Historical Perspective


Rose Church - Flight Nurse to Astronauts

The thought of having nurses in space dates back as far as World War II. During this time there was a need for nurses to transport wounded soldiers by air (Lay, 1959). Nurses who took on this role had to be physically fit, liked flying, and were able to take on the responsibility of working on their own (Lay, 1959). It was thought that this would apply to all nurses on spaceships as well.

In 1949 the Department of Space Medicine was founded and differences between air craft medicine and space medicine were identified (Lay, 1959). In space, biological problems must be solved prior to the space craft being designed or going into space. For example, anoxia or lack of oxygen supply meant that sealed pressurized cabins were required (Lay, 1959). Similarly, in 1992, Martha Rogers (1992) a nursing theorist developed a theory on space nursing and explained that “both basic and applied research are necessary to nursing’s future; basic research provides new knowledge while applied research tests the new knowledge already available” (p.28). Therefore it was
thought that nursing in space was imperative to new developments of research “to provide knowledgeable innovative services” due to the nature of advancement in space technology (Rogers, 1992 p.27).
Above: Rose Church, nurse, discusses her contribution
to the space shuttle programs.
Rose Church, Flight Nurse to Mercury and Gemini Astronauts, Will Be NASA Guest for Last Space Shuttle Launch Next Week (July 2, 2011)
Read more:
Historically, the role of nurses in space included; being responsible, maintaining a healthy environment, the regenerative process for air, food and water, and the prevention of disease or injury (Lay, 1959). Nurse teaching would include informing the
space crew of the space age process and how to maintain their health with regards to nutritional, physical and emotional needs and safety in space (Lay, 1959). During this time the expectation was: nurses work at the rocket site and aboard the space crafts (Lay, 1959). Due to the nature of space travel it was thought that the medical staff and team would be small. Therefore nurses working on the space crafts were expected to have a keen interest in problem solving and a well-rounded scope of practice, rather than specialized, so that they would be able to provide complete care (Lay, 1959). To ensure that nurses had the ability to provide complete care it was suggested that they partake in “cross-training” programs offered by the air forces (Lay, 1959).

Due to the nature of space travel nurses were also expected to
do additional training in the management of casualties, and be responsible for deciding how jobs were distributed to best suit professional skills (Lay, 1959).

Overall, it was thought that the air force was a great stepping
stone to space nursing, and that nursing care would include nutritional, physical and emotional care.
NASA - Registered Nurse Patch                    
Woman from St. Louis waves a fond farewell at final shuttle launch (July 8, 2011)

Linda Plush, MSN., CNS/FNP, FRSH
Vice President, Space Medicine Associates, LLC

Linda Plush is the founding president and current Executive Director of the Space Nursing Society. Linda first became aware of nursing in space when she was asked to make a presentation to her graduating class of 1989. She then learned of the Rogerian theory, the Science of Unitary Human Beings which she related to space nursing. The Rogerian theory was what helped Ms. Plush come up with the idea of a nursing society dedicated to space. Due to her great interest in Martha Rogers, she was invited on two separate occasions to attend conferences regarding nursing in space. During these conferences she had the chance to speak one on one with Rogers to discuss what would be required of a nurse in future space exploration (Corbett, 2007). During this conversation, Rogers was quoted as saying:

“For Space we need not think every change is a disease or pathological. For example, it’s not pathological to loose calcium in space, it is normal in that altered environment' (Corbett, 2007).

She also said that she believed humans would evolve and change body and that space spin-offs will affect the Earth instead of the other way around. Rogers suggested that Plush establish a doctorate in space and an international space university for space nursing. Rogers was very supportive in establishing the Aerospace Nursing Organization in 1990, later known as the Space Nursing Society (SNS). In 1991, the SNS became incorporated and a board of directors was formed. Rogers was the first honorary board member in 1992. In 1996, Plush because the executive director of the board (Corbett, 2007).

“The Society was created with the goal of promoting the role of nurses in the planning and providing of health care to persons living and working in space. At the dawn of new millennium, we are more than ever witnesses to the irrevocable evolution of mankind unceasingly pushing back the limits of our environment. The nursing profession has been, is and will remain close to individuals who have health experiences wherever they find themselves” (Corbett, 2007).

Ms. Plush has been on several panels and task forces related to her interests in healthcare in space and extreme environments. She is a life member of the Aerospace Medical Association. Currently she is working on the use of medications in the space environment, and healthcare issues for long duration spaceflight. Four years ago, Ms. Plush became the only advanced practice nurse to participate on the Therapeutics and Clinical Care Integrated Product Team at NASA Johnson Space Center. This is an honorary advisory panel which reviews and advises scientists and flight surgeons on operational issues related to clinical
management and drug treatment, choice of medications and pharmaco-therapeutic research goals, emerging technologies and procedures for the US Space Program. In addition, Linda was recently asked to participate on the Advanced Projects Team at NASA Johnson Space Center. This team is currently working with telemedicine issues for long duration space flight (Livingston, 2005). 

Delores (Dee) O'Hara
"An ordinary person - an extraordinary job!" 
Dee O’Hara got her start in the Space Program by entering the Air Force after nursing school (Wright, 2002). She was the first nurse chosen with the honor of being an aerospace nurse and ironically accepted the position without knowing what it entailed (Wright, 2002). In an interview, O’Hara disclosed that after being asked by her boss if she wanted the job with the National Aeronautics and Space Administration she stated “I didn’t know what else to say, so I said, “Well, I guess so,” absolutely not knowing at all what I committed myself to” (Wright, 2002 p.3). However, in the end, she looked at her decision as an exciting opportunity.
O’Hara recalled, that the role of nurses in the Space Program, was to be a part of the support teams (Wright, 2002). These support teams, would be aboard recovery ships, which would set up little hospitals to be available if anything were to go wrong with the landing of the space craft (Wright, 2002). Other nursing duties entailed being positioned in multiple areas just in case the space craft landing was not quite where it was supposed to be;and to make medical kits to be used by the astronauts if something were to happen while they were in space (Wright, 2002). 
NASA's first nurse assigned to the first astronauts.
Started with Project Mercury (1961-1963) and remained
with the program while also working with the astronauts assigned to
Gemini, Apollo, Skylab and Apollo-Soyez Test Program (1983). 
O’Hara’s role in the Space Program was to get to know the astronauts. This was necessary, as it was her duty to detect any illnesses, as often pilots including astronauts, would hide their illnesses so they would still be able to fly (Wright, 2002). She was also involved in the creation of one of the med labs located in a hanger (Wright, 2002). However, most of O’Hara’s involvement, was in doing pre and post flight physicals (Wright, 2002). She admits that this experience was one where she did not receive a lot of direction and mainly worked independently (Wright, 2002).
Once the first flight astronaut was chosen O’Hara remembered that she became more medically oriented with regards to medical exams and twenty-four hour urine samples (Wright, 2002).  She disclosed, that once everything was set in motion (after the picking of the first astronaut), the flight surgeon often relied on her clinical judgment to determine whether everything was alright with the astronauts (Wright, 2002).  These actions provided her with independence and showed respect for her clinical judgment; it also gives a glimpse into the future with regards to the independent nature of nursing as its own profession.
Dee O’Hara is notably one of the trends setters of our time. Her ground breaking involvement in the Space Program solidified the role of nurses being involved in space travel. Through her role as a nurse at the National Aeronautics and Space Administration she was able to set the pathway for future nurses interested in working in this field.

"Pod 34 Medical Station - 8/30/60" 
- Dee O'Hara, Mercury Nurse 

Dee O'Hara Discusses how she became a Space Nurse and provides some advice to University Students

"Scott shows me his new Astronaut watch."
- Dee O'Hara, Mercury nurse with Scott Carpenter

Space Nursing,
Mar 12, 2012, 1:11 PM