During the war, the Sanitary Commission provided floating hospital ships for the Union Medical Department. Under the terms of service, it required all persons who engage in the hospital service under the army to be “entirely at its disposal.” This service was quite an undertaking for the Sanitary Commission. Each boat had an appointed agent for the commission. That person was responsible for the fittings and the supplies necessary for the hospital ship to effectively and efficiently transport its wounded soldiers.
It is interesting that the Commission divided the ship into wards just like land hospitals were during this time period. Each ward was to accommodate 50 to 150 patients. If there were convalescents being transported, they were to comprise their own ward in the vessel.
Surgeons in these ships were to be appointed for each vessel. They were to be responsible for the reception, classification, and distribution of the patients in the various wards. If practical, each ward was to have been assigned one surgeon. An assistant to the surgeon (with the title of Ward Master) was to be on duty at all times. There were shifts of Ward Masters on the ship. The Ward Master was under the surgeon and followed his orders. The Ward Master was to superintend and be responsible for the entire treatment of the patients of the ward while he was on duty.
Unlike the regular army, two or more nurses were to be constantly on duty in each ward. Their instructions were to be received from the surgeon through the ward master. A dispensary (pharmacy) was to exist on each ship. One or more apothecaries were to be placed in charge of the pharmacy. They were responsible for the medical stores and for compounding and issuing the drugs requested by the surgeons, which were distributed by the ward masters.
In addition to the nurses, women were in charge of the hospital pantry and the linen closet. They issued their materials to the ward masters or the nurses. They could also issue their materials on their own. Special diets, drinks and articles of bed and personal clothing were under their control.
Like all seafaring ships, there were watches that were set by the sanitary commission for their ships. People were divided into two groups (watches). A watch cycle went like thiS
1. From 7 am to 1 pm (Group A)
2. From 1 pm to 4 pm (Group B)
3. From 4 pm to 7 pm (Group A)
4. From 7 pm to 1 am (Group B)
5. From 1 am to 7 pm (Group A)
6. From 7 am to 1 pm – Day 2 – Starts with Group B
Meals were fixed on board the hospital ships for the patients. There was a general house diet for the men. Breakfast was served at 7 am. It consisted of: Bread (or Toast) with butter and coffee or tea. Dinner was served at 1:15 pm. It consisted of: Beef soup and boiled Beef or Beef Stew, Boiled Rice or Hominy, and Bread or Crackers. Tea was served at 7 pm. This “meal” was Bread or Toast or Crackers with butter and coffee or tea.
It is interesting that the Commission states that “when practical” the house diet should be served at tables. When “practicable”, the patients will be divided into squads of 40 and a squad master appointed to each to receive and distribute the food. Partients not able to leave their beds will have their meals served by the nurses of their wards, but only if ordered by the ward surgeon.
Every morning Surgeons were to ascertain from the Administrative agent or the ladies what food stuffs were available to issue to the men. From that listing, they prescribed the diets of the men under their care. Because of the schedule, the ward master that was on duty during the morning rounds of the surgeon would be also on duty during that day’s meals. He will get verbal instructions on each patient and would be in charge of carrying out those menu requirements during that day. He was also responsible for all meal distribution.
Just like on land, the surgeon carried out daily rounds on his patients. The two daily rounds would start at 9 am and at 6 pm. Note that the evening rounds were before the evening tea so changes could be made in the next days’ meals. The ward master would both attend the surgeon’s rounds and take notes of the surgeons instructions for each patient. The ward master off duty could, at his discretion, attend the evening rounds for his benefit.
In cases of an emergency or during receiving/discharging patients, the ward masters and nurses may have been required to do duty in their time off. During the cleaning, fitting, or repairing the ship for hospital purposes the administrative agent could require them to assist.
Before patients were taken on-board, the ship must be properly moored. Gangways or other means must be arranged. The surgeon detailed a sufficient number of guides and bearers to move the patients from the gangways to the ship’s wards. What is interesting is that they were required to remove their boots prior to performing this service. Perhaps this was to keep the wards cleaner for the patients. The guides would give the orders for where each patient went. Only they were allowed to speak while patients were being moved into and about the ship.
After each patient was placed on-board, they were examined by the surgeon in charge who directed the ward that they were to be placed in on the ship. If practicable, the patients were then washed and supplied with clean clothing prior to being put into their cots or berths.
The administrative agent was in charge of the soldiers effects. A number was placed upon the effects of the patient. The effects were to be returned to the patient when they left the ship.
The surgeon was not given the power to select the patients for his vessel. It was proper for him to protest against taking patients whose illnesses were not of a “sufficiently serious character to warrant their withdrawal from the seat of war.” They could also indicate that the vessel may have, “a less suitable provision” than the land hospital that they came from. Those already in a “dying condition” could also be protested in that a potential surviving patient should be given first chance. Those with compound fractures of the lower extremities were usually excluded because of the potential of further injury from the tossing of the ship.
Overall, it is interesting to note the differences between what we assume sea hospitals would be like compared to the requirements set forth by the Sanitary Commission on their ships.
Until next month,
Surgeon T.T. Steinbach
17th Corps Field Hospital