From handmaiden to right hand—the beginning of World War I

AORN Journal,  Sept, 2004  by Victoria L. Holder

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Editor's note: This is the fourth in an ongoing series about the history of perioperative nursing. The first two articles in this series appeared in the September and October 2003 issues of the AORN Journal. The third article in the series appeared in the February 2004 issue of the Journal.

Despite old social customs and resistance by many, the concept of women being trained as nurses began to evolve slowly at the end of the nineteenth century. Those interested in nursing were energetic, independent young women, who had watched their older sisters help injured and dying young men during the Civil War. They had witnessed the possibilities of women working outside of the home in a capacity that formerly had been reserved for men.

In September 1872, the first US nurse training program opened at the New England Training School, Boston. By the end of the nineteenth century, numerous training programs had been established. They ranged from short correspondence courses to one- and two-year programs affiliated with major hospitals across the nation.

The turn of the century was a time of liberation for women. They did not have the right to vote, but they were organizing for change and growth. Nurse Lavinia Dock and others spoke out and demonstrated for women's rights. Labor unions were being organized and so were trained nurses. America was rebuilding and expanding; it was a time of peace. Across the seas in Europe, however, unrest was brewing, setting the stage for a conflict that previously could not have been imagined.

THE GREAT WAR

World War I has been called "... the Great War that changed the world," (1) and "the most avoidable but most terrible of wars." (2) (p9)

   Never had so many nations taken up
   arms on a battlefield so vast--in the
   trenches, in the skies, and on the
   seas. Never before had a war been
   fought with all the might of modern
   industry. This was the war to end all
   wars. (3) (p19)

The origins of World War I are complex. "[It] was the result of choices made by identifiable people under particular circumstances." (3) (p19) The explosion of industrial growth left Europeans feeling unstable. Railway lines and steam traffic were expanding. Europeans were receiving imports of wheat and beef, and ordinary people were eating better than ever in their history. Populations and cities grew rapidly. People began to migrate west through

Europe to the New World, in hopes of finding an even better life. (3) It was a revolutionary time, not only in industry and economic power, but also in areas of art, science, and philosophy. Old ideas and cherished concepts were being challenged. (3)

The political arena in Europe also was changing.

   Part of the problem was the persistence
   of an old political order at a time
   of rapid economic and social change.
   Russia, Austria-Hungary, and Germany
   were all ruled by feudal hierarchies....
   France was a republic, and
   Britain had constructed a compromise
   form of constitutional monarchy. (3) (p36)

The leaders in Germany and Russia had family ties to Great Britain through Queen Victoria, and thus, they presumed that their common interests, respect, and personal ties would ally them in a time of international crisis. (3) This was not to be the case, however, because each of these imperial powers had a different agenda.

EVENTS LEADING TO WAR

At the turn of the century, the tiny province of Bosnia, located west of the independent nation of Serbia, had been formally annexed to Austria-Hungary against its will. (2) This created unrest among the Serbian minority living in the region. They felt that Bosnia should have been part of Serbia. Tensions arising from this situation brewed for several years.

On the morning of June 28, 1914, the Archduke of Austria-Hungary and heir to the throne, Franz Ferdinand, accompanied by his wife Sophia, visited Sarajevo, Bosnia's capital city (Figure 1). As the Archduke and his wife were leaving the railway station, a group of seven Bosnian-Serb terrorists threw a bomb at the car. Although the attack missed the Archduke's car, it hit the car behind, wounding three aides and several bystanders. The Archduke continued on to the city hall, where he was scheduled to speak. As the group was leaving city hall, however, the Archduke asked to go to the hospital to check on those injured in the bomb attack.

Enroute to the hospital, the chauffeur made a wrong turn onto a side street. Twenty-year-old Gavrilo Princip, one of the terrorists, stood in the street. He quickly pulled out his pistol, jumped onto the running board of the car, and shot the Archduke and his wife at pointblank range. Gravely wounded, both the Archduke and his wife were dead within a few minutes. (3)

Austria-Hungary seized upon this incident to exert control over Serbia, and on July 23, 1914, the country's leaders issued a list of demands and ultimatums to the Serbian government, which they accused of masterminding the assassination. (3) Knowing that Serbia had an alliance with Russia, the Austrian-Hungarian Emperor, Franz Josef, (Figure 2) called upon his own ally, Kaiser Wilhelm II of Germany to support Austria-Hungary if the Russians did get involved. The Serbian government tried to resolve the issue by accepting most of the conditions, but that was not enough for the Austria-Hungarian government, which insisted that their demands had not been met. (3) As a result, the Serbian military began mobilizing their forces. Austria-Hungary and Germany broke off all diplomatic relations with Serbia and began a war against Serbia on July 28, 1914. (4) Russia came to Serbia's defense. On August 1st, Germany declared war on Russia, and Russia began to mobilize its army, which "numbered nearly a million and a half; mobilization brought its size to a breathtaking 4.5 million, with another two million soldiers in reserve." (3) (p71) Two days later, France, which was allied with Russia and had its own grudge against Germany, entered the war. (2)