New research reveals lessons from history about nursing in a pandemic

The University of Huddersfield has investigated the role of nurses during the Spanish Influenza pandemic of 1918-19 and found parallels with the COVID-19 emergency.

History shows that nurses have the skills and knowledge to help patients survive pandemics. But it also reveals how their dedication makes them vulnerable to contracting serious illness themselves - while being used as propaganda tools by the authorities.

The findings have been made by Christine Hallett, who is Professor of Nursing History at the University of Huddersfield. Working with the researchers Amanda Gwinnup and Olivia Gordon, she has investigated the role of nurses during the Spanish Influenza pandemic of 1918-19, an episode that is seen as grim precursor of the current COVID-19 emergency.

“We found that the nurses of the early twentieth century had an armoury of skills at their disposal to enable their helpless and debilitated influenza patients to survive,” said Prof Hallett, who is the author of several books dealing with nursing during WWI.

“They hydrated influenza sufferers, sometimes using techniques such as subcutaneous infusion, but more often by administering sips of water from a spoon or feeding cup. They also learned when and how to offer appropriate nutrition, to understand when foods such as beef tea or chicken soup, containing minerals, ions and protein, would enable their patient’s immune systems to combat infection, and when they should focus exclusively on hydration.”

Nurses also became adept at positioning sufferers to enable more effective breathing and lung expansion, continued Prof Hallett.

“Among their most effective and least-recognised work was the maintenance of hygiene, cleanliness and good ventilation to eradicate the dangerous effects of dust mites, moulds and other potential allergens,” she added.

Heroic nurses were exploited

But Prof Hallett and her co-researchers also found that nurses were exploited as what they term “emblems of resilience” during the Spanish Flu pandemic.

“Images of nurses resembling angels appeared in the national press and on propaganda posters, and their work with influenza patients became merged with what was seen as their heroic wartime ‘national service’.  

“We know that hundreds of military nurses died as a result of contracting influenza in the course of their work, but no record was kept of civilian-nurse deaths,” continued Prof Hallett. 

“Our ongoing research is examining the damaging impact on nurses of their work with this and other infectious diseases during the second decade of the twentieth century.”

In August, the University of Huddersfield researchers were invited by the Royal College of Nursing to give a presentation of their work, delivered via Zoom.  The lecture is now freely available online.

An article on the research and its findings will also appear in the Nursing Times, online and in print.