From Barnyards to Bedsides to Books and Beyond

FROM BARNYARDS TO BEDSIDES TO BOOKS AND BEYOND: THE EVOLUTION AND PROFESSIONALIZATION OF REGISTERED PSYCHIATRIC NURSING IN MANITOBA, 1955-1980 Beverley Clare Hicks A Dissertation Submitted to the Faculty of Graduate Studies in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Faculty of Education University of Manitoba Winnipeg, Manitoba May 2008 © Beverley C. Hicks ii ABSTRACT FROM BARNYARDS TO BEDSIDES TO BOOKS AND BEYOND: THE EVOLUTION AND PROFESSIONALIZATION OF REGISTERED PSYCHIATRIC NURSING IN MANITOBA, 1955-1980 In the 1950s, psychiatric nursing in Canada was developing into two models. East of Manitoba, psychiatric nursing was a part of general nursing. To the west of Manitoba, it was evolving into a distinct profession. Manitoba, during the 1950s, did not fit either the eastern or western model. But in 1960, it achieved the same distinct professional status, through legislation, as its neighbours to the west. This study is an examination of the factors that swayed Manitoba to adopt the western psychiatric nursing model and achieve the legislation which governed its first twenty years. The factors are: male collegiality with the leaders of the other three western psychiatric nurses associations, the support of the western based Canadian Council of Psychiatric Nurses, the encouragement of medical superintendents of the provincial mental hospitals in the formation of an alternative workforce, and the lack of interest by general nurses in working in the provincial mental institutions. The legislation achieved in 1960 gave some authority to the Psychiatric Nurses Association of Manitoba to govern its own affairs, but it was not entirely effective in bestowing full professional status on psychiatric nurses. This was especially true of the control over education which was placed in the hands of a committee, dominated by medical superintendents. iii This study also examines the evolution of the profession during its first twenty years as it worked to gain control over education, develop a professional ideology, and establish a place for itself in the Manitoba mental health system. This study concludes in 1980 with the passage of full professional legislation. A genealogical analysis was used to examine data which came from archives, oral interviews, and secondary sources. The findings suggest that registered psychiatric nursing in Manitoba is a contingent and political construction, but that it can continue to evolve and grow in unique ways through an ongoing examination of its roots, icons, practices, and philosophy. iv ACKNOWLEDGEMENTS This journey would never have been completed without the support and direction of many people. They are too numerous to mention individually and it is always difficult to leave someone out. But there are some who have invested large amounts of their professional lives who must be acknowledged. Obviously, the chair of my committee deserves the greatest appreciation. To Dr. Denis Hlynka I owe a debt that cannot be expressed in words. His patience was endless, but his intellectual challenges and penetrating questions left no room for complacency. I will continue to be challenged by his teaching: Thank you Denis for endless hours of discussion and consultation. The other committee members were equally, though differently, influential in the completion of this work. Dr. Yatta Kanu was always attentive to curriculum perspectives and never allowed the curriculum to be lost in the myriad of other details. Yatta it was a privilege to have you on this committee. Dr. David Gregory ensured I stayed on track and did not stray too far down too many blind-alleys. His thoughtful comments and observations have helped to keep me focused. Thank you David. Dr. David Creamer always reminded me of the humanistic approach, so necessary for dealing with people in distress, and encouraged me to find a way to include humanism and spirituality in psychiatric nursing education. Thank you for your guidance and blessings David. Historical research cannot be accomplished without patient and diligent librarians and archivists. I want to thank Barb Devlin for helping me access documents at the Provincial Archives of Manitoba. There were also many helpful people at the Provincial Archives and the Legislative Library. In particular, Idelle Talbot who helped unravel the mysteries of the Brandon Mental Hospital collection and patiently answered endless questions about archival research. Thank you to Monica Ball who found obscure documents in the Legislative Library. At Brandon University Tom Mitchell was always available to ensure access to the Brandon Mental Hospital School of Nursing records. The library staff at Brandon University, especially in government documents, were generous with their time and energy. Dr. Linda Ross, who was Dean of Health Studies at Brandon University when this project started, accommodated and supported this scholarly undertaking in numerous ways. Also thanks to other colleagues from Brandon University. Each of the four western Canadian psychiatric nurses associations took great interest in this project and I had generous assistance from each provincial executive director and office staff. The Manitoba College of Registered Psychiatric Nurses office staff and executive director, Annette Osted were, of course, particularly helpful. Many individuals have also been generous such as early presidents of the Registered Psychiatric Nurses Association and family members of those deceased. There were many people who participated in interviews and conversations and shared their documents. Friendly colleagues in the Manitoba Association for the History of v Nursing have provided support and intellectual stimulation, especially those who have already been down this path or are traveling it simultaneously on their own history projects. To the external examiner Dr. Michel Tarko, I thank you for agreeing to undertake the review of my thesis and providing thoughtful feedback. One last person who must be thanked is Joyce Smith. She did endless editing and kept documents and papers organized. Finally, thanks to my family and to Luke who was born during the last stages of this project. Thank you to the Registered Psychiatric Nurses of Manitoba Foundation, the Manitoba Association for the History of Nursing and the Canadian Association ofr the History of Nursing for financial support. vi DEDICATION This thesis is dedicated to all the men and women who worked to achieve distinct professional status for psychiatric nurses in Manitoba. vii TABLE OF CONTENTS Abstract ii Acknowledgements iv Dedication vi Table of Contents vii Abbreviations xiii Pivotal Events xvi Chapter One: Positioning the Study 1 Introduction 1 A Note on Names 1 Introduction to Psychiatric Nursing 3 Manitoba Background 4 The Early Psychiatric Nursing Schools in Manitoba 7 Rationale for the Study 12 Research Approach 16 Writing History 16 Writing Nursing History 19 Writing Psychiatric Nursing History 25 Conceptual Framework of the Study 26 Data Sources 29 Records 29 viii Oral Data 31 Significance of the Study 33 Outline of the Chapters 34 Endnotes 37 Chapter Two: From Barnyards . 44 Introduction 44 Asylum Studies 45 British and American Asylum Studies 49 Eastern Canadian Asylum Studies 58 Western Canadian Asylum Studies 64 International Psychiatric Nursing Studies 69 A Study of Psychiatric Nursing in the United States 72 A Study of Psychiatric Nursing in Great Britain 76 A Study of Psychiatric Nursing in Holland 78 A Study of Psychiatric Nursing in New Zealand 80 Canadian Psychiatric Nursing Studies 82 Veryl Tipliski’s Study 82 Saskatchewan Psychiatric Nursing Studies 92 Manitoba Psychiatric Nursing Studies 95 Conclusion 97 Endnotes 98 Chapter Three: . To Bedsides . 108 Introduction 108 ix Socio-political Status of Psychiatric Nursing 1955-1960 109 The Culture and Therapeutic Strategies of the Mental Institutions 114 Portage 114 Selkirk and Brandon 121 Nursing Procedures 129 The Knowledge and Values Underpinning the Training 134 Milieu 135 Content and the Licensed Practical Nurses Curriculum 136 Teachers and Learners 140 The Male Attendants in Manitoba Institutions 142 The Canadian Council of Psychiatric Nurses 147 Manitoba Legislation 151 Conclusion 156 Endnotes 158 Chapter Four: . To Books . 173 Introduction 173 The First Two Presidents (1960-1966) 174 The Barnett Years (1960-1965) 174 The Psychiatric Nurses Association Act 176 The Psychiatric Nurses Training Act 178 Professionalism in Nursing 193 The End of the First Five Years 196 x The Russell Year (April 1965-June 1966) 199 The Elusive Curriculum and Curriculum Makers 204 Psychiatric Nursing Knowledge 1960s 209 The Martyniw Years (1966-1971) 211 The Minister’s Report on the Supply of Nurses 1967 213 The Emerging Curriculum and Curriculum Makers 233 Curriculum Concepts in the 1960s 236 A New Curriculum Sub-committee 237 A Licensing Crisis 238 The End of the First Decade 245 Conclusion 247 Endnotes 248 Chapter Five: . More Books . 265 Introduction 265 The Holleman Years (1971-1979) 266 The Clarkson Report 267 The Move to the Community 272 Philosophy and Objectives of Psychiatric Nursing Education 278 A Substantial Curriculum 284 Proposals and Counter Proposals 288 The Breen Report 290 Challenge and Change 294 The Task Force 295 xi A Bigger and Better Curriculum 306 Tom Street The Final Year: Are We Ready? 312 Conclusion 319 Endnotes 320 Chapter Six: . And Beyond . 333 Introduction 333 The Framework 335 The Questions of the Study and Synthesis of Findings 336 Post 1980

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