Profiles in Nursing

Louisa May Alcott (1832–1888), From “Hospital Sketches” to “Little Women”

A beloved writer, she was also a Civil War nurse, staunch abolitionist and suffragette

Before achieving fame for her literary accomplishments, Little Women author Louisa May Alcott served as a nurse during the Civil War. Although ill health forced her into premature retirement, her experiences as a nurse and a patient shaped her voice as a writer and helped her to craft what would become timeless stories.

An Enlightened Family

Born in 1832 in Germantown, Pa., the daughter of Transcendentalist Bronson Alcott, Louisa May spent many years surrounded by great literary minds, including the well-known authors and poets Ralph Waldo Emerson and Henry David Thoreau.

Her family was fiercely dedicated to the abolition of slavery, sometime sheltering escaped slaves as they traveled along the Underground Railroad to freedom. As an adult, Alcott remained a staunch abolitionist as well as a feminist and suffragette.

Before becoming a nurse, Alcott wrote short stories and poems, which she often published under the pseudonym A.M. Bernard. Due to the limited success of her few published works and her concern about her family’s financial stability, she also worked for a time as a kindergarten teacher.

RN Career Events

The Call of Duty

In the winter of 1862, at age 30, Alcott entered nursing at Union Hotel Hospital in Virginia. This career shift reflected both her desire to contribute financially to her family and her ongoing commitment to ending slavery, the central issue of the Civil War.

As a Union nurse, Alcott faced many challenging and emotional situations, including witnessing soldiers’ deaths in the service of a cause she had dedicated her life to supporting. Her duties went beyond dressing wounds; Alcott was sometimes called upon to deliver the news that a soldier she had grown fond of would not recover from his injuries.

A supporter of nursing pioneer Florence Nightingale, Alcott also advocated for cleaner conditions in Union hospitals, believing that a dirty and unsanitary environment contributed to soldiers’ illnesses and increased fatalities.

After providing care for soldiers for only six weeks, Alcott contracted typhoid pneumonia. The cure was almost as bad as the disease: She was treated with calomel, a toxic mercury compound widely used during the Civil War, which led to hallucinations, coma and permanent physical damage that likely contributed to Alcott’s early death.

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Nurse Tribulation Periwinkle

After deteriorating health forced her to retire from nursing, Alcott used her wartime medical experience to write Hospital Sketches, originally published as a series of short stories for a Boston antislavery newspaper and compiled into a book in 1863. Although the stories’ heroine is a fictional “Nurse Tribulation Periwinkle,” many literary scholars believe that the incidents described were lightly fictionalized versions of Alcott’s actual experiences.

The success of Hospital Sketches, and the experience of writing it, opened new doors for Alcott and helped her find her voice as a writer. She went on to author many other stories, including her most famous work, the classic novel Little Women, initially published in two volumes in 1868 and 1869. The now-beloved, semi-autobiographical story has been adapted for film and television many times, mostly recently as a 2019 motion picture.

Alcott died in Boston in 1888. She was only 55 years old. Though her nursing career ended prematurely, Alcott is still praised for her patriotism, commitment to abolition and dedication to human rights. Despite her personal distaste at caring for Confederate soldiers who were fighting against her beliefs, Louisa May Alcott upheld the code of nursing ethics, providing care for all who needed it.


Jessica Dzubak, RN, MSN, is the director of nursing practice for the Ohio Nurses Association and a freelance writer specializing in the healthcare industry.


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