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[[File:Kate Cumming.jpeg__320x439_q85_subsampling-2.jpg|thumbnail|200px|Kate KummingCummming.]]Many belles responded to the call with a sense of duty and pride, while an even greater number deemed this type of work to be unfit for a lady. Kate Kumming, a dedicated Confederate nurse, recalled being told that the hospitals were no places for women and that was not considered “respectable to go into one.”<ref>Kate Kumming, quoted Cunningham, 73.</ref> In April 1862, Kumming arrived in Corinth, Mississippi at a hotel that had been converted into a hospital. She was initially unaware of the sights, sounds, and smells she would encounter and confessed to her journal that the “foul air” made her “giddy and sick,” and that it was necessary for her to “kneel, in blood and water.”<ref>James McPherson, ''Battle Cry of Freedom: The Civil War Era'' (New York: Oxford University Press, 1988), 479.</ref> Circumstances such as these were in stark contrast to anything these women experienced in the Antebellum Era. The levels of care and sanitary conditions varied from hospital to hospital. Cleanliness was continually emphasized as the medical directors were well aware of the prevalence of disease and infection. The most common symptom upon arrival at any hospital was dysentery. A soldier's life in camp was conducive to this problem as water sources were contaminated by human excrement. The southerner men who arrived in camp from rural areas were what one might call "rubes." They had little experience with community latrines or education with regard to proper sanitary procedures. Unfortunately, these poor hygienic practices were continued when the soldier arrived at a hospital. For example, Jackson hospital in Richmond was described as having the “floors and seats of sinks…smeared with excrement.”<ref>Cunningham, 88.</ref> These foul examples of sights and smells offer just a glimpse of what the nurses had to endure; the emotional impact was equally great.

The levels of care and sanitary conditions varied from hospital to hospital. Cleanliness was continually emphasized as the medical directors were well aware of the prevalence of disease and infection. The most common symptom upon arrival at any hospital was dysentery. A soldier's life in camp was conducive to this problem as water sources were contaminated by human excrement. The southerner men who arrived in camp from rural areas were what one might call "rubes." They had little experience with community latrines or education with regard to proper sanitary procedures. Unfortunately, these poor hygienic practices were continued when the soldier arrived at a hospital. For example, Jackson hospital in Richmond was described as having the “floors and seats of sinks…smeared with excrement.”<ref>Cunningham, 88.<dh-ad/ref> These foul examples of sights and smells offer just a glimpse of what the nurses had to endure; the emotional impact was equally great.

While Dix and Livermore were actively pursuing social reform and education during the 1840’s, Mrs. Virginia Clay of Tuscaloosa, Alabama was attending balls. She described scenes of “belles of the town” looking “resplendent in fresh and fashionable toilettes.” Twenty years hence, Phoebe Yates Pember, who was of the same social standing as Mrs. Clay, was holding her finger on a man’s artery in order to keep him alive. While women on the plantations complained about disciplining their slaves, nurses were dealing with the rowdiness associated with hundreds of young men being confined together. According to Kate CummingKumming, “the most unruly and dastardly in our hospitals have been from Louisiana.”<ref>Cunningham, 91.</ref>