Introduction New Zealand’s initial contribution of 50 nurses to WWI was thought to be sufficient. However, by the time of Armistice Day, at least 550 nurses had served for the New Zealand Army Nursing Service. According to diaries and records, many arrived back broken with a wide disparity in care. No formal analysis of this exists to understand the impact in more detail. The hypothesis is that the nurses who served the longest would carry a higher sickness burden and have a shorter life span than those nurses who had a shorter length of service.

Methods Service files of the first 50 nurses were analysed and compared with the last 50 nurses who served while war was still active. Data from each nurse’s file were confirmed with other sources for age, length and type of service, sickness, date of death and any other notable events.

Results The first cohort of nurses (N=50) had longer periods of sickness, with a higher number of illnesses related to overcrowding, overwork (nervous disorders) and poor hygiene. The first cohort also were awarded many medals of merit, indicative of the extreme conditions they were working in. Individual nurses experienced poor medical treatment on their return to New Zealand. The last cohort (N=50) experienced fewer incidences and different types of sickness, with Spanish Influenza having an impact on serving nurses near the end of the war. In addition, the second cohort died younger compared with the first cohort, and none received medals of merit.

Conclusions This analysis has identified that many New Zealand nurses experienced severe health effects due to their service, and their health needs were poorly considered on their return to New Zealand. The Matron in Chief and others battled to have the nurses cared for appropriately. These lessons remain as valid now as they did in 1918.