Nursing in the Wild West

Smallpox was no exception. At that time, smallpox, known as the “speckled monster,” was one of the deadliest and most contagious of all known diseases, with a mortality rate of 30 to 60 percent.

A Tender Kind of Cussin’

During the smallpox outbreak in Deadwood, the story is that Calamity Jane single-handedly cared for eight stricken gold miners. She had no training or qualifications for this role other than compassion and her childhood immunity to the disease.

But, she was so dedicated that one writer said she even “dropped all her vices and spent day and night nursing.” One witness remembered her as “a perfect angel sent from heaven when any of the boys was sick.”

In the rough mining town of Deadwood, the sick were isolated in filthy tents or shacks on White Rock Mountain, without running water or sanitary provisions. The only things Calamity Jane had to work with were herbs, Epsom salts and cream of tartar.

According to author Dale L. Walker, former president of Western Writers of America, Calamity Jane fought for fresh water for her patients, commandeered groceries from the general store and settled at least one payment dispute at gunpoint. When several of her charges succumbed to the disease, she buried them with the only prayer she knew: “Now I lay me down to sleep.”

Despite these limitations, five of her patients survived the ordeal. The town doctor, L.E. “Old Man” Babcock, believed that without her care, none of the eight would have made it through.

It was rare praise from Babcock, who usually regarded she as unkempt, overly impulsive and manly. “Oh, she’d swear to beat hell at ‘em,” he said, “but it was a tender kind of cussin’.”

Unregistered, unlicensed and possessing only rudimentary skills and a big heart, Calamity Jane — whose life was otherwise a “train wreck” — exemplified what is best about nursing: care for others and ferocious patient advocacy.

Ellen “Nellie” Cashman (1845–1925)

Prospecting philanthropist

by Merritt Henson, RN, BSN, OCN, SANE

Born in Ireland, Nellie Cashman’s indomitable spirit and compassion for others drove her deep into the American frontier. There she cared for sick and injured miners while chasing the gold and silver that she used to help others in need.

Go West, Young Woman

Ellen “Nellie” Cashman was born in Midleton, County Cork, Ireland, around 1845 — the beginning of the Great Irish Famine.

Cashman’s father died when she was five, and to escape starvation, Cashman, her mother and little sister emigrated to the United States, settling in Boston. When the Civil War broke out, Cashman obtained a job as a hotel lift operator, a position usually reserved for men.

According to legend, this led to a chance encounter with Gen. Ulysses S. Grant, who, upon observing her pluck and drive, suggested Cashman travel west. West she went: all the way to San Francisco. However, Cashman had a wandering spirit and no inclinations towards marriage, so she packed up and left to seek her fortune in Pioche, Nev., the site of a new silver strike.

Gunfights and Silver Claims

Like most Wild West mining towns, Pioche had a well-deserved reputation for violence and lawlessness, recording 40 violent deaths in just two years. Nevertheless, the unmarried, 27-year-old Cashman held her own.

With savings she earned working as a cook, she opened the Miner’s Boarding House. In addition to providing lodging and meals for miners, she offered nursing care for the sick and injured among them. It was a valuable service: Mining and prospecting were dangerous work, and not everyone could afford what little skilled medical care was available.

When a miner couldn’t afford lodging or meals, Cashman provided them free of charge. However, she was also a shrewd businesswoman. Cashman would sometimes “grubstake” miners and prospectors: financing their claims in exchange for a cut of their earnings if they struck it rich. When she wasn’t tending to business at the boarding house, she was out working mining claims of her own.

Cashman moved from camp to camp this way — setting up one or more businesses, providing charity and care to miners, buying and working mining claims, and then quickly breaking camp to pursue a more promising site elsewhere.

A Daring Rescue

In 1872, gold was discovered in the Cassiar District of British Columbia, Canada. Because of the area’s severe winters and difficult terrain, the rush to the Cassiar was more of a trickle. Cashman arrived with several other Nevada miners in 1874. She again opened a boarding house, cared for miners with physical ailments and financial needs, and prospected on the side.

A devout Catholic, she also collected donations for the Sisters of St. Ann for the construction of St. Joseph’s Hospital in Victoria, B.C. Before winter set in that year, Cashman left the Cassiar district to deliver the donations. Some of her fellow miners were not so wise, and a heavy snowfall left them trapped in the Cassiar with inadequate provisions.

The Canadian Army refused to mount a rescue mission because conditions were so treacherous, so Cashman organized her own rescue party, recruiting six men to accompany her. The party had to hike in on snowshoes, each dragging a sled laden with supplies. When the rescue party finally reached the Cassiar 77 days later, they found 75 stranded miners — three times as many as expected. Still, Cashman was able to nurse them all back to health.

After newspapers reported her heroic expedition, she became known as the “Angel of the Cassiar.”

Tombstone Tales

In 1879, Cashman headed south to Tombstone, Ariz. Tombstone in the late 1800s was a wild place, and she became friends with some of its most colorful characters, including Wyatt Earp and Doc Holliday. (Holliday allegedly defended her honor — or at least the integrity of her cooking — by drawing his sidearm and demanding a retraction from a customer who had complained about a meal at her restaurant).

Not long after arriving, she also began soliciting donations for the construction of a hospital — the city’s first. Cochise County Hospital opened its doors to patients in 1881; Cashman worked there for a time as a nurse.

In July 1884, Cashman’s sister died of tuberculosis, leaving Cashman to raise her five orphaned nieces and nephews. She continued her various business and charitable works in Tombstone, responding to tragic events with integrity and resolve.

One such event involved five men sentenced to hang for a robbery that had left four bystanders dead. Some local profiteers built bleachers around the gallows, planning to charge admission to the hanging, but this so appalled Cashman that she recruited friends to demolish the bleachers in the middle of the night.

Yukon Bound

Even Tombstone couldn’t contain Cashman’s adventurous spirit. In 1886, she packed up the kids and moved on to Montana, Wyoming, New Mexico, the Yukon Territories, then Alaska, where at age 70, she drove a dog sled team 750 miles from Koyukuk to Seward, in just 17 days.

In 1925, Cashman died of pneumonia in St. Joseph’s Hospital in Victoria — the same hospital her donations helped to build 50 years earlier.

Although her professional nursing career was brief, caring for others was in Cashman’s blood, and her lay nursing work and fundraising efforts for local hospitals touched many throughout her long life. It’s little wonder she’s still fondly remembered in the many places she called home.

ELIZABETH HANINK RN, BSN, PHN, is a Working Nurse staff writer with extensive hospital and community-based nursing experience.

MERRITT HENSON, RN, BSN, OCN, SANE, is a registered nurse, freelance medical writer, and Lyme disease advocate. Reach out to her at .

In this Article: Historical Nurses