Dorothea Dix had built a global reputation as a reformer for mental health institutions in the 1840s and 1850s. She had already changed medicine by insisting that the most vulnerable in society were treated with dignity. When the Civil War started, her influence would spread even further as she moved to change the nursing profession.

Dix, a Massachusetts native, was already 59 years old when the Civil War erupted. She had spoken out against slavery in the past, and though she could not serve in the military, she was determined to serve in some capacity.

In June 1861, Dix was appointed superintendent of army nurses, though she was a civilian. Her position, based in Washington, DC, made her the highest-ranking woman in the history of the federal government to that point. There was very little formal training for nurses at that point, but Dix was in charge of training the volunteers who stepped forward as nursing shortages increased. As casualties mounted, she was also in charge of setting up field hospitals to treat the wounded.





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