In Nursing Civil Rights: Gender and Race in the Army Nurse Corps, Charissa J. Threat accomplishes her purpose of broadening our thinking about discrimination history beyond race and gender to economic rights and labor as part of an equal rights agenda. Her narrative vehicle is the story of the integration (of both race and gender) of the Army Nurse Corps between World War II and the Vietnam War. The Army Nurse Corps is an effective subject choice for her analysis: Nurses are the largest group of women workers in the United States, and the Army Nursing Corps provides a novel way of thinking about gender and race as cofactors in reshaping American perspectives of masculinity, femininity, and race within the context of changing ideas about social structures, citizenship, and nationhood.
Threat argues that there is a shared history between African American women nurses and white men who are nurses (very little data exist on African American men). In the introduction, and in the five chapters and the conclusion that follow, Threat's narrative weaves African American women's and white men's attempts to join the war effort through their professional nursing role. Although race figures highly in the book's narrative, both groups, their supporters, and their detractors, used gender as an argument for inclusion and exclusion and as a way to solidify and undermine traditional gender assumptions and redefine the work of nursing.
In Chapter 1, Threat traces the movement of nursing from a domestic, unpaid responsibility to paid work, tying in the role of war and the growth of hospitals to the social perception of nursing as women's work. Threat begins to detail African American nurses’ integration campaign during World War II in chapter 2. African American nurses used gender as an argument for their inclusion in the Army Nurse Corps, emphasizing that race should not be a factor in the care of soldiers. All of the military branches denied African American women entry into the Nurse Corps (or kept a strict quota) until 1944 when a severe shortage of nurses in both battle and civilian hospitals forced policy changes. Lifting the quotas for African American nurses was a first step to help alleviate the shortage, although most of these nurses were ultimately assigned to segregated hospitals. The threat of a draft of primarily white women nurses in 1945, through the Nurse Draft Bill, pushed the Army to open the Nurse Corps as public sentiment overwhelmingly favored inclusion of all nurses—except men who were nurses.
The military leadership, including women officers, used a conservative gender argument against the inclusion of men of any race into the Army Nurse Corps. Men who were nurses were denied nursing roles during World War II and were assigned as Corpsmen or medical technicians, and they only began to break the gender barrier in 1955 via an amendment to the 1947 Army-Navy Nurse Act. In chapter 3, Threat examines the very delicate (and sometimes not so delicate) dance between men who nursed and the woman-dominated hierarchy in the Army Nurse Corps. Women feared encroachment on their domain in the Corps and actively resisted the inclusion of men, although men were admitted to membership in the American Nurses Association beginning in 1930. The military hierarchy proved harder to crack. Threat points out that African American nurses and men who nursed could have seen their causes as compounded and supplemental, but their efforts were divisive. African American nurses were better organized, connecting to the National Association of Colored Graduate Nurses and to the nascent Civil Rights Movement. They also effectively and consistently used the rhetoric of gender—as women they were naturally best suited for nursing roles. These arguments resonated with the military leadership and the public, who believed that gender rather than race determined who should care for soldiers during World War II and into the 1950s.
Chapter 4 focuses on the years following World War II, including the Korean conflict, and on the continuing gender and race conflicts in the Army Nursing Corps. After the war, Threat notes the public push for social stability led to stronger holds on traditional values and beliefs. Along this line, President Harry Truman's Executive Order 9981 in the summer of 1948, Nondiscrimination in the Armed Forces, reiterated the inclusion of African American women in the Army Nurse Corps, but did not specifically call for the inclusion of men. Even so, African American nurses continued to face individual discrimination in their assignments. Men made little progress toward entry and equality in the Nurse Corps. Even as the American Nurses Association eased entry of African American women and men into the organization, the military continued to operate under traditional gendered notions of nursing. Women officers were a major obstacle. Women had created a place of dominance and control in the Corps and feared the inclusion of men might alter their authority and expose them to the workplace inequality they experienced in society.
In chapter 5, Threat describes how changing perceptions of the role of nurses in the military in the 1960s reshaped the way the Army provided care to its soldiers. Pragmatically responding to military nursing shortages, particularly during the mid-1960s as President Lyndon Johnson fed more troops into Vietnam, the Army increasingly recruited all nurses. Threat notes that the Army was a reluctant leader in integration, moving toward inclusiveness only when forced by presidential order, legislation, or shortages. Even so, as men moved into the Army Nursing Corps, they faced different hurdles to advancement, officer status, and assignments. Men also received different privileges than women, receiving housing allowances for families and being allowed to marry. Although their assignments were restricted to all male units until well into the 1970s, men were allowed assignment to units in action, which positioned them for faster promotion through the ranks. Threat also weaves the American Nurses Association (ANA) into this broadened agenda, noting that the ANA moved at a faster and more deliberate pace to integration: by the mid-1950s, ANA policies reflected inclusiveness in terms of race, religion, and gender. Although not all of these sentiments may have trickled down to rank and file, many nurses participated in the 1963 March on Washington. Threat concludes the book with a short synthesis that situates the Army Nurse Corps as a reluctant participant in the Civil Rights Movement, as a conflicting mix of conservative action and pragmatic leadership that reflected American society.
Threat effectively threads her argument, that although race and gender were key Civil Rights forces, labor and economics were also critical in shaping the agenda. Of all of the chapters, chapter 1 is probably the weakest. Threat's choice of secondary sources should have included more recent works by historians of nursing. There are, for example, better sources on Nightingale and on the history of nursing than Kalish and Kalish (1995). Threat's inclusion of the ANA as a counterpoint to the Corps provides context, but she only includes the perspectives of the leadership on equality and integration, which was at times quite different from that of the rank and file. She struggles, as do many who write about this subject, with how to refer to men who are nurses. The term “male nurses” is an interesting artifact that reflects the highly gendered history of the nursing profession. Although Threat does not intend her book to be a nursing narrative, she effectively uses nursing, as should other scholars, to understand broader social and political issues.