The Flu Pandemic of 1918 to COVID: An Impact On Generations

Deborah Johnson, BA, RN, has a family history with health care.

The University of Kentucky's College of Public Health alum (’66) worked as an RN, following her mother, who was a psychologist, and her grandmother, a nurse during the pandemic of 1918. That interest has even passed to Johnson’s daughter, who attended nursing school and is currently practicing as an RN.

“We are linked to other generations,” Johnson said.

Johnson, who graduated with a triple major in health, physical education, and recreation, was recently published in the November 2021 edition of the American Journal of Nursing (AJN). Her historical feature, “The Flu Pandemic of 1918: A Nurse’s Story,” dives into her grandmother’s experiences as a nurse, and those of thousands of other nurses, during the 1918 pandemic and the correlations to nursing during COVID-19.

“I want nurses, in particular those on the front lines, to understand that we are linked,” Johnson said. “The similarities illustrate the relevance of one generation’s nursing experience to that of subsequent generations—and the importance of history and learning from it.”

Johnson said that, while retired, as an RN she could see what was happening with the COVID-19 pandemic. She said the stories she heard from other nurses about the stresses they were enduring resonated with her, especially because of the stories her grandmother had shared from the 1918 pandemic.

So Johnson began comparing the two—looking at what is going on now and what she remembers from her grandmother’s stories. She also had journals that her mother had kept. “My mother thought that what [my grandmother] had gone through was very remarkable and that the part my grandmother played was something she’d like for others to know,” Johnson said. “My mother actually journaled about a lot of the things that happened during the 1918 pandemic.”

As she worked on comparing the pandemics, she found several striking similarities, including a shortage of personal protective equipment (PPE), a lack of medical interventions such as vaccines and technical supportive equipment to begin with, and nursing shortages, with student nurses used to fill gaps. One of the biggest similarities though was the use of basic nursing tenets, such as those espoused by Florence Nightingale, that have been at the forefront of nursing for generations and the value of the having a health care worker at the bedside of the ill.

“I applaud their courage, applaud their caring, and their being at the bedside during a very trying time,” Johnson said. “I think of when my friends have said, ‘Every time we go to work, we know we’re putting ourselves and our families in harm’s way. We do it anyway. Because that’s what we do.’

Johnson had always been interested in health care because of her grandmother’s experiences and her mother’s career. “I had always been interested in health and the human condition,” she added. Working in health care also allowed Johnson flexibility, as her husband’s—also a University of Kentucky graduate—engineering job would take them to different cities due to transfers. After working a variety of roles across her career, Johnson completed her RN degree later in life and became a labor and delivery nurse.

“The University of Kentucky offered me a pathway to follow into health care,” she said. “My undergraduate education really allowed me to enter into a variety of roles. UK had prepared me extremely well. I was ready just to hit the ground and be enthused about a career in nursing.” Johnson recalls many of the lessons she learned from UK, with the most important, she said, being the importance of listening to your patient.

Johnson said nurses and those in health care need to be visible so people know who they are and what they do.

“Nurses and people in health care will read The Flu Pandemic of 1918: A Nurse’s Story in the November edition of AJN and they’ll all understand it, but I believe that the public needs to understand what goes on to provide them and their loved ones with a safe environment,” she said. “Nurses provide proper treatment of those people, not just medically and not just technically, but on a caring level, especially in times when sometimes they can't be in the hospital with them.”

Johnson said many worry about their loved ones and if they are being treated with care, love, and compassion. She said letting the whole community, not just those in public health, know what they do, how they do it, and why they do it is important to help dispel that worry. “We really care,” she said.

The original feature article in the American Journal of Nursing, "The Flu Pandemic of 1918: A Nurse's Story", is available for purchase here.