By the end of 1940, Miss Mary Beard, Director of the Red Cross Nursing Service, acknowledged that Shimmoler had the idea of something that was needed. However, there was a general lack of enthusiasm among most medical officers. As late as July 1940, the Chief of the Medical Division felt that in time of war, nurses would not be used on airplane ambulances. He felt it was too dangerous for a woman and that they could not handle the physical and mental demands.
Without the personal interest of General David N. Grant, an air surgeon, the concept of the flight nurse as a part of the medical team might not have ever been realized during this time because of the military's indifference and the danger during war time. But, on Nov. 30, 1942, an urgent appeal was made for graduate nurses for appointment to the Army Air Forces Evacuation Services. The nursing program at Bowman Field, KY was at this time under the direction and leadership of Capt. Grace Mundell.
On Feb. 18, 1943 the first formal graduation of nurses of the 349th Air Evac Group was held at the base chapel at Bowman Field. The 30 members of this group had completed a program on instruction that was only in the experimental stage. The 4 week course included class work in air evac nursing, air evac tactics, survival, aeromedical physiology, mental hygiene in relation to flying, training in plane loading procedures, military indoctrination and a one day bivouac.
Gen. David N. Grant officiated over the first class graduation. At the end of his address, realizing no one had thought of an insignia for the flight nurse, he unpinned his own miniature flight surgeon's wings and pinned them on the honor graduate, 2nd Lt. Geraldine Dishroon, remarking that the insignia of the flight nurse would be similar to that of the flight surgeon, with the addition of a small "N" superimposed on it. Having created this insignia on the fly without authority, there was much difficulty having it manufactured as no insignia manufacturer would make the wings without the War Department's approval.
The School of Air Evacuation was the first of its kind and its influence was world wide. During 1943 nurses from the Royal Canadian Air Forces attended the school. The Brazilian Government, in cooperation with the Brazilian Red Cross, sent a representative to study the school so that one could be instituted in Brazil.
The training of the flight nurse was designed to equip her for her duties in connection with the evacuation of the sick and wounded and prepare her for duty with ground medical installations. In order to become a flight nurse, graduate nurses were required to apply for a commission in the Army Nurse Corps. After a minimum of 6 months in the Army Service Forces unit hospital, she could apply for admission to the school. She had to be 62-72 inches in height, weight from 105-135 pounds, her age between 21-36. Physical fitness was important, in view of the fact most of the work was done at altitudes of 5,000 to 10,000 feet. Work at that altitude is very tiring. The work of the flight nurse was not without danger. The aircraft used, usually C-46, C-47 or C-54 types, acted in a dual capacity. They carried cargo and troops to the battle fronts, after the planes were unloaded they were rapidly converted into ambulance planes for the return trip. Because of the dual use of the planes, they were not marked with the Geneva Red Cross, and on the return trip they were fair game for the enemy. Thus all nurses, who entered this field were volunteers.
In July 1943, 2nd Lt. Ruth M. Gardiner died in an aircraft crash en
route to evacuating patients in Alaska. She was the first USAAF flight
nurse killed in a combat theater. She was with the 805th MAES. Gardiner
General Hospital in Chicago, Illinois, is dedicated to the memory of Second
Lieutenant Ruth M. Gardiner as the first Air Evac nurse killed in the line of duty.