 After the outbreak of the war, she convinced the U.S. Army to establish a Women's Nursing Bureau on April 23, 1861 and became the first woman to head a federal government bureau.Although army officials were dubious about the use of female nurses, Dix proceeded to recruit many women who had previously been serving as unorganized volunteers.One of her greatest challenges, given the biases of the era, was to demonstrate that women could serve as competently as men in army hospitals.