field. Like other medical jobs, nursing became more professionalized and specialized during the late 19th century. , New York City鈥檚 Bellevue Hospital opened the first U.S. nursing school based on the standards developed by Florence Nightingale. , hospitals in New Haven and Boston opened similar schools.

However, this professionalization also created a gendered hierarchy in pay and prestige. At the turn of the century, men of doctors and surgeons, while increasingly more women held lower-paying nursing jobs, which were seen as less prestigious.

Today, nursing is the healthcare profession in the United States. Although more men have entered the field in the 21st century, women are still in the majority, making up of nurses.

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