Nurses and Nursing in Alberta Prepared to Care "" Public health immunization clinic, circa 1950, Edmonto.n. (AARN P453) Pre ared to Care Nurses and Nursing in Alberta, 1859 to 1996 ]ANET C. Ross-KERR ~ The University of Alberta Press Published by The University of Alberta Press Athabasca Hall Edmonton, Alberta, Canada T6G 2E8 Copyright © The University of Alberta Press i998 ISBN 0-88864-292-x CANADIAN CATALOGUING IN PUBLICATION DATA Ross-Kerr, Janet C. (Janet Catherine), I940- Prepared to care Includes bibliographical references and index. ISBN 0-88864-292-x 1. Nursing-Alberta-History. 2. Nurses-Training of-Alberta-History. 3. Nursing schools-Alberta-History. 4. Medical care--Alberta-History. I. Title. RT6.A5R67 1998 610.73' 097123 C98-910243-2 All rights reserved. No part of this publication may be produced, stored in a retrieval system, or transmitted in any forms or by any means, electronic, mechanical, photocopying, recording, or otherwise, without tlie prior permission of the copyright owner. Printed and bound in Canada. Printed on acid-free paper. oo Printed by Hignell Book Printing, Ltd .. , Winnipeg, Manitoba, Canada. Photographs scanned by Elite Lithographers, Co. Ltd., Edmonton, Alberta, Canada. The University of Alberta Press gratefully acknowledges the support received for its publishing program from The Canada Council for tlie Arts and tlie Department of Canadian Heritage. TH! CAt>IACM. COUNCI L I L! (ONSt:IL OU AJ.TS ro• Tllll AJl.TS DU CANADA SIN<;li 19SJ D"UIS 1957 Contents Acknowledgements x1 Preface xv Introduction xix 1 THE ORIGINS OF NURSING 1 They Came By Ox-Cart-The Pioneering Grey Nuns 3 The First Health Care Agency in Alberta Is Established byNurses 5 The Expanding Domain of Nursing 8 Health Care Expansion and Nursing Services io NURSES AND THE ESTABLISHMENT OF EARLY HOSPITALS 17 Developments in Southern Alberta 19 Nursing as a Womanly Virtue 24 Building Hospitals in Northern Alberta 27 The Value of Nurses' Work in Hospitals 43 DILIGENCE, DEDICATION AND DISTINGUISHED SERVICE NURSES IN THE MODERN HOSPITAL ERA 47 Changing Definitions of Professional Work 50 Nursing During the Expansionary Era, 1948 to 1980 54 Current Trends in Hospital Nursing and Health Care Reform 63 4 THE PUBLIC HEALTH MOVEMENT AND THE EMERGENCE OF PUBLIC HEALTH NURSING 67 Community Organization to Promote Health 69 Women and Health in the Community 73 The Development of Public Health Nursing 75 Voluntary Organizations and the Development of Public Health Nursing 81 Valuing Public Health Nurses' Work 83 6 DISTRICT NURSING ON THE ALBERTA FRONTIER 87 The District Nursing Movement 89 The Efforts of Women in Establishing Public Health Nursing Services 90 Controversy Erupts Over District Nursing 93 The Work of District Nurses 97 VI I CONTENTS 6 ALBERTA NURSES IN THE WORLD WARS 107 Nurses in Military Conflicts in Canada 109 Nurses in World War I 110 War Service Unites Nurses 114 Nurses in World War II 117 Service by Alberta Nurses uo 7 NURSING EDUCATION BECOMES SYNONYMOUS WITH NURSING SERVICE THE DEVELOPMENT OF TRAINING SCHOOLS 129 p AULINE p AUL "The Historical Accident" 130 Monitoring Diploma Nursing Education 134 The Educational Experience 134 Change in Nursing Education 145 Diploma Schools Shift to the General System of Education 148 THE EMERGENCE AND GROWTH OF UNIVERSITY NURSING EDUCATION 155 University Courses in Public Health Nursing 158 The Degree Program in Nursing at the University of Alberta 159 Concern over Nursing Education 160 Nursing Education through the Depression and War Years 163 Integrated Baccalaureate Degree Program Emerges 164 Helen Penhale's Vision of Nursing Education 170 Consolidation and Growth in University Nursing Education 182 An Integrated Degree Program at the University of Calgary 186 Degree Program in Nursing at the University of Lethbridge 191 Distance Programming in University Nursing Education i92 Baccalaureate Preparation as Entry to Practice 196 Development of Nursing Research 199 Doctoral Education in Nursing at the University of Alberta 201 CONTENTS I VII y THE BEGINNING OF ORGANIZED NURSIN,G THE ALBERTA ASSOCIATION OF REGISTERED NURSES, 1916 TO 1956 205 Graduate Nurses Organize and Seek Employment 207 The Graduate Nurses Act 208 Standards of Nursing Education 211 A Name Change and New Alliances 215 The Weir Report and Standards of Nursing Education 218 Concern About Media Portrayals of Nurses 220 Discussion of Health Insurance 221 Working for Improvements During Wartime 223 Continuing Shortage of Nurses and Workplace Concerns 228 Experimentation in Diploma Nursing Education 230 10 CONSOLIDATION AND GROWTH THE AARN IN THE YEARS FROM 1956 TO 1996 233 Growth of the Profession Under National Health Insurance 233 Standards of Practice 235 Structural Issues and Legislative Concerns 237 Standards of Diploma Nursing Education 240 Continuing Development of Degree Programs 245 The Entry to Practice Position 246 Collective Bargaining Developments 252 Standards of Practice 254 Continuing Threats to the Legislation 254 Dispute Leads to the Nursing Profession Act 256 Nursing Legislation Is Threatened Once Again 260 VIII I CONTENTS II THE RISE OF NURSING UNIONS IN ALBERTA 263 The Economy and the Livelihood of Nurses 264 The Right to Bargain Collectively 268 Amendment of the Registered Nurses Act 271 The Supreme Court Ruling of 1973 273 Strikes or Threatened Strikes Prior to 1977 274 The Emergence of the United Nurses of Alberta 275 Confrontation and Strike Action by Nurses 276 Legislation Removes Hospital Workers' Right to Strike 280 The 1988 Illegal Strike 282 Continuing Labour Unrest in Nursing 283 The Staff Nurses Associations of Alberta 285 Relationships Between Professional Associations and Unions 286 12 ISSUES, COMMITMENTS, AND DIRECTIONS AS THE NURSING PROFESSION APPROACHES THE 21ST CENTURY 291 Notes 301 Bibliography 331 Index 345 CONTENTS I IX Acknowledgements I am indebted to a considerable number of people who have helped me to identify, access and integrate diverse and extensive sources of information about nurses and nursing in Alberta. Dr. Pauline Paul contributed a chapter on the history of diploma schools of nursing and through her doctoral work on the history of the Edmonton General Hospital and the work of the Grey Nuns as well as her assistance on two projects funded by the Alberta Foundation for Nursing Research has been a wonderful colleague and supporter of the project. Alice MacKinnon's inter­ est and tremendous assistance with archival data gathering in the Edmonton area was invaluable in the funded projects and contributed to XI the availability of historical information on nursing. I am also deeply indebted to Dr. Helen Sabin for her expert data gathering on materials about Alberta nurses and nursing held at the Glenbow Alberta Archives in Calgary. Doreen Reid, Tracy Shaben, Hafiza Hemani and others also assisted in the collection and assembling of information which was essen­ tial to the project. The Alberta Association of Registered Nurses provided a great deal of encouragement and assistance over the duration of the project. I am grate­ ful to Evelyn Henderson, Information Officer prior to her December, 1995 retirement, for her unfailing commitment to the history of nursing and the publication of this book. Lorraine Mychajlunow assumed responsibil­ ity for the AARN from January, 1996 and has been very helpful to me in various ways including the selection of photographs and illustrations from archival collections. I am grateful also to AARN members who served as members of the Provincial Information Committee, the committee responsible for the project for their patience, perseverance and ongoing support. To the Provincial Office Staff of the Association and Provincial Council members throughout the gestation of this book, I express my appreciation for their deep interest and unflagging commitment. From 1859 on, it has been the nurses of Alberta who have worked unfailingly in the public interest who made this history what it is. To all of them, I offer my respect and my gratitude. I am also most appreciative for assistance given by those who reviewed this book for the University of Alberta Press and provided excellent recom­ mendations for improving the manuscript. Evelyn Henderson and Dr. Helen Sabin also reviewed the manuscript at my request and gave me sub­ stantial suggestions and comments. I am particularly grateful to former AARN Executive Director Yvonne Chapman who provided excellent critical commentary as well as suggested revisions of several drafts of particular portions of the manuscript. Mary Mahoney-Robson of the University of Alberta Press has provided ongoing and substantial assistance over several drafts of the manuscript. Her unfailing good humour and editorial exper­ tise has helped to guide and nurture the development of the manuscript in important and helpful ways. The support of Norma Gutteridge initially and after her retirement of Glenn Rollans, Director of the University of Alberta Press, has also been critical to the direction of the project, and to both of them I am deeply grateful. XII I ACKNOWLEDGEMENTS Finally I would like to express my appreciation to colleagues and stu­ dents of the Faculty of Nursing, University of Alberta and to AARN mem­ bers from all of whom I have learned a great deal and whose confidence in me helped me to take on and complete this project. To my family I also express my appreciation for their understanding of the time and effort it has taken to write this book and for their belief and trust in me. ACKNOWLEDGEMENTS I XIII Preface In writing Prepared to Care: Nurses and Nursing in Alberta, my focus is the evolution of nursing as a professional discipline in the context in which it developed in Alberta. In pursuing this objective, the intent is, in part, to attempt to record some important milestones for the profession as well as contributions of nurses in Alberta over 137 years. My purpose is also to present a perspective on the meaning of nurses' work and its relation to the social fabric of the province and to the status of women in society.