Vietnam War Nurses

by Patricia Rushton

  Another example involved the blood bank. Each unit of blood came with a pink tag which had three perforated sections so you could tear them off. One section was tied to the unit of blood. One was tied to the patient’s bed or it went in the chart when the patient left the ward, and the third one stayed in the blood bank. The chief in the blood bank would send me a whole stack of pink tags and string and the bed patients would put the string through the holes in each section. Our patients often needed surgery several times a week and it was not uncommon to have four or five of them going to the OR each day. Since a type and crossmatch only lasted for 48 hours, it meant we had to type the patients really often. The chief would extend the expiration date an extra day until we got the hematocrits back. Then we could see how their crits were instead of having to go through type and crossing again. It was a trade-off.

  One of my career highlights happened during my first tour of PMs. Admiral Nimitz was the only five-star admiral in the Navy at the time and there has not been another since then. He was a neurosurgery patient and had back surgery. Each shift one of the new ensigns was assigned to take care of him. I was called and told to report to the SOQ (sick officers’ quarters) ward. I ended up caring for the admiral for my entire week of PMs.

  One night I came back from dinner, checked in with the head nurse on SOQ to see if there was anything I needed to know, and she said, “No, but these flowers came for the admiral,” as she pointed to a huge arrangement of anthuriums. Some people call it the little boy flower and you see a lot of them in Hawaii. They have heart-shaped leaves and red heart-shaped blooms surrounding a yellow pistil. I could see the card had the presidential seal. So I picked them up and went traipsing into the admiral’s room and he promptly said, “Get those #@&* flowers out of here.” I said, “But admiral, you didn’t see who they’re from.” He said, “I said, get those #@&* flowers out of here.” “But admiral, they are from the President of the United States.” “I don’t give a damn. Get those flowers out of here.” Apparently this was one kind of flower he didn’t like. So I took them back to the charge nurse and told her the admiral didn’t want them and to give them to somebody else.

  Shortly after that tour of PMs, my supervisor, Commander Jane Wathen, wanted to move me from the routine ortho ward to 76–B, the amputee ward. All the nurses on the ramp did change of shift report in her office, which was in 76–B. So I had walked through the ward every day and, as a brand new grad, it was absolutely intimidating. I didn’t think I knew how to take care of those guys. It was difficult enough being on a regular ward. This was another one of my serendipitous events. Not only did I prove to be up to the challenge, I grew to adore working with those fellas and actually looked forward to going to work each day.

  It was a handful though. We had four or five surgeries every day. We had to mix our own IVs. They weren’t done in the pharmacy. At one point, we had so many really ill patients that CDR Wathen would try to assign one extra nurse who did nothing but mix IVs for the next 24 hours, just for 76–B. On the 3 to 11 shift there were usually two corpsmen on each ward and each nurse covered two wards.

  On AMs there were two, maybe three nurses and two to three corpsmen. Every patient got a bath and clean sheets. We always had patients who were running fevers of 102 or 103. Because they were wounded in a filthy environment (like rice paddies fertilized with human waste) almost every wound was infected with pseudomonas. The sickest patients and the ones who were running the highest fevers were in the two beds adjacent to the nurses’ station. The wards were not air conditioned. In the summer we had these huge floor fans that were probably two or three feet in diameter on pedestals and they were put next to the first two beds. Whatever germs the patients had were being blown all over the ward. If we weren’t sure what was causing their infections, we put a stainless steel basin containing Betadine and hot water on an overbed table at the foot of their bed. The instruments from dressing changes, their plates, silverware, etc., were all put in the basin. If we were lucky, it got changed once a day and that was our infection control. Things have really changed since then.

  I hadn’t been on the amputee ward at Oakland very long when California Governor Brown came to visit on Veterans Day, November 1965. It seemed like every dignitary who came to the hospital wanted to visit the Marine amputees on 76–B. Captain Bulshefski, the chief nurse, came up to the ward that morning while I was frantically trying to get everybody’s baths and A.M. care done before the governor’s expected arrival between 0900 and 0930. She walked down the ward and lowered all of the Venetian blinds to the same level. Then she turned all the wheels at the foot of the beds in same direction. She put pillowcases on the pillows on the empty beds. It was really kind of neat that she didn’t tell me to get this done, she just did it herself. They were things I would never have worried about or fooled with, even for the ward inspections on Fridays. Perhaps it was an old Navy or nursing school habit.

  My first tour of nights was over Christmas, December 1965. We did 14 straight nights. We covered the five wards on the ramp; four ortho wards, one urology and we were also on call and standby for the urology and ortho clinics. There was one corpsman on each ward. So, you were really hopping as the acuity and the number of casualties increased.

  Because of the staffing on nights, the 3 to 11 shift tried to give all the patients their sleeping pill, pain medication and can of beer. Most of them had an order for a can of beer. Almost all of them had lost weight and looked so terribly thin and skinny. The beer helped them put some weight on and it also helped them sleep. So we made a real effort to work with them and hold off the pain medications as long as we could, then medicate everyone close to 1030 or 1100. That would give the night nurse time to check the other four wards and then get back to the amputee ward, which was the busiest with the most acute patients.

  I don’t think I realized at the time, but while I was giving physical bedside care, I had actually woven psychological patient support into that as well. I could be caring for one patient, but be carrying on a conversation with several of them all at the same time. Over the years, I have spoken with many amputees and health-care providers and we all agree that the open-bay wards were the best way to provide patient care and psychosocial support for the amputees as well. I was used to the open-bay ward from my student days at the University of Michigan. I think there is room for both open-bay and closed-room type of situations. There are times when patients need their privacy and there are times when those open-bay wards were just wonderful.

  The sickest patients were closest to the nurses’ station at one end of the ward. The three to four at the opposite end were the ones closest to discharge. We actually rearranged the beds with the guys in them on a daily basis according to acuity. We usually received casualties two to three times a week. In 1965, there were no hospital ships, no Navy nurses in Vietnam. Casualties were initially treated in ‘Nam, flown to the Philippines or Japan and then on to us. Fellows who were on their “pity pots,” feeling sorry for themselves, could look to either end of the unit. At one end was someone in worse shape than they were. Those who were ready to be discharged could look the other way and see that they had come a long ways toward recovery. They could see that there was someone worse off. Being a Marine is the epitome of esprit de corps. They all pitched in and helped one another.

  One of my favorite “sea stories” involved one of my first inspections on 76–B. Every Friday morning there was command inspection. Every ward, clinic and space in the hospital was inspected. Every drawer had to be open, every patient bedside locker had to be open and its contents neatly organized. No “gear adrift” and no civilian clothes were allowed on the ward. In the linen room everything had to be stacked just so. I was standing in the middle of the ward at 0959 with a wheelchair loaded with hangers, coffee mugs, civilian clothes and all sorts of gear adrift and absolutely no place to put any of it. One of the patients said, “Here Miss K., we’ll fix it for you. Just give me this stuff.” I said, “Okay, fine
,” left him with the wheelchair and went to the ward entrance to meet the inspecting officer. As I escorted him through the ward, I noticed the wheelchair, but there wasn’t anything in it. I looked around and the guys are just grinning. Then, I noticed that the bilateral amputees had all grown legs. One leg might have been all the coffee mugs, another leg the clothes, etc. That became our practice every Friday. They would just take it all and make it look like legs. They were a very creative group.

  As a disciplinary measure, one of the nurses took away one of the patient’s wheelchairs. She put it in the sun room at the far end of the ward. The patient was a bilateral amputee who was bound and determined to get it. He used the balkan frame on each bed to swing from one bed to another all the way down the ward to reclaim his wheelchair. Where there was a will, there was a way. While these antics were humorous, psychologically they were also very healthy and healing for the amputees.

  I learned a lot from these men. You have to remember that there were maybe four to five years difference in age between me and most of them. I was naïve and innocent. I was helping a patient with his bath one day. I said, “You have the most unusual freckles I have ever seen. I have never seen anyone with gray freckles.” He said, “Those are powder burns.” I was so embarrassed.

  One day during morning rounds or sick call, we had already seen about three quarters of the patients when we came to Ray’s bedside. While he wasn’t an amputee, he was on 76–B because his wound was badly infected. He had a gunshot wound to his elbow and that arm was in a Statue of Liberty cast but he never complained. Usually very glib and talkative, this time he was hemming and hawing, he kept saying, “I um, I um.” So I said, “Come on Ray, what can we help you with?” “Well, I um, I um.” After a few minutes of this, I finally said, “Listen Ray, we don’t have all day. Doc Salisbury has to get to the OR. If you have a problem, spit it out. We’re here to help you.” He said, “I have crabs.” I immediately replied, “Where are they? I’ll take them home and cook um.” Needless to say, the entire ward erupted in laughter. Dr. Salisbury looked at me and shook his head, finished sick call, then took me into his office where he drew this little oval with lines off either side. He said, “What does that look like?” I said, “It looks like some kind of little bug.” “It is pediculus pubis.” “I know what that is. It’s lice.” “Well, the guys call it ‘crabs.’ “ I was mortified. Of course, from then on the fellas teased me unmercifully. Each morning for a while, when I walked on the ward some one would hold up his thumb and forefinger pinched together and say, “Miss K, I’ve got some crabs. Want some?” Talk about total innocence.

  One amputee who was in the Army and had been drafted, didn’t want to go to physical therapy. He just wanted to stay in bed and vegetate. He was uncooperative, kept to himself, had no visitors and made no effort to talk to any of the other patients. Needless to say, caring for him became extremely frustrating as well as challenging. CDR Wathen said, “You know, the only thing you can do is throw a pitcher of cold water in his face, and that is perfectly acceptable.” We only had to do that a couple of times and he started to shape up. Treating a patient that way as a brand new graduate was terribly hard. The fellows taught me tough love and I can say, after 26 years, it was really and truly a gift from them.

  I received orders to Guam in 1967. I was there from June 1967 until December 1968. I was the charge nurse on one of the two orthopedic wards. We had 40 beds in the main ward, but the “sun porch” had 20 bunk beds. So it was possible to have a census of 80 at any given time. We either treated the casualties and returned them to duty in ‘Nam or stabilized them for medevac back to the States. Sending the fellas we had treated and cared for back to Vietnam was one of the toughest things we had to face. We knew the odds. We knew what awaited them and so did they. It was equally difficult when the young corpsman we had worked so closely with received orders to the Fleet Marine Force, which meant Vietnam. That was truly devastating because corpsmen had one of the lowest survival rates.

  I keep in touch with more people from that duty station than any other. No doubt it is because of what we went through together, what we endured and indeed survived. We were there during the Khe Sanh and the Tet Offensive in 1968. During Tet, medevac flights with casualties arrived every single day rather than three times a week. Not only were we overwhelmed by the numbers, the casualties were really in bad shape. They would be stabilized in Vietnam and then sent on their way. It was an extremely hectic time clinically with the medevacs. Everybody you worked with, the doctors, nurses and the corpsmen, knew what you were up against because we were all in the same boat. It wasn’t easy for any of us. Thank goodness for the Serenity Prayer. It became my mantra during the darkest days.

  Our OR schedule was single spaced, on both sides of a legal piece of paper. We would do two cases in one room at a time with one nurse anesthetist or anesthesiologist for both patients. We even opened an annex hospital known as Asan. We had to expand. ICU, ortho and medicine stayed at the main hospital and the annex was mainly for general surgery patients. Additional doctors were even assigned from the States for temporary additional duty, or TAD.

  One of the differences between the Army and the Navy Nurse Corps policies during Vietnam was that Captain Bulshefski, director of the corps, was adamant that nurses, particularly new graduates, not go overseas, not go to Da Nang, not go to one of the hospital ships unless they had a full, two-year tour stateside first. She wanted them to have that tour at one of the large Navy teaching hospitals where they would get some experience with casualties. She wanted them to get out of school, go through Newport, get clinical skills established, and get used to the military. The Army didn’t do that. Frequently, Vietnam was the first duty station for many of their new graduates. I always felt that the nurses in-country (Vietnam) had it worse than we did because they dealt with so much death and dying. I didn’t lose any patients on Guam on the orthopedic ward and only two at Oakland. However, those who served in-country felt that they didn’t have to deal with any of the families. Nor did they have to deal with any of the psychosocial aspects of rehab and returning to the civilian world. And that was no doubt very true.

  There were some memorable patients on Guam. Ted, a Marine amputee, talked to me for hours about the war during a tour of night duty. The day he was medevaced back home, he gave me a lighter that was engraved: “To Miss K from all the guys shot up in the dirty little war.” I cherish that. Then there was Tim Davis and Bill Gostlin. Tim was severely wounded, lost both legs above the knee and spent several days in ICU before he came to my ward. Bill had lost one leg below the knee. They served together in ‘Nam and were in beds side by side directly across from the nurse’s station, which was in the center of the ward. They would repeatedly pull pranks on one another and seemed to play a game to see which one could get their next pain medication first. Tim was finally well enough to go to the movie one evening. However, in the process of transferring from his bed to the wheelchair—it was one of the really old-fashioned, high-back, caned ones—he ended up sitting on the floor instead of in the chair. One of the things I had learned by “my guys” at Oakland was tough love. They must learn to help themselves. You can’t mollycoddle them. The air turned blue when I told Tim to act like a Marine or I would not help him. If he was well enough to go to the flick, he was well enough and strong enough without legs to get up into the wheelchair by himself. It took him about 15 or 20 minutes, but he managed. The entire ward applauded and he went triumphantly off to the movie. It would be more than 25 years before I knew the impact I had had on these two fellas.

  Toward the end of my tour on Guam, I was still single, and with a little encouragement, decided to extend in the Navy for another tour of duty. I requested Bremerton, WA, recruiting in San Francisco, or Camp Pendleton, CA. I received orders to the Naval Hospital on the Marine Corps Base, Camp Pendleton, and worked on the orthopedic ward there. The day my household goods were delivered to a cute little house I was renting, and the movers h
ad left, I sat down to decide what kind of curtains I was going to make. The phone rang and it was Bess Feeney, the chief nurse. She said, “How would you like to go to recruiting duty in San Francisco?” I said, “Well, I did put that on my dream sheet. But they just delivered my household goods.” “Oh, they’ll move you again. Come to my office tomorrow, we’ll call the recruiter and find out what recruiting duty is all about.” I was only at Pendleton for the first four months of 1969. I unpacked just enough to be comfortable.

  It was the first time I had ever worked with Marine Corps recruits. They had to request permission to speak before they asked for anything. You didn’t want to undermine their training. It could be a fairly busy ward at times, especially on evenings when medevac casualties arrived. One night when I got home from a tour of PMs, I realized, “I’ve seen enough of this. It really is time for me to go.” I had admitted a youngster with multiple shrapnel wounds to both legs, relatively minor injuries compared to all of my amputees. For some reason, he got to me and I was glad I was going to have a break from bedside nursing and Vietnam casualties. While there I worked with some nurses who had been stationed in Da Nang. The chow carts were pulled to the wards by little mini tractors and we could hear them coming down the ramp. It was really scary for one of the gals who told me that they sounded exactly like in-coming in Vietnam.

  Sandra Kirkpatrick Holmes on active duty.

  After four months I was off to recruiting in San Francisco. It is the only time I lived downtown in a city. My office was in the Federal Building, which had been Admiral Nimitz’s headquarters during WW II. It was located near Market Street and the opera house. I covered two thirds of California, Nevada, Utah and Hawaii. I would go to Hawaii once a year to attend the state nurses’ convention. Some of the schools in California were a good five-hour drive from my office. Antiwar sentiment was very high. I was even threatened once in San Francisco. A hippie-type called me a killer. I pointed to the oak leaf insignia on my sleeve and said, “I’m a nurse. I don’t even know how to handle a gun. I put the bits and pieces of America back together.” I used public transportation to go back and forth to work because parking downtown was a hassle. After the hippie incident, I asked the commanding officer’s permission to wear a civilian raincoat over my uniform. Several of my patients had told me that feces was thrown at them or their medevac buses en route to Oak Knoll. It was difficult, but I don’t recall anything negative or a lot of antiwar activity at the schools of nursing I visited. Many of them were in the heartland, farmland away from San Francisco and Berkley—the hotbeds.