Work, Skill and the Occupational Culture of Mental Nurses at the Brandon Hospital for Mental Diseases, 1919 - 1946

"WHEN LOVE AND SKILL WORK TOGETHER:" WORK, SKILL AND THE OCCUPATIONAL CULTURE OF MENTAL NURSES AT THE BRANDON HOSPITAL FOR MENTAL DISEASES, 1919 - 1946 Christopber Patrick Alan Doofey (Chris Dooley) A Thesis Submitted to the Faculty of Graduate Studies in Partial Fulfdment of the Requirements For the Degree of: MASTER OF ARTS Department of History, University of Manitoba, Winnipeg, Manitoba 01998, Chris Dooley National Library Bibliothèque nationale I*H of Canada du Canada Acquisitions and Acquisitions et BibIiographic Services seMces bibliographiques 395 Wellington Street 395. nie Wellington OttawaON K1AON4 OrtawaON K1AW canada Canada The author has granted a non- L'auteur a accordé une licence non exclusive licence allowing the exclusive permettant à la National Library of Canada to Bibliothèque nation& du Canada de reproduce, Ioan, distribute or seil reproduire, prêter, clistniuer ou copies of this thesis in microfoq vendre des copies de cette thèse sous paper or electronic formats. la forme de microfiche/film de reproduction sur papier ou sur format électronique. The author retains ownership of the L'auteur conserve la propriété du copyright in this thesis. Neither the droit d'auteur qui protège cette thèse. thesis nor substantial extracts fkom it Ni la thèse ni des extraits substantiels may be printed or otherwise de celleci ne doivent être imprimés reproduced without the author's ou autrement reproduits sans son permission. autorisation. FACULTY OF GWCATESVDIES *te** COPkTUGZTT PERMISSIOS PAGE A Thesis/Practicum subrnitted to the Faculy of Gnduate Studies of The University of Manitoba in partial fulnllment of the requirernents of the degree of Christopher Patrick Aïan Dooley Cl998 Permission has been granted to the Libray of The University of Manitoba to lend or seB copia of this thesislpracticum, to the Sational Library of Canada to microfilm thb thesis and to lend or seIl copies of the fdm, and to Dissertations Abstracts International to publish an abstract of this thesidpracricum. The author reserves other publication riphu, and neither this thesis/practicurn aor extensive exrracts from it may be printed or othede reproduced without the author's wrinen permission. TabIe of Contents Chapter 1 .Mental Health Care in Manitoba Before 1919..................... 1 Chapter 2 . Establishing An Historiaal and Theoretical Context For Mental and General Nursing ....................... 27 Chapter 3 ."From Asylum to Hospital" .The Baragar Years. 19281929 .....-60 Chapter 4 . "Men Love and Skill Work Together" Therapeutic and Dernographie Change, 1930 = 1939 ......137 Chapter 5 O Conclusion O Persistence and Change, 1939 O 1946 ................204 Bibliography .........................................................220 Abstract The Brandon Hospital for Mental Diseases became, in 1921, the first mental institution in Western Canada to establish a training school for female nursing attendants. The founding of this school must be seen primaxily to have served the psychiatric wmmunity, and it conveyed minimal advantage upon its graduates. With limited opportunities for advancement or future employment, mental nurses at the hospital in the 1920s evolved a culture of resistance to the long houn, poor working conditions and restrictive regulations of the training school. By the late 1930s, the Depression had dramatically aitered the labour market in Manitoba, and the Hospital was able to exercise a preference for hiring native-bom women of higher social class and educationai attainment. Unlike the nurses of the 1920s, many of these wornen saw their aniliation as irnpemuuient and their credential to advantage them in their friture career advancernent They were consequently more disposed to subscribe to the ideology of the training school. in response to ongoing marpinaiization by the general nming community, the mental nunes of the 1930s differentiated the work that they did fiorn that of general nurses on a conceptual level. They developed a hierarchy of carhg that privileged their "caring care" over the more prescriptive clinical care of the general hospital nune. In so doing they created the intellectual basis for a discrete occupational identity. This identity may have played a pivotal role in the creation of the Western Canadian system of fieestanding training schools for psychiatric nunes. Introduction This work is concemed with the occupational culture of the mental nurses at the Brandon Hospital for Mental Diseases between 19 19 and 1950. It concentrates on the changes thai were made at the hospital in these decades, the impact that these changes had on the &y to &y lives of the women who worked there, and on the way in which these changes altered the perception that these women had of their work. The selection of the Brandon Hospital for Mental Diseases is at once arbitrary and delikrate. Ractical consideraiions Iike the proximity of the cornrnunity of Brandon and the existence of an established archives at the institution influenced the selection however. Brandon is appropriate on several other counts. The Brandon Hospital for Mental Diseases was at the time of its construction the largest and most modem mental hospital in Canada. It will be argued that it represented the pimacle of nineteenth century asylum design, and for this reason was singled out by the Canadian National Cornmittee for Mental Hygiene for critical treatment in its highly political suwey of custodiai institutions in 1919. On the heels of the CNCMH Report, the Noms govemment resolved to remedy the problems of the mental health senice and put in place an institutional structure which set the stage for aggressive, doctor-driven refonns to the institutional care for the insane. In 192 1, the hospital became the first in Western Canada to establish a Schwl of Mental Nursing. Although beyond the scope of the present paper, it is argued that the evolution of this hospital through the pecuiiar circumstances of the Depression created the context for the emergence of the separate system of psychiatnc nurses' training that was to prevail in the western provinces fkom the 1950s to the 1990s. This work draws on four distinct bodies of historical scholarship. Labour history provides a framework for understanding the labour process and the evolution of occupational cuitures. It also provides models for understanding the strategies employed by mental nurses to alter the conditions of their labour and to contest the way in which power and privilege were allocated within the hospital community. From women's history comes an understanding of the function of gender in shaping identity and occupational culture. It provides a context for understanding the dichotomy that divided the male work of curing from the female senice of caring that mental nurses inherited from the general hospitai system. From the history of psychiatry comes an understanding of the genesis of change in the North Amencan mental health system in the early twentieth century, including an understanding of the rise of the therapeutic mental hospital, the emergence of medical psychiatry as the dominant clhical paradigm, and of the role of the First World War and the emergence of the Mental Hygiene movement in recasting the meof the mentally ill. The present work owes its greatest debt to the proliferation of scholarly works devoted to the fourth approach, the understanding of general nursing. Reacting against the whiggish preoccupations with nursing élites and heroic portrayals of nurses which had dominated the field before the 1970s, scholan like Barbara Melosh and Swan Reverby in the United States and Kathy McPherson and JobMagda Whittaker in Canada have begun to create a theoretical conte* for understanding the iives and work of ordinary nurses. Drawing on feminist interpretations of iabour history, they have explored the structural lunits to professionalism, the dominant ideologies of inter-war nursing and the role of gender in the cultural negotiations of the hospitai workplace. The work is divided into five chapters. The £htprovides a brief narrative history of the care of the mentally il1 in the Canadian Northwest and the founding of the Brandon Asylum for the Insane in 1891, and it contextualizes the opening of the new asylum with the latter nineteenth century emphasis on the moral treatment of the mentally ill. Mer the Brandon Asylum bumed to the pundin 1910, it was reconstructed as the Brandon Hospital for the Iasane and rwamed in 19 19 the Brandon Hospital for Mental Diseases. These narne changes reflected changes in the dominant aetiology of mental illness and the ambitions of the psychiatn'sts to integrate themselves into the broder medical community. It is argued that this change was driven by two concomitant phenornena The first was the Mental Hygiene movement wtiich, drawing on the tactics and ideology of the public healtti movement, sought ways to improve society by identifjmg and eliminating moral and intellechial defect. The second was a paradigm shift from moral treatment to medical intervention, dnven by a new and ambitious corps of psychiatrists whose techniques had been validated by the imperative to connont Shell Shock during the First World War. The second chapter shifb in emphasis away from Brandon and mental nuning to look at the social, political and intellecrual context of general hospital nursing in Canada in the first three decades of this centuy. it does so to provide a political context for the formation of the School of Mental Nursing. It argues that by the 1920s, the gatekeepen of the discipline of nursing were the powerful superintendents of the general hospitals, and it explores the ideological and practicd devices that these élites employed to assert their hegemony. Similarly, this chapter provides an intellechial hmework for understanding nursing work, specifically the interplay of science, skill, ideology and femininity as they related to the formation of occupational culture in hospitai nursing. The third chapter carries the narrative through the superintendency of Charles Baragar in the 1920s. It traces the efforts to establish the Brandon hospitai as a centre for the delivery of modem, scientific care for the mentally i11.

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