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Roman Catholic Irish nuns formed a large part of the American Civil War nursing experience in both the North and the South. In fact, when Confederate President Robert E. Lee beseeched the assistance of Irish-born Patrick Lynch, then Bishop of Charleston, South Carolina, to provide nurses for his hospitals, Roman Catholic sisters from a local convent were pressed into service. Sister M. De Sales (Brennan), born in County Kilkenny, Ireland, became instrumental in establishing two hospitals in the Virginias. During the war years she penned over 1000 pages of letters to him. Initially, the paper provides an overview of the cultural milieu and medical knowledge that existed prior to the onset of the conflict. Attending to soldiers whose wounds changed both the nature of medicine and the approach to it, women willing to move beyond the confines of predominantly private and family-oriented care assisted on battlefields and in field hospitals of various kinds. In these settings, widows, adventure seekers, good-hearted women and Irish Catholic nuns alike offered many kinds of on-the-job training. Their duties ranged from the more traditional tasks of setting up kitchens, organising laundries and writing letters, to the more daunting services of 'cupping', administering anaesthetics such as whiskey and chloroform, and surgically removing limbs. By virtue of the sheer magnitude of the suffering, the experiences endured by these women altered their confidence in their abilities to minister, changed their perspectives on public life, and ultimately redefined their futures in organisation and administration. De Sales' letters serve as a case study by which to examine how, as a result of the American Civil War, the Roman Catholic Church gained ground and its Irish nuns acquired a stronger foothold in American nursing. [ABSTRACT FROM AUTHOR]