[The military nurses of Canada: recollections of Canadian military nurses. Vol 1]
Quiney, Linda J
She Answered Every Call: The Life of Public Health Nurse, Mona Gordon Wilson (1894-1981). Douglas O. Baldwin. Charlottetown: Indigo Press, 1997.
The Women of Royaumont: A Scottish Women’s Hospital on the Western Front. Eileen Crofton. East Lothian: Tuckwell Press, 1997
The Military Nurses of Canada: Recollections of Canadian Military Nurses. Vol. 1 E.A. Landells, ed. Whiterock, BC: Co-Publishing, 1995.
Bedside Matters: The Transformation of Canadian Nursing, 1900-1990. Kathryn McPherson. Toronto: Oxford University Press, 1996.
Nobody Ever Wins a War: The World War I Diaries of Ella Mae Bongard, R.N. Eric Scott, ed. Ottawa: Janeric Enterprises, 1997.
Jean I. Gunn: Nursing Leader. Natalie Riegler. Markham: A.M.S./Fitzhenry & Whiteside, 1997.
Canadian nursing history is strongly rooted in conventional biography and the descriptive narrative style. Consequently, the careful recording of events and preservation of archival material has ensured a rich resource for future research in nursing’s early development and its notable leaders (Gibbon and Mathewson). While recording the contributions of exceptional nurses, this method necessarily limits analysis of the role of the wider community of nursing practitioners, preventing comprehensive understanding of nursing’s history and development and its place in the history of women’s work. In 1991, historian Veronica Strong-Boag confidently predicted that “the history of nurses is changing women’s history and the history of Canada”; she noted a new interest in nurses and nursing among social historians as they began to question nursing’s relationship to issues of gender, class and race (231). Yet historians Kathryn McPherson and Meryn Stuart have cautioned that not all nursing scholars welcome these new “historical studies informed or motivated by political theory,” and many prefer that nursing history mainly serve nursing’s own interests (18). This conservative approach history has led to cautious consideration of nursing within the broader context of Canadian social history. By comparison, in the 1980s American scholarship took the lead in examining the work and culture of nursing. New interpretations by American historians Barbara Melosh in “The Physician’s Hand”: Work, Culture and Conflict in American Nursing (1982) and Susan Reverby in Ordered to Care: the Dilemma of American Nursing, 1856-1945 (1987), directed American nursing scholarship towards labour history as a model for analysis. Until recently, Canadian nursing lacked a similar analytical framework for interpretation of its own historical development.
The history of nursing in Canada spans the centuries; before the religious nursing orders brought to the continent by the earliest European colonists were the healing practices of Aboriginal peoples. Yet nursing as an organised and structured profession for Canadian women dates only from the late nineteenth century, when the Victorian enthusiasm for order and institution building gave rise to the development of the hospital system (Rosenberg). The regularised training of Canadian nurses was initiated as educated, single, young women were recruited to prepare for certification as graduate nurses over a two- or three-year period while working on the hospital wards. The new century saw the evolution of standardised, professional nursing in Canada, with much credit due to a generation of remarkable leaders, each of whom put a distinctive stamp on her own training programme. The history of these inspired women has dominated the wider development of Canadian nursing history into the 1990s, but the achievements of the much larger force of working nurses who trained in the schools, served in the field of public health, and were a major component in the development of a much-heralded Canadian hospital-care system, deserves equal scrutiny; Kathryn McPherson’s Bedside Matters: The Transformation of Canadian Nursing, 1900-1990 has finally given Canadian nursing history its own comprehensive analysis.
McPherson situates her study within the history of woman’s work, employing the “tools of social history to probe the everyday lives of ‘ordinary’ nurses at work” (2), specifically the analytical categories of gender, class and race. By this means, Bedside Matters explores the world of nursing from the ward corridors, rather than from the offices of the nursing supervisors. Oral histories and archival material are woven into a fabric that includes student workbooks, hospital records, and the minutes of nursing associations, illustrating the historical transformation of Canadian nursing on several levels. The reader thus observes both the uncertain young student becoming a confident graduate and the evolution of the work and culture of nursing over 90 years, from its inception as a new career for women into a profession under stress. McPherson claims that a substantial portion of this stress has developed from within, through conflicting visions of nursing as, to some, a skilled profession and, to others, as “women’s work.” Gender-based perceptions of nursing have devalued both the status and wage base of nursing. Struggles between the nursing and medical administrations of training hospitals, as well as the internecine conflicts between nursing leaders and teachers to promote their own priorities have contributed to the continuing efforts of trained nurses for recognition as skilled practitioners, rather than hospital workers.
Recognition of nurses as skilled professionals has also been impeded by the sexual connotations which have attached to their depictions in popular culture, as Chapter 5 illustrates. Using the example of a magazine advertisement from 1958, which portrayed a demurely smiling hospital nurse glancing back at two contented male patients under the caption “Best Medicine a Man Ever Had…?” (192-3), the author shows how nurses have been forced to navigate a tortuous path between perceptions of them as either caregivers, or courtesans.
This is one of two chapters which deviate from the chronological structure of the study to emphasise the influences and issues that have affected nursing across a longer period. Chapter 3 addresses the developments that affected the content and performance of nursing work during the first half of the twentieth century. These two topical sections present a backdrop for the transformations in Canadian nursing as events, trends, politics and social developments of succeeding time periods are explored across nursing generations. In her first chapter, the author reconceptualises the history of trained nursing in Canada, reviewing the historiography and justifying her interpretative framework, as she argues, “Neither fully professional nor part of a male-dominated proletariat, the social relations of class, gender and ethnicity combined to create a distinctive position for nurses” (18). The last quarter of the nineteenth century is seen as the era of the first generation of Canadian-trained nurses who struggled to gain both recognition and respectability.
The main focus of Bedside Matters is on the four succeeding generations, as nursing responded both with conformity to the demands and developments of the twentieth century and with innovation. Each of these four developmental, or transformative, nursing eras is characterised by defining events that also affected Canadian society overall. From its inception in the promise of the new century, the author traces the second generation of nursing to its conclusion at the end of the Great War. The third generation, in the inter-war years, coincides with the great scientific breakthroughs in medicine, while the fourth generation takes Canadian nursing through the Second World War to the advent of Medicare in 1968. The fifth and final generation bears the burden of the promise of universal health care and the upheavals and changes resulting from the work of the women’s movement, the labour movement and the role of government in health care policies. The author leaves her subject without speculating on the uncertain future of Canadian nursing but with an understanding that the next generation will have no easier a path than their sisters in the past. Emphasis throughout is on gender, class and race as they have defined the work and perception of nurses and nursing. The study addresses racism within the nursing profession, and within the social and political forces influencing Canadian history, noting that liberalising tendencies have been directed more by workplace needs than open minds. Bedside Matters draws on sources from across Canada, especially oral and archival records from Nova Scotia, Manitoba and British Columbia. Personal narratives reinforce analysis to give cogent insights into the complexities of nurses’ relationships with peers, superiors and patients. With this study, Canadian nursing history has entered its own transformative era; McPherson’s book establishes a new standard for interpretation of nursing within the context of Canadian social history and the history of women’s work.
Bedside Matters is too recent to have influenced the direction of scholarship in Canadian nursing history as yet. While it offers a methodology that enables nursing history to incorporate aspects of women’s and labour history, bringing it into the mainstream of Canadian social history. Two recent biographies, Natalie Riegler’s Jean I. Gunn: Nursing Leader and Douglas O. Baldwin’s She Answered Every Call: the Life of Public Health Nurse, Mona Gordon Wilson (1894-1981), permit a discussion of how biography can incorporate aspects of social history. Riegler examines her subject by analysing the relation of Gunn’s life and work to developments in Canadian nursing in the first 40 years of the last century. Gunn was an important leader in Canadian nursing’s quest for professional status and was also superintendent of nurses at the Toronto General Hospital from 1913 until her death in 1941. Although Gunn left few personal documents, a wealth of material remains from her work as an administrator and in national nursing organisations, as a Red Cross official and from her numerous published articles and commentaries. Gunn endeavoured always to promote” better educational standards, shorter hours and more financial support” (110) for nurses and nursing students, without which, she feared, nursing would remain a low status occupation. She believed that the control of nurses’ training had to be wrested from the hospital schools and the medical hierarchy and placed under the aegis of the universities, thereby emphasising the science of nursing practice. This is the main theme of the Gunn biography, situating it within Kathryn McPherson’s analysis of the transformation in trained nursing during the second and third generations, from 1900 to the Second World War.
Through Gunn’s difficulties with the male-dominated medical hierarchy of hospital administrations, Riegler illustrates the gender and power issues both within the hospital corridors and elected governments attempting to maintain a low-cost hospital system staffed by captive, unpaid, female nursing students. Gunn’s struggle is extended to the recruitment of nurses for military service in the First World War. Concerned that only the best qualified nurses should have the privilege of serving abroad, Gunn and other officers of the Canadian Association of Trained Nurses (CNATN) offered to control the selection of applicants for overseas service through a system of registration. Although directed to proceed with their plan by Prime Minister Borden and the Director General of the Canadian Army Medical Corps, their recommendations were ultimately ignored. The government “knowingly accepting nurses not approved by CNATN” [79]. Although many well-qualified nurses did achieve overseas service, the episode serves to demonstrate how little control nurses had over their own work and status.
Unlike more conventional narrative biography, this book employs the life and passions of its subject as a mirror for the tensions and issues that dominated developments in Canadian nursing in her lifetime. While the personal achievements and disappointments of Jean Gunn’s career are recorded, her struggles illuminate the issues both from the broad perspective of a nursing administrator and activist, and the consequent struggles and difficulties confronting aspiring students. Unfortunately this biography is too brief; Jean I. Gunn is based on Nancy Riegler’s doctoral dissertation and designed for an academic publication and it does not do justice to the original analysis. Most frustrating is the decision to minimise notes and references “to make this book easier read than the thesis” (9) which in turn minimises its value as a research tool. None the less Jean I. Gunn is a significant contribution to the genre of biographical study in nursing history, going beyond the traditional narrative style and presenting an analysis that both enhances the achievements of its subject and places her within the historical developments she directly influenced.
A second recent addition to nursing biography, Douglas O. Baldwin’s She Answered Every Call: the Life of Public Health Nurse, Mona Gordon Wilson, illustrates the life of a woman who was in many respects a pioneer in public health nursing. Concern for public health, particularly in the area of maternal and infant care, grew significantly during the inter-war years, in part as a consequence of the alarming examples of unfit military recruits for the First World War. In recent years, Canadian women’s history has taken a critical look at this phenomenon, examining the programmes and propaganda directed at mothers (Comacchio; Arnup). The front-line workers, the public health nurses, have received much less attention despite the work of Florence Emory, Meryn Stuart and Kari Delhi; there has yet to be a major interpretative study of public health nursing history in Canada. Baldwin’s book necessarily concentrates on the life and work of Mona Wilson, who was, for a time between the wars, the only public health care practitioner in the remote regions of Prince Edward Island. Although she had worked with the American Red Cross in Russia and the Balkans prior to this appointment, and later worked in Newfoundland during the Second World War, it was her involvement in the development of a system of public health care in PEI that marked Wilson’s career.
Baldwin’s research is comprehensive and wide ranging; archival and personal documents are combined with the reminiscences of colleagues, family and friends in personal interviews. While no aspect of Wilson’s life is neglected, more attention could have been paid to her work in public health nursing. This would have clarified her role in the development of provincial government social policy; the health care infrastructure in Prince Edward Island was being constructed at the same time as the broader pattern of the Canadian welfare state was also being designed.
The island in the 1920s was a bleak place for a public health nurse; its poverty and isolation added to the enormity of Mona Wilson’s task when she was first appointed by the Red Cross. The province had neither a department of health nor a branch of the Victorian Order of Nurses, and provided the minimum in health care support. Wilson courageously accepted the challenge; that she remained for 38 years is testament to her dedication and professionalism. While he documents the development of public health nursing in the island and Atlantic Canada in general, Baldwin refrains from a critical analysis of the issues and concepts that influenced Wilson’s part in this process. Nursing as an evolving profession for women, and its particular influence on the health care system created during Wilson’s tenure, is not considered within the context of the history of women’s work; there is no examination of the gender and class issues that directly affected how a female health care practitioner was incorporated into the new structures of health care bureaucracy in the province. This in turn limits the inclusion of this study in the wider scope of Canadian nursing history addressed by Kathryn McPherson. While She Answered Every Call adds material to the historical development of public health nursing in Canada, it stops short of situating its subject in the evolution of the policies and practices that she influenced so directly with her work. As with Jean Gunn, however, one individual can be seen to have had a significant effect on events and Mona Wilson’s biography contributes new insights into the historical development of public health nursing in Canada.
The studies so far discussed have addressed aspects of Canadian nursing’s development in civilian hospitals, training schools and community health care. Far less attention has been paid to the history of Canadian military and wartime nursing.(f.1) Each of the two volumes reviewed here contributes to the resource base of such a study and enlarges the frame of reference for this field. The fragmentary nature of archival sources has been a critical impediment to the research and writing of military nursing history in Canada. As Stuart and McPherson noted, the archival material for Canadian nursing history is rich, but it is also dispersed, and frequently situated in small private collections (16-17). For nursing, as for women’s history in general, many personal documents, such as diaries and letters, are hidden in attics or buried in the collected records of male relatives. The narratives assembled for The Military Nurses of Canada: Recollections of Canadian Military Nurses, edited by E.A. Landells and the diaries published by Eric Scott, Nobody Ever Wins a War: The World War I Diaries of Ella Mae Bongard, R.N., bring new, accessible sources to the study of military and wartime nursing history.
E.A. Landells endeavours to personalise the experience of individual military nurses through the century, from the Great War through to the Gulf War and Somalia. The commentaries from participants in both the earlier and more recent conflicts are few, however, the main focus of the book is on the recollections of Second World War participants. Grouping material by hospital location, the nurses’ role in the structure and organisation of each facility, and other personal experiences in that setting, makes it easier to evaluate the information. Most of the accounts are accompanied by photographs and personal service data, a basis for further analysis. The narratives are varied in style and quantity, from brief summaries to rich, anecdotal descriptions of the work, problems and pleasures of wartime nursing. While analysis is left to the reader, the nurses’ detailed memories provide sharp insights into the atmosphere, organisation and intensity of wartime nursing. A nurse from Alberta stationed in France, for example, recounts that on a 12-hour shift she would administer “more than 100 injections of penicillin and morphine” (207). The scope of the work, plus the magnitude of the conflict and its consequences, is demonstrated by a nurse’s recollection of processing 1,700 patients a day at her hospital in southern Italy, as the fighting raged around them (305). She was amazed to have real eggs on a transport ship that took her from England to Italy, since she had eaten only powdered eggs for three years while posted in England (309).
While these recollections, both grim and humourous, lack the immediacy of diary entries, they are no less valuable. The lack of explanation concerning methodology limits the research value of the narratives but the quality and detail of the data, with its insights into the culture and atmosphere of wartime nursing, helps to fill a void in the much neglected area of Canada’s nursing history.
The publication of Nobody Ever Wins a War, the Second World War diaries of a Canadian nurse is all the more notable because of their serendipitous discovery. The diaries were recovered from obscurity inside the trunk of nurse Ella Mae Bongard by her son Eric Scott, eight years after her death at age 95. They recount Bongard’s experiences with the American Army Nursing Corps from her embarkation in New York in August 1917, through her arrival at a British Base Hospital near the town of Etretat, France and the time spent nursing there, until her return home in February 1919. The editor notes the irony of “a Canadian in the US Army, serving at a British hospital, in France” (ii). The diaries offer stories of personal experiences and observations on topics ranging from the climate, the accommodations and the camaraderie of the wartime nursing experience; they provide a warm and honest view of a young woman’s first experience of a wider world in the early twentieth century. Yet, they also offer glimpses into the horrors of the war, the terrible destruction of young men, both allies and enemies, and the back-breaking work and mind-numbing atmosphere of wartime hospital nursing. Nurse Bongard’s words reveal the emotional struggle of these unworldly young women, as they come to terms with the courage of the men, accepting the destruction of their bodies in order to satisfy the needs of distant military leaders, no matter how much less glorious the cause than it had once seemed. She also speaks of the delicate balance of relationships between nurses, doctors and patients, at both the personal and professional levels. The editor has generously provided the volume with photographs taken by his mother during her service, as well as mementoes of religious services, social events, base magazines and news clippings. These all contribute to the vitality of Ella Mae Bongard’s commentary.
Nobody Ever Wins a War is one of only a few published personal recollections of Canadian nurses in the First World War.(f.2) The careful and sensitive editing of this brief volume, barely 70 pages, transmits the war, with its ravages and horrors, across eight decades, with the immediacy of an eyewitness camera. Nurse Bongard’s words speak to the strength and professionalism of these young women, their humanity in the tears they shed for the bravery of a dying boy, and the laughter in the preparations for a Christmas concert. While such a volume necessarily records the thoughts and impressions of one woman, it opens a window into the wider experience of military and wartime nursing and is a contribution to the greater understanding of the history of nursing.
Canadian publications like Nobody Ever Wins a War are all the more notable because of their rarity. By contrast British interest in the war has continued unabated over 80 years, with contributions to women’s history growing steadily over the past two decades, much of it fuelled by the wealth of archival material preserved in Britain’s Imperial War Museum. Eileen Crofton’s The Women of Royaumont: A Scottish Women’s Hospital on the Western Front, is a recent contribution to the history of British women’s medical service during the Great War. Its unexpected references to Canadian women’s contributions to the allied war effort direct attention to possible areas of Canadian research.
The Cistercian Abbey of Royaumont, near Paris, was a voluntary hospital during the First World War, funded and supported by the Scottish Women’s Hospitals for Foreign Service (SWH), a branch of the National Union of Women’s Suffrage Societies; it was administered and operated entirely by women. A retired physician without previous experience in historical scholarship, Dr Crofton has produced a sound study of this singular achievement. The book first explains the development and functioning of the hospital from 1914 to 1919, then presents a biographical survey of notable staff members. Anecdotal material was gleaned from interviews with family members of Royaumont staff, as well as from diaries and letters of former staff, the hospital records, and newsletters from the post-war Royaumont Association.
Snubbed by Britain’s War Office when they offered to provide a voluntary hospital, the SWH offer was readily accepted by France. Medical and nursing volunteers with a knowledge of French were particularly welcomed by Royaumont administrators; consequently, Marjorie Starr of Montreal came to Royaumont in September 1915 as a young orderly, or a volunteer nurse’s aid, otherwise known as a VAD or Voluntary Aid Detachment nurse in Canada and Britain, and stayed until January 1916. Her diary of her stay is among the most vivid of the personal accounts cited in the book. Another Canadian, Dr Edna May Guest of Ontario, worked briefly at Royaumont from June to August, 1918, after seven months’ service in another SWH Hospital in Corsica. After the war, Dr Guest was renowned in Canada for her work in preventative medicine and women’s health, becoming the first woman to be elected to the Academy of Medicine in Toronto. She was also noted for her promotion of women’s ambitions in the medical profession, politics, and public service. Crofton also discusses the 100-bed “Canada Ward” established in the old monks’ refectory at Royaumont, funded by the Canadian Red Cross Society, and boasting an enormous Canadian flag hung at one end.
Crofton’s analysis of the Royaumont experience is well defined and carefully considered, competently handling issues of gender, race and class. Most of the patients were the French poilus, privates in the French army, including many from French Colonial Africa, while the all-female staff ranged from titled British women serving as orderlies to local French villagers doing sewing or kitchen work. Crofton recognises the professional tensions, including the resentments of the trained nurses who saw unqualified orderlies undermining their authority and status; she questions the apparent insensitivity of Dr Frances Ivens, chief physician and commandant, who disregarded the nurses’ concerns, despite her otherwise active promotion of the rights and ambitions of medical women. Although Women of Royaumont does not qualify as a Canadian study, it describes a wartime experience in which Canadian women were actively involved, and offers a small addition to the much neglected history of Canadian women’s medical and nursing contributions to the Great War.
Health care has become a critical area for discussion and dispute and nursing is one of its vital components. Recent contributions to the scholarship on nursing history demonstrate a new interpretative model that moves beyond studies of exceptional individuals, to consider the special position of nurses within the history of women’s work. The analytic categories of gender, class and race connect this work to the wider scope of Canadian social history, enriching both. New methods do not negate the value of biography as an historical tool, but call for a more analytic approach. Whether in the development of a new society, in the crisis of war, or the construction of the modern urban, commercial-industrial landscape, nurses have been present, as volunteer caregivers or trained professionals. Recognition of nursing’s role as a part of the history of women’s work can only advance the scholarship of Canadian social, political and economic history.
Notes
(f.1) For the single historical survey devoted to Canadian military nursing, see G.W.L. Nicholson, Canada’s Nursing Sisters. There are only brief references to nursing in Ruth Roach Pierson’s “They’re Still Women After All.”
(f.2) See an early recollection by Mabel Brown Clint called Our Bit. More recent, but brief, is A.J.B. Johnston’s “Into the Great War.”
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Women at Work Collection. Imperial War Museum, London, England.
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