From Houston to Memphis: the Kezia Payne Depelchin letters and the yellow fever epidemic of 1878
A first-person account of an individual nurse's experience during the Memphis yellow fever epidemic of 1878 was examined to explore nursing as it was evolving from a pre-professional to professional status. Nursing's contributions to the framework of care established as a response to the yellow fever public health crisis were considered within the context of influencing geographical, social, and historical factors. Characteristics of Memphis, including its location on the Mississippi River, supported the burgeoning of a yellow fever epidemic. Eventually overwhelmed, the city required outside assistance as the disaster unfolded. Care of yellow fever victims demanded intensive and prolonged nursing care. The Howard Association, a philanthropic organization, provided physicians and nurses to the stricken city. Five hundred twenty-nine nurses, including Kezia DePelchin, traveled from locations outside Memphis on free rail passes to provide nursing care in the suffering city. While no nursing schools existed in the South in 1878, nurses were valued for their experience rather than their training. Without training or standards of care, however, the nurses were a heterogeneous mix with varying levels of skill. the letters of Mrs. DePelchin provide a comprehensive account of her nursing experiences during the epidemic. From the time of her departure from Houston at the end of August until her return in December, she recorded in great detail her daily experiences as a Howard nurse. The demand for nurses increased awareness of the need for trained caregivers. Nursing was a vital component in the interdisciplinary framework created to combat the devastating epidemic. Nursing care was crucial at a time when medical science was limited. The need for and dependence upon nursing helped to encourage the growth of professional nursing. The influence of the nurses, however, is not limited to Memphis in 1878. The letters of Mrs. DePelchin provide insight concerning the roles and functions that nurses fulfilled during the epidemic as disaster nurses within a multidisciplinary framework of care that today's nurse can apply to the threats of disaster confronting the 21st century.