of Service

'Ghe 1Cistor~ of .'nursing in Albert~ THE UNIVERSITY OF CALGARY

LIBRARY

j-{eritage of Service

'Ghe '}(isto11J of '11ursin3 in Alberta

'J-(eritage of Service

'Ghe j-HstorH of 'nursing in Alberta

TONY CASHMAN

Published by The Alberta Association of Registered Nurses Printed by Commercial Printers Limited Edmonton, Alberta

Introduction This book has hundreds of authors, about six hundred I would think. If you can stand one more paraphrase of Mr. Churchill's resounding comment of 1940: Never in the history of Alberta has so much original research been done by so many. It started about the time of the Churchill remark. The Al­ berta Association of Registered Nurses was then gathering material for the book Three Centuries of Caruidian Nursing. Miss Birtles' diaries were brought to light at this time. Marion Moodie was prevailed upon to write her fascinating memoirs of Calgary General in the 1890's. So much material was gathered that Kate Shaw Brighty, then president of the AARN, engaged Eugenie Myles to put it together and it was mimeographed - they couldn't afford to print it - under the title A History of Nursing in Alberta. Margaret Fraser brought in some more things in the 1950's. The project was revived again in 1964 when local chapters of the AARN were asked to research the history of nursing in their own districts and the alumnae associations were asked to help retrace the progress of nursing education through the history of their own schools. Digging localized history is unsatisfying work. The results often seem trivial and disappointing and hardly worth the bother. The project might well have foundered in grassroots discouragement at this point but it didn't. The hard-sought information came in, and when it was added to the material gathered earlier, the story began coming into view. It was a revelation. The story of nursing in Alberta was a more exciting story than anyone had imagined. It was more in­ spiring, more amusing, more human and more important. It showed as much "invention" as a biography of Thomas A. Edison. It had more significance for the growth of Alberta and the growth of the nursing profession across Canada than anyone had realized. The local committees and alumnae groups also brought in the names of nurses who had worked in times that are now historic and could be interviewed for further details. In the personal con­ tacts with the past we had a break, because the secret of eternal youth seems to be membership in the Alberta Association of Regis­ tered Nurses. Through these interviews I had the pleasure of meet­ ing and knowing such lively people as Iva Marshall McLeod, the pioneer nurse of Cold Lake, and Mrs. Sigrid Hoyme Magee, who, on September first, 1905, had a holiday from Strathcona Municipal Hospital for the inauguration of the province of Alberta. Nurses like Mrs. McLeod and Mrs. Magee are witnesses to everything related in this book. And from this technique there may arise a misunderstanding. It may· seem that some nurses are mentioned by name when others just as worthy are not. In cases like this, the names are given to certify that the information is reliable, that someone who "was there" has given it. It might also appear that some institutions get more space than others; St. Joseph's Hospital in Radway, for example. It was Radway's good fortune to have two sparkling biographers who were nur­ sing there in the twenties and thirties, but what they wrote about St. Joseph's was true of similar hospitals of the time. In addition to the hundreds who gave stories, there were some who were pressed into service as sort of technical advisers and special acknowledgment is due them. Dr. M. R. Bow, deputy minister of health from 1927 to 1952, was helpful on many points. For advice on Alberta's unique district nursing service, we had tech­ nical assistance from Kate Shaw Brighty, Blanche Emerson and Mrs. J. R. Heffernan, the former Miss de Turbeville. Mrs. Rachel Young advised on mental nursing. Elva Taylor and Mrs. Winnie Roscoe formed an advisory committee on the Indian service. Help with the new era was always available from Mrs. Helen Sabin and Mona Staves of the AARN head office, Marguerite Schumacher, Frances Ferguson, Jean Clark Tronningsdal, Ruth Thompson and Jessie Morrison did some remarkable detective work in the old minutes of the AARN. And Isabel MacMillan, editor for Com­ mercial Printers, was unfailingly kind in fitting in late additions. If the book is half as good as the story it will be a good book.

Tony Cashman Edmonton, 1966 The Chapters

THE BEGINNINGS

I The First Nurses, 1859 1

II The Old West Passes 7

III The Smallpox 12

IV 1871 -1889 15 v Two Firsts at Medicine Hat 23

VI First Student at Calgary General 29

Vil The Nineties 35

THE NEW CENTURY

Vil/ Hospitals Run Training Schools and Vice Versa 42

IX Town and Country Hospitals 66

x Nurses On Duty, Mostly Private 93

XI The War and the Founding of the AARN JOB

X/l Flu Epidemic 121 BETWEEN THE WARS

XIII Nurses Equal Hospitals 126

XIV Nurses Individually 156 xv Nurses Collectively I73

XVI The Weir Report I81

XVII Alberta's District Nurses I90

XVIII The Thirties 208

XIX The Second War 229

IN PARTICULAR

XX The Indian Service 244

XX/ Mental Nursing 265

XX// The Specialists 277

XX/// Nursing Missionaries 293

THE POST-WAR

XXIV 1945, The Modern Era Begins 304

XXV 1954, The Future Begins . 326 CHAPTER ONE Nursing in Alberta began in 1859. Because of the ladies involved, Alberta was able to start with a legacy of the advances made in nursing up to that time. Because of the date, the history of nursing in Alberta is a participation in the events which then transformed the techniques and the standing of the nursing profession. The advances up to 1859 had been accomplished within religious orders, and the ladies who began nursing in Alberta were Grey Nuns. Within the year of their coming to Alberta there would be four historic breakthroughs in Florence Nightingale's campaign to make nursing a respected profession for laywomen, and make the nurse the trusted executive in any health program. The success of the Nightingale campaign is seen in the photographer's window. In today's nervous world, in which man views his future with alarm, there is no sight so reassuring as a photographer's window full of pictures of the latest graduates of the nearest school of nursing. It's a sight for sore minds; a covey of young women radiating individually and together the calmness, the warmth, the under­ standing, the humanity, the confidence and the knowledge of their profession. Every year a new crop brings new hope and the photographer puts the evidence in his window. But on August third, 1859, there wasn't a photographer in the world who would have put up a gallery of nurses. A purist might quibble that there weren't any commercial photographers then, but even if there had been they wouldn't have put nurses in the window on August third, 1859. That was the day the Grey Nuns started on their journey to bring nursing to Alberta. Sister Lamy, Sister Emery and Sister 1 Alphonse left St. Boniface, the suburb that predates Winnipeg, for fifty-two days on the oxcart trail to Fort Edmonton, the trading capital of the remote northwest. Their destination was a further fifty miles beyond Edmonton, at a mission on a lake. It bad been called Devil's Lake by the gentlemen adventurers of the Hudson's Bay Company but when Reverend Father Thibault built a mission there in 1842 he thought it .should have a more distinguished patron than the Prince of Liars and had called it Lac Ste. Anne, for the mother of the Blessed Virgin Mary. Father Thibault had built his mission for the Cree Indians back at this lake to be well removed from the Blackfeet who came to trade at Edmonton. He had built it there lest the catechism lesson be interrupted by a resumption of the centuries-old feud between Crees and Blackfeet. The feud was still very much on in 1859, which made this a rough district for ladies. However, the Grey Nuns were a pioneering order, founded by the niece of a famed Canadian ex­ plorer. In 1844 they had come to Winnipeg from their mother house in Montreal when no other order would attempt it, and they had shown the cheerful toughness of their sanctity by taking the risque songs the boatmen had sung on the journey and rewriting them as hymns. Their order had been founded by Mother d'Youville, a niece of the renowned adventurer La V erendrye. The year of the founding was 1738, the same year that La Verendrye was in the west on his historic trading mission to the Mandan Indians. To finance the humanitarian work of the Grey Nuns, Mother d'You­ ville pioneered such commercial projects as the first ferry in Canada. She has now been beatified by the Roman Catholic Church, the second step on the road to sainthood, and may be­ come the first Canadian saint. In August, 1859, the three nuns of her order were bringing to Alberta, over the oxcart trail, a tradition of hospital care and nursing administration which religious orders had started in France in the sixteenth century. The tradition had been transferred to New France, had taken root in Quebec and become part of the Canadian heritage. Sisters Lamy, Emery and Alphonse were bringing with them, and represented, a knowledge and tradition about hospitals which, 2 exactly a hundred years before, had surprised the English victors in Quebec, and which, more recently, had been commented on with admiration and envy by the British military mission investi­ gating the medical disasters of the Crimea. The Sisters walking beside the oxcarts on the long, long trail to the northwest were living symbols of this transplanted tradition. The moccasins they wore instead of shoes were their only concession to the rigors of the trip. The trip now takes twelve hours by train, and through Manitoba their trail was almost exactly the route the train takes today. Their religious garb also emphasized another important point. Nursing the sick was considered an admirable enterprise for a woman in religious life but not for an educated laywoman, even though she might have every qualification but the religious voca­ tion, and even though it was clear that only a great influx of educated laywomen could raise the standards of nursing and hos­ pital administration and put to wider use the knowledge developed by religious orders. In England at the time, lay nurses were so poorly regarded that the nursing profession was often equated with the OLDEST profession; by some they were considered synonymous. A leading English hospital administrator had even required that nurses have had at least one child without benefit of clergy, since only such a woman could be degraded enough to survive the sights, the sounds and the smells of hospitals. In England hospitals were institutions where, instead of calling for Doctor Kildare, the nurse could be out on the street calling for Constable Kildare to come in off his beat and break up a free-for-all. In Canada, nursing was better, in spite of an impression given by some widely - printed memoirs of the Montreal and Toronto General Hospitals, left by prominent doctors. There was Dr. F. J. Shepherd, for example, who entered the Montreal General in the 1870's, and recalled many years later: "Age and frowsiness seemed the chief attributes of the nurse, who was ill-educated and was often made more unattractive by the vinous odor of her breath. Cleanliness was not a feature, either of the nurse, the ward or the patient; each one did as best pleased her and the language was frequently painful and free. Armies of rats frequently disported themselves about the wards and picked 3 up scraps left by the patients and sometimes attacked the patients ~emselves." Sir William Osler, who entered the Montreal General in 1868, told an audience of the hospital of his youth in these words: "We had the old-time nurses. They were generally ward ser­ vants who had evolved from the kitchen or the back stairs into the wards. Many of them were the old type so well described by Dickens, and there are some men present who remember the misery that was necessary in connection with the old-fashioned type of nurse." Such was the Montreal General, a full decade after the Grey Nuns left for Alberta. A picture of nursing at the Toronto General about the same time was given by Dr. Taylor, the house physician. Dr. Taylor said: "The nurses were nearly all young, many of them from the country and probably never saw a hospital before they entered this one. "There were two or three who possessed experience and they were the terror of the patients. The rest were raw and uncultured - good girls enough, some of them, but absolutely without train­ ing. Eliza was the senior, a faithful old woman who tried to do her best. She was on night duty. She was utterly useless ...." The foregoing are words which may not be doubted. Even allowing for the fact that the remarks were made years afterwards for an appreciative audience, and the speakers were possibly laying it on a bit thick, they still give a depressing picture of conditions _in the early days of the Montreal and Toronto Generals. However, it's not fair to equate the efficiency of lay nursing in Canada with the efficiency of lay hospitals. Nursing was nor­ mally in private homes, as it would be for another half century. There are nurses still active in Alberta who remember when most nurses were on private duty, working from case to case in homes under the direction of doctors. And when the Toronto and Mon­ treal Generals were indeed as bad as described by Doctors Shep­ herd, Osler and Taylor, there were many capable nurses working from case to case in private homes. They were clean, sober and intelligent and quite capable of following the directions of the doctors. They were practical. Their status was near that of the domestic servant, and their knowledge was self-acquired, but they weren't all like Eliza. 4 The weakness in the system was that there were no schools where a lay nurse could learn a co-ordinated system of nursing skills. There was little to attract the intelligent laywoman to nur­ sing, and if she was attracted there was no place for her to learn. This knowledge was obtainable only through membership in a religious order such as the Grey Nuns, and even then it was more learned than taught. This was the sort of knowledge the three Grey Nuns were bringing over the Carlton Trail. By the beginning of September they had crossed both branches of the Saskatchewan River, passing over the north branch at Fort Carlton, the post for which the trail was named. As they moved into Alberta, ·the trail stayed on the north bank of the river because the Blackfeet were on the south bank. Fall was in the trees and in the night air as they passed the site of present-day St. Paul. The Sisters were travelling with a French-Canadian, an Indian and two metis. Every day they moved farther away from their base in St. Boniface, and from the mother house in Montreal, where the Grey Nuns' Notre Dame Hospital offered a calm, well­ ordered comparison to the rowdy atmosphere of the Montreal General. When they reached their destination they would be the only white women in Alberta. It was an adventure that fell to the nuns because there were yet no lay nurses to attempt it, although there had long before been hope expressed for the future of the lay nurse. There was even a duel fought on the subject in Montreal. That was forty years before, back in 1819, when a Mr. Michael O'Sullivan, a member of the Quebec assembly, pro­ tested to Dr. Caldwell over the doctor's plan to introduce lay nurses at the Hotel Dieu. Mr. O'Sullivan said it was wrong for the sick to be trnated by hirelings rather than women dedicated by religious vows to the service of the Deity through service to the sick. The argument got so hot that the gentlemen fought a duel over it, and it might be said that the champion of lay nurses won the argument three to one because he hit the detractor three times and caught only one bullet himself. Both men recovered, with what sort of nursing is not now recorded. In the forty years since the duel little had happened to give the lay nurse the chance to prove Dr. Caldwell's confidence in 5 her. However, within the year that started with the trek of the Grey Nuns to Alberta, events of great change would take place in England. Within that year of beginnings, Florence Nightingale would start the first training course for lay nurses at St. Thomas's Hos­ pital, London; she would also propose and have accepted her scheme for uniform hospital statistics; she would publish the Vic­ torian best-seller, Notes on Nursing, designed to make every ·mother of a family a nurse; and in Liverpool the philanthropist, William Rathbone, would found district nursing. Those four events were already in motion as the Grey Nuns made their fifty-two day trek to the northwest, although the nuns could not possibly have had any knowledge of them. It was the beginning of nursing in Alberta. It's also unlikely that they were aware of the surprising re­ semblance their establishment at Lac Ste. Anne would bear to Kaiserswerth, the Lutheran institution in Berlin where Florence Nightingale was a student in 1851. Kaiserswerth represented a movement in the Lutheran Church, with a parallel in the Dutch Mennonite Church, and in the Angli­ can Church and Quaker Society in England, to revive the order of deaconesses, the female helpers of humanity in the earliest Christian church. Kaiserswerth had been founded in 1836. It was four institu­ tions in one, and the Grey Nuns' mission at Lac Ste. Anne would bear a striking resemblance on a much smaller scale. Where Kaiserswerth was a nursery school, Lac Ste. Anne would be an orphanage. But Kaiserswerth was a boarding school, so was Lac Ste. Anne. Kaiserswerth was an old people's home, so was Lac Ste. Anne. The rambling stone pile in the heart of Berlin was a hospital. In the log cabins by their remote lake, the Grey Nuns would also have a hospital and they would know enough about nursing to run it.

6 CHAPTER TWO It was still the first west to which the Grey Nuns had come. The first nurses were the only white women in the unmarked land that is now Alberta. __. Twenty miles to the southwest, beyond the low sand hills they could see across their lake, the Stoney Indians still camped on the knoll called Stoney Plain. It was one day's travel from Fort Edmonton. The Fort stood as it had for as long as anyone could re­ member, on the highest bank, the capital of the fur trade. The buffalo hides and beaver skins still came into the Fort and went down to Hudson Bay. The beaver still abounded in the creeks of the uncleared woods. The buffalo herds still roamed the land, from horizon to horizon. Beyond the North Saskatchewan River, away to the south, the Blackfoot confederacy still held actual control of the country. Calgary did not exist, and the Elbow River joined the Bow and swept around St. George's Island unobserved. The Blackfeet, and their enemies the Crees, still ambushed and killed each other within strolling distance of Fort Edmonton. The northwest was just as it had been for as long as anyone could remember. There was nowhere any indication that the old order was embarking on its last decade. While the Sisters administered their carefully hoarded knowl­ edge of nursing to the Indians and metis of the Lac Ste. Anne mission, the pre-historic art of the Indian medicine man still flourished in the country around. It was an art, because the Indians like all primitive peoples, could not raise their knowledge to the system of a science. How­ ever, their knowledge of specific cures for specific ailments was impressive. It impressed medical people well into this century. 7 The Crees, among whom the Grey Nuns were working, knew the most, as David Thompson had noted. In the cool shade of the parkland abounded the herbs and roots and berries that were the basis of Indian medicine. The Crees, for example, knew the power of red willow root to induce a fever. In the first great war, when the supply of quinine from Africa ran short, Canadian doctors improvised a stop-gap quinine from red willow root. There were excellent midwives among the Indian women, as the white settlers gave testimony when they started coming into the country. The Indians also had cures for the "summer com­ plaints" that bothered freighting and trading parties on the western trails and river systems. They would brew tea from certain leaves. The state of Indian medicine was unchanged from 1804, when Dr. D. W. Hamon toured the prairies for the Northwest Company and wrote of the medicine men: "These physicians do at times perform distinguished cures. Their medicines consist of the bark of particular trees, of roots and of herbs, used at some times in their simple state and at others in compounded form. For wounds and sores they use chiefly de­ coctions of roots. The doctor is well paid for his services and his profession is the most lucrative of any among the Indians .. . ." At the back door of the Lac Ste. Anne mission the freighting parties passed on their way from Edmonton to Fort Assiniboine on the Athabasca River, on the route that took them eventually over the Howse Pass into British Columbia, where the Indians chewed foxglove. The mountain Indians knew that if they chewed foxglove they'd feel more energetic while travelling. They didn't know why it made them feel better, and didn't care. Like primitive people everywhere they did not inquire into the "why" of anything that worked, so they did not build on their knowledge. They would never have discovered, as Withering had in England in 1785, that foxglove makes the chewer more energetic because it stimulates the heart. It's digitalis. Indian medicine was changeless, as the west itself seemed to be in that first year of the Grey Nuns at Lac Ste. Anne. But unimaginable changes were soon to sweep over the west, and within that year of 1859-60 in England, Florence Nightingale and her ally, William Rathbone, would do things to change the face 8 of nursing as much as the rush of history would change the face of the west. In 1859 the Liverpool merchant, William Rathbone, founded district nursing, by hiring a trained nurse to work in his district, and thereby gained for Liverpool a sort of interim fame until the Beatles could come along and secure it. Mr. Rathbone was the sixth-generation head of a Liverpool trading company. As a young man he had been an honorary visitor for the District Provident Society in one of the poorest quarters of Liverpool and there he saw the miseries endured by the poor when sick in their own homes. In 1859, in consultation with Florence Nightingale, the heroine of the Crimea, he engaged a qualified nurse, at his own expense, to visit these homes. Mr. Rathbone saw a need for district nurses in crowded cities. In Alberta there would be a difference. In Alberta the need for district nurses would be in scattered areas of pioneer settle­ ment, and in filling this need Alberta nurses would write an im­ portant chapter in this book. In December of 1859, as the Grey Nuns prepared for their first Christmas at Lac Ste. Anne, Florence Nightingale published her historic Notes on Nursing, a Victorian best-seller which sold fifteen thousand copies in a month and was translated into French, German and Italian. Notes on Nursing was intended to make a practical nurse of the mother of a family. Into it Miss Nightingale crammed hun­ dreds of workable suggestions, the results of her meticulous in­ quiries and experiments. It was the first standard reference work on nursing. In the spring of 1860 she made another important contri­ bution to the revolution in nursing. She brought out, and bad accepted, her scheme for uniform hospital statistics. Every hos­ pital in England was following its own method of naming and classifying diseases. She decided that hospital statistics should be kept on some uniform plan so they could provide information for research and control. Miss Nightingale had become something of a recluse but she emerged from her back room to give a series of brilliant breakfasts for the Statistical Congress of 1860. A person who can be brilliant at breakfast can achieve anything, and Miss Nightingale had her 9 scheme <}Ccepted at once by four hospitals, with six more joining shortly. Notes on Nursing and the statistical plan were two big steps but the third was bigger. As Miss Nightingale's biographer wrote: "In 1859, when she became concerned with the affairs of St. Thomas's (Hospital), she began a scheme to establish a school there." The scheme grew out of the Nightingale Fund, a fund that had been pressed upon the heroine of the Crimea to spend as she saw fit. She saw that it could be best spent to endow a school for nurses, for laywomen. This would be the first all-necessary step in raising lay nurses from the level of some of "the fat drunken old dames of fourteen stone and over" she had been faced with while raising a nursing corps for the Crimea. This would be a pilot school to produce a new and revolu­ tionary lay nurse; one with the intelligence to acquire knowledge and the character to use it. In other words, the ordinary lay nurse we take for granted today. The school opened July 9, 1860, with fifteen probationers, handpicked for their intelligence and character. Since we'll be seeing the development of Alberta nursing schools in this book we should perhaps take a close look at how this first and most famous school actually ran. We have the benefit of a memoir by Rebecca Strong, who died in 1944 at the age of 101, and entered St. Thomas's in 1867. Miss Strong wrote: "Each pupil had a cubicle in which to sleep and there was a common dining-room with a neatly-appointed table. Very little was expected from us, as progress was slow in regard to organized teaching. Kindness, watchfulness, cleanliness and guarding against bedsores was well engrained. "A few stray lectures were given, one I remember especially, I think was on The Chemistry of Life, or some such title. It caused me to get a book on the subject which I found most useful. "There was a dummy on which to practise bandaging and some lesson were given; also a skeleton and some ancient medical books, one fortunately on Anatomy for those who attempted self­ education. The more enterprising pupils provided themselves with something more modem, Hoblyn's Dictionary being a great favorite. 10 "I may say that although Florence Nightingale had scrubbed floors and cleaned brasses at Kaiserswerth, she did not ask this of her pupils. The whole time on duty was given to the patients." Miss Strong paint a surprisingly quaint picture of a classic institution in the history of nursing; a place where the lives of the students were tightly organized but their education was loose. However it was a better system than any before it. After a year in St. Thomas's the girls were expected to have gained enough knowledge to become pioneers in other hospitals, in Britain or abroad. In a generation there would be Nightingale nurses working in Alberta, but back around Lac Ste. Anne there were no signs that the old west would not go on forever, exactly as it was. By 1863, when the American Civil War was making a nursing heroine of Clara Barton and the Grey Nuns' hospital mission had been moved to St. Albert, the governor of the Hudson's Bay Company indicated that he didn't realize the end was near. The nuns were witnesses to the dispute over the bridge, the first bridge west of Winnipeg, which Father Lacombe had built across the Sturgeon River at the foot of the mission hill. When Governor Dallas saw the bridge he recognized it as a threat to the old order. But he thought the old order could be preserved. He directed that the bridge be taken d~wn , a direction which Father Lacombe ignored, after the governor went on his way. Watching history and making history, the nuns were making history that would often repeat itself as the frontier was rolled back in Alberta. They were in ahead of the doctor. They were in five years before the first resident doctor came into the territory. He was William MacKay, graduate of &linburgh and student of Simpson (pioneer of anaesthesia), Monro, Brown and Syme. Dr. MacKay came as company surgeon, to look after health at Hudson's Bay Company posts from the bay to the Rockies and north to the Arctic. Dr. MacKay was sturdy, dedicated and ingenious about getting to where he was required. Once in the fall when he was needed in &lmonton, he skated most of the way from his post on Lesser Slave Lake. But he was a thousand miles away at Fort Simpson when the decade, and the era, went out in the convulsions of the last smallpox epidemic. 11 CHAPTER THREE The smallpox epidemic was a horror story. It was a creeping, pursuing horror, spread by the Indians as they fled from it. It attacked them as they camped together for protection from it, in their own camps and around missions and carried off three thousand of them. Smallpox devastated the Indians again, as it had in 1738, 1781, 1829 and 1838 when half the Indians died. In 1858 there was a local outbreak at Qu'Appelle; in 1862 in British Columbia, and in 1865 twelve hundred B1ackfeet died in southern Alberta and Montana. The last plague began in 1869, around Fort Benton, Mon­ tana, where some passing Indians picked it up off infected gar­ ments thrown from a steamboat. It was suggested that this last epidemic was started on purpose by white traders, possibly for revenge. Although it seems unlikely, from a purely practical point of view, Captain W. F. Butler put enough credence in the story to report it when he made his historic tour of the Northwest Territories the next year for the new owners: the Dominion of Canada. The epidemic spread over two summers of horror and delirium. The Indian's roving way of life made him an easy victim of smallpox in the nineteenth century, as his reservation style of life made him an easy target of tuberculosis in the twentieth. The nightmare crept north along the foothills through Al­ berta. In the spring of 1870 some Wood Crees went on the war­ path in the south, where the epidemic was already raging and carried off prizes from a Blackfoot encampment which had been wiped out. Mountain Stoneys raided a Piegan camp in the infected area. It was then inevitable that the infection would come north. At St. Albert the Grey Nuns moved to meet the threat with 12 the best of intentions and with the best knowledge available. But their efforts were swamped by the rush of the virus, a virus which, as Captain Butler said: "preys on (the Indian) with a violence nowhere else to be found. " There were about nine hundred people around St. Albert. Two-thirds of the population caught smallpox, including Father Leduc, and three hundred and eleven died. The heroism of the helpers was no match for the disease. At the Methodist mission at Victoria, sixty miles downriver from Edmonton, there was one helper who could move among the stricken Indians without fear. Mrs. George McDougall, the wife of the missionary, had had smallpox in England and this experience was her immunization. Her two daughters and an adopted Indian child had no immunity, however, and they joined the list of the victims. Her husband understood the only type of isolation which could save the Indians. His son, John McDougall, also a mis­ sionary, quoted him as saying: "Scatter them, scatter them. Do all you can to scatter the people, John, for that is the only hope of saving them." Reverend Henry Steinhauer "scattered" with one band, north­ wards to Whitefoh Lake. Reverend Peter Campbell and another band went southwest to Pigeon Lake, well off the beaten path. Both these bands survived untouched while the worst suffering went on in the area they'd vacated - the area from the Mc­ Dougalls' mission east to Fort Pitt, on the present Saskatchewan border. Father Lacombe worked through the epidemic, at St. Paul des Cris and later at St. Albert, organizing burying parties at dawn so that the dead would not infect the living. In a quaint and pathetic attempt to ward off the disease with medical science, he kept a ball of camphor under his tongue. This was supposed to have the same effect as a bag of garlic around the neck. And it did have, exactly the same effect. Father Lacombe did not catch the virus, but the Reverend John McDougall used more practical medication when he did. While all but two members of an Indian camp died within sight of the McDougalls' home at Pakan, he was struck by the nausea and blistering pain of the virus. He staggered into his room, and took to his bed with Dover's 13 powders. Dover's powder, a compound of opium and ipecac, was displaced from the medicine chest only in recent years. The opium was a sedative, and the ipecac derivative loosened the breathing. He perspired profusely. In two days he was up again and working. There were two pockets of immunity to the disease, both in Saskatchewan. At Prince Albert, the Reverend James Nesbitt im­ provised a successful vaccine and at Fort Qu'Appelle, in the south, Isaac Cowie did the same. Cowie was the son and brother of medical men. He had as­ sisted his father in vaccinations at home in the Orkneys and had been out from home only two years when smallpox threatened Qu'Appelle in the fall of 1869. Into the fort rode Pascal Breland, the metis leader from Winnipeg. With him was his nine-year-old grand-daughter who had recovered from smallpox. Isaac Cowie took lymph from the little girl's arm, smeared it on bits of glass, and vaccinated hundreds of Indians. Not one caught smallpox. On the fifteenth of July, 1870, when the epidemic was at its worst, the tortured land became part of the dominion of Canada. The new lieutenant governor arrived in Winnipeg in six weeks and almost immediately dispatched Captain Butler to the northwest to report on the possibilities of the dominion's new acquisition and report on the smallpox epidemic. Butler's departure was delayed while the printers were turn­ ing out instructional pamphlets for him entitled: The Smallpox in Three Stages, and while medical authorities packed eight chests of medicine to combat the epidemic. The well-meant medicines were sent too late and never reached Alberta anyway. It was all over when Butler came to Fort Pitt. The last of the dead who had lain around the fort had been buried, and the last survivors of a band that had tried to infect the white residents of the fort, had withdrawn to the south. Butler left the medicine piled against the walls of Fort Pitt. He wrote that the "blisters, pills, powders, scales and disinfecting fluids had been wildly bent upon blistering, pilling, powdering, weighing and disinfecting one another ever since leaving Winnipeg". He left them behind and passed on into present-day Al­ berta, through The Great Lone Land, as he called his famous book, a land made more "lone" by the absence of the Indians who had lived there. The horror was past, and it does not return. The nurse guards against it - with a vaccine needle. 14 CHAPTER FOUR The old order was vanishing. In another three years the buffalo herds would disappear from the Great Lone Land, and further demoralize the Indian population. The patriarchy of the Hudson's Bay Company was ended. The country made its first move to­ wards self-government and in Alberta it was in the field of health. A board of health was set up in 18 71. It was the beginning of local government and its membership was drawn from men who had been deeply involved in the smallpox disaster. There was Reverend George McDougall who had recognized that isolation in the farthest woods was the only escape for the Indians; there was his son John; Reverend Henry Steinhauer who led one band to safety at Whitefish Lake; Reverend Peter Camp­ bell who took another band to Pigeon Lake; Father Leduc, who would carry the scars of the epidemic to his death; Father La­ combe; Father Andre; Bishop Grandin of St. Albert; Bishop Faraud of Lac La Biche; Chief Factor Hardisty of the Hudson's Bay Company; and John Bunn. The first act of the first local government put an embargo on the shipment of buffalo robes, leather and furs out of the district. This was to keep any lurking infection from the smallpox epidemic from breaking out in a new area. That was the start of representative government, and a good place to start: with the health of the community. There were soon other events which would come to affect the health of the community. In 1873, the year the buffalo herds finally disappeared, the first nursing schools appeared in North America. The first was at the Bellevue Hospital in New York, with the driving influence coming from Sister Helen Dowin, who had been trained in one of the Anglican sisterhoods in England. Training programs followed 15 quickly at the Massachusetts General Hospital in Boston and the New Haven General. The next year, 1874, the first nursing school opened in Canada and in the west there was another step forward in the health field: the Mounted Police arrived. The first training school in Canada was at St. Catharines, Ontario, in the Mack Hospital. It was set up by two Nightingale graduates recruited in England and began with two students. And although present-day nurses bridle at the term "training school", the Mack went beyond that. If the rules indicate the reality, it was almost an "obedience school" and installed in Canada a concept of nursing e ucatioothat would take a full eventy years to break down. In regard to the North West Mounted Police, who came to the west in 1874, although they have never suffered from a lack of publicity their contribution to health is not widely appreciated. In the construction of Fort Macleod they designated one building as a hospital. It had no permanent staff but the police surgeon treated patients there, assisted by the constable who had charge of the drug dispensary. Civilians, as well as members of the force, were treated there. It wasn't much, as hospitals go, but it's considered to have been the first in Alberta. In 1881, the year Clara Barton founded the American Red Cross, and the Toronto General founded the second nursing school in Canada, the dominion government arranged the first census of the territory that's now Alberta. Although there was perhaps much for the inhabitants to grumble about, they could hardly complain of overcrowding, because the census found only 18,075 Albertans of all races. Calgary and Edmonton each had about three hundred and Pincher Creek was third with eighty. For the benefit of this sparse population the Grey Nuns made another important nursing contribution that year. They invested ten thousand dollars to create a hospital wing at the St. Albert mission. Although the new building was connected to the mission it had the effect of separating the nuns' hospital work from their work in education and social welfare. The hospital was a one-storey frame building, eighty feet long and forty feet wide with a service wing forty by twenty leading off one side. It was the forerunner of the Edmonton Gen­ eral and is considered the first staffed hospital in Alberta .. (Some 16 reports give the year of this hospital as 1870. However, this is an error, apparently arising from a slight ambiguity in an article by Dr. Heber Jamieson, who, in other of his definitive historical writings, gave the year as 1881.) It was a great benefit to the community in the typhoid outbreaks of 1881 and '84 and the measles epidemic of 1886. For the newcomers moving into the country at this time the most pernicious and pervasive health problem was posed by the water. Water was not by any means the safe beverage described by the temperance preachers. It contained typhoid and the elusive, weakening ailment called Rocky Mountain Fever. Dr. George Kittson, who came west with the Mounted Police on their founding expedition of 187 4 spent a good part of his career with the force trying to track down Rocky Mountain Fever. Although he never identified the germ he learned much about it. He first decided that it came from streams. Then he discovered that it appeared after a rain, or a run-off, had raised the levels of the streams. Studying the country he noted the muskegs, with their content of swamp water and rotting carcasses of horses and buffalos. He noted the effluvium on the surface of the muskegs, and decided that a heavy rain would raise the level of the surface until the effluvium drained off into the nearest stream. That was where the fever originated. Dr. Kittson described it as miasmatic and malarial in character. He didn't come any closer, but what he did find caused the Mounted Police to close their fever-ridden post at Fort Walsh. For the next half-century water would be a health problem in country where the treams were polluted by nature before settlers could put up a single factory. In 1883, the railroad - builders emphasized the hazard of typhoid in the water. The track-layers of the Canadian Pacific entered present-day Alberta in the spring of 1883, and all that summer and fall raced across the southern prairie at three-and-a­ half miles a day, putting down the first railroad line in Alberta. The workmen got typhoid from the water and, living cramped together, they infected others. Typhoid attacked the native population too. About this time it nearly wiped out the Piegan band of southern Alberta. The band was reduced from a thousand to only 270 in one summer, by a 17 fever the Indians thought was caused by poisoned baking powder, and which they called "the baking powder sickness". The effect of typhoid was described in a long-forgotten book by Reverend Wellington Bridgman, who came to Medicine Hat with the railroad-builders in 1883, on behalf of the Methodist church. The book was Breaking Prairie Sod. In it Reverend Mr. Bridgman wrote: "The first funeral (in Medicine Hat) was that of a surveyor who was brought into town and died of the fever. For a time we were without a doctor or nurse, and often our cabin home would be deserted at night, my faithful wife, who is a good nurse, looking after the women and I doing my best to take care of the men. The first year I visited seventy-seven cases of (typhoid) fever and attended eleven funerals." In another section he wrote: "We were then without doctors or nurses and the fever was raging. One day I found the genial freight and baggage agent at the C.P.R. absent from his place. I found my way to his cabin and here he was down with fever and quite out of bis mind. Often I used to make my rounds early in the morning and find him out in the blazing sun, quite unconscious of who be was or where be was. I would get him back into bed, tuck him in and administer our simple remedies. A kind providence and a good constitution enabled most of those men to pull through." The historic summer of 1883, in addition to producing the first railroad, also produced the beginnings of hospital systems in the camps and townsites along the way. Some shelter was needed for the sick and injured, and someone bad to look after them. In 1885 the Riel Rebellion brought evidence of the increasing competence of Canadian nursing and of the existence of nursing as a profession. In Alberta there was a "military hospital" at Ed­ monton, based on the Mounted Police model, where six casualties of the fighting were brought for treatment by the police surgeon and police orderlies . . But on the eastern edge of the battle area, at Saskatoon and Moose Jaw, there were base hospitals run by women nurses. At Saskatoon, Nurse Millar, bead nurse at the Winnipeg General and formerly of the Montreal General, was in charge. She bad two lay nurses with her. At times they bad as many as eighty casualties to look after. At Moose Jaw, there was a forty-bed hospital, operated by the founder of the new ~glican Order of St. John the Divine. 18 This remarkable Canadian woman was Hannah Grier Coome. She had taken some ward training at the Bellevue in New York, and for the work at Moose Jaw had brought three graduates of the Bellevue and three Sisters of her own order. The eastern front nurses were in the field through the spring and summer and when they returned to civil life Canadian nursing was established on a new plateau. The next year, 1886, the first lay nurse arrived in Alberta. She was Miss Mary Newton, a graduate of Queen Charlotte's Maternity Hospital, London. She came to live with her brother, Canon Newton, at The Hermitage, the Anglican mission eight miles downstream from Edmonton. Miss Newton represented the first influence in Alberta of an English movement which was having profound effects on nursing. It had begun in the 1840's with an attempt to revive the dea­ conesses of the ancient Christian church. There were the Protestant Sisters of Charity, who helped doctors as ward aides. There were the Protestant Sisters of Mercy, who nursed among the poor. There was the St. John's House Project, organized in 1848 by the Anglican church. These nurses lived in St. John's House, London, and went out to hospitals for training. They devoted some of their day to nursing and a great deal more to prayer. Considering the hospital conditions of the time this was perhaps not a bad idea, and it insured that the nurses were of high character. When Florence Nightingale sailed for the Crimea in 1856 St. John's House was able to give her six excellent nurses. This revival produced Sister Helen Dowin, the Anglican nun who set up the first training school in North America at the New York Bellevue. Queen Charlotte's Maternity Hospital, where Mary Newton was lady professor until her health broke down, started training in obstetrics. The story in the Edmonton Bulletin of August 7, 1886, which announced her arrival at The Hermitage, said Miss Newton hoped to resume nursing if her health permitted. Very shortly she was nursing at the mission, specializing in women and children. Later (1891) she advertised that she was prepared to do nursing and midwifery in homes - fee ten dollars per week. Miss Newton added another civilizing touch, which stands 19 as a credit to the nursing profession. She introduced the fLrst lilacs into the province. The same year that Mary Newton came to The Hermitage a nurse who was to play a prominent role in Alberta began her career at the Winnipeg General. She was Mary Ellen Birtles, who went to the Winnipeg hospital on July first, 1886, "to learn nursing". Those are Miss Birtles' exact words, and she had a keen sense of the exact word for a situation. In addition to being a fine nurse and a clever organizer she could write; and she left much bright matter-of-fact material to guide historians. For this alone she would deserve the Order of the British Empire she would get on the jubilee of King George the Fifth. Riding the train from Alexander, Manitoba, on her per­ sonally - historic journey she brushed a bit of history going the other way. It was a noisy, gaily-decorated special train, making the first transcontinental run to the Pacific over the new CPR. The Winnipeg General's school of nursing, the first in the west, had not been started when Miss Birtles arrived "to learn nursing". She wrote of her efforts in these words: "Sometimes we got a little clinical instruction from the doc­ tor on his rounds, but we were fortunate in finding some books in a second-hand store on anatomy and physiology. From these we studied, together with a book on nursing by Florence Nightingale." (This was probably Notes on Nursing.) Miss Birtles learned what she could from the five graduates on the staff. One of these was Grace Louise Reynolds, a graduate of a igbtingale school at the Leeds Infirmary in England. Miss Reynolds, like Miss Birtles, would be important in Alberta. When the school of nursing was formally organized Novem­ ber first, 1887, Miss Birtles was given credit for nine months' work on the three-year course. The course was divided this way: two months probation, six months night duty, two months on iso­ lation, two months in maternity, six weeks in the diet kitchen, two months in the operating room, two months at the Margaret Scott Mission and the remainder to serving in the wards. The time in the operating room did not necessarily mean in the room of that name. As Miss Birtles wrote: "Two large closed­ in balconies at the south end of the hospital building were often used for operations as they were larger and the light better than in 20 the operating room. Operations were also performed in the wards in the midst of other patients with various ailments." When operating on "the ward system", Miss Birtles would pump a Lister's spray around the patient to keep infection off. The hours of duty were seven to seven, with one free after­ noon a week. The head of the training school wrote after one year that it was "thoroughly organized and there was a regular course of instruction". However, Miss Birtles wrote: " ... lectures were instituted. Sometimes we had one a week and sometimes two; two bones by way of illustration in anatomy - a rib and a femur - until some doctor lent a skull . . . " In this atmosphere she gained the knowledge on which she would set up the second nursing school in Alberta. And she had little chance to study for her final examinations. For the last seven weeks of her apprenticeship she was sent out to a private home to nurse a fourteen-year-old boy with rheumatism, a service for which the hospital kept the fee. The mother held her almost a prisoner in the patient's room. She was outdoors only twice, but on the day before the examinations she told the mother flatly that she was going. The examinations took one day. She passed, and she and two other nurses comprised the first graduating class of the first school in the west. They were her sister Sarah, and Jessie Mc­ Dougall, a nurse who is still remembered with affection in a country district of Alberta. Shortly after the graduation, Miss Birtles and Miss Reynolds moved on. They moved west. They came to an institution that was vivid evidence of how fast the country was changing. They came to the first municipal general hospital in Alberta. Mind you, there were already some hospitals going in Al­ berta. In addition to the Grey Nuns' place at St. Albert there was "sort of" a hospital in Lethbridge and a "remarkable" hospital in Banff. The one in Lethbridge opened in 1886 and was maintained by the Alberta Railway and Coal Company in cooperation with the Mounted Police. It was there principally for the miners. The "remarkable" hospital at Banff was opened in 1888 to serve the men who were building and running the Canadian Pacific Railway. It was on the second storey of a rough building. Down below there was a pool room, a bar and a barber shop, and the barber, George Paris, also served as hospital orderly. When George 21 was required for medical duties a nurse could bang on the floor for him. In ancient Athens, barbers used to participate in surgery; they did the cutting while the surgeon pointed where. However, at Banff, George Paris didn't have to undertake any surgery. That was done by the railroad doctor, Dr. R. G. Brett, who supervised the hospital and would become the second lieutenant governor of Alberta. This institution served admirably its purpose and its time. But while it was certainly a "remarkable" hospital it was hardly a "general" hospital. Not like the Medicine Hat General, to which Miss Birtles and Miss Reynolds were coming.

22 CHAPTER FIVE The first municipal hospital in Alberta was also the first in the Northwest Territories and the only one on the railroad from Winnipeg to Vancouver. It was at the junction of three rivers, one of which was known to the Indians as the Medicine River but classified by the new white owners as the South Saskatchewan. It was at Medicine Hat. The Medicine Hat General grew out of the makeshift hos­ pitals that came with the railroad in 1883. It was incorporated in 1888 by a special act of the territorial assembly, built in 1889, and the official opening was set for January ninth, 1890. How­ ever, the ceremonies had to be postponed because the staff was too busy with a flu epidemic to listen to speeches. It was supported partly by grants from the dominion and territorial governments and the CPR, partly by subscriptions, and partly by a bear. On top of its other distinctions the Medicine Hat General is the only hospital on record which drew financial support from a bear. The bear was the property of a Medicine Hat citizen and could be viewed for a donation to the hospital. The bear raised more than one hundred dollars for the construction and main­ tenance of the twenty-five thousand dollar hospital. There were twenty-five beds within two storeys of cut stone, with a mansard roof under which the isolation patients stayed and the nurses lived. There were only two nurses, Miss Reynolds the matron and Miss Birtles. Miss Reynolds had trained under Nightingale gradu­ ates in England and thus became the first Nightingale nurse to bring her influence to Alberta. She had entered· Leeds Infirmary as a student in 1879. Her first matron was a Miss Gordon who had trained under Miss Nightingale at St. Thomas's, London, and Miss Gordon was followed by a Miss Fisher from the same hos- 23 pital. She spent three years in training and two years on the staff at Leeds Infirmary. Although she bad to give up her nursing career at Leeds because of poor health, within a few months she was able to resume it in Winnipeg. This was in 1884. She worked at Winnipeg General for four years, then went to Washington, D.C., for two, and when she came to the Medicine Hat General in 1890 sent for Miss Birtles to assist her. Miss Birtles, in her bright, matter-of-fact way, has described how they ran the place: "(We) divided the duties of orderly, cook and ward aide between us. (Miss Reynolds) prepared the meals and looked after the downstairs work. I attended to the furnace, did the up­ stairs work, sweeping, dusting, etc., besides attending to the patients. When any surgical work was to be done, we had to ar­ range the work accordingly. Miss Reynolds gave the anaesthetic and I looked after the instruments and waited on the doctors. There was no sterilizer so we had to resort to boiling the instru­ ments in a large saucepan with a steamer on it for towels and dressings. This was the only hospital between Winnipeg and Nanaimo, B.C., patients coming from near and far and a great deal of surgical work was done there." "Aseptic surgery was just becoming known about that time with much better results than formerly. Dr. (J. G.) Calder was very courageous and did some wonderful work and successfully too, considering how little there was to work with." In the first year patients came from as far as Edmonton in the north; Field, in the west; and Winnipeg, in the east. And as time went on, nurses of the Medicine Hat General went almost as far to nurse patients in their homes. It was an aim of the hospital board to "fill this need for outside nursing, to supply skilled nurses to persons any place in the Territories at a moder­ ate rate". The rate was one dollar a day. The dollar went to the hospital, not the nurse. It was a condition of her employment that she could be sent to "private cases among the rich or poor in any part of the Territories" and would receive no extra pay. In the hospital's first year, 124 patients were treated on the premises. After Miss Birtles left in July, 1891, to go to Brandon she was replaced on the staff by an angel of mercy whose temper was not always cherubic. This nurse appears in the minutes of a board meeting held September fourth, 1891: 24 "Allusion was made to the peculiar temper of one of the members of the nursing staff whose occasional displays are more human than angelic. As her strong-mindedness serves as a power­ ful preventive against soft-hearted swains making love during convalescence and as no instance was cited when any of these displays of temper had disturbed the equilibrium of the nervous system of any patient, the matter was not deemed of sufficient importance for anything but a few mild comments." The secretary of the board certainly had a flair for interesting minutes. Summarizing the meeting of December fourteenth, 1891, he, or she, made a coy entry concerning the resignation of Miss Reynolds as matron: "Mr. Spencer inquired if anything was wrong that she was resigning, and was answered, nothing, except that there was a sup­ position that she preferred living in the cottage close by, rather than in the hospital. In the cottage she will be a real matron; in the hospital the title was simply a misnomer." This was a coy way of noting that Miss Reynolds was leaving to marry Dr. Calder, the medical superintendent, and would be living in his cottage beside the hospital instead of in the hospital itself. Dr. Calder had succeeded the first medical superintendent, Dr. Albert Olver. Dr. Olver died at the age of thirty of typhoid, the water-borne disease that would be a lurking menace for an­ other generation and make necessary thousands of hours of bed­ side care by the nurses of Alberta. In her new position as matron of the cottage it is not unlikely that the former Miss Reynolds continued to be an influence in the development of the Medicine Hat General. Her husband, Dr. Calder, in his reports to the board of 1892 and 1893, wrote: "We can do a great public good by establishing a training school for nurses." The training school was established in August 1894, with two student nurses following a two-year program under the new matron, Agnes Miller, a graduate of the Royal Infirmary of Edin­ burgh. Miss Miller came to Medicine Hat from Neepawa, Mani­ toba, where she had emigrated with her farmily, and was matron at Medicine Hat General until 1897. In Edinburgh she took a one-year course laid out by a Miss Pringle, based on the Nightingale system. Miss Pringle was noted for her opposition to "metallic" nurses. The Royal Infirmary 25 kindly supplied a photostat of the record of training of the first supervisor of the first school of nursing in Alberta. The photostat gives her period of training as "3 lst July 1886 to 30th July 1887". "Particulars of Training. She was twenty-five weeks in medi- cal wards, twenty-six weeks in surgical and gynecological, absent a few days. "Remarks: Reliable, capable and kindly, observant and sym- pathetic, managed the patients well and proved a very good nurse; did not manage quite so satisfactorily as assistant day nurse. "Situations: She was put on the staff 31st of July 1887 and employed as N.N. of W. 30 (night nurse of west thirty) until 16th Nov. 1888, when she was made assistant day nurse of wards 17, 18. She was appointed head nurse of the medical waiting rooms in Nov. 1889. Left to go to America." This was the experience and training on which Agnes Miller ran the first school of nursing in Alberta. There were two candi­ dates in the first course, Gertrude Hales and Jean Miller, who may have been a sister of the lady superintendent. They signed an agreement to serve for two years of training, and agreed to abide by a long and detailed list of rules, based on those of older institutions in England. Trainees were described as "inmates" and the rules were full of cautions about being obedient, not being boisterous, and going to church on Sundays. In the matter of church, at least, they were given a choice of which one to attend. They weren't given much choice about anything else. Paradoxically, although they were allowed little personal freedom they were expected to take great personal responsibility. The regime for student nurses, approved by the hospital board, is too long to include here, except for the all-important section on what her education as a nurse should cover. Here it is: TRAINING The training includes: ( 1) The dressing of blisters, bums, sores and wounds, the prepa­ ration and application of fomentations, poultices and minor dressings. (2) Application of leeches and subsequent treatment. (3) Administration of enemata and use of female catheter. 26 ( 4) The best method of friction to the body and extremities. (5) Management of helpless patients, moving, changing, giving baths in bed, preventing bedsores and managing position. (6) Bandaging, making bandages and rollers, and lining splints. (7) Making beds and changing sheet while patient is in bed. ( 8) The preparing, cooking and serving of delicacies for the sick, to understand the art of ventilation without chilling the patient, both in private houses and hospital wards, and the management of convalescents. (9) They are also instructed in preparing reports for the physi­ cians, as to the state of secretions, expectoration, pulse, tem­ perature of the body, skin, appetite, intelligence, (as to delirium or stupor), breathing, sleeping, condition of wounds, eruptions, formation of matter, effect of diet, stimulants or medicines . . . . Lectures will be given on such subjects as anatomy, physiology, hygiene diseases, surgery, materia medica and obstetrics. . . . That was the outline of the curriculum. It was apparently the joint work of Miss Miller and Miss Reynolds and represented the Nightingale method from two angles. Miss Pringle of Edin­ burgh was identified in the book, Six Disciples of Florence Nightingale, as one of the Lamp Lady's favorite proteges. When the first matron of St. Thomas's retired, Miss Pringle was chosen by Miss Nightingale to succeed her. And when Miss Pringle left Miss Gordon of Leeds followed her, also by choice of Florence Nightingale. So the first nursing school in Alberta had two direct lines to the fountainhead. A copy of the rules and curriculum were sent to Miss G. E. Watts, matron in 1965 of the Leeds Infirmary. Miss Watts, a native of Saskatoon, commented: "Although I have no firm reason for confirming that (they) are based on the training at the Leeds Infirmary, I would say that this is almost certainly the case as so many of the points were applicable in this hospital at the beginning of the century." The school of nursing, like everything else about the Medicine Hat General, was made a community enterprise. Women of the town were invited to attend the lectures. The student nurses were expected to learn a great deal from these lectures, and from the bedside instruction by the staff nurses. 27 Here is the first question on the first examination paper given to the first class: "Suppose a patient to be brought into the hospital with severe lacerations of the arm involving all structures - integu­ ments, muscles, tendons, bones and blood vessels - in which there is severe haemorrhage both venous and arterial. State what treatment and dressing you would apply until the arrival of the physician and what palliative treatment you would adopt in the meantime." Both students were able to pass this test, given in January of 1896, and became the first qualified nurses trained in present-day Alberta. They were also the first of 638 Medicine Hat graduates up to the golden jubilee year of the Alberta Association of Regis­ tered Nurses in 1966.

28 CHAPTER SIX In 1894 Mary Ellen Birtles returned to Alberta. She came to Cal­ gary to become superintendent of the Calgary General and direct the second school of nursing in the province. She was the only nurse, at a salary of four hundred dollars a year, because the board demurred at engaging a second nurse who might require fifteen to twenty dollars a month. The hospital was in existence four years when Miss Birtles arrived to take over its management from the Road family. Mrs. Road ran it and her husband, Nelson, did the nursing, dosing the patients with the prescribed medicines, and threatening to "tum them over to the undertaker" if they resisted. The surgical supplies consisted of a robe, a pair of old scis­ sors, one dressing forceps, one macintosh and a winchester of carbolic acid. A doctor wishing to operate had to bring the rest. The operating room was also the hospital dining room, and the surgery was performed on the dining room table, a not too satisfactory piece of equipment because of its great width. There was room for eight beds in the place, but sometimes there were more than eight patients and then beds had to be stowed wherever room could be made. The hospital was a house on Seventh Street. It was a house with a past, which took some doing in a town as young as Cal­ gary but it had been employed for purposes frowned on by church and state, and there were bullet holes in one of the doors. Patients came and went as they pleased. When Miss Birtles would remonstrate with a convalescent going out for a night on the town he would say: "Show me your rules!" A high school drama class would have a grand time writing a farce on the operation of this place, and yet it represented the earnest effort of some good citizens to give Calgary a permanent 29 hospital and relieve the Mounted Police of the burden of treating ailing Calgarians at the camp hospital, which they had been doing since 1884. The town was fast outgrowing its welcome at the fort. The project began with the bequest of a dying Chinese rail­ road laborer. As the young man, known as Jimmy Smith, lay dying in a Calgary hotel, he willed his entire estate to found a hospital. Jimmy Smith's estate came to only a hundred dollars but it sparked a drive for more, led by Mrs. Pinkham, wife of the Anglican bishop. The hospital got into operation in January 1890. Miss Birtles arrived in the fall of 1894, and the training school opened in April 1895. To help run the school the board allowed Miss Birtles to engage an assistant and this was Miss Tyers, another Winnipeg General graduate. Miss Tyers must have been something special. At the age of ninety-seven, William McHenry, a cowboy of the High River district, looked back on ninety-seven years of life and 1picked Miss Tyers as the finest-looking woman he had ever seen. The reason the Calgary General opened the second training school in Alberta was a common one, and would remain so for many years. Student nurses were cheap. With the hospitals' limited funds and the limitless demands placed on their facilities, a lay hospital could hardly operate without students: dedicated girls who were prepared to give three years' hard work in return for training as a nurse. The need was so great that students were swept into the actual operation of the hospital from the moment they entered the doors. Marion Moodie, the first probationer at the Calgary General, wrote about her first day: "As the first pupil nurse, I entered on St. George's Day, April 23rd, and was sent to get what sleep I could in a vacant bed upstairs. I was to commence my probation by taking charge while the matron (Miss Birtles) and the nurse (there was only one) got a chance to rest. An hour later I was roused to make room for a new patient." Miss Moodie, like her tutor Miss Birtles, was a bright, matter­ of-fact writer, and has left us an intriguing memoir of her duties as night watchwoman in the first three weeks of her apprenticeship, before the hospital transferred to its new building. She wrote: "An old lady, convalescent, left the hospital and was suc­ ceeded by a man with cancer of the tongue. Across the hall from 30 him was an Irishwoman with synovitis of the knee, who was an inveterate talker and used to make the most of any opportunity she could get to talk to the tongueless man, till he besought us by gestures to pitch her through the window. "The only man downstairs requiring attention at night was a bronchitis case, but the matron used to retire for the night with the warning to the new probationer (Miss Moodie) that ten minutes must not elapse without looking at him in case he should choke. "Then a D.T. case was put upstairs opposite the pneumonia ward and the probationer was not to go out of sight of his door in case he took a notion to come out and jump over the bannister. . . . Nights were spent sitting on the top step of the staircase by the cancer man's door, in sight of the D.T.'s door and in sound of the bronchitis man's cough.'' That's how Marion Moodie, age eighteen, spent the first three weeks of an outstanding career in nursing: sitting in the dark at the top of the stairs, listening and watching all through the night while the matron and her assistant got the sleep that would enable them to carry on another day. Miss Birtles, conscientious nurse that she was, rested easy, confident that the untried girl would perform as expected. From the moment a girl declared herself a nurse it was expected that she would show the mental, moral and physical stamina the profes­ sion required, whenever, wherever and however required. Miss Moodie thought her introduction to nursing was interesting. In­ teresting, yes; unusual, or unreasonable, no. Nor did she consider unreasonable the start of her fourth week in the profession. She wrote: "Monday morning I retired as usual but was called up in an hour, as the men had come for the furniture and my bed must go. The remainder of the day was spent helping with the five patients who were transferred to the new building, and finally, after at­ tending to a newly arrived patient and being too exhausted to eat the evening meal, going back on night duty with only five hours of sleep in sixty hours. "When the patients were quietly sleeping I rolled myself in a blanket, and lying down on the bare floor of an empty ward, slept for thirty minutes. After a survey of my charges I returned to that most-welcomed blanket, and, lying down on the bare floor, 31 slept exactly another thirty minutes, after which I kept guard the rest of the night. Retired about eight-thirty a.m. and was awakened about three p.m. to go out in a shack at the back of the hospital and nurse three children through scarlet fever." She didn't get paid for any of this because she was on pro­ bation, but after three months, in addition to the training, Marion received a stipend. Five dollars a month, rising to seven-fifty a month in the second year, and ten in the third. She had oppor­ tunities to gain experience outside the hospital too. There was then only one nurse with training in Calgary and she hadn't much. Doc­ tors were anxious to borrow nurses from the hospital whenever they could, even though the girls hadn't always been in training long enough for the necessary experience. In Miss Moodie's first year she arrived at a maternity case' shortly after the baby, and the doctor left the baby in her care. The trembling nurse was starting to dress the new arrival when the aunt came in. She looked on for a minute or so and then re­ marked: "I suppose you're getting used to bandaging a good many babies in the hospital." "Yes," said the student, "I haven't kept count." The aunt left and the nervous Miss Moodie slowly but safely bathed and dressed a baby for the first time. After three years and three months of this, on July twenty­ fifth, 1898, Marion Moodie was pronounced qualified to call her­ self a nurse. She had doubtless given fair service in return for her training and was certified to go out into the world and practice nursing. She literally did go out into the world, because the average nurse was then "in private practice" like the doctor, and went from job to job in private homes. Many more things were done at home then. Making music, making clothes, making bread, making ice cream, distilling beverages, being sick and having babies were all activities that were carried out at home. It would be another forty years before even half the working nurses would be at work in hospitals. As Miss Moodie went from house to house in the Alberta south country, she met resistance to the new status of graduate nurse, which she represented. She met it from the public and from the untrained nurses who were being replaced. She wrote about it: "The public had to be gradually enlightened as to what it meant to be nursed by a trained nurse, and to the fact that she 32 could not give her patient proper attention and fill the position of washerwoman and general servant at the same time. Also that a nurse spent over three years fitting herself for her work, and her services were worth more than an untrained woman who could neither give the same care nor take the same responsibility." The charges were modest enough: maternity twelve-fifty a week and medical cases fifteen. Of the opposition from the old guard she wrote: "The advent of the trained nurse was not welcomed by some of the women who had previously posed as nurses and had things pretty much their own way. They could not resist the temptation to discredit her work if there seemed an opportunity of doing so. (On a maternity case north of Calgary) one of the first services I had performed for the mother had been to give her a good bed bath. Nearly three weeks later, after my return to Calgary, she went for a walk, got overheated, sat out on the verandah to cool off and took an attack of pleurisy. The village woman (who worked as a nurse) care­ fully spread the story of the pleurisy with the comment: 'What else could you expect? That nurse they had up from Calgary bathed her in bed!' " Miss Moodie was on the road for five years, going to cases in Calgary homes and at ranches thirty miles from a town or doctor; to railroad towns from Innisfail to Lethbridge, to the Crowsnest Pass and to Banff. Trains to Macleod left Tuesday, Thursday and Saturday, returning the next day. One night, after the Macleod train had left, Miss Moodie had a telegram from Pincher Creek, 125 miles away. She rode trains to Medicine Hat, Lethbridge and then to Pincher Creek, travelling 300 miles but saving twenty-four hours. There was inevitably a buggy ride at the end of each train ride. Once, on an August night, there was an extra buggy ride she never forgot. She was at a case on a ranch and had it well under control. From across the river came a shout, to know if the nurse could be borrowed for the night. The ranch houses were only two miles apart as the chinook blows but fourteen miles by road. Miss Moodie agreed to go. A team was harnessed to the rig and the hired man deputed to drive. The team was not re­ assuring. One horse had been harnessed for the first time that day; the other was a big mean brute who had recently kicked a wagon over in protest at a steep grade. 33 Miss Moodie wrote of this August night: "The first and worst four miles on the road were covered before the moon rose. A narrow stream had to be forded twice, the second time under the shadow of trees, in such darkness that we could not see the horses' heads and the water was above the axle. "The landing was a little off the track and the rig hung poised for a few seconds while we sat uncertain as to whether it would keep its balance or tip over and spill us back into the stream. "Then there were gates to be opened; gates that had to be searched for in the darkness; a task which I preferred to sitting in the carriage and watching for rebellious action on the part of the team. "Then came the coulee with the steep grade, but a neigh­ boring rancher had put in a good bridge. So when the bridge was found the driver turned his team down the hill at my call and they followed me quietly across. "A mile or so further on, the moon rose over the hills and lighted a smooth trail . ..."

34 CHAPTER SEVEN In the last decade of the ninteenth century fifty thousand people came into Alberta. They began tearing away strips of forest to reveal the face of the north and they strung barbed wire across the unmarked face of the south. They didn't build any cities but they built towns and the largest towns had to have hospitals. Calgary was the first to have two. The Holy Cross opened in January, 1891. It began with $73.75 in cash and four Grey Nuns, led by Sister Agnes Carroll. They arrived midway in the night of January thirtieth, and with no rigs in sight at the station, walked with their belongings to the eight-bed unit that was the foundation of the present Holy Cross. It was an unfinished building, twenty-four feet square, two storeys high, lighted by candles, heated by a single stove. Within two years the nuns had a three-storey brick building, fifty feet square, but in the meantime were involved in the smallpox scare of 1892. This scare began with the discovery of a Chinese laundryman dead in his shop from smallpox. And it had ugly overtones for Calgary's health officer, Dr. Henry George, and his family. Dr. George was a pioneer medical man of historic proportions - he was with the great chief Crowfoot when the famous Indian died. At the discovery of smallpox in Calgary he ordered the burning of all the clothes in the laundry to prevent the spread of the disease. Some of the rougher element in Calgary decided this burning of other people's property was high-handed and set out to burn down the doctor's house in retaliation. Dr. George was not at home. He was away at the isolation camp which two of the Holy Cross nuns, Sisters Beauchemin and Valiquette, were running at the request of the Calgary civic au­ thorities. It was a sort of tent camp, east of the town at the junc- 35 tion of the Bow and the Elbow and on the far side of the Elbow. The Sisters remained there, with patients and suspected carriers, until the scare passed. On the night the mob set out to burn the doctor's house the doctor's wife was in. A determined Irish girl, she was waiting with a rifle to protect her home and three small children if the mob came too close for safety. There was an oil lamp burning in the kitchen to signal for help. The mob marched up and down several streets, shouting and singing in the June night but never came within range. The doctor's house was not attacked but when the smallpox camp was closed and the nuns from Holy Cross re­ turned to the applause of the town, the Chinese patients were driven out of Calgary and were found starving on the prairies by the Mounted Police. One of the sisters who founded Holy Cross had been a Grey Nun only eight days when she left the mother house at Montreal. She was Sister Gertrude. Sixty-four years later, living in retire­ ment at St. Albert, Sister Gertrude's mind was more on the future than the past but she recalled for an interviewer the effort of obtaining water: "First we carried water from the priest's well. Then when Sister Superior got enough money she had a well dug on the grounds. For laundering, though, we got water from the river to conserve the supply in the well. We began poor all right. I think that's why the hospital prospered." Farther south there were other hospital developments in 1891. In Lethbridge, the Coalbanks mine hospital gave way to an up-to­ date fifteen-bed unit built with the help of Sir Alexander Tilloch Galt, who was a father of the Lethbridge coal industry in addition to being a father of confederation. The dominating influence here was Dr. Frank Hamilton Mew­ burn, who performed the first appendectomy in Alberta, was later the first professor of surgery at the University of Alberta, and after his death was named by Lady Nancy Astor as "the finest man I ever knew". (He ran a hospital for wounded Canadian soldiers on Lady Astor's estate during the first great war.) Life at the Galt Hospital, where the drinking water was kept in barrels on the verandah as a guard against typhoid, was de­ scribed by Helen Chapman, a graduate of the Montreal General, who came there as matron in 1894. Miss Chapman, like Miss 36 Birtles and Miss Moodie, had the gift of writing. She wrote of the Galt: "It was as fine an institution as there was anywhere in the west. Dr. Mewburn did a great deal of fine surgery with success, patients coming from all parts of the country for treatment." Miss Chapman wrote on: "For the first year that I was in the hospital, our patients were mostly men, accidents in the mines and stabbing affrays at Slav and Hungarian weddings filling up the wards. "We had patients from many of the Indian reserves. Lupus seemed to be quite prevalent among them, and several came in for operation. At first we kept them in the wards but afterwards we allowed them to pitch their teepees outside the hospital, and when the patient was well out of the anaesthetic, we carried him out to his tent. We found that they made much better progress that way. "At first there was no fence around the hospital grounds, and if bedding was put out to air on the side verandah, 'and a windstorm got up, one was likely to see the pillows and mattress careening across the prairie in the direction of the town, and the patients betting as to whether the orderly would catch up with them before they struck the first or second house." "So far as nursing methods in those days are concerned," Miss Chapman concluded her memoir of the Galt, "I do not think they differed very much from what they are today. The funda­ mentals are the same. The difference is in the multiplicity of tools and equipment which the present-day nurse has at her command, and in place of which a nurse (of the nineties) had to call upon her ingenuity. . . . " In the north, meanwhile, the Grey Nuns' hospital at St. Albert was becoming too small and too far out for the population that was building up in Edmonton. Nine miles was a long way to go. So six doctors urged the Grey Nuns to build a general hospital in Edmonton. In 1895 the nuns built The General. They put up "the largest, most substantial and most costly building in town" - to quote the Bulletin. More than that, it was "substantial without being gloomy and handsome without being tawdry". From this description, we're sure, there should be no difficulty in recognizing the east corner 37 of the old wing on lOOth Avenue. It was due to come down in the golden anniversary year of the AARN. It had thirty-six beds and cost thirty thousand dollars, of which the town gave a thousand. To reach it, the town also put in the first wooden sidewalk to the west end, a spidery thing along lOOth Avenue that in boggy places was almost on stilts. In 1896 the Canadian Red Cross was formed. There's also a good chance that 1896 was a significant date in the history of Alberta nursing. We put it this way because it was not possible to confirm the point but there is circumstantial evidence in favor of it. It likely happened in Fort Macleod, scene of the first Mounted Police hospital, where, in the fall of '96, the town's three-year-old cottage hospital was enlarged to seventeen beds. This was a project of the grand old pioneer Dr. G. A. Kennedy and his wife. (The doctor was the first president of the Alberta Medical Association in 1889, 1890 and 1891.) From the records now available it appears that to serve as matrons in the new hospital, they engaged in order the two girls who had formed the first class at Medicine Hat General. This would mean the Alberta nursing system was already beginning to produce administrators for the hospitals of the growing near­ province. The records state that Daisy Hale came first, in November, 1896 and was followed next year by Nurse Millar. The records of the Medicine Hat General name the first graduates as Gertrude Hales and Jean Miller. They graduated in the fall of 1896 just before the opening of the enlarged Macleod hospital. Considering the time, and allowing for the fact that record­ keepers were casual about spelling of proper names, and con­ sidering that Daisy was likely a nickname, it seems reasonable that Daisy Hale was Gertrude Hales and that Nurse Millar was Jean Miller. Lending further weight to the supposition is a story from the Macleod Gazette, late in the 1890's. It quoted the rules for nurses on staff, and they're identical to the Medicine Hat rules, suggesting that either or both nurses transplanted these rules to Macleod. While this is a likely story-really-these are some incontro­ vertible facts: The patients paid a dollar a day to be in the general ward and twelve dollars a week for a private. To help finance, the 38 Territorial government paid fifty cents a day for the first four patients and twenty-five cents a day for the rest. Washing cost the patients extra. It was done by Tom, a Chinese gentleman who was also the cook. And the water for washing and all other purposes was hauled by Tom from the nearby Oxbow River. It was good planning to build a pioneer hospital beside running water since that was as close as you were likely to come to it. Tom boiled the water in the kitchen in the constant watch against typhoid. Mary Ellen Birtles wrote in an interesting way about typhoid, as she wrote about everything. Her diary has this account of life at the Calgary General, one fall season in the nineties, when ty­ phoid was prevalent: "There was a great deal of typhoid fever in the autumn and amongst others the senior pupil nurse developed it which left the staff short-handed. Patients were in all stages of the disease and seemed to have every kind of complication that accompanied typhoid. It was almost impossible to watch the delirious ones as there were not enough nurses to do the work. "The matron (Miss Birtles was referring to herself) appealed to Mrs. Pinkham, the president of the women's hospital aid for help in the dilemma. She arranged for several ladies who volun­ teered to come to sit beside the delirious patients to keep them in bed. One or two came in the evening for the night and the others in the morning for the day. "One lady was a beautiful pianist and sometimes would go to the matron's parlor and play for the patients. This seemed to have a soothing effect on them; even the delirious ones would ask for more music. It was a great satisfaction to know at the end of the season that they had all recovered. "The citizens were extremely kind and good to the nurses and for recreation, those who had conveyances would take them out for a drive for half an hour daily. One at a time could only be spared." Thus did Mary Ellen Birtles write of the 1890's when civiliza­ tion was bringing its lines to the face of the south; railroad lines, lines of telephone poles, and long snaky lines of barbed wire stretching for miles. The influx of civilization was making it easier for people to get the doctor but harder for the doctor to get to people. 39 For example, by the end of the decade it was no longer pos­ sible to duplicate the feat of Dr. L. G. De Veber, who made a famous ride from Macleod to Morley in 1890. In that year a boy set out from Morley to Calgary to get a doctor for his sick mother. There was no doctor in Calgary so the boy rode on to Fort Macleod and found Dr. De Veber, who agreed to go. Dr. De Veber rode 167 miles in eighteen hours. He rode four horses on the journey. One he picked up at High River he had to break first, and then ride. By the end of the decade such a determined dash across open country was no longer possible. Dr. G. D. Stanley used to recall what he found when he came to practice at High River in 1901. On one emergency medical trip of thirty-five miles he had to open and close nineteen barbed wire gates. Years afterward he could recall with feeling the strain of stretching a barbed-wire gate enough to close it again. Through this land of barbed-wire entanglements and un­ finished towns there passed a lady who saw the country from a nurse's point of view. She was Lady Aberdeen, whose husband was governor-general of Canada from 1893 to 1898. In England Lady Aberdeen had been noted for her causes, and they were all good, practical, helpful causes - such as the committee to get shopgirls chairs with BACKS. Lord and Lady Aberdeen had only five years to be Cana­ dians and wasted neither time nor opportunity. They travelled up and down the country, joining in the enthusiasm. It was in 1895, on a trip across Canada that brought them through Alberta, that Lady Aberdeen saw the need for the Victorian Order of Nurses. The Aberdeens visited the Medicine Hat General Hospital on their western tour. They had made a donation to it. Later that year, in August, the hospital opened a separate maternity cottage on the grounds and it was named for Lady Aberdeen. When the Royal Tour hit Kaslo, B.C., her ladyship is said to have first expressed the idea of the V.O.N. While her husband, with true Victorian optimism, joined the town officials in excite­ ment at the coal resources and the future prospects of Kaslo (1960 population 669) , Lady Aberdeen noted in her practical way that the town his lordship found so exciting was really a string of shacks and that it could use a cottage hospital. She told the mayor about it. This is said to be the beginning of her campaign to give 40

Medicine Hat General Hospital --in 1894 The staff in 1896. Agnes Miller is front center. The first graduates are Jean Miller, front right and Gertrude Hales upper left Marion Moodie, with her diploma as Calgary General's first graduate, 1898 The Galt Hospital, Lethbridge, 1891 The operating room in 1896. Miss Chapman is second from left; Dr. Mewburn on the right Canada a society of trained nurses to run cottage hospitals and do home nursing. It took courage to oppose Lady Aberdeen when she took up a cause, but some in the medical profession did their level best to stop her on the V.O.N. plan. They feared it. They feared that the women in the order would be only half-trained as nurses and would be out in pioneer districts working not only as nurses but as cut-rate doctors. The fight went on all through the year 1896, in the east. In the west, the board of the Medicine Hat General, reporting on its work of that year stated: "We are already doing a large amount of the work which Her Excellency Lady Aberdeen is advocating at Ottawa under the name of the Victorian Order of Nurses." The board was referring to its scheme for sending nurses to do home nursing anywhere in the territories, a condition of service to which all nurses, staff and student, had to agree. During 1896, nurses were sent to fifty-six cases outside the hospital, as far east as Regina and as far west as Donald, B.C. The president's report for 1896 said: "Our training school for nurses has furnished us with material from which we have been enabled to provide nurses for outside work without interfering with the efficiency of the hospital." (There were then six student nurses and two graduates.) The board called it "a large staff". In the east, meanwhile, Lady Aberdeen wore down the oppo­ sition, partly with assurances that only graduates of recognized schools would be accepted and that they would get four months' extra training. In J 898, the year the Aberdeens' term as Canadians ended, there was a V.O.N. nurse in Fort Macleod helping in the hospital. There was also a party of Victorian Order nurses en route to the Klondike gold rush. In the gold rush towns the facilities for enter­ tainment were excellent but health facilities lagged far behind. The V.O.N. party would close the century with a quick justifica­ tion of Lady Aberdeen. In 1900 V.O.N. nurse Christine Smith took charge of Good Samaritan Hospital at Dawson City. Years later, when the prov­ ince of Alberta set up its public health nursing service, she would be the first superintendent. On notes like this the nineteenth century closed-feelings of great achievement mingled with high hopes. 41 CHAPTER EIGHT The twentieth century opened with a joyous wild ride, a ride that reached full gallop when Alberta became a province in 1905. Swept along by an epidemic of optimism Alberta rode off madly in all directions, towards all the unlimited horizons. Most of the railroads were built, most of the towns were founded, the cities took on their lasting character and permanent institutions sprang up. The newcomers in their hurry started much more than they could finish but they started things well. For in­ stance, by the time the first great war brought the exhilarating ride to a halt, the newcomers bad started enough schools of nursing so that no more were needed until 1953. The nursing profession, like everything else, expanded in so many directions and made so many contributions to the new province that no one could keep all the action in view simul­ taneously. Not even the proverbial matron of a small country hospital could follow so much action. Therefore we'll try to keep up with nursing as it developed in three general directions: the start of the nursing schools; the start / of the country hospitals; and the work of the private duty nurses, which most nurses were. This chapter is on the nursing schools, and in briefest sum- mary the action might be summarized like this: In 1905 the first students entered the Edmonton Public Hospital, now the Royal Alexandra, and the Strathcona Municipal Hospital, now the University. In 1907 training programs began at the Edmonton Misericordia; in 1908 at Edmonton General and Calgary Holy Cross; in 1910 at the Lethbridge Galt; in 1912 at Lamont Public, now the Archer Memorial; and in 1915 at St. Joseph's in Vegreville. The Strathcona Municipal school was in­ terrupted by the war and if you count the University's 1923 pro- 42 gram as a continuation, and if you don't count the short-lived schools at the Brett Hospital in Banff, High River Municipal and Camrose St. Mary's, and if you take the Ponoka Mental Hospital as a special case, you can say that after 1915 there were no more schools of nursing needed in Alberta until Lethbridge St. Michael's opened thirty-eight years later. These hospital schools were the product of a young and healthy age, an age in which enormous vitality carried to success many a half-baked plan. When Mabel Wallis became the Ed­ monton Public's first student nurse in 1905, the city's official policies on health were often stuff for the Keystone Kops. While Miss Wallis survived the three-year course that would make her the first graduate, the city survived Dr. Sullivan and the volunteer medical health officer. Dr. Sullivan ran the isolation hospital. When the new province told the aldermen of the new city they'd have to provide an isola­ tion hospital, the boys obliged by putting the institution on another well-known institution, the city dump. They hired Dr. Sullivan to run it. He said he was a doctor all right, and just happened to be working as a railroad laborer for a bit of a holiday. He seemed to be satisfactory until the rubbing alcohol began disappearing. A nurse established that it was dis­ appearing into "Dr. Sullivan" and then he disappeared too. Another health official who did a disappearing act was an alderman of 1907. He really was a doctor, and since the city had no medical health officer, he volunteered to act in that capacity in addition to his other duties. And he did a fine job until the day he heard that measles had broken out among the ladies of Norwood. Norwood was then a district of fun and games on the northern city limits; the doctor got a warrant to go gunning for measles. He went and discovered that the rumor was unfounded. Having made the discovery, he then lingered - most of the day - in one of the bars. By evening, as he rode home, his judgment was some­ what impaired. He began banging on doors, waving his warrant, and demanding to check housewives for measles. He left town shortly after. But even though the raw new province had not yet developed a bureaucracy capable of handling a sophisticated health program, the people thrived. Their hearts were young and gay and the rest 43 of them was young and healthy. Dr. Sullivan and the medical health officer passed away but other aspects of the program en­ dured, including the nursing school at the Edmonton Public Hospital. The first student entered in December 1905. She was Mabel Wallis, who persevered to become the first graduate and she learned a system taught by matron Mary Mclsaac, a graduate of the Tor­ onto General. Toronto General had also supplied the first matron, Miss Turnbull, for the opening of the hospital in 1900, but by the time Stella Donnan (Mrs. R. C. Dawson) entered the training program in January, 1910, the Royal Victoria Hospital of Mon­ treal had become the dominant influence. Miss Fairservice was the matron and she was the first of six consecutive Royal Vic gradu­ ates who would head Edmonton's public hospital for the next twenty-eight years. The Royal Vic had been handsomely endowed by Lord Strathcona and was affiliated with the McGill medical school so the system was a good one. At the beginning, however, the system could not be adopted entirely because there was no maternity ward and no facilities for practical work on infectious diseases. These would come later when the operation moved to the new Royal Alexandra in 1913. When Miss Donnan entered, students were taken in as needed to help staff the thirty-bed hospital. There were eight students. They worked with two orderlies and three graduates: the superin­ tendent, the assistant who ran the operating room, and the night supervisor. Senior students were expected to help in operations; the hours of work were seven to seven with an hour for lunch. Students could have five hours off on Sunday and were allowed to stay out till eleven one night a week, but these were privileges which could be lost for not dusting properly or failing to have a rubber sheet exactly square. Students were allowed three weeks holidays per year and ten days sick leave for the entire three years of their course. Eating on duty was not permissible; and smoking, drinking, rouge and lip­ stick were not even thinkable off duty. Christine McKinnon (Mrs. R. M. MacCrimmon), who joined the student nursing staff on Dominion Day, 1913, was one of eight junior nurses, running the hospital with six seniors and five graduates. 44 On her first day she made rounds with a senior nurse and did the "dirty work". The juniors "looked up" to the seniors and they all "looked up" to the graduates, and if a doctor or head nurse entered a room, they stood up and waited for the superior to speak first. It was an authoritarian regime but they didn't resent it. It was the same the whole world over. In the nearby fire hall the single men lived in the hall and were allowed out only an hour at a time for meals. The regime was authoritarian and the work was hard. Mrs. MacCrimmon said there were none of the "petite" nurses who contribute so handsomely to the nursing profession today. They were sturdy girls, in the 125-130 pound cla~ s. A list of rules for students, preserved by the alumnae asso­ ciation, is curt and final in tone, but not without straight-faced humor. The second-to-last rule says: "Nurses who use their face towels as stand covers, or forget to change bed linen, must not be surprised if they find this cannot be remedied by application for more linen." There was also a directive that nurses spend half an hour each day in the open air. People are always greatly impressed by the rule in the first Medicine Hat General course requiring students to spend fifteen minutes in the open air, so the architects of the Royal Vic system must have been real fresh-air fiends. Students of the present may wonder why there's been no mention of lectures in the twelve-hour working day. That's be­ cause they weren't taken during the working day. They were taken afterwards, in the evening, or during an afternoon off, when the girls would have to come back and get into uniform. A girl became eligible to take the lectures if she survived the six-month probation and got her cap. Even after twelve-hour days there were sleepless nights as the time of decision drew near and girls wondered if they, or some special friend, would be found qualified to go on. There were always tears at the decision, either of joy or sorrow, but no one questioned the verdict. It was the same the whole world over.

When Mabel Wallis entered the Edmonton Public (Royal Alex) school in December 1905 the "forgotten school" across the river had already been operating more than half a year. We say the 45 "forgotten school" because in the later amalgamation of Strathcona with Edmonton, and the dissolution of the Strathcona municipal hospital board, and the building of the new hospital for the Uni­ versity of Alberta, and the first-war occupation of this hospital by the Canadian army, the records of the Strathcona municipal hospital were lost. There would be almost nothing kn.own of the school if it weren't for the fact that in the golden anniversary year of the AARN, Mrs. Sigrid Magee was living in Red Deer in her eighty-third year and was able to tell about it and show her gradua­ tion pin - a large Maltese cross in pewter with a red cross in the center. The school was in operation well before September first, 1905, the day Alberta became a province, because Miss Hoyme (as she then was) and Cora McWhirter, the other student, were given a holiday to go home to their farms near Camrose. They had gone in training in the spring. Miss Hoyme was a Norwegian girl, from Oslo. In 1903 she had come to her brother's farm near Camrose for her health. While she was recovering, the town of Strathcona started a public hos­ pital in a converted three-storey house. The first patient was a man who broke his arm in the railroad yards and when he was brought to the hospital the painters had gone away for lunch leaving the doors locked so he was boosted through the window and was then well on his way to recovery-like Miss Hoyme. The first matron was Jessie Dickson, a bright little Scottish nurse and a recent graduate of Brandon General, a hospital that was "really looked up to", and to which Mary Ellen Birtles had returned as superintendent in 1898 after her sojourn in Alberta. There were three or four staff nurses but they got so busy that more help was needed. With only half the patients paying for the service, the board couldn't afford to hire any more graduates at thirty dollars a month so it was decided to start a training school in which student wages would be four dollars a month. Miss Dickson then began a campaign to get young girls to come in and train. Cora McWhirter was the first to go in. Then she made a trip home and persuaded her friend and neighbor, Sigrid Hoyme, to go in too. They formed the first class, learning as they worked from Miss Dickson and the other nurses, buying their books and uniforms out of their four-dollar stipend and hearing lectures by the doctors. The horse-and-buggy doctors were 46 extremely busy men so the lectures bad to be at their convenience which always seemed to be when the students were sleeping and they would have to get up. The first winter Miss Hoyme and Miss McWhirter slept in a tent with the cook and the laundress, and it was so cold at times that the hot water bottles froze. The second winter an Aladdin cottage was provided for the nurses. This was a prefabricated hut that was put together with books and was nearly as drafty and nearly as cold as the tent in which the cook and the laundress still slept. They used to hear a great deal about the new University Hospital that was going to be built for them. A. C. Rutherford, the first premier of Alberta, was a resident of Strathcona and used to come and talk about it. At one time an excavation was dug in the present Tipton Park on 109th Street and the nurses used to walk over in the summers and watch for developments but nothing ever developed but mosquitoes. It did come later on, of course, in a location farther west, and much later there would be close by it the McEachem cancer research laboratory named for Cora McWhirter's future husband, who was then running a country hospital in connection with his practice at Bawlf. A training school at that time, Mrs. Magee recalled, was supposed to have thirty-six beds, and although the Strathcona had more like twenty, when typhoid was bad there would often be more than forty patients on cots in every available space. Typhoid time was hardest for the students because before the sheets went to the laundry they had to be rinsed in disinfectant -by the students. Miss Hoyme came down with typhoid and was off duty four months. Another student, a Miss Dahlquist from Calmar, caught it and dropped out of training. Students were still sent out on private duty, with the hospital keeping the fee. Miss Hoyme was once sent to a maternity case at Wolf Creek, on the Grand Trunk Pacific grade to Jasper. The rails had been laid only as far as Stony Plain, so after a short train ride she had to ride with the company surgeon on an open buggy on the grade, trying not to look down into the awful depths on either side of the narrow roadbed. There were six known graduates of Strathcona municipal at this stage. In addition to Misses Hoyme and McWhirter, there were Arletta Fouls and Mrs. Collinson who entered in 1906, and 47 two Thompson sisters who entered in 1909 and would have finished the three-year training period in 1912. On the strength of her three years at the "forgotten school" Miss Hoyme was able to get a job as matron of a hospital in Grand Forks, B.C., at fifty dollars a month. She went there in 1909 and the next year Miss Dickson left to marry Dr. Fuller, the dentist, who became noted later as the Flying Dentist of the north, travelling around the north with the bush pilots. Miss Dickson was succeeded by Agnes Baird from the Winnipeg General. In 1913, with the opening of the first unit of the present University Hospital becoming imminent, Miss Baird recruited a class of twelve students and set up a course based on the system of her alma mater and thereby launched a feud with the Royal Alexandra across the river where the Royal Vic was the last word on everything. For example, the Royal's six-month probation period was considered vastly more "right" than the Strathcona's two. The eleventh of the twelve girls to enter this class was Evelyn Smith (Mrs. Shrigley). This would be the only class to graduate as a group with Strathcona Municipal pins, a round, smaller pin than the Maltese crosses. A second class was quickly formed so that the first group could be seniors, and have somebody to direct, when the institu­ tion moved a few months later to the first wing of the present University Hospital. The new place had a hundred beds but it lacked one feature of the old two-storey house near the post office; there were no pictures on the doors. A pestle and mortar, for example, had identified the door to the dispensary. The new place was operated by Miss Baird, six graduate nurses, two dozen students and two orderlies. The hours, as everywhere, were seven to seven, with two free hours in the middle of the day and lectures in the evening. The doctors who gave the lectures were pretty hard to corral in the summer so these occurred only in the winter months but the girls still studied out of the books preserved by Mrs. Shrigley. They were Practical Nursing (1907) by Anna Caroline Maxwell and Amy Elizabeth Pope of Presbyterian Hospital, New York; Obstetrics for Nurses (1913) by Joseph B. De Lee of Northwestern; Materia Medica for Nurses (1906) by Lavinia 48 L. Duck of Bellevue; Anatomy and Physiology for Nurses (1913) by Diane C. Kimber of Bellevue, and A Dictionary of 34,000 Medical Words Pronounced and Defined, by George M. Gould, A.M., M.D. Mrs. Shrigley used the dictionary in her nursing work until she retired in 1962. While they picked up their education at what might be called "night school" the students' daytime hours were fully occupied with the patients. They did everything for the patients, even things that were not in the medical sphere. Most women had long, braided hair, and the nurses acted as hairdressers in addition to the other jobs. In addition to the dusting, and the trays, and the treatments and the dressings there were the spongings every four hours in pneumonia and typhoid cases. Students also expected a tour of night duty in their second year, in which they would have to take a great deal of responsi­ bility, and in which the job was often complicated by language problems. The problem was not the language of some of the pioneer doctors. Colorful and salty though it was, it was at least in English. There were many new languages in the new province, and many of the patients and some of the nurses were not at ease in English. Dorothea Engelcke, a member of the second class who was still doing private duty nursing when this was written, knew three languages when her family came to Alberta from her native Flanders but none of them was English. She had wanted to enter nursing in Holland but there were only two ways. One was through the Catholic sisterhoods but she wasn't a Catholic. The other was through a Red Cross school where the minimum age was twenty-one, and she wasn't twenty­ one. So Dorothea was able to realize her ambition in Alberta. In her second year Miss Engelcke was on night duty when some men arrived with an accident victim and proposed putting him in an empty bed at the entrance to the ward. Miss Engelcke cheered up even the victim when she carolled: "Oh no. Oh no. That bed is preserved." In January 1916 all the beds in the Strathcona Municipal were "preserved" for sick and wounded members of the Canadian army by the military commission, and the school of nursing was 49 disbanded after graduating one course. Most junior students finished at the Royal Alex. But the Strathcona nursing school was not dead. When the University of Alberta took over the hospital, as intended, in 1923, the school was revived. Due to official carelessness the records of the first school were lost and the school was officially forgotten. Fortunately, a few students who were there had better memories.

It was in 1907 that the Misericordia opened its training program for nurses and in line with the custom of the time the program emphasized the particular work of the institution. Here the emphasis was on obstetrical nursing. The Sisters of Misericorde - Misericorde is a beautifully expressive French word with no exact English equivalent but a meaning something like "compassion"-were founded in Montreal in 1848 to help the unmarried mother and her child and also to do hospital work. This combination of aims inevitably brought the Order into general maternity nursing. It brought the Order to Edmonton in 1900, because the settlers moving into the district by the trainload were creating a coming need for a maternity hospital. Father Lacombe, who had brought the Grey Nuns to Lac Ste. Anne forty-one years before, made the actual arrangements for the four Sisters and Mary Jane Kennedy, a lay nurse, to work in Edmonton. They started in a five-room house on 111 th Street and the work was made heavier because half the sisters had to go out begging every day-soliciting enough cash to keep the place going. Sister Ste. Christine (Pepin) entered the order early in the century and came west to the Edmonton house. In 1965 she was still at work in the Order's mother house in Montreal, and at the request of this writer sat down at her typewriter to produce a delightful letter explaining the life. She wrote: " ... the Hospital opened in a little house, tiny nor new, where the wind, rain and snow were allowed in freely; speaking in one room it could be heard all over the others, nevertheless we enjoyed a real family life. "As we started in this shack almost, it was purposely for maternity cases for unmarried mothers only; a graduate nurse (Miss Kennedy) was assigned to care for them. Unfortunately 50 this little Home could not accommodate but few patients, in the meanwhile with the encouragement of Doctors, we decided then to build the first wing (of the present hospital) in 1905, which wing looked spacious until not long after it became too small again. "As the patients were increasing we were forced to have a school-nursing incorporated in 1907." The school referred to by Sister Ste. Christine opened on March fifteenth, 1907, with one student, Miss Mills. It was an eighteen-month course in maternity nursing, supervised by Sister Ste. Catherine de Sienne, a graduate of the Sisters' own training program, begun in 1887 at Montreal's Hopitale Generale de la Misericorde. The first graduation ceremony, in September, 1909, must have attracted the greatest concentration of dignitaries ever to attend the graduation of a single nurse. Premier Rutherford, Archbishop Legal and many others turned out to applaud Miss Mills as she received her diploma. By this time, however, the Misericordia had converted its training program to a general one and a class of three girls was already going through, working towards the first general graduation in 1910. Sister Ste. Christine entered the program as a student in 1911. Of this she wrote: "We had lectures on anatomy, physiology, bacteriology, gynecology, obstetrics, surgical nursing, medicine and pediatry, E.E.N.T., pharmacology and therapeutic. Now in regard of the work: we had to be on duty from 7 a.m. to 7 p.m., day and night, no hours for rest and relaxation whatsoever, no days off and vacancies never, not the least shadow of same! For meals we had to rush and you may rest assured that our menus were not the same given to the Fort Garry Hotel, but hard work is the best aperitif." · Sister Ste. Christine graduated in 1914 and in September of the next year was named director of the school of nursing. This made her the first Alberta-trained nurse to become director of her alma mater, and she was appointed not once but five times, being director from 1915-17, 1919-21, 1923-26, 1935-44 and 1949-50. When Mary Sadlo (Mrs. F. X. Drouin) entered in 1915 she found the regime a little less Spartan than the one described 51 by Sister Ste. Christine, but there was little time to stop. She was caught up with eight students, two graduate nurses and a half­ dozen Sisters in running a forty-bed hospital. The girls still worked seven-to-seven, but there was a fifteen­ minute coffee break at three in the afternoon, a blessed departure from current custom, and there was another departure from custom at other schools: at least some of the lectures were given during the day. Dr. Donald McGibbon, the surgery instructor, insisted that the girls take his lectures in the morning because "a nurse's brains are clearer then". However, there was no deviation from the custom of paying for breakages. A student once broke a water jug valued at seven dollars, which took some paying off since she was making only four dollars a month. To gain the diploma, students had to qualify in eleven sub­ jects, with the doctors who gave the lectures signing the diploma individually to testify that a girl was proficient in his subject. To drum the material in, each subject was taken twice over in the three years. As a further aid to retention, the girls had books to study which they, of course, bought themselves. There were Hughes' Practice of Medicine (1911) including a section on mental diseases and one on diseases of the skin; Primary Studies for Nurses (1913) by Charlotte A. Aitkens; Anatomy and Physio­ logy for Nurses (1913) by Leroy Lewis M.D.; Materia Medica for Nurses (1914) by Emily A. M. Storey; and the American Pocket Medical Dictionary. There was an easing of the regime in Mary Sadlo's time. A strike for better food brought no wrath upon the tudents, and high starched under-the-chin collars gave way to low flat ones. But curling the hair was frowned on and much responsibility was demanded. One night Miss Sadlo had to look after the entire second floor, with thirty-two patients, all by herself. She was on her own from seven in the evening till seven the next morning. It only happened once but it was expected that a student nurse could cope with such a challenge if required.

In 1908 two nursing schools opened in Alberta and the forerunner of the Canadian Nurses' Association was formed. The nursing schools were at Edmonton General and Calgary Holy Cross. The forerunner of the CNA was the CNATN, the Canadian 52 National Association of Trained Nurses. The CNATN was orga­ nized at a nation-wide meeting of nurses in Ottawa. At this meeting an executive committee of nurses who headed training schools was broadened to include all graduates of a recognized school. And the Grey Nuns opened two recognizable schools in Alberta in 1908, at Holy Cross in Calgary and the General in Edmonton. The first probationer at the General was Mabel Denhardt (Mrs. J. R. Vincent of Arbuckle, California), who later worked with the St. John Ambulance Brigade (1939-53) and was made a Serving Sister of the order. Miss Denhardt had already spent nine months in training at the Strathcona Municipal when the night nurse, Miss Cowan, a Calgary General graduate, told her the Grey Nuns were starting a training school at the General and she should try to get in across the river. Miss Denhardt had gone in for nursing with the idea of becoming a medical missionary. While in Strathcona she was greatly impressed by a nurse who came into the hospital as a patient. Her name was Isabelle Kuhlman, who told amusing stories of her life as a nurse in the Yukon, even though, with TB, she knew she had only a few months to live. Miss Kuhlman was moved into a tent, in a field outside the settled part of town, to give her fresh air and keep an infectious disease away from other people. But Miss Denhardt went to visit her often and the older nurse gave her her medical books, including a medical dictionary by Gould, which she used for forty years. Miss Denhardt was accepted at the General two months before the new wing of the hospital was ready and was on the job when the other five girls arrived to start the first course in September. The superior was the memorable Sister Casey, a regal six­ footer and a graduate of the Grey Nuns' Notre Dame Hospital in Montreal which started training nurses in 1900. The doctors thought of her as a pal; "a damn fine girl," one old-time practi­ tioner said. The students hardly thought of anyone so imposing, as a pal, but they did feel at ease with her. One day, in a cheerful discussion of the future, Mabel told Sister Casey that when she got married she would name a son for her. After a good many 53 years-and five daughters-she did. His name is Casey Vincent; lives in California. By the time the second class of four students was added to the first class of six, the General was being run by ten tudents, an orderly named Smithy (a gentleman of real nobility of character), a maid to each floor, and ten Sisters, the greatest of whom was Sister Casey. Sister Casey ran the school like a novitiate, so the General Hospital nurses led a more cloistered life than others. They weren't even supposed to watch maternity cases, they didn't get a full afternoon off, being allowed out only from two to five one day a week because they had to be back at five to serve the patients' dinners. However, they had a champion, a white knight who was ready to do battle for them and that was something other students lacked. Their knight was Dr. Tommy Whitelaw, a fiery fellow who had become Edmonton's first full-time medical health officer, succeeding the over-zealous chap who had gone looking for measles among housewives. Dr. Whitelaw made the front page, for himself and the nurses of the General, when he pushed another doctor out of his car and made him walk back downtown. In an argument about a case the other doctor had stated, "the nurses at the General Hospital are a bunch of damn liars". Dr. Whitelaw stopped his car and pushed the detractor out, and since Edmonton was pretty small then, only forty thousand or so, the news that the General Hospital nurses had a champion was important enough for page one. More important from a professional viewpoint, of course, was the fine training in surgical nursing the girls were getting in the General. They lived on the third floor with the operating room. The hospital specialized in surgery and the students got special experience because much of the post-operative work was done back on the floor. The washing-up and dressings were done there, after the doctor and Sister Casey had carried the patient back from the operating room. When the nun in charge of the O.R. went "on retreat," senior students replaced her. The students were encouraged to learn by watching opera­ tions, but the doctors could tell how green a girl was by how quickly she turned that color. Dr. Duncan Smith would look over 54 kindly and say: "I think you'd better leave now." But she'd be back.

At Calgary Holy Cross, the first class of seven entered during 1908, and they entered one at a time, qualifying for their diplomas three years to the day from their entry, a practice borrowed from the indenture of the apprenticeship trades, on which nursing training was then firmly based. Of the first seven, Elsie Black (Mrs. Lorne McQuade) recalled that the hospital was run by the seven students, thirteen sisters, a maid for each of the three floors; Old George, the orderly, and a procession of assistant orderlies. As a special treat on Christmas Day the students got three hours off duty. Students did so much work that is now reserved for graduates that their activities were hedged around by safety procedures. There was the procedure for giving medicine, for example. Medi­ cines were all out on the floor, in cabinets. For safety, students were drilled on the rule about looking three times at the label on the bottle: before removing the cap, before pouring the contents and before returning the bottle to the shelf. There were one-hour lectures about twice a week, including some excellent talks on surgery by Dr. J. S. McEachern. Nursing Ethics was a subject in the curriculum and the lectures were given personally by Sister Mary Bissonette, who would tell the girls many times, with the most intense sincerity, of the dreadful thing it was for a nurse to reveal anything she learned in her capacity as a nurse. They certainly got few chances to broadcast around Calgary anything they might have learned. They didn't get out of the hos­ pital much and seldom got a leave later than 9:30 but they didn't find the regime oppressive. Like student nurses everywhere in that age, they giggled and played elaborate, practical jokes on each other. Unlike other student nurses anywhere, they had the visits of Bob Edwards, the fabled editor of the Calgary Eye Opener, for entertainment. When the grape got Bob so befuddled that he couldn't get the paper out any more, his friends would bring him into Holy Cross and the nurses would have the fun of keeping Bob away from his clothes so he couldn't get out and resume the party. Even in his worst confusion, though, Bob was always a gentle- 55 man and had names for the girls: Lady Diana, Peaches and Cream, etc. He'd entertain them by writing sayings on the wall of his room, then he'd come back later and copy them down to put in the Eye Opener. Mona Sparrow, who entered in 1915, quotes a typical sample of Bob's wall decoration. "Q. Is it safe to go out walking with your girl friend? A. Yes, as long as you keep on walking." Mona was an adventurous spirit, like most apprentice nurses of the time. In the summer holidays she used to amaze swimmers at the old Cave and Basin in Banff with her Sappho act. She would start climbing the cliff behind the basin while reading a newspaper. The crowd would stop talking and watch fascinated as she climbed the perilous rocks, face buried in the paper. She would come out on a ledge thirty feet above the pool, still reading. Then she'd emit a piercing wail: "Oh, my love is gone!" Like Sappho of old she'd dive off the rock. However, unlike Sappho of old she read the newspaper all the way down, and even more unlike Sappho of old, she came to the surface again and served the nursing profession for half a century. Not every student could be as exuberant as Miss Sparrow, of course, but the high-spirited nurse could better put up with the discipline and the hard work and the long hours, and better take the physical and mental shocks of nursing as it then was . In an age when the student was allowed almost no personal freedom but tremendous professional responsibility only a girl of spirit could measure up. It took spirit to withstand the slow, dragging pace of nursing a patient in the age before antibiotics; to be cheerful through the endless sponging to bring down temperatures: in the typhoid season in the fall and the pneumonia season in the late winter. There were rewards of course. Patients were in longer and nurses got to know them better. This closer relationship made for a great day when the patient would pass the crisis and begin to recover. It would also make the day sadder when a patient would fail. This was life at the Calgary Holy Cross. It was also life at the Calgary General where the nursing school was well into its second decade when the Holy Cross school opened. Ann Hebert has described the life, and it would be hard to find a nurse better qualified. She entered the General as a proba- 56 tioner in 1910, beginning a career in which, thirty-one years later, she would become the first General graduate to return as director of nursing. When Miss Hebert entered with a class of thirteen, the direc­ tor was Emma Jane Smith. Miss Smith had been a teacher before training as a nurse at Montreal's Royal Victoria and was cer­ tainly one of the very first Alberta nursing school directors to have the combination of nursing knowledge and teaching experience which came to be considered so important later on. Many of the supervisors were also from the Royal Vic, which was then as strong an influence at Calgary General as it was at the Royal Alex. Of her own decision to enter nursing, Miss Hebert explained that a girl choosing a career in 1910 could either teach, nurse or be a stenographer; and if she didn't like to sit at one place all day her choice was narrowed to two. The girls who chose nursing learned as much from the patients as they did from the instructors - in Miss Hebert's experience. The girls also got help in their work from the patients. When there was more than could be done even in a twelve-hour day, the patients who were able, wanted to carry trays and help with the housekeeping. Mary Watt, the well-known Scottish-born nurse who gradu­ ated in 1915, recalled the remote ancestors of the auxiliary hos­ pitals of today. They were tents pitched on the General grounds in typhoid season. Many of the patients would be bachelor railroad construction men or farm workers, with no homes to go to. For convalescence they were put into tents on the hospital grounds. The days were full but there were plenty of jokes and most of them were "in" jokes because the students spent so much time "in" the hospital. Jokes like Dr. Mewburn singing hymns as he scrubbed for an operation. The O.R. nurse had objected to his characteristic cussing so he sang hymns from then on. More of the fun is recorded in the silver jubilee yearbook of the General's alumnae association. In a grab-bag of notes titled, "the good old days", older nurses recalled how students used to tease Old Sing, the cook, by creeping up behind him and yanking the string of his pigtail for the fun of seeing Sing's hair fall to the floor ... and the day Bella Lamont (class of '19) saved the day when the cook chased his assistant around the dining room brandishing a long wicked knife ... the days when bloomers and stockings were popular receptacles for stolen tidbits ... the days 57 when the theater and dinner parties were allowed only when a chaperone was along . . . the days when smoking was taboo, and the report of a nurse seen smoking was sufficient cause for the medical superintendent to call an emergency meeting at eleven p.m . . . . the day when a patient complained to Dr. Deane, making the rounds with Miss McDonald, that be bad been served rotten eggs for breakfast and the doctor turned to Miss McDonald and said: "When my patient is ready for rotten eggs for breakfast, I shall let you know ...." They were small things to be so well remembered, but they loomed important when days were twelve hours long and nurses had to find, and make, their entertainment on the job. They were a necessary part of life at Alberta's second school of nursing.

At the first school, meanwhile, the training program was being extended to three years from the original two. This happened in 1906, and one of the last graduates of Medicine Hat General's two-year program was &:Ina M. Auger, one of the hospital's out­ standing personalities. Sixteen years later she would return to Medicine Hat General as matron. Some lively memoirs of student life in this era have been supplied by Anne Elizabeth Combes (Mrs. A. E. Underwood of Vancouver), whose aunt, Emma Alice Combes, had trained in Florence Nightingale's London school. Mrs. Underwood entered Medicine Hat General in 1914. It was wartime, graduate nurses were being attracted away to the army and students had to assume responsibilities of staff nurses. Night nurses would be awakened at two p.m. to attend classes and by the time they got back to bed the day nurses were having hours off, making further sleep impossible. Day nurses would be called during the night to attend surgical and maternity cases with no compensating time off. Mrs. Underwood remembered: "The uniform for student nurses, and rigidly enforced, was dresses and aprons nine inches from the floor, no less and certainly no more, with MHGH em­ broidered on the left arm. The bib crossed over the back and was fastened with safety pins underneath the apron band. A very stiffly starched, modified Eton collar, the cap worn well forward on the head, no puffs or curls unless natural. With black stockings and high black boots, the uniform was complete. 58 "When the temperature hit 90° to 100°, the collar presented a somewhat dejected appearance and the stockings itched. "Having no high boots I wore oxfords and in one week was called into the office to answer for the deficiency. The fact that I had not been off duty during shopping hours was no excuse, so at the first opportunity I purchased high black button boots with cloth tops, patent leather toes and patent leather straps down either side of the buttons. Like Queen Victoria, the matron was not amused. Those high black boots with cloth tops and patent leather trim, simply disappeared I knew not where. Fortunately the order for high boots and starched collars was soon rescinded and low black shoes, cotton hose, and front bibs with V neck allowed, adding much to our comfort and appearance. "General ward treatment was a dollar fifty a day, with two­ fifty for a semi-private, and private wards ran three to five dollars. This charge included food, nursing care, treatments, medicines and dressings. Minor operations cost three dollars and majors were five. X-rays were three dollars and the case room charge for ma­ ternity was five. The rates were low but so was the economy, and some patients paid in kind: vegetables, meat, poultry, eggs, etc. This method of paying certainly complicated bookkeeping. It also complicated housekeeping, like the time a promised cut-up half-pig did not arrive on Saturday." Mrs. Underwood also recalled a student's prank which will ring a bell with anyone familiar with the student life of the time, which was centered right in the institution. This was The Case of the Man with the Bottomless Pit. This was a man with an un­ pronounceable name, a broken arm and a prodigious appetite. All the trays from his ward were coming back without a crumb. It was found that the man was consuming everything the other patients left. "One day just before the noon trays were to go out, three soldiers were picked up by the army to join their battalion which had received orders to proceed overseas. Having three full trays over, the nurses decided to see how much this man would eat. He consumed six soups, four full dinners of pot roast, vegetables and baked potatoes, four desserts of rice pudding with raisins, bread and tea unlimited and patients' leftovers undetermined. The nurses were positively fascinated. The housekeeper was furious." Mrs. Underwood concluded her memories of the Medicine 59 Hat General with an expression of loyalty to the school typical of the time: "There were no miracle drugs during the first world war, and the recovery of patients depended upon nursing care, and the instruction and insistence on correct bedside nursing in the Medicine Hat General Hospital was second to none."

In 1910, the year Florence Nightingale died, training began at the Galt Hospital in Lethbridge. During the first year, thirteen girls answered the advertise­ ment for "refined young ladies" which Annie Forgie, a graduate of the Rochester, New York, General Hospital, put in the Leth­ bridge Herald. Miss Forgie sought to assure refinement by re­ quiring two years' high school, the highest academic entrance requirement in the province. The candidates came to a sixty-five bed hospital just three years old. The families of Indian patients still pitched teepees on the fields surrounding the hospital and the medical superintendent, Dr. F. H. Mewbum, still rode the range to visit the sick--on horse­ back, in riding breeches, highly-polished boots and a white coat. And Dr. Mewburn was the strongest single influence in the school of nursing. With his patented manner, a studied ferocity that failed to inspire fear, he was all over the place admonishing the student nurses to "Use your eyes, use your ears, obey instructions - don't let the patient die". He also had a shorter version of this which went :"Use common sense - don't let the patient die." The probationers started at the top, of the new nurses' resi­ dence that is, and worked down. They supplied their own uniforms and books and got eight dollars a month for the first year with annual increases of two dollars. Graduates got forty. Students were allowed off one afternoon a week, starting at two p.m., after they'd already worked seven hours. The doors of the residence were locked at ten and lights were turned out at 10:30. The standards were so high that only three of the first thirteen candidates went on to graduation. They were Lucy Hatch, Lillian Donaldson and Elizabeth Patteson, who, as Mrs. Arnold Tayler, was named Edmonton's Citizen of the Year in 1945 for her work with hospitalized soldiers and the blind. Even the director of nursing, the dedicated Miss Forgie, cracked under the strain of the regime and the graduation of the first class had to be post­ poned until her health improved. 60 The lectures were given at 7:30 in the evenings by the staff doctors. The students were closely watched and even the most careful were often in the matron's office being reprimanded for lapses in dress, decorum or care of the patients. There was a strong military influence in the training, because of the connection Dr. Mewbum and other staff doctors had with the militia, and the process of losing one's cap for a serious offense had the atmosphere of a court martial. As a result, the dropout rate of the second class was little better than the first, with only three of the original eleven going all the way through. And the North West Mounted Police provided an unusual hazard. The Mounties were then encamped on the court house square and when a scarlet-coated guardian of the plains needed the at­ tention of a hospital, it was said by officials of the force, and of the hospital, that he got more attention than professionally necessary. The girls reacted to the Mounties as Rose Marie reacted to Nelson Eddy. Lillian Donaldson had a sister living in town, the path to whose house ran past the police stables. So many girls took that path on the pretense of going to visit Lillian's sister that the commissioner finally complained to Miss Forgie that they were distracting his men from such duties as maintaining the right. An investigation followed. Students who had visited the stables were confined to the grounds for a month and had their training extended two weeks. A prohibition on Mounted Policemen as escorts was added to the other rules guiding the lives of the students of Galt Hospital. But the students survived. So did the school. So did the name of the school, many years later in 1955 when the Galt Hospital, a city institution, was converted to a municipal hospital serving the district. The name was changed to Lethbridge Municipal Hos­ pital, but the school was allowed to retain its name of Galt School of Nursing because of an endowment from the Galt family which would have been lost if the name had disappeared. Income from the endowment continues to provide bursaries for Galt graduates.

In 1912, a training program ,started at the Lamont Public Hospital and the course of instruction came from Chautauqua, the foundation which sent lecturers touring around North America in circus tents. 61 It seems surprising at first; less surprising when you consider that the Lamont hospital was a mission sponsored by the Home Missions Board of the Methodist church, and that Chautauqua began its career giving advanced training to Sunday school teachers, and then expanded into other fields. Courses such as the one on nursing were prepared by Syracuse University and were on a good level for the time. The third girl to enter the Lamont program, and the first to graduate, was Anna Purschke, (Mrs. W. E. Blewett of Cal­ gary). Anna was recruited in person by Dr. Alfred Archer, the founder of the hospital which is now his memorial. Dr. Archer knew Anna's mother because she was a sought­ after practical nurse. As in most pioneer communities, a woman with a great number of children was thought to be a likely source of good advice on medical problems and Mrs. Purschke had nine. Dr. Archer suggested that Anna might do well in a nursing career and that was the start of it. She entered in 1912, and found that the mission board had added some rules for nurses which the Chautauqua people hadn't thought of. Dancing was prohibited. Mrs. Blewett said: "The girls weren't allowed to dance, even off duty. But the way we had to work we couldn't have stood up under much night life. We didn't feel much like breaking the rules." The superintendent of nursing was Sarah C. Slaughter, who brought to the raw community hospital her experience as a mis­ sionary in China, and the traditions of the Massachusetts General Hospital in Boston. Massachusetts General was one of the three American hospitals which founded nursing education in the United States in 1873, the others being the New York Bellevue and the New Haven General. Miss Slaughter died in the Lamont hospital in 1917. A former student wrote of her: "She gave us our training on a very high standard. Working under the handicaps of those growing years she never faltered. We would always depend on her to stand by us at all times. She was one of those women one wanted to work for, always true to her students but very firm." The student who wrote that about Sarah Slaughter was de­ scribing thousands of senior matrons from the period 1873 to the second world war. In the pattern of the time, student nurses did the work of 62 running the hospital, working under the direction of "senior" stu­ dents who might be only a few months senior. As late as 1921 the staff consisted of three doctors, three graduate nurses and eighteen students. Since the hospital had a medical missionary role in the com­ munity the students had to do outside work too. An early graduate wrote: "We trainees took turns going out into the country to help the doctors with maternity cases. It was not unusual to go into a home to find mother, father and several children in one or two rooms and have to dig for mother under a feather quilt. "The quilt would be all we would have to drape the mother with. Often we found only a thin pie plate or a granite cup to boil anything that needed boiling. We could come back after a night out on a maternity case and prepare the O.R. for surgery. It was mostly the O.R. trainees who went along and the doctor really appreciated this help."

Forty miles down the railroad line, Alberta's second rural nursing school opened in 1915. This was at the Vegreville Gen­ eral, now St. Joseph's, a hospital built in 1911 by an order of nuns who brought direct to Alberta the nursing traditions of France. The Sisters of Charity of Evron were founded by Madame Thulard, 1654-1735, with a double mission: the care and instruc­ tion of children and the care of the sick. Reorganized in Evron in 1803, after the anti-clerical excesses of the French Revolution, the order survived the anti-clerical forces of the early twentieth century and was able to despatch a missionary party to Vegreville in 1910. In 1915 the order sent Sister Josephine Boisseau, a graduate of their hospital at Le Mans, to start a nursing school at Vegre­ ville. The remarkable Sister Josephine was to head the school for a quarter of a century, and graduate seventy students, including the two originals. Seniors today compete for the Sister Josephine award, given in honor of a quick little nun, a nurse and teacher who was quick to move, and quick to notice every changing detail. Early days at the Vegreville school were described by Anna Landry (Mrs. W. C. Barrie of Edmonton), who entered in 1919 as one-half of a class of two. Her younger sister, Albertine, en­ tered later, joined the Sisters of Charity and in 1965 became superior of the institution. 63 When Anna entered training the forty-five bed hospital was run by nine students and about the same number of nuns. There was no running water. The kitchen was in the basement and the students had to carry boiled water from the kitchen to the second or third floors. It was considered a blessed relief when a coal-oil stove, something like a Coleman campstove of today, was installed on the third level for boiling purposes. One spring, Sister Josephine and some of the students, including Anna, came down with typhoid. It was traced to pollution in the hospital's well, behind the building, and then water had to be hauled three blocks from the convent. The students worked the usual seven-to-seven shifts, plus calls whenever needed, and they took lectures in the evenings, from the doctors or from Sister Josephine, who translated from her old French textbooks as she read. There was not yet an affiliation with larger city hospitals but the students did spend three weeks in their senior year at the Edmonton General. "We looked on and saw how they did things," Mrs. Barrie recalled.

Only one of the schools started in such haste in the booming first years of the new century failed to survive. It was the one at Banff, at the Brett Sanatorium. The exact starting date could not be determined but it was shortly after 1909, when the new sana­ torium was built. By 1900 the picturesque blend of hospital, hotel, pool room and barber shop which had served the railroad builders so well, had become passe, and Dr. Brett had built a hotel-hospital to accommodate a hundred guests who came to enjoy the healthful effects of hot sulphur water piped six hundred feet down Sulphur Mountain. The waters were recommended for treatment of arthritis and rheumatism. Dr. Brett brought in Nurse MacLachlan from the Winnipeg General to head a modest nursing service. By 1909 more hospital service was needed for the growing town of Banff. Dr. Brett then built what was known as the "new" sanatorium, and Nurse MacLachlan set up a small nursing school to staff it. The three-year course was based on the Winnipeg General system. Nursing lectures were given by Miss MacLachlan and three other graduates, Nurses Kelly, Miller and Day. Dr. Brett's son, Dr. Harry Brett, gave the medical lectures and after the 64 father's appointment as lieutenant-governor in 1915, the running of the hospital fell more and more to the son. Student nurses were well-paid by the standards of the time, going from ten dollars a month in the first year to twenty in the third. The New Brett graduated two small classes but the girls were recognized as graduates only in their own hospital. When the Alberta Association of Registered Nurses was formed, and brought the University of Alberta into nursing education, arrangements were made for New Brett students to spend their third year at the University Hospital. However, the death of Dr. Harry Brett in 1922 ended the brief existence of the New Brett school of nursing. It was the only school, founded in the splendidly hectic time from 1905 to 1915, which failed to endure. If you consider the University program a continuation of the Strathcona Municipal, and if you don't count the New Brett, or the later short-lived programs at High River and Carnrose, you can say that eight schools founded from 1905 to 1915, plus two from the nineties, were enough to serve Alberta for thirty-eight years - until Lethbridge St. Michael's opened in 1953. Founded in haste along with everything else, they were never­ theless founded to endure. They were founded mainly to provide their hospitals with cheap staffs. But they were going and they were growing. They were rigid enough to absorb the shocks of the depression which was to be chronic in Alberta for the next quarter century. They were flexible enough to absorb the new ideas that would flood the nursing world. They were good enough to begin developing leaders for the profession in Alberta.

65 CHAPTER NINE There's danger in writing a book about nurses: a danger of getting sidetracked and having the book become a history of hospitals, or of doctors, or government-organized health schemes, or the town of Strawberry Creek. The danger comes from the nature of nursing and the unique position of the nurse. Nursing would not exist by itself; it's a re­ sponse to human need and the need is strongly influenced by the conditions in which people live. And then, in responding to the need, the nurse is responsible for the success or failure of plans devised by somebody else. If the actions of the nurse are to be understood, the writer must set out the conditions in which she worked and the needs to which she responded. In doing this he's in danger of having his piece become a history of a hospital, a doctor, a health scheme or a town. Nursing is a part of many human activities. The writer must keep attention focussed on the element of nursing. This particular chapter, for example, might appear to be about hospitals, since it deals with institutions of that name which appeared in Alberta from the turn of the century through the first great war. However, it's really about nursing because it was nursing which made them hospitals. Nursing was really the only service which most of them offered. Few of the buildings had anything about their appearance or design to suggest what they were supposed to be. It was the presence of the nurse, with her knowledge, skill and dedication, that made them hospitals. This chapter relates the efforts to provide shelters where nurses could work: the efforts of communities, missionary societies, doctors, and nurses themselves, either individual lay nurses or parties of nurses in religious orders. 66 The first two hospitals built in the new century nere memorials; memorials to local men killed in the war in South Africa, a war in which eight Canadian nurses served with the status of officers, a great step-up in class. The hospitals were at Pincher Creek and Red Deer. From the volunteers who joined the Canadian Mounted Rifles at Pincher Creek, three men failed to return: Corporal James Frederick Morden, Trooper Robert John Kerr and Trooper Ovide Smith. In the community they left behind it was decided that the best memorial to these men would be a hospital. It was finished in 1903, two storeys of wooden frame con­ struction as bare and unadorned as the foothills in which it was set. Even before it was finished the first patient had to be treated there; a teamster with pneumonia. No trained nurse was yet avail­ able so women of Pincher Creek volunteered to work as ward aides and housekeepers until the poor fellow recovered. Which he did. Although the photograph hardly suggests that it was big enough, oldtimers insist that the Pincher Creek Memorial Hospital had eight single rooms, a ward, an operating room, a sterilizing romr and a linen cupboard upstairs; and downstairs had six single rooms and space for two more. A larger operating room was added to the north side of the building later but was seldom used because it was too difficult to heat. When the hospital opened officially it was staffed by a matron, two nurses and a cook by day, and a nurse or ward aide by night. The wages were thirty to fifty dollars a month, depending on the money available. In Red Deer, Lord Strathcona gave a thousand dollars to start construction of a cottage hospital in memory of three local boys killed in South Africa while serving with Lord Strathcona's Horse, a cavalry unit he financed personally. The dedication stone, in a comer of the 152-bed Red Deer General of today, carries the names of Charles Cruikshanks, Angus Jenkins and Archie Mc­ Nichol. And this was not Lord Strathcona's only philanthropy in the hospital line. He endowed the Royal Victoria in Montreal. Donations for the thirteen-bed Red Deer Memorial reached $5,365. It was in use in 1903 and was opened officially in April, 1904, as a Lady Minto cottage, the successor of Lady Aberdeen having taken over that energetic lady's interest in frontier nursing. 67 The opening also marked the permanent entry of the Vic­ torian Order of Nurses into Alberta. This was the first of a num­ ber of hospitals the V.O.N. would help to operate in Alberta, bridging the gap until the communities were well - enough or­ ganized to take over. The V.O.N. managed hospitals in High River, starting in 1909; at Islay, of which we'll hear more later, in 1912; in Edson in 1914 and Athabasca in 1917. V.O.N. nurses also participated in hospital projects at Entwistle and Sedgewick which their his­ torian described as having enjoyed "an ephemeral existence". While the order was involved in hospitals due to public de­ mand, its nurses maintained the order's principal work of home­ visiting. V.O.N. centers were started in Edmonton in 1907 and Calgary in 1909, although the nurses' association in Calgary ob­ jected on grounds that the center would take away some of their livelihood. However, there was little overlap of V.O.N. work into the field of the private duty nurse. The private duty nurse spent days or weeks on one case; the V.O.N. nurse might attend several cases in a day, giving treatments or advice. The V.O.N. nurse was always on the move; on one occasion in Edmonton in 1913 she was moving while on the job: She attended a maternity case in a shack that was being hauled to a new location at the time of the blessed event. In addition to this fascinating nugget of history, the Edmonton report for 1913 draws attention to one of the prime problems of nursing in that time, the language problem. The report stresses that much of the Edmonton work was done in the "foreign district". It includes the Irish in the list of foreign races, a side-point too quaint to be disputed. The main point was too true to be disputed. A nurse working in Alberta might at any time find herself trying to communicate medical and nursing information to people who could not understand her language. The language barrier to communication could be difficult for the nurse and dangerous for the patient. In fact, Mabel Den­ hardt, when in Strathcona Municipal in 1907, witnessed a case that was fatal to the patient. The man was in with typhoid. Neither he nor any of his family could understand English. The nursing staff was not able to com­ municate to him or to his family the nature of his illness nor the 68 purpose of the treatment. Both he and his family became convinced that the nurses were trying to starve him to death. When he had survived the worst of the typhoid and was beginning to recover, his wife brought him a hamper of highly-seasoned ethnic food. He ate heartily, relapsed and died.

Lay nurses were coming more and more into the picture in this period but nurses in religious orders were still renewing the traditions of the Grey Nuns of 1859. The first nursing order to enter Alberta in the new century came with the Ukrainian settlers who opened the Willingdon-Mundare area. They were the Sister Servants of Mary Immaculate, a new Catholic order of the Eastern rite, founded in the Ukraine in 1892 by Sister J osaphat Hardeshewska. The aims of these sisters were strikingly similar to the Grey Nuns of 1859: "To sanctify souls through conducting hospitals, schools, homes for the aged and homes for children." A party of four arrived in Edmonton in November, 1902, and Father Lacombe, just the man you'd expect, had made ar­ rangements for them to stay with the Grey Nuns at the General Hospital while they took a course in English and learned about the needs of the new country. Sister Thias died during the winter and in July, 1903, the three survivors set out for their mission at Beaver Lake, now called Mundare. In their chronicle they re­ corded that the trip through swamp, bog and bush took two whole days and a night. Sisters Isidore and Emelia were teachers and social workers but Sister Ambrose (Lenkevich) was a qualified nurse from a hospital at Lviw in the Ukraine. Sister Ambrose had an impressive knowledge of herbs and the medications she prepared were re­ assuring to ailing settlers who found comfort in familiar things. Before long, doctors from Edmonton, Vegreville and Lamont were giving her common drugs which she would administer when a doctor couldn't make the trip. The Sisters taught a school in their mission house until 1911, and they all nursed when needed, giving poultices, massages, plasters, hot and cold compresses and other supportive nursing of the time. They usually did their nursing in district homes but often brought patients into the mission. Their work led inevitably to the general hospitals at Mundare and Willingdon. 69 In 1907, a Canadian nursing order, the Sisters of Providence, sent three nuns to Daysland to start the first of seven hospitals the order would eventually have in Alberta. They came to Daysland at the invitation of E. W. Day, and this gentleman was clearly within his rights to extend the invitation because the town was named for him. The Daysland nuns were from the English-speaking wing of a bi-cultural nursing order. They were the Kingston branch, begun in Kingston in 1861 as a counterpart of the Sisters of Providence of Montreal. The founder of the order, Mother Gamelin, had something in common with the founders of other nursing orders working in Alberta. Like Mother D'Youville of the Grey Nuns, and Mother Elizabeth Seton of the Sisters of Charity of St. Vincent de Paul, and Madame Thulard of the Sisters of Charity of Evron, and Mother de la Nativite of the Sisters of Misericorde, Mother Gamelin was a widow. Both Mother Gamelin and Mother de la Nativite (Madame Marie Rosalie Cadron Jette), were citizens of Montreal, both were widowed early and both founded their orders on the encouragement of Bishop Bourget. Madame Jette was a few years the senior, born in 1794. As the widow Jette she began helping unmarried mothers and their children. In 1848 she consecrated this work through the formation of the Sisters of Misericorde, who operate the Misericordia in Edmonton. Madame Gamelin was born in 1800. In childhood she showed an extraordinary concern for the poor, and when her parents, her young husband and three young children died in quick succession, leaving her alone at twenty-eight, she turned her charity on widows who were aged and sick. Her concern quickly branched out to cover all the unwell, and to nursing as a practical solution to the problems. She helped nurse the political prisoners of the rebellions of 1837 and '38. The bishop of Montreal finally had to build an asylum to house the objects of all her charities and in 1843 he helped her found the Sisters of Providence of Montreal. Mother Gamelin died in 1851 nursing in a cholera epidemic, but fifty-six years later three members of her order brought the influence of her work to Alberta. The three nuns who came to Daysland were all graduate nurses: Sister Mary Angel Guardian, Sister Mary Camillus and Sister Mary Austin. It was almost two 70 years before their twenty-bed Providence Hospital was ready, and in the meantime they nursed in the district homes. The rule of the order emphasizes charity toward one's neigh­ bor - through care of the poor, the sick and the infirm - and the word "neighbor" has seldom had such full and rich meaning as it had in this early time in Alberta. In 1910, the Montreal branch entered Alberta, sending a party of nuns to Fort Vermilion, up on the Peace River, to care for the aged and mentally-infirm Indians who camped around the Oblate mission and often spent the winter there. There were no graduate nurses in this party and it would be another fifteen years before one was sent, but a one-room log nursing station was built on to the convent and this was the beginning of St. Theresa's Hospital. In 1913 the Sisters of Providence sent a party of nuns to Athabasca to operate a new hospital there. It was a two-storey frame building, put up by volunteer labor and must have been an impressive structure for its time, with room for perhaps twenty­ five beds. This project ended in disaster after four years. Early in January, 1917, an irrational patient upset a coal oil lamp, starting a fire that destroyed the hospital and took five lives.

In 1909, another nursing order founded by a widow made its appearance in Alberta. The Sisters of Charity of Evron were a French order. They came first to Trochu, the only town of its kind in Alberta, a town founded by French army officers who had left France in the religious persecution that marked the early years of the century. Eight of the Evron sisters came to Trochu, to carry on the traditions of their founder, Madame Thulard, who was left a widow in 1678 at the age of twenty-four. Madame Thulard turned to charity in her own parish in Paris, and gathered a congregation of women with two chief aims: education of children and care of the sick. She died in 1735. One hundred and seventy-four years later, nuns of her congregation would begin the care of the sick in Al­ berta. (Another year later they would start St. Joseph's General Hospital in Vegreville.) In Trochu they began their work in an old stopping house, 71 doubtless left well-equipped with bugs by some of the previous tenants-travellers who had stopped overnight on prairie journeys. There was a sort of tunnel joining this hospital to the old granary which was the convent. The sisters would have preferred to get things better organized before starting the work but they were confronted immediately by a series of accident cases which they handled well, and then an epidemic of the ever-present typhoid, in which their skill kept the death rate low. Madame Thulard would have been pleased.

1911 brought still another order of French nursing sisters to Alberta. The Daughters of Wisdom came to Castor to establish Our Lady of the Rosary Hospital; in spite of the fact that their founder was not a widow. The first member of their congregation was Marie-Louise Trichet, the first to join the order when it was formed in 1703 by St. Louis de Montfort. It was formed expressly to improve conditions at the hospital of Poitiers and became a nursing order. Two centuries later its influence extended into Al­ berta with the four Daughters of Wisdom who came to Castor. There were two nurses and two teachers in that party. Before they came, the only form of hospital care available in the district was to surgery patients who were taken briefly into the home of the local doctor and were treated by nurses engaged by him. The Daughters of Wisdom opened a ten-bed hospital which has since grown to twenty-eight beds and eight bassinets.

While many communities got nursing service from Catholic sisterhoods, others got it through Protestant missionary societies. The Anglican, Methodist and Presbyterian churches were all active, with seven nursing and/ or hospital projects in this period. A gift from the Archbishop of Canterbury made possible St. Barnabas' Cottage Hospital at Onoway, which was opened in 1913. The Anglican missionary society also sent the first two matrons, Miss Dalton and Miss Storrar, graduates of University College Hospital, London. The official opening, on behalf of the societv. was performed August seventeenth, 1913, by Mary Pink­ ham of Calgary, daughter of Bishop Pinkham, and the society showed a fine sense of history in choosing Miss Pinkham because her mother had been involved in the start of the Calgary General. When the dying Chinese laborer, Jimmy Smith, left his hundred 72 The Strathcona Municipal Hospital about 1907 with three student nurses on the balcony. Sigrid Hoyme is on the railing with Mrs. Collinson and Miss Foulls. The gentleman striking the Napoleonic pose is the photographer's brother An operation at the Lamont Public Hospital in 1914 Mrs. Archer, in a street dress and without a mask, gives an anaesthetic for Miss Slaughter, Dr. Archer and Dr. Rush. At the right, Lamont's first graduate, Anna Purschke, looks dubious The Pincher Creek Memorial Hospital early in the century Nurse Blodwen Hughes, a graduate of 1911, in the men's ward of the Edmonton Public Hospital, later the Royal Alex When caps had ceremonial significance - the staff of Calgary General in 1905. Miss Egerton, the matron in black, wears a cap from a Nightingale school. That's a Montreal General cap on the left. A cap like a mushroom cloud indicates a girl is a student nurse Listening to speeches at the opening of the Katherine Prittie Hospital in Grande Prairie, June 16, 1914 Mr. and Mrs. Forbes The hospital at Islay as it appeared in 1961 The successful schemers, in a picture taken in New Hampshire in 1955. Mrs. Lively is the lady on the left. Her sister Ada Teetgen, "Green Veil", is next to her. Mr. Lively is on the right Sister Ste. Christine of the Misericordia Sister Casey of Edmonton General dollars to found a hospital the money had been given to Mrs. Pinkham for safekeeping, and she had then called the first public meeting to promote Jimmy's dying wish. The Onoway Cottage Hospital was well-equipped, with a lighting plant and a hot-water heating system. It provided the first job for Kate Shaw Brighty (Mrs. Harry Colley) when this noted nursing leader, one of the first home-grown leaders produced by the Alberta system, graduated from ,the Royal Alex in 1917. The cottage hospital at Onoway was a frontier mission, de­ signed to serve a community without a doctor. The frontier receded slowly. Forty-one years after, when the oil-drillers came whooping into Drayton Valley, they would find there an Anglican nursing station serving the remote district with missionary nurses.

The Methodist Church, through its board of home missions, contributed health projects at Morley, Pakan and Lamont. The work in Alberta was part of the church's world-wide system of medical missions, and was a fit continuation of the work of the Reverend George McDougall, who, in the smallpox epidemic of 1869-70 had seen correctly that the only form of isolation that could stop the disease was isolation of the healthy, not the patients. The missions' report of 1906 states that a missionary nurse was stationed at the McDonald Orphanage at Morley. The report, unfortunately, does not give her name, but it says Miss Buehler, the deaconess, who was also stationed at Morley, used to travel to eighty-four homes scattered through the foothills district. So we may assume that The Unknown Nurse was called to these homes when needed, worked with the Indian children in the orphanage and among the Indians on the nearby reservation. In 1901, Dr. C. H. Lawford, a medical doctor and ordained minister, was appointed "missionary to the Galicians", with head­ quarters at Pakan, the old Fort Victoria mission established by George McDougall, and scene of much tragedy at the time of the smallpox. Dr. Lawford started taking patients into his home, and in 1904 the home missions board built a two - story frame hos­ pital, staffed by missionary nurses and named for the Reverend McDougall. The McDougall Memorial Hospital served Pakan for eighteen 73 years, until it was moved fifteen miles north, to the center of population at Smoky Lake. In 1901, the year Dr. Lawford was sent to Pakan, Dr. Harry Smith went to Star, a hamlet north of Lamont. This was the start of the Lamont Public Hospital (now the Archer Memorial), the biggest medical project of the Methodist church in Alberta. When Dr. Smith, a member of the Student Volunteer Movement, died in 1903, the church sent Dr. Alfred Archer to replace him. And Dr. Archer brought a nurse to assist him in his long career of medical-missionary work. She was his wife, the former Jessie Valens. They had met at City Hospital in Hamilton where he was an interne and she was a student nurse. For many years she would be an integral part of the missionary medical team. She gave the anaesthetics for her husband's operations. Mrs. Archer was present through many operations, including some favorite ones the doctor liked to recall in later years to show what it was like trying to sell the latest developments in health to a community of newcomers, newly-arrived from rustic environ­ ments in eastern Europe. She gave the anaesthetic for the man who had the abscess at the base of his skull, and she had a large audience because the man and his many relatives agreed to the operation only on con­ dition that all the relatives could come and watch. Patient and family were not in favor of the surgery because they thought the doctor was going to operate on the man's brains. There was intense silence as Dr. Archer opened the abscess and began deftly to remove the infected matter. Then the Archers nearly lost their professional composure as a large lady relative sighed: "Poor fellow. He never had much brains to start with." Mrs. Archer was a missionary spirit who intended fully to carry on nursing with her husband when she married. But other nurses who thought they were retiring from nursing when they married and went to live in country points in Alberta, would soon be discovering that marriage was no escape. Travelling as fast as they could, and as an aid to travel the doctor bought the first automobile in the Lamont district, the Archers weren't able to get to everyone who needed them. In 1911 Dr. Archer organized a project to provide a central gathering point so that patients could come to THEM. He organized a local committee to build a hospital and then, with his Methodist church 74 connections, enlisted financial support from the home missions board. The community raised $13,500 for the fifteen-bed Lamont Public Hospital. The board contributed $2,500 for the construc­ tion and undertook to finance the operation with grants such as an annual grant towards the salary of the head nurse. The first head nurse was Miss V. Shuttleworth, a former missionary from Japan, who was at Lamont for the opening in 1912 and gave the hospital from opening day, its unique international character. Within ten years, the Methodist home missions board raised the capacity to fifty-five beds, and supported the hospital until church union in 1925 when the project was taken over, and con­ tinued in the same spirit, by the United Church of Canada.

The Presbyterian church was also active in the medical mission field and its activities in this line are of special interest because they began as a response to the Yukon gold rush. The church's first western medical mission was established at Atlin, B.C., in 1899, when two nurses agreed to go there for two years at the going missionary rate of twenty-five dollars a month. They were Elizabeth Mitchell and Helen Bone. Miss Mitchell wrote of the "hospital" that was waiting for them: "It had a roof of mud (a roof, mind you), a floor of sawdust and only two small panes of glass for a window. It held four cots, made of canvas, stretched between poles and driven into the ground, with two grey blankets and a pillow made of the packing that came in our cots from Vancouver." From this beginning the Presbyterian church moved into medical missionary work in Alberta, with projects at Vegreville, Grande Prairie and Bonnyville. Vegreville was first in 1906, with Grande Prairie starting in 1910 and Bonnyville in 191 7. In Vegreville, the Rolland M. Boswell Hospital was opened with a four-thousand-dollar gift from Mrs. Boswell of Elora, Ontario, a memorial for her husband. The missionary society sent a qualified missionary doctor, Reverend A. Paterson, M.D. It also sent a recently-graduated nurse, Alberta Playfair. Descriptions of the hospital vary. The society's annual reports call it "a nice new building with comfortable beds". How­ ever, a nurse who prefers not to be identified, spent a week there in 1913, and, fresh from eastern Canada, found the place 75 so crude and so open to the weather and so lacking in all the neces­ sary equipment, she could bear to stay only a week. However, it gave a needed service, and the annual report of the Presbyterian church women's missionary society for 1914-15 gives some revealing figures on the operation. The staff treated 45 charity patients in the hospital and another 28 in the office or in their homes; of paying patients there were 110 treated in the hospital and 24 in the office or at home. Of the 155 patients of both types admitted to the hospital, 74 were described as "foreigners", indicating the chronic problem in communication. The income of the hospital totalled $10,044.66; of which the society gave $4,111.56, including $100.00 listed as "arrears of salary". The provincial government granted $5,932.10; the dominion gave $915.25, and the matron, Miss Clinkscale, a graduate nurse, figured the value of produce donated at $76.00. Estimating the value of produce would complicate Alberta hospital accounts for decades. The Rolland M. Boswell would give good service to the Vegreville district through these decades, right up to 1938.

At Grande Prairie, in 1910, the Presbyterian church operated one of the most appealing of all the missionary projects in Alberta, a project that started with the Reverend Alexander Forbes and his wife, the former Agnes Sorrel. Although as a writer, we would like to question that "one picture is always worth ten thousand words", a glance at the pictures of the Forbes' will illustrate at a glance what sort of project it must have been, warm and humanitarian. Mrs. Forbes was not a trained nurse but she had studied the problems, and as her picture will attest, was willing to tackle any problem in the name of charity. This included assisting the nurse that the Forbes' had asked the women's missionary society to send to the straggling and struggling Peace River country. The nurse was the remarkable Agnes Baird, who arrived in October of 1910, recruited by the women's home mission society of the Presbyterian church. Her salary was forty dollars a month. On such a salary she could hardly afford to hire anyone to break a horse for her so she broke her own. She chose him from a herd kept bv the Revillon Freres, the fur traders, and Miss Baird named him Candy. Candy was so wild it took two hours just to 76 catch up to him, and Miss Baird was the only human who could ever ride him. For five years Miss Baird travelled around the Peace River country on Candy, meeting settlers as they came in, and nursing them in their rough homes. She rode hundreds of miles, helping anyone who needed her. We choose with some care the word "needed" because her most difficult session was with a disagreeable old cuss who didn't want her but needed her just the same. He was a bachelor, living forty-five miles from Grande Prairie. At the insistence of his neighbors, Miss Baird rode out and found him in great need and suffering from a disease in an advanced stage. She made a long trip back to town to arrange for supplies, then stayed with him for several weeks until returning health gave him strength to be more disagreeable than ever. On her return to the Forbes', Miss Baird remarked: "I've just saved one of hell's angels." Agnes Baird was of the finest type of missionary nurse sent out by the missionary societies. Some were deaconesses in the church, renewing an ancient tradition, and giving their whole lives to the religious work as laywomen. Others gave part of their careers to missionary work. Wherever possible, a missionary society would send a deaconess, if not possible it would be a dedicated nurse with missionary spirit. Sometimes Miss Baird brought patients to the hospital operated by the Forbes' at their mission. It was at Flying Shot Lake, five miles from present-day Grande Prairie, and grew out of the Forbes' first home, which was a "caboose'', a sort of van. While the term "caboose" usually signifies the end of something, this one signified the start of the present Grande Prairie Municipal Hospital. The caboose was the first hospital. To it the Forbes' added a log building twelve by twenty-four. Then Miss Baird added a tent kitchen to save steps, but the kitchen was soon made into an isolation tent for a girl with TB. This interesting grouping was replaced in 1914 by a new hospital in the town, which Miss Baird and the Forbes' worked to bring about through their missionary connections. The biggest donation was five thousand dollars from a Toronto couple, Mr. and Mrs. R. W. Prittie, in memory of their daughter. And because 77 of this, the new place was called the Katherine Prittie Memorial Hospital. Although of necessity built of logs, cut and moved to the site by volunteer labor, it was on a solid masonry foundation to keep the logs from separating and letting in bugs in summer and cold drafts in winter. The local women's missionary society pledged four hundred dollars for two furnaces for the fifteen bed hospital, a very good effort for its time and place. With the opening of this hospital Miss Baird had been in the district for four years. The railroad was approaching. It was time for a re.<>t and a change, but she agreed to stay as matron of the new hospital until a replacement could be found. The replacement, who arrived in September of 1914, was one of the outstanding Alberta nurses, who made two tours of mission­ ary nursing duty in northern Alberta. She was Miss Olive (Dolly) Ross, the first Edmonton-born girl to train as a nurse, a graduate of the Royal Victoria, in Montreal. Nursing was a second career for this pioneering daughter of Edmonton's pioneer hotel man, Donald Ross, who had walked over the mountains to Edmonton in 1876. For six years she had been a legal stenographer, but, as she said: "There were always complaints. The office was always full of people with a grievance against somebody. So I decided if I couldn't please the well people, I'd be a nurse and try to help the sick people." On graduating from the Royal Victoria she went to Van­ couver for five years but was glad of the opportunity to go to Grande Prairie because she was tired of pavement and telephones. To get there from Edmonton she and a companion spent nine days on the Edson Trail, leaving the train at Edson and spending nine days on the up-and-down track through the wilderness to Grande Prairie. On the way, Miss Ross met so few people and heard so little mention of Grande Prairie, that she began to wonder if there was such a place. But it was there all right, and so was the hospital, although there weren't so many people around it as there had been on June sixteenth. That was the day of the official opening, and a memor­ able day it had been. There was a big turnout, on a June afternoon that was bright and soft and full of promise. In those years, when people drove 78 miles to attend a gathering they expected to hear speeches, and there were plenty. Mr. Forbes pointed out that since the beginning of the ministry in Grande Prairie, fourteen hundred patients had received help. Then a speaker for the community went at it. And when he came eventually to his closing remarks he put them in the form of a motion. It was a motion which expressed what all missionary societies were doing for all the western communities in which they operated. The speaker addressed his motion of thanks "to the Women's Missionary Society of the Presbyterian Church in Canada, Toronto, Ontario". As the crowd listened with attention he said: "We, the citizens of Grande Prairie, desire to place on record our high appreciation of the splendid work that has been done at your instigation among the sick in isolated parts of western Canada. Through your agents, timely help and nourishment have been brought to many a new and discouraged settler." The speaker warmed to his work: "The hospitals that have been erected through your efforts have been a widespread blessing in their communities and a large asset to the commercial value of property for miles around. (You couldn't leave out the booster spirit, even at a time like this.) To have a doctor, nurse and hos­ pital within reach of the homestead has given many a weary and timid woman confidence and hope in her struggle to build up a home." Every head nodded assent as the speaker went on: "We in Grande Prairie have been very fortunate in coming within the scope of your consideration. Far removed from railroad facilities as we are, and means of transport difficult, yet in many ways we are as well supplied with medical attention as those much nearer the city life. "At the commencement of immigration over four years ago, your work began. It began in a small way. Since then it has grown and developed and now you have a large, commodious and beauti­ ful building on its own ground-ten acres-which will be of the utmost value to the district and a credit to the whole countryside. "To the Reverend Alexander Forbes, Mrs. Forbes and Miss Baird, who have been your agents in this good work, we owe a special debt of gratitude and we congratulate your organization 79 on having such able and faithful helpers in your work in Grande Prairie." The speaker sat down to unanimous cheers. The speaker was the Reverend F. C. Smith. The Reverend CANON Smith, of the ANGLICAN church.

The Presbyterian church had another project in Alberta at this time, It was at Bonnyville and was mostly a nursing station. It will be described in the next chapter, so here let's see what the government was doing. The government of the new province was not much involved in the affairs of hospitals in these years, although there were operating grants of twenty-five cents a day per patient. However, where government facilities existed, they were at the service of the community; a continuation of the "hospitality" shown by the Mounted Police at their pioneer forts. Ponoka, for example, got a good thing with the opening of the Provincial Mental Hospital in 1911. District doctors could use the medical section for surgery and treatment. There were other ways to get a hospital; that is to say, a nursing station that would be the forerunner of a modem hospital of today. A community that wasn't hospitalized by the governme.Qt or a nursing order or a missionary society, could fend for itself. A number of our hospitals started with a burst of community energy; the seventy-bed Peace River Municipal, for example. It got started on a pool table in 1914. On a day in 1914 public-spirited citizens of the brand new town of Peace River gathered around the pool table to start a collection, a collection with a target of $1,650 to build the Irene Cottage Hospital, "Irene" meaning "Peace" in Cree. "Dad" Pringle opened the session by tossing out a five-dollar bill. Someone followed with a ten. "Well, if you're going to raise my ante," said Dad, "give me back my five. Here's ten." Within minutes there was four hundred dollars on the table with promise of more. The resulting hospital was typical of the time; little more than a shelter to keep the nurse from being blown away or freezing while performing her mission of mercy. The entire community contributed to the project. So did the first nurse, Jean McEwan. Miss McEwan donated her first two months' salary, and she was 80 only getting one salary although doing three jobs: nurse, cook and laundress. The town of Lloyd.minster was only two years old, in October 1905, when the women of the community formed a hospital auxiliary to work for a general hospital. The auxiliary helped with a log-cabin nursing home run by two private nurses: Nurse Drew and Nurse Rowe. Eventually the municipal council set up a hospital board. In 1914 the board bought the farm home of T. J. Lyle, hauled it into town and converted it to a twelve-bed hospital, the forerunner of today's ninety-two beds with-all-the-trimmings. Hospital service at Lacombe was likewise the result of a burst of civic energy. The first service was provided starting in 1907, by Mrs. Trotter, who came from High River and opened a nursing home for maternity cases. Her home also had a tele­ phone, to which calls came for medical help and advice. The telephone line was extended thirty miles west to Bentley that year, and old-timers of Bentley still recall the feeling of comfort and reassurance from the primitive phone, on which district mothers could call to Lacombe for a doctor or advice. Old-timers at Rimbey, farther on, recall the thrill too. They then could get to the same comforting phone after a ride of only fourteen miles on horseback. In 1910 Mrs. Burris of Lacombe sparked a drive to raise $1,000 to buy a private home (now a boarding house known as the Devon Lodge), and make a hospital. A board was formed. The campaign resulted in a fifteen-bed hospital which served until the present one opened twenty-seven years later. There was always a trained nurse as matron, plus a staff of two girls who learned what they knew about nursing on the job, a cook, and a maid. There was no running water but there was electric light, which helped and was also safer. Miss Ballard was the first matron, followed by Miss Jean Pye from 1910 to 1915, and Nancy Hamilton Creighton until 1921. The hospital was built to last and to grow, and has been in continuous existence to the golden jubilee year of the AARN, in which the matron had a staff of twenty graduate nurses, twelve ward aides, two X-ray technicians, eight cleaners, four laundry workers, two cooks, a janitor, an engineer, five doctors, two visiting radiologists, two office workers, a record keeper, a house­ keeper, and an associate public health doctor. 81 In Camrose, too, hospital service began with a burst of civic pride. On June third, 1909, a hospital aid was formed to raise funds, and raise interest among the public. The response was so great that only weeks later, on August nineteenth, a hospital board was formed. The board rented a private home for interim service, plans were drawn during the winter and contracts awarded in May. The hospital was only nine weeks in construction, and opened August eleventh, 1910. Then the fun began. Within a year there was only one registered nurse on the staff, Miss Sutcliffe, the first matron. The rest were practical nurses. A year later these nurses were talking of going on strike because of the long work and short pay. By 1913 the government was being asked to increase the twenty-five cent per patient grant, and the patients were required, in theory anyway, to pay one week in advance and settle their accounts in full before leaving. Running a pioneer hospital was no picnic for an administrator. In some communities the citizens never could get their hos­ pital operating. In Edson, for example. In May, 1913, a Mrs. Hastings and her daughter opened a private nursing home, and in February, 1914 a group of citizens incorporated a society known as The Lady Minto Hospital, Alberta, to obtain a V.O.N. hospital. The V.O.N. advanced $3,000. The town donated the site and $2,000, and the hospital was built that summer. However, it was never furnished, and did not operate, although it was opened tem­ porarily by volunteers during the 'flu epidemic of 1918. It was still the nurse that made a place a hospital.

There was another way for a community to have a hospital. Sometimes the local doctor would provide one as an accessory to his practice. This happened at Castor as we've noted. It happened also at Bassano, in 1915. Dr. A. G. Scott, after four years in prac­ tice, decided that if Bassano were to deserve its nickname of "the best little town by a damsite" it would need some sort of hospital. He started one in a house and hired graduate nurses to run it. In Drumheller, Dr. D. Graham, the first physician in the district, provided a hospital in the same manner for treatment of men injured in the coal mines. In Consort, Dr. Mooney built an eight-bed hospital on the main street. This was in 1912. When he died the next year, Dr. 82 A. M. Day took over. In a later decade the Canadian Red Cross would make its entry into the Alberta hospital field in this building. In Olds, Dr. Reg. Stevens and Dr. C. C. Hartman took ad­ vantage of a trip home to England - by Mrs. Stevens - to start hospital service there. There had been a sort of shack, run by a kindly Good Samaritan which had been useful for isolating in­ fectious diseases, but the lady had moved away. In 1962 Dr. Hart­ man told the Olds chapter of the Alberta Association of Registered Nurses how he and Dr. Stevens achie:ved a hospital. Dr. Hartman said: "Dr. Stevens had built the large cement house opposite the telephone office, in which he had his office. When Mrs. Stevens decided to go home to England for a visit in 1912, as soon as her back was turned we converted her nice home into a hospital, with Miss Moore (a graduate nurse) in charge. "We were able to take in a number of sick, and many minor operations, tonsils, etc., and quite a few abdominal cases. Of course we knew what would happen when Mrs. Stevens returned, so by that time we had changed our location to a large frame building which has since burned down." Dr. Hartman continued: "This new place gave us more room and consequently increased the work we could do. But some of the patients were very heavy to carry up and down the narrow, crooked stairs, especially as Dr. Stevens was a very little man, and the same could not be said for some of the patients. "We carried on, as well as carrying up and down, for some time, until the brick Hainstock home became vacant. Then came 1914 and Dr. Stevens went off to war. At this time of stress I certainly needed and got great help and support from the nurses." "Our early hospital may have lacked some facilities," Dr. Hartman said, "but we did have an incubator when needed. A cardboard box with a light hung over the edge of it." Dr. Hartman had a tough time getting rid of this hospital. The community was quite content to let him go on running it and he had to resort to all kinds of persuasion to convince the com­ munity otherwise. Dr. Mary Magill had no such problem at Wetaskiwin. Dr. Magill, a graduate of the Royal Free Hospital in London, England, came to Wetaskiwin in 1906 and operated a cottage hospital as part of her practice. In 1908 a group of citizens in- 83 corporated the Scandinavian Hospital and rented a two-storey home back of the Court House. There was room for four beds, an operating room and a maternity ward, and the names of the staff were in keeping with the name of the founding society. Miss An­ dersen was the matron, Miss Swanson was the nurse and Mrs. Johnson was the cook. By 1912 the hospital had grown too much for a volunteer board to handle and the city of Wetaskiwin - you could get a city charter then with 1,500 people - took over and rented a grey stone house on the Camrose highway, a house that provided two private rooms, and three-bed wards for men, women and maternity cases, plus a large operating room. The matron in 1914-15 was a local girl, Maude Lucas, a recent graduate of Cal­ gary Holy Cross. Maude's parents had settled in 1879 just north of Wetaskiwin, where the Calgary-Edmonton trail crossed Big­ stone Creek. Maude had grown up in a time when Indian women were respected midwives in the Wetaskiwin district. Later, Maude would give a lifetime of nursing service to the Indians. Forty-five miles east of Wetaskiwin, hospital service at Bawlf began with one of the best-known doctors in the history of the province. He was Dr. I. W. T. McEachem, who was later pro­ fessor of surgery at the University of Alberta medical school, and for whom the Alberta division of the Canadian Cancer Society named a research laboratory on the campus. Dr. McEachern organized the hospital in 1906, two years after he came there to practice. The hospital started with two nurses and fifteen patients, doubling in both departments in a year and was the scene of some fine surgery. In 1913 a young girl named Florence Reid made a three-day drive over the frozen November trails from her home at Wainwright for an appendix operation. She enjoyed the English nurses, Miss Pidgeon and Miss Littledale, and the doctor's wife, the former Cora McWhirter, who had been the first probationer and first graduate of the Strathcona Municipal. She helped with the nursing. Fortunately the operation was a success or Florence Reid might not have grown up to be a nurse herself and to be Calgary's citizen of the year in 1953 for her work at the Red Cross Children's Hospital. A little before Florence Reid's stay in the Bawlf hospital, Dr. McEachem recruited for the nursing staff a girl with historic connections. Severine Frette was visiting her sisters, on a ranch at 84 Kingman, when the doctor discovered that she was a graduate of Deaconess Hospital in Chicago. This was a Lutheran institution with a training program for nurses based on the one Florence Nightingale had taken at Kaiserswerth fifty years earlier. Sister Severine was apparently Alberta's first direct link with this historic influence in the history of nursing. The lines of communication with Kaiserswerth are quite plain. In 1848 the Reverend William Passavant, an American Lutheran clergyman who had visited Kaiserswetth and seen the work being done there, started a hospital in Pittsburgh. Pastor Theodore Fleidner, the founder of Kaiserswerth, then brought to Pittsburgh four deaconess sisters trained in nursing to start the Lutheran dea­ coness work in America. Pastor Passavant later founded Deaconess Hospital in Chicago, where Severine Frette came to train for the diaconate in 1903. In the golden anniversary year of the AARN, Sister Severine (now Mrs. Olav Olesberg), was living in the Lutheran Bethany Home in Camrose, and described the program at Deaconess Hos­ pital. It was the program Florence Nightingale had described at Kaiserswerth. The hospital was under a clergyman with a sister superior in charge of the nurses. She would open the day with a Bible service and then send the students to their assignments. All deaconess students took nursing training, no matter what line of church work they were entering. The nursing program was based on the philosophy of diaconics, which emphasized total care of the total person with awareness of emotional, social, spiritual and physical needs. It included training in nursing children and old people, as at Kaiserswerth. The course was flexible, at the discretion of the sister superior. Students were trained for their particular aptitudes so that some spent more time in the operating room, others on general duty, and some like Severine Frette were chosen for outside visiting, going out with graduates to do district nursing in slum areas. At the end of three years, students were consecrated dea­ conesses. They did not take vows, as do nuns in Catholic orders, but made a solemn promise, in the presence of a clergyman and the sister superior, to do the work faithfully as long as they were in it. Sister Severine worked in a parish in Chicago for two years, then for her holidays in 1909 she came up to Kingman to visit 85 her sisters, who had moved from a Norwegian settlement in Iowa to another one in Alberta. It was there that Dr. McEachern spotted her. At the Bawlf, she worked a couple of more year , at twenty­ five dollars a month, and on one occasion worked three consecu­ tive shifts when no relief was available. Nowadays that would mean twenty-four hours' consecutive duty, but then it meant thirty-six. The uniform of the Lutheran dea­ coness was supposed to be unworldly. (Some of Severine's fellow-students were dropped from training because of their interest in worldly pursuits like cards.) But if the uniform was unworldly, it was hardly unattractive, as this picture, taken at Deaconess Hospital, will show. That's what Olav Olesberg thought. However, in marrying Sister Severine, Olav couldn't offer to "take her away from all this". As long as a nurse stayed in pioneer country she couldn't be taken away from nursing. The neighbors would see to that.

There was one other way in which a new community could obtain a hospital; or, just as important, obtain the start of some­ thing that could evolve into one. An individual nurse might start a cottage hospital, which, because of her training, would be a cut above the vague nursing homes which, welcome as they were, came and went and had no roots. There are three fine examples to be cited: in Lethbridge, Vermilion and Islay. St. Michael's in Lethbridge grew from the work of a Dutch nurse, Mrs. Elizabeth Van Haarlem, who came originally to southern Alberta to try homesteading. The farm failed - her husband had been a shoemaker in Holland - and by 1910 the Van Haarlems moved into Lethbridge and Mrs. Van Haarlem resumed her nursing career. She nursed at homes in the city and kept two rooms in her own home for patients. Her home was for maternity cases to begin with, but she was so kind and so capable that patients and doctors sought her out 86 and in a very few years she had a hospital. When she finally had to give it up in 1929, the Van Haarlem hospital had grown to an institution with thirty-five beds, two operating rooms, an X-ray room, a phy iotherapy room and a biology lab. And it had be­ come so important to the community that the Sisters of St. Martha were recruited to come to Lethbridge and keep it going as St. Michael's. Mrs. Van Haarlem was not, technically, a graduate nurse. The course in her native Holland was seven years and she had had to drop out after five. Because of that she could never wear a school cap or the uniform of a graduate, so she wore plain white dresses buttoned to the neck, with two straight lines to the belt and no aprons. But when the Alberta Association of Registered Nurses came into being Mrs. Van Haarlem's service was recog­ nized by her fellow nurses and she was granted registration and the use of the initials R.N. She was called "the Florence Nightingale of southern Al­ berta". Her whole life was the hospital. She was small, fair and stout, with a low soothing voice that seemed out of character with her quick energy and administrative drive, but entirely in keeping with her kindness. She showed her kindness once in the case of a woman who was in hospital for her sixteenth child. The woman had had a hard labor and Mrs. Van Haarlem stayed with her all night. When the maid arrived for work in the morning Mrs. Van Haarlem told her: "Poor woman, it is her sixteenth and she is so tired and worn." The maid observed that after fifteen, the lady should be used to the pain. At this the Dutch nurse came as close as she could to being angry. In her fluent, but accented English, she barked: ''Never, Eleen (Helen) does one get used to dat pain. Never let me hear from you like dat once more!" She was understanding with fathers too, notably with a cer­ tain father of twins. He was a jovial soul, very popular around Lethbridge. On returning from a road trip he found his wife missing, and while there was a blessed event expected it wasn't for another six weeks so he decided she'd gone visiting somewhere and called his pals in for a poker session. It went on for two days. Occasionally someone would ask him about the twins but he thought it was a joke and would laugh heartily and go on with the game. Then about midnight of the second day he began to wonder. He phoned Mrs. Van Haarlem and found out that he was indeed 87 the father of twins who were now several days old and well­ started on lives in which one would become an actor and the other would become a doctor on the staff of the University Hospital. The father asked if he could come and see them, and kindly Mrs. Van Haarlem said midnight was not the usual visiting hour but a father of twins should be entitled to a relaxation of the rules. Even after Mrs. Van Haarlem turned over her hospital to the Sisters of St. Martha she still had more to give. She was a public school nurse and welfare worker.

Another place which owes a hospital to an individual nurse is Vermilion. The nurse was Edith Boyd, a graduate of Jefferson Park Hospital, Chicago, who came to Vermilion in 1909 to nurse her sister after an operation. The town was only six years old when Miss Boyd arrived, but it was already health-oriented; the mayor was Dr. George Ryan, the pioneer doctor of the district. Miss Boyd stayed on after her sister recovered. In October, 1910 she was advertising in the local paper that she would do home nursing. By 1913 there was so much nursing to be done that she opened a private hospital. In 1916 the town took over with the idea of building a new municipal hospital. Miss Boyd stayed on as matron, and before returning to Chicago to teach in 1920 she had helped set up and operate the third municipal hospital in Alberta, a hospital that now has fifty­ four beds, two operating rooms, and X-ray rooms.

East of Vermilion, on the line to Lloydminster, another nurse­ and-sister team combined to give the town of Islay a hospital. In this case the roles were reversed. The sister who came to help was a laywoman; the nurse was having a baby. The nurse was Mrs. Ellen Teetgen Lively, an English nurse with a certificate in midwifery. In 1905 she married Jack Lively and came to western Canada to join the Barr colony west of Lloydminster. They took a homestead and Mrs. Lively was quite prepared to settle down to running the homestead. However, a nurse going to live in a pioneer community enjoyed as much retirement as the doctor who goes to the lake for a holiday. He's soon surrounded by wounded and aching humanity needing his special skills. It was 88 ever thus with Mrs. Lively and other nurses who went farming in pioneer times. The birth rate is usually high in such communities. Mrs. Lively was kept busy making her deliverie . Sometimes she was called to farms thirty miles away, and the uncertain flavor of a journey of that length, in the Islay district of that time, is revealed by Jack McNeilly of Islay, who, in 1911, drove Dr. Mahood to an emergency at a farm home thirty miles south and east. The call came in over the single telephone line. It was already eight o'clock in the evening of a very dark night in early fall. There was no moon. But Jack and the doctor started out in the general direction of the emergency, steering by the lights from familiar farmhouses. Eventually they drove out of range of familiar farm house lamps, but kept angling south and east, steering by the distant light of the stars. Towards morning they heard a dog barking in the darkness ahead. Then they heard another dog, ap­ parently answering, off to the right. "Which dog are you going to head for?" asked Dr. Mahood. "I think we'll take the one on the right," Jack decided. They drove on. The dogs kept up their helpful serenading so that Jack and the doctor could check directions. It brought them in sight of the lights of the farm home where a sick woman was lying. In this way a doctor or nurse of Mrs. Lively's time could expect to travel. A woman of warm heart and bright mind and a knowledge of nursing, Mrs. Lively made astute observations about the prob­ lems of staying healthy in a raw new farming district like the one in which she served. On every maternity case she saw how vulnerable women were in such a community. She saw it most plainly one time when she was called, too late, to a homestead where the mother was already dying of a burst appendix. She recogniz.ed how vulnerable bachelors were one day when she and her husband were driving across a neighbor's hay field and found him lying unconscious where he had fallen from his wagon. He was a bachelor. He had no one to go for help, or even to notice that he was in need of it. Not every bachelor would be lucky enough to have a neighbor ride by at the crucial time, especially a neighbor who was a nurse and recognized that his shoulder was dislocated. Mrs. Lively viewed these events with compassion plus knowl- 89 edge, the professional knowledge which she put into the design of the Islay Hospital. This project had its beginning in 1909, when Mrs. Lively was expecting her second child and her sister, Ada Teetgen, came out from England to be with her. The baby was born. He died after six weeks, on July fourteenth, 1909. He prob­ ably had pneumonia and should have been having hospital care. This realization brought to being the Islay Hospital. Mrs. Lively designed it. Her sister, Ada Teetgen, raised the money. And Mrs. Lively designed it with such knowledge and fore­ sight that it exists today, more than half a century later, almost as she conceived it. It's a two-storey building with a full basement; it bas a four­ bed women's ward, a maternity ward, two bassinets, a four-bed men's ward, two semi-private rooms and an operating room. Typi­ cal of the practical thought which went into her design are these words by Mrs. Lively: "I planned a wide stairway with ample turning room at the top for stretcher cases." She also insisted on a wide upstairs hall which could be made into a temporary ward in emergencies. Her foresight about the upstairs hall was borne out by the flu epidemic of 1918. Mrs. Lively and her sister also discussed bow to finance the operation of the hospital. They decided that Ada should tour the British Columbia mining towns and see bow hospitals were fi­ nanced there. Ada made the tour and they decided that the hos­ pital could be supported on a subscription basis. Three hundred families paying ten dollars a year would do it. The subscriptions would give the hospital enough to operate and give the families a form of medical insurance for ten dollars a year. Being practical women they recognized that the subscription would be beyond some families. There was one family in the district whose entire cash resources during one winter was twenty-five cents. But they persevered. By the spring of 1911 plans were ad­ vanced enough that a hospital board was formed and there bad been communication with the V.O.N. about running it. There were two women on the board although women did not yet have the vote in provincial elections. A hospital fund was started, two hundred dollars was sub­ scribed and then Miss Teetgen set out to get the rest of the money, and bring her sister's eminently-practical plan to construction. 90 Florence Nightingale, who had only recently passed on, must have been applauding wildly from her vantage point on high. On July ninteenth, 1911, Miss Teetgen held up a train. It was a special train sent out by the Edmonton board of trade to chant the commercial glories of Edmonton in the railroad towns of eastern Alberta. When the train stopped at Islay, Miss Teetgen, Mrs. Lively and a Miss Pageant got aboard. When they got off at the next siding they had another fifty-five dollars for their hospital, collected from the touring members of the Edmonton board of trade. And Miss Teetgen pursued the Edmonton businessmen right back into their lairs. Tall, blonde and slender, she attracted the attention of the Journal, which dubbed her Green Veil for her scarf-like hat. The Journal reported: "Green Veil would kiss any­ body who would give her a furnace, a bath tub or a half dozen beds." She called on merchants; on August fourteenth she descended on the Alberta Medical Association meeting in Edmonton and came away with better than seventy dollars; she spoke at a militia camp and made another satisfactory haul; but her finest hours were at the Edmonton Exhibition of 1911. The Journal described her fund-raising technique in the column, Fair Notes: "A noticeable figure at the fair was Miss Teetgen, a young English girl from Islay, who, it will be remembered, held up the businessmen's excursion train at that point and demanded dona­ tions - not at the point of a bayonet but at the point of a most disarming smile - for her hospital schemes. "She is six-feet-two, very slender and very blonde, and wears a flowing veil of green and white. These particulars are given for purposes of identification. "She does her work well, and no man escapes her eagle eye. The little fellows try to hide behind the bigger men or women's hats. But there is no escape. 'Tommy' Whitelaw was one of the first victims yesterday. (You'll remember Dr. Whitelaw. He was the champion of the General Hospital nurses.) "This lady of the flowing veil happened to be standing near a group of men in the enclosure near the racetrack. One of the bettors, little dreaming of danger, boasted in a loud voice that he had just won three pools. "'Pardon me,' said the lady very politely, stepping forward 91 in a slightly intrusive manner, 'but would you mind giving that to my hospital?' "Without a murmur, outwardly that is, the collection was handed over. "'Never again,' sighed he, afterward." Thus did the nurse's sister get the money to build the hospital designed by the nurse; a hospital that was built on the hill at Islay in 1912, and stands today largely as conceived by a pioneer nurse more than half a century ago.

92 CHAPTER TEN In the United Church at Heatherdown, in a sandy clearing in the lake country north of Stony Plain, there's a memorial plaque to honor Jessie McDougall, the pioneer nurse of the community. In a way it also honors most nurses of her time, the time from the turn of the century to the war, because she, like most nurses, was on private duty. The average nurse was not yet at­ tached to an institution. In fact as late as 1930 the Weir Com­ mission would find that more than sixty percent of all registered nurses in Canada were on private duty. The story of Jessie McDougall and the private duty nurses of early Alberta is not one, but many. It's an anthology of individual stories, about individual patients. A nurse might have only twenty cases a year. From the time she came on a case until the time she left she gave it her complete attention and there were no others in sight because she lived with the family and became part of the family. Jessie McDougall, pioneer nurse of the Heatherdown district, was a pioneer several times. She was a Scotswoman who came to Manitoba with her parents as a child. As a student nurse she was a member of the first graduating class in western Canada, a class­ mate of Mary Ellen Birtles and her sister in the first course at Winnipeg General. She came to Alberta about the turn of the century and like so many in the profession struck up a working arrangement with one doctor. Miss McDougall's business partner was Dr. Tommy Whitelaw, the fiery "champion" of the General Hospital staff. She travelled wherever she was needed, nursing Dr. Whitelaw's patients. Many were in the country and her professional life was a series of stays in pioneer farmhouses with long wagon rides in between, on trails primitive as the houses. 93 It was in 1905 that she made her first trip to Heatherdown, to assist in a maternity case in which the central figure was the first white child born in the district. She liked the community. She returned to other cases and in 1909 bought her own farm and became part of the community. She hardly ever had time to "settle down" on the farm, because she was away so often nursing the neighbors. But when she was away, healthy neighbors did the work on the farm of the community nurse. After she died in 1919 the neighbors put up a plaque, with her picture, in the church. Jessie McDougall was middle-aged when she came to Alberta and she had much experience of life to help her through difficult problems and trying times. But most of her sisters in the profession were barely of voting age if women had been eligible to vote which they weren't, when they were pitched out of the regimented training schools into the sink-or-swim of private nursing. The story of Elsie Black (Mrs. Lome McQuade), who graduated with the first class from Holy Cross in 1910, is a fair illustration of what a twenty-one-year-old graduate might expect on her first case. So is the story of Bessie Patteson (Mrs. Arnold Tayler), who graduated with the first class from the Galt Hospital in 1913. We'll take her story first. She was sent on her first case in January, 1914, to a ranch in the high foothills beyond Lundbreck post office. The ranch was twenty-five miles from the railroad station and seven miles past the last telephone. The doctor in Lethbridge called, opened the conversation with "Is your bag packed?" and without waiting for an answer went on to describe the case. The patient was a mother with a young child, who was dangerously low with post-operative com­ plications. He couldn't give her any instructions other than Dr. Mewbum's advice: "Use your common sense. Don't let that patient die." When Bessie stepped off the train in the foothills a man on a sleigh called: "Are you the nurse?" He was a neighbor. The sleigh was a wagon box in summer, set down on runners for winter travel. The neighbor had brought a buffalo robe for her to sit on, another to put over her and a buffalo coat to put on. Furred-in against the January cold they set off on the twenty-five mile drive, which brought the nurse to a typical ranch house of the time, quieter than most because the mother was in a near coma. 94 Here lay the challenge for the young nurse on her first case. Patient and nurse were so far from effective medical help that the nurse would have to save the patient by herself. With her knowl­ edge of nursing she would have to bring the semi-conscious woman back from the outer limits of life. She was not afraid. In later life Mrs. Tayler often asked her contemporaries if they had ever been afraid on their first isolated cases, and they agreed that they hadn't been. They knew what to do. In this case, the patient was erratic of pulse, slow of breath, apathetic, and growing weaker from continued nausea. "She can't keep anything down," the husband said. Bessie Patteson's job was to decide the moment at which she might be urged to try a sip of water, then a teaspoon of water, then a cup of water, then broth, then solid food. The nurse had to watch night and day for the moment when the patient might be eased another step forward. The process took a month. This is what older Nightingales mean by "nursing a patient through". That was Bessie Patteson's first session of private duty. Elsie Black was called on her first case by Dr. McLaren of Calgary. Twenty-one-year-old Miss Black accompanied Dr. McLaren to a case at the Glenbow stone quarry, seventeen miles west of Calgary. It was late winter. Getting off the train, she and the doctor climbed half a mile through snow and found the patients in a tent, with a stovepipe through the canvas roof. The husband was a stonemason, employed at cutting brown sandstone from the quarry for such landmarks as the Alberta Legislative Building. He was almost unrecognizable from the swelling and discoloration of erysipelas on his head. He was lying on the bed. His wife was lying next to him, helpless with pleural pneumonia. Lying in a bundle on the floor, was their baby. The doctor prescribed the treatment young Elsie was to give the patients and went back to Calgary, leaving her to cope. She set to work to make a success of her first case. Realizing that husband and wife would have to be separated, she found an extra bed for the wife, got a neighbor to take the baby, and made herself a sort of bed­ roll on the floor. For three weeks this tent was her home. She swabbed the husband with icthyol and kept the wife alternately from getting too hot or freezing. One night a storm swept over the foothills and shook the tent so badly that the stovepipe blew over. She had also 95 to look after a cow and some chickens belonging to the patients, but the cow got away and the chickens quit laying. In addition, every evening she had to walk half a mile to the phone and call the doctor to report. In a week or so she was able to report that they were actually recovering. And the husband, on recovering, proved to be a braw Scottish lad of booming voice and booming good spirits. And the wife, on recovering, proved to be a Scottish match for her husband. Elsie's last days with them were days of bright companion­ ship. When she left them it was spring, and she left them with genuine loneliness, a feeling many a nurse took away with her from a case where she had helped good people regain their most valuable possession. But she knew that very shortly she would join another family circle. Of course the family circle was not always congenial and the family was not always understanding. Florence Churchill (Mrs. W. Richards), a Halifax graduate who came to Edmonton in 1913, recalled a case where she had been up without sleep for well over a day. She heard one member of the family say: "That nurse has been up all night. She should have a rest." Tired as she was Florence had to chuckle at the reply of another member: "Oh that's all right. She doesn't need it. She's trained for it." This is what was expected of the nurse who went to a home to see a patient through. A nurse could not give a pill to see a patient through. She could give only herself. Patients were often restless at night. There was no pill to bring repose, only the per­ sonality of the nurse. They felt a personal responsibility to make people well. It's obvious that people didn't go to hospitals so much then. One reason was that some people were deathly afraid of them. A frightened woman gave Florence Churchill one of her first cases. The woman had insisted on being removed from the hospital and taken back to her home on Walterdale flats at midnight. At one a.m. Florence got a phone call to go down. The place didn't even have an address, and she wasn't sure how she'd get there, but just at that moment a fellow-boarder was brought home by her boy­ friend at the end of an evening out. The boy-friend had a car and volunteered to drive Florence to the house of the sick woman, wherever it was. They found it eventually by waking up other residents of 96 Walterdale. The woman was very sick with an infection. There was a young baby, and the husband wasn't much more help than the baby. Florence laid out some cushions on the floor to make a bed for herself. When the doctor came in the morning he pre­ scribed hot packs and ice bags for the patient. There was no water and no ice in the house but it was Florence's problem to provide it, somehow. She wasn't surprised. In homes and hospitals for years to come, nursing would be a process of improvising things that weren't there. She hauled water and boiled it on the stove. The ice she got from WalteF's nearby sawmill. When she left at the end of a month the woman had made a good recovery and the baby had survived. In her career on private duty, Florence was called to a hundred cases like this. Only twice did she fail to collect her fee of twenty-five dollars a week. There was little protection for the private duty nurse. A hos­ pital undertook no responsibility for seeing that she was paid when she was called in to special a case. This was noted by Mrs. A. E. Underwood when a student at Medicine Hat General in the 1914-17 period. She wrote: "During my second year a terribly burned case was admitted to a private ward with a special nurse. The man had crawled under a car smoking a cigarette. His appearance was night­ marish, a most frightful sight. The cost to the hospital for skin grafts and medication must have been tremendous and a most arduous case for the special nurse, who nursed eighteen hours straight duty with six hours off for rest. Seven days a week for six weeks for three dollars a day, the usual fee at that time. There were tears after the nurse had not been paid and the man's where­ abouts were unknown." Usually a nurse had only one patient, but not necessarily. In 1913 Jeannie Abernethy was called to Rocky Mountain House to nurse a small epidemic of typhoid. She found the sufferers, all men, had been isolated on the second floor of a boarding house. The floor was reached by an outside staircase. Jeannie was almost as isolated as the men. For weeks she carried meals and water and ice up that outside staircase with no one to help. She was on duty twenty-four hours a day and was on call even when she found time to sleep. But she nursed every one of them through. On this assignment, Miss Abernethy rode a caboose to Rocky 97 Mountain House, fairly plushy transportation for a nurse of the time, and not at all unusual. The railroads would sometimes lay on a "mercy train" of a caboose and one car for ballast when a doctor-nurse team was needed in emergency. They were fore­ runners of the mercy planes that came with the age of flight. Mary Scully (Mrs. James A. McCool), a graduate of the second class at the Edmonton General, rode one of these "mercy trains" in 1913. She was working out of Saskatoon and was in demand for surgical cases because of the specialized training at the General. To the doctor in Saskatoon came a phone call from a woman boarding-house-keeper, a hundred miles up the line towards Ed­ monton. The woman told the doctor her symptoms. He diagnosed them as a rupture of the abdominal wall, told her to be as quiet as possible and he'd be along by special train. Within the hour the train left, an engine, a ballast car and a caboose containing the doctor and Nurse Scully. After a fast run, in which the caboose travelled a hundred miles forward and twenty miles from side to side, the young nurse helped the doctor perform an emergency operation on the big table of the boarding house. When it was over, the doctor rode the next train back to Saska­ toon, but Nurse Scully stayed for weeks until the patient had convalesced. There's an important point to be noted about convalescence, and why nurses spent so much time on one case. Convalescence was supposed to take longer. The trend to having the patient sprint back to his bed from the operating room is a recent innovation. Lottie Hunter, a graduate of Abbott Hospital, Minneapolis, who began nursing around Edmonton in 1910, was a charter member of the AARN and cut the ribbon at the opening of the AARN Building in 1958, told a story to illustrate that point. She worked for a doctor who kept mothers in bed a full three weeks after the blessed event. When Miss Hunter once hinted to him that she thought he might be overdoing the bed rest, he said: "I've let a lot of patients up too soon, but never kept one in bed too long." And if a nurse had to be with the patient through a longer convalescence she had also to spend longer with the patient before convalescence set in. There were no wonder drugs to speed the course of pneumonia. Lottie Hunter, like her sisters of the time, 98 spent many a day and night guarding pneumonia patients through the period of crisis. The only treatment was to keep the patient's temperature down and at the same time provide him with enough fresh air to let him breathe with his congested lungs. This involved swathing the patient in pneumonia jackets, which were like form-fitting quilted blankets. It also involved open windows. Since most pneumonia occurred in winter, the treatment in farm homes ex­ posed the other occupants of the house to the danger of frostbite. On a night in 1962, a pioneer doctor of Olds described the life in the farm houses where nurses like Lottie Hunter and Jessie McDougall nursed people through pneumonia and typhoid. Dr. C. C. Hartman was looking back over fifty-two years of medical work in the district as he spoke to the Olds chapter of the AARN. Dr. Hartman told the meeting: "Conditions for the nursing profession were similar to, and equally difficult in those early days as for the doctor, or perhaps harder. As there were no hospitals at first it was necessary that the nurse travel to some isolated farm house, ten, twenty or thirty miles, over roads that were often so heavy with mud or snow that your team was played out in twelve to fifteen miles. "Living essentials in the home frequently were very meager and in some instances cleanliness had long gone out the window. Of course the window pane was broken anyway. "Doctors made only very necessary calls ancl as telephones were rare and frequently not working, it meant that the nurse had to accept a great responsibility as she could not discuss the diffi­ culties with the doctor. "She had to decide if the case was, or was not, doing as ex­ pected, and whether medicines should be continued, changed or stopped, or if the seriousness of the case demanded another visit by the doctor." The eighty-five-year-old Dr. Hartman concluded his tribute to the pioneer nurse: "She was on practically a twenty-hour shift and rarely was there a room for her to lie down for a while where she could be away from the family. In spite of the great difficulties under which they worked the Florence Nightingales of the time saved many lives." In the years Dr. Hartman described so sharply, there de­ veloped the idea of "registration" and the force that brought to 99 being the Alberta Association of Registered Nurses. The registry began in a simple way, in country points especially. It was usually kept by the town druggist, a list of women willing to do nursing. Being willing was the only consideration. Being able did not enter into it. As an Alberta old - timer used to say about the old - time lawyer: ". . . said he was a lawyer and he could lick any man who said he wasn't." In the cities of Calgary, Lethbridge, Medicine Hat and Ed­ monton, where the registry was kept by nurses, the question of ability was first raised. The friendly small-town druggist was hardly able to demand diplomas and certificates of a girl who said she was a nurse; especially if she looked as though she could ' lick anyone who said she wasn't. Anyway, the druggist had plenty to keep him occupied and hadn't time to worry whether the standards of another profession -the nursing profession-were being kept up. It didn't matter to him whether or not a nurse was qualified. It did, however, matter very much to nurses who were, and knew the importance of their qualifications. Qualified nurses ran the registries in the cities of Calgary, Lethbridge, Medicine Hat and Edmonton, and a woman had to show credentials to get on the registry in the cities. Out of this spontaneous attempt within the nursing fraternity to set standards for the profession grew the movement which gave "registration" the dignity of law. The first draft of the law was eventually written by the nurse who kept the registry in Edmonton. She was Mrs. Bob Armstrong (Lilian Matthews), a Nova Scotia nurse who came to Alberta in 1907, along with so many other nurses from eastern Canada, the British Isles, and the United States. She came to Wetaskiwin first, and then moved to Edmonton and married Mr. Armstrong and took on the registry. Nurses who could show documentary evidence of their quali­ fications paid her five dollars to be on the register. She also got a free telephone and acted as a·despatcher. When a call came in from the country, Mrs. Armstrong would contact a nurse, tell her what train to take, and· advise her whether anyone would meet her. Through this time injuries occurred in the sometimes literally back-breaking job of clearing the trees and the stumps and build­ ing the railroads. The illnesses were pneumonia and typhoid. The continued threat from the water supply still suggested that water 100 wasn't as safe as the foes of stronger drink would have people believe. Typhoid continued to weaken, and to hang over the rural population, and the first efforts of the provincial board of health were directed towards safe water supplies. Alberta was the second province in Canada to set up a separate department of health, in 1907, only two years after the province started. The department tried to get new communities to set up local boards of health and provide proper waterworks and sewage disposal systems. With towns starting so fast these things lagged, but the department was persistent and by the mid-twenties its efforts would pretty well relieve the Nightingales of Alberta of the drudgery of nursing typhoid. In this period in the frontier communities it was perhaps easier to resign from the Mafia than to resign from the nursing profession. This was attested to by Mrs. Arthur Stonhouse, a graduate of Good Samaritan Hospital, Los Angeles, who came with her husband to the Brooksley district, north of Red Deer, in the spring of 1916. There was no keeping the secret, and with the stringing of spidery telephone lines across the raw province, the nurse and the doctor were becoming more accessible to the patient, although the reverse was not yet true. Shortly after her arrival, Mrs. Stonhouse got a phone call from Doctor Creighton of Stettler. She had never met Dr. Creigh­ ton but she could not refuse when he asked her to go to a farm near Botha, on the other side of Stettler, where a farm wife had spinal meningitis. He told her the train would stop for ten minutes at Stettler. He told her he would leave all the supplies and prescrip­ tions in the station and to get off and ask for them. At Botha she would be met by the farmer. There was still snow on the trails, but Mrs. Stonhouse started out. She got a ride with the postman as far as the railroad line at Clive. At Stettler there was a mix-up. As she got off the train looking for the druggist, he got on the train looking for her, and while she was being paged on the train, the druggist was being paged on the platform. After ten minutes the train went on, with Mrs. Stonhouse still on the platform. The druggist then found her, and it was decided that she would ride to Botha on the freight train which was due 101 shortly. She rode on the caboose and when she got off at Botha there was no one to meet her. But a call was placed and the farmer eventually came with a team. Unfortunately the sick woman, with a small child, died ten days later. But such were the realities. That summer, when the nurse quit the Creighton hospital in Stettler, Mrs. Stonhouse agreed to fill in as matron until a replacement could be found. She was there all summer. Then there was the time she was about to sing at a Red Cross concert. It was being held in the school at Brooksley, a gathering of neighbors to raise a few dollars for the war work of the Red Cross. She was going to sing Mother Machree. And just as it was announced that Mrs. Stonhouse would favor the gathering with Mother Machree, a neighboring sheep rancher burst in to announce that his wife was about to become a mother, and would the singer come at once and sit with his wife while he went for the doctor. The baby came long before the doctor; and Mr. Stonhouse held the lantei:n while Mrs. Stonhouse assisted with the delivery. There was no resigning from the nursing profession, but as Mrs. Stonhouse pointed out fifty years later, in such a situation a nurse didn't want to. The Florence Nightingale pledge was binding on the frontier. The words "I solemnly pledge myself . . . to practice my profes­ sion faithfully . . . do all in my power to maintain and elevate the standard of my profession . . . endeavor to aid the physician in his work and devote myself to the welfare of those committed to my care" were given a special meaning. The experience of Harriet Baum, a 1908 graduate of Cook County Hospital in Chicago, was another illustration. In 1911 she gave up nursing and came to the Leedale district, west of Lacombe, to join her brother and mother on a homestead. She loved the life of the farm and was glad she had quit nursing but she soon found, as all the others did, that it was not possible to quit. "The nearest doctor was at Lacombe," she recalled. "So many people needed nursing I couldn't refuse to go." She went day or night in any season, and if it was in the spring, the wagon wheels would be hub-deep in water as the wagon left the knoll that was her brother's farm. She went as a neighbor, she didn't ask for pay and was seldom offered any. Even after she married Frank Johnsman in 1915 people in the district 102 needed nursing as much as ever, and Frank became one of the nursing team, looking after the J ohnsman children when their mother was needed by a neighbor. When Rimbey got a hospital in the 1940's Mrs. Johnsman finally did what she had started out to do thirty years before - she gave up nursing. And passing the hospital she could remember operations performed by coal-oil light in log cabins. She remem­ bered in particular a case to which she was called about 1912 or '13, the period of this chapter. She was nursing a young man through the slow convalescence from pneumonia when he suddenly became violently ill and wracked with stomach pain. She realized the young man who had just beaten pneumonia now had acute appendicitis. She had the doctor phoned in Lacombe. He came out with an assistant, ar­ riving in the middle of the night. There was no waiting for day­ light so the doctors, with Miss Baum assisting, converted the kitchen of the log cabin into an operating room and removed the appendix by coal-oil light. The kitchen table was the operating table. "They were fine for operations as long as they were home­ made," she recalled.

Doctor-and-nurse teams did some memorable travelling in this era. Mrs. Winnifred MacPherson, who graduated from White Plains, New York, nursed around Lethbridge, and she liked to tell about being out on the foothills at night with Dr. Mewburn. When he wasn't just sure whither the horses had taken them, he would begin his favorite hymn for this situation: Lead, Kindly Light. And Dr. G. D. Stanley told about another Lethbridge practi­ tioner who frightened a Toronto nurse on her first trip into the country. This doctor was noted for his economy with words. He and the nurse had been travelling a couple of hours and he hadn't wasted one. Then, with their destination in sight, they came to a stream which so impressed the horse that he refused to cross. The doctor got off, took a closer look, then descended on the nurse, grabbed her without a word, and, also without a word, carried her over the water and put her down dry but petrified on the other side. Perhaps the most remarkable travelling ever done by a doctor­ nurse team in Alberta was achieved by a doctor and nurse riding 103 separately from opposite directions. It was in 1915. The doctor was G. M. Atkin of Banff. The nurse was a Miss Fulcher, and the objective of their winter journeys was a fifteen-year-old girl on the Brewster Ranch, high on the headwaters of the Red Deer River. Dr. Atkin started from Banff and reached the ranch from the south. Nurse Fulcher started from Olds in the east. Each travelled about sixty miles. The doctor went at the request of the ranch foreman, who had made a hazardous trip to Banff to get help for the girl, suffer­ ing from a ruptured appendix. The trail was up through the valley of the Cascade River and out onto the high ground above the Red Deer. At one river crossing the ice broke under the doctor's horse and he had to ride on soaked to the skin. But he performed a successful operation. Then, with the surgeon's work done, a nurse was required to bring the patient through convalescence. Dr. Atkin returned to Banff as he had come, and contacted Nurse Fulcher by telephone. She started her approach from Olds. She rode a two-wheel cart to the Red Deer River, a distance of about forty miles. Arriving at the river after dark she still had twenty miles to go. So she borrowed a horse and rode up the valley most of the night to get to the ranch. The famed mountaineer Norman Luxton of Banff, who founded the museum, used to marvel at Nurse Fulcher's ride. He used to say of her route: "I have done it in good weather and it must have been damn tough in winter." There can be no doubt that it was.

There were once many more stories, about many more nurses, than are recorded here. Through time the stories have been lost, and even the names of selfless, dedicated nurses have grown dim in areas where they once kept so faithfully the traditions of the Nightingale pledge. West of Rimbey for example, someone remembered Mrs. Greenough, who settled there about 1907. Mrs. Greenough had had medical training in a Russian university and served her fron­ tier neighbors in many an emergency. Unfortunately that's all we know about her. James G. MacGregor, in his book The Land of Twelve Foot Davis, makes reference to a Mrs. Hare, who kept a stopping house on the tortuous Edson trail, which ran from Edson to the Peace 104 River country. He wrote of her: "Mrs. Hare had been a nurse before coming to the Edson Trail. What a blessing she was to mothers with feverish children!" These are fragmentary remains of what must have been fine stories of Alberta nursing. Many more stories have disappeared without a trace.

Another type of nurse appeared on the Alberta scene in this time. This was the nurse attached to a mission. Such was Sister Michel de Jesus, who went to St. Augustine's mission school, ten miles from Peace River, in 1911. A few years ago Sister Michel wrote a delightful memoir of her experiences in that role: "I left Montreal on July twenty-sixth, 1911, and arrived in Edmonton one month later. The only means of transportation for the north was the covered wagon and an Indian guide. It took two days to reach Athabasca this way. Each night we slept in tents. If we thought there were wild animals around we kept a fire burning all night long. In another three days the mission of St. Bernard was sighted at Grouard, and it took another four days before the hamlet of Peace River came into view. Here there was the Hudson's Bay post and a few scattered shacks. "From Grouard to Peace River the trip was through dense forests. There were no roads, no shacks, and no people. All along the way was one desolate stretch of trees and more trees. Yet my sister-companion and I lived through it, and I dare say we liked it. "The mission school of St. Augustine was ten miles from Peace River. It was here that I was stationed. Since there were no doctors within reach, the sister-nurse cared for the sick of the locality. These were mostly Indians. "The Department of Indian Affairs annually sent a supply of medicine for the whole year. The chief supply was cod-liver oil given to the children during the school year because there were no citrus fruits to be had. I was nine years without seeing an orange. We dealt the medicine by reading the prescription on the bottles and that was all." Sister Michel continued her memoir: "Among my many ex­ periences I find this an interesting one to relate. It was forty years ago when a young doctor was travelling through the area and a patient with an infected leg was brought to him for help. The 105 doctor examined the leg and said only an amputation would save the young man. "The Indians were loath to accept the idea so they brought the victim to me and said that Indian medicine could save the leg. I told them to bring some of it to me and they did. I sat up all night applying the medicine as compresses to draw out the infec­ tion, and to my surprise the next morning the leg looked fine. "This is the recipe: 'Boil slowly together the same quantity of resin and beef suet until all is dissolved. Then use.' It worked," reported Sister Michel de Jesus. She concluded her memoir with a paragraph on her more recent activities. "In order to serve our buildings I took a course in engineering and now hold a certificate for operating steam boilers. So with nursing and engineering I am living my life to the full."

The last word on nursing, in the time when Alberta con­ tained many frontiers, must be allowed to a nurse who was on one of them. She was Janet Mcintyre, who served at a five-bed hos­ pital in Bonnyville, opened in 1917 by the Home Missions Board of the Methodist Church and the forerunner of the present Katherine Prittie hospital. The nearest railroad and the nearest doctor were thirty-five miles away at Elk Point. In a routine report of her activities at this time, Miss Mcintyre wrote: "The nurses are called upon any hour, day or night, to attend and visit the sick; and as doctors are so few and far, we have to diagnose, prescribe and attend the sick ourselves. Riders come from as far as sixty miles to us for medicine, and we have to surmise the nature of the illness from the meager information we receive, as very often these people cannot talk any English. "One night last month," Miss Mcintyre wrote in her routine report, "we had the occasion to send our man with the team to Cold Lake, about fifty miles north of us. I was alone with the maid. That night a little French baby was born, and about mid­ night a French gentleman came for me, to see his neighbor's wife, who was, he said, going to have a baby at eight months. "I did not know what to do, leaving a mother and babe a few hours old practically alone, yet I dared not allow the other woman to be neglected, so I started. "When I arrived I found the woman alone with her husband, 106 and in labor. I could not remain very long, and as I could not leave her, I gave her some sedative and took her along with me, her husband sitting on my lap driving and I holding a lantern. "It was eight miles to the hospital and I lived through an agony of terrible suspense and fear in case the baby would be born on the way. How I did bless every old shack as we drove near, in case I'd have to make it a temporary abiding place for patient and self. "Imagine my relief when I perceived our dim little hospital light. We always leave a light burning all night to welcome anyone who may come for aid." On these heart-catching words of Nurse Mcintyre's report we'll leave her era, leave with a consciousness of an oil lamp shining dim but reassuring through the darkness of a frontier night, in a fitting allusion to a profession whose modem traditions stem from a lady with a lamp.

107 CHAPTER ELEVEN On the twenty-eighth of June, 1914, one Gavrilo Prinzip came out of a crowd in a Bosnian town and shot his way into history. In the assassination of one Grand Duke, the unknown revolution­ ary signed death warrants for eight million other unknowns. He opened the floodgates on a torrent of evil and good, human grandeur and human misery, scientific debasement and scientific advance, which is known to history as the first world war. Prinzip created in a single act a long list of new requirements, for even the smooth functioning of a disaster needs a great many things. The Canadian armies, which were caught up in Prinzip's flood, needed two thousand nurses, and the Canadian nursing school supplied most of them. Although in existence less than twenty years, the schools provided most of the nurses for the wounded overseas and the convalescents at home. The Alberta schools, which were really only starting, sent about sixty-five. The medical disasters of the Crimea were not repeated. There was no need to press into service "fat, drunken old dames of four­ teen stone and over", the girls Florence Nightingale had lamented. The girls did not pack a thirst for their journey overseas. They packed knowledge. And if most were short on experience they had the knowledge to make the most of experience when it came. Not one even approached fourteen stone; that would be 196 pounds. The cots required no reinforcing. The girls were trim and fit, in their light blue uniforms with the pearl buttons and the maple leaf badges to identify them as graduates of the Canadian system. They were ready, willing, and God bless 'em, they were able. In England, France and Greece they staffed twenty-six hos­ pitals, four casualty clearing stations, and eight other establish­ ments for the army, plus hospitals of the Red Cross. 108 Alberta's first school of nursing, the Medicine Hat General, sent fifteen trained nurses into uniform, including Matilda Green, who died in France in 1918. The second school, Calgary General, sent fourteen graduates overseas and had twelve in Canada, in­ cluding the first graduate, Marion Moodie. Miss Moodie ran the Ogden military hospital in Calgary which opened in 1915. The Holy Cross sent seven, including two winners of the Royal Red Cross: Phyllis Gilbert and Janet McDonald. There were four from the Edmonton General, which extended its training time from two-and-a-half to three years so its graduates could qualify for commi sions in the army nursing service. The Royal Alex sent seven. The Galt had Bessie Patteson, of the first class, in the Red Cross. Lamont sent its first graduate, Anna Purschke, to the army, and the first and only graduating class of Strathcona Municipal had a representative in Vera Strange (Mrs. Bertram Hull). The generals, caught in a stalemate war for which history offered no precedent and no guides for winning, were unable to halt or speed up the grinding progress of the disaster. The nurses couldn't either. What they could do was reduce the toll of the disaster as much as knowledge and tireless dedication would per­ mit. They did it well. What a Canadian nurse going to France could expect is found partly in the experience of Alice Mary Blackwell, (Mrs. John Turner) , a Canadian graduate of a Detroit hospital, who came to Alberta in 1913. After a couple of years doing the private duty nursing of the time she joined the service. After the briefest possible indoctrination in military life Sister Blackwell was plummeted right into it and sent to France. She was sent to Outreau, to Number Two Canadian Stationary Hos­ pital, behind the front near Boulogne. The term "stationary" was hardly appropriate since the unit moved several times during the war, and the term "hospital" wasn't very appropriate either if one went by looks. The unit was set up in commandeered buildings, the school, the mayor's house, etcetera, and it was so close to the battle area that most of the windows were blown out and there were dugouts in case of air raids. Nurses would spend some time at this hospital, then shorter periods of duty in the casualty clearing stations, which were almost in the lines.

109 For the nurses, there was a shortage of almost everything to work with - except bandages. There were no antibiotics and no blood for transfusions. Sister Blackwell saw many wounded men die for lack of blood. A quarter of a century later, in a second world war, she would organize a Red Cross blood donor clinic in Edmonton. The experience of Marion Lavell, who, in the post-war was widely known in southern Alberta for her public health work, gives another insight into the work of the Canadians in France. Miss Lavell left Edmonton in 1913 to train as a nurse in the Toronto General. On graduating in 1916 she worked her way to England escorting a patient and then went straight into the Canadian army in London. After a cursory introduction to military routine she was sent to Etaples, France, to Number One Canadian General Hospital. It was a base hospital, far from the front, but it was bombed by German aircraft in 1916 and three nursing sisters were killed and more wounded. Sister Lavell's responsibility was a ward of fifty badly­ wounded men. One nurse to fifty wounded men. She spent every waking hour changing dressings and cleaning wounds, while or­ derlies and convalescent soldiers performed all the other duties of the nurse. One to fifty was a thin nurse-patient ratio but nurses were in short supply along with everything else. In some hospitals for convalescents the ratio was one nurse to two wards of sixty. Although we tend to associate bombing raids on England with Hitler's war, there were raids in the Kaiser's war too. Anna Purschke, the Lamont nurse, was stationed in army "special" hos­ pitals at Folkestone, Ramsgate and Buxton. When the hospital was bombed out of Ramsgate it was shifted inland to Buxton. The army would accept only single girls for the nursing service but many married ones were able to get into the work with the Red Cross. Bessie Patteson, of the first class at the Galt, disqualified herself by becoming Mrs. Arnold Tayler. But she got to England with the Red Cross, and wound up in a handsome location, outside Newby, Berkshire. She ran a Red Cross auxiliary hospital in the home of the governor of the Bank of England. The governor's lady was named commandant because she had given her home, and the hospital was on the top floor with 110 Mrs. Tayler as sister in charge. She was the only nurse, and the only nursing aide available was the butler. Between them they handled twenty-seven disabled soldiers to begin with, fifty later on. And when Mrs. Tayler needed strength to keep going she drew it from the uncomplaining patients. Another Red Cross nurse was Mrs. Joe Ross, who trained at the Brandon General under Mary Ellen Birtles and found her "very strict, very stem but very just" and liked her very much. Mrs. Ross's husband was overseas with the armed forces . So she left Edmonton as a civilian and joined the Red Cross in London, and after service in England was sent to France, to a hospital at Boulogne operated as a private Red Cross philanthropy by Lady Hatfield, a Virginia-born British noblewoman. Physically it was better than most. It was an officers' hospital and was in a converted hotel, one of eight hospitals in the Bou­ logne area. The nurses worked seven days a week and the days were long and full. There were occasions when there was little work to do, and plenty of time off for the nurses, but these were eerie, uncom­ fortable occasions. When word came to start evacuating the wounded to England, the beds would be emptied and the con­ verted hotel would be quiet. But it was an uneasy quiet because this was the signal that a "big push" was about to start on the western front, and that the beds would be needed for the new wounded of the imminent battles - new wounded who would be coming "down the line" and carried in at all hours of day and night. That was the experience of Mrs. Joe Ross, who left Edmon­ ton in 1915 to be a Red Cross nurse. And experience in the primi­ tive hospitals or rural Alberta was apparently useful training for military nursing overseas. This is revealed in a story told by Mrs. Byron Morrison, (Madeleine Jaffray) , a nurse from Galt, On­ tario, who came to Edmonton after the war with a French Croix de Guerre, the only Canadian nurse so decorated. Once in a Red Cross hospital camp in northern England she met three English nurses who had worked in northern Alberta before the war. They were hauling water for nursing purposes. They laughed when they told her they'd carried water in hospitals in Alberta, and now they were doing it again. There were other Alberta woman working in the nursing 111 program overseas. They were in the V.A.D. - the Volunteer Aid Detachment. They were in Europe or England when the war broke out and volunteered for any war service they could perform. In the V.A.D. they became military nursing aides and did some of their most useful work in preparing bandages. Two of the V.A.D.'s were Jean and Leona Secord of Edmonton, who were in school in England when war started. There was also Marjorie Sanders (Dingwall) and Mrs. T. D. Fitzsimon. There must have been others, but these four are known and have always been included in the activities of the Overseas Nurses Association of Edmonton. These are only a few stories, of a few of the nurses, who went from Alberta to service in the first great war, but they contain an experience common to all.

On August twenty-ninth, 1915, when the lines of no escape had been drawn, the Germans inadvertently gave a new image and a new meaning to the profession whose members were reducing the toll of the disaster. They arrested the English nurse, Edith CaveU, at the Institute Depage in Belgium. Nurse Cavell had run the hospital since the 1890's when she was brought in to introduce English nursing methods to Belgium. She was charged with helping Allied prisoners to escape. She admitted it was so, and on October second the German masters of Belgium shot her. They shot her for an object lesson; and her death provided one, though not the one intended. It gave a forceful new expression to the ideals of the nursing profession. Although the press made her sacrifice an act of patriot­ ism it was in fact dedication to the ideals of her profession that brought her into the trap and before the wall. She gave the nursing profession itself a new heroine, a contemporary heroine to set alongside Florence Nightingale. After all, it had been sixty years since Scutari. Nurse Cavell was a symbol admired all around the world but it was in Alberta that the symbol was given form . The most impressive peak in the valley at Jasper, rising 11,033 feet above the sea and almost two miles above the valley floor, was renamed in her honor. The mountain is not unlike her. A little remote, a little for­ bidding, countenance never changing, a little obscure at times, absolutely inflexible, and of course immortal. 112 Every year, on the Sunday nearest the day of her arrest, there is a memorial service held at the foot of the mountain. Below the glacier known as The Angel, with its arms spread in a gesture of mercy, the pastor from the Anglican church of St. Mary and St. George, in Jasper, conducts the service. There is always a crowd. The service opens with Rock of Ages and the Twenty-Third Psalm. There is a brief sermon. The sergeant in charge of the Jasper detachment of the RCMP lowers the flag to half staff, a bugler plays the Last Post, the crowd sings Abide With Me, and the service is over. It's a simple ceremony. Anything elaborate would be out of keeping. It's arranged each year by the Jasper chapter of the Alberta Association of Registered Nurses.

And at this point, the connection of the Jasper chapter with the Cavell memorial, serves to introduce the Association into the narrative of the first war. Because at the time of Edith Cavell's arrest and trial, the Association was coming into being. Before the war there were nurses' associations in the four large centers of Alberta. Their aim was limited to keeping a registry of nurses available for private duty, and their organization was local. However, communication quickly developed among these local groups. They had the same problems and the same interests, and by 1915, they had decided they should band together and raise their sights. In particular they should band together to ask the provin­ cial government for registration for all nurses on a uniform province-wide basis. Marthe Markin, one of the charter members of the organiza­ tion that resulted from registration, wrote about the campaign in these words: "It was an uphill fight for a time. The powers that be, or were, took a dim view of women, especially nurses trying, as they felt, to unionize. The medical profession was anything but helpful. However, we had a good committee, and were persistent, and finally won out. During the 1915-16 years when I was with the department of agriculture Women's Institute, I met frequently with the nurses' group and we were all happy when we were officially launched as an organization, not a union." Although the nurses had few supporters in the campaign, they had at least one solid champion in the rough and ready form 113 of the Hon. A. G. MacKay, the minister of health and member for Athabasca. Mr. MacKay steered the registration act through the legislature in April, 1916, and it was passed without a dis­ senting vote. Even the member from St. Albert, who cast the lone vote against women's suffrage that year, did not oppose registra­ tion, and today, when registration is taken for granted as a pro­ tection to the public, it's surprising to find that Florence Night­ ingale, champion of all things for the good of nursing, was against it. Florence, in fact, made the last public fight of her long public career, against a plan to register nurses in England. To this last fight, waged in 1894-96, she committed all her prestige, her energy, her tenacity, her charm and her cunning. As usual, she won. And, also as usualyher arguments command in- terest even now. "' Her first objection was that a good nurse needs both knowl- < 'edge and character and that in a registration plan she could be examined only on knowledge. She had a good point about knowledge: It gets out of date. A nurse deemed knowledgeable in 1894, might, if she didn't keep up with the fast-moving medical profession, be sorely deficient in knowledge within ten years, but the public would not be aware of it. Nurses working today realize that Miss Nightingale's point about knowledge going out-of-date is more valid now than when she made it. The nurses who formed the association in 1916 realized it too. One_of.. their fir_i;t aims was to be refresher courses offered through the University of Alberta. The Nightingale objections were known and considered when Alberta approved registration in 1916 but considering the public interest from all angles it was deemed that the public was better protected knowing a nurse had been knowledgeable on a certain a date, rather than having to guess, or take her word for it. With the shifting of population, girls with partial training were going to some other part of the country and representing themselves as fully trained. For the protection of the public, the act to incorporate the Alberta Association of Graduate Nurses, which recognized the principle of registration, was passed in April, 1916. With this step, l Alberta became one of the first three provinces to register nurses. Nova Scotia led off in 1910, Manitoba followed in 1913 and New Brunswick accepted registration the same year as Alberta. Cape 114 Colony, in South Africa, was the first in the world in 1891. North Carolina, in 1903, was the first in the United States. Great Britain didn't achieve it until 1919, and the funeral coach of the editor of the nursing journal, who had opposed it to the end, was pas ing the House of Commons as the act was going through. Progress in Alberta came comparatively fast. So fast in fact that the legislature granted incorporation to a society which didn't exist. This deficiency was remedied in October, 1916, when six nurses met in Calgary in the office of their solicitor, George Ross. They were Eleanor McPhedran, Victoria Winslow, Mrs. Lillian Armstrong, Lottie M. Edy, Miss E. J. Smith and Miss E. M. Rutherford. Five of them were among the twelve founding members of the Alberta Association of Graduate Nurses. The founders held registration numbers, one to twelve, numbers which passed twenty­ one thousand in the golden anniversary year of the organization. There wasn't a single Alberta graduate in the founding twelve, although products of Alberta nursing schools would shortly be coming to positions of leadership in the profession. In order of the numbers they held, the twelve founding members were: 1. Eleanor McPhedran, graduate of New York City Hospital, 1906. She went overseas, was the first secretary-treasurer of the association, superintendent of nurses at the Central Al­ berta Sanatorium (Keith) , worked with the V.O.N., won the Order of the British Empire and the Mary Agnes Snively Award. 2. Lillian Armstrong, of Nova Scotia Hospital, Halifax, kept the registry in Edmonton. 3. Lottie M. Edy was a graduate of Harper Hospital, Detroit and was in one of the early classes to take the Nightingale pledge, written in 1893 by Canadian-born nurse, Mrs. Lystra Gretter, superintendent of the training school. Miss Edy was superintendent of nurses at Calgary General from 1917-23, and died in Ontario in 1965 aged ninety-two. 4. Marthe E. Morkin, graduate of St. Roch's, St. Boniface. She went overseas afterwards, did public health work in Alberta, the Yukon and California. 5. Mary Patterson. Nothing is known about her. 6. Edith Rutherford, graduate of West Philadelphia Hospital, 115 Chicago, 1904. She was instructor at Calgary General for many years. 7. Margaret Walsh, from St. Mary's, Rochester, N.Y., 1910. She was with the health department in Calgary. 8. Lottie Hunter, graduate of Abbott Hospital, Minneapolis. She did private duty in Edmonton; was known as "the cam­ pus nurse" because she was in such demand at the University; made a life member of the AARN in 1965. 9. Agnes Hurcomb, graduate from Sherbrooke, Quebec. She did private duty and public health nursing. 10. Hester McKay, of Royal Infirmary, Glasgow. She was an overseas nurse; was active until 1948. 11. Sarah Kingston, graduate of Lady Stanley Institute, Ottawa, 1903. She was matron of Red Deer General and later a hospital superintendent in Los Angeles. 12. Victoria Winslow, graduate of Winnipeg General. She was the first president of the association; at the time of founding superintendent of nurses at Medicine Hat General. In 1921 she moved to Halifax as superintendent of Children's Hospital. These were the founding twelve in a group of nurses whose numbers passed twenty-one thousand in the golden anniversary year of the AARN. At the fifty-year mark there were forty-two chapters in the province, and to form a chapter it was necessary to have twelve members. Some insist there is no connection be­ tween this rule and the twelve founders and say the nursing pro­ fession has enough romantic traditions cluttering things up as it is. However ... The new AAGN quickly established itself as an action group. In May, 1917, the minister of education was surprised to receive a communique from the association. It informed him that "there are many things in nursing and the nursing profession in this province that should be remedied and improved. . . ." (The poor chap probably wondered what education had to do with the training of a nurse.) Miss McPhedran, in her first roll-call as secretary, treasurer and registrar, got ninety-one graduates in her books. The fee was ten dollars to join, with an annual fee of two dollars after that. By the end of the first year, when the first convention of the asso­ ciation was planned for Calgary in December, 1917, she had two hundred and fifty-five. 116 The association was growing but still small enough that the convention could be accommodated in the lecture room of the Calgary Public Library, which it was. The one-day session was held December twelfth. The convention conformed to the AAGN's aim of continuing education for nurses. There were two papers: The nursing of ner­ vous cases-by Mrs. Anderson; and the relation of the nursing and medical professions-by Dr. Lincoln. And Miss Winslow's presidential address set out the objec­ tives of the association. Having organized to gain registration, the nurses now had a force with which they could gain other worth­ while objectives. Miss Winslow outlined a campaign which was hardly less sweeping than some of the offensives launched on the western front that year. The objectives were these: A standard examination to qualify nurses for registration; A standard curriculum for Alberta nursing schools; Legislation to bring nursing education under the University of Alberta; An amendment to the Hospitals Act requiring that schools of nursing be not established in hospitals with less than fifty beds; Summer school for nurses, at the University, similar to the summer schools for teachers, which would give private duty nurses an opportunity to learn the latest methods. The girls were certainly feeling militant, but they were living in an age when women were getting things done at a faster rate than ever before. It was the age of Emily Murphy and Nellie Mc­ Clung who led the fight to get the vote for the women of Alberta. The women of 191 7 had abandoned the Victorian system of getting things by having hysterics; giving men hysterics was more effective. The day after the first convention the council of the AAGN held a day-long meeting in the library, and the council approved some tactics to further the strategy outlined by Miss Winslow the day before. It passed without dissent a resolution that a certain committee be set up. The resolution laid down the terms of reference for this com­ mittee. It would "recommend a course of study that might be adopted by all training schools; study standards of education to 117 be required for entrance to schools of nursing; and requirements for hospitals conducting schools as to bed capacity and staff". The committee would be composed of people representing the senate of the University, the Alberta Medical Association, the council of the Alberta Association of Graduate Nurses, private duty nurses and superintendents of training schools. At the time, it was more of a revolution than a resolution. The chairman of the meeting was Henry Marshall Tory, president of the University, a gentleman of historic proportions whose interest in nursing was something of a mixed blessing. Dr. Tory liked to be on hospital boards. He had taken so much interest in the nursing at the Strathcona Municipal in 1915 that Miss Baird, the matron, resigned and demanded a public investigation and had to be pursuaded to go quietly to another job in Winnipeg. Dr. Tory gave his support to a meeting of the bodies men­ tioned in the resolution and although a permanent committee did not result, there was a meeting. It was held at the Royal Alex on May seventh, 1918. Dean W. A. R. Kerr represented the university. There were three members of the Medical Association and four nursing school representatives. There was great interest at this session in the idea of the summer school for nurses similar to the one for teachers. Dean Kerr said the university was willing, and for the nurses Mrs. Arm­ strong, Miss McMillan of the Royal Alex, and Mrs. Manson, were made a committee to outline a course. Suggested topics for the refresher course were obstetrics, infant feeding, dietetics, ortho­ paedics, urinalysis and bacteriology. The value of the course was apparent, especially for the nurse on private duty. An institution nurse would have a good chance of keeping up with new trends but the nurse working always on her own would be out of contact. Florence Nightingale would have liked the idea. Unfor­ tunately, for various reasons, nothing came of it. However, there was progress in other directions. The AAGN was offered a seat on the University senate, which had the effect of raising nursing education to the level where it was a matter of attention for the University. Miss Winslow was the first representative, followed by Miss McPhedran. And the minister of education appointed a board of examiners to set up uniform examinations for nurses under the Registered Nurses Act. Dr. D. G. Revell, of the University, was chairman and Mrs. 118 Armstrong was secretary. The members were Dr. T. G. Norman, the provincial health officer; Miss Winslow; Sister Duckett, of Holy Cross; Sister Casey, of Edmonton General, and Miss Mc­ Millan of the Royal Alex. The board met in Edmonton on June twenty-eighth, 1918, and decided to hold the first R.N. exams in Calgary. They would be held October first, second and third; they would be written, oral and practical, and would be under three divisions: medical nursing, to include charting infectious diseases, dietetics and materia medica; surgical nursing, to include charting E.E.N.T., anatomy, bacteriology and bandaging; and obstetrical nursing, to include gynaecology, diseases of children and urinalysis. At this stage the nursing profession was not yet considered able to police its own standards, and the doctors, as a matter of course, set the examinations. Nursing was still a profession on which another sat in judgment. But the first Alberta R.N.s were qualified on schedule, and the years 1916, '17 and '18 gave the profession much in which to find cheer. And 1917 brought another cheering honor to the profession. A nursing sister with the Canadian army overseas was elected by her fellow-soldiers to the Alberta legislature. She was Roberta MacAdams, who shared with Mrs. Louise McKinney of Clares­ holm the honor of being the first woman elected to a British parliament. Roberta was the daughter of a crusading newspaper publisher and the sister of another - Billy MacAdams, who ran the Ed­ monton Daily Capital before the war. Roberta was serving over­ seas at Number Sixteen Canadian General Hospital at Orpington, Kent, when the Alberta government announced that there would be seats for two service representatives in the provincial election of 1917. Roberta's campaign was handled by some of her many gentle­ man friends, who circulated thousands of pictures of her sitting on a piano. The campaign was a great success. Her supporters didn't get to find out much about her views on hog production or con­ vertibility of silver, but that piano was certainly as good a plat­ form as any politician could offer. And while there was in her demeanor none of the "drunken old dame" of Florence Night- 119 ingale's time, it was clear that Roberta wouldn't be a drag on a party. It was Roberta by a landslide. Of course it might be questioned whether she was really a nurse. She had graduated in household economics from Macdonald College and had been commissioned as a dietitian. But Florence Nightingale wrote so much about diets that you'd have to make her one of the nursing team, as the army did when they commissioned her a Nursing Sister. And the clincher is that the boys who voted for her thought they were voting for a nurse. The majority rules in a free society. So a nurse became one of the first two women elected to the legislature of Alberta.

120 CHAPTER TWELVE In the fall of 1918, when the war was ending in Europe, a girl from the province of Quebec went to visit a farm near Legal. She brought to Alberta the virus of Spanish influenza, a disease which would take more lives than the war. As the first reports of flu at Legal reached the department of public health, the department sent Nurse Dorothea Engelcke to investigate. She found a leery community. The hotel wouldn't take any newcomers, not even the nurse. The only home that would accept her was a house where a man, weakened with TB, had already died of the flu. In a short time Miss Engelcke felt herself coming down with it too, but she couldn't leave because the passenger trains had been stopped in a futile effort to localize the flu. The phone operated only two hours a day but she got through to Dr. Heber Jamieson in Edmonton and a Mounted Police car was called off the search for a murder suspect to bring her in. Completely floored by the flu, she lay in the back of the open car all the way, and she believes this probably saved her. She was sick three days, then she had to get up to nurse her mother, and when she returned to nursing the flu epidemic was in full force everywhere, and the province was meeting it with a wonderful display of volunteer nursing, in which almost every able-bodied woman was a nurse. It was a winter of human misery and human grandeur, like the war which had just ended. As the schools closed, the teachers rallied particularly well. Centers were set up in the cities to direct teachers to homes where a practical nurse was needed. It could be a home where the mother had flu and the children needed at­ tention; or where the father was unable to work and the mother had to go out. 121 The effects of the flu were described by a nurse who came down with it during her third year training at the Misericordia. Iva Morgan (Mrs. George Mattern) said that due to the prolonged high temperature, patients suffered desquamation, much muscular weakness and later muscular rigidity. Mrs. Mattern said that after recovering from the flu she had to learn to walk all over again. There were several theories on prevention. The officially­ recommended method was the gauze mask, several of which can be seen in the picture of the crowd watching the 1918 Armistice Day parade in Edmonton. However, the masks were probably harmful unless the gauze was changed constantly and many nurses and doctors refused to wear them. The cure involved a partnership between patient and nurse. For the patient it meant doing nothing, absolutely nothing. A travelling salesman, feeling the virus coming on in a small town, had to stop where he was and go to bed. If he did, he would probably recover. If he tried to ride home he might not. A house­ wife would have to stay quiet in bed. Getting up to do simple household chores or to attend to the children could be dangerous. Much of the value of the nursing was keeping children fed and washed so the mother could wait out the disease with peace of mind. The remedies were elementary. Whiskey, aspirin, Epsom salts and castor oil to keep the body active enough to survive the fevers and chills; hot packs to ease convulsions; mustard plasters to reduce coughing. Many a travelling salesman rode out the flu in a country hotel room with a bottle of whiskey by the bed. The flu had a complicating factor, a nasty characteristic for which people used to pneumonia and typhoid were not prepared. It would recur. People who had seen pneumonia were deceived into thinking the patient was safe when his temperature dropped. He would feel better, get up, and have a fatal recurrence. The nursing profession could supply only a fraction of the nursing that was needed for this epidemic. The demand was de­ scribed by Mrs. W. Richards (Florence Churchill), who was keeping the private duty registry in Edmonton at the time. She had only thirty-five nurses on the registry and scarcely ever had one available to send. She would often answer the phone in the middle of the night and have the conversation end with the caller crying, or swearing, or both. 122 All over the province, emergency flu hospitals were set up in commandeered buildings. At Olds, Vermilion and Claresholm the agricultural schools were converted to flu hospitals. At Olds, school teachers and other capable women volun­ teered to do ward duty and free the trained nurses to supervise the wards and give instruction. Trained nurses scouted the farm homes of the district, pinpointed the flu cases and gave emergency help until the patients, with their bedding, could be moved into the hospital. Citizen committees also did a form of nursing, pick­ ing up food prepared in the college kitchens and delivering it to homes where there was no one well enough to prepare food or go out to get it. At Vermilion, the agricultural school took the overflow from the hospital and nursing home, with young women of the town and district acting as nurses. One of these volunteers was Dorothy Spencer, who later went into training at Lamont, and in 1929-30 returned as matron of the Vermilion municipal hospital. The army nurses, used to working in makeshift hospitals overseas, would have been very helpful at this time, but there were few available. The nurses were still overseas. They were the last to come home. In Ponoka, a ward for flu victims was set up in the school and when the school was full the new victims were moved into the town hall. At Drumheller, where a hundred people died in thirty days, the old school was a hospital. There was one trained nurse, Mrs. Duncan, with the teachers working as ward aides. At Redcliff, the new three-storey brick school became a flu hospital with Nurse Nash in charge. The epidemic brought back into service a number of married nurses but most of the volun­ teer helpers were housewives. In Red Deer, when the hospital was full, the town rented a large house to accommodate the patients who were still coming in. Mrs. D. Parker, a trained nurse, was installed as matron, but her staff were all volunteers from the district. In Athabasca, when everything else was full, space was found in a second storey flat above Falconer's hardware store. Mrs. Mutch, a practical nurse, and her husband, did the work. This in­ cluded carrying water and fuel up the stairs. 123 In Camrose, where six hundred people were stricken, the town was under a travel ban. But there was no ban on travel for Mrs. Olesberg, the former deaconess Sister Severine Frette. She nursed forty patients in their homes, travelling all the time. In Edson and Islay, the hospitals were not operating when the epidemic started, but j.hey were soon reopened as emergency flu hospitals by volunteef- nurses. In Edson, the women of the town rallied to meet the danger of flu as they had done in 1908 to meet an epidemic of typhoid. At Islay, Mrs. Roy Stone, the former Florence Mayson, who had come to the Islay hospital as a staff nurse in 1914, was asked to reopen it. She recalled that the harvesting had just been finished on the Stone farm, that epidemic fall of 1918, when Jack Fyfe and Neil McEachran came by. They told her the "hospital on the hill" was being reopened because of the flu; the government was going to pay the expenses; and would she please act as matron. When Mrs. Stone arrived a few hours later she found that two patients had already been brought in, and the women volun­ teers had finished a clean-up job on the hospital, which had been closed for two years. Eventually there were almost thirty patients in the rooms - and in the wide upstairs hall designed by Mrs. Lively. District people lent cots for the emergency. Mrs. Stone worked in the hospital in the morning, visited flu cases on district farms in the afternoon, and patients in the village at night. Mrs. Stone's help presented a problem. No sooner would someone come to help than she would become a patient. But in three months there was only one death; an old man for whom the flu was the last straw. At Vulcan, where graduate nurse Cora Rhinehart ran the town hospital as a private enterprise, both Miss Rhinehart and the town doctor came down with the flu. But the local women moved in and kept up the treatment for new victims. At Bassano, Dr. Scott's private hospital was used only for flu victims, with Bertha Walsh, an American graduate, directing local volunteers. And one hampering disability for the graduate nurse trying to run a hospital was pointed out by Miss Engelcke, who, after recovering from her own bout with the flu, was called to Lovatt, in the Coal Branch. Employees of the Lovatt mine were flu-ridden 124 and the company was paying her fifty dollars a week to supervise their nursing, an astronomical wage for the time. Miss Engelcke was ordering drugs and supplies and the com­ pany was willing to get her anything necessary, but one day the accountant asked her if she'd like to see the bills. She was as­ tounded to see that they totalled more than three hundred dollars, even with the discounts the company was doubtless getting. She had no idea what the drugs and supplies would cost. As she said: "We weren't told anything about costs in training. We were told to work and keep our mouths shut." At High River, Annie McLeod, matron of the V.O.N. hos­ pital and her assistant, Miss Stewart, tried to run the hospital them­ selves, leaving the staff nurses free to work in district homes. The town policeman, Fred Robson, became a member of the nursing team, delivering food prepared by women of the town to homes where there was no one to cook. In the hospital, Hing, the Chinese cook, and Wing, the Chinese orderly, added their own theory to the many theories on how to avoid the flu. These gentlemen revived an oriental idea that letting blood would safeguard them. So they scratched their wrists with pennies until the blood came. Hing and Wing did not catch the virus. Not so fortunate were two volunteer nurses. They were Pearl Talbot, a graduate nurse visiting her brother near High River when the flu came, and Miss Bond. Both came into the hospital to help. Both fell to the disease and died within a few days of each other. And so it went, all through that winter of 1918-19. And even the efforts that failed to save lives were not without effect. When the flu lifted, it left an awareness in every community of Alberta of the need for nursing skill. The Women's Institutes sponsored short courses in home nursing and first aid. The courses were given at fifty-four centers and taken by 3,409 women. The flu also left an awareness of the need for hospitals. New hospitals would be a feature of the post-war.

125 CHAPTER THIRTEEN Between the collapse of the western front and the collapse of the stock market, a good thirty hospitals were started or revived in Alberta. The new hospitals were a feature of the post-war period and are covered in this chapter. However, the nurses of Alberta were up to so many things in the post-war period that not even the legendary matron of the small hospital, the kind of hospital described in this chapter, could follow all the action at once. So this chapter is the first of five on developments of the post-war. Chapter Fourteen considers the Alberta nurse of the time as an individual: her status, her private life, her education, how the nursing profession in Alberta began to show its maturity by de­ veloping its own leaders, and how the average Alberta graduate used her training; that is, on private duty. While Chapter Fourteen considers the nurse as an individual, Chapter Fifteen considers the post-war nurse as a member of groups which the growing maturity of the profession were bringing to being. Such organizations as the nursing school alumnae asso­ ciations, the growing influence of the Alberta Association of Regis­ tered Nurses, and the Weir report on nursing education which the AARN helped to bring about. Chapter Sixteen considers what the Weir commission found and recommended. Chapter Seventeen is devoted to one of the finest expressions of the spirit of nursing in Alberta. That's the district nursing ser­ vice, which began with the post-war.

Meanwhile, back in Chapter Thirteen, the nurses who went out to bring hospital service to the towns and villages of Alberta, worked against discouraging realities. The province, with a vio- 126 lent effort, had jerked itself free of the wilderness and now lay gasping for breath. The effort had produced a set of towns as raw and bare and devoid of comfort as any devised by civilized man. The optimism of pre-war years no longer softened the ugliness of these towns. The towns needed a lot of things. They needed hospitals, and it was the nurses who provided them. By their presence they con­ tinued to turn vacant houses and bankrupt banks into hospitals. The nurses were fully educated, educated to use the most sophisticated medical equipment. But the hospitals were as raw and unfinished as the towns and didn't have such equipment. The nurses put their skills and knowledge to improvising what wasn't there. The Catholic nursing sisters were as active as ever. Working in small parties of three and four, like their lay companions, the nuns who had vowed to live a life of poverty could hardly have found a better place to do it than rural Alberta. They opened twelve new hospitals and took over the operation of six more which had foundered. And six new orders of nursing nuns came to Alberta to get in on the poverty. The Protestant missionary societies expanded their work and three new and important forces were added. There was the Muni­ cipal Hospitals Act which came into effect in 1917-18. There were the Women's Institutes. And there was the Red Cross. The new factors were important, but the single most important factor in making a hospital go was the nurse. To the Alberta hospital nurses of the 1920's, this chapter is dedicated. It is dedicated to nurses like Cora Rhinehart, who started the hospital at Vulcan and kept it going for eleven years until the municipality took over. An American graduate, Miss Rhinehart began private duty nursing in the Vulcan district in 1909. In 1914 she took a re­ fresher course in California and in 191 7 made a hospital of a four-room house. It was the only one on the railroad line between Calgary and Lethbridge, and it had a modern touch in the form of a sewage system. However, the water for washing had to be caught in a rain barrel and the water for drinking and cooking had to be carried from a well. The stove and the heater burned coal and had to be stoked. The lamps burned coal oil and had to be trimmed. 127 Miss Rhinehart didn't have to do all these chores herself, not all the time anyway. The women of Vulcan helped, and in the flu epidemic, when Miss Rhinehart was stricken, the women kuew enough of the hospital routine to take over the nursing. There was also help from two practical nurses in the com­ munity, Mrs. Morton from 1919 to 19~,and Mrs. Elizabeth Speer after that. These women took. con alesc;ent and maternity cases into their homes, and their homes b c e auxiliary or con­ valescent hospitals to the active-treatment hospital Miss Rhinehart was keeping with her dedicated, selfless efforts. The heavy work and responsibility eventually wore down Miss Rhinehart's own health and when she had to give up in 1928 the community filled the void with a twenty-bed hospital and five graduate nurses. Rocky Mountain House owes its first hospital to a nurse of the same cast as Miss Rhinehart. She was Mrs. Stewart. Born Mary Louise Burki, she graduated from a training school in Sioux Falls, South Dakota, in 1903. In 1912 she came with her husband to homestead in the Caroline district, and like all homesteading nurses, wasn't able to spend all her time at home. She nursed in neighboring houses, getting there on horseback, or sometimes on foot when it wasn't safe for a horse to travel. In 1922 the Stewarts moved to Rocky Mountain House, where she built a nursing home that would be the town hospital until 1938. The town paid two dollars a day for welfare patients, but much of the service Mrs. Stewart gave to non-welfare cases was paid for in food. Mrs. Stewart was the entire staff: day nurse, night nurse, cook, laundress and housekeeper, and she did all these jobs without electricity or running water. The hospital was licensed by the province for minor surgery. However, in emergencies there had to be major surgery as well. Once when a man who had been "riding the rods" and fallen under the train was brought in, Dr. A. C. Greenaway amputated the man's leg on the home - made operating table. For this surgery the operating staff was enlarged to include Mr. Stewart, one of the Stewart daughters and a reluctant trainman. Mrs. Stewart provided Rocky Mountain House with a hos­ pital for sixteen years. Elk Point owes its hospital start to Mrs. Jim Hitchcock, who had been a nurse in England, and kept in practice in her farm 128 home five miles west of the town. In 1920 the first doctor, F. G. Miller, came to Elk Point, and when his patients required it, Mrs. Hitchcock provided a hospital in her home, plus an operating table in her kitchen. In 1923 Dr. Miller started a small hospital in a vacant house in the town and persuaded Mrs. Hitchcock to become the hospital staff at seventy-five dollars a month. Sterilizing was done out­ doors when weather permitted. There was neither water nor elec­ tricity and when emergency forced a night operation "the lady with the lamp" had to stand outside with her lamp and shine it through the window. (The doctor didn't like using chloroform around an open flame.) The doctor's wife would serve as anaes­ thetist, but if she wasn't available, one of the tellers from the bank had considerable talent in that line. Mrs. Hitchcock, game woman that she obviously was, was already middle-aged and could take only a year of this, a year in which thirty-five patients were admitted. But when she left, the new school of nursing at Lamont had trained a replacement for her, a Miss Bell. Miss Bell had a ward aide to help her. Later, two Royal Alex grads, Nora Williams and Ema Hanna, both '25, came to work. The nurses lived in a shack behind the hospital. When there were too many patients tents were set up in the yard. But the nurses, starting with Mrs. Hitchcock, demonstrated the value of a hospital, and in 1928 Elk Point put up a proper municipal hospital. In the Peace River Country there are two hospitals which date back to the same nurse. They are the fifty-bed Fairview Municipal and the twenty-one bed Berwyn Municipal. The nurse was Mrs. William McKenzie, the former Grace Connor, a graduate of a Manitoba school who came to the Waterhole district in 1919 with her husband. For five years Mrs. McKenzie travelled to the farm homes of people who needed her professional skill and cared for them there. But travel was difficult and the demands were many so in 1924 she took over a house in Waterhole and kept two rooms for patients. When required, J-er kitchen was the O.R., the kitchen table was the operating table and Mrs. McKenzie acted as anaesthetist and assistant to the doctor. A patient who had a successful appen­ dectomy performed in the McKenzie kitchen was Mrs. Duncan 129 McLean. In the golden jubilee year of the AARN Mrs. McLean's grand-daughter, Sharon Cameron, was in the University Hospital school of nursing, class of '67. When Mrs. McKenzie needed rest her husband would come in from the farm and relieve her. In 1928, the Women's Institute, one of the new forces in Alberta hospital work in the 1920's, followed up her pioneering by qpening a twelve-bed hospital in Waterhole, with financial arrang 'ments that were fairly common at the time. The arrangement was this: e W.I. owned the hospital and the equipment, and the matron, s. Moffat (a graduate of the Grey Nuns hospital in Regina) , upplied the dressings and other expendable items. The matron c llected from the patients, paid the bills and anything left over wa~ for salaries. Twenty-four hour duty was e)qJected of the staff when re­ quired. When there was time to spare;the matron and her assistant engaged in carpentry, taking orange crates and making bedside tables of them. We have no information on the stability of these bedside tables but the table in the O.R. was tricky and tipped easily if the weight was not evenly distributed. Mrs. Moffat felt the sterilizer was also unsafe so she would finish sterilizing jobs in the oven. The work was heavy but the hospital itself was light, light enough to be hauled three-and-a-half miles to Fairview when the Waterhole townsite was abandoned in the fall of 1928. A steam tractor pulled it to the new location. For the move most of the patients were discharged, but there were two who were too ill to leave the hospital, so they stayed in it until it reached Fairview. Mrs. McKenzie, meanwhile, was in Berwyn, twenty-five miles east, starting her second hospital. The Women's Institute was or­ ganized in Berwyn on March 28, 1928 to provide a hospital and keep a doctor in the community. The municipality bought a house and the W.I. converted it to a four-bed hospital with an operating room and two rooms upstairs for the staff. Mrs. McKenzie and Roa Chapman, a ward aide, were the staff, and Mr. McKenzie helped with heavy work. Raising funds through all the devices known to the W.I., the hospital opened free of debt, and Dr. Mark Levy (later Mar­ shall), who performed the first operation, gave his fee to the hos­ pital. The first baby born there was a girl, to the Guignion family. 130 She was named Berwyn Grace Guignion, after the town, and after the matron, Grace Connor McKenzie, R.N., whose work led to two municipal hospitals in the Peace River country.

In Empress, in March, 1921, eleven citiz.ens of the town put up fifty dollars apiece and signed a fifteen-hundred dollar loan at the bank to buy a house that could be made into a hospital. And they had a graduate nurse living in the community who was persuaded to give up private duty and become matron. She was Miss Ledan, who had trained in Holland. Miss Ledan and her sister moved in; Miss Ledan constituting the nursing staff and the sister the housekeeping staff whose duties included cleaning four­ teen kerosene lamps every day. The place didn't look much like a hospital by today's stan­ dards but Drs. Caldwell and McCharles convinced the department of public health that it was and should therefore get the daily grant per patient; soon there were an average of ten patients daily. Surgery was done and while efforts were made to keep a night nurse, the matron was often left with a twenty-four hour load. Sometimes untrained women were employed as nurses, but at least the board tried to get mothers who had some experience in nursing their own families. As a matter of fact, one of these non-profes­ sional ladies was a great asset to the health of the Empress district and the smooth operation of the hospital. She was "Auntie" Rowles. She took infectious cases into her home on a farm near Em­ press. Once a scarlet fever victim was found to have acute appen­ dicitis as well. The man had to be taken into the hospital for an operation. He was revived in the operating room, then taken out to an open car and driven to "Auntie" Rowles' place. In 1924 the hospital acquired a sterilizer but it didn't work very well and everything boilable was still boiled. In 1926 a Delco light plant was installed and the hospital said goodbye to oil lamps. With the load of work it's not surprising that the hospital also said goodbye to a good many matrons. There were six in seven years, until Marion Flock came, fresh from the Edmonton General in 1928 and Miss Flock has been there ever since.

At Cereal, on the prairie fifty miles east of Calgary, the Women's Institute teamed with the local doctor to provide a hos- 131 pital. It was in 1918. The W.I. bought a house and Dr. Chandler and his wife undertook to run it. There was a Victorian Order nurse in the hospital for a brief time and then in 1919 Mrs. Mary Cody came and spent thirty years, the last six with running water. Mrs. Cody bas provided a lively insight into the operation of the place. Mrs. Cody (born Mary Barter) was a Quebec girl but she had come to the west to train because she bad to be twenty-one to get into a Montreal hospital. She went to Medicine Hat General, graduated in 1915, nursed in the hospital at Provost before coming down with flu, and on recovering, went to help at the Cereal hospital where she was later matron. Mrs. Cody writes: "The hospital consisted of five rooms. The front room was small and when not used as an operating room it was usually filled with patients. There was a larger room holding four beds and a smaller one containing two. Then there was a small bedroom occupied by the doctor's wife, for as there wasn't a girl on at night, Mrs. Chandler would get up if a bell rang. "There was a tiny kitchen. If an operation came up, we would have to move the patients out of the front room, then clean it up to the best of our ability before operating. "We had an antique sterilizer which we used, sort of a double­ boiler affair the size of a large pail. This we set on the stove to sterilize our dressings. It was some job and we had no assurance they were sterile. We had to finish them off by drying them in the oven. This was a great worry to me; a far cry from our electric sterilizer in Medicine Hat. The X-ray room was my broom closet. I took most of the X-rays. "We had to improvise a good deal. Dr. Chandler ran the hos­ pital on his own. Therefore the money wasn't too plentiful and we got very little equipment. Dr. Chandler died of a heart attack in 1923 and Dr. Esler took over. He had one graduate nurse and a maid who cooked, washed, ironed, helped with trays and carried water from the well for washing. "The babies were kept in baskets in the kitchen by the stove and were bathed on the kitchen table. No one was allowed to open the door, no matter what, in case of drafts. I sometimes wonder how we saved so many with our old-fashioned methods. "The work was very hard but interesting and challenging." In the golden anniversary year of the AARN Mrs. Cody was still 132 working in Calgary. Looking back on a town hospital operation that was typical of Alberta in the 1920's, she added: "We had a wonderful time." To a hospital nurse schooled in today's affluence, Alberta of the 1920's may well seem a disaster area, worthy of rescue by the Red Cross, and it's a fact that the Canadian Red Cross was a force in hospital nursing in the post-war. It was a new force, along with the Women's Institutes and Municipal Hospitals Act. For its entry into peace-time Alberta, the Red Cross used the local contacts it had built up in war. A questionnaire was sent to local Red Cross societies, towns and organizations seeking infor­ mation on medical and nursing service available in their com­ munities. From the results of the questionnaire the society made up a medical map of Alberta, showing proposed municipal hos­ pital centers, areas served by graduate nurses, areas where practical nurses only were available, areas where district nurses were needed. The blanks in Alberta's nursing coverage all showed on this map, which became the guide to Red Cross action in the post-war. The society sponsored a hospital for crippled children in Calgary, (see Chapter Twenty-Two) , and Calgary is not hard to find on a map. However, if you can go to a map of Alberta and in less than sixty seconds point out Consort, Foremost, Rife and Altario you're something of a genius. The Red Cross had hos­ pitals in these places. They were called "nursing outposts". The first was at Consort. The society went there in 1920 after a crop failure when the district was threatened with a loss of hospital service in addition to losing the crop. Following its plan for peacetime emergencies like this, the local branch of the society provided the building and the provincial office supplied equipment and helped pay the salaries of the nurses. The most money the provincial office ever contributed in a month was one hundred dollars, but it was a lot of cash in that situation. There were two nurses stationed at the Consort "outpost". They maintained a hospital which could handle twelve beds in a pinch. They also visited homes in the area and gave the nursing advice which Alberta's new district nursing service was giving in the north. Later in 1920 the Red Cross set up a nursing outpost at Altario, twenty miles east of Consort. In an article in the Red Cross magazine of May, 1922, Mrs. M. H. Conquest called it 133 "the smallest hospital in the world". It had four beds, but could. go six when necessary. In 1921 the society opened an outpost which was in British Columbia but served a wide farming area of Alberta. It was at Pouce Coupe in the Peace River Country. In 1922 there was a brief involvement in Athabasca. Next was a station at Foremost, on the prairie sixty miles east of Lethbridge, which had nine patient beds. There was also the station at Rife. Rife is the hardest to find. It's roughly between St. Paul and Bonnyville and was not on a railroad or actually on a road of any kind, though it was almost on a lake-Moose Lake. The Red Cross nurse had four patient beds at the Rife outpost. In out-of-the-way, or out-of-luck places, the Canadian Red Cross remained in the health field throughout the post-war decade, and the most effective service it could give in these places was nursing service.

There were new forces at work in the twenties but the old forces didn't rest on their previous work. The missionary societies didn't. The Methodist mission hospital at Pakan was moved to Smoky Lake, and the Lamont Public continued to grow in stature and to train nurses for mission work in other countries. The Presbyterian hospital at Grande Prairie was turned over to the municipality but the Rolland Boswell continued at Vegre­ ville; the nursing mission at Bonnyville grew to hospital size; a nursing mission was founded at Cold Lake which soon became a hospital; and a mission was opened at Fort McMurray. After church union in 1925, all continued to operate, with the Rolland Boswell staying under the Presbyterian wing. When the Methodist mission hospital established by Dr. Lawford at Pakan was moved to Smoky Lake, it was moved literally. The two-storey building was towed across fifteen miles of new farmland to the town on the railroad which had become the center of the district. Dr. Walter Morrish was put in charge and the first matron was Mae Griffith, who came directly from her graduation at the Royal Alex in April 1923. In her two years at the fourteen-bed hospital Miss Griffith had the help of graduate nurses on only two brief occasions. How­ ever, she had two practical nurses who had taken some training 134 in maternity at a private maternity home in Edmonton. They worked for twenty-five dollars a month, plus room and board, and were very helpful in the many maternity cases the Smoky Lake mission handled. Women were not left alone from the time they went into labor. The mission was well-equipped for its time, with running water, a septic tank, a Delco light plant, a telephone and an X-ray machine. Only one of the new municipal hospitals of the time could boast an X-ray. However, there was still a lot of impro­ vising to be done. As Miss Griffith recalled: "If a nurse couldn't improvise she was at a terrible loss in any country hospital." Everyone associated with the Smoky Lake hospital found im­ mense pride and satisfaction in the results of their work. And not just inside the hospital, where the surgery was often of city complexity. They also did a great deal of outside work in the public health field. The V.O.N. about this time commissioned a study of public health work across Canada and found that the new municipal hospitals of Alberta were public health centers for their communities.. It was true of most hospitals, ,including the Smoky Lake mission.

At Cold Lake, Chapter 46 of the AARN is named for the nurse who opened the Cold Lake mission in 1921. She was Iva Marshall, later Mrs. Fred McLeod. And although she was running an outpost for the Presbyterian missionary society she belonged to the Baptist church and was a 1919 graduate of the Catholic Misericordia Hospital - a sort of one - woman ecumenical movement. Iva Marshall might have appeared an unlikely candidate for such work. She weighed only 102 pounds in 1921; she was not very strong and had required four years instead of the usual three to complete her course. But she was not thrown by the job, nor by the horse which was provided for her, a horse who liked to pitch off riders by sudden jumps sideways. The horse pitched a good many but never Miss Marshall. She rode it on all her district nursing trips. When Miss Marshall first saw Cold Lake in June of 1921, it was sixty miles from the end of steel at St. Paul. It had one tele­ phone and a population of sixteen, including a bride from Penn­ sylvania. She had a room over the store, and out in back, a log 135 shack which had been used to store fish, was cleaned up to be the nursing office. In August of 1921 she had to make a hospital of the con­ verted fish house. A young fellow living alone on a farm rode in one day in a state near delirium. There was no doctor near but he obviously had double pneumonia and his temperature was 105. The nurse in this frontier emergency had no choice but to make the fish house a hospital and admit the young pneumonia victim as the first patient. People in the community supplied a bed and the bedding and Miss Marshall moved in with the patient to wait out the case. There was at least plenty of ice available from the fishermen, for the ice packs that helped bring down the fever. She slept in a chair in the cottage - with her feet off the floor because there were mice skittering about. On the ninth or tenth night she woke and found the patient so still and peaceful she thought he had died. But he was all right. The crisis had come. The fever had dropped and he was having a restful sleep, on the way to recovery. That was the actual beginning to the John Neill Hospital of today. In 1922 Miss Marshall left to marry Fred McLeod but they returned two years later when Mr. McLeod was appointed postmaster and Alberta Government Telephones agent at Cold Lake. Mrs. McLeod continued her nursing by helping out the hospital staff at night. The new John Neill hospital, provided by a gift of three thousand dollars from Westminster Central United Church in Toronto, to honor a former pastor, was a far cry from a converted fish house. It consisted of a converted dance hall plus a converted garage for quarantine cases. There was no resident doctor in Cold Lake and wouldn't be until 1936, so once a week the d~ctor came from Bonnyville to hold a clinic at the hospital. Patients and their families, many of them metis or Indian, would come and camp on the hospital grounds. The clinic would sometimes go on until two in the morning. Bookkeeping had to allow for barter and moose meat and butter were often credited to accounts. (In more sophisticated centers bacon and butter would be credited to accounts.) Nurses were paid seventy-five dollars a month for a twelve­ hour seven-day week. The night nurse did the ironing, with a flat iron. There were many interruptions and thus many scorched 136 Iva Marshall McLeod (on the horse that liked to jump sideways) in front of the fish shack she converted into the first Cold Lake hospital A closeup of that institution

The nurses who received their graduation pins from the Prince of Wales. Evelyn Robertson and Jean Laidlaw on the steps of High River Municipal Hospital with Annie McLeod uniforms. There were many new babies and on cool nights they were moved into the kitchen because it was warmer for them. One night when Mrs. McLeod was relieving, a young man was brought in suffering minor damage from a fracas. She fixed him up and gave him a bed. The next morning he came into the post office where Mrs. McLeod was relieving her husband. He blinked a bit. Then he came around the other side to the telephone office and she was there too. "Shee," he exclaimed. "lss you the whole town?" It was a logical question to put to Iva McLeod, the only Alberta nurse to have a chapter of the AARN named in her honor.

The John Neill Hospital was opened in July, 1926, the same day the new hospital at Bonnyville was dedicated. The Bonnyville development carried on two traditions. The new fifteen-bed hos­ pital carried on in an expanded way the work of the Bonnyville nursing mission started in 191 7. It also preserved the name of Katherine Prittie in the mission field. When the historic Presby­ terian hospital at Grande Prairie was turned over to the munici­ pality the mission board transferred her name to the project pro­ posed for Bonnyville.

There was another missionary development in 1926. In April, the United Church opened a nursing station at Fort McMurray, and to make it go Mrs. D. G. McQueen obtained Olive (Dolly) Ross, who had been matron at Grande Prairie before going to war, for a second tour of duty on the mission frontier. Miss Ross went to Fort McMurray with the opening of the navigation season in 1926 and kept the mission for the eight years of its existence. It was an interesting time. The bush pilots were just starting to open the north and McMurray was an important place on the air map. The term "mercy flight" would soon be coming into the language and the pilots who made these flights were frequent callers at the mission. The mission had sick beds for one or two patients if required, but most of Miss Ross' work was district nursing. She didn't have a radio which was a blessing in a way because then she didn't know how cold it was. One night she walked three miles through a blizzard to visit a sick woman at Waterways, 137 across the nver. She discovered when she got there that it was sixty below. Although she didn't have a radio she had a phonograph to play her favorite records and this phonograph once helped her in a case. A man came in, in great pain, with metal chips that had lodged in his eye after an explosion. She used a magnetized phono­ graph needle to draw out the metal chips and the pain vanished. It was not difficult for Miss Ross but it was like a miracle to the suffering man. It was a fine example of the service the missionary nurses and their supporting societies were bringing to frontier Alberta in the 1920's.

'lbrough the post-war decade nurses in the Catholic sister­ hoods continued to tackle the same worldly problems as nurses in the lay side of the profession. Ladies who sought to live their lives in poverty could hardly have found a better place to achieve it than in rural Alberta. They started twelve hospital projects and rescued four more. Nuns from established orders were involved in eight projects, the rest were the work of newcomers to the Alberta hospital field. In 1924 the Filles de Jes us, newcomers to nursing although not . to Alberta, revived the historic hospital project at Pincher Creek. In 1925, the new Canadian order, the Sisters of Service, came to Vilna and in 1926 to Edson. In the same year, the Sisters of Ser­ vice of Mary Immaculate started their first and only Alberta hos­ pital at Radway. In 1927 the Sisters of St. Joseph (of London, Ontario) came to Galahad. In 1927, also, the Sisters of Charity of St. Vincent de Paul (the American order founded by Mother Seton) came to Hardisty and Westlock. In 1929, the Canadian Sisters of St. Martha took over the old Van Haarlem Hospital in Lethbridge and made it St. Michael's. While the six new sisterhoods were coming into the Alberta nursing scene, orders which had been through hospital projects before, showed they were game to try again. In 1919 the Evron Sisters went to Bonnyville. In 1920 the Sisters of Providence of Montreal went into Wabasca; in 1925 they raised their mission at Fort Vermilion to hospital status; and in \ 1929 opened a hospital at McLennan. In 1924 the Kingston (or English-speaking) branch of the same order reopened the Cam- rose hospital and in 192 7 converted an empty office building on 138 south Edmonton's Whyte A venue into St. Joseph's Hospital for the aged. The Ukrainian order, the Sister Servants of Mary Im­ maculate, who had been nursing among the settlers of the Willing­ don-Mundare district since the beginning of the century, built their hospital at Mundare in 1929. And the Grey Nuns who had started the whole business in 1859, were still at it in the post-war. In 1926 the Grey Nuns went to St. Paul and took over a foundering community hospital. We'll take a close look at the new orders, and the traditions they brought to Alberta nursing, but let's review first the work of the established ones. And let's start with the Grey Nuns, who were established the longest. They added St. Paul to their centers of activity. The old-timers of St. Paul all remember how the hospital got its start. In 1925, a young teacher was brought in from the country on a wagon in immediate need of an appendix operation. There was no time to take him farther. Dr. P. J. Decosse had to operate on the desk in his office. This stirred the town to action. A group, including the local M.P. and the two bank managers, bought a house and made a hospital of it, by cutting it in two and mounting one half on top of the other. It was good for eight beds. A plan to staff it with two graduate lay nurses apparently didn't work out and the next year the Grey Nuns were approached. They took over on September twenty-fourth, 1926, and within five weeks a campaign had started for a real hospital building, with a recognizable operating room and space for thirty patients. It was named for St. Theresa, was built in ten months, and was staffed by two R.N. sisters and a lay nurse, Miss Lafond. A lay nurse in a sisters' hospital was a rarity at that time. In 1919, four sisters of Our Lady of Charity of Evron came to Bonnyville, forty miles northeast of St. Paul, to open their third Alberta hospital. (The Evron sisters were already in V egreville and Trochu.) The nuns arrived on October fifteenth, but the roads were so \ poor that their equipment was not brought in until three months later. Equipment or not, a month after the sisters moved in, a patient insisted on being admitted to the hospital and the parish priest sent over his bed to accommodate the sick man. He got the hospital off to a good start by recovering. On Christmas Eve, three 139 people were brought in with typhoid and on January tenth, a man was brought in with severe head injuries. The sisters were overjoyed four days later when the beds and other equipment of the hospital finally appeared, but beat and water were still a problem. The house was heated by wood stoves which required constant supervision because of the danger of setting the whole building ablaze, and the stoves gave very in­ different heat anyway. It was often said in that first winter of 1919-20 that people roasted on one side and froze on the other. Then there was the water. It had to be pumped and carried by hand, which did not ease the work or the fire hazard. But progress came. In December of 1920, a coal furnace was put in and a well was sunk from inside the laundry room. The sisters still had to pump the water but they at least didn't have to go out for it. In 1922 came electricity. In 1923 came a tele­ phone. In 1928 came the first train. And in 1929 came a new St. Louis Hospital, with thirty-two beds. The sisters took posses­ sion on October sixteenth, 1929, ten years and one day after coming to Bonnyville.

The Kingston branch of the Sisters of Providence added two more projects to its Alberta list in the post-war decade. There was St. Mary's Camrose in 1924 and St. Joseph's Edmonton in 1927. Six sisters went to Camrose in 1924 to put the operation of the town hospital on a more continuous basis. They were Sisters Mary Clotilda, Matilda, Cleophas, Emerita, Gerald and Alban. Sister Mary Alban was to be director of the school of nursing (see Chapter Fourteen). Sister Mary Gerald was still there at the golden jubilee of the AARN. They began work in the old hospital while construction started on a new fifty-bed St. Mary's, a solid red-brick building designed to be a hospital. St. Mary's was ready for the official opening on October twenty-fourth, 1924, and it was, of course, a treat for the R.N. sisters to do hospital work in a building designed for that purpose. When the Kingston Sisters opened St. Joseph's Hospital in Edmonton, however, they did it in an abandoned four-storey office building. It was the old Whyte Block, at Whyte A venue and 107th Street, a white elephant left over from the pre-war building boom. 140 Five nuns, under Sister Monica, took over the Whyte Block to make a home for the aged and infirm. Although care of the aged was a traditional aim of religious congregations, both Catholic and Protestant, there hadn't been much call for it in Alberta up to this time. This was still a young country, and there were few elderly people among the white popu­ lation. At the start of St. Joseph's there were only a few bed patients. Most were older people who needed a peaceful and com­ fortable home, and one of these was Mrs. Mary Longmore, of Clover Bar, a Cree Indian woman and the last practitioner of the art of Indian medicine in the Edmonton area. The sisters were experimenting to see whether St. Joseph's should be run as a home or a hospital. In 1929 the sisters de­ cided it should be a hospital. Two years later the provincial govern­ ment would agree and authorize St. Joseph's as a chronic hospital. The Sisters of Providence of Montreal, the French-speaking counterpart of the Kingston Branch, were busy in northern Alberta in the post-war decade. They were active at Wabasca, Fort Ver­ milion and McLennan. McLennan was on a railroad but the others were far to the north of anything so civilized. In 1920, a registered nurse, Sister Stephana, went to Wabasca, in the bush ninety miles north of Athabasca, to open St. Martin's mission hospital. St. Martin's had eight beds and little equipment. Sister Stephana had another Sister with her, apparently not a trained nurse, who could help when needed. And they did a re­ markable piece of work in the public health field. They converted the traditional Indian Treaty Day into Clinic Day. On the day the Indians assembled to receive their rent for the use of the country, the nuns arranged to have the doctor make his annual visit. The doctor would perform minor surgery and ad­ vise Indian mothers about the health of their children. In the clever conversion of Treaty Day to Clinic Day, the nuns at Wa­ basca were creating something very similar to the travelling clinic program that appeared later with the provincial district nursing service. In 1925, the Sisters of Providence raised their nursing mission at Fort Vermilion, another two hundred miles north of Wabasca, to the status of a hospital. They sent the first registered nurse to Fort Vermilion: Sister Mary Ange. St. Theresa's is still the most northerly hospital in Alberta. 141 When Sister Mary Ange arrived on the riverboat the hospital was just an annex built on to the convent. It was a wooden fire­ trap cluttered with partitions that divided it into twenty closet-like rooms. There was little equipment, and no water supply. In sum­ mer the sisters had to haul water from the Peace River and boil it on the stove. In winter they had to melt snow on the stove. Shortly after Sister Mary Ange came she was joined by an­ other R.N., Sister Marcella. They treated patients in the hospital, and travelled about the surrounding bush country by dog team or wagon - according to season - doing district nursing and public health work. And the sisters participated in one of the epic stories of the north. They cared for half a dozen suspected cases in the diphtheria scare of 1928-29 and were witness to the dramatic emergence of the airplane as an aid to nursing. On January third, 1929, Wop May and Vic Homer landed on the river ice in front of the mission at the end of their flight from Edmonton with the serum that could avert an epidemic. May's and Homer's flight, in an open bi-plane, across six hun­ dred miles of bush at temperatures down to thirty-three below, received the international attention it deserved. However, there was a nurse involved in the story whose importance was largely over­ looked. She was Mrs. Albert Logan, from Calgary's Holy Cross, the wife of the Hudson's Bay Company trader at Little Red River, fifty miles beyond Fort Vermilion. In December, when her hus­ band became violently ill with a sore throat, it was Mrs. Logan, from her nursing knowledge, who recognized diphtheria. Mr. Logan died after ten days; he was already beyond help. But he was the only victim and for this Mrs. Logan deserves much credit. She took all the correct steps. Her husband had been ill three days when she diagnosed the disease. She immediately isolated him from the rest of the com­ munity. She also recognized that because of his position as a trader, he might have exposed all five hundred residents of the Red River­ Fort Vermilion area to diphtheria. So she sent a musher fifty miles to Fort Vermilion to warn Dr. D. A. Hamman, the government doctor. Dr. Hamman had only a small supply of over-age diphtheria serum, not enough to immunize his district. So he sent veteran trapper Louis Bourassa to the nearest telegraph station at Peace 142 River with an urgent request for anti-toxin, by air if possible. It took Bourassa twelve days to make the two-hundred-and-eighty mile journey up the Peace River to the telegraph line. The request was received in Edmonton New Year's Day by Dr. M. R. Bow, the provincial health officer, and the next day Horner and May were flying north. It was a two-day ordeal in the open plane. The first night out they stopped at McLennan, where the Sisters of Providence opened their Sacred Heart Hospital later in 1929.

McLennan was a divisional point on the Northern Alberta rail line to the Peace River Country and was always ready to re­ ceive patients arriving by train, caboose or speeder. Sacred Heart began with sixteen beds, and in the golden anniversary year of the AARN had fifty-three, plus fourteen bassinets, with a staff of forty-two including fourteen professionals. And so, through the 1920's, the established orders of nul'Sing nuns expanded the work they had begun in earlier decades and demonstrated a point about hospitals. Hospitals weren't built. They grew. The real cornerstone was not the block of rock on which the government dignitary laid a blob of mortar with the engraved silver trowel. The real cornerstone was the nurse, and the surest illustra­ tion of this was what happened at Mundare. At Mundare the Sister Servants of Mary Immaculate built their first Canadian hospital in 1929. The thirty-bed il'.stitution was completed and blessed on September twenty-second but the open­ ing had to be delayed to the next summer while two young Sisters completed their course in nursing at the Misericordia. They were Sister Gertrude Lesuik and Sister Macrina Scab, the first Canadian­ bom members of the order to train as nurses. Sister Macrina came from Saskatchewan but Sister Gertrude was a local girl whose parents had come in to the Mundare district from Austria at the tum of the century. Sister Gertrude, and Dr. N. C. Strilchuk who came to Mundare in 1927 to start his medical practice, represented the younger generation who were finding their way into the uni­ versities and professions, and were a source of pride to the immi­ grant community.

So the old orders were expanding their work in post-war Al­ berta and six new orders of nursing sisters came to join the action. 143 The first of the newcomers were Les Filles de Jesus (the Daughters of Jesus) who came to Pincher Creek in 1924 to revive the historic Pincher Creek Memorial Hospital. They were from a French order with a predictable pattern of development. Les Filles de Jesus were founded in Brittany in 1834 by Mother Perrine Samson. They did social work to begin with, and then inevitably this took the form of teaching and nur­ sing. In 1903 part of the order left France in the same persecution that caused the Evron sisters to leave for Trochu and Vegreville. The Daughters of Jesus came to Lewiston, Montana, and ·started a hospital. In 1904 another party opened a boarding school in Pincher Creek and in 1905 they opened a mission at Lac La Biche. They would eventually have hospitals at both points in Alberta. From their school in Pincher Creek they had witnessed and participated in the struggles to keep the hospital going. They had seen it die finally in 1919. In 1924, responding to the need of the community, four nursing nuns started St. Vincent's. They had trained at the order's hospital in Lewiston. They were able to get one of the largest buildings in Pincher Creek, an Edwardian mansion from the Le Bel estate for only ten thousand dollars, a bargain even at 1924 prices. The town offered all the linen and equipment from the old Memorial Hos­ pital and the opening of St. Vincent's was set for November nine­ teenth. However, following an Alberta custom, it had to open early, seven weeks early, to help a mother who needed hospital care after the birth of twins.

Alberta was bound to attract the Sisters of Service, a new Canadian order founded in Toronto in 1922, to do nursing and teaching and give religious instruction to children in rural areas. The order drew many nurses who had served in the army in the first great war. Within three years of founding, the new order had started Our Lady's Hospital in Vilna, and the following year brought continuous hospital service to Edson. Three Sisters of Service opened a hospital in Vilna in an abandoned bank. It was November twenty-ninth, 1925. There were six beds. The running water was the kind the nurses ran for; and so was the plumbing in cold or rainy weather. Fuel for the sterilizer came from the woodpile. lit was a prospect to make the faint­ hearted want to abandon the bank again, but Sister Catherine 144 Wymbs, Sister Mary Rodgers and Sister Ann Geraghty didn't mind. Sister Wymbs had been an army nurse overseas; had stayed in France after the war to help in the flu epidemic, and had been decorated by the French government. Sister Geraghty was a jovial soul with a fund of Irish songs and Irish tales which were rated as good as medicine in the district homes where she went to nurse. Sister Geraghty was a sort of public relations officer for the hos­ pital as she travelled around the district on her home visits. She was also a public health nurse. In three years of hard work and firm organization the sisters were able to abandon the bank and move into their present fifteen-bed cottage hospital. In conjunction with the hospital they ran a small farm. By this time Sister Wymbs and Sister Rodgers had gone to Edson with three other sisters to give that railroad town its first continuous hospital service. Edson had been trying since 1913. Although the hospital had been built with help from the Victorian Order of Nurses, the V.O.N. bad not been able to operate it. In September of 1921 the hospital board made an agreement with Nurse Reeve from Provost to run it rent-free, with the nurse's salary to consist of what was left over after she bad collected from the patients and paid the ex­ penses. However, eleven months later Miss Reeve and her assistant had to resign after treating eighty-three patients, and the Edson hospital remained closed until the fall of 1926 when the Sisters of Service sent Sister Wymbs there to reorganize it as St. John's. St. John's opened December eighth, 1926, and the next day there were two patients: a man with a broken hip and Joe. Joe had an injured foot. He may have bad a last name although no one asked about it because in Joe's case it wasn't necessary. Joe stayed around for years as orderly and maintenance man. Edson finally had a permanent hospital.

Then there were the Sisters of Charity of Immaculate Con­ ception, another Canadian order. They brought a particularly ap­ pealing tradition to Radway, when they opened their only Alberta hospital there in 1926. The order was founded by the bishop of St. John, New Brunswick, in 1854, to care for the hundreds of children left home­ less by the cholera epidemic which had swept the maritimes the 145 two previous years. It began with five nuns headed by an Irish girl, Honora Conway, known as Mother Vincent. Their work in­ cluded teaching, which the order does in several schools in Alberta, and inevitably nursing. In 1926, when three sisters came to Radway to found St. Joseph's Hospital, it seemed so remote that it was referred to in the order as "our foreign mission". They took over a shack on the main street. There were two registered nurses in the first con­ tingent, Sisters Benedicta and Aimee. Sister Joseph was not a nurse but nevertheless an indispensable member of this nursing team. She was cook, housekeeper and laundress and when the place was crowded, often did the washing outside in the cold. But the sisters managed to keep up with the work and plan ahead too, and by 1928 had built a "modem" fifteen-bed hospital, which still stood in the golden anniversary year of the AARN, and added an English lay nurse, Miss Essex, to the staff. In rural Al­ berta in 1928, a hospital could be considered "modem" without running water and by that standard the new St. Joseph's was modem. The sisters had to be resourceful mechanics to keep the septic tank and the Delco light plant working. They had to be resourceful on many occasions, such as the time a premature infant boy ar­ rived in the case room and they improvised an incubator for him from a wash boiler. The boy lived and grew up to be a fine man and everyone around Radway knew the sisters had saved his life. Forty years ago it was easy to reckon the number of lives that were saved by nurses, both lay and religious, working in the hospitals of rural Alberta. The people of the homestead era knew death. They had seen so many lives slip away - infants, mothers, injured men - that they could say with certainty: "This child would have died without the nurses." The people around Radway were still very eastern-European in speech and outlook then. When the sisters saved the life of some member of a family they would try to get down and kiss the feet of the nurses. The sisters found the older people still very east­ European in their appetites too, and young nuns who came to Radway, fired with their first enthusiasm for both nursing and the religious life and eager to enjoy the hardships, found garlic more than they'd bargained for. 146 Some wondered at first whether charity, which can cover so many offenses, could be stretched to cover garlic. The noon train, which ran from Edmonton to Radway and points east, was known as the Garlic Express. One new nun, who was under the impression that it was the train's official name, once announced on the station platform that she was waiting for the Garlic Express. It caused some momentary ill-feeling until her pained and startled expression turned the ill-feeling to gales of laughter. When running water came to St. Joseph's it came with an extra ingredient - natural gas. The water came from a deep well on the hospital grounds and gas came up with it. There wasn't enough for commercial development but it had enough kick to give a workman a fast lift to the surface when he broke a light bulb at the bottom. The nuns ran a gas pipe from the water line and boiled the water for their afternoon tea on it. Visitors always found this entertaining, and there were lots of visitors. A hospital in rural Alberta at this time was expected to be a hospital in the medieval meaning of the term. When people brought in their sick by wagon or sled, the nurses' responsibility included warming them and feeding them for the return trip. It was part of the routine, part of the service, that nurses, lay and religious, brought to rural Alberta in the 1920's.

The Sisters of St. Joseph of London, Ontario - who came to Galahad to open a small hospital in 1927 - have a unique history. Their order came within a day of not being founded at all. Their founder, the French aristocrat, Mother St. John Fontbonne, was sentenced to the guillotine during the reign of terror. But the day before her execution, Robespierre fell, and she and many other religious escaped to continue their work. In 1812 she re-established the Sisters of St. Joseph at Lyons. The order had four familiar aims common to many such orders. They were to be teachers, pro­ vide orphanages for the young, homes for the aged, and hospitals for those in between. The order came to north America in 1836, and established their Canadian mother house at London, Ontario, in 1869. In 1927, Sisters Patricia, Mary Virginia and Jane Frances opened the order's first hospital in Alberta. It was at Galahad. While their twenty-bed St. Joseph's Hospital was being built, they improvised a hospital in a teacherage at the edge of town. Here, 147 for almost two years, in the most crowded and trying conditions, they were able to manage as many as twelve patients at a time. From this effort grew a forty-three bed hospital, with a staff of twenty, including nine sisters and three lay nurses. In the 1930's the Sisters of St. Joseph would open hospitals at Rimbey, Killam and Barrhead.

In 1927 the Canadian branch of an American nursing order with a record for pioneering, opened the first of three hospitals in Alberta. The Sisters of Charity of St. Vincent de Paul had opened the first hospital west of the Mississippi River - at St. Louis in 1839. Their founder, Elizabeth Ann Seton, like the founders of other nursing orders that work in Alberta, was a widow. She was left a widow with five children in 1804 and five years later she and four other nuns started the order in Baltimore. When the Montreal widow, Madame Jette, was founding the Sisters of Misericorde, she went to Maryland to study the rules and the work of the Sisters of Charity of St. Vincent de Paul. Four sisters of the order came to Westlock in June, 1927, and opened Immaculate Hospital in a five-room house. They were Sisters Elizabeth Seton, Mary Anacletus, Marion Francis and Patricia Clare. Within seven months they had moved into a new building designed to be a hospital, and Immaculate has grown to a place of seventy-five beds and sixty-one staff. But there were times at the beginning when the project seemed financially unendurable. Sometimes the actual cash avail­ able to run the hospital would be less than ten dollars. There must have been some point of financial despair at which Immaculate would have gone under, but things never quite reached that point, and in 1928 the order took on another tough assignment at Hardisty. The bed capacity of St. Anne's, Hardisty, was rated as ten. But official records show that in the first month the beds were 120 percent occupied, so the hospital was obviously a need. There were two R.N. sisters in the first contingent, along with the in­ evitable cheerful nun who was the housekeeper, and a sister superior who acted as orderly and ward aide when required. The staff of St. Anne's has grown to two doctors, four R.N. sisters, two lay nurses, a sister housekeeper, a sister who is secretary-treasurer and a superior. The rated bed capacity has 148 grown to twenty; although again, official records show that at times they've been 175 percent occupied. In the 1930's the Sisters of Charity of St. Vincent de Paul would take on a hospital at Jasper.

In 1929 the last of the new orders came to Alberta. The Sisters of St. Martha came to Lethbridge when the city faced the loss of its second hospital with the retirement of Mrs. Van Haarlem. The Sisters of St. Martha were founded in 1900 by the bishop of Antigonish, Nova Scotia, to do teaching, hospital, and social work. The bishop thought they'd just work in the diocese, but as anyone knowing the maritimers could have predicted, in a short time they were all across the country, with social service centers, schools, hospitals, orphanages and an Indian day school. In 1929, when the saintly Mrs. Van Haarlem advised the Lethbridge doctors that she could no longer carry on her private hospital, the Sisters of St. Martha were invited to the rescue. The Van Haarlem was then up to thirty-five beds. Just before the stock market crash the sisters committed themselves to a new hundred-bed hospital. The depression might have been a crippling blow, but there'd been a depression going on in the maritimes for two hundred years so it didn't faze the Sisters of St. Martha. As the stock market collapsed, they were being invited to rescue the Brett Sanatorium in Banff.

In the foregoing ways and places, the Catholic nursing sisters continued through the 1920's the work they'd started in earlier times of bringing hospital nursing service to Alberta. Other familiar forces, the protestant missionary societies, local doctors, town boards and individual lay nurses continued their own work in that line. The V.O.N. dropped out but three new forces were added. We've seen something of the Canadian Red Cross and the Women's Institutes. A third new force was the Municipal Hospitals Act. Alberta was the second province to experiment with municipal hospitals. The aim was to finance hospitals through taxes, and set up a hospital board like a school board. In its early stages it pro­ vided a hospital for a yearly tax of about $4.80 on a quarter­ section, plus a dollar a day for treatment in the hospital. At the first three municipal hospitals set up under the act, at Mannville, 149 Vermilion and Drumheller, there was an extra charge for opera­ tions, $2.50 for small ones, and $5.00 for big ones. A hospital district, to be approved, had to be deemed large enough to support a ten-bed, fully-equipped hospital; and needed a two-thirds ma­ jority of the ratepayers involved. In addition to financing, the act also attempted to provide standards for hospital buildings. Designs had to be approved by the new hospitals branch of the department of health. There was some loss in this. It meant that such delightful institutions as Dr. Brett's combination hospital, bar, barber shop and pool room at Banff, and the Forbes' caboose and log cabin at Grande Prairie, could no longer be recognized as hospitals but on balance it was a step in the right direction. The act was passed in 1917, amended in 1918 and the first results were seen in 1919. In 1920, a government publication ex­ plaining the scheme said it was going to "eliminate philanthropy in hospital operation and place responsibility on the people of the district". However, some philanthropy was required of the nurses because the taxes seldom yielded the revenue they were supposed to and the government's requirements for being "fully equipped" were not very demanding. Of the first eight hospitals opened under the act, only one had an X-ray machine. By 1935 twenty-two Alberta hospitals would come under the operation of the act. Some were new. Others, like those revived by the nuns, had been built but operated irregularly. The first product of the act, and the first hospital in Canada to be run by a municipality, was at Mannville. The chairman of the Mannville municipal hospital board was R. G. Reid, who later became premier of Alberta. The matron, and adviser on organization of the hospital district, was Elizabeth Clark (Royal Alex '14) , a nurse with the department of public health who was lent to Mannville to get the plan going. The hospital was built in 1919, with fifteen beds, a good operating room and a power plant. The staff consisted of two R.N .'s, Miss Clark and her assistant, Miss Louis; a ward aide; a cook, a maid and a janitor, and they worked twelve-hour shifts. In the golden anniversary year of the AARN the hospital still had fifteen beds but the staff worked eight-hour shifts and consisted of a matron, four R.N.'s, four nursing aides, four kitchen staff, a janitor, a housekeeper and a secretary-treasurer. 150 The act also brought to steady .functioning the historic hos­ pital at Islay, built with such thought and effort by Mrs. Lively and her lively sister, Miss Teetgen. The ratepayers of the Islay municipality voted 549 to 37 in favor of the scheme, a debenture issue of eight thousand dollars was approved to complete the building, and Mrs. Roy Stone, who had come back from her farm to be matron during the flu epidemic, came back to help as tem­ porary matron, and it opened for good on February fourth, 1920. The new matron, Miss Mcintyre, came in April, and the board had seen that the staff of two nurses - one for day duty and another for night - was not enough. Miss Mcintyre was authorized to hire two "undergraduate" nurses. The "undergraduate" nurse was a familiar figure in Alberta institutions of the post-war. She was usually a girl who had spent some time in a nursing school but had not graduated. An under­ graduate, or under-done nurse, was likely to be a better bet than a girl with no training at all, and could be obtained cheaper than a girl who had pressed on to graduation. The economic squeeze on the better qualified nurse was beginning to show this early in the post-war. An undergraduate was the matron at the Onoway mission hospital when it was taken over from the Anglican church mis­ sionary society by the municipality in 1920. However, this girl went on to complete her training eventually and became a nurse genuinely qualified. So not all undergraduates were terminal cases. There were two undergraduates on the staff of the new Ver­ milion municipal hospital shortly after it opened on February eighteenth, 1920. There were also two graduates and the matron, for the three-storey, twenty-two bed hospital. Edith Boyd, the original matron, from whose pioneering the hospital grew, returned to Chicago shortly after the opening and she was succeeded by Alice Keith, Royal Alex '19. And it might be said that Miss Keith nursed the hospital through the next thirty-six years of its existence. Except for four years for post-graduate study, Miss Keith was matron of the Vermilion municipal hospital. The Drumheller hospital had the X-ray machine. It handled a higher number of injury cases requiring X-ray because of the coal mining in the area, and its financing was eased by the payments of the Workmen's Compensation Board for the injured miners. There was another interesting difference to nursing in the thirty- 151 six bed Drumheller municipal hospital in the 1920's. Matron Barbara Beattie wrote about it this way: "The discovery of coal led to an influx of miners from all over the world, from the mines of Nova Scotia, Wales, the Ukraine, Hungary, Italy and other central European countries, who came with their families in hordes. The list of daily admissions makes one think of members of the League of Nations. To understand each individual and his needs, ill spite of foreign tongue, different religious beliefs and peculiar diets - in addition to the usual routine - calls for a high order of nursing." In High River, years of service by the V.O.N. ended in October, 1921, when the V.O.N. staff moved into the newly­ built municipal hospital. The patients were moved from the old cottage on stretchers in trucks, with a nurse accompanying each transfer. Hing, the Chinese cook, did not break his routine for the transfer. Hing insisted that there be no interruption and kept on preparing the vegetables for supper, sitting on the floor of the truck with his pots and pans about him. On November fifteenth, 1921, Premier Greenfield came to declare the new hospital officially open, and tell the crowd of three hundred that it was being recognized as a training school for nurses, the first municipal hospital in the province to be so recognized. At this time, High River had five graduate nurses in addition to Annie McLeod, the matron. They also operated a satellite ten miles east, at Blackie. Miss Nash (Mrs. Wilson) ran this sub-station and nurses from High River relieved her on week­ ends and holidays. In 1922 Athabasca turned to the Municipal Hospitals Act after nine years of service from many of the agencies providing hospitals. There had been a Catholic nursing order (the Sisters of Providence of Montreal), the Victorian Order of Nurses, the Canadian Red Cross and a local doctor, Dr. Meyers. The sisters' hospital had burned down in 1917. For a short time Dr. Meyers kept hospital beds in his home and the nuns stayed in a hotel and looked after his patients. Then in 1918 the Anglican Bishop Robins moved to the Peace River country and his house became available for a hospital. The V.O.N. then sent Miss Thornley, a graduate nurse, and Miss Stead, a most remark­ able nursing aide, to make a hospital of the bishop's house. Miss Stead was a person of genuine nobility. She was an English gentle- 152 woman who, in her youth, had been restrained from gardening and cooking, things she really enjoyed. In the V.O.N. hospital at Atha­ basca she was able to employ her talents in these lines to the benefit of the hospital and the pleasure of the patients. Life in the homestead farmhouses was hard and harsh, and bare of all comfort for the women patients who came to the hospital. And the teas Miss Stead would serve in the afternoon, and the magazines that she received from England, made a stay in the hospital a blessed holiday for women of the district. The Red Cross sent a nurse to Athabasca during the switch­ over from the V.0.N. to municipal operation, and the change came in 1922. By 1923, Grande Prairie was moving beyond the mission stage and the municipality took the burden of operating the Katherine Prittie Hospital from the Presbyterian church. Edna M. Auger, a graduate of Medicine Hat General, came to Grande Prairie to organize the hospital district and was a matron of the hospital for a brief time before returning to Medicine Hat to be­ come matron of her alma mater. She was succeeded at Grande Prairie by Edith L. Hibbs (Mrs. Fredette) , who was matron until 1929 and has supplied some revealing notes on the nursing situation. To begin with, the town power went off at midnight and from the witching hour till daylight, a nurse became literally a lady with the lamp (kerosene) . The nurses' hours were seven to seven with two hours off if possible, but the matron was on call around the clock. Her salary was a hundred and twenty-five dollars a month; staff nurses started at seventy-five and did the OR and babies' washing with water pumped from a cistern. The babies were kept in the nurses' dining room. At the start of municipal operation the nurses still slept upstairs in the hospital, but in 1925 they got a small house nearby. That was the nursing situation at Grande Prairie Municipal Hospital in the twenties, recalled by Mrs. Fredette, who was there. 1928 saw the formation of municipal hospitals at Elk Point, where a twenty-eight bed hospital was to be staffed by three or four nurses with no auxiliary help, and where interesting nursing continued to be done despite the short staff. In 1929, the town of Vulcan crowned the heroic work of 153 Miss Rhinehart with a twenty-bed municipal hospital, staffed by a matron, Miss Willows with four general duty graduates on staff. The Vulcan historian comments: "In saying general duty, that is the correct term, as they did many of the cleaning chores. They worked a twelve-hour split shift daily, had a half-day a week off, worked two weeks of nights at intervals with no time off, and in the event of emergencies, a nurse had to be summoned from the residence to help out." In 1929, Claresholm, too, took the municipal way out after intermittent service from a number of hard-pressed nurses. In 1921 Mrs. Blanche McKay Parr had bought a house and started a hospital with two nurses on contract. In 1923 the old war-time Red Cross building was moved to the back of the hospital to be an operating and supply room. Over the next five years Mrs. Mc­ Kay, Mrs. Taylor, Mrs. Runion, Mrs. Tulley and Miss A. Copely each had a turn at running the hospital. In 1929 it went municipal. Stettler experienced several ways of having a hospital before the Municipal opened in 1929, and even with that the nurses were called on to make the last one go, in a surprise twist. The Stettler story began in one of the familiar patterns. About 1916 Dr. Frankum took over a house across from the lumber yard, with two local women, Mrs. McGillivray and Mrs. R. 0. Bull as practical nurses. About 1918, Dr. Creighton opened a similar hospital with Mrs. Bill Streit Sr. doing the work. Mrs. Streit had no formal training but she was game and apparently tireless. She looked after the kitchen, helped with operations, and when the supper dishes were done she washed bandages and dried them in the oven. There was no running water but every day the garbage man came to take away the slop. The first graduate nurse came in 1924. This was Lillian Carter, RN, a Calgary graduate who came to the Mills hospital, a six-bed private venture. Mrs. Mills rented a house and engaged Mrs. Carter to run it. Mrs. Carter had a graduate assistant, a student, and a girl to help in the kitchen. Mrs. Mills was not a nurse but was very capable and helped out when the action got heavy. The thirty-bed municipal hospital superseded all others in 1929. This was a public hospital in more ways than intended be­ cause the operating room was open to public gaze. The favorite 154 "I dare you" sport of Stettler youngsters was to climb up on a wagon and watch an operation; after which their mothers would wonder why they looked so white. However, this introduction attracted a future member of the hospital staff. A pair of twins, Violet Buss and her sister, Virgie, watched several operations. Later on, as Mrs. Carl Homey, Violet was a ward aide. Although the thirty-bed hospital opened with a burst of civic enthusiasm - the undertaker volunteered to shine up all the bed­ pans for the opening - it was soon in difficulties. The original staff of nurses quarreled among themselves and quit. Then six Holy Cross graduates arrived. They not only ran the place with vigor and skill, they organized dances and other entertainments to buy equipment and furniture - maybe even shades for the operating room. In closing this chapter, on the Alberta hospital nurse of the post-war, let's fade out on a scene of a dance put on by the nurses of the Stettler Municipal to buy equipment for their hospital. And as the orchestra plays, "Should I Reveal Exactly How I Feel" (for the seventh time), let us reflect that not even a hospital of proper design, in a community of proper size, could be made to "go" by the power of the Municipal Hospitals Act alone. Only the Alberta hospital nurses of the post-war, to whom this chapter is dedicated, could achieve that.

155 CHAPTER FOURTEEN The chapter after this takes the post-war Alberta nurse in groups. This one considers her as an individual: her status, her work, her progress, her prospects, and what she could aspire to as an indi­ vidual in her profession. As the post-war era set in, you could find in a number of places the best evidence of the growing status of the Alberta nurse. Nurses trained in Alberta were rising to positions of responsibility. In Grande Prairie, in 1922, Edna M. Auger was organizing the Grande Prairie municipal hospital district, before returning to her alma mater, the Medicine Hat General, as the first graduate to become matron. At the Misericordia, Sister Ste. · Christine, a graduate of the hospital's school of nursing, was superintendent. Then there was Elizabeth Clark (later Mrs. George Dorland), Royal Alex '14. After four years on private duty, Miss Clark joined the new nursing staff of the department of public health. In 1919 she was loaned to the new Mannville hospital district to help set up the first municipal hospital. She was matron for two years and when Miss Christine Smith, the first superintendent of public health nurses resigned, Miss Clark was appointed to her position. A few years earlier such positions would have been filled automatically by graduates from outside Alberta. In 1919, the Royal Alex graduated a girl named Margaret Fraser, who would return eighteen years later as the first graduate matron and be the first Royal Alex grad to break the long mono­ poly of the Royal Victoria in the direction of nursing at that hospital. Two years after graduation, Miss Fraser made some more firsts which marked an increase in status for the Alberta nurse. She was awarded the first scholarship of the Alberta Association of Registered Nurses. She went to Columbia University with her 156 scholarship and earned a degree of bachelor of science in nursing. She thus became the first graduate of an Alberta hospital to re­ ceive a degree in nursing, and the first to study at Columbia. The second point is important because in the next decade, when nurses came to be "educated" rather than "trained", Teachers College at Columbia would become the dominant influence in the education of all nurses, rather than individual hospitals which, through their graduates, transmitted their systems of training to newer hospitals. At the time Miss Fraser received her scholarship from Colum­ bia, an Edmonton girl who would become the first Canadian nurse to win a master's degree in nursing education from Teachers College was already embarked on her career. Her name was Agnes Macleod. Before entering the nursing program at the University Hos­ pital in 1924, Agnes Macleod had already graduated from Victoria high school, the Camrose normal school and the University of Al­ berta with a degree of bachelor of arts. She graduated with a B.Sc. in nursing in 1927, instructed at Lamont for a year, then did a year with the travelling clinics before going on to Columbia where she worked her way to her degree by doing laboratory work at nights. With this widely-based preparation, Agnes Macleod, like Margaret Fraser, would become the first graduate of the University hospital to take over her alma mater. These outstanding products of the Alberta system were on their way as the post-war era began. The careers they had laid out for themselves were evidence of the growing stature of the Alberta nurse. There were even faint signs of growth in the status of the student, in events at the Royal Alex and Lamont. At the Alex it was the feud between Fanny McMillan, super­ intendent of nurses, and Irene Castle, the dancer. The ladies weren't feuding directly of course. Miss McMillan's feud was with a style decreed by Miss Castle and taken up by her followers, who in­ cluded the student nurses at the Alex. Irene Castle and her late husband had dictated dance styles. Irene also dictated styles of dress for women, and when she said women should bob their hair, the student nurses said they would certainly comply. But Miss McMillan said they most certainly would not. Miss McMillan's edict against bobbed hair produced so much defiance that nurses were bobbing anyway, and the newspapers picked up the story and fanned the flames. The public got in on 157 the fight. Even one of the staff doctors commented for publication. He said bobbed hair was probably more hygienic - and then did some bobbing and weaving of his own. It was the public who settled the issue. The public recognized that in the ye<1.r 1921 the way a nurse fixed her hair was her own business. Even though students were trained on the apprenticeship system and hospitals were staffed that way at five to seven dollars a month plus room and board, there were now some elements of a student's existence that were her own business. This was progress. At Lamont there was progress which, though it went un­ noticed by the press, was of more significance. In 1920 the Lamont Public became the first training school in Alberta with student government. Although this school, because of its church character, lagged behind current thinking on the morality of dancing and cards, it was well ahead on student government. In fact it was nine years ahead of any other school in Alberta. The start was recalled by Florence MacDonald (Mrs. B. I. Love). The idea was brought into the hospital by a classmate who had spent some time at university and had seen it there. Some senior students were delegated to present the idea to the matron and then to the hospital administration and were sur­ prised at how readily it was accepted. The student organization had no power except the power of suggestion but even the sug­ gestions that were rejected most flatly got a courteous hearing. In 1922 Florence MacDonald was sent to a meeting of the AARN in Calgary, the first Alberta student nurse to fly so high, and in the mid-twenties the hospital administration left it to the students to decide whether oriental girls should be admitted to the school. The Lamont students voted unanimously in favor, and welcomed Grace Oyama and Chyo Kubo from Japan. Lamont graduates be­ lieve their school was the first in Canada to extend the same status and training to orientals as to "white" girls. Consulting the students on a matter like this showed an ad­ vance in status, and the Royal Alex became the second school with student government in 1929, but there was a current running the other way. Dr. Angus McGugan, of the University Hospital, spoke of a military influence that carried over into nursing education after the war, with "heel-clicking and yes-sir-ing". Of course the record of the Canadian nurses in the war had given the entire profession a lift in status. A nurse in Alberta in 158 1920 could claim things as a right which she couldn't have in 1914. She could claim land - as former army nurse, Mary Alice Blackwell (Mrs. John Turner) , related. When Mrs. Turner found that her former comrades, the soldiers, were taking up homesteads under the Soldier Settlement Act, she decided she'd take one too. She told Mr. Norquay, the registrar, about it, and Mr. Norquay said it was impossible, abso­ lutely impossible, he'd never heard of such a thing. But when Mrs. Turner wouldn't retreat, Mr. Norquay said he'd phone Ottawa. He did, and a half hour later told her she could have one. So she claimed a homestead near Rycroft in the Peace River country. She wrote some of her nursing sister comrades about the new status of veteran nurses and they too took up homesteads and ar­ rived in Alberta with all kinds of riding clothes to take up lives of farmers. ot all of them stayed. But one who did was Mrs. Elizabeth Young, who went to Rycroft and continued her nursing as a neighbor to those who needed her. Years later, in 1965, the town of Rycroft would name its civic park Elizabeth Young Park in honor of her. Although some things were changed in the post-war, there had been no change whatever in the position of a nurse in a pioneer community. A nurse couldn't quit. Trapped between the code of the frontier and the code of her profession, she had to give her neighbors professional help when it was needed. A Lethbridge graduate, who married a veteran and went to live on a farm near Whitecourt, told the story of being hauled out of her house by a neighbor one evening. The neighbor said: "Hey missus, you come. My wife she's going to have a baby. You got to come." lo' The nurse went and found the woman in bed and apparently in no great hurry about the blessed event. The husband then pro­ ceeded to remove his boots and trousers and climb into bed with her. He indicated to the nurse that she could sit up in a chair. When the nurse protested the man protested too. He said HE had to have HIS sleep so he could work on the farm. The nurse had to sit there - in the chair which wasn't very comfortable - and take it. The codes of the frontier and her profession gave her no choice. She couldn't withdraw her help 159 from the woman in the bed just because her husband was a pre­ sumptuous boor and because she knew she wouldn't be paid. All through rural Alberta in the post-war era, married nurses were on call. A typical hard-working housewife-nurse of that time was Mrs. George Mattern, who as Iva Morgan, graduated from the Misericordia in 1919. For years Mrs. Mattern nursed at the homes of neighbors around Ponoka, going out on cases with the Matterns' own family doctor, Dr. Graham. The doctor would call around at the Mattern house and ask her to go with him to a patient. He would leave her with the patient and with orders for treatment. However, this was with the understanding that she was authorized to vary the treatment at her discretion. ~ It wouldn't always be possible to communicate with the doc­ tor. <;ommunication was a problem for the rural nurse-housewife in the post-war. Transportation was another problem. Mrs. Mattern made most of her country trips by wagon or sled. Direc­ tions were often a problem too. Mrs. Mattern recalls trips where neighbors would hang lanterns along the road leading to a farm home where doctor and nurse were being awaited. * Accommodation was another problem. There was rarely any consideration given to the comfort of the visiting nurse. She would sleep in a cot by the bed of the patient, if she were lucky. If not she would sleep on a makeshift bed on the floor, or a bed made from putting three chairs together. In many homes a problem was an absence of any grasp of hygiene. She found the dirt and ignorance appalling. In these homes she did her best to combine her stay with a short course on clean living. But the results were sometimes discouraging. An often-repeated instance was the one in which she'd in­ struct members of a household with a maternity case that the bath basin was to be used only for the mother and her baby. Her dis­ appointment would be great when she'd find someone making bread in the basin or doing the family wash in it. There was still another problem in regard to Mrs. Mattern's nursing. It was posed by the arrival of the first of her four ·children. But Dr. Graham solved that one. When the first baby was six months old he persuaded her to start taking patients into her home. The Mattern home had a hot-water system, and as time went on the older girls helped with the laundry. 160 Mrs. Mattern, like most nurses of her time and place, did a form of public health nursing in her home. Under directions of doctors she gave injections, removed sutures and dressed wounds. Two nurses from Brandon, who thought they could abandon the profession and become farmers near Pigeon Lake, found that it was no easier to stop being a nurse than to start being a farmer. Edith Lamb (Mrs. R. S. Rossiter) wrote about the attempt: "My friend and classmate, Miss Betty Chapman, and I de­ cided to get away from it all and go "out west". Betty had been an operating room supervisor in Brandon General Hospital and I had been working a number of years in the Bigelow clinic in the same city. It was the year 1926 when we arrived in central Al­ berta, not to do nursing, but to try our hand at farming. We bought a quarter section of land about ten miles south of Pigeon Lake where two of my brothers were farming. "It was not long until people heard there were two nurses in the district and they were soon calling on us to attend maternity cases, broken ribs, infected fingers, kidney and bladder infections, malnutrition, etc. At that time the roads were almost impassable. An occasional Model T could get through but most transportation was by horses, with buggies or wagons, so you can readily under­ stand residents not wanting to go forty miles to Wetaskiwin or the same distance to Ponoka to visit a doctor. "There was little money in the country and we received very little for our services. More often we were given a slab of bacon or some venison or some chicken feed. These were welcome, and we did enjoy the life on our farm for over three years, especially the humorous parts of it induced by our attempts at farming." ·, A change began to come over private duty nursing in the twenties. More and more of it was done in hospitals. Although there were not yet many staff jobs for nurses in hospitals, they were at least moving in to work there. Alice Payzant (Mrs. I. Bjorge), who graduated from the Royal Alex in '25 did almost all her work in hospitals, with more and more nurses being called in for post-surgery. The standard wage was five dollars a day, for an eight-to-eight shift, either day or night. It was usually a matter of the person who could afford it getting the special treatment. A person who could afford a private room could usually afford a nurse. While he was coming out of the ether in a nauseated condition he would have a private 161 duty nurse watching him, while students would be watching the man in the public ward. This was also the observation of Mary Cumberland, (Mrs. E. C. MacDonald), who graduated from Cal­ gary General in 1920. Mrs. MacDonald recalled that the first shift after the operation would usually run right through, eighteen or nineteen hours, until the day nurse came on at eight a.m. the morning following the operation. Patients were sometimes violent coming out of ether and there were no sedatives except narcotics which doctors hesitated to give if the nurse could restrain the patient at all. After heart surgery, especially, patients were not allowed to move for weeks and a nurse was required constantly at the bed­ side. The long cases were the best financially for the nurses. A two-or-three-month case at five dollars a day could buy a nurse security for a year. Although more was done in hospitals, there was still plenty of country work in homes for nurses who were willing to travel. Mrs. MacDonald spent half her career in country homes, or country railroad stations where the agents were prone to pneu­ monia and typhoid. At Grainger, near Drumheller, she went once to a station where both agents had pneumonia and were in bed on the second storey. To give them fresh air someone had taken all the windows completely out. That was fine until a prairie storm blew up, at which the nurse had to nail up grey blankets to keep out the gusty rain. Mrs. Charles Parker, who graduated from Calgary General in 1925, recalled that the rates for private duty were five dollars a day for ordinary cases, six dollars for pneumonia, and ten dollars for DT's. (Nowadays DT's are not on the approved-cost list for hospitals and institutions have to cope with them without govern­ ment grants.) Private duty work in homes was harder than in hospitals, really back-breaking, because of the bending over the low beds. The nurse also had to improvise substitutes such as newspapers for rubber sheets. The nurse going out on private duty had her black bag like the doctor, only it was more of a black trunk. She was supposed to have rubber sheets, a hot water bottle, bed pan, urinal, enema and douching equipment, thermometer, hypodermic kit, bottle of alcohol, bichloride of mercury and lysol. At the end of the twenties 162 the Weir survey would find that sixty percent of active nurses in Canada were still on private duty.

In 1923 the University of Alberta raised the ceiling on the status of the nurse in this province. The senate approved a degree program, leading to a bachelor of science in nursing. A work which had once been less than a trade, more of a domestic service, was raised to the level of human activities worthy of recognition in the University. The course was to be five years: a year of arts preparation on campus; something less than the full three years of hospital work taken by diploma nurses at the University hospital; then another year on campus. The degree program began simultaneously with a three-year diploma program at the University hospital, and to be superinten­ dent of nurses Margaret McCammon was brought from Montreal. Miss McCammon was a graduate of the Montreal General, but her certificate for the job was her certificate from the McGill school for graduate nurses, which offered a one-year course in teaching and supervision. It was to be expected that Dr. Tory would insist on someone with the stamp of McGill on her to run the nursing school at his University hospital. Dr. Tory was a McGill man through and through. His first academic pioneering in the west had been founding the University of British Columbia as McGill College of the West. When he moved to Alberta to found our university in 1908, he brought the McGill standard with him. Miss McCammon stayed until 1926 and then was succeeded by another lady with a certificate from the McGill graduate school. She was Ethel Fen­ wick (Mrs. H. H. Cooper), who stayed nine years, and then was followed by the beloved Helen Peters, also from McGill, who stayed until her final illness in 1953. The school began with an unusual uniform. Miss Mc­ Cammon brought a pink-and-white print from her alma mater, the Montreal General. The material was woven in Scotland and had the letters M.G.H. (for Montreal General Hospital) woven in white into the design. The new school in Edmonton ordered the same material with U.A.H. instead of M.G.H. Since the hospital had been for some years a veterans' hospital staffed by army 163 nursing sisters, the students took a nursing sisters' veil rather than the traditional stiff white cap. The diploma program began with about a dozen students, and had peculiar problems. The school of nursing was regarded as an adjunct to the hospital, which was not unusual, but then the hospital was regarded as an adjunct to the University's faculty of medicine. When the first class was to graduate in 1926, the girls wanted to get their diplomas at the spring convocation, but Dr. Tory wouldn't hear of it. In the fall they were allowed a diploma ceremony in Convocation Hall but were refused permission to hold a reception on campus. On the other hand, Dr. Tory had great ambitions for the graduates of his University hospital, and this led to friction with the Royal Alexandra, where Dr. Tory was also a member of the board. He thought the University-trained nurses should be recog­ nized as an elite, a sort of brigade-of-guards among Alberta nurses, who would go around and tell other nurses how things were done. The nurses at the Alex, of course, thought they knew quite well how things were done, so there was friction. And it was difficult for University nurses to act superior when their hospital hadn't facilities for training in obstetrics and communicable diseases and the students had to go to the Royal Alex for affiliation. The degree program had its difficulties too. Only one class of three was able to complete the course in Edmonton, with Martha Black, (a Winnipeg General graduate with the all­ necessary certificate from McGill for graduate nurses) acting as instructor for their final year. The three graduates were Agnes Macleod, Annabel Raver and Frances Alexander. But when Miss Black left in 1927 she was not replaced-for reasons of economy-and for the next ten years girls seeking a degree of bachelor of nursing had to go elsewhere, usually to the University of British Columbia, for their final year, usually on teaching. The University of Alberta gave the degree, but couldn't give the full course. And so two plans involving the University hospital school of nursing got off to difficult starts. But there was another plan which never started at all, a plan that was described in 1922 to the national meeting of the Canadian National Association of Trained Nurses. The CNATN was meeting in Edmonton and A. K. 164 Whiston, provincial organizer of municipal hospitals, described the plan. Mr. Whiston said it was "the vision and the ambition" of the provincial government to bring girls of rural Alberta into nursing through the new municipal hospitals. They would spend a year in their district hospital and then spend two years in a "finishing school" run in conjunction with the University Hospital. This interesting proposal never came to anything but a nursing school did start at one of the new municipal hospitals, and instead of two years of finishing at the University hospital, the students had one year at the Royal Alex. The school was in the High River Municipal Hospital. It started in 1921 and graduated nineteen nurses in the thirteen years of its existence, a new class forming when the seniors of the old class left for affiliation. The existence of this school in a small hospital was the work of, and a vote of confidence in, the energetic matron, Annie McLeod. Miss McLeod taught the system of the Lady Stanley In­ stitute, now part of the Ottawa Civic Hospital. The institute was founded in 1890 to be a training school independent of a hospital and so is of historic interest today when many in nursing consider it the ideal. Miss McLeod's energy and persuasiveness not only convinced the government to recognize her school at High River. It also caused seven or eight good graduates of her alma mater to come to Alberta. Miss McLeod, like most nurses of her time, believed firmly in the principles and procedures of her alma mater but she was not narrow about it. When a senior class was leaving for Edmonton she would tell the seniors: "Girls, I've been teaching you the system I know. You're going to see other ways of doing things. Don't criticize or say: 'We did it this way or we did it that way.' It's up to you to decide which is best and act accordingly." The first graduates of High River were Evelyn Robertson (Mrs. A. A. Leitch) and Jean Laidlaw (Mrs. Ted Brooks). They were the only Alberta nurses to have the experience of receiving their diplomas from the Prince of Wales. And it was an experience made more memorable by the prince arriving three hours early for the ceremony. The prince at that time had his E-P ranch at High River. 165 There'd been a picnic at the ranch for his rancher neighbors. It had rained most of the day and the ceremony at the hospital was scheduled for 8 p.m. All the members of the board, and their wives, and innumerable guests had been invited. But at five the prince arrived at the door with a couple of aides and asked if he could make the presentation then, as he was returning to his private railway car and did not wish to come out again in the evening. Miss McLeod, with her usual presence of mind, said: "It will take some minutes to get ready. Would you care to visit the patients while I make the necessary arrangements?" Most people know that five p.m. is the really busy time in a hospital. However, Miss McLeod was unflustered, introducing patients to His Royal Highness, and giving orders to the nurses on the side. A young airman from the High River air force base was on the bedpan when introduced and always said afterwards that not many had the distinction of shaking hands with the heir to the British throne under those circumstances. Arrangements were finally complete, and, before a dozen or so guests, the graduation pins were presented. It was over in a few minutes. All evening Miss McLeod had to tell guests arriving from the neighboring towns through the rain: "I'm sorry. The Prince of Wales has come and gone." It was a small school. The classes were never larger than seven, and it closed in 1934. But it was a good school. Florence Cameron, a High River girl and a member of the last graduating class, was later matron of the hospital.

In 1924, the year the Prince of Wales presented the pins to High River's first graduates, the first class entered Camrose St. Mary's. In eleven years of existence the Camrose school would graduate forty-four nurses, including a high percentage of matrons for Alberta municipal hospitals. The director of the school for its full eleven years was Sister Mary Albin (family name Hawkins), a graduate of the Sisters of Providence St. Francis Hospital in Smiths Falls, Ontario. Sister Mary Albin apparently instituted the Smiths Falls regime in Cam­ rose and it was a regime that was already becoming quaint, if some of the rules are to be taken seriously. 166 Rules like: "Pupils are not to visit patients in their homes. All unnecessary conversation with doctors, patients and visitors strictly forbidden. "No pupil nurse shall consult a doctor or receive treatment without the consent of the sister superintendent. "All pupils are required to be honest, truthful, trustworthy, punctual, orderly, neat and obedient. In a word, they are expected to keep in mind the importance of their position and to evince at all times the self-denial, good temper and gentleness so essential to successful service." In the business of instruction the school clung to the old way of the students taking lectures and studying in the evening after a twelve-hour day. There was no affiliation program with other schools. Students spent their entire three years in St. Mary's. It was a hard regime, and one graduate, Mrs. E. W. Snider, re­ called a high dropout rate. The school closed in 1935 but it made a significant contri­ bution to nursing in Alberta, particularly through the matrons it provided for municipal hospitals. In the golden anniversary year of the AARN there were St. Mary's matrons in Stony Plain, Edson and Provost and before that, Amelia Gronberg, who with her twin sister Marie were the first students to enter the school, was matron at Bassano. And, in the golden anniversary year, there was the possibility that St. Mary's might re-enter the field of nursing education as a satellite school for third-year affiliation, as suggested by the Scarlett report.

And so, in the post-war twenties, the individual nurse might be confused at times and wonder just what her status was. In some spots she would find progress or the promise of progress. In others, there would seem to be no change at all. However, the graduate nurse was undoubtedly gaining prestige at a faster rate than the student, the harassed, hard-running student who staffed the large hospitals in return for a three-year training. To the student the world looked about the same as it had before the war, and to show us exactly how it looked, and how some historic figures in Alberta nursing appeared in the eye of the student, we have a memoir written by Mrs. Charles Parker of Red Deer, who, as Nettie George, went through the Calgary General in the period 1922-25. She was a daughter of Dr. George, 167 the pioneer Calgary medical officer, and of the Mrs. George who waited with a rifle for the mob to come and try to burn the house. Many Calgary General nurses have written well. The very first one, Marion Moodie, wrote well. In fact she really wrote Chapter Six of this book. In 1931, the General graduated Amy Wilson, who spent many years working with the Indian service in the Yukon and in 1965, the year of her untimely death, pub­ lished a book No Man Stands Alone, based on her experiences in the north. And in 1940 there entered a student nurse who would write an international best-seller from what she saw and felt at the Calgary General. Her book was one of the most elo­ quent of all statements on what it means to be a nurse. Her name was Sheila MacKay. Her book was A Lamp is Heavy, published in 1950. Mrs. Parker didn't intend that her memoirs would ever be published at all. She wrote them to be a sort of family heirloom, for the instruction and entertainment of her children and grand­ children. But they are a req:>rd which all student nurses of her time will recognize as their own experience. We are publishing here what Mrs. Parker wrote about the time of trial and terror, the period of probation.

On July first, 1922, I entered training in the Calgary General Hospital with all the expectant fervor of any aspiring carrier of the lamp. Phyllis McGregor and I went together, marching up to the door marked Training School Office, hoping we didn't look as terrified as we really were. We were received by a dumpy little nurse who informed us that she was Miss Rutherford, instructress of nurses. She marked our names off her list and after a short chat about rules and regu­ lations, she led us out of the hospital and around the corner to a large brown house known as The Brown Cottage. This was to be our home during the probation period of three months. We would work eight hours a day, from 7 a.m. to 7 p.m. with four hours off during the day. Later when we were considered capable, we would do shifts from 3 p.m. to 11 p.m. or 11 p.m. to 7 a.m. We must be in our rooms at 10 p.m. each night and lights out at 10:30. We would be called at 5:30 a.m. and must be in 168 the dining room by 6:40 or lose our late leave for that week. Late leave was 11:30 one night a week and midnight once a month for which we must ask at the T.S.O. and sign in when we came home at the house mother's office. Our beds must be made properly and our rooms left clean and tidy before going to breakfast. They would be inspected and they were! Telling us that the rest of the day was ours to settle in, Miss Rutherford left us, saying: "Be in the dining room in uniform by 6 a.m." We were left to unpack. Soon other probies arrived and we wandered about our new home, exchanging names. In the evening, Una Dale, a girl from home who was a senior, came to greet us. She was accompanied by several of her classmates who came along to look us over. We were glad to see Una and know there was someone we knew in this strange new world. The girls proceeded to tell us of the many things that were expected of us, plus some of the awful things that could happen. We were told that you must always let any nurse who was senior to you, go first - through a door, off the elevator, up or down the stairs. If someone was coming down or going up the stairs, you would wait at the bottom or top, wherever you were. And you must never pass anyone on the stairs, especially Miss Edy, the superintendent of nurses, who was superstitious. Any nurse who entered training before you was senior to you; so Phyllis was senior to me because she registered first. The doctors were "chosen people" and utmost respect and deference must be shown to them at all times. Miss Edy was absolute monarch and apparently all in the hospital were in fear and trembling of her when she was near, and one never knew where or when she would show up. To be called to the T.S.O. by Miss Edy was something to be avoided at all costs. Next morning there was a thunderous noise about 5:30. It was a man walking through the halls ringing a large brass bell. There was a mad scramble for the two bathrooms and to get into the unfamiliar uniforms-a blue chambray dress with long sleeves, a preacher's collar, a voluminous apron and high laced black boots. The skirts were seven inches from the floor, carefully measured. Beds were made in what we hoped was the approved hospital fashion and then we made a dash for A Block and breakfast. As 169 we ran the gauntlet into the dining room, we were very self­ conscious and wondered if we would ever be as unconcerned as our awe-inspiring seniors. Our first day was a busy one. We had a meeting with the awesome Miss Edy, a very severe-looking personage who fixed us with her piercing eyes and welcomed us to the hospital and told us what she expected of us. We must ALWAYS be on time, a nurse is never late! We should always be clean and tidy, obedient, act like ladies, work hard and be cheerful at all times. A big order! Then Miss Rutherford took over. (We had learned last night that she was called "Bunty" behind her back.) Bunty told us what our duties would be and what SHE expected of us . After this came physical examinations by Dr. Follett. We were put to bed in nurses' sick quarters and given a once-over by the doctor. We were to learn as time went on that Dr. Follett was a good friend to the nurses. He never forgot our names and had time to ask how we were getting along. Our training began in the gauze room, where we learned to make dressings and wrap them for sterilizing. We also cut bandages. They came in a "cane", about four feet long and were cut with a sharp knife to the desired width. I was chosen to go to the dressing room on each floor to pick up the dressing covers used the day before and leave a clean bag for the next day. To my horror, my boots squeaked. They embarrassed me continually for weeks. I sure cussed those boots. After several weeks of gauze room, lectures on ethics, bedside care and simple dietetics (how to make soup and cocoa), we were sent to the wards. I was sent to Two East, which was a mixed women's surgical ward. I had lived a sheltered life and there were many eye­ openers in store for me. Miss Wainwright, the supervisor, turned me over to a nurse who had just received her cap, Eva Glover. Glover showed me over the ward and explained what my duties would be after helping her make beds. The hopper rooms were to be my special care. The hopper room consisted of a bathroom, two toilet cubicles, several wash sinks and a room containing a deep "hopper" sink. Racks of white enamel utensils - bedpans, urinals, douche pans, K basins, wash basins, enema cans and douche cans decorated the wall. All had to be soaked in Lysol every morning and cleaned and 170 returned to the racks gleaming white. The baths, sinks and every­ thing else in the room had to be scoured and I mean scoured. The Lord love you if inspection found a smidgin of dirt. All this must be finished by ten a.m., when I had to go to the kitchenette to help give out the morning nourishments, if I did not have a class. If I got finished ahead of time I could go up to the diet kitchen on the top floor for a cup of coffee. I was allowed exactly ten minutes for the coffee. The third day I will always remember because at dinner time Miss Wainwright decided that I was to sit with an anaesthetic patient, a T & A. She showed me what I must do, how to hold the jaw up and forward should the patient vomit into the K basin. I was to hold her mouth just in case. I was hanging on, inhaling chloroform, when Miss Wainwright and Miss Edy came into the room. I promptly fainted and was hauled into the corridor and stretched out on the floor. If there could only have been a hole in the floor I would gladly have crawled in. Just after this Miss Edy left us and Miss Sara Macdonald became superintendent of nurses. She had been assistant before this but I hadn't seen much of her. All through my training I seemed to be in Miss Macdonald's bad graces. As sure as I carried a tray down the hall with my sleeves rolled up, I would meet "Sadie" and get what-for. At last our three months' probation was over. I had been on children's ward as well as Two East during that time. Exams were written and orals taken and we waited. Every day, it seemed, someone was called to the T.S.O. and packed her bag in tears. Who would be next? Finally, one morning, the list was posted on the bulletin board in the dining room for all to see. We were scared to look but one brave soul stepped up and read the names. Most of us had passed. Now we were first-year nurses and could look sympathetically at the new probies."

That's how Nettie George, (Mrs. Charles Parker) wrote of her period of trial and terror, her period of probation at Calgary General in 1922. It's the journal of one nurse, but the experience of almost every nurse who entered the profession through training schools of Alberta in the 1920's. The nurse was sure of work only in her student days, be­ cause the big hospitals functioned on student labor and hired a 171 minimum number of graduates for supervisory jobs. And the graduates with jobs had to be as awesome as Mrs. Parker de­ scribed them to get the necessary amount of work out of the students. It was not a good situation, but it was the one most im­ portant fact in considering the status and prospects of the Alberta nurse in the post-war decade. And the results of the system were starting to force changes, because the training schools were turning out so many individual nurses that the nurses had numbers enough to form effective groups and work for improvement. The next chapter considers the effects of this group action. This chapter, however, must end on a footnote, a footnote on the fearsome Miss Edy, who paralyzed students with a glance and held registration number THREE in the Alberta Association of Regis­ tered Nurses and left the Calgary General in 1923. Miss Edy left because she was ahead of her time. In 1918 she had instituted an eight-hour day for staff nurses. When the General was taken over by the city of Calgary, this departure from orthodoxy was ordered to cease. That was why Miss Edy left.

172 CHAPTER FIFTEEN As human society re-formed itself along new lines in the post­ war, the nurses of Alberta began to develop group consciousness. They began to realize what they could achieve in groups, a new trend in a profession most of whose members still worked as individuals. They grouped together in associations which required not only common goals but a common body of experience; the experience of war or of training for the profession in a particular school of nursing. The Edmonton unit of the Overseas Nursing Sisters Asso­ ciation of Canada believes that it was the first unit in Canada. It was formed on April 27, 1920, with one following in Calgary a year later. There were forty-four on the first roll-call in Edmonton, nurses who united, as their constitution said, to "continue a fellow­ ship peculiar to those who served overseas in the first great war and to help one another should occasion arise". Hattie "Happy" Acton, a Royal Alex grad of 1910, was the first president, with Marion Lavell as vice-president, and Mrs. Chester Chinneck (Nellie McRae, Royal Alex, 1912) as secretary­ treasurer. They called themselves The Overseas Nurses Club of Edmonton. They were granted honorary membership in the Great War Veterans Association. They made the first donation to the fund for the Edmonton Cenotaph, and the comradeship with the soldiers, established in the war, was carried on into the 1920's and '30's when the peace was as unkind to some of the soldiers as the war had been. They helped the Canadian Corps with relief work. In Calgary an overseas nurses club was formed at the Colonel Belcher in the spring of 1921. Miss Nichols Gunn, who I 73 was the first vice-president, recalled: "There were about thirty of us at the beginning. We felt we needed an organization to keep together. The nurses of 1914-18 were much more conscious of each other." In 1929, local organizations across the country joined to­ gether as the Overseas Nursing Sisters Association of Canada, and the Calgary and Edmonton clubs became units of the national organization.

Alumnae associations began to appear in Alberta during the 1920's, and depending on how you look at it, the first was either at the Royal Alex or the Edmonton General. How you look at it, of course, will depend to some extent on whether you're a graduate of the General or the Royal Alex, but here are the facts: In the fall of 1922, about fifty graduates of the General formed a club with the aims of an alumnae association. However, there can't be an official alumnae association without the consent of the school, and the sister in charge, fearful of more paper work, advised the girls to have their meetings by themselves but to please not involve the hospital. So the General grads associated on this basis until 1928 when the formal sanction was given for an alumnae association. In 1923, the Royal Alex graduates organized with official approval. The first meeting was held June twenty-third of that year and the first president was Annie Lawrie, class of '18, later matron of Regina General. The objectives of the Royal Alexandra Alumnae Associa­ tion were common to all the graduate groups which came later, and were defined by the founders in these words: "The promotion of unity, loyalty and good feeling among the alumnae; "The advancement of the interest and upholding the standards of the profession of nursing; "To keep in touch with our alma mater for our mutual help." The Royal Alex alumnae began the custom of an annual banquet to honor the year's graduating class and thus welcome the new class to the alumnae association. It also began a scholar­ ship fund to help outstanding members take post-graduate work. It wasn't until 1934 that the fund was large enough for the first 174 scholarship, but money came slowly in those years. In the sum­ mer of 1934 Carrie Genek went to the University of Toronto for a course in public health nursing, on a fund raised slowly but unswervingly with garden parties, teas, dances and donations from student nurses still in training. Such were the beginnings of the Royal Alex alumnae group, either the first or the second in the province, depending on how you look at it. At the General, finances were even tighter, and the first unofficial graduate group of 1922 grew out of this stringency. The General could not afford to hire its own graduates as the Royal Alex could. Every spring the sisters would put the unpaid bills behind the statue of St. Joseph and they'd go out two-by-two with their well-known black satchel, canvassing every home and business in Edmonton for donations to pay the bills and carry on the operation of the General for another year. In the spring of 1922 the sisters employed their first lay graduate, Ruby Conroy, who had finished the previous year. Paperwork was coming into the operation of hospitals and the sisters needed a lay person to handle accounts, records, statistics and admissions. Mrs. Conroy had to be careful not to drop anything heavy in her office, in which she also had her cot, because Sister Olymphe's chicken house and hatchery were just below the window and Sister Olymphe figured that noise disturbed the hens and their full pro­ duction was needed. The sisters also had to take turns working in the huge garden that extended down to Jasper A venue, and in springtime they had to cover for the sisters who were off can­ vassing with the black satchel. They hadn't the money to hire lay nurses, not even their own graduates, so the graduates organized informally in the fall of '22 to help each other find work. There was keen competition for the few hospital and institution jobs that came open and the General grads wanted a sort of intelligence network to help them in the never-ending quest for work. In the mid-twenties the city and the province took the pres­ sure off St. Joseph as guarantor of General Hospital finances with a system of grants. The city paid fifty cents a day for Edmonton patients and the province paid fifty for all. However, to get the grants the sisters had to produce records kept in a standard form, 175 and the new paperwork on top of their other chores, made the grants seem almost a mixed blessing. But when the grants began coming in the situation was much happier. The hospital could offer employment to its alumnae, and Sister Wagner, the new superintendent of nurses, who came in 1926, helped the graduate club set up an official alumnae asso­ ciation. The constitution was based on the one of her own alma mater in Toledo, Ohio. In this new atmosphere the alumnae could then work more for the advancement of the school than their own survival. That's the case for the Edmonton General being first with an alumnae association. However, if it wasn't first then it has to be third because the Misericordia formed one in the fall of 1926. "Our aim was to hold the girls together," said the group's second president, Mary Verchomin (Mrs. Peel), who succeeded the first president, Marie Munn, shortly after the formation. The aims were not so much economic as those at the General because the Misericordia then had four graduates on staff, al­ though senior students were in charge of two wards. The alumnae helped the training school by raising money for scholarships for top students. The money was raised by teas so the scholarships were really prizes, in the order of twenty-five dollars. But- they were greatly prized. When Miss Verchomin had graduated at the head of her class, her award had been a nurse's uniform and she and her classmates had thought it was wonderful. So the Misericordia had the second alumnae association, and either the Royal Alex or the General had the first depending on how you look at it. Five more alumnae associations appeared in the next decade. All schools now have them and they are a proven asset to their alma maters.

Through the post-war era the nurses' group set up by the Registration Act continued to grow in size and effectiveness. The goal of uniform registration examinations for all nurses in the province, was made in October, 1919. The first were held in Calgary from October first to third, and all new graduates began taking them that year. The AAGN appointed a committee to settle on the standards for these examinations and work with some Alberta doctors in drawing them up. The doctors probably had more say than the 176 nurses on what should be done, and there weren't many models to draw on. Great Britain did not have registration until 1919. There was registration in New York and California and the nurses were interested in the New York and California standards because one of the aims of registration was reciprocity. Refresher courses, to keep the R.N. up to date, and heed the warnings of Florence Nightingale, were arranged in connection with annual meetings. The courses would run two or three days following the meeting and would consist of lectures by doctors or demonstrations of new techniques in nursing. The planning of the courses was based largely on requests from practicing nurses and would have helped reassure Miss Nightingale. So the asso­ ciation itself was a force in the continuing education of the nurse, and the guest speakers brought in for the annual meetings were also part of the post-basic education plan. One of the first was Ethel Johns, an historic figure in Canadian nursing, who was then matron of the Vancouver General and in 1920 joined the new department of nursing at the University of British Columbia with the rank of assistant professor. A later speaker was Jean Browne, who was so effective with a talk on "Nursing Conditions in Can­ ada" that she inspired the nurses of Alberta to action of national and lasting significance. This came later. In 1921 the Alberta group made a significant change in their name. In the name, Alberta Association of Gradu­ ate Nurses, the word Graduate was replaced by Registered. This was a significant change. It gave better expression to the intent of the Registration Act, and also served notice that graduation was a requirement for registration but did not make it automatic. There was another important change in 1921 - an internal one. With membership approaching three hundred, the clerical work was getting beyond the after-hours capacity of Miss Mc­ Phedran, the association's combination secretary, treasurer and registrar. She was authorized to engage a stenographer, when needed, and to buy a desk and a filing cabinet. This one filing cabinet was big enough to do the AARN for years. It was later installed in the Edmonton office of the superintendent of pro­ vincial public health nurses, and in the next decade was moved again when the association got an office of its own with a paid secretary. In 1922 the Alberta group made another advance in stature 177 and organization. It was host for the eleventh general meeting of the CNA'IN, the Canadian National Association of Trained Nurses, forerunner of the CNA. The CNA'IN meeting was held conjointly with the annual meeting of the CANE - the Cana­ dian Association on Nursing Education. The CANE was formed in 1917, and two years later the two bodies merged to form the Canadian Nurses' Association. The national meeting was held at the Macdonald Hotel in Edmonton, from June ninteenth through the twenty-third. The exact number who attended is not recorded. However, ninety-nine delegates and observers signed the guest book at gov­ ernment house, where a reception was held for them. The Edmonton Journal printed the entire guest list and the names included some names historic in Canadian nursing. There was Jean Browne, then the executive director of the Junior Red Cross, who was elected president of the CNA1N at the convention. There was also Ethel Johns, Mary Shaw, Kay Mathe­ son, Muriel MacKay and Miss E. MacPherson Dickson. The nurses at the convention met some of the historic Al­ berta people we've met earlier in this book. The lieutenant­ governor who made them royally welcome at government house was Dr. R. G. Brett, who entertained them with stories of the early days of medicine at Banff, both at the reception and at the opening ceremonies of the convention. Dr. F. H. Mewburn, grand old man of Lethbridge, and then professor of surgery at the univer­ sity, was unable to tell his own stories because he was away. But the convention enjoyed a talk by Marion Moodie, the first graduate of Calgary General, who had them laughing and wondering with the stories told earlier in this book. Some of the business of that 1922 convention had an amusingly modem sound. There was, for example, a resolution put forward by the private duty section of the CNA'IN. It read: "That whereas there is a growing feeling of criticism of the present-day nurse, be it resolved that this section request the general body to appoint a committee for the purpose of making a careful inquiry into the cause of criticism." That resolution had a deceptively modern sound but others were clearly dated 1922. There were two from the Calgary chapter of the AARN. One asked that hospitals stop hiring nurses who lacked a diploma from a recognized training school. The other 178 condemned the long-established practice of hospitals sending stu­ dent nurses out on private duty and keeping the fee. The life of the student nurse, and public health nursing, were the dominant themes of the convention. The chief of the V.O.N., Mrs. J. Charlotte Hanington, announced that the order was going to offer fifty scholarships in the public health field. The brief of the Canadian Association on Nursing Educa­ tion expressed concern that the drudgery of the student's training regime was dulling the ideals that attracted her to nursing, and left her so physically and mentally tired that she turned to the lightest and most frivolous diversions in her spare time. It was to this convention that Mr. Whiston revealed the Alberta government's "vision and ambition" of attracting country girls to nursing through the municipal hospitals; a plan in which the girls would spend a year in their local hospital, then two years of "finishing" at a school attached to the University.

In the early twenties there were suggestions that the AARN affiliate with other women's groups, principally the Women's Institute. From some standpoints this affiliation was a practical idea, since much of the demand and support for health services at country points came from the Women's Institutes. The short courses on home nursing which followed the flu are a good ex­ ample of the influence of the W.I. However, the affiliation would have blurred the main issues in the nursing campaign and it was wisely declined. In the middle twenties there were requests for support from another quarter. People from the hospitals asked the support of the nurses' group in setting up the Alberta Hospitals Association. The support was given, and the association was formed, and the collaboration paid off handsomely to the benefit of the nursing profession. In 1926, Dr. Harry Smith, superintendent of the Royal Alexandra, carried to high places a resolution of the AARN and the AHA which had a profound influence in achieving the aims not only of the AARN, but the nursing profession across Canada. It started in Calgary, in November of 1926. On the twenty­ third and twenty-fourth of November the AARN convention was held in Calgary. The AHA convention was held at the same time and some of the sessions were held together. The principal speaker at the nurses' meet was Jean M. Browne and her talk started it. 179 Miss Browne's subject was Nursing Conditions in Canada. In it, she described how the Canadian Medical Association, meeting in Victoria in June of that year, had appointed a committee to study the curriculum in Canadian nursing schools. This committee of doctors was to report to the medical association on the state of the curricula, and how these curricula had evolved. In making the study the committee was to ask cooperation from other Cana­ dian organizations concerned in nursing education, plus similar bodies in the United States. After hearing Miss Browne, the AARN decided this was a poor way to study nursing education in Canada. The nurses should be involved jointly, and equally, with the doctors. Their feelings were defined in a resolution which was worded as a joint resolu­ tion from the AARN and the AHA. It was passed in a joint session. The words were: "Resolved that the joint meeting of the Alberta Hospitals Association and the Alberta Association of Registered Nurses deprecate the method taken by the Canadian Medical Association to study the curriculum of the training schools for nurses in Can­ ada, as stated in the resolution outlining the function of the com­ mittee, and suggest that this resolution be annulled, and that a joint committee composed of representatives of the Canadian Medical Association and the Canadian Nurses' Association be appointed to make a study of the question." This resolution, passed in Calgary on November twenty­ fourth, 1926, was carried to the executive of the Canadian Medi­ cal Association by Dr. Harry Smith. What arguments or per­ suasions or promises of help on some CMA project Dr. Harry Smith had to offer, we don't know. We do know that the idea which originated with the nurses of Alberta led to the most famous document in Canadian nursing history: the Weir Report.

180 CHAPTER SIXTEEN The plan of action was decided on June fourteenth, 1927, when the nurses were invited to meet with the Canadian Medical Asso­ ciation in Toronto. Edna Auger was the AA.RN representative at the meeting. The CMA had already appointed a chairman for the study com­ mittee, Dr. Stewart Cameron, of Peterborough, Ontario. With him were Dr. A. T. Bazin, chief surgeon of the Montreal General, and Dr. Duncan Graham, professor of medicine at the University of Toronto. Dr. Cameron decided that the committee members from the Nurses' Association should be able to work closely together and also be in close personal contact with him, so the nurses elected three Toronto women: Kathleen Russell, director of the depart­ ment of nursing at the University of Toronto; Jean Gunn, super­ intendent of nurses at Toronto General; and Jean Browne, secre­ tary of the Junior Red Cross Society. This jury of six quickly decided that if the results of the study were to carry the necessary weight, it would have to be done by someone outside the field of medicine but inside the field of edu­ cation; somone with an independent reputation to give further weight. They decided their man was Dr. George Weir, head of the department of education at the University of British Columbia. The university gave Dr. Weir leave of absence to make the survey. It started November first, 1929, and went on to July thirty-first, 1931, with the nurses paying seventy percent of the cost and the doctors thirty. Dr. Weir worked hard. He travelled 35,000 miles, making a note of the fact that five thousand was by automobile. He seemed to suggest that the auto part was a fairly adventurous way to travel 181 in 1930, and the district nurses of the Alberta department of public health certainly had some adventures getting around in cars. In conducting the first comprehensive survey of the nursing profession ever undertaken in Canada, he visited 145 of the 215 nursing schools, from the biggest to hospitals with less than fifteen beds. He held 650 conferences attended by eleven thousand people. He observed seventy-five lectures, tabulated questionnaires re­ turned by 4,576 registered nurses, ran 1.Q. tests on 2,280 stu­ dents, read letters sent in by two thousand nurses. He said the survey "had access to the most comprehensive and reliable body of data yet available regarding nursing educa­ tional problems". From it he produced six hundred pages of yard­ sticks for judging the progress of nursing education and the nursing profession from then on. The report is a little disappointing to an Alberta historian, especially after the role of Alberta nurses in obtaining the survey, because the professor divided Canada into five zones. Quebec, Ontario, British Columbia and the Maritimes were treated as individuals. Alberta, Saskatchewan and Manitoba were lumped together under "prairie provinces'', a lumping that was more valid in 1930 than today. In one of bis few direct references to Alberta he says it is not easy to generalize on nursing conditions across the country because "conditions in rural Alberta do not parallel those found in industrial centers of the east"; as though there were nothing so rural as a district in Alberta and nothing so industrial as a city in the east. However, the illustration was acceptable in its time, and the lumping of the prairie provinces was acceptable since they were on an equal economic level, which is to say, pretty low. His re­ port on salaries alone is indicative of economic conditions on the prairies and of the thoroughness of the survey. A superintendent of nursing in the prairie provinces got $140.63 a month, against a national average of $146.00. An assistant was paid $98.96 a month against the national average of $102.27. Residential superintendents got $75.00 against the average of $82.89. Charge nurses made $87.50, just above the national scale of $84.77. 182 Professor Weir suggested that a dollar a day be added to represent the value of room and board received in the hospital. The prairie average was typical of what a nurse could expect to make in Alberta, if she were lucky enough to have such a job. As the Weir report made clear, the hospitals were not hiring many graduate nurses for staff duty. Graduates were wanted mainly for supervisory duty with the student nurses doing the work in return for training in the profession. The Weir survey discovered 18,174 registered nurses in Canada. Of these, just over ten thousand were active. 25 percent were working in institutions, 15 percent were in public health, and sixty percent were working on their own as private duty nurses, earning an average of 920 dollars a year on the prairies, against a low of 827 dollars in the Maritimes and 1,189 in Quebec. Many of the private duty nurses reported that they could not have made ends meet if they had not lived at home. On the prairies, with the average of 920 dollars, some earned less than 300 and the highest was two thousand. (The average salary of a lady elementary school teacher was $1,040.) This breakdown of the employment of active nurses in 1930 provides a wonderful yardstick for comparison with today, that is, with what the Hall royal commission found in 1960. In 1930, 25 percent of active nurses were in hospitals; by 1960 it was 59 percent. In 1930, 60 percent of nurses were in private duty; by 1960 it was nine percent. In 1930, 15 percent of nurses were in public health; by 1960 it was seven percent. In 1930 there were not enough nurses in "other fields" to provide a statistic for the Weir report. By 1960 a full twenty-five percent of active nurses were in "other fields'', private clinics, the airlines, foreign missions, industry, education, the armed forces, and the fascinating Indian service which takes a full chapter later on in this book. The Weir survey found that the numbers of nurses were going up faster than the population. In 1901 there were in all Canada only 280 lay nurses. By 1911 there were 5,600. By 1921 there were 21,385 (including 223 men). By 1930 it had jumped to an estimated 30,510 - made up of 18,174 registered nurses, 183 an estimated 2,742 who were qualified to register but hadn't, and 9,594 in training schools. The Hall Commission, of the early sixties, found that the proportion of nurses to population is going down. However, in Alberta, the proportion of students is rising. In 1930 in Alberta, the Weir report found 862 students in thirteen schools, including Ponoka, plus the Camrose and High River schools which have since closed. That gave Alberta one student nurse per 821 people. In December, 1964, there were 1,944 students in twelve schools, Lethbridge St. Michael's being added and Camrose and High Prairie dropping out. With the increase in population that gave Alberta one student nurse per 663 people today. This comparison on students is but one of many made pos­ sible by the yardsticks manufactured in the Weir survey, and 1930 being the median year of the figures and facts flushed out by Professor Weir, is particularly useful in a history of nursing in Alberta. That's because it comes exactly midway between the opening of the first school of nursing, at Medicine Hat in 1894, and the golden jubilee of the Alberta Association of Registered Nurses in 1966. Reporting on what had happened up to 1930, Professor Weir said nursing was a profession more honorable than ancient but noted that considerable ritual was already becoming imbedded. He pointed out, what nurses already knew, how much rituals , like changing uniforms for classes, rituals instituted for "discipline" in a less-disciplined age, were actually costing. These ceremonies grew out of a "trade" concept of nursing, which, he said, was gradually yielding to a scientific and profes­ sional outlook. But he found that in some schools of nursing the viewpoint was still too narrow, and that many schools seemed to have halted halfway between the two viewpoints and there was therefore confusion. This confusion, he said, was a handicap to the work of his commission. In his words: "Considerable delay and additional expense were occasioned as a result of the unsystematic method, or lack of method, certain organizations adopt in keeping the various records pertaining to nursing education." Noting that the material often required complete reworking before it could be tabulated he said: "While the working over of 184 disorderly material seems to be an inescapable adjunct of survey pioneering, it is confidently expected that at least one of the bene­ fits accruing from this investigation will be the adoption of greater system, uniformity and general efficiency in the matter of ex­ amination standards and the keeping of records." Many of Dr. Weir's prophecies and recommendations have been realized, some sooner, some later. This one was realized later. It wasn't until 1965 that a simplified record-keeping system was laid down for schools of nursing in Alberta. It was worked out by a task committee, appointed by the University's committee on nursing education, and was incorporated in the regulations. It aims at recording the education of a nursing student in a new concept, a concept that emphasizes thinking and applying basic ideas to nursing problems rather than memorizing facts. There is less detail on individual subjects. Clinical experience is recorded in hours spent in actual learning, rather than weeks of service. The lack of uniformity in statistics on nursing education, referred to by Dr. Weir, showed up as late as 1965 when the advisory committee of a large Alberta hospital polled Alberta's twelve nursing schools for information on the cost of training a nurse. The committe found so little uniformity in cost-accounting methods that the cost could not be established from the figures returned. The nursing schools which drew heavy criticism from Dr. Weir were schools affiliated with small hospitals which were run more for the economic needs of the hospital than the educational needs of the student. He recommended that no training school for nurses be officially recognized unless connected with a hospital having at least seventy-five beds and fifty patients at a time. He also recommended that each school have at least one full-time instructor, a "prepared" instructor, meaning one with training in education as well as nursing. In 1930, the year of the survey, it's unlikely that there were more than two or three instructors, "prepared" according to Dr. Weir's specifications, in all Alberta nursing schools. There has certainly been great progress here. In December, 1964, when the most recent survey was taken, the twelve schools of nursing had 158 full-time faculty members. Of these instructors, six had master's degrees; sixty-eight had baccalaureates; sixty-nine had at least one year of university preparation in teaching or 185 public health, and only fifteen were registered nurses without further preparation - the level at which almost all instructors were at the time of the Weir report. On another recommendation of the Weir report there has also been progress. He had found that too many of the lectures the students were hearing were slightly-altered medical lectures given by doctors. He found that many of these lectures were not very helpful, for two reasons. The fact that a man was an author­ ity on a subject did not necessarily make him a good teacher; and the emphasis was usually on the medical, rather than the nursing side, of the subject. A study done by an advisory committee of the Royal Alex­ andra Hospital in 1963 showed the trend away from doctors' lecturing in that school, a trend noticeable in all Alberta schools, and brought out the reasons. The board was aware that at the time of the Weir report doctors were giving about seventy-five percent of the lectures and the nurses twenty-five. By 1963 these proportions had gradually reversed themselves. The board was curious, not angry, just curious. So were the doctors. The study found that time-scheduling was one problem that had led to nurse instructors replacing doctors. Because of opera­ tions and other commitments, doctors had to cancel classes fre­ quently and it was difficult to re-schedule them. Increasing spe­ cialization and the flood of new medical discoveries was another reason. Where a specialist could once explain his field in one hour he now would ask for ten. With doctors trying to convey more medical information there was less and less emphasis on the how and why of nursing. And the school was trying to turn out nurses, not doctors. There was also the problem, noted by Professor Weir, that it's one thing to know a subject and another to be able to put it across in lecture form. The study found that a doctor's most effective contribution to the education of the nurses is in clinics right on the floor of the hospital, where he can demonstrate a nursing problem in relation to an actual patient. This was a study at just one institution but it accurately re­ flects a trend common to all schools of nursing in Alberta, and shows progress, using the Weir report as the yardstick. There's been progress in another matter too, the matter of 186 fatigue. Professor Weir gave attention to the fatigue endured by student nurses, trying to take lectures and study on top of a twelve-hour work day; something everyone had taken for granted up to 1930. He recommended the eight-hour day for students, with no lectures after six p.m. By 1940, when Kate Shaw Brighty (Mrs. Harry Colley) sent out questionnaires gathering information for a history of Alberta nursing, only one school still had students on the seven a.m.-seven p.m. routine. The others were all down to seven to nine hours a day, although for six days a week. And there was another factor to fatigue, more sinister than making girls too tired to study. It weakened their resistance to disease. There was high TB rate among student nurses, as those who were students at the time of the Weir report have testified. There's another point which Professor Weir didn't mention because it was taken for granted in 1930. It was taken for granted that students gave almost all the bedside care in hospitals with nursing schools, and the Professor didn't get any exact percentages. However, in 1960 the Hall Commission found that in Alberta the percentage was down to twenty-six percent and that's progress. On other points little progress has been made since 1930. Dr. Weir, for example, wanted the students' schedule to provide more time for independent reading and investigation, and no one has yet figured out a way to achieve this desirable state. On another of the professor's ideas there has been almost no progress at all. He thought that the school of nursing should be closely affiliated with a hospital but should be financially in­ dependent. This was not a new idea even in 1930; Florence Nightingale proposed it, as Mrs. June Taylor (president of the AARN from 1959-61) pointed out to the Alberta cabinet in 1965 when a delegation from the AARN was waiting on the cabinet and an honorable gentleman wondered how long the nurses had been urging the separation of school and hospital. While little has happened in this direction, at least it's not a dead issue. In fact, as an issue it's never been livelier, so the Weir report may yet become a yardstick of change in this matter as it has in so many others. Here in Alberta, there were some early results from the re­ port which the nurses of Alberta helped to bring about. The pro­ vincial government appointed an inspector for schools of nursing, and named Eleanor McPhedran to the position. And the schools 187 in High River and Camrose, which were in hospitals considered too small to provide the necessary instruction, were closed down. There were other follow-ups to the Weir report. There was the first comprehensive history of nursing attempted in Canada: Three Centuries of Canadian Nursing. There was a book entitled, A Proposed Curriculum for Schools of Nursing in Canada, which came out in 1936 and in which the Canadian Nurses' Association tried to define its aims and principles, and which was the bible of Canadian nursing education for many years. It was followed four years later by a supplement titled, The Improvement of Nursing Education in the Clinical Field. Another follow-up is the Schumacher report. If you haven't heard of the Schumacher Report it's not surprising because it was an analysis done especially for this book by Marguerite Schu­ macher, president of the AARN from 1963-65, and Adviser to Schools of Nursing in Alberta. Miss Schumacher analyzed the education of a typical Al­ berta nurse, in hours of classroom and clinical instruction, as it was at the time of the Weir report, and at the time of the golden anniversary of the AARN. That's 1930 contrasted with 1966, keeping in mind that 1930 is exactly halfway between the start of Alberta's first school at Medicine Hat in 1894, and the golden anniversary. The curriculum of this school for 1966 is based on the regula­ tions issued by the University in 1960. These regulations say the total number of hours of classroom and clinical instruction must be at least 815 hours during the three-year course, which may be arranged like this:

General education: Elective Biological and Physical Sciences 145 hours Social sciences 50 hours Non-clinical nursing 45 hours Clinical nursing 575 hours Total 815 hours

With these minimum hours in mind, the schools' curriculum is set up now to provide the following level of instruction: 188 Hours in Hours in 1966 1930 General education Biological and phy ical sciences 178 30 Social sciences 60 Nil Non-clinical nursing 50 12 Clinical nursing 942 239

Total 1,236 341

The 1930 figures are based on the actual record of a student who graduated from this school in that year. Her record provides another interesting yardstick to measure clinical experience.

Weeks in Weeks in 1966 1930 Medical-surgical nursing 40 134 Diet therapy 4 8 Operating room 8 8 Pediatric nursing 12 8 Obstetric nursing 12 8 Psychiatric nursing 8 Nil Classroom and additional experience 57 4

Florence Nightingale, who "liked to bite on a hard statistic," would have found these figures very tasty.

189 CHAPTER SEVENTEEN At the time of the Weir survey, Alberta's district nursing service was at the peak of its remarkable career. Starting with the post­ war, it was a product of public health concepts applied where the frontier still existed. In 1930 there were only about fifteen nurses altogether, exactly one percent of the public health nurses in Canada, but they travelled fast and far. The district nurses were part of the public health service of the province of Alberta and the government's real involvement began with the post-war. However, long before this, right from 1859, wherever there were nurses there was a public health ele­ ment in their work. A national V.O.N. survey in 1922 reported that Alberta's municipal hospitals were public health centers but this had always been true of all hospitals in the province. There had also been privately-sponsored projects with public health benefits, the most notable being the Lethbridge nursing mission, founded in 1908 by a lady who was concerned about people with TB who needed nursing in their homes. Mrs. J. T. Robinson was not a nurse, nor was Mrs. Tilley, who ran the mission for nearly forty years. But in 1910 they engaged their first graduate nurse, Bessie Cook, and the mission had one or two nurses on staff until the city of Lethbridge brought its work into a civic department forty-five years later. Much of the work was motivated by welfare considerations but there was inevitably a public health element inseparable from welfare. The milk was a case in point. At the beginning the mission used to get free milk from the dairies and dole it out to the needy with a dipper, filling uncovered jugs, pitchers and pails as they were presented. That was welfare. But when the dairies began pasteurizing their milk, the mission went to the Elks lodge and asked the Elks to raise money with which the mission could buy 190 milk tokens. The tokens were then distributed to the needy and they were able to obtain pasteurized milk in bottles. That was public health nursing. Some projects, like Christmas hampers, were welfare. Others, like the TB clinic and the nurses' registry, were nursing. But the well-baby clinics, the pre-natal classes, the work with neglected children and unmarried mothers, were inevitably a mixture. Flor­ ence Nightingale was opposed to nurses being welfare workers but even the doughty Florence never devised a plan to separate them, and welfare areas continue to be the most rewarding areas for the public health nurse. The involvement of the provincial government in public health began through the department of agriculture during the first great war. Early in 1916, the department engaged three women, two of whom were nurses, as advisers to the Women's Institutes. The director was Mary Mcisaac, a Toronto grad who had been matron of the Royal Alex; Bess McDerwand was named lecturer in home economics, and Marthe Morkin, a St. Boniface grad of 1913, was appointed to give courses in the agricultural schools on personal and public health, and to lecture to Women's Institutes on health education. The appointment of Miss Morkin - by the department of agriculture - was the start of the government's involvement in public health nursing. The Public Health Act itself was at that time administered by the provincial secretary because Alberta did not yet have a separate ministry of health. Of course, no other province had one either. New Brunswick became the first in 1917, and Alberta became the second a year later. The first minister of the separate department was the Hon. A. G. MacKay, who represented Athabasca in the legislature, and it was providential that a man from a frontier constituency was the minister because with a city man in charge, district nursing service could hardly have got off to the fast start which it did. The new ministry included a public health nursing branch under Christine Smith, a Toronto grad with seven years' V.O.N. experience in the Yukon. Miss Smith was authorized to engage four graduate nurses to form the first public health staff. She got two Royal Alex grads, Elizabeth Clark (who succeeded her) and Gladys Thurston; Bessie Sargent of the Toronto General, and 191 Maud Davidson, from the Highland Hospital, Rochester, N.Y., class of 1902. They set up health exhibits at the Calgary and Edmonton exhibitions of 1918. The next year they enlarged the show and afterwards took it to eighteen towns. And in taking the show on the road they began a pattern of travelling that would be character­ istic of Alberta's public health nurses for decades. An annual post-graduate course for nurses entering the de­ partment was started at the University in 1919. The curriculum of the course was laid down by The Public Health Nurses Act of that year. It was to include lectures on sanitation, personal hygiene, bacteriology, public health, examination of the eye, ear, nose, throat and teeth, the pre-natal period, infant welfare, child welfare, instruction and inspection of school children, communi­ cable diseases, preventive medicine and methods, and "such other studies as from time to time the senate of the University shall prescribe". The course took about three months. In June, 1919, the seven graduates of the first course were added to the staff of the department: the Misses Gimby, Lawrie, Elsey, Runnians, An­ derson, Crosbie, Matthews and Brighty - the seventh being Kate Shaw Brighty, who would be superintendent of the department from 1929 to '43 and make many contributions to nursing in Alberta. The courses were cancelled in 1921 when the United Farmers of Alberta took over the government. It was ironic that the United Farmers should cancel this course when the United Farm Women of Alberta and the Women's Institutes were leaders in all health causes, but the new faculty of medicine at the Uni­ versity was also threatened. It was fortunate anyway that a third group had been able to take the public health course because it contained some live ones. There was Amy Conroy, the gentle dynamo; Blanche Emer­ son who is sometimes called the Marion Lavell of northern Al­ berta, and Marion Lavell who is sometimes called the Blanche Emerson of southern Alberta. In a very short time the work of the public health nursing staff fell into two categories: that done in larger centers like Cal­ gary, Edmonton and Medicine Hat, and that done in isolated dis­ tricts. The second was known as district nursing, and it produced an outstanding chapter in the history of nursing in Alberta. 192 The credit for originating the district nursing service, Miss Brighty gave to Dr. Heber Jamieson. Dr. Jamieson she described as having "a most lively interest in life itself, even life in micro­ scopic form. He was a bacteriologist." He was a great student of nature and sometimes wondered if he hadn't some Indian blood. He was one of the chief lecturers in the brief existence of the public health course at the University, where he was an assistant professor. He would step into any vacancy in the public service. He was a man of high good humor and could also bend his elbow with the best of them and that surely included the Hon. A. G. MacKay. Mr. MacKay was described by Miss Brighty as "rough but kind, a bachelor and something of a lady's man, but he had some sterling worth because he bad certain large, good viewpoints and representing a half-settled riding like Athabasca, be recognized the value of district nursing as a city man wouldn't". Dr. Jamieson proposed the district nursing scheme to Mr. MacKay after a trip to Manitoba to see how a similar plan was working there. During the war Dr. Jamieson was administrator of the Public Health Act. When he heard that Manitoba bad formed a corps .of nurses to do public health work in rural areas, he went down to have a look and came home convinced. He convinced Mr. MacKay and Aiberta's district nursing service became official policy. Alberta's district nurses introduced a twist that would have surprised William Rathbone, the Liverpool merchant who had the idea in 1859. Mr. Rathbone conceived it as a service to crowded urban districts; here in Alberta it became a service to people in thinly populated areas so far from anything that they could hardly be called rural and were in fact on the frontiers. The Alberta nurses were the "grandmothers" of the frontier. Blanche Emerson explained the term. In older, longer-settled parts of the country, if a child was not doing so well, his grandmother would be consulted for advice. But on the frontier there were no grandmothers to turn to and the district nurses did their valuable work. Other agencies provided district nursing of course, notably the missionary societies and religious orders, and the new govern­ ment agency was not intended to duplicate or replace a service that already existed. In its creation, the government acknowledged a responsibility in areas not served. In the summer of 1918, 193 Elizabeth Clark was sent on a horse· and-buggy tour of outlying areas gathering opinions on the type of service the new agency proposed to give. In the Y eoford district, an area of tall timber and scattered farms west of Pigeon Lake, an English woman expressed an idea that became a policy. She told Miss Clark that the work proposed was excellent but didn't go far enough. In this remote area the need was for obstetrical nursing and closer contact with the mother in the home. Miss Clark took the idea back to Edmonton, and the next year three nurses with obstetrical training were sent out. They were Mary Conlin and Genevieve de Turbeville, gradu­ ates of Roosevelt Hospital and Sloan Maternity Hospital in New York City, and Mary Hall, a graduate of the Calgary General. All three were war nurses, just returned. In October 1919, Miss Conlin was sent to Bluesky and Miss de Turbeville to Griffin Creek, both north of the Peace River. Miss Hall was sent to Yeoford, where the idea of maternity nurses originated. These three were the first of many. Their work was written up in Canada's national magazines. Nellie McClung wrote the story for Maclean's and F. C. Pickwell wrote The Heroic Nurses of the Prairies for Toronto Saturday Night. Miss Hall told the Saturday Night writer about some of the people in her district for whom the nursing service had started too late; of a boy who was blind from sheer neglect at birth. For years district nurses would be haunted by cases like this; of un­ fortunates who could have been saved from crippling disabilities if the ounce of prevention offered by the district nursing service had only been there a little sooner. Describing her particular district Miss Hall told of a thirty­ five mile trip in the spring, when the bridges were all washed out and the mosquitoes were driving her frantic and the horse flies were torturing her horse. She was quoted: "Another of my weary trips was to a place called Woilf River. I thought I would never reach my destination. I rode for miles and miles and all I could see was tall timber on all sides, only the occasional twitter of a bird breaking the deadly silence of the journey. When I arrived the one thing that interested me was that I reached the end of surveyed land, the country beyond being an unrecorded wilderness. Fifteen miles west of this point the Brazeau River joins the Saskatchewan on their eastward course from the 194 mountains. It was through this wilderness that John Keith fled to find peace and happiness in River's End." River's End was a very popular novel of the northwest by James Oliver Curwood and was sub-titled A Story of God's Coun­ try. Miss Hall, apparently, did not find it as divine as John Keith did. Far to the north, beyond the Peace River where Miss Conlin and Miss Turbeville were working, there was plenty of wilderness. And they were so far out that they were often out of touch with their headquarters in Edmonton, as departmental correspondence reveals. Miss Conlin was twice a casualty. The first time she was thrown by her horse, landed on a stump and broke her hip. After recovering from that, she accepted an invitation from some boys to ride a toboggan down the hill behind her cabin. On the way down she injured her leg. Miss de Turbeville was a powerful spokesman for the district nursing service. In 1921 she spoke to the convention of the AARN in Calgary and the Calgary Albertan called her talk "the outstand­ ing address of the entire session". She gave a spellbinding talk on her work in the outer limits of the farm belt, describing the feeling of being warm in her cabin on a night when it was thirty below and having just gone to bed and then hearing "the well­ known tinkling of sleighbells on the trail" and knowing she had to leave her warm bed and go out in the cold. She told of the satis­ faction of saving a mother and child and then returning to the cabin where the fire had gone out and the food frozen. But she emphasized that the district nurses were not doing acts of charity. She said the hard-working people on the frontier had a right to expect the state to provide health service, just as it provided education. Miss de Turbeville was a forceful spokesman for her branch of nursing, and she was also a good representative of the Canadian nurses who had gone to war as officers in the army and had brought back to civil life a confidence and assurance which gave the nursing profession its strongest voice ever. The reporter who was so impressed by her talk thought the government was pro­ viding everything. But this wasn't the case. There was an element of community self-reliance in district nursing, the same element as 195 in the Municipal Hospitals Act. The r,ommunity had to provide the house for the nurse, and the fuel and water supply too. Her public health work - consulting with mothers, speaking at schools, and immunization - was given free. But there was a scale of fees for personal nursing which a grateful family - or an ungrateful bachelor; many a grumpy bachelor regarded his "angel of mercy" as an intruder - was expected to pay. An office visit was fifty cents, a house call was a dollar, and ten dollars covered maternity, including care before and after. These fees, instituted in 1919, have never been changed because they were intended to be tokens. But where there's been a district nurse, people have grown accustomed to her fees, and this, coupled with the fact that the nurse sold drugs and dressings at cost, bas made many a district angry and bitter when it has ceased to occupy the frontier and the district nurse has been withdrawn. There was some opposition to the district nurses being in midwifery. Miss Brighty is the authority for that; the opposition was from the doctors. The idea was new in Canada although com­ mon and long-accepted in Europe and Asia. On the frontier in Alberta it was supported by the unwritten law that there is a duty for one woman to help another; and the unwritten law was soon put into writing through amendments to the act. The nurses were given legal status as midwives and being often the only official agent in an area, they also bad power to do things like issuing certificates for burial in places where there was no cemetery. The nurses saw the children of their schools during the year, and since the teachers were mostly adventurous young women too, there was good liaison between nurse and teacher. The nurse gave health talks in the school, inspected the children, and organized lectures and demonstrations for their mothers, and was at all times a sort of "minute-woman", ready to go anywhere in an emergency. By 1922 there were a dozen district nurses and a staff of thirty altogether in public health. And the scope and responsibility were stimulating. As an Ontario graduate expressed it: "In Toronto we weren't allowed to diagnose a burn." In 1923 the U.F.A. government reduced the funds available to the public health nursing branch and there were some cuts in staff, but even so it was necessary to open two more districts. And one of the nurses that year introduced an extension of the district nursing service by a program she devised for her own 196 district. The nurse found a lot of tonsil and adenoid trouble among the children of her schools and during the summer vacation ar­ ranged for a doctor to come in and have a session of T & A operations in a school. This was obviously such a practical idea that it started the travelling clinics. Starting in 1924, and for nearly twenty years afterwards, the health department would organize teams: doctors, nurses, and sometimes dentists, and send them on tours of outlying areas. The district nurse would make the arrangements: line up the children, get the consent of the parents, book the school or community ball for the clinic, organize a local women's group to set up beds and act as ward aides, and arrange accommodation for the travelling team. The first was arranged in the summer of 1924 by Olive Wotherston, district nurse at Halcourt. Nineteen children gave up their tonsils and adenoids. In August Miss Clark, who was by then superintendent, Dr. Graham Huckell, and Dr. Heacock, the provincial dentist, went on tour. They conducted clinics set up by the district nurses at Kinuso, Slave Lake, Rife, Yeoford, and Wenham Valley. The tour resulted in sixty-nine T & A's and seventy-two other minor operations. In October of the same year Dr. Heacock held dental clinics at six places. These, too, were set up by the district nurse. The travelling clinics, with the district nurse acting as booking agent, became well-integrated road shows, touring the province from mid-May to mid-August. The eventual form of the clinic was a motorized caravan of two trucks - if one got stuck the other could winch it out - two drivers, a surgeon in charge, two dentists, a dental student and a medical student. The clinic would set up at two centers a week for the length of the tour, and handle one hundred to three hundred children at each stop. The first day would be vaccinations, the second day would be T & A's and the third would be moving day. District nurses were booking agents and advance agents for the travelling clinics all through the twenties and thirties, until the remote areas acquired the services the clinics provided, and the clinics gradually disappeared. Through this time travelling was the constant and the chief problem of the district nurse. One nurse who, alas, forgot to sign 197 her name, described the transportation problem in a departmental report of 1935. She wrote: "When anybody wishes to call the nurse to his home he must provide transportation, an arrangement which provides us with a great scope for story-telling. Not infrequently we start a journey by car, often a Model T, which if it is taken to pieces on the kitchen table every Saturday night and reassembled, can be relied upon to work for the rest of the week. When the road gives out, we may change to a wagon or sleigh. When that road melts into obscurity, it will mean saddle horses. A stoneboat is agreeably near to mother earth when the thermometer stands at forty degrees below zero, although it becomes tiresome supporting one's own back over many miles when sitting flat on mother earth as it were. Ten miles behind an ox team will make a ripened philosopher of any nurse, while a few miles behind trotting oxen will reduce the severest individual to a state of helpless gaiety." The railroad speeder was often brought out to help a nurse to an emergency destination and the nurses always found the railroad men glad to cooperate. When anybody was sick, every­ body helped. The only trouble with speeders was the air-conditioning in extremely cold weather. Miss Brighty has described a winter's journey from Slave Lake to Kinuso, a distance of thirty miles. Miss Brighty was relieving the regular nurse one winter in the early twenties when a call came down the telegraph that a man had been injured at Kinuso. The railroad men got the speeder ready, then they got Miss Brighty ready. They provided the fol­ lowing wardrobe additions: A fur coat; a buffalo coat borrowed from a large Mounted Policeman to go over the fur coat; an oilskin fisherman's slicker to go over the top of the buffalo coat and break the wind; and two water buckets borrowed from the department of forestry. The buckets were for her feet - to keep the frigid gale off them on the fresh-air ride to Kinuso. Blanche Emerson's favorite transportation story concerned a drive to Rocky Mountain House to put on a lecture-clinic for mothers and expectant mothers. It was in the late 1920's when a Model T could make the road in dry weather. She got there all right and started back to the Calgary-Edmonton trail after a successful day but luck then deserted her. It rained. She got stuck 198 twice and the wear on the forward gears soon wore them out, leaving her only reverse. After a night in a farmhouse, where co­ incidentally, a nurse was needed, she backed the Model T twenty miles into the nearest garage at Blackfald . Miss Emerson was travelling backwards in aid of another important branch of public health effort, the well-baby clinics. The well-baby clinics started in 1920 with one in Edmonton, operating Tuesdays and Fridays on the fourth floor of the William­ son Building and making these days clamorous for other workers in the building. Another was opened in Medicine Hat, with which Martha Hagerman was associated for many years. In 1922 Marion Lavell went to Calgary to open a well-baby clinic in the police station and stayed on the job for thirty-four years. Miss Lavell recalled that the chief early work of the clinic was education on infant feeding. "Magazines and newspapers now­ adays are full of advice on infant feeding," she said, "but in those days people knew nothing about it." The clinic was a democratic place because it was free and means were not an obstacle or an advantage. The Calgary clinic had some unique opposition to its public health campaign for vaccination. Calgary had a vigorous and vocal anti-vaccination society, which used to have a float in the stam­ pede parades and got lots of space in the Calgary Herald. The society objected to vaccination on grounds that it put disease into people. Ironically an outbreak of diphtheria helped the clinic break down resistance to smallpox vaccine. Miss Lavell and her assistant -the assistant was usually a recent graduate-argued that the diphtheria vaccine was not a living organism and when inoculated children escaped diphtheria, they were likely to be brought back for vaccination. The department of public health did not maintain a well- baby clinic in Lethbridge because of the excellent work of the Lethbridge nursing mission. But there was an obvious need for this type of clinic at country points. The service it gave was not provided by the travelling clinics and the district nurses were sta­ tioned only at remote points mostly in the north of the province. The need opened up another possibility for travel and Miss Emerson used to go on the road from Easter to September, work­ ing through the local Women's Institutes and holding one-day clinics for ten to ninety pre-schoolers in towns from Coutts, on 199 the Montana border, to the town of Peace River. The concern with children also involved the public health nurses in the fight for pasteurization of milk in the early twenties. This was in the cities. In the country they urged people to boil milk, trying to re-educate those who insisted they had "pure" milk direct from the cow. In the south, where the irrigation projects were starting, they urged people to not give their children drinking water out of the irrigation ditches. It was nursing on the go. But on one occasion the railroad offered transportation more comfortable than a speeder. This was in the mid-twenties, when the department of agriculture, in co­ operation with the CPR, was sending a "mixed-farming special" around the province. This was an educational venture, to sell the farmers on mixed farming rather than complete dependence on wheat. The farmers would bring their families along and the families would have nothing to do, so the department of public health was offered a "lecture car" in which it could put on en­ tertaining and instructive talks for farm mothers and their children. The public health nurses took every opportunity to spread their particular gospel, and in 1929, when Elizabeth Clark left to be married, and Kate Shaw Brighty (later Mrs. Harry Colley) became superintendent, a new opportunity opened. Miss Brighty became the first broadcasting nurse. Miss Brighty was to spend fourteen years as superintendent. After serving as a district nurse at Pendry!, west of Pigeon Lake, she had been away in New York for three years doing advanced work at Columbia University and had arrived back in Alberta in 1928. By this time the extension department of the University of Alberta had put CKUA on the air and when she became superin­ tendent, CKUA offered her an easier means of reaching the pub­ lic than riding around on horseback as she had done at Pendry!. She gave weekly talks on health and hygiene, children and diets. The department had to take every free means of putting across its message because government economies had reduced the staff to fifteen by 1930, half the strength of eight years before. How­ ever, in spite of the depression that characterized the thirties, the department then began a gradual climb, and by the start of the next decade there were forty provincial public health nurses, of whom thirty-four were on district service. One reason for the increase was the stubborn refusal of 200 The travelling clinics - two views of the season of 1929 Elizabeth Clark Dorland in front of the old cottage at Pendry[, about 1926 Amy Conroy boarding a cutter in front of the new cottage at Pendry/, about 1940 Taking a patient to hospital by speeder. Hines Creek 1945

Sheila MacKay Russell and friend Nurse's cottage at Grouard 1940 at Haemaruka 1944 Some well-known public health nurses

In April I946, this group celebrated twenty-five years in public health nursing: Marion Lavell, Olive Wath erston, Amy Conroy, Isabel Hawkes, Blanche Emerson areas with district nurses to give them up. In the early thirties, when lack of funds forced the department to cancel the appoint­ ment of Mary Black at Vegreville, the community rose up and offered to pay her salary. Miss Black had then been there about ten years, living on a farm on the outskirts of Vegreville and travelling to the schools and district homes. When the district refused to give her up, she stayed on the job for another thirty years and when she retired from the job, she stayed on the farm. The Vegreville Observer once ran a series of articles on her called, "Miss Black Knows Her Onions". But it's not surprising that a district nurse would know about onions since she had to know about everything else. At a community gathering honoring her final retirement, Dr. Edmunds said there were many in attendance who had Miss Black's mark on them-by way of vaccination. While Vegreville guaranteed the district nurse's salary to keep her, others did so to obtain one in the first place. This hap­ pened at Vau:xhall, on the prairies between Lethbridge and Medi­ cine Hat in 1934. A nursing association was formed. Miss Brighty came down to attend a meeting of the association in February. The Vauxhall people agreed to provide the cottage and guar­ antee the salary of the nurse. Shortly after, a Galt graduate of '29, Hilda Fairhurst (later Mrs. Craig Furlong and mother of Calgary football star Jim Furlong), was appointed district nurse. She stayed three years. She had to leave a note on her door whenever she went anywhere because there was seldom a doctor available and she used to officiate at maternity cases. Once she delivered a set of twins for whom no preparations had been made. So she had to put one twin in a roasting pan and the other in a well on the oven door while she made cribs for them out of padded appleboxes. Miss Fairhurst sampled all the approved forms of transportation for district nurses-stoneboats, Model T's and grain wagons. But she also arranged an airplane trip to bring a dangerously ill patient to Medicine Hat. You might say that Alvine Cyr came into the district nursing service through the back door. Or perhaps through the back woods. She went into the Plamondon district west of Lac La Biche as a private missionary enterprise, but her work was soon recognized and supported by the department of health. Miss Cyr, now Mrs. Gahagan of Munster, Indiana, went to Plamondon in March, 1933, a year after her graduation from the' 201 Edmonton General, and she left a pos1t1on as head operating room nurse of the General, with a princely salary approaching one hundred dollars a month, to become district nurse at a salary of ten dollars a month. By the way, the ten dollars was guaranteed for the first two months only. After that she would be on her own. Miss Cyr made this break at the earnest invitation of Father Loranger, the young priest in the remote French-speaking area. Within a few weeks, Father Loranger had conducted funeral ser­ vices for two young mothers who had died in childbirth. Early in 1933, he came to Edmonton to visit a parishioner who was in the General dying of cancer. He asked the Grey Nuns for help in finding a nurse for his impoverished back woods parish. The sisters told him they had a Miss Cyr who met all the qualifications but she could not be spared because she was head operating room nurse, and there would be "an earthquake" if Dr. Blais, who had brought her into the world and trained her per­ sonally for the job, discovered that she was leaving. There apparently was "an earthquake", as the sisters put it, but Miss Cyr would not be deterred. On March fourteenth, 1933, she boarded the mixed train for Lac La Biche, with twenty-five dollars worth of medical supplies, a guarantee of a cabin to live in, ten dollars for two months, and unlimited opportunity for nursing at its finest level. From the train she was driven twenty-five miles on a sleigh to a cabin where the eggs froze in their shells if the fire was al­ lowed to go out. In her memoirs, Miss Cyr has added a previously­ unlisted hazard to the inconvenience of being called out suddenly on a winter night. It seemed that whenever she had washed her hair someone would knock on the door and want her to go some­ where at once. What to do then? Put your head in the oven, what else? The people were even poorer than Father Loranger had been able to convey. Few services were paid for in cash. It was nursing on the barter system. The people would give the nurse food, wool, even feathers, and she would accept even feathers. Helping people save face and salvage pride was a function of nursing. Poverty, chronic ·the year 'round, was felt acutely at Christ­ mas time, and it shows in Miss Cyr's recollection of her first season on the job. It was Christmas Eve in 1933 and she had 202 gone to bed with a mustard plaster hoping to beat a nagging chest cold when the inevitable knock came at the door. It was a frightened man whose wife was very ill and who had left his two children in the two-room shack with her while he went for the nurse. It was a long ride in the sleigh through the winter night. The man was hoping the fires would last. He had stoked the fireplace and the stove for slow-burning and had set some extra logs on a table beside his wife's bed, so she could tip them into the stove with little effort. When they reached the cabin they found that the fires had burned too fast, and with the little girls crying with cold the mother had struggled from bed to push some logs into the fireplace just before the fire died. Miss Cyr found that her condition was not dangerous nor even very serious. But she had painful and crippling pleurisy, and with the cold of the cabin and the exhaustion of the struggle for survival, was unable to carry on. A half-finished rag doll in the sewing basket was a reminder of Christmas plans that she couldn't carry through. Miss Cyr had her Christmas dinner with the family: some bouillon made from a beef heart, a few boiled potatoes and half a dozen thin tarts which the little girls ate with delight and appreciation. It took very little medical or nursing knowledge to help the mother and reassure the father. It took very little actual medicine. And it took very little effort Christmas night to send two small dolls back to the girls. But it took someone with the qualifications, both professional and personal. In 1937 Miss Cyr left the district nursing service to be married and went to live in Indiana. But in the summer of 1963 she returned to Plamondon - for a visit that became something of a triumphal homecoming.

The district of Maloy, between St. Paul and Bonnyville, rounded up all the spare flour sa<:ks in the effort to get a district nurse. The flour sacks were to make the curtains, sheets and pillow cases for the nurse's house after an earlier community effort raised enough money to build the house. Carl Berg built the house and the furniture too, and it was ready to open in the fall of 1939. Ten nurses would occupy the Maloy house in the succeeding eleven years: Margaret Reid, Madeline Matthews, Mary 203 Willis, Marion Lyons, Mrs. Catherine Cole, Gladys Anderson, Dorothy Colgan, Barbara Taylor, Enid Doyle who went to India as a missionary, and Mrs. Nina Renwick. Miss Matthews gave it the name Twin Pines and the govern­ ment gave the name diplomatic recognition by having a sign painted, which was the only paint on the outside of the house. The Maloy nurses did a lot of work in the schools, with a farmer from the school she was to visit providing transportation by wagon or cutter. In the spring of 1946, after Miss Taylor had arranged to visit the Garth and Sandy Rapids schools, there were floods that knocked out the bridges. But the message (about health) had to go through. Miss Taylor borrowed a horse and forded the Beaver and Sandy rivers to keep her appointments. The Twin Pines cottage would operate until 1950 when a new municipal hospital at Glendon would take over its work.

In 1931 two nurses of the small public health service parti­ cipated as senior nurses in the first of the experimental health units, which, by 1966, had increased to twenty-four. Financing of these demonstration units was arranged in correspondence be­ tween Dr. Bow, and Dr. John Ferrell of New York, director of health projects for the Rockefeller Foundation. The foundation agreed to put up a third of the money for a three-year experiment with units centered on Red Deer and High River, with the province and the municipalities each matching the grant. The aim of the units was to provide a system of pre­ ventive health for towns too small to afford their own by spreading the cost over about eight towns and five municipal districts. The Rockefeller foundation also provided fellowships for Dr. G. M. Little and Dr. W. G. Saunders to take a nine-month course at the University of Toronto, and funds were made available later for about half a dozen public health nurses to take similar courses in the United Stat:!s. Dr. Little, later medical health officer for Edmonton, headed the Red Deer unit and Dr. Saunders went to High River and was later succeeded by Dr. A. Somerville who became deputy minister of health. The staff of each unit included a nurse, a secretary­ technician and a sanitary inspector who commuted back and forth between the two units. When the first three-year period was up, the Rockefeller 204 foundation came through for another three years. Then in 1937 when its help was withdrawn the provincial government and the municipalities each increased their share to fifty percent and the health unit concept was established and grew, to the point where in 1965 there were twenty-four units employing 141 nurses. In the same year the city of Edmonton had 7 6 public health nurses and Calgary 66. In 1931, when the health unit experiment started, Edmonton had two and Calgary had as many. The nurses in the public health department were useful for many duties in the period between wars. As we've noted already Miss Clark was lent to the Mannville municipal hospital board to set up the hospital there when the department wanted a working model of a municipal hospital. The nurses inspected private nur­ sing homes and children's foster homes in the twenties. In 1923, when the department of education set up a hospital for mentally defective children at Red Deer, Amy Conroy was sent there as matron, a nice break for the fifty retarded children. Early in the hungry thirties the depression generated a public health require­ ment in the field of low-cost well-balanced meals. This require­ ment too called for the special talents of Amy Conroy and she ,went around the province giving nutrition clinics. In 1934, how­ ever, she was able to take on her favorite work, district nursing. She took the post at Pendryl, west of Pigeon Lake, where sixty percent of the people were on relief. She was there ten years and became everybody's favorite district nurse. She was very short and plump and could scarcely reach the gas pedal of her ancient Ford and see over the dash­ board at the same time but she got around. She once wrote about it: "The fact that you can be of service is well worth any effort. Sometimes I think of the days when I drove a Ford car in the rural district examining schools. In the distance I could see steep hills and deep coulees and I would wonder how I would ever get over them. But by feeding a little more gas and holding the wheel a bit firmer I was over them almost before I knew it. So it will be with any of our problems ,if we just keep going forward." Amy Conroy was a simple person. It's not surprising that her favorite poet would be Edgar Guest and that she would find in his words "Let me live in a house by the side of the road and be a friend to man" the expression of her own work as a district 205 nurse. It worried her that other district nurses might not realize what a privilege it was to be able to enter a home and give nursing care and advice.

Through the 1920's the district nursing service operated in the northern part of the province only, but in the thirties it was extended to the south. Dr. M. R. Bow, provincial medical health officer of the time, explained that it was to extend the intelligence service of the department of health. The department had come to depend on the keen observations and penetrating reports of the district nurses and wanted their reports and help on a province-wide basis. In these southern postings, nurses performed two pieces of work which Dr. Bow cited as outstanding examples of Alberta's district nursing service at its best. The first involved one of the finest products of the Alberta system, Helen McArthur. A native of Stettler, Miss McArthur went on to be president of the Canadian Nurses' Association and director of nursing services for the Canadian Red Cross. After taking her B.Sc. in public health nursing from the University of Alberta in 1933 she went briefly to Kinuso as district nurse and then was assigned to Stanmore, a hamlet in the dry country east of Hanna. And at Stanmore her work averted what might have been an outbreak of sylvatic plague, the ominous "black plague" of the middle ages. Dr. Bow told the story. It began when Miss McArthur was called to the home of a mink rancher who was delirious with a high fever. The man died en route to hospital in Calgary. In the best tradition of her service she then went back and tried to recon­ struct the events leading to the man's strange fever and death. She determined first that he had become ill after skinning mink. She found that he had been skinning the mink for quick sale because the animals were dying. She then investigated to see if there could be a connection between the disease that killed the mink and the one that took the life of the rancher. She found that he had been feeding them gophers, which he caught and shot on the prairies. Times were so hard he hadn't money to buy food for the mink. She knew that sylvatic plague is transmitted by fleas, and although usually confined to wooded areas, can be carried by an infected 206 animal. Miss McArthur reported her suspicions to Edmonton and a field man was sent to the Stan.more area to investigate. On his first day he came across a ground squirrel which bad just died in convulsions. The squirrel was sent to the dominion laboratory which confirmed that it bad died of sylvatic plague. The department of health quickly posted warnings all over the south about handling gophers and there wasn't another case in humans. Dr. Bow stated that if it hadn't been for the quick and keen work of Helen McArthur, the district nurse, the story could have had a much grimmer ending. The second case involved a Lamont graduate of '37, Norah McCallum, (Mrs. Arthur Southworth). It was a search for a typhoid carrier. This one was around Medicine Hat. In a period of a few weeks twenty cases of typhoid were reported, an unusually high incidence, worth an investigation by the department of public health. The detectives first decided that the infection was being carried in cheese. Then they narrowed the source of the cheese to one store. With the help of the storekeeper they identified factory which made it. Then things became complicated. The owners of the cheese factory were anxious to cooperate but they got their supplies from fifty different shippers in their farm area and had no way of knowing which one of the fifty farmers was sending typhoid. This was the point at which the district nurse came in. Her job required tact and diplomacy and patient salesmanship. She had to visit every farm and persuade every resident to cooperate, explaining why the department needed samples of stool and urine. Miss Mccallum was six weeks on this assignment, doing a job which was a credit to all Alberta's public health nurses. Her work traced the infection to a farm housewife who had had typhoid thirty years before but was still a carrier. The carrier was per­ suaded to have her gall bladder removed and the infection was closed off. The cases cited by Dr. Bow are only two examples of the kind of service the department of public health came to expect from its nurses. They are also two more good reasons for dedi­ cating this chapter to them.

207 CHAPTER EIGHTEEN On the twenty-ninth of October, 1929, Frances Ireland, a student at Medicine Hat General, was scrubbing up for an operation. She was listening idly to the conversation of the two doctors but didn't pay too much attention because they were discussing a crash of the stock market on Wall Street. The doctors had lost some money in the crash. Frances Ireland, like all student nurses, had no hold­ ings on Wall Street and didn't see how it could affect her. Of course it did, just the same. It affected everybody for the next decade, a decade that would be known as the hungry thirties or the dirty thirties. There were few places where the thirties were any dirtier than Alberta. It was a time when products of the farms and factories went begging for buyers, but most discouraging of all, it was a time when hard-earned skills went begging for buyers. It was hardest on the young, a time in which the principal of Edmonton's Eastwood high school told the graduating class of 1933 that only five percent could hope to find employment within a year. By any logic the people should have been hopeless but people are often illogical and those who had entered Alberta refused to abandon hope. They were sure there was some cure: dollar wheat, or a million-dollar rain, or twenty-five dollars a month. How this deflated world looked to a student nurse is de­ scribed by Alma Wagner, (Mrs. Donaldson) who entered the Galt school in Lethbridge in 1933. For the golden anniversary booklet of the school she wrote an article titled: I Nursed in the Hungry Thirties. She wrote: "It was in our personal lives that we noticed the depression most. Nurses had come from homes where fathers were out of work. One student nurse I roomed with was paying a dollar a 208 month to an appliance company to prevent them from taking her mother's washing machine. "Nurses on graduating no longer pushed off for parts un­ known. Jobs were too scarce and if you were lucky enough to be kept on at the hospital you were only too glad to stay. The nurses did not get married right away because the boys could not support a wife. The graduate nurse who earned thirty-five a month plus her board and room was comfortable, while those who earned sixty-five a month were rich." Mrs. Donaldson summarized the attitude of the students in these words: "But the girls were cheery all the time. When one of the nurses had a new beau we'd all contribute to her ensemble and she'd sally forth in style." In mentioning "those of us lucky enough to be kept on," Mrs. Donaldson touched on a key point. The depression didn't affect the student nurse very much. A young person wanting an education in nursing had an advantage over one who wanted to study law because she could trade work for room and board. But once she was out in the deflated world with her new skills she was on the same discouraging footing with the rest, trying to make a living on private duty. In her report for 1931, Phyllis Gilbert, the chairman of the AARN's private duty section, said: "We hear the words 'depres­ sion' and 'unemployment' daily until we are weary." There was an attempt to create more employment for private duty nurses by limiting shifts to eight hours, but this effort was overpowered by the hard economic facts of the time. In 1934, Fanny Munroe, superintendent of nurses at the Royal Alex and the last of the six Royal Vic grads to hold the position, was president of the AARN. In her presidential address to the annual convention she said: "The continued output of new graduates has not only a direct bearing on unemployment, but is the main cause of it." In this atmosphere the hospitals began an effort to find work for their own graduates. The Royal Alex tried to take on as many as possible, at twenty-five dollars a month plus room and board. The Calgary General tried the same plan, offering thirty-five, al­ though there was no hope of returning to the eight-hour shifts introduced by Miss Edy as an aid to employment. The Alex became pressed for space as the demands increased 209 and the supply of money for expansion went down. The impro­ vising, so characteristic of nursing in the twenties and thirties, was extended to setting up lecture rooms for the students. In the hot months of summer the hospital was willing to let Sam McCoppen, the undertaker, supply free fans for the patients. The fans were inscribed: Compliments of Sam McCoppen, Your Favorite Undertaker. My cousin, Jerry Cashman, was on the private duty register in Edmonton in the mid-thirties and recalled that nurses were afraid to turn down any job or their names would go on the bottom of the list. One job was to accompany a woman with a broken back from Edson to Edmonton. This didn't sound too ominous because the move was to be made by train. However, it turned out to be a long night ride in a baggage car because the stretcher wouldn't fit into a coach. There was a sealed coffin in the baggage car, which didn't add much to the patient's morale but Jerry managed a few naps on it. The progressive deflation of the thirties is captured in the minutes of the Fort Macleod hospital board. In 1928 the matron was making one hundred and twenty-five dollars a month, and staff nurses were starting at seventy-five, going to eighty-five in their third year. The minutes of the board then reflect the deflation: July 1931: Nurses' salaries reduced five dollars a month; cook and laundryman ten dollars a month. 1933: Matron's salary reduced to ninety dollars a month. June 1935: Miss Ardis Wood engaged as matron, salary eighty-five dollars a month to start. The AARN itself undertook a project to create employment for graduate nurses. At Alder Flats, west of Pigeon Lake, the AARN provided a district nurse. Her salary was paid by the association and the community provided the house and fuel. The Alberta Association of Registered Nurses made pro­ gress, though not uninterrupted progress, in the hungry thirties. In 1932 there was progress in the appointment of Mrs. Harold Vango, R.N., to the permanent paid position of registrar-secretary­ treasurer. Mrs. Vango's salary was seventy-five dollars a month and she opened the office in St. Stephen's College on the University campus. The campaign to raise standards and improve the image 210 of the profession hit occasional snags, as in 1934 when the council discussed a money-making scheme of the Calgary graduate nurses' society. The Calgarians were conducting a sweepstake. They were selling tickets for twenty-five cents each with the prizes being a certain number of hours of free nursing service. A letter was sent to the Calgary secretary "advising her of council's disapproval in their taking this unprofessional step, as it is contrary to the objects and aims of this, and the Canadian Nurses' Association". The response, if any, from Calgary, is not recorded. But this and weightier incidents showed a need for more communica­ tion and understanding between the central organization and the local groups. In 1936, following a tour of the locals by Kate Shaw Brighty, the province was divided into eight districts. There was one in the Peace River country and the north. Others were cen­ tered on Edmonton, Ponoka, Red Deer, Calgary, Lethbridge, Medicine Hat and Drumheller. The nurses found it difficult to come to meetings in Ed­ monton. It was hoped that they could meet more easily in their districts and this would keep members in closer touch with the association. However, the plan was ahead of its time. In the thirties it was not much easier for a nurse to attend a district meeting than a provincial one. After working twelve hours it was discouraging to think of driving thirty miles over the roads of the time even if a nurse had a car which she almost certainly had not. However, it's easier to show individual setbacks than general progress, and progess was general and steady, especially in the field of nursing education, where the AARN put more and more of its ideas across. In 1932, inspection of nursing schools, long advocated by the AARN, became a reality. The provincial government authorized a committee of four, to be organized once yearly, tour and assess the schools of nursing. The committee would have three from the University: the registrar, a member of the faculty of education, and a member of the faculty of medicine. The fourth would be a representative of the Alberta Association of Registered Nurses. Miss McPhedran was the first. And the same year she directed a two-month experiment, spon­ sored by the AARN, to demonstrate the value of having an adviser to schools of nursing. 1932 also brought signs of increasing recognition of the 211 association. The AARN was asked for advice by a committee of the legislature. This was a committee to recommend on health insurance and state medicine. The AARN was asked to report on the nursing implications of health insurance and government medi­ cal plans and Miss Munroe of the Royal Alex was appointed to report. In 1934 the need of a broader preliminary education for a nurse was recognized by the government. Through amendments to the Registered Nurses' Act the entrance requirement for schools of nursing was raised to grade eleven. The same year Alberta registration was granted any nurse with a B.Sc. in nursing from a recognized university. Through the thirties there was evidence everywhere of an in­ crease in the teaching qualifications of people conducting nursing schools; a trend in the direction recommended by the Weir report. In 1937, for example, the Edmonton General got its first degree nurse when Sister Alice Bonin, with a B.Sc. in nursing from the University of Montreal, took over the school. In the same year Agnes Macleod returned to the University of Alberta with her degree from Columbia, to be director of the school of nursing, and with the rank of lecturer in public health nursing and health education. In 1934, Margaret Fraser returned to the Royal Alex with her Columbia degree and four years later became superin­ tendent of nurses. In smaller schools there were no degree nurses in the 1930's but there was still a trend towards education, and separation of the nursing school from the operation of the hospital, with the ap­ pointment of full-time instructors. In 1933 Martha O'Brien was named first full-time instruc­ tress at St. Joseph's Hospital, Vegreville. Miss O'Brien was a graduate of St. Mary's in Rochester, New York. She had held executive positions at a children's orthopaedic hospital in Seattle and the Misericordia in Edmonton and had lectured to women's clubs on social hygiene. Although not a "prepared" instructor as defined by the Weir report, she had broad experience to bring to the job. The classrooms were in the new nurses' residence, separate from the hospital. Classes were smaller than in city hospitals, ten­ to-fifteen, and Miss O'Brien taught all the nursing subjects. The program she put in stressed the social aspect of nursing, an aspect 212 that no training school of a decade earlier was concerned about. Teas and other social affairs with the three classes taking turns as hostesses, were a regular part of the curriculum. This signifi­ cant innovation pointed out that the nursing profession had gone long beyond the time when social acceptability was an aim and had entered a time where the full social graces were expected. Early in 1935 the Galt school decided the time had come for a full-time instructor and the board invited a 1930 graduate, Alice Pelletier (Mrs. W. L. Jacobsen), to go out and gain some qualifications. It was pretty well left to Miss Pelletier to decide what the qualifications should be and how to go about getting them. So she wrote to Grace Fairly, the matron of the Vancouver General and Miss Fairly offered to put on a course for her in ward adminis­ tration and teaching. The course at the hospital would be fitted in with two other courses she should take at the University of British Columbia - in psychology and the principles of teaching. Miss Pelletier spent an extremely busy summer in Vancouver and after four months returned to her alma mater as the first full­ time instructor in the school of nursing. In her one year in the job she introduced case studies and clinics and her program recog­ nized the value of recreational activities in the education of a nurse. These examples are not by any means an encyclopedia of progress in Alberta's nursing schools in the 1930's but they're a fair sampling of the new winds that were blowing and the new directions the schools were taking. Many of the old ways still persisted, of course. Time off was still a privilege, not a right, and could be lost for minor infractions. Students at the University got a weekend off after their night duty and thought it was something special and Margaret Baxter, one of the liveliest graduates of the school, lost an afternoon off be­ cause of a spoonful of prune whip. It was lunch time for the patients but her own was a long way off. She was trying to interest a patient in some lunch but he was not long out of the ether and showed little interest. When she offered the dessert, prune whip, the patient turned his face to the wall as if to indicate that if the world had nothing better to offer than prune whip, he'd rather be out of it. It was a long time to lunch. The prune whip looked better to Miss Baxter than it did to the patient. She thought she'd just have a spoonful to sustain 213 her, and at that moment the floor supervisor walked in and Miss Baxter's afternoon off went out the window. But although time off was still rated a privilege, there was more of it by the end of the thirties. At the start of the decade the twelve-hour day for students was taken for granted. By 1939, a questionnaire sent out by the AARN found the old seven a.m.-to­ seven p.m. day in effect at only one school in Alberta. One other had a nine-hour day and the rest were around eight with a full day off. The same questionnaire also found at least one full-time instructor at all the nursing schools of 1939. Holy Cross and Calgary General had two, and the Royal Alex had three.

The growing influence of the nurses, the growing emphasis on education, were making changes in the practice of nursing, and midway in the thirties there appeared the first signs of an influence from medical science which would cause a revolution in nursing practice. At Elk Point Municipal Hospital, Mrs. Dorothy Pele­ chosky, a '31 graduate of Lamont, noted the introduction of this new influence. Mrs. Pelechosky had plenty of time to see what was happening at the hospital because there were only three to four nurses for twenty-eight beds and one of them had to be on twelve-hour night duty with no help. Of the night duty, she wrote for this book: "Our hospital was always full. Treatments were given day and night and besides the treatments, the night nurse had to stoke the furnace with coal every hour, on the hour, on very cold nights. She also kept the kitchen fires going and cooked the porridge for breakfast - the long-cooking kind. Also among her jobs might be drying three or four tubs of linen in the winter, using radiators or chairs. We had three days off at the end of three weeks' night shift. Wages ranged from forty-five to fifty-five dollars a month but in those early thirties one couldn't carry what was bought for five dollars. Now one can hardly see what one gets for five dollars." At Elk Point in the thirties the art of nursing continued to stress originality, as it had done in the twenties. Mrs. Pelechosky recalled the treatment for eye infections. If they didn't respond to saline or boracic foments, the nurses put rotten apples between 214 strips of gauze and applied for several hours. When eye infections were prevalent the town stores were canvassed for rotten apples. The treatment for pneumonia offered some interesting alter­ natives to the standard sponge baths and mustard packs. She wrote: "Straight lobar cases with high temperatures were treated with beechwood creosote. One teaspoonful of creosote was rubbed, a little at a time with a rubber-gloved hand, into the axilla until all was absorbed. The temperature would drop to ninety-seven in one or two hours with profuse diaphoresis. The temperature would bounce back to one hundred or so the next day, then back to normal after that. Then the axilla was treated for bums­ by washing with saline solution and the application of vaseline dressings. Steam pitchers with hot water and a sheet over the head for twenty minutes was given for inhalations. Mashed onions in gauze was also good." Although Elk Point Municipal had original ideas of its own, it was always willing to try new methods proposed by other sources in the medical field, and in the mid-thirties Mrs. Pele­ chosky noted the appearance of the ancestors of today's "wonder drugs". "In 1933 the first antibiotics were introduced - prontosil injections, five c.c. intramuscularly, I think. Then dragenin was started. Quite severe reactions were encountered. Men especially were miserable. I told them that was how pregnant women with morning sickness felt. Sulfas came in 1935." In these words, a Lamont graduate working in a rural hos­ pital noted the coming of the wonder drugs. Mrs. Pelechosky, and her fellow nurses around the province, saw them come but none were aware that in ten years the new drugs would revolu­ tionize nursing; would in fact do away with a large part of nursing as it then existed. They would do away with the long, patient waiting and watching over victims of pneumonia and typhoid. Where nature was slow and inefficient, nature would no longer be allowed to take its course. It would be speeded up. Wonder drugs would make obsolete the art of the nurse who could sit with a pneumonia patient for ten days, nursing him through his illness as a river pilot brought a paddlewheeler up a difficult river. The railroads made the heroic art of the river pilots obsolete; wonder drugs would do the same for one of the treasured skills of the nursing profession and sooner than anyone thought. 215 But it didn't happen in the thirties. All the old arts were in demand in the Alberta hospitals of the time, especially the rural ones. For a glimpse of hospital life in Alberta, we have a memoir prepared by two sisters of St. Joseph's Hospital, Radway. Of the operation of the hospital at Radway, Sisters Stella Maris and Mary Winifred have made an enlightening memoir, of personal memories of running a rural hospital in the 1930's, and although it concerns Radway, it really concerns all rural hospitals in Alberta at that time. So it is reprinted here because the nurses who kept Alberta hospitals going in the thirties will recognize it as their own: "Did you ever have to care for an infectious case where there are not sufficient facilities? Just as soon as you are masked and gowned, the telephone peels off. Then Mrs. Podburinsky rings the maternity bell with might and main as she is beginning to bear down now. So you get her ready, call the doctor and the case is over in no time. With your right hand you are giving an anaes­ thetic, with your left one you are holding the jaw up, and the mask on, for you are assisting the doctor with a repair. With your third hand you are massaging the fundus to keep it firm and with your fourth hand you pull over the bassinet to see that the new­ born is breathing alright. "Just then the front door opens and in comes a heart case, assisted to the waiting chair in the hallway. You stretch your neck real well and get a good look at her. You thank your lucky stars that the doctor is right here and presently she is put to bed in the hallway by the door for plenty of fresh air. In your spare moments you can more easily watch her there. "Now little Annie N osleepum wakes up and cries and wakes up all the other children in the heavily-packed children's ward. You and your ward aide both need rollerskates by now. "Things are just beginning to quieten down when poor old Mr. Kancercase gets up, falls down five or six steps on to the landing and it takes two of you to get him back into bed. It is evident now that he is in earnest about keeping his rendezvous with St. Peter. The chaplain is out tonight so you start the prayers for the dying with Ritual in hand. "Your thoughts race back to that maternity case. You wonder if her fundus is remaining firm. Is that infant maybe bleeding from the cord tied? St. Peter has now welcomed the dear old man and 216 you have fixed up the body to be taken to the morgue when the day staff comes on. (The morgue of necessity was back of the hospital and in a warehouse and at times it was a work of art to struggle through the big snowdrifts carrying a body to its tem­ porary resting place.) "All is quiet when in comes a suspected fracture of the leg. You call the sister who runs the X-ray out of bed. First she has to go out and start the engine in our power plant to provide the extra voltage to be converted into X-rays. She has not yet gone back to bed when in comes an acute abdominal case with a slip from a doctor who wants to do an appendectomy on this patient as soon as we can get ready. We wake up one more of the day staff to take scrub ...." So ran a memorable night at the Radway hospital in the 1930's, and every nurse who worked in a rural hospital in Alberta in those years will remember similar nights. Sisters Stella Maris and Mary Winifred contribute another memoir of Radway which will be true of all: "In the early years also we had to contend with psychiatric cases more so than in later years. We took them on until they were committed. One night, just such a case went on the rampage and the night nursing-sister was her target. The day staff heard the commotion and ran to the rescue in their night attire. The woman twisted one sister's clothes into a rope-like mass with one hand, and with the other hand pulled a bed with an occupant in it all the way down the hall, while three sisters tried to hold her down. Finally the doctor arrived and administered anaesthetic sufficient to get the situation under control. Ben Casey, or The Nurses, on modem TV look tame in comparison." This paragraph too is true of all rural hospitals of the time: "We are happy to add in conclusion that hospital life was not all work and no play. We have happy memories of picnic lunches out in the field behind the hospital with lots of trees and a creek. We remember ball games too which we all enjoyed, and many a roaring sing-song in which everyone took part and sang to their hearts' content." No new orders of nursing sisters came to Alberta in the hungry thirties. In fact, a prospective newcomer order had two nuns in Rimbey for a short time and decided against it. However, one of the old orders took over and in the 1930's, nuns started, or 217 revived, eight hospital projects. In 1930 there were four: at Rim­ bey, Jasper, Banff and Killam. In 1937 there were three: at High Prairie, Willingdon and Lac La Biche. And in 1938 there was Fort McMurray.

At Rimbey, the community had a well-designed twenty-bed hospital with five bassinets ready to operate at the start of 1930. Teresa McDonald, Edmonton General '25, came as matron after nursing-station work at Forestburg and hospital work at Corona­ tion. She became the daughter-in-law, wife and mother of Dr. Byers. (The daughter-in-law of Dr. Sam, the pioneer of the dis­ trict; wife of Dr. John, and mother of Dr. Jack.) Two nuns of an eastern order came for a brief time with the idea of running the hospital but this didn't work out and they left. Until the Sisters of St. Joseph arrived, Miss McDonald ran it with another graduate and an English practical nurse with a talent, though no papers, for midwifery. The Sisters of St. Joseph operated the hospital as St. Paul's for nineteen years until its return to the community. Meanwhile, still in 1930, they took on another project at Killam. The General Hospital, Killam, opened with a capacity of nine beds and four nursing nuns: Sisters Mary Patricia, Margaret Mary, Bernardine and St. John. Through the thirties the sisters had a thin time of it, a near-carbon copy of conditions at Westlock where their Immaculate Hospital was often down to less than ten dollars cash. But there was no lack of the poverty in which the sisters had vowed to live: Killiam General today has twenty-eight beds. Still in 1930, the Sisters of St. Martha, though fully engaged with transforming the Lethbridge Van Haarlem hospital into St. Michael's, continued the work of the historic Brett Sanatorium in Banff. Two nuns, Mother Mary Faustina and Mother Mary Stanis­ laus, arrived at Banff on June tenth. Twelve days later they had the old Sanatorium ready to reopen for a patient brought in by Dr. Atkins. This was the same Dr. Atkins who had ridden over the mountains to meet Nurse Fulcher at the headwaters of the Red Deer in 1915. Through the decade, the bed capacity of the renamed Mineral Springs hospital was increased to forty-two. At the northern end of the Banff-J asper axis, the Sisters of Charity of St. Vincent de Paul opened Seton Hospital in January, 218 1930. Named for the American founder of the order, Seton Hos­ pital opened with four nuns and fifteen beds. There followed a period of about seven years, seven very lean years, when practically nothing of any kind was started any­ where in Alberta. In the post-war we became accustomed to a zoom on top of a boom, but the depression was a chronic bust, and to add insult to misery, the dust bowl appeared and we had dust on top of a bust. So it was certainly a lasting credit to the community of Bentley that its community-built hospital was put into operation in 1932. The hospital succeeded a three-bed doctor's hospital and a nursing home which bad come and gone in the 1920's. It had nine beds, two cribs, four bassfaets, and a combined case room and operating room. It had a bathroom which doubled as a utility room. It had a pharmacy which was half in the kitchen and half in the nursery. It had three nurses and a cook. It also had a ladder, and the ladder was of some importance because there was no fire escape and it was placed at the window of the nurses' quarters on the second floor. Lyla Thompsett (Mrs. James Scoular), came to Bentley in 1938 as matron. Mrs. Scoular supplied the above information, along with some information on the autoclave. The steam in the autoclave came from a wood stove and the nurse had to know exactly how many sticks of wood it took to give the required pressure.

By 1935 the Sister Servants of Mary Immaculate had built up a big enough staff of graduate nursing sisters at Mundare to take on a new venture at Willingdon, twenty-five miles northeast. In June of that year, in response to many requests, four nuns were sent to Willingdon to open a hospital. They were Sisters Gertrude, Stanislaus Kozak, Theophane Malonany and Onufria. They packed some supplies, a few beds and some spare equipment and started out. And they got halfway to their objective before the truck slid off the road into a ditch and tipped over. They had to leave the equipment in the ditch overnight but got it to Willingdon the next day and started moving it into the small house they had rented. Even before they could fix it up, patients were arriving and the Willingdon General Hospital a~tually started operation in the hotel. Within a month they had started work on a 219 permanent twenty-five bed hospital. By September, the framework was up and was blessed by ecclesiastical authorities. However, just at this crucial moment the new Social Credit government declared a debt moratorium and further work was not blessed by the bankers. So the nuns went to work raising the money personally, canvassing the district, in addition to keeping their unbeatable rented house going as a hospital. They managed to get enough here and there to continue con­ struction and by October, 1936, it was almost ready. Then on the night of October tenth it was destroyed by fire and the sisters had to start all over again. A person seeking an illustration of "the irre­ sistible force" might well choose four nuns building a hospital. By August, 193 7, they had the money to resume and Willingdon General opened September ninteenth. There were two more new entries in 1937 - at High Prairie and Lac La Biche. At Lac La Biche, Les Filles de Jesus, who had the Pincher Creek hospital, converted an abandoned railway hotel into St. Catherine's Hospital. The hotel was a handsome building, in the already-quaint style of the resort hotel overlooking the lake. It had been built in the optimistic construction days of the Alberta and Great Waterways Railway with the hope of its being a tourist attraction. But it had been standing there twenty-two years vacant when Sister Marie Aurelie and three other nuns moved in to make it a hospital. The first patient arrived on December twenty-third, 1937, and the first baby on the twenty-ninth. At High Prairie, the Grey Nuns took over a seven-bed doc­ tor's hospital which had been running about ten years. It had been started by the pioneer doctor, Dr. Paulson, with the aid of a fine practical nurse, Mrs. Mary Florence. When the Grey Nuns came in they made plans for a new sixty-bed hospital which they opened four years later. The Grey Nuns were also good for one more new hospital in the hungry thirties. In 1938 they opened St. Gabriel's at Fort McMurray. Three sisters ran a ten-bed hospital, which, in its first year, admitted one hundred and eight patients.

1935 was the silver jubilee of King George the Fifth, a year in which decorations in the Order of the British Empire were con­ ferred on many Canadians. There were twenty-seven nurses in the 220 Canadian list. Mary Ellen Birtles was awarded the OBE for her historic work in Medicine Hat and Calgary, and it was appropriate that an Alberta municipal hospital matron of the hungry thirties should also be honored. The MBE went to Elizabeth Pearston, matron of Grande Prairie. In that year there were twenty-two municipal hospitals in Alberta, with twelve to ninety-six beds, seven hundred and forty-three beds all together. Miss Pears ton, a Winnipeg General grad (like Miss Birtles) came to Grande Prairie in 1929 and spent ten years as matron, a stay of unusual length. But she was an unusual person. She went out into the community and rekindled the interest in the hospital which had marked the pioneer time. She sparked a women's auxiliary, knew and worked with the public health nurses, and although she could be extremely demanding with staff nurses on duty, she took them with her into the community. The OBE's and MBE's of the King's jubilee were given to representative people in different fields, and Elizabeth Pearston was an excellent representative of the municipal hospital matron of the hungry thirties.

The missionary societies continued their work of previous decades, probing farther north and west. In 1936 the women's missionary society of the United Church had an urgent request from the Peace River presbytery for a hospital ninety miles north of Peace River town. A new homesteading area was growing up around the settlements of North Star and Notikewin. The government at this time did not build hospitals in un­ organized districts, but was willing to contribute an amount equal to the salary of a district nurse if the society would build the hos­ pital and get a doctor. It was a strenuous undertaking but it was done, with the biggest lift a gift of a thousand dollars, given in memory of her mother by a Toronto friend of the society. The mission hospital at North Star or Notikewin (it was called both) opened in September, 1937. Obtaining a doctor was not such a problem because he was a missionary and on the same salary as the nurse. It was charac­ teristic that all medical missionaries worked anywhere in the world for the same honorarium. The mission was difficult to reach but its work was so ap­ preciated that patients went to great exertions to get there. One 221 Indian woman travelled by dog team, horse and sleigh, and the last few miles by truck to reach the hospital. And the hospital had a surprising side effect in the social field. It was built on the Battle River to ensure a good supply of water. As time went on the entire hamlets of North Star and Notikewin moved to the hospital site because of the water. The gathering of transplanted buildings around the mission became the town of Manning on the Mackenzie Highway. In 1938 the Presbyterian church made an historic decision concerning Vegreville and Rocky Mountain House. Vegreville was no longer to be considered "on the frontier" but Rocky Moun­ tain House was. So after thirty-two years and with the gratitude of the district, the Rolland M. Boswell hospital was closed and the presbytery switched this operation to Rocky Mountain House where the pioneer nurse, Mrs. Mary Stewart, had finally given up her private hospital. The equipment was transferred from Vegreville and the new hospital opened July eighteenth, 1938. It had ten beds, which was good, but the operating room, delivery room and nursery room were all one and that wasn't so good. There were two private rooms, which no one could afford because of the depression. There was also a morgue, so the cook was moved into the morgue and one private became the nursery. The second-hand autoclave didn't work very well so bundles were taken to the Eckville hospital, thirty-eight miles east, to be sterilized. The doors were too narrow so beds had to be dismantled to be moved. One of the early janitors found the strain of the arrangements so great that he would often turn for comfort to the grape, and on these occasions matron Irene McRae would commandeer the first able-bodied man who appeared and get him to stoke the furnace. This was usually an unsuspecting local boy come to take a nurse on a date. The hospital, of course, flourished. In 1939 bed capacity was doubled to twenty and the presbytery kept it for seven years, until Rocky Mountain House was deemed to be off the frontier and it was turned over to the community. The last matron was Hilda Hermanson, who had been on the staff of a church mission hos­ pital in Formosa.

The Anglican church resumed its medical missionary work with nursing stations at Drayton Valley and Hondo, which is on 222 the NAR line to the Peace River Country. The Drayton Valley station was opened in 1936 with a gift from Lady Agnes Farren and was named for her. It was a five-room house, with three bed­ rooms and one very large room, suitable for meetings or epidemics -a very practical idea since there were unlikely to be any meetings during epidemics. The first nurse was Barbara Whittaker, an R.N. from Eng­ land, whose work, in effect, added a district nurse to the provincial service. She worked for the physical well-being of the whole district, then as remote and untracked and as deep in the woods as any in Alberta. She held immunization clinics in schools and ar­ ranged mass tonsillectomies in the community hall when a doctor could come out. She also attended maternity cases, staying a week or ten days in a cabin and doing missionary work for basic health among the mother and her family. In 1938 Miss Ayling, who was both an R.N. and a Bishop's Messenger, arrived. But being both made no difference in her salary. It was still ten dollars a month. There was supposed to be a charge for services but these were more often than not paid with meat or vegetables. On cases, Miss Ayling and Dr. Chisholm, who came down from Evansburg, could depend on help from four women of the valley, especially in maternity cases. The helpful four were Grandma Mastre, Grandma Jonzon, Mrs. Lucky Louth and Mrs. Trucker. One of these self-trained nursing aides was once out assisting in a maternity case in a cabin where the mother had used all the available flour sacks to prepare one layette. That would have been all right if there'd been only one baby, but a second arrived unexpectedly and this baby really came naked into the world because his twin brother had all the clothes. So the helpful lady asked Dr. Chisholm to turn around for a minute, a minute in which she took off her slip and made the newcomer presentable. Miss Ayling worked out of the Drayton Valley mission for seven years, retiring to marry the Rev. Canon W. de V. A. Hunt, then of Jasper. In 1935 another Anglican missionary nurse came to Alberta on her own. She was Lucy B. Drummond-Hay, a veteran of thirty years in the profession who had been a Queen's Nurse, equivalent of a V.O.N., in the British Isles. Miss Drummond-Hay had read 223 in a church magazine about a need for missionary nurses in Al­ berta, and she came out on her own and offered her services to the diocese of Athabasca. If the diocese would provide a house and the drugs and medi­ cines, that was all she would require. The church authorities sug­ gested that she set up at Hondo, a hamlet on the Northern Alberta Railway ten miles south of the Athabasca River, with the nearest hospital sixty miles away at Westlock. Although Miss Drummond-Hay was about fifty-five and in­ tended to give only two years of mission service, she became so attached to the district and to the people that she stayed for twelve. She was always packed and ready to go when a neighbor came to ask for her. Once at midnight she rode in a canoe across the Athabasca, while fog hung low over the water and the paddler picked his way through the ice floes of early spring. It was a situation in which any real missionary spirit would want to be. Alberta in the 1930's still offered plenty of situations like it.

Five more nursing schools gained alumnae assoc1at.J.ons in Alberta's hungry thirties: Lamont and Holy Cross in 1931, the University in 1933, Vegreville in 1935 and Calgary General in 1936. The Lamont school, whose graduates feel is "different" from all others, certainly had a "different" start to its alumnae asso­ ciation. It grew out of the annual reunion and homecoming which attended the graduation of a new class. Through the twenties all previous grads tried to make it back to the old school for the ceremonies honoring the latest graduates. On the evening after the ceremonies of 1931, about twenty of them were talking and decided it was time they formed an alumnae association. So they did, right on the spot. The first president had graduated only that day, another "different" touch, the sort of touch that endears Lamont Public (or Archer Memorial) to her products. She was Marie Boutillier, later Mrs. Charles Wolff. Miss Boutillier was remaining on staff at the hospital and it was thought advisable to have a president who was so closely in touch with the alma mater. Since then the group has tried to have at least one member of the executive, pre­ ferably the secretary, on staff to keep the grads in touch with 224 latest developments at an institution they believe to be like no other. The Holy Cross alumnae association was started in June, 1931 with Mona Sparrow as president and she led the alumnae for eight years before getting involved in a wartime program to train girls as motor mechanics. The Holy Cross alumnae raised funds for projects in the hospital and helped the school by as­ sisting graduates towards post-graduate certificates and degrees. At the time of writing the Holy Cross had 1,858 graduates. At the University Hospital, an alumnae association was formed in 1933 with about forty at the first meeting. M. Jane Lees, who was a graduate that year and later was associate director of nursing services at the University, became secretary of the first executive. Miss Lees described the aims as partly education, partly social, and social in a broader sense too, because U.A.H. grads were becoming a scattered group, in positions all over the con­ tinent. The monthly meetings took the form of educational talks and the talks too were educational in the broad sense, dealing with almost any subject except nursing. The graduates of this time were intensely aware of the need of the profession to widen its viewpoints. By 1956, U.A.H. would have one thousand graduates, the thousandth being Alice Delowski. The two-thousandth graduate was in the class of September, 1965. She was Maureen Zender, daughter of an earlier graduate, Audrey McLure of the class of '41. The alumnae of Calgary General were organized in 1936, at the request of Sarah Macdonald, the superintendent of nurses. Miss Macdonald was a member of the alumnae association of Massachusetts General (in Boston) and knew its value to a gradu­ ating nurse and also to the school. She asked Elizabeth Shirley (Mrs. R. G. Straker), of the class of '25, to write to other alumnae groups and find out how they worked. Following Mrs. Straker's correspondence the organization meeting was held January eighth, 1936, in the lecture room of the old A Block nurses' residence. There were ninety graduates at the meeting. At that time the General had six hundred and fourteen altogether and by the time the first annual banquet was held in May the membership committee had found addresses for all but fifty. Miss Moodie, the first, was named archivist and 225 press representative. By this time her niece Peggy Moodie (Mrs. Dan Munn), class of '31 was a member of the alumnae, and in 1962 Mrs. Munn's daughter Cathie became a General graduate. The association worked vigorously in the pre-government era to supply the school and hospital with equipment. (As late as 1949, it presented two resuscitators to the maternity department.) From the start there was emphasis on scholarship and advance­ ment and in the first year there was a donation of ten dollars to the Florence Nightingale scholarship fund. The big source of revenue, in the first year and fifteen that came after, was the annual ice carnival. The first one was sug­ gested by the manager of the old Victoria arena, a show to tie in with the introduction of artificial ice at the arena in the fall of 1936. The General alumnae thought it was a fine suggestion, and the fact that none of the alumnae nor any of the student nurses were figure skaters was not considered too much of an obstacle. The nurses served as live scenic backdrops in this and later car­ nivals, they got the Glencoe Club to participate and they brought in skating stars from exotic places like Edmonton and Saskatoon. The first carnival cleared $703.33, a lot of money in 1936, and an accurate gauge of the help the Calgary General alumnae would be to their old school and hospital.

And so the nursing profession advanced in Alberta in the 1930's. There was more progress than people were aware of at the time. Despite the economic difficulties the profession gained strength and solidarity at all levels and the depression itself was a factor in improving the nurses' lot. The depression had the odd effect of creating more salaried jobs for graduates. There are figures to show what happened. In 1930, the Weir survey found that sixty percent of active nurses were on private duty. By 1943, a survey of the CNA would find only twenty-nine percent on private duty. (And by 1964 it was down to eight percent.) The depression was one of the factors in creating more salaried jobs, first because the hospitals began making places for their graduates, and second, because people who could not afford a private duty nurse in their homes, could afford to go to a hos­ pital. (A nurse could hardly accept a side of bacon in payment where a hospital could and did.) 226 Hospitals themselves became more sophisticated and offered more services, gradually closing the era in which nursing was the only service hospitals offered and a sick person was as well off at home. So more people went to hospitals and more nurses had to be employed. The trend to more education of students was also a factor. As students spent more time learning, they spent less in the actual running of the hospital and they were replaced by graduates. So after the low point of the depression, usually considered to be 1934, each new crop of graduates found itself with somewhat better prospects than the crop of the previous year. There were opportunities for salaried work in hospitals, and in other and newer areas where R.N.'s were required. One of these new areas was with the airlines. The airline de­ velopment came very quickly when you consider the experience of Mrs. Catherine Cole, who, in the early thirties, was one of the first Alberta nurses to fly in the line of duty. After a month of relief duty at Fort Vermilion, Mrs. Cole agreed to be flown out because it couldn't be worse than going in overland. It was about January, 1933, when she was in the provincial public health sen1ice and was sent from Peace River to Fort Ver­ milion to mind the store while Dr. Hamman was on vacation. The government offered to fly her in but she had never flown and thought she'd take the trip "over the road". The trip took six days. One night she stopped with Dr. Mary Jackson of Keg River, which was pleasant as always, but the first night out, the Indian driver, Willie Bulldog, produced one sleeping bag for Mrs. Cole and an American man who was making the trip. Willie was sur­ prised when Mrs. Cole objected. Willie was also the cook, which meant six days and nights of tea, bannock and beans. Mrs. Cole decided riding in a plane couldn't be any worse and consented to be flown out. When she climbed aboard she asked the pilot where she ought to sit as she didn't want to upset the balance of the flims y-looking machine. But progress came rapidly and only six years later, in 1939, when the AARN had increased its registrations to three thousand three hundred and three, Trans-Canada Airlines began passenger service, and the first step was a training course for stewardesses, all of whom had to be registered nurses. The first course was held 227 in Winnipeg in March of '39; there were fourteen girls from across Canada and no less than four were nurses from Alberta. They were Constance Haibeck, a Galt graduate of '38 who had won the top proficiency award in her class; Evelyn Allan of Calgary Holy Cross; Margaret Brass, Royal Alex '38; and Mar­ garet Beeber from Wayne, Alberta, whose school is not recorded. The nursing profession as a whole wasn't exactly flying as the hungry thirties ended but the profession had certainly got a lot of ideas off the ground in ten years. In every department it could count gains; gains in standing and solidarity and ability to meet the new challenge which was coming fast.

228 CHAPTER NINETEEN The second war made great levies on the Canadian nursing system. The Canadian armed forces alone took thirty-six hundred nurses. Another three hundred were lent to the Union of South Africa. More were needed for Red Cross projects. There was volunteer work for all and many who had retired came back to keep the civilian hospitals running. Among the many contributions which the Alberta nursing schools made at this time, the University had the distinction of sending graduates who became the chief nurses of the armies of two countries. Agnes Macleod became principal matron with the Canadian armies in Italy, was wounded and won the Royal Red Cross, and in the post-war was the top nurse in the Department of Veterans' Affairs. Ann Fuller went to the American army and re­ tired in 1965 as chief of the United States army nursing service. They were but two of forty-three University Hospital alumnae in wartime military service. Calgary General sent forty-one graduates overseas, including four to South Africa, and had twenty-six on active service in Canada. Holy Cross sent nine, including Julia Ondras-who left the army to be a TCA stewardess, and left TCA to be Sister Mary Bernardine and infirmarian of a monastery in California. The Royal Alex had thirty-five graduates on active service, including eight who went to South Africa. Ann Lorraine Young, class of '33, was awarded the Associate Royal Red Cross for her work as senior nursing sister at the Red Deer military hospital. The Edmonton General sent a dozen. The Misericordia had eighteen overseas and ·a few more in Canada. Medicine Hat Gen­ eral had eight and the Galt nine. Camrose St. Mary's, which had closed, was still represented by Christine Albers and Mary Mc­ Leod. The Ponoka Mental Hospital had one graduate in service, 229 Verna White (Lister). And from Lamont, Jessie Archer, the doctor's daughter, went to South Africa. For Alberta nurses entering the army, the routine was hardly different from the first war. They entered at either Calgary or Edmonton, drew uniforms and went to work as second lieutenants with the assurance of a promotion to first lieutenant in six months. The way into the air force or navy was a little more complicated. The RCAF had a three-week induction course at the Institute of Aviation Medicine in Toronto and the navy had two weeks of lectures in Halifax followed by a familiarizing sea run. The nurses who went to South Africa got plenty of sea time. The first group got thirty-eight days aboard an Egyptian freighter from New York to Capetown. Most of them had responded to radio advertisements asking for nurses to serve in the South Afri­ can military nursing service. The radio said they'd be taken into the Canadian army, then lent to South Africa where they'd con­ tinue to receive Canadian pay. The bit about the pay proved to be incorrect; they got about seven-five dollars a month, less than half the Canadian rate. But they were quick to join. Emily Mayhew, a Royal Alex grad of 1940, was listening to the radio at home while having lunch. When news of the South African corps came over, she got up without finishing dessert, walked two blocks to the armory and signed up. Miss Mayhew, like most, had given her name to the Canadian Nurses' Associa­ tion as being willing to serve anywhere for the duration, and was impatient waiting for the Canadian forces to call her. Later she bought her way out of the South African service, joined the Cana­ dian army and served on hospital ships. The Canadian nursing uniform attracted a lot of attention around the Dixie Hotel in New York where the nurses waited for their Egyptian freighter to arrive. The actor, Louis Hayward, stopped Germaine Quilichini, (Mrs. Peter Strong) an Edmonton General grad, on the street, and asked her about the uniform. The United States and Japan entered the conflict while the nurses were at sea and they landed in Capetown on Boxing Day, 1941, where the smart-looking uniforms soon drooped in the 110-degree temperature. While the freighter Kawizar was taking the first contingent to Capetown, another ship was taking twenty-one Canadian Red Cross nurses to Scotland, to set up an orthopaedic and plastic 230 surgery unit at Hairmyres, outside Glasgow. There were three Alberta nurses in this group, all chosen for their experience in surgical work. They were Kay Stewart (Sterrenberg), a graduate of Lamont; Betty Webster, of Calgary General, and Esther Higgs, an English-trained nurse who left a position as matron of the Blairmore hospital, to join the staff of this noted unit. A promi­ nent Alberta orthopaedic surgeon, Dr. Graham Huckell, came to Hairymyres later. Mrs. Sterrenberg recalled a great many wounded commandoes and burned airmen coming into the unit and some remarkable restorative surgery. The nurses were not so badly outnumbered by the patients as they were in the first war. The ratio of one nurse to fifty wounded men in a surgical ward was shortened considerably. In the military hospitals in Canada the ratio was about one to ten. The Calgary military hospital had twenty nursing sisters for two hundred beds and the Edmonton hospital (later the Camsell) had thirty-one nursing sisters for three hundred and fifty. Overseas, the ratios varied with the nature of the unit. Frances Ferguson, a Royal Alex grad who served with a casualty clearing station in France after the Normandy landing, recalled that a C.C.S. was supposed to handle up to two hundred casualties. For this there was a nursing establishment of eight, from which operating room staff was also drawn. There were sixteen male orderlies. Back in England, she recalled, there would be two nurses per twelve-hour shift for a fifty-bed ward, plus a floater, often a supervisor who had charge of two wards. Mary Mac­ Donald, a Misericordia grad, recalled two nurses to a ward of forty-two, and at Number Ten Canadian General Hospital at Taplow, a total of ninety-six nurses for twelve-hundred beds. Another Alberta nurse recalled being on night duty at a convalescent hospital at Colchester. She and one other nurse had a thousand men. Lillian Bibby, a Calgary General grad who was called up July twenty-eighth, 1940, and landed in London five weeks later with the first big group of Canadian nurses, just in time for the Battle of Britain, recalled being one nurse on a fifty-bed ward with a second if the work was heavy. Miss Bibby went to Sicily and Italy late in 1943, and found Italian hospital conditions closer to those reported by nurses of the first war. She was with 231 a casualty clearing station that moved north with the fighting front and commandeered schools as it went. Lorraine Quehl (Connelly) , a Misericordia grad, was sent from England to Italy to replace a Canadian nurse who had been found married. There was a regulation against married nurses in the war zone so Miss Quehl was sent out to replace her. Since ar­ riving in the United Kingdom, she too had been married and was then Mrs. Connelly but not wishing to upset Mr. Churchill's plans for winning the war, she didn't say anything about it. She was in Italy one winter attached to a psychiatric unit which was based in an ancient Italian cavalry barracks. Most of the battle fatigue cases were living outside in tents but they wouldn't have been much better off inside. All the windows had been blown out. The war led to a specialized career for at least one Alberta nurse. Margaret Egan, a Misericordia grad, worked with a casualty clearing station in northwest Europe, and a surgeon who did am­ putations made a lasting impression. He would operate sixteen hours at a stretch, then spend hours checking back on the men on whom he had operated, making sure the pressure pads were exactly right and calling down the nurses and orderlies if they weren't. He was already preparing the patients for artificial limbs. The surgeon died on the job, from exhaustion and a tropical disease he'd picked up from one of the soldiers. But the work he did so impressed the nurse that in the post-war she and her husband, Walter Stauffer, formed a team for fitting artificial limbs. She became the first Alberta nurse to study prosthetics, taking sum­ mer courses at the University of California, Northwestern and New York University. There were many differences in the nursing side of the two great wars, but the biggest difference for Canada's second genera­ tion of wartime nurses was the supply of blood plasma for trans­ fusions. In the 1914-18 war direct transfusions were a rarity but for 1939-45 there was plasma, labelled "instant" blood. It saved many lives. Plasma that came from Alberta was gathered in clinics at Calgary and Edmonton, clinics sponsored by the Red Cross and organized and staffed by volunteer nurses, who gave their time as citizens gave their blood - free. The clinics were set up in 1942, in the basement of Mc­ Dougall United Church in Edmonton and the basement of the Lougheed mansion in Calgary. To head the nursing side of the 232 Edmonton clinic, the Red Cross recruited Mrs. John Turner, the Alice Mary Blackwell of the first war, who had seen young men bleed to death in France and whose only son, Flying Officer John Turner, had just been killed in the crash of his plane in England. About forty graduate nurses were involved in the program that developed. Many were wives of American servicemen sta­ tioned in Edmonton. It was a labor of love, a love of many things that are more clearly appreciated in time of war. The clinics were held Monday and Tuesday and the rest of the week was given to processing blood for shipment and sterilizing the equipment. Flor­ ence Nightingale, who liked statistics, would have checked over the figures on the work done and the plasma shipped and would have been pleased. In Calgary the blood clinic grew out of an earlier Red Cross service in which some nurses had formed a group to make dressings and bandages. This group had also organized a complete sixty-bed emergency hospital, with an inventory of every necessity, which could have been set up in Elbow Park School. The chair­ man of this group was Mrs. T. L. "Barrie" O'Keefe, a Calgary General grad who took over the blood donor clinic after the war and was still at the helm, unpaid, when this was written. The wartime clinic was set up when a local Red Cross com­ mittee including Mary Pinkham (keeping up the Pinkham family's historic interest in Calgary's health), invited Mrs. George Hewitt to organize it. Mrs. Hewitt was the former Alice Oliver, a Royal Alex grad of '25. The clinic was located in the basement of the home of Senator Lougheed, with the Canadian Women's Army Corps upstairs. The Calgary branch opened in January, 1943, on a morning when it was near fifty below. But nineteen donors came anyway, and without breakfast, because food clouded the blood and it was thought at the time that this might affect it. For the duration, donor clinics were held Wednesday morning for service personnel; Thursday morning for civilian men, and Friday for women. There were seven tables, each manned by a volunteer nurse from among those living in Calgary, some of whom were working full-time at the profession. Mrs. Charles Parks, who supervised the processing and shipping of the blood, and the sterilizing and preparation of the equipment, was also a laboratory technician on the staff of the Calgary General, from which she 233 was a graduate R.N. At the height of the fighting in Europe, Mrs. Parks and the other volunteers were handling life-saving plasma from as many as two hundred and twenty donors in one day. For each donor it was a personal gift, given with the thought that a relative or a friend, or the son of a friend, might depend on it for life.

The AARN, which has a pretty good sense of historical timing, was host for the first wartime convention of the Canadian Nurses' Association. It was held in Calgary in June, 1940, opening on the day that Marshal Petain went on the air to tell the French people that their navy and air force had passed under control of the axis powers. Rae Chittick, president of the AARN, was official hostess. A Calgary girl with a nursing degree from Johns Hopkins and a master's from Stanford, she would (in 1954), receive an honorary doctorate from the University of Alberta for service to nursing in Alberta, Canada and Africa. Miss Chittick told the Calgary Herald: "We know that nurses are vitally necessary to a nation at war and that a dominion-wide conference at this time will provide the quickest way of co-ordinating our activities." There were five hundred and thirty delegates at the conven­ tion, including Mary Ellen Birtles, who had come from her home in Alexander, Manitoba. She was then eighty-one and it had been fifty years since her first appearance in Alberta but she was at all the sessions listening, and in personal chats restating her lifetime conviction that nursing education should be at the bedside. Fanny Munroe, late of the Royal Alex who had returned to the Royal Vic as director of nursing, was a keynote speaker, talking about the experience of Canadian nurses in the first war and the CNA's plans for the second. The convention was told that five thousand nurses had al­ ready offered their services and it passed a resolution saying: "As an organization Canada's nurses stand ready to respond to any call for home or overseas defence, for health and nursing service in connection with refugees or in any other need that may arise." The convention voted to put its surplus cash into war bonds and to buy the armed services three complete surgical units at a cost of forty-five hundred dollars each. On the home front, the CNA heard about the campaign to 234 get better working hours in British Columbia. The speaker, Mrs. Rex Eaton, said the eight-hour day seemed impossible so they were campaigning for a ninety-six hour fortnight. She added: "There is a self-sacrificing spirit about nurses that can lead to their disadvantage." Edna Moore, of Toronto, warned members there could be pressure to allow standards of nursing to drop to meet the war­ time emergency. She urged them to "seek diligently to keep up nursing standards in both service and education". She said that licensing of all who nurse for hire should be considered at once. Another speaker, Dr. A. V. Douglas, dean of women at Queen's, warned that the pace of progress was increasing and that postgraduate courses should be available for members of a pro­ fession that was "going from an ancient art to a modern science". The CNA has met in Alberta three times, always at a time of significance.

Early in the war the AARN formed a committee to work for better working conditions. The chairman was Barbara Beattie, director of nurses at the Ponoka Mental Hospital, and the com­ mittee took its name from the ultimate, though apparently mirage­ like and unattainable goal of the profession. It was called the Eight-Hour Day Committee. At the AARN convention of 1941, held in Lethbridge (the first time ever outside Calgary or Ed­ monton), Miss Beattie reported only "a trend towards improve­ ment" and that in the training schools some were including lecture time as duty. The wages were not exciting. When Gertrude Payzant (Bjorge) returned to staff duty at the Royal Alex to help the hos­ pital meet the wartime shortage of 1941, the wages were sixty-two dollars a month. However, there was salaried work for nurses, a situation that was to remain standard until the time this was written. On September seventh, 1942, the Edmonton Journal carried a story headlined: 'Surplus of Nurses Fades; Jobs Are Matching Supply.' The story began: "The lot of the 'angel in white' has been a hard one in past years as girls in their crisp uniforms ended three years of ar­ duous hospital training to find no place for them in the medical profession. 235 "A hospital diploma in one hand, a registered nurse's cer­ tificate in the other, young women in years gone by have been forced to take up stenography, teaching, or even domestic service, but it's a different story now. With the services taking up a good deal of the slack and the hospitals expanding all the time, the graduate nurse is really coming into her own." ~ By the start of 1943 an attempt was made to bring inactive mir'ses back to work. This was a program that would reappear in the post-war when the wartime shortage wouldn't go away. The AARN advised all ninety-seven hospitals in the province that nurses eligible for registration within the previous ten years would be given permits for the annual dues of three dollars. This would allow inactive Canadian nurses to help the war effort, and enable American nurses, who had joined their husbands in Alberta, to work in Alberta hospitals. In May of 1943, the AARN arranged a six-week summer school course through the University's school of nursing to help meet the wartime shortage of hospital and public health nurses. Helen McArthur gave the public health section and Helen Penhale the lectures on ward teaching and supervision. It was open to any nurse who had been active within ten years. In May of 1944, the AARN sponsored another war-time refresher course with funds from a federal grant. It ran daily for three weeks and was given at hospitals with schools of nursing. Tuition was free and there were no examinations. It was aimed at getting inactive nurses back to work for the emergency. In 1944, Belle Rogers succeeded Mrs. Vango as registrar of the AARN and the office was moved from St. Stephen's Col­ lege to the Capital Building on 102nd Street. This location had historical overtones for the AARN, because it was here that the crusading editor Billy McAdams had once published the Daily Capital, and he was the brother of Roberta McAdams, the nursing sister who was elected to the Alberta legislature in 1917. Miss Rogers gained the editorial approval of the Edmonton Journal when she spoke to the Associated Hospitals of Alberta at a meeting in Calgary. It was before D-Day, when no one yet sus­ pected that the wartime shortage of nurses was going to be per­ manent. The Journal said: "Miss Rogers has made a suggestion which deserves serious consideration. She suggested that one way to get more girls into 236 nursing would be to train sufficient girls and women for jobs as nurse's aides. These aides could be used to do routine work around the hospitals, leaving the nurses free to concentrate on their proper work of looking after patients and administering treatments. 'Most people in the know,' said Miss Rogers, 'are definitely convinced that if nurses, both student and graduate, were not called upon in­ numerable times daily to do work that should be done by ward aides, cooks, maids, laundresses and even internes, there would be very little if any shortage of nurses.' " The Journal added: "Miss Rogers has undoubtedly indi­ cated one major cause of the current shortage."

The AARN kept up its interest in education through the war years. In 1941 the Registered Nurses Act was changed to upgrade the entrance requirement for schools of nursing. It became a high school diploma with Chemistry Two and either Physics Two or Biology. And in that same year the AARN took up a project which it promoted for nearly ten years without result but without growing discouraged. Although the project then went dormant for the next fifteen years there would be positive action on it in the association's golden anniversary year. The project was a central school of nursing for the province, with students taking their course in a school independent of a hospital and going out to hospitals for clinical experience. In the fall of 1966 Mount Royal Junior College in Calgary would begin an experiment on this idea, an idea advocated originally by no less a nurse than Florence Nightingale. It seems to have started officially with the provincial con­ vention of 1941, at which Margaret Fraser of the Royal Alex out­ lined the factors to be considered in establishing a central school in Alberta. A committee with Miss Fraser as chairman was di­ rected to work out detailed plans. During the year, Miss Fraser's group sent a brief to the Alberta government and had a meeting with the president of the University. University authorities were reported by Miss Fraser to have "regarded the scheme most favorably, but since large classrooms and laboratories would require a new building develop­ ment it seemed impractical (to them) to launch such a scheme at the present time". 237 At the 1942 convention the central school committee said it would keep the idea alive. The project next appears in the minutes of an AARN execu­ tive committee of January, 1944: "It is agreed that the establish­ ment of a central school be kept in mind and brought to the attention of University authorities." In 1946 the Canadian Nurses' Association passed a resolution supporting experiments with central (or independent) schools. Jessie Morrison, who was leaving the RCAF that year, heard Government House being discussed as a possible site for a central school in Alberta. (It became a veterans' home instead and Miss Morrison was head nurse.) By 1947 the project had been taken up by the AARN's edu­ cational policy committee, of which Helen Penhale was chairman. In January, '47, the committee reported that considerable work was still necessary and that a decision should be made first on who should control the central school, since it would not come under a hospital. It was decided that control should lie with either the university or the department of education. This executive meeting thought Calgary might be the best site and a committee was appointed to study the site problem. In April the central school was discussed at the annual con­ vention and someone suggested that the existing schools be polled to see if there would be enough students for the school. The opinion was that there would be. In 1950 the Canadian Nurses' Association tried to get each association to sponsor a demonstration school in its own province. The AARN approved the plan in principle but could not see its way clear to attempting the experiment in Alberta, largely because of the cost. The project would then go dormant but the idea would not die and a full quarter century after the opening move, Mount Royal Junior College would be acting as a demonstration school in an experiment with twenty-five students.

Penicillin appeared during the war. The armed forces had priority on the supply but it was growing and nurses in Alberta hospitals became familiar with it. The Stettler municipal hospital recorded the first use of penicillin there and it was typical of the way it was introduced 238 in other places. It was in September, 1940. It was ordered by Dr. Kennedy for a Mr. Lawson Dewar who was being treated for an abscess. The shots cost Mr. Dewar eighteen dollars. There wasn't much hospital construction during the war. For years there had been building material with no money to buy it and just as the money became available, there was nothing to buy. This enforced "holiday" built up a backlog of hospital needs that brought on the post-war explosion of hospital construction and it took so long to build enough that the population grew old in the meantime and the builders kept on putting up auxiliary hospitals and nursing homes. One community which succeeded in building a new twenty­ bed hospital in the face of wartime shortages was Taber. The hospital district was created in 1941, construction started in 1942 and it opened in 1943. The board had to agree to sell its bonds within the hospital district so as not to interfere with the sale of victory bonds. And the project became a constant scouting for dribs and drabs of building material that contractors might part with at a price to further the Taber municipal hospital. The scout­ ing was a success and it opened in July, 1943, with Claudia Tennant, recently graduated from McGill, as director of nurses. On the first staff of seven was Mrs. M. C. McGuire, who spent twenty years with the hospital in almost as many capacities. The war brought a new hospital at Spirit River and also brought a new Catholic nursing order to Alberta: the Grey Nuns of the Cross. This order was founded in 1845 in Kingston by Mother Elizabeth Bruyere and three other nuns. While it has only one hospital in Alberta, in Canada, the United States and four African countries, it has twenty-one hospitals, two colleges, four normal schools, three domestic science institutes, eight in­ dustrial schools, 113 primary schools, fifty-one secondary schools, fifteen boarding schools, twelve kindergartens, sixteen dispen­ saries, four orphanages and five old peoples' homes. Its sixteen hundred nuns included sixty-four native Africans. In spite of its far-flung commitments the order had five nuns to send to Spirit River in 1941. Spirit River had a lengthy history of hospitals and nurses. In 1920, Pleasant Binkley, with her sister and mother, opened a three-bed institution that lasted about three years. In 1931 , the community bought a house and hired a nurse to run it. In 1936, 239 an abandoned bank building was hauled in to the present hospital site and converted into a six-bed six-bassinet unit. In January, 1941, arrangements were made for the Grey Nuns of the Cross to take over and Ruth Young, a local girl who had just graduated from Vancouver General, agreed to fill in for a week. It turned out to be four months, quite a test for a rookie on her own. But with the help of local volunteers the single nurse kept things running smoothly until the five sisters arrived on May third. There were only two registered nurses in the first group: Sister Martha of the Cross, the superior; and Sister Ste. Genevieve (Germaine Hurtubise), who left the order but stayed as operating room nurse and was still at Spirit River when this was written. In 1943, the sisters opened a new thirteen-bed hospital and in. the post-war it expanded to forty-four beds and fourteen bassinets. The war-time marked the final end of the era in which a nurse on her own would start a hospital as a business. The loca­ tion was Turner Valley and the nurse was the redoubtable Annie McLeod, who will be remembered for her activity at High River in the 1920's. Turner Valley, site of all the early oil booms in Alberta, had another one in the late thirties. Miss McLeod was then working at Western Hospital in Calgary, to which some injured oilfield workers were brought for treatment. This got her interested in the Valley. She loved to start things and early in 1940, at the sugges­ tion of the Herron oil interests, went to Turner Valley and started the Oilfields Hospital in a converted cookhouse. She rented it from Okalta, one of the biggest companies in the field, recruited Mrs. M. C. Burke (the former Cora Stauffer) to come with her and they fashioned a six-bed hospital of the cookhouse. The nurses lived in the dugout basement for six months but then were able to come up to ground level. They kept the bills paid and built on a maternity wing. A board was organized and by 1949, when Miss McLeod died, the Oilfields Hospital was up to twenty-four beds.

Hospitals with schools of nursing continued to add organiza­ tions at the student and alumnae level. In 1940 student govern­ ment started at St. Joseph's in Vegreville. At the University the Macleod Club (named for Agnes), which began as a club for students on the degree program, took in girls on the diploma 240 program, and this became the student government. Alumnae as­ sociations were formed in Medicine Hat and Lethbridge. Mary Rowles, class of '29, is credited with being the prime organizer of the alumnae of Medicine Hat General. The first meeting, with thirty-five graduates attending, was held September twenty-second, 1941. The objectives set out by the first meeting were the organization and promotion of unity and cooperation among graduates; advancement of the interests and upholding of the standards of the profession of nursing; and the activities in harmony with the objects and spirit of the association. Medicine Hat alumnae have chapters in Calgary and Ed­ monton and had one for a long time in Vancouver. The asso­ ciation gives an annual award in pediatric nursing to a member of the new graduating class, and has a banquet in connection with the commencement which serves as a reunion for the old grads and welcomes the new crop to the alumnae. One of the prime organizers of the Galt alumnae was Lucy Hatch (Mrs. Mcinnis), a member of the first graduating class, of whom it's sometimes said: "She WAS the Galt." Mrs. Mcinnis was on the staff of the Galt after her graduation in 1913. In the second war, when the Galt needed nurses to carry on, Mrs. Mc­ Innis came back and worked a full four years. When the war-time staff was breaking up after the victory, it seemed that the time had come to bring all the Galt graduates into a formal associa­ tion. Some meetings were held and the organization took shape in October, 1946, with fifteen founding members. The official aim was "to help the cause of the Galt student nurses wherever possible". The association has the usual banquet to mark the gradua­ tion ceremony. It also has a luncheon to mark the capping cere­ mony. It has built a sun deck on the roof of the nurses' residence, bought a refrigerator, refinished floors, and arranged educational programs for students and graduates. The work is financed by a concession. Since 1950, the association has run the concession at the stock saJe ring at the Lethbridge exhibition grounds.

In this second time of war, the district nurses were getting around in the traditional ways, and discovering at least one new way. There were several articles in Canadian Nurse. One was en­ titled, Better Storks for Alberta, written by Mary Willis. It de- 241 scribed a post-graduate course in advanced obstetrics set up for district nurses at the University by Helen McArthur, Barbara Eben and Dr. Vant. Describing the conditions in which the knowledge had to be applied, Miss Willis wrote: "No course can equip us with ready­ made rules for all contingencies. What to do, for example, when at the moment of delivery you turn to your table for an instru­ ment and find a kitten of whose existence you were previously unaware, intimately inspecting your sterilizing gear; or when, (in caterpillar season) the errant caterpillar, slowly paying out his rope, descends from the ceiling with stately deliberation in the most unsuitable of places." Irene Stewart wrote in Canadian Nurse about a flood on the Athabasca River when she was district nurse at Whitecourt. It happened in the spring of 1940. Miss Stewart was bound for a farmhouse on a river flat, seven miles from the town, to see a mother and baby she had delivered a few weeks earlier. She was riding on a wagon with a neighbor who was going in that direction. As they drove closer to their destination they met river-bank dwellers who were moving to higher ground because the river was rising. The house to which Miss Stewart and her driver were going was out on a river flat. They became concerned for the family and drove on harder. They were soon driving through water, brown, eddying water that came up to the wheel hubs. With a mile and a half to go, they unhitched the wagon and went ahead on horseback. Another half mile and the water was higher and the horses were swimming. They came to a point where they could see the farmhouse. The river was up around the lower storey and the ice was smashing the house as it raced by. Miss Stewart and her companion saw there was nothing they could do to help and decided to turn back. But the horses wouldn't turn back. They were swimming for home and trying to buck off the riders. Miss Stewart decided she'd have to swim for it too. She slid off into the icy water and struck out four or five strokes for the road-allowance fence, which was partly under water but which was on slightly higher ground where she could stand. Hold­ ing on to the top strand of barbed wire, she and her driver spent an hour slipping and sliding back to the first farmhouse through the icy muck. 242 They were taken in and given dry clothes and a girl was sent to town on horseback to find a lifeboat for the isolated family on the river flat, a family with a new baby and four older children. It was two hours before the men arrived with the boat, but they brought the family to safety in two trips, rescuing them from the second storey, where they'd taken refuge, and watched the river fill the entire valley and felt the ice jar the house. Miss Stewart wrote: "It was a great relief to get the mother and baby comfort­ ably settled in a warm dry home." Later on in the war, Laura Attrux was stationed at Whitecourt and discovered a transportation hazard which no one in the district nursing service had yet thought of. She was riding on a wagon driven by a farmer whose wife was at home about to have a baby. The horses were being driven at a good clip because there was no time to lose, and there was a rowboat trip across the Athabasca River yet to be negotiated. Then it happened. The 1inch pin broke. The horses raced on dragging the front wheels of the wagon with them. The rest of the wagon pitched to a stop, pitching Miss Attrux and the driver on their heads. But they got up, bloody but unbowed, walked to the river, rowed across, climbed the hill on the far side and arrived in time for Miss Attrux to do the work the people of the frontier expected from the district nurses of Alberta. In the Canadian Nurse of October, 1944, Mrs. Elizabeth Smith Heldal had a story she called On The Home Front in Al­ berta. A London, England-trained nurse, Mrs. Heida! knew what went on at the fighting front because she had spent five years nursing in France in the first war. She had come to Alberta in 1921 and in 1924 began twenty-two years with the district nursing ser­ vice. In her article, she tried to express the satisfaction it had given her to assist a new life into the world in a remote farmhouse in the Peace River country. Through the war, the service of the district nurses was more needed than ever. So many doctors were away at the war.

243 CHAPTER TWENTY When the war ended it was the signal for an important develop­ ment in the Indian nursing service. This development was the third phase of a federal program that began in 1921. With the close of the military campaigns in 1945, there were hospitals and people available to launch a campaign against Indian tuberculosis; a nation-wide campaign in central hospitals. The site chosen for the assault on Indian TB in Alberta was the old Jesuit College in northwest Edmonton, which had been converted into a military hospital by the American and Canadian armies. It was to treat Indians of Alberta, and the Indians and Eskimos of the Northwest Territories, so it was named for Dr. Charles Camsell, the famous man of the north. The Camsell added a new dimension to a service that offers a special challenge and satisfaction to the young graduate of today. For a girl who joins the Indian health services (of the de­ partment of national health and welfare) , the experience is not unlike the American Peace Corps. She finds herself being sent to a nation-within-a-nation. In fact there are several Indian nations within Alberta and the Northwest Territories. All of them have histories and traditions as old as those of the white societies which took over their country. Mem­ bers of these nations are well aware of their histories and of their historic relation to Indians of other tribes. Their feelings have to be taken into account in close quarters like the Camsell. A nurse in this service is bringing white man's medicine to people who know their own medicine was good enough to handle their diseases but was no match for smallpox and tuberculosis, which were visited on them by the white man. (The first case of Indian TB - they called it coughing sickness - was noted in the west in 1765.) 244 The Indians also know they lived in harmony with nature until the white man butted in and upset the balance of nature. They know they lived clean and free of disease before they were crowded onto reservations. There was enough room in the country for them to move on when their surroundings became polluted. If infant diarrhoea, caused by infection from "the bush toilet" is the biggest killer of children on the reserves, the reserve was the white man's doing. The Indians know now that they were often victimized by white traders, and although it happened a long time ago it was no longer ago than the American Civil War and how many south­ ern Americans have completely forgiven the north for winning? The young nurse who starts her career in the Camsell or in one of the reserve health centers or in one of the few remaining nursing stations, is dealing with people who think about these things. They don't say much. One of the Indian "problems" is communication. Indian reactions are hard to judge because they give no indications. They are, for example, very sensitive about slurs on their traditional skills in the woods but give no indication of this to a well-meaning nurse who will joke with an Indian as she will with a white man. The Indian's own sense of humor is difficult for the nurse because he'll give no indication that he is playing an elaborate game, with no time limit, to see how much he can put over on the nurse. A nurse getting started can play safe on the business of making a promise. An Indian has a high sense of fair play and a promise given must be kept or the nurse will be of less use to the service from then on. Some nurses who have been many years at the Camsell and the Edmonton regional office, sum up the differences in white­ Indian viewpoints this way: We, the whites, live for the future; the Indians live for today. Indians are not interested in accumulating wealth for what it can do for them. Indians have no habituation to hard work as we have; (or as we used to have anyway) . Indians have no concept of time as we have. While it's said in white society that people wind up clocks, it is, of course, the other way around. Clocks keep people wound up and on schedule. This is one of the hardest viewpoints for a new reservation nurse to ac- 245 cept. Through her years of training she has been run by clocks and then is suddenly transported to a nation-within-the-nation where the clock doesn't matter. If she calls a family health confer­ ence for two o'clock and the Indian families start arriving at four, she mustn't fume. Or if an old man comes into her office and doesn't speak for a long time (as measured by the clock), she mustn't let her clock-washed mind tell her that he is wasting time. Nursing is listening, and it offers a nurse a real challenge having to listen to silence. The Indians aren't changing their viewpoints. The new nurse in the Indian service is on her way when she sees the unwillingness to change as a sign of strength of character, not a defect in charac­ ter. The beginning of respect is the beginning of success in this Peace Corps field. The Indian will sense the respect even though he won't give any information to that effect; any more than he'll give the field worker details of his diet. After forty years and more, field workers can't give the Indian service any figures on what the average Indian family eats. The beginning of respect is more than the beginning of success. It's also the beginning of friendship, which can exist only in mutual respect, and the Indian will show friendship in his own terms. A good example is the case of the Indian who showed up outside the nurse's residence at dusk in company with the most vicious dog on the reservation. The Indian said nothing. He just sat and looked, and the nurse knew he was out there looking all through the night. A greenhorn might have been frightened out of her wits but the nurse knew it was a friendly act. The local school had been burned down by a firebug and the Indians were worried about the nurse. If the firebug came to burn down the nursing sta­ tion the most anti-social dog in the neighborhood was going to chase him all over the reserve. The nurse's knowing this was an act of friendship was a form of communication, and progress is being made in communication. The service now deals more with chiefs and natural leaders, recog­ nizing that the Indian tribal organization, matured over thousands of years, is no match for the bureaucracy spawned so hastily by the twentieth century. It's recognized that a shrill, bossy nurse may achieve results which look good on paper but set back diplo­ matic relations. There is a dilemma here, because Indians tend to listen more to an older nurse than to a younger one, but the 246 younger nurse is likely to be less set in her thinking and better able to adapt to the conditions she will find. She is also quicker to recognize that while her field is the Indian health problem, if the other Indian problems were solved, the health problem would largely disappear. The older nurse may be slower to realize that great progress has been made. The success of the Camsell program has been clear. When it opened in 1945 the nurses worked with every kind of tuberculosis among the Indians. Now TB is down to the ordinary kinds. And the success of Indian health services generally can be demonstrated by a few figures. The Indian population, which once seemed des­ tined for extinction, is now the fastest-growing ethnic group in Alberta. The resurgence is illustrated in the population record of the Piegan Indians of the south. In 1881 there were about a thousand. Then a typhoid epidemic (the "baking powder sickness") reduced the Piegans to 270. By 1918 they were up to 414; then the flu epidemic knocked them back to 380. By 1930 the number had climbed again to 411. By 1964 the Piegans numbered 1,243.

The federal government entered the Indian health service in the early twenties when the health and morale of the Indians were at their lowest. In 1919 the V.O.N. was asked to supply twenty­ five nurses for all the Indian reservations across Canada but this request was impossible so in 1923 the department of Indian affairs made a modest beginning by engaging four nurses for all the Indians of the prairies, travelling from reservation to reserva­ tion. Two of the travelling nurses were Albertans. The first en­ gaged was Harriet Gerry, a Royal Alex graduate of 1922. Maude Lucas, Holy Cross '14, whose parents had settled near Wetaskiwin in 1879 and who had known personally the Indian midwives of the district, was another. The others were Annie Brandon and Annie Ledrew. Miss Gerry worked out of the Edmonton agency for five years. She acted as public health nurse to twenty-four reserves, six residential schools and many day schools and wrote that her "districts and duties were wide as the prairies". There was a lot of travelling involved in this, of which Miss Gerry wrote in Three Centuries of Canadian Nursing: "Travelling was far from easy - roads were from good to bad, mostly bad - rivers to ford - 247 snow and mud - then dust, black flies and mosquitoes." Of the customers she wrote: "The Indian knows and reads us. We can fool ourselves and our friends but not our Indians." Even with the most furious travelling, it's obvious that the four nurses couldn't do too much but they concentrated with good effect on immunization. Vaccination of whole reserves stalled epidemics of smallpox, measles and typhoid. Wherever possible, Miss Gerry and her associates took advantage of retired, married nurses to carry on the work. One was Mrs. Pete Conway, (Dora Mennell, an Ottawa General grad), wife of a farm instructor at Riviere Qui Barre. The wives of teachers on the reserves were also recruited as volunteer field matrons: to be in charge of the medicine chest and try to interest mothers in the health of the children. Maude Lucas (later Mrs. Smart) wrote in a bright enter­ taining way of her travels. Here is one story she wrote: "One of my first assignments was requested by a priest of the Anglican church who wished me to visit an Indian family where there was a sick mother. When I arrived at the Indian hut there seemed to be many people inside. When I opened the door the stench almost flattened me. I immediately set about clearing the hut of Indians so as to attend to the woman. After getting them all outside I discovered seven dead skunks and one very sick woman. Fresh air was what this woman needed and after a few aspirins and much cleaning up she soon revived." Of another case, Miss Lucas wrote: "The most grateful patient I ever treated was a little Indian boy who had a fishbone crossways in his throat and penetrating his tonsils. It was a simple operation to carefully insert my fingers and extract the tortuous bone but I shall never forget the delightfully happy smile this little Indian boy gave me. Indian children have a very sweet way of expressing their appreciation for relief from pain." Another time, Miss Lucas gambled and won when attending an Indian youth with diphtheria. He was choking with mucus in his bronchial tubes. So she took the only chance. She poured small doses of coal oil down his throat to let him breathe. He recovered, thanks to Maude Lucas, the Holy Cross graduate whose father had been the first Indian agent at Hobbema. For this book, Dr. E. L. Stone wrote about the travelling nurses. And Dr. Stone was a close observer of all three phases 248 of Indian health history. In 1927 he was appointed the first di­ rector of medical services for Canada's Indians. After the second great war Dr. Stone decided he'd had enough of Ottawa and elected to finish his career as director of the new Foothills Nursing Region, which took in Alberta, the Alaska Highway, the Yukon and the Mackenzie River section of the Northwest Territories. Of Miss Lucas and the other travelling nurses he wrote: "They were women of first-rate character and accomplished as much as could be expected in the (Indian and other) circum­ stances of those days. By modern standards they lived a discour­ aging life and one and all suffered from progressive neurasthenia. Their territory was the whole of the prairies and their overlord was Commissioner Graham, not the easiest man in the world to live with or work for. These travelling nurses never came under the real authority and direction of my office at Ottawa but we were able to increase their pay, improve their working conditions and in some degree get for them the security and standing of other civil servants. "They were heroines under every kind of unbearable pressure. They had no independent means of transport, no cars, not even saddle horses. They could hardly expect to be regarded as wel­ come guests at Indian agents' or farm instructors' houses. The Indians, especially the old women, were conservative and sus­ picious to a degree hard to imagine now. In plain fact, nobody really wanted them and they did not stay in one place long enough to get appreciated." In the time of which Dr. Stone was writing, the demoralization of the western Indians had reached its lowest ebb. In 1926, he noted, the Sarcee band was down to 150 and was dying out from tuberculosis. In 1930 there were only two live births among the Sarcees. In 1930, thirty percent of the children in Indian boarding schools had trachoma. Eleven of the 700 Blackfoot were too blind from trachoma to do any useful work. Dr. Evelyn Windsor, who went to the Blackfoot in 1928, said they were too demoralized physically and spiritually to care whether they had children or not. In 1927 Dr. Stone visited the Hobbema reserve and described the 900 residents as "the sickest lot he had even seen". He had a nursing station founded there. In that year the deputy minister was Dr. Duncan Campbell Scott, the poet. He visited Morley in the spring and was told that 249 every baby born in the previous year was dead. He then had Annie Brandon stationed at Morley to see what a nurse in permanent residence could do to improve the situation. Miss Brandon (no relation to' Kay Brandon who came to Morley after the war and has a memorial cairn on the reserve) opened a baby clinic. After getting to know some of the mothers she called a health conference at which there was a good crowd of women and children. At a second meeting two weeks later there were more than fifty. She talked on sanitation and prevention of disease and this time examined some of the children. The next step was to have the mothers agree to a real clinic with a doctor to give advice. In the next three months there were eleven babies born at Morley. They were introduced to bathing very early in life and apparently all survived. As a result of this experiment a permanent nursing station was opened at Morley. In 1927 a hospital with one nurse opened on the Blackfoot reserve and a hospital with a permanent nurse, Nancy Ballard, opened on the Piegan reserve. Until the hospital and the resident nurse were available, the Indians, especially the older ones, de­ pended on Indian medicine men when they were sick. The better known practitioners were Big Face Chief, Medicine Calf, Mrs. Many Chief and Mrs. Grassy Waters. With the establishment of permanent nursing stations, the work of the nurse was placed in the same category as that of the agent, the farm instructor and the teacher and the Indian health service entered the second phase.

A witness to this second phase was Kathleen Conroy, who opened the Hobbema station in 1931 fresh out of Grace Hospital in Detroit, and stayed for eleven years. When she arrived at Hob­ bema, Father Moulin the Belgian priest, said: "Do not expect to see improvement in the people because it will come all at once but you will not be here to see it." Father Moulin, good man that he was was wrong. The improvement came gradually and Miss Conroy could see plenty of it when she left in 1942. At the start she found the usual resistance from the older people. Children or young people who tried to follow the first aid and hygiene instructions she gave them in the school, were told they were "acting white". In school or clinic, the younger 250 people would agree to do certain things but when the nurse checked on their homes later they weren't being done. To create a more favorable climate for her public health program, it was necessary to demonstrate what white medicine could do. The first chance to present itself was a woman who had lost thirteen children, either before birth or within a year after. When she became pregnant for the fourteenth time the nurse told her she would do all she could to save this one and advised her to refrain from heavy work. The woman followed the advice. Whenever Miss Conroy called at her house she would find her sitting on the floor on a mat. She kept the baby and when time approached for confinement, Miss Conroy got clearance from Ottawa - it had to come direct from Otawa - to take the lady to a hospital in Wetaskiwin rather than have the delivery at home. On the way to town their car was nearly hit by another darting from a sideroad but the baby arrived live and healthy in the hos­ pital and grew up that way. This youngster was a good selling point for the health pro­ gram Miss Conroy was trying to put over. The clincher was the victory over trachoma. Trachoma is a contagious infection that gets lodged under the eyelids and unless checked, causes blindness. It was just the sort of disease that Indians on reserves were fated to get. It was widespread at Hobbema but the clinics organized by the nurse licked it. The treatment was painful. The Indians would come on clinic days and pass sticks of copper sulphate over the infected parts. The treatment was painful and slow but it cleared up every case on the reserve except for two or three among older victims that were too far advanced. After this success, when the nurse advised residents of the reserve to be careful about passing dirty towels across their eyes, they listened. That was one trouble, of course. They always listened but didn't always follow the advice. A good example was her advice about cleaning up around their summer camps. In summer they moved out of their houses and worked farther west, camping as they once had. Despite the nurse's urgings that they clean up around the tents, they would merely move on to another spot when one became too noisome. Just as they had done in ages past. There was often striking beauty in their way of life. One eve­ ning in fall, Miss Conroy arrived at a hay meadow where they had all gone to cut hay for winter. It was a low, swampy place, 251 not healthy at all. But when she drove up in the autumn dusk she came upon a living tableau of pre-history: the tents in a circle with a fire in front of every tent an4 a ring of people around each fire. Her nursely duty compelled her to tell them they'd likely get rheumatism in that spot but they told her: "Ah, nurse, it's so lovely." And it was. When Kathleen Conroy left in 1942, trachoma was beaten, and a lot of prejudice was beaten too. When she went to a house where there'd been a burn she would find that they had followed the proper first-aid procedure. When she made post-natal visits she would find them doing what she had advised. In fact, when she left after eleven years, the Indians were probably in better health than she was. But the progress she noted, and contributed to, was typical of the progress made in the second phase of the Indian health program. The assault on TB would come in the third phase.

It was during this time that Indian girls began coming into the nursing profession. Nursing was almost the ideal medium for an Indian girl making the difficult transition to urbanized society. It's hard to make on her own. While making the transition she has the security of the school and afterwards has the support of a professional group. Many Indian nurses went through the Ed­ monton General, because the Grey Nuns had missions and hospi­ tals in Indian areas and one on the Blood reserve at Cardston. This points up the fact that many nurses, in addition to those in government service, were doing Indian work. A notable personality in this category was Irish-born Jane Megarry, who was made an honorary member of the Blood tribe with the title of On-Atakie which means "good woman". She was made a serving sister of the Order of St. John of Jersusalem by King George V, and a chapter of the IODE in Lethbridge was named for her. Miss Megarry said she came from Ireland to Canada at twenty because, "I wanted to be a nurse and missionary, and in Ireland they all thought it was too hard work for a girl and wouldn't let me. So I came to Canada and finally got what I wanted." She came to Alberta in 1916 and worked on the Blackfoot reserve at Gleichen for four years, learning the language. She then went to the Galt to complete her training and in 1923 became 252 matron of St. Paul's residential school on the Blood reserve near Cardston. In summer, when the school was closed, Miss Megarry ran a camp for Indian children at W aterton Lakes, with three or four older girls helping her. She had great success teaching these children first aid and teams she taught placed well in competitions arranged by the St. John Ambulance brigade. In 1933 Miss Megan-y's team came second in the national competition and won the Lady Drummond silver medal. Miss Megarry's successor as matron of St. Paul's was Kay Potter. Miss Potter (Mrs. Dombro) took over in 1937 but after twelve years visited the Goodfish Lake reserve in eastern Alberta and was so charmed with it that she accepted Dr. Stone's offer to run the dispensary and worked there until 1955. And Miss Potter described a factor which the Indian nurse must understand to be successful: the Indian sense of humor. She gave as an example the election campaign of Francis Wickford. About 1951, Francis ran for chief of the Goodfish band on the promise that he would not allow anyone to be taken off the reserve to the Camsell hospital in Edmonton against his will. But the day of the election an order-in-council was issued, directing the mounted police to pick up any open cases of TB. The day after the election, two mounties came to the reserve and the first man they picked up was the new chief. Francis and the whole reserve thought it was very funny. As Miss Potter explained: "An Indian can enjoy a joke when it goes against him. We enjoy jokes in our favor or at the expense of someone else." Mrs. Una Flett Rodgers, who was at Morley in the early forties, gave another example. She was called from her supper one bitter night because "Christine was in labor". The call seemed urgent so she left at once with the Indian driver. It was a long, cold journey and en route she asked why Christine hadn't been brought to the hospital. The Indian said with profound gentle­ ness that they didn't think Christine would like to come to a hospital. At the end of the pilgrimage she saw the logic and the humor of it. Christine was a dog. After all, she had told the people she would help if their horses or cows were sick. Mrs. Rodgers, like the Indians themselves, began to appre­ ciate this and other jokes that went against her. Another time, again in deep winter, a call came from the Kananaskis area on behalf of a man who was said to be very ill. She and a driver went 253 in a cart piled with hay and the nurse buried herself in the hay for protection from the foothills wind. Twice en i;oute she stopped at Indian cabins to change horses and .drivers and the women heated stones to help ke.ep her warm. When she finally came to the shack of the sick man there was a sign on the door: GONE HUNTING. There is a great deal of "acceptance" in the Indian sense of humor. His philosophy is one of acceptance. He doesn't make scenes, or show "white" emotional reactions to certain conditions, because he accepts them if they're there. Mrs. Catherine Cole told a story that illustrated this. Mrs. Cole knew the Indians well. She was matron of the Peace River hospital from 1920 to 1928, then she spent twenty-one years in the provincial public health department, and after retiring in 1949 decided to spend two more years in the Indian service. One fall she was stationed at Hay River, at the west end of Great Slave Lake. At evening an Indian came from a camp across the river and asked Mrs. Cole to come with him to se.e a sick baby. They had to cross the river ice. Mrs. Cole, who was then about sixty-five, became really frightened as they crossed. The ice was still rubbery. Waves from the lake made it go up and down. She expected to break through at any time. The Indian walked ahead so their combined weight wouldn't put too much stress on the heaving ice. On the way back, the Indian brought her across farther up the river where the ice was thicker. When Mrs. Cole asked why they hadn't gone that way the first time, he replied softly that there wasn't time.

By this time the Indian health program was in its third phase, on a campaign laid out carefully in the last stages of the second great war. As the end of the war came in sight, the Indian health service was busy with post-war planning, most of it a massive assault on TB. In July and August, 1945, Dr. Lynn Falconer was sent from Ottawa to survey the west and the north, get the full picture of the problem, and case military hospitals that would become avail­ able for the campaign. It would start in November when Indian health services were transferred from Indian affairs to the department of national health and welfare. On the same day responsibility for Eskimo health was 254 transferred from northern affairs, so both Eskimos and Indians came under the same campaign. The Indian death rate from TB was thirty times higher than the white rate of forty per 100,000 and it was no secret. Dr. Fal­ coner recalled: "All the anti-TB organizations and provincial health departments were after Ottawa to do something about it, and we were happy because we knew the more bad publicity we got the more money we'd get." At the time the post-war expansion was being plotted there were fewer than a dozen nurses working on Indian health in Alberta. Some of the nurses were not registered and some were not even graduates but the service had to take what it could get to keep the nursing stations and hospitals open. The hospital at Cardston, run by the Grey Nuns, was no problem. At Gleichen, where the Blackfoot tribe had built their own twenty-nine bed hospital, the staff were paid from band funds, but the one at Brocket, on the Piegan reserve, was always a problem. It didn't look so good, being the standard two-storey Indian agency building. And it didn't sound so good either. It had been built with green lumber, which in shrinking left cracks and loose nails and when the wind blew out of the Crowsnest Pass, the hos­ pital groaned and screamed and shivered in a manner that made nurses resign with regularity. Caroline Fiske was often called to fill in at Brocket when the matron resigned. Miss Fiske, who was the travelling nurse based in Edmonton from 1936 to 1944, also filled in for nurses taking holidays, and Miss Fiske was not afraid of hospitals that groaned dismally in the night. She was not afraid of superiors who groaned dismally either. In the early thirties when she was matron of the Files Hills Indian hospital in Saskatchewan, she had in­ sisted on applying for the holidays to which she was entitled, even though an official of the department warned her it was an imper­ tinence which would likely lose her the job. Miss Fiske also found that the lower echelons of the Indian affairs department in Ottawa were rather vague about departmental activities in the west. She once had some paperwork sent back with the query: "Where is Gleichen?" But the last traces of this quaint detachment from the Al­ berta problem were about to be hypo'ed out of existence as Dr. Falconer made his tour in 1945. He left Ottawa on July first, and 255 working out of Edmonton, studied conditions along the Alaska Highway to Whitehorse and down the Mackenzie to Aklavik. It was clear that the nurses on the reserves, even if there were a lot more of them, would not be able to cope with the enor­ mous problems of TB control. They were too busy with their public health work and the inescapable welfare work that went with it. The field nurses would help identify TB cases and these would be treated in a central hospital. For Alberta, Dr. Falconer seized on the old Jesuit College in northwest Edmonton, which was still a military hospital but would be "war surplus" soon. The original college building had been used by the U.S. engineers building the Alaska Highway earlier in the war and the old brick college had been surrounded by redwood-faced huts connected by corridors. In his official re­ port, Dr. Falconer said: "It is difficult to describe this institution without detailed plans. . . ." He also wrote: "I consider it impera­ tive that we obtain this group of buildings as a central treatment center ...." To make "this group of buildings" the center for the assault on TB, Dr. Falconer recruited Dr. Herb Meltzer, who was about to return to private practice in Winnipeg. Dr. Falconer later came into the program directly, taking over the hospital when Dr. Meltzer left in 1949, and becoming regional director for eleven years, when Dr. Stone retired in 1952. The converted college was the center for the worst TB spot in Canada: Alberta, the Yukon and the Northwest Territories, and it was named for Dr. Charles Camsell, one of the great men of those northern territories. Two figures convey more than the proverbial ten thousand words about the success of the program which was carried out from the Camsell. In 1946, the first full year of operation, there were twenty-four thousand Indians in Alberta and a hundred and thirty died of TB. In 1964, there were thirty-four thousand Indians and one died of TB. At the peak of the stamp-out-TB campaign, the new Foothills region had four hundred Indians and Eskimos at the Camsell (plus a hundred DVA patients) with another two hundred Indians and Eskimos in hospitals at Aklavik, Whitehorse, Fort Norman, Fort Rae and Fort Smith. 256 The sudden creation of this force was a credit to many people, including the first group of nurses who got the Camsell off the ground when some said it couldn't be done. Nurses were scarce. The hospital was still under army regulations, which meant that the pay was a little better, but the army was still running twelve­ hour split shifts and three weeks' night duty without a night off. The staff was small but dedicated and started with about a dozen civilian nurses and another fifteen who were still in the army. Lillian Kautz, Calgary General '32, who was on staff, was appointed matron for the formative years. She was succeeded in 1947 by Elva Taylor, a St. Boniface grad who was still matron as this was written. The recruiting was slow but the Camsell managed to attract some young graduates from the General and got some outstanding service from some experienced nurses. One of these, Mrs. Cecilia O'Sullivan Kilcoyne, wrote of the start: "We trans­ ferred ten male patients from the TB section of the Edmonton General and from then on, at times we felt they were coming in the windows. No sooner was one ward opened and equipped than we were filled again. The nurses did yeoman service, always willing 'to go another mile'." Dr. Meltzer observed that the nurses were looking after people who weren't clock-watchers and the nurses weren't either. They improvised. They even improvised procedures for getting supplies when bureaucracy failed. Within six months there were a hundred and fifty native patients in residence. One of the problems peculiar to this nursing staff was taking on the hospitalization of large groups of people who were com­ pletely unprepared for life in such an institution. This problem was described by Mrs. Harry Hamilton, who joined the staff in April '46 and remained for eighteen years. To begin with, the historic tribal enmities were still strong and southern and north­ ern Indians had to be put in separate wards or they'd devote their limited strength to pounding each other. The Eskimos offered a different problem. Many had never seen wheeled vehicles, and when put in wheelchairs for trips to the X-ray room, would roll off down the corridors in high gear and high glee. Most Indians were unused to sleeping in a bed by themselves and were frightened at night. There was a little Indian girl, about six, who cried piteously on her first night in the hospital and could 257 not be comforted. When she quieted down, Mrs. Hamilton inves­ tigated and found that she had stretched her sheet over the end of the bed to make a tepee, and was :;leeping peacefully inside. The Indians' tremendous powers of observation were some­ times unnerving. Once, for example, a nurse arriving for duty found she had forgotten her white shoes. So she borrowed a pair from a nurse going off. And when she went into a ward of pre­ school children they said, almost as one: "You've got Miss Brown's shoes on." Some Indian girls, who had graduated and registered as nurses, came on staff and were useful as interpreters. However, they were resented by older Indians because they were "acting white" and because they were usurping authority, which in the Indian world, belongs to the older people. Indian nurses were sometimes ordered out by patients they were trying to help. In her eighteen years at the Camsell, Mrs. Hamilton ob­ served a quiet but steady evolution in the way the Indians viewed the workings of the hospital.

When the Indians started coming they often arrived with extras. When Max Conaty, the wardmaster, would go to meet a plane or a train, he would often check back with unexpected guests. If a mother coming to the Camsell could not find anyone with whom to leave her children, she would simply bring them along. Although the extra guests meant extra work for the nurses who already had plenty, most of them needed some of the Cam­ sell's medical service so no extras were denied entry. The planes and trains brought in some appealing little people, like Moses, the six-year-old Indian boy who was brought in from Norman Wells with advanced TB. Moses was almost blind. His sister Doris came with him. Moses was a happy child, with an active mind. Although he could not see well, he enjoyed the gold­ fish in the bowl by his bed. Mrs. Kilcoyne recalled the night he was given sardines for supper. When Mrs. Kilcoyne called on him later, the sardines were gone, and so were the goldfish. Moses said he had taken the fish out of the bowl and wrapped them in Kleenex to save them from the fate of the sardines. Moses was one of the TB victims for whom the Camsell service had come too late. The Camsell was never so affected as it was by his death at the age of six but in his short time at the Camsell, Moses created in all 258 who knew him, a greater appreciation and respect for the Indian character, and this was essential for the program to succeed. Every Indian or Eskimo who left the hospital cured was an asset to the health program, but one in particular became an offi­ cial part of the program. He was Donald Ayolik, an Eskimo, who was flown into the Camsell with severe burns. Donald Ayolik re­ covered and went home and at the time of writing was the com­ munity health worker at Coppermine. The frequent arrival of Eskimos once gave a fast-thinking charter airline pilot a chance to save his plane from damage by excited Edmonton football fans. He was flying a plane-load of Edmonton Eskimo football players home from a playoff victory in Winnipeg, when he heard on the radio that several thousand fans were waiting at the municipal airport. In Winnipeg, a short time before, exuberant fans had swarmed into the airport and pounded a TCA Viscount, full of Blue Bombers, with such ecstacy that the plane had to go in for repairs. The pilot heading for Edmonton knew that planes with Eskimo patients were allowed to land at the Namao air base, north of the city, by special arrangements between the departments of national defence and national health and welfare. So he called the Namao tower, gave his flight num­ ber, said he had a load of Eskimos, and asked for landing instruc­ tions. The tower operator assumed they were sick Eskimos bound for the Camsell, and cleared the plane for landing. There was quite a ruckus about it but the plane suffered no damage from the fans, thanks indirectly to the Camsell hospital and the campaign to stamp out TB in the native population. The Camsell made rapid progress in its new role, as Rita Murphy (Mrs. Morin) found when she arrived in 1948 to join the staff. Mrs. Morin wrote of 1948: "(The Camsell) was rapidly building up as the center for the care of tubercular Indians and Eskimos. The mobile X-ray equipment had by that time made two or three trips around the reserves, usually in conjunction with the annual payment of treaty money, for it was then that they found the largest congregation of Indians at one time and place. "Many cases were spotted in this way but the problem of persuading these victims that hospital care was their best chance for survival was still far from solved. When the Camsell began, many far-advanced cases were brought in and a number of them 259 were too advanced to save. This gave the Indian people the firm conviction that the Camsell was where they went to die. This, plus the fact that the less-advanced cases required a year or more away from the family, made the Camsell image a rather dismal one. "We recognized that the first important step was to build some kind of liaison between these people and the hospital. So the nurse doing the TB follow-up was well-prepared with infor­ mation about every patient from the areas to which she would travel. Before each visit to a reserve, several hours were spent with patients from the reserve. Little notes were jotted down to relay news to their families. There was also a sound briefing from the medical staff so the patient's condition could be interpreted to the family. This interpretation often resulted in obtaining permission for surgery. Gradually the time came when there was always a re­ covered patient ready to go home. It reached the point where every field trip saw someone going home with the nurse and the return trip to Edmonton brought in a friend or relative for treatment. It was a great step forward." This careful liaison work, with the nurse as mediator between the medical profession and the public, is one of the fine and true functions of nursing. Mrs. Morin wrote further of the work the nurses did in this line: "There were at one time several cases of open advanced tuberculosis at Morley. Three cases involved lads of about sixteen. I was never able to get closer to them than to see them flying past on galloping horses, their favorite pastime. The parents of one lad in particular was told bluntlv that without hospital care he would be dead in less than a year. By the next visit he had died and was buried out by a hay meadow. Several of the younger people told me he had been heard calling out across the meadow but they could not understand him. In a spirit of mischief I told them to listen carefully the next time and perhaps he would be advising some of his friends to go for hospital care of their tuberculosis. Within a few months several cases from this area were persuaded to come into Camsell. "If an ancient grandparent was a known source of TB, the young people were given basic instruction on having the old­ timers use a tobacco can in which to expectorate and then burn can and all in the campfire. The teaching had to be elementary and directed to the person who seemed best to understand. You 260 knew you were not going to persuade the rheumatic oldster of eighty or ninety to come out from his warm bed on the floor be­ hind the stove to be taken to the Camsell. He would live out his days with grandchildren and great-grandchildren sharing the warmth and picking up their share of his germs." The growing service attracted some outstanding nurses. One of them was Amy Wilson, who worked in the Yukon and left a published testimonial to the work and spirit of the nurses in Indian health. Miss Wilson was a Calgary General graduate and was al­ ready a veteran provincial district nurse when she joined Indian health in 1949. She had come to know and respect the Indians while stationed on Lesser Slave Lake and found irresistible a chance to apply for the position of "Alaska Highway nurse". This nurse was to be based at Whitehorse and be responsible for the Indian bands who lived in the valleys along the highway. Her first Christmas on the job was spent at a diphtheria-stricken Indian camp miles off the highway between Fort St. John and Fort Nelson. This experience and others she told in the book No Man Stands Alone, published in 1965 by Gray's of Sidney, B.C. Amy Wilson died a few months after, knowing her attempt to express something basic about Indian nursing was a success. On the Blood reserve at Cardston there were many Indian girls named Jean, and Indian boys named Burgess, in the 1950's. They were named for Jean Burgess, a Halifax nurse who joined the Indian service in 1946, served at Driftpile, and then took over the hospital on the Blood reserve from the Grey Nuns in 1950. When Miss Burgess took over the hospital, an Indian coming in for a stay of any length would still bring his family along. The family would pitch a tent outside until he was ready to come out. Growing with the Camsell was a new concept of Indian health centers, replacing the nursing stations on the reserves. The nursing stations had bed facilities for patients, but with improving roads and communication, it was becoming easier to drive a patient to a hospital than to keep him or her on the reserve, so they gave way to health centers and by 1966 there were nursing stations at only three remote spots: Hay Lakes, Fort Chipewyan and Goodfish Lake. There were health centers in connection with the Edmonton and Calgary agencies, the Gleichen and Cardston hospitals, Hobbema, Rocky Mountain House, Morley, Brocket, 261 Bonnyville, Saddle Lake, High Prairie, Driftpile, Fort Vermilion and Fox Lake, where a nun was working in a trailer. The start of the health centers -may be dated January first, 1947, when Miss B. K. Aimer was appointed to the Edmonton agency and the Camsell was made base hospital for the four re­ serves. Nurses in the health centers were called field nurses. By 1953 the force had grown to the point where a supervisor was appointed. She was Kay Brandon, a former RCAF nurse. Miss Brandon was appointed in April and died in September in the polio epidemic. A memorial cairn was erected in her honor at Morley. Her successor, Madeline Taylor, also met tragedy, being crippled by a stroke while making her first inspection trip. After an interval, Mrs. Winnie Norquay Roscoe was named supervisor and she was still in the position as this was written. The roads on the Indian reservations lagged behind the gen­ eral advancement of the times. While the now-affluent province of Alberta was building new highways to the reserves, and past the reserves, and around the reserves, the roads ON the reserves were a federal responsibility and they retained their 1912 look. Margaret Lillie, (Mrs. J. M. Steinhauer), who came from On­ tario in 1947 to work at the Saddle Lake reserve, a hundred miles east of Edmonton, wrote about this problem: "My orientation period at the Camsell was cut short by a measles epidemic at Saddle Lake. They needed a public health nurse in a hurry and I was it. It was a lovely golden, fall day when we drove via Highway 28 to St. Bride's on a gravelled road and then drove into the reserve by a quiet country road. This last stretch of road was to become a challenge to me many times in the following fifteen months. I travelled it in the 1942 Ply­ mouth supplied by the department, and in a Bennett buggy (a car with the engine removed and pulled by horses) or wagon when the mud was oozing, and in a cutter or caboose when the snow was piled high. "The trails on the reserve were a real nightmare because I had always driven on pavement in the east and carefully read the road signs. Now I was supposed to read 'road signs' by looking at the tracks of my predecessors, and I should find my way home again by backtracking on my own tracks. I was continually lost and often found myself back at the house I had just visited. 262 "When I was told to follow the telephone lines straight south for six miles, I astounded everybody by driving into a slough. The telephone line went straight across the slough and so did the winter trail but the summer one went around and this little detail had escaped me. "When the roads were impassable for the car, I was allowed to hire an Indian driver and team and this was very enjoyable. I usually returned home liberally spattered with mud and hair from the horses but I had been spared the agony of deciding which trail to travel for a whole afternoon." Mrs. Steinhauer also wrote of the other challenges, and the rewards, of the field nursing in the Indian service: "At this time there was no office for the nurse, merely a medicine cupboard in the agency office. People came in during the mornings to borrow machinery, to get canvas or ammunition or supplementary rations; to enquire about a job on a neighboring farm for a teen-age son or daughter, or to bring news of a sick person and ask for medicines. Since I could do very little nursing in a general office setting, most of my nursing was accomplished on home visits. I was told about sick people in the morning and then set out to visit them, along with my follow-up calls to TB patients and pre-natal patients. No woman ever volunteered the information that she was pregnant. I had to see for myself or ask prying questions. " On one occasion when Mrs. Steinhauer was travelling into Goodfish Lake, east of Saddle Lake, Jess Samson was her driver. "As we drove along," she wrote, "he coached me in some Cree words and phrases such as, 'where do you hurt?' and 'when did it happen?' and, 'have you got a man?' It was surprising how many • little things I could find out with my new vocabulary and how pleased the patients were when I tried to speak their language. "There was no outline of work to be done and no nursing supervisor to see whether the work was progressing according to plan. There were two doctors in St. Paul (father and son) who treated the serious cases, but twenty-two miles by team was quite a trip. Most babies were born at home, attended by a native mid­ wife. It was a new experience to try diagnosing illnesses and pre­ scribing treatment after years of nurse's training in which I learned to take directions and follow orders implicitly. I consulted the 263 textbooks daily and was often on the telephone to the doctors, describing symptoms and seeking advice. "Naturally there was always pJenty of equipment to carry around and I longed for a clinic where I could set up my equip­ ment and have the patients come there to visit. After a few months it was arranged for me to use a room in the agent's house for a clinic. He had a huge front verandah and half of this was boarded in for a waiting room and from there a door was opened into the clinic room. A monstrous cupboard was built in one corner to store medicines and an army surplus table and chair were sent down from Edmonton. Benches were built in the waiting room. I tacked up some posters and was ready for business. "When I worked in the baby clinic in Ottawa, my job was to set up for the doctor and to assist him. Here I was on my own and it was a thrilling experience. I began to make plans for an immunization clinic, by posting notices, having announcements read in the church, and, of course, by using the moccasin tele­ graph."

This was the spirit of '47, as the Indian health program took off down the Indian trails at high speed. It was built on the work of a generation of nurses who had carried on through official indifference and lack of everything except work to be done. But all that was changed in the post-war. There was money. There was interest. There was better understanding of the problem. And the lower echelons in Ottawa knew where Gleichen was. Where late in the war there were less than a dozen nurses on Indian work in Alberta, by 1966 there were 180 with another 120 in the north. The death rate from TB had dropped from 130 per 24,000 in 1946, to one for 34,000 in 1964. The Piegan Indians who were down to 380 in 1922, numbered 1,243 in 1964. The story of the Indian nursing service is a success story. And in 1966, coincident with the golden anniversary of the AARN, there was to open a new Camsell Hospital. The new Cam­ sell would reflect the success. There would be only 380 beds re­ quired, compared to 500 originally, and half would be for active treatment of diseases other than TB. The new Camsell would stand as a monument to a proud race that wouldn't say die. And to the nurses who supported this resolve.

264 CHAPTER TWENTY-ONE There is a word to describe the direction in which psychiatric nursing has been going; since 1911 when the six-year-old prov­ ince of Alberta opened the mental institute at Ponoka and two hundred Alberta cases were transferred back from Brandon. The word is a new one, minted especially for this book, be­ cause the exact word did not exist. The word is adlibertarian. It was created on request by Dr. W. G. Hardy, dean of classics at the University of Alberta, who had written several million words but up to this point had not added any new ones to the inventory. The old regime for mental patients used to be authoritarian. The new regime is one that "tends towards permissiveness". In a word, that brand new word, it's adlibertarian, constructed by the the classical scholar, Dr. Hardy, from the Latin words ad and libertas - ad meaning to or towards, and libertas being under­ stood as a freedom which is granted by higher authority. The trend is towards greater freedom inside the hospital, building up to much greater freedom outside. The atmosphere was authoritarian in all respects in the earliest years when Dr. F. A. Cook was the superintendent and would be driven up the front drive in his carriage every morning; when the doctors on the staff were like the officers of a garrison, and Ponoka society regarded the institute as a sort of country club. Dr. Cook's authoritarianism is illustrated in a story about a staff dance. One staff member was elected to ask Dr. Cook if the staff could use a hospital dining room for the dance. Feeling like the mouse who was elected to bell the cat, the staff man entered the presence and made his request. "I shall consider it," said the doctor, and dismissed the sup­ plicant by turning to papers on his desk. Days went by and nothing was heard from the great man. On the eve of the proposed dance, 265 the same supplicant was again elected to approach the presence. "I have not yet considered it," said the doctor, turning back to his papers and when he retired in ~ 926 he had apparently still not got around to considering. Perhaps it was because the staff didn't have much status then. The people who staffed the institutes were known as attendants. There were a few nurses to handle the physical ills of the patients but their supervision was left to "attendants" without nursing education. It was still felt that the duty of society towards a man mentally sick, was protection: protect society from the man, protect the man from himself, and also protect government prop­ erty from violence. Most of the attendants who manned Ponoka in the first two decades, were products of the British mental hospitals who had emigrated to Alberta. They were both men and women, and al­ though they hadn't medical or nursing training, it would be a grave disservice to downgrade their humanity and their intuitive under­ standing of what the patients needed. There were some wonderful people among these attendants, who lived in the wards with their patients. There was old Tom Watt, for example, a Scotsman of gentle but commanding presence who had a wonderful faculty for calming the violent. When the police would bring in a struggling man, Tom would take over. With a commanding, yet reassuring tone, he would say: "Come awa' wi' me." And the man would stop struggling and go. The wisdom of the Tom Watts is incorporated in the course which nurses at Alberta mental hospitals are now given: the psy­ chiatric nurses who take the four-year course for registration; and all the nurses in Alberta schools who come to Ponoka (or to Oliver) for eight weeks' affiliation. It's part of the education of every nurse. The difference is, of course, that the educators try to probe the "why" of Tom's success, just as medical research probes the "why" of Indian medicine. The Tom Watts of the world, in their daily contact with patients, found that some methods were more successful than others. The sophisticated mind, in scientific inquiry, then found out why. Refined and processed, the original discoveries of the Tom Watts are now applied in daily contact by registered or graduate nurses, not attendants. 266 A new team has emerged. The doctor is at the head of the team and lays out a plan for each patient, a plan involving the occupational therapist, the recreational therapist, the psychologist and the nurse. It's the nurse who has the complete picture of the plan and the complete picture of the results. The nurse is the team member who makes the plan go. Things have come a long way since 1911 when the first staff began to arrive at Ponoka. There were no educational fa­ cilities for them. There weren't even living facilities for them and some lived in tents. It wasn't until 1921 that the first nurses' home was completed, at which time someone said: "This home, accom­ modating forty-three people, should meet all future requirements." (The person who made that prediction is anonymous, fortunate fellow.) Not only were there no educational programs for the staff at Ponoka, but even staff doctors were not allowed to consult books in the medical library without permission of the medical superintendent. This all changed in 1930 with the arrival of Dr. C. A. Baragar, who came from the Manitoba mental hospital at Brandon. By this time Ponoka had fifteen hundred patients and the provincial mental institute at Oliver, nine miles northeast of Ed­ monton, was building to handle an "overflow" of more than four hundred. Oliver had started in 1923 as a temporary veterans' hospital. It was shortly converted into a training school for men­ tal defectives. When this home was moved to Red Deer, the pro­ vincial health department made it a satellite of Ponoka, with a staff of twelve and a bed capacity of one hundred. It was intended as a place for long-term patients with little hope of recovery. Shortly after Dr. Baragar's arrival at Ponoka, he started a six-month course of lectures for people on the staff. Aimed at giving the "attendants" some theoretical background to their job­ learned knowledge, the medical staff gave lectures on psychiatry and talks on psychiatric nursing were given by the new superin­ tendent of nurses, Catherine Lynch, and her assistant, Hilda Bennett. Dr. Baragar instituted another new program in 1930. This was a post-basic course in psychiatric nursing for graduate nurses on the staff. Psychiatric work was not then a part of the general nurse's training. Thirteen completed the course the first year; by 267 1964 there had been a total of 318; and in 1954 it was possible to develop this course to the graduate level. In 1931 Dr. Baragar institute? a three-year program for attendants on the hospital staff. It combined general and psychia­ tric nursing with Miss Bennett as chief instructor. In 1933, twenty­ three men and eight women attendants graduated and the event was given appropriate publicity and recognized by the press as a good thing. (Between 1933 and 1936 a similar course was given at Oliver and examinations were held. However, there was no graduation ceremony because Oliver was not yet recognized as an active treatment hospital. This recognition did not come until 1948.) The three-year psychiatric program continued at Ponoka and by 1964 there had been 215 graduates. In 1932 came the start of Dr. Baragar's most ambitious plan, a course which would lead to registration. It would be a four-year program, with the first two years at Ponoka and the remainder at regular schools of nursing. The senate of the Uni­ versity approved the program without hesitation or reservation but the schools with which Ponoka wanted to affiliate, weren't so sure. He finally got his girls placed around on a basis of: "We'll take two of your students for training if you'll hire two of our graduates for your staff." The doctor was relentless in his campaign to blast Alberta's psychiatric nursing into the twentieth century and to raise it to a level that would attract girls with the qualifications to be regis­ tered nurses. The psychiatric team could not develop or function without the nurse. Dr. Baragar had to manufacture the product and sell it too. In one of the many letters he wrote in support of his plan, he said: "Psychiatric nursing has sometimes been regarded as a sub­ sidiary branch of general nursing, on a par with fever, orthopaedic, or obstetrical nursing, to be picked up in a few months or even weeks. But thoughtful consideration of the nature and complexities of the mind, and of the peculiar requirements associated with the care and treatment of mental disorders, should, I think, correct such a misconception and place beyond a doubt the importance and dignity of psychiatric nursing as a major profession in its own right." He continued: "While it is highly desirable that the general nurse should have some training and experience in psychiatric 268 nursing, it is imperative that the psychiatric nurse receive training in general nursing. Upwards of half the occupied beds in Canada are in mental hospitals and even in general hospitals a certain pro­ portion of the patients are mental cases to a lesser or greater degree. "Furthermore a very considerable proportion of the health and social problems that confront the district public health nurse are psychiatric in nature - problems in mental hygiene. The im­ portance of psychiatric training in nursing can hardly be over­ estimated." For all his irresistible force, Dr. Baragar was a gentle, quiet­ spoken man. It would be nearly twenty years after his death before "the general nurse would have training in psychiatric training". More poignant, it would be only weeks after his death in 1936 that the first class of five would complete the first four-year course - in which the psychiatric nurse would receive training in general nursing. This first class produced leaders for the psychiatric nursing profession. There was Edith Kemp, who, at the time of writing, was director of nursing at Ponoka; and her sister Olive (Mrs. Noonan), who was director of nursing at the Camrose Rosehaven auxiliary hospital, the first mental hospital for geriatric patients. The second class, which entered in 1933, included Rachel Scott (Mrs. Young), who was assistant director of nursing at Oliver. Another leader graduate was Mrs. Helen Gemeroy (1940), director of nursing at the Allan Memorial, a hundred-bed hospital in the McGill psychiatric set-up.

Mrs. Young's progress was interrupted twice by illness, so she was a student in Ponoka from 1933 through 1939. She has de­ scribed two ceremonies of almost religious intensity which used to be the highlights of the week. The first was GRAND MEDICAL ROUNDS, held every Monday morning without exception. Medical and nursing superin­ tendents, and medical and nursing staff in descending order of seniority, paused and talked and visited with staff and patients on a tour through every ward. The patients were in their accustomed positions on long lines of benches around each ward; the staff standing at attention with appropriate demeanor. Both staff and 269 patients expected and looked forward to GRAND MEDICAL ROUNDS. The next day came a ceremony .of equal importance: TUES­ DAY CUPBOARD ROUNDS. With no exception, sharp at one p.m. every Tuesday, the superintendent of nurses, or her deputy, toured through the entire hospital on cupboard inspection. Every inch was exposed to scrutiny with fingers run over window-sills. Spreads and towels were in neat lines on shelves, brass and porce­ lain shined to a high degree of reflection, treatment trays com­ plete and in neat array. There was no question that this was very important as patients and staff held their breath awaiting their turn. Mrs. Young recalled: "We became skilled at producing acres of softly-gleaming battleship linoleum. Our linen and clothes-rooms were models of order and a delight to the eye." But then, as Mrs. Young recalled further, there came doubts -in the minds of the nurses who were getting the upgraded psy­ chiatric nursing education. While there was no denying the beauty of softly-gleaming linoleum and the impressiveness of ceremonies like Grand Medical Rounds and Tuesday Cupboard Rounds, they weren't really doing anything for the patients. The new breed of nurses being produced by Dr. Baragar's system were the first to see that their time and knowledge could be better spent. "The combative patient was always with us," Mrs. Young re­ called of student days in the thirties. "Our basis for interpersonal relationships with the patients was The Golden Rule. We thought little of the feelings and forces which prompted the patient to be impulsive - to crown a nurse's fresh hairdo with an inverted bowl of porridge because she had disobeyed the 'two in attendance' rule. Nor did we recognize that often we perpetuated combative behavior by our lack of understanding in approach." In the late thirties, there was once a student nurse who had to delay going home until the scars, inflicted by a patient with broken glass, had healed. In 1966, the patient, after many years in solitary seclusion, had been brought by new inter-personal skills and attitudes to a point where she could participate with interest and enthusiasm in a regime of work and recreation. The new direction that psychiatric nursing was taking placed emphasis on skilled, controlled procedures; using the nursing arts and social sciences to understand the patient better and help the patient to a better understanding - with the nurse and others - 270 of his own condition. There was a revolutionary departure in this new direction. When Tom Watt, with all his tact and humanity, said "Come awa' wi' me", Tom meant, come in. When the modem nurse expresses Tom's invitation she means come out. "Come out as far as you can towards the world outside. There is a word for our program. The word is adlibertarian." In 1936, the year the first four-year course graduated, the Ponoka hospital took a brave step towards the future by abolishing physical restraint for violent patients. Physical restraint is the professional term for things like straitjackets. A few years later, during the war, tranquilizers appeared, a safety item for both nurses and violent patients. Penicillin appeared too, and with it, the hospital was then able to let its non-stop case of malaria die out. From the early twenties the hospital had kept this case going like a perpetual flame to be used in the treatment of neurosyphlilis, or syphilis of the nervous system. Doctors had borrowed a case from a chap in a veterans' hospital in Calgary who had picked it up - malaria that is - in the Pacific. It was passed from patient to patient to arrest neurosyphilis. In one of the custodians of the malaria, Dr. Michie, a later superintendent, fo md a fascinating link with Dr. Von Yorec, the Viennese scientist who discovered the malaria treatment. The treat­ ment was being given to an Austrian woman. She asked about it. When it was explained, the woman said she had once worked as a nurse in Vienna for a doctor who was working with malaria to arrest neurosyphilis, but she and the other nurses had been sworn to secrecy because he wasn't sure how, or why, it worked. The doctor's name was Von Yorec, she said. Dr. Michie brought her a picture from the medical library and it was indeed the man. Just one of the human dramas from the mental hospitals of Alberta.

By the end of the thirties there were four mental hospitals in Alberta. The health department took over abandoned schools of agriculture in Claresholm and Raymond and made them institu­ tions for long-term cases with poor prognosis. The Claresholm school was taken over in October, 1933, with Dr. Valens as the first staff psychiatrist and Ruby Poile as matron. By 1964, the year the first unit was demolished, the Claresholm hospital had grown to a complex with more than a hundred beds, and Agnes Hill, a graduate of the Ponoka four-year program, was matron. 271 The old agriculture school at Raymond was reopened in February, 1939, as a long-term institution for women patients. In 1966 there were 125 patients, and the matron, Alice Birt, expressed the opinion that building smaller mental hospitals in different dis­ tricts was bringing the problems of mental health more closely to the public, banishing the taboos and mystery surrounding mental illness and educating the public to its responsibility for mental health at the local level. At Oliver, facilities increased during the war years. In 1942, the first building for women patients was completed and within a year the total patient population was near a thousand. In 1945, the first "open ward" was built. It was the farm dormitory for the patients who worked on the hospital farm. That same year of 1945, the three-year course in psychiatric nursing was reinstated on a permanent basis. There were nine men and two women in the first graduating class and at the time of writing, 314 men and women had completed the course. At Ponoka, the three-year course was for men only. At Ponoka, the facilities for instruction increased during the war years. In 1939 the first full-time instructor was appointed. In 1941, entered the first class to enroll as a class. By 1942 all head­ nurse and supervisory positions (in clinical areas used by the school) were filled by RN's with preparation in psychiatric nur­ sing. In 1943, a course in psychiatric nursing was added to the curriculum. In 1945 a second full-time instructor was added. In 194 7 oil was discovered at Leduc and although at first glance this might appear to have little connection with psychiatric nursing, it had profound and far-reaching effects, because with it came money. Where before there had hardly been money for proven necessities, now there was money left over for experiment and research. Just at this time some federal health grants became available and institutions were invited to think up projects on which to spend the grants. From Ponoka came the suggestion that general nurses in training be brought to Ponoka for part of their course. This had been one of Dr. Baragar's ideas. The government was agreeable, but Ponoka found little en­ thusiasm among the general schools of nursing. It seemed the idea might perish without a trial but finally Lamont and the Galt agreed to participate in a trial affiliation and in 1949 the first group of student nurses arrived to take part in an eight-week experiment. 272 It was a complete success, so great that eight weeks in a men­ tal hospital has become part of the education of every Alberta nurse. Every eight weeks Ponoka and Oliver feel the fresh breeze of the students arriving from the general schools - the southern schools at Ponoka and the northern at Oliver. The proponents of the scheme thought this eight weeks' affiliation would be good for the students. They didn't realize how good it would be for the in­ stitutions and for the nurses who had made a career of the psy­ chiatric field. In addition to the short-term boost of morale, it has created a lasting, working dialogue between general and psychiatric nur­ sing, making the psychiatric nurse, who once suffered the same ostracism as the patient, feel less isolated. In 1962 the AARN arranged a program of its own to promote understanding between registered nursing and the graduates of the three-year psychiatric nursing program. The AARN arranged with St. Michael's Hospital in Lethbridge to provide a sixteen-month course for graduates of the three-year program, to bring their bed­ side nursing to the level where they could qualify for registration. Graduates of the St. Michael's course may then hold mem­ bership in both the AARN and the Alberta Psychiatric Nurses' Association. The APNA was founded in 1950 and incorporated in 1963. At the time of writing it had a membership of 220 in Alberta, was affiliated with a national body, and its place in the scheme of things was recognized officially and in fact. The APNA's number one project at this time was a campaign to have the education pro­ gram of the psychiatric nurse brought directly under the Univer­ sity, the same as that of the general nurse. In this the APNA had the full backing of the institutions which developed the program. It would be a recognition and confirmation of the standards al­ ready attained. Psychiatric nursing was somewhat ahead of general nursing in meeting the problem of the aging population. It was in Decem­ ber, 1947, that the old normal school in Camrose was converted into Rosehaven, the first institution in Canada set apart from the mental hospital for the treatment of elderly. This pioneering was recognized in 1950 by the American Psychiatric Association> with a special award. 273 It was the idea of Dr. R. R. McLean, then superintendent at Ponoka and later director of mental health for the province. Two hundred elderly patients, whose permanent senility put them beyond help of the "return to life" program, were transferred from Ponoka and Oliver. Three nurses were transferred from Ponoka to head the nur­ sing staff: Mrs. Noonan (Olive Kemp) and Mr. and Mrs. Felton. In 1966, when the patients had increased to 510, Mrs. Noonan was matron, and the nursing staff of 155 included nineteen RN's and psychiatric nurses, five certified nursing aides and 95 atten­ dants. (At Oliver, for 15 hundred patients there was a nursing staff of 378, including 32 RN's and 220 graduate psychiatric nurses.) The term "attendants" is the key to the nursing approach in Rosehaven. It's a sort of throwback to the care that was provided all mental patients as recently as Mrs. Noonan's student days. It's custodial, but with the enlightened difference of better unders­ tanding of the patients and greater regard for the patient as an individual. In 1966, the future, to those inside psychiatric nursing, lined up like this: A four-hundred bed hospital was slated for Calgary. Ponoka would likely go to geriatrics and there would be more geriatric hospitals. Looking farther ahead there would be more outpatient clinics. All hospitals would have small psychiatric wards and some mental patients would be admitted to ordinary hospital wards. Many of the old obstacles to progress were gone, but insiders still found some factors that might slow progress. One was the unique position of all psychiatric nurses in being provincial civil servants. This made them less vocal, less able to reach the public with their ideas. Another was the increasing geriatric load, which might sidetrack the nurses from goals they now understood and had more clearly defined than ever before. A third was the Uni­ versity's non-involvement in the education of the psychiatric nurse. It was felt that psychiatric nursing could not keep pace unless the three-year program was under the University, and unless a major in psychiatric nursing was added to the B.Sc. degree pro­ gram. At the time, a degree nurse could major only in public health or teaching and supervision. 274 That was the balance sheet of objectives and obstructions at an important date, a date at which more than 52 hundred hospital beds in Alberta were for mental patients, a date at which hard­ won progress had laid the base for much swifter advances. The progress to that date was tremendous, of course, and swift, too, encompassed as it was within the working experience of many Alberta nurses. One necessary advance was in the attitude of the public, and Mrs. Richards (Florence Churchill of chapter ten) told a story to illustrate that. About 1916 she went on a private duty case to a farm home in central Alberta. Her patient was the woman of the house, a young mother, who had been released from Ponoka. On Sundays, Mrs. Richards' heaviest responsibility was shooing away the neighbors who came driving by to "look at" the patient. The neighbors were not unintelligent or unkind. Their desire to "look at" the former mental patient like an object in a wax mu­ seum was typical of the time. District families were so interested in the patient they would pile into wagons and democrats on a Sunday and drive miles to "look at" her. And were disappointed when the nurse wouldn't let them in.

The progress of psychiatric treatment has been a story of changed attitudes - in the public, in the doctors, in the nurses, and finally and most important, in the patients. At Oliver there is a file on a woman who had spent almost all her adult life in mental hospitals and would never leave. The file, thick as the New York telephone book, tells her story, a story of progress that parallels exactly the advances in psychiatric method. Student nurses at Ponoka in the l 930's knew about her. She was the wild woman, Indian-Scandinavian, who was kept in the specially-built vault. She was in there for the protection of the staff, so many of whom had been attacked by her. If the students saw her at all, it was through the slot in the door - the slot through which the attendants would peer and try to guess if it was safe to enter that day. They could never be sure. Her file contains letters to every conceivable agency begging someone to take this wild woman off the hands of Ponoka, but there were no takers. She made no progress in the "custodial" system of the 1930's and probably suffered more damage to her mind. Then with the 275 war years, and the "empirical somatic" era of treatment with its new drugs, tranquilizers, shock treatments and surgery, her periods of violence were shortened and sometimes headed off. When the post-war "therapeutic" era arrived, she was fit to benefit from it. She was never able to come out into the world, but she was able to come out of her vault and participate in the life of the in­ stitution. Nurses who remembered the mysterious, unseen patient who screeched in the night, unreachable and unapproachable, found her living a community life with other patients at Oliver, her mind at ease and in strange harmony with the world. The most interesting item in her file is a story she wrote in 1965, in the belief that she was participating in a literary compe­ tition she had read about in the Edmonton Journal. She wrote her version of the story of creation, a mixture of the Bible with Indian-type legend. The style is vivid and fascinating. Her writing shows the marks of the years she spent in solitary safe-keeping. There are many descriptions of eyes - a reminder of the time when her only awareness of the outside world was the eyes that appeared at the slot in her door. Her work shows an irrational mind, but it's a mind nevertheless and it's at work, and working effectively within its limits. The instrument of the program that brought this woman back into life is the nurse. The nurse makes the program work. With such dramatic results to show, it was little wonder the psychiatric nurses of Alberta were impatient for more. More money. More support from the government and the public. And more nurses.

276 CHAPTER TWENTY-TWO The two previous chapters have dealt with a single specialty in. the broad field of nursing. This chapter considers other groups of nurses who have a specialty or are in a class by themselves. Operating room nurses, for example, have always been in a class by themselves. Doctors love to tell stories about O.R. nurses and some day a committee of Alberta doctors will certainly collaborate on a book about O.R. nurses which will be almost as good reading as the book the nurses will then write about doctors. So, leaving this specialty to other hands, we'll proceed to Mrs. Albert Fiske, who was literally in a class by herself. Mrs. Fiske was the only human anthrax nurse in the history of Alberta. She is alone in this unique field, a field she occupied for six hot weeks in the summer of 1942. In fact, she was alone for the entire time she occupied the field-alone with a four-year-old girl whose case of human anthrax was so rare the laboratory in Toronto would not believe it and wouldn't send anthrax antitoxin. It happened in Provost. Mrs. Fiske, the former Eleonor Ridder, graduate of St. Mary's Hospital, Hamburg, Germany, had retired from nursing and had two children when Dr. Pearl came to her in desperation on Dominion Day, 1942 and asked her if she would special the case for twenty-four hours until a replace­ ment could be found. Twenty-four hours became six weeks, in which she was in isolation with the patient in a second-floor comer room of the Provost Municipal Hospital. Meals were left at the door. The doctor did not come in; in fairness to his other patients he could not. Once he climbed a ladder on the outside of the building and took a picture of the patient through the window for a medical journal. Through the hottest weeks of summer Mrs. Fiske was in the room with the stools and urine. At night she would take 277 them out to a field where local garages would dump oil and she would burn them. (Anthrax can survive for twenty years if it gets into the ground.) , The diagnosis by Dr. Pearl represented some fine detective work. The little girl was the daughter of an itinerant farm worker. As the doctor reconstructed the case, a cow had been slaughtered on the farm and the hide stretched on the ground to dry. The cow had anthrax. A cat walked across the hide. The little girl played with the cat. The cat scratched her and she contracted the disease so rare in humans that the Toronto laboratory would not accept the diagnosis. About the third day of her fever the doctor rounded up some penicillin, still very scarce and very expensive, which Mrs. Fiske gave he.r. This brought the fever down. About the sixth day the United States Army Air Force agreed to fly up some antitoxin for animal anthrax, and drop it by parachute. Through her window, made steamy by the constant cloud from the sterilizer, Mrs. Fiske could not see the plane but she heard the roar as it passed over and she saw the parachute coming down. Within the hour she had given the patient the animal serum. The little girl then went into forty-eight hours of convulsions and when she came out the fever had passed and she was convalescing. This took another five weeks, in which time she filled the walls with crayon murals - and Mrs. Fiske might, understandably, have begun cutting out paper dolls. But she emerged unscathed, one hundred dollars richer, and Alberta's only anthrax nurse re­ turned to the hospital later on as matron.

In the golden anniversary year of the AARN the isolation hospital belonged to history. However, this was not true of many of the nursing specialists who ran these hospitals. They weren't ready for history. Take Mildred Dobbs, for example, who ran the isolation in Lethbridge from 1911 to 1950. At 'the age of eighty­ seven, Miss Dobbs slowed down only long enough to be inter­ viewed for this book. Miss Dobbs was trained in general and fever nursing in London and then worked in the English equivalent of the V.O.N. In 1910 her brother came out to Lethbridge. The next year she came out to visit him for a short time but stayed instead and ran the isolation hospital for the next thirty-nine years. 278 In the early years she was more isolated than any of her patients. She was asked by the chairman of the board of health to please not go to church because if she went to church on Sun­ day the chairman would have his time taken up Monday by excited citizens telling him the isolation nurse had been in church. The doctors seldop:i came inside when they visited but kept her standing in the doorway. Relatives would often phone to tell her they were bringing candy or fruit for the patients and would leave them on the fence and would Miss Dobbs please not come out while they were there. The girl who helped with the housekeeping got out one day every three months and in preparation for the great day, washed her hair in disinfectant and kept her clothes in the fumi­ gating closet the night before. But Miss Dobbs just stayed in the hospital, which was a poor sort of house three miles from town on the most windswept bluff in Lethbridge. When the wind blew in winter she couldn't keep the place warm, not even with six coal fires. To keep the pipes from freezing she and the girl would fill every receptable, including the bath­ tub, with water during the afternoon and then shut off the water below the ground. Miss Dobbs laughed cheerfully as she recalled: "Every winter I would complain of the cold and every summer someone would come out to check on the complaint and couldn't see what I was complaining about." There was almost no equipment and no medicine either. The hospital had no beds, just folding cots and dark heavy blankets abandoned by the Mounted Police, of such an appearance as to suggest they might be war surplus from the Riel Rebellion. When Miss Dobbs put in a request for beds she was turned down. After ten years she asked for a new pot and a new tablecloth and was told: "There were two tablecloths when we opened. What happened to the other one?" She didn't get either the pot or tablecloth and eventually bought them herself. In 1914 she was turned down on a request for aspirin. Dr. De Veber, the chairman of the board, told her: "We can't afford that. You got them better before without aspirin and you can do it again." She once had twenty-one cases at a time--polio, scarlet fever and measles. She never had a cross-infection, although there would be three to four contagious diseases in the crowded quarters at the same time. Nor was she ever off sick herself. She had a flaming 279 sore throat one day and thought about calling a doctor but decided, in effect, "What's the use?" and went on with the day's routine. The smallpox patients lived ~ a special isolation of their own, in a shack behind the main hospital. There was no hot water in the shack and "the girl" wouldn't go out there so Miss Dobbs would sometimes make thirty trips a day with hot water for the ointments and fomentations she applied to the patients day and night. She was particularly proud of her !iuccess with one patient, a young teacher who had the pox all over her face. With the treat­ ment, she recovered without marks. Catching the board once in a rare moment of generosity, Miss Dobbs got them to build a shelter from the house to the smallpox shack. She said she told the board they'd soon get the money back in the saving on toast that used to blow off the trays as she carried them out to the shack. By 1928 it was recognized that neither the hospital nor the site were fit for two women alone and the isolation hospital was moved to a place on Seventh A venue South which had once been a children's shelter. Miss Dobbs found it had also been a shelter for bedbugs and spent her spare time for months evicting the bugs. There was no single cause for the disappearance of the iso­ lation hospital. There were a number of causes and Miss Dobbs described one of them. In 1919, the year before toxin-antitoxin for diphtheria came into use in the Lethbridge area, she had sixty cases of diphtheria. The year the serum was introduced, she had nineteen cases. The next year there were only six and there wasn't another for six years. Finally, in the 1930's, when she had a couple of cases, some young doctors phoned and asked if they could come out and look. They had never seen a diphtheria throat. Violet Chapman, long associated with the Royal Alex, saw the decline and disappearance of the isolation hospital from a different angle. As student and staff nurse, Miss Chapman was at the Royal Alex from 1924 to 1957, entering the school the year the then-brand-new three-storey hundred-bed isolation hospital was opened, and retiring after twenty-one years in the isolation as an instructor. It was Miss Chapman's experience that an isolation nurse had to be cheerful in a special way, a sort of long-term, chronic cheer­ fulness that could rise above the separation from fellow-nurses and the life of the rest of the hospital. There was also a separation from 280 the life of the patients. They couldn't be as close to the patients as nurses in the rest of the hospital because of the obvious dangers of infection. The students used to come into the isolation hospital for part of their training. The Royal Alex nurses spent three months in isolation and students from other schools spent six weeks. When their time was up, the students would be washed and disinfected and would go out, but the staff nurses would be left in their separate sitting room. Gradually the student nurses stopped coming - because there weren't enough patients for them to learn on. Prevention was keeping people from getting the old diseases in the first place; and if they got them anyway, antibiotics got the patients out faster. Scarlet fever, which meant six weeks in isolation at the start of Miss Chapman's career, was reduced to seven days by the time she left. By 1957 only one floor of the three-storey wing was needed for isolation. By 1964 no floors were needed and the building was demolished.

You could say that the first polio nurses in Alberta were Gladys Smiley and Elizabeth Greig and you would be officially correct. They were the first nurses appointed in November of 1927 when the provincial government took action after the bad polio epidemic of that year. The epidemic had left victims in town and farm homes all around the province. Mostly children, they needed a planned convalescence with expert supervision. The only solution was to bring them to a central place. The government set up a sixty-bed pavilion for them by the University Hospital. Miss Smiley (Mrs. Ray Staples) was a graduate of Halifax Victoria General and Miss Greig was from Calgary General. They ran the pavilion with three or four graduate nurses and three physiotherapists. During its infectious period, when polio was doing its dam­ age to the patient, it was a matter for the isolation nurse. So polio nursing has always meant the nursing aspect of the rehabilitation of the patient - keeping up his physical and mental condition so he can benefit from the therapy. Therapy has changed, even polio has changed, but this principal has remained. 281 In the early years, when treatment stressed immobility, in splints and Bradford frames, the nursing task was to guard against the dangers of immobility, from pneumonia to bedsores. After a patient had eaten, the nurses had 'to check the bed meticulously for crumbs. One crumb under a patient's back could produce a bedsore. The patients were moved to the verandah for sunbaths, and to the pool, provided by the Junior Hospital League, for hydrotherapy, but medical thinking on rehabilitation said the af­ fected limbs should not move. A dramatic change came in 1942 and a witness to this change, and to all that happened from the start of the polio wing in 1927 until the last terrible outbreak of polio in 1953-54, was Edith Wood. Miss Wood was a staff physiotherapist through all those years. A Yorkshire girl, she took her training in the first war with the Lady Paget Massage Corps, in a school in the Duke of Devon­ shire's riding stables. She served with the British army, came to North America in 1920, to polio work at the University Hospital in 1927, and in 1942 the Alberta government sent her to Minne­ apolis to take a course from Sister Elizabeth Kenny. Miss Wood was the first Canadian physiotherapist to study with the tempestuous Australian reformer. After two months with Sister Kenny she returned and introduced the hot packs and muscle-retraining of the Kenny system. Through the last epidemic of 1953-54, when the hospitals could handle only the most serious cases, Miss Wood went around to private homes in the evenings, teaching parents how to start the retraining of polio-damaged muscles. With this epidemic, polio nursing entered a new era because it was a new kind of polio. It affected the respiratory system and its most vicious attacks were on people in their thirties. In its physi­ cal and mental effects it was far worse than the old-style "infantile paralysis" that affected the limbs of children. The basic aims of the nurse in the polio situation were harder to achieve. ~ Instead of dealing with children, who are optimistic and buoyant by nature, they had to try to save the morale of young adults cut down suddenly in mid-career. They tried to carry on encouraging conversations with deeply depressed people who were often unable to respond because of their impaired breathing. The physical work of nursing in this new situation was heavy and taxing. It took three people to get a patient out of an iron lung 282 ~ and as these awkward machines depended on electricity, there was the constant anxiety, in both nurses and patients, about power failures. The rule in the University Hospital was that if the power went off, all free staff members ran for the polio wards. One sum­ mer evening the power went out three times. Two witnesses to this time were Elizabeth George and Mrs. Eileen Turgeon, who were in the work still in 1966. In the wake of the respiratory epidemic, the manufacturers came up with newer and more convenient devices to assist breathing, and the inven­ tiveness of the suppliers required a new talent of the polio nurse. She_ had become mechanicabminded during the crisis so as to have an emergency knowledge of machines that might fail. No~ she had to learn to talk with the salesmen and be able to interpret the combined technical jargon and sales promotion language of the salesmen's brochures. The evolution of new machinery to assist breathing also brought in the patient and led to a closer under­ standing between patient and nurse. As this was written, vaccines existed that could practically end the danger of people becoming professionally acquainted with the polio nurse. Unfortunately people were still putting it off.

In Calgary the new Red Cross Children's Hospital was opened in 1952, just in time to play an important part in the last epidemic. There were 161 cases in 1952, 292 in the peak year of 1953 and 162 the next. With the Salk and Sabin vaccines the number dropped to 44 in 1964. Authoritative observations on the contributions of this hos­ pital, and on nursing of children generally, was given by Florence Reid, Lamont '27, who was superintendent of nursing from 1932 to 1961 and was named Calgary's citizen of the year for 1953. At the time of writing the nursing staff of Children's Hospital included fifty-five registered nurses, thirty-five nursing aides, up to twelve students on a four-week affiliation program from nur­ sing schools in Calgary, Lethbridge and Medicine Hat, seven full­ time teachers and countless volunteers. The situation was considerably different in 1932 when Miss Reid began her twenty-nine year association with the institution. It had then been in existence ten years, its beginnings financed largely by the children of Alberta, and promoted by Miss Peat, sister of Private Harold Peat of Edmonton, the badly wounded 283 soldier of the £irst war who wrote a widely-read book about his experiences and made speaking tours for the Red Cross. It began with fifty beds, increased to seventy, and in 1929 was moved to a house in Mount Royal where it remained until the new building was provided on Richmond Road. When Miss Reid came in 1932 the project was running on a hand-to-mouth day-to-day basis, fighting a battle with the depression in which it seemed that the decision might go to the depression at any time. The nurses' home had been closed. The nurses had moved into the hospital and the patient beds reduced to twenty-five, so that the place could accept only children who were actually suf­ fering. It was exhausting work for the nurses. There was n<' elevator in the house and the children had to be carried up and down the stairs for therapy and treatment. With twelve-hour days of such effort, the nurses managed to keep the hospital open. They not only kept up the work; they kept up the standards, and defined their work in terms that are still valid. As Miss Reid expressed it: "The work covers the physical, social, educational and spiritual life of the child, all of which comes under nursing." In the early thirties the nurses noted that a child with a physical disability may also have a social disability because he can't get a normal start in school. They noted that the younger children suffered the most from this disability and established a school inside the hospital with a primary specialist in charge. For years there was just one full-time teacher but there were extra volunteers. There have always been volunteers to help the cause of Children's Hospital, in its Red Cross days and its later days as a public enterprise. Miss Reid's requirement for the nurse who wants to work with children is respect for the child; people who have no respect for children can't handle them. Mar aret Baxter who succeeded Miss Reid, added another. A successful children's n~s~ must be at ease with children. If she isn't at ease, the most devoted nurse can crumble under the strain. Miss.Baxter also cited teen­ age baby-sitting as a good basic preparation for pediatric nursing. Trends in preventive and restorative medicine, which put the isolation hospitals completely out of business, also had an effect on Children's Hospital. The work, and the nursing emphasis, has gone from orthopaedics to general pediatrics. And on at least one occasion, the originator of a new technique has visited the 284 hospital. In 1961, Dr. Paul Harrington, the Texan who originated the surgical procedure for correcting curvature of the spine, lec­ tured at the hospital and performed five operations. Children's Hospital contributed much to its special branch of nursing. It also contributed at least two nurses to the profession. There was Eileen Marple, who, as a child, came to the hospital with a bad case of burns, and graduated with a B.Sc. in nursing from Alberta. There was also Betty Paul, who was in with a bone infection, and graduated from Miss Reid's alma mater, Lamont.

There's an interesting historical tie-in between the start of TB nursing in Alberta and the start of the AARN, because Eleanor McPhedran, who was Registered Nurse Number One, was also the first officially-appointed TB nurse. Her appointment came in 1919 when the dominion government was setting up a sanatorium for army veterans with TB. The only place available was a hotel at Frank, which had been missed in the disastrous slide of Turtle Mountain. The hotel served until the Central Alberta Sanatorium could be built west of Calgary. (Building material and supplies for the institution were consigned to an obscure railroad siding known as Keith and for years afterwards the new hospital was said to be at Keith although there was really no such place.) Dr. A. H. Baker, for whom the hospital is now a memorial, was the first superintendent. By 1925, when the military need was past, the Alberta government took it over, the same staff continued to run it, and it remained the only TB hospital until the Aberhart opened in 1952. In the meantime there were TB wards in the Edmonton General, Royal Alex and University. The project at Keith showed a new disadvantage of building a house on sand. The sand didn't undermine the foundation but it came in through all the windows - even when they were shut. Since fresh air was one of the primary treatments, it was fortunate that the hospital administrator, Captain Rollie Knight, was an old country man with a green thumb, green enough to get grass and shrubs growing in the sand. In the 1920's and 30's, the treatment for TB was rest, food, fresh air and fun. The nursing problem in the hospital was to keep something happening in an environment where nothing hap­ pened. To try to fill the time for patients who were taking three to five years out of their lives to do nothing. Nurses had to make 285 big productions of cribbage tournaments, parties and garden parties in season. They lived under the same roof with the patients and although they were somewhat cut off from the rest of society, like nurses in the isolation hospitals, the sanatorium had no trouble attracting nurses. The government paid seventy-five dollars a month and it always paid on time. Kathleen Connor was involved with TB for three decades, in­ cluding a short stint as a patient, and joined the staff at Keith in 1936. She was there in 1939 for the first major attempt at TB surgery - taking out ribs. She was there in the 1945-51 period when the introduction of three new drugs plus more complex sur­ gery, reduced the hospital term of TB patients from three to five years down to six to nine months. In the 1950's she was at the Aberhart, in the time when TB became more of a public health, than an institutional, problem. (Fewer and fewer nurses were re­ quired. In 1949 a twelve-week affiliation program was set up for student nurses, but it was reduced to four weeks by 1958 and one week by 1965.) In the 1950's, too, TB was eliminated as a con­ stant threat to the health of nurses in general hospitals. A chest X-ray became part of the admission procedures for all patients, and although this addition to the routine was at first regarded as a nuisance by many nurses, it kept open cases of TB out of gen­ eral hospital wards and ended situations like the one that existed in a large nursing school in the early fifties - when one-third of the class was under observation for TB. Having seen all these changes at close range, Miss Connor observed that the requirements for a successful TB nurse have not really changed very much. Although she now needs more mechanical and technical skill to deal with new treatments, she still has to deal principally with the patient. And although the maximum term has been reduced from five years to nine months, nine months is still a long time out of a person's life. It's hard for a man to settle down for nine months to relax when he's wondering how his business is going. It's hard for a mother to settle down when she's wondering how her family is getting along. Bringing patients around to the necessary mental attitude is still a nursing problem, a problem that can be solved only by a nurse who is interested in people and will take time to know enough about them. When the patient goes home she must often know enough about 286 the patient and his or her home environment to be able to explain to the family that the patient's healthy appearance is deceptive. Looking to the future, Miss Connor predicted that the sep­ arate TB hospital would eventually follow the i olation hospital into oblivion, which will be agreeable to everybody because no­ body needs TB. However there will always be need in some branch of nursing for the RN's who make good TB nurses.

In the golden anniversary year of the AARN some honored branches of nursing were disappearing or bad gone already. Others were growing. One special field that was expanding as rapidly as the older population was geriatric nursing. Its principles and philosophy were still being defined in October, 1965, when I visited a nursing home in Lethbridge and met an early graduate of an Alberta nursing school who was living there. Some days she thought she was a nurse again and would be at work doing things as she had been trained to do them a half century before. She did them very thoroughly. It was very important to be thorough. When dusting a picture it was important to dust the front of the picture, the back, the four edges and then dust the nail. The latter-day nurses agreed with her that this was very important. The historian who will write the hundred-year history of the AARN will be sure to record somewhere, the year in which the University of Alberta school of nursing added a major in geriatrics to the B.Sc. course in nursing.

Industrial nursing was still making slow progress in the golden anniversary year of the AARN. The industrial nurse was given legal status in 1938 when regulations of the Workmen's Compensation Board recommended that a plant employing two hundred people (and five miles from a doctor) have a nurse on staff. However the regulation was put forth merely as a good idea, not a binding necessity, and while few have disputed that a nurse on staff is a good idea, few have acted on it. After twenty-eight years there were only about fifty industrial nurses in Alberta, although the big hospitals were doing their bit to promote the idea by having a nurse for their own staff members. The first appears to have been Mona Sparrow, the student­ day-diver from Holy Cross, who was engaged by the Hudson's 287 Bay Company retail store in Calgary in 1930 and served there for thirty-three years. The Workmen's Compensation.Board itself hired a nurse in January, 1945. She was Barbara Graham (Mrs. Walker), a Royal Alex grad of 1943. She did private duty after graduation while she looked for a nursing job in which she could show initiative. The opportunity came when she was nursing an American engineer in Edmonton. Her patient was a friend of the chairman of the compensation board. The chairman called her in for a talk and she was hired. Her first job was to go around to factories checking first aid kits and lecturing on first aid. Then her duties were raised to liaison work with industrial nurses and selling other employer on the idea. In 1966 Mrs. Walker was still on the job, patiently wearing down employers with statistics that showed the benefits to a com­ pany of having a nurse. The board was then recommending a nurse for 150 employees but engaging a factory nurse continued to rank with getting out of bed on a cold morning or filling out income tax forms. Late in 1965 one large company had an office all fixed up for a nurse but the plan was postponed again when a department took on more staff and needed her space. But eventually there would be a nurse in that company. Even­ tually there would be more in others. The inevitable happens sooner or later.

The extent of what Alberta nurses might achieve in the future was in their past record. In that record, one achievement alone suggested that there were no limits. It resulted from three nurses working independently towards a similar goal and from similar motives. In overcoming a personal sorrow, each recognized and exploited an opportunity that could only be seen by a nurse who was also a mother. Winnifred Stewart, Christine Meikle and Dorothy Gooder each had a retarded son. In each case their efforts to help their own children led to schools for the training of other retarded children. The schools were in Edmonton, Calgary and Lethbridge and were named for the pioneering nurses. And the collective result of their work was a wider public (and official) understanding of retarded children. Mrs. Meikle was not a graduate nurse. She dropped out of Montreal's Royal Victoria after two years to be married but many 288 old-time alumnae of the celebrated school would be ready to argue that two years at the Royal Vic were worth three at some lesser places. Mrs. Gooder, the former Dorothy Ottewell, gradu­ ated from Holy Cross in 1940 and Mrs. Stewart from Edmonton General in 1929. Mrs. Stewart began the work first, shortly after the birth of her retarded son, Parker, in 1935. She wrote of the beginning: "Being a mother of a retarded child I always thank God that after my son was born I did not go through the anguish and suf­ fering that most mothers do. As I was not privileged to have any other children, I felt that Parker bad been given to me for a very special reason, and my attitude from the very beginning had to be, 'What can I do for this child that I love, to help him be the very best of what be is capable of being?' " Putting it from the nursing point of view she wrote: "A true nurse does not sit down and cry when a situation arises. She is immediately alert and thinks 'What can I do about this to make it the best of what it can be?' " Combining these attitudes with her nursing knowledge, Mrs. Stewart devised exercises for her son which helped bis coordina­ tion. She stressed motor control activities in the belief that a healthy body helped stimulate a healthy mind. For years she worked alone because there was no society to turn to for help. She studied methods of teaching in the primary grades and tried to apply them to teaching Parker. She accepted his retardation as a disability, and felt that her knowledge of the symptoms of many disabilities, learned through nursing experiences, gave her a better understanding of why a child would act a certain way under certain conditions. Later on she would try to pass on this understanding to teachers in the Winnifred Stewart School. The incident that sparked the school was a visit to the office of A. Venmore-Williams, secretary of the Rehabilitation Society for the Physically Handicapped. This was early in 1953 when Parker was approaching eighteen and Mrs. Stewart was looking for some useful aspect of the handicapped program that she might adapt for him. The secretary told her there had just been a couple in the office with the same problem. He suggested that she start a society, and the first meeting was held in her home on February sixth, 1953, with six parents and four interested people. 289 The meeting decided there must be a school. An ad was placed in the J oumal to locate parents with retarded children. On March sixth, a general meeting was c~ed with sixty people present, and the first classes started on April sixth in the old Recreation Building on 1 OOth Street. There were twenty-five children in April. By August there were forty and plans were made for a specially built school in the west end. In April, '54, Mrs. Stewart spoke to a committee of the legislature about the program and the govern­ ment agreed to pay half the salaries of the teachers. In September, 1955, a $155,000 building was ready for sixty-five children. Fa­ cilities and enrolment continued to grow and at the time of writing, the school named in honor of the nurse who brought it about, had 278 children, a staff of fifty-three and nine buses. In Calgary, Mrs. Meikle's son, Roddy, was born in 1946. Like Mrs. Stewart earlier, and Mrs. Gooder later on, she made the exciting discovery that her retarded son could do more than expected if he was taught with patience and understanding. When Roddy was three-and-a-half she began a campaign to find advanced help for him. She went first to the Calgary public school board to see what the schools had to offer and was told about slow learner classes. But Roddy was obviously going to need something differ­ ent. Then she tackled the provincial government and the minister of health thought it was probably a matter for the department of education, and the minister of education thought it was probably a matter for the department of health. Mrs. Meikle also wrote letters and she got the most encouraging responses from Dr. Jerry Weingold who ran a residential school for the retarded in Vineland, New York. Dr. Weingold's advice was to get something started. Unless some one person got something going, nothing could be done. So she arranged a public meeting for May twenty-first, 1952, in the Board of Trade rooms and was surprised to have forty people tum out. They formed the Council of Parents for Retarded Children, with Mrs. Meikle as president. Classes for six retarded children began in Mrs. Meikle's home at the end of January, 1953, and by the end of June there were twenty-two coming in two shifts. In another year there were fifty­ four children in the program and the school was in a house on Sixth Avenue West provided by the Junior Hospital League. In 1957 the provincial government built an eight-room school. By 290 1964, enrolment had grown to 278 and a second school was opened in southwest Calgary.

In Lethbridge the work began with Mr . Gooder's son, Ronald, who was born in 1950. Mrs. Gooder was told early of her son's limited potential but found that with a little encouragement he could be taught to do much more. She got the inspiration to broaden her work in 1955 on a visit to Calgary. In the Calgary Herald she read an editorial praising the program of the Christine Meikle School. She called on Mrs. Meikle, saw the school, and returned home so encouraged she went to the Lethbridge Herald and Radio Station CJOC seeking help to start a school in Lethbridge. Support from the news media was complete and immediate. In February a public meeting was called for the Gas Company Auditorium. More than a hundred people came. Two board members from Calgary described the civic support that would be necessary and in April '55 classes for five retarded children began in a school recreation building. In 1958 a special school was built for the program and was named for Dorothy Gooder. In 1966 there were forty-five children in this school and the idea was spreading. There were schools in Medicine Hat, Camrose, Red Deer and Sherwood Park and asso­ ciations in Hinton and Drumheller. An idea that started with three Alberta nurses had become an active province-wide campaign and the time had come to assess the results from a viewpoint that no one had dreamed of at the beginning. Dr. Henry Ziel, of the Uni­ versity of Alberta, was planning a research project to see whether graduates of this special system of education could work in in­ dustry - doing semi-automated jobs in a sheltered environment. In the heritage of service built by the nurses of Alberta, it is hard to find anything finer than this. It is perhaps the Alberta nurse at her best. Seeing a need through the knowledge and spirit of her profession; and then, through that knowledge and spirit de­ veloping a program to meet it; and then carrying it through - not in a dramatic dash but over a long, long grind. And in the modern age too. In earlier times of official indifference, nurses had ideas because officialdom didn't bother. But in the age of official enlightenment and concern, these nurses beat the govern­ ment to a good idea. And the government showed its sportsmanship by giving the idea full support. 291 In Alberta nursing's heritage of service, this is an achieve­ ment difficult to equal. Of all the special fields, it is perhaps the most special.

292 CHAPTER TWENTY-THREE The first graduating class at Lethbridge St. Michael's contributed to a long tradition of Alberta nursing. One member of the class of '56 was a missionary nurse. Millie Hagel served in the British West Indies; her sister Marie, a later St. Michael's graduate, worked in the Caribbean. In service to areas of the world that need nurses with missionary spirit, the Hagel sisters and many other Alberta graduates, have repaid the debt which Alberta owes to the nurses of its own missionary days. In fact, this province had not yet outgrown its missionary needs when Laura Allyn began her long career in India. Miss Allyn was a Royal Alex graduate of 1917. Her interest in India began in childhood when she won as a Sunday school prize the book The Life of William Carey. Carey's story of girl babies being thrown into the Ganges to the crocodiles, haunted her. As she wrote many years later from her mission training school in India: "I wanted to do something about keeping those crocodiles from being so well-fed." Laura Allyn entered the Royal Alex in 1908 but had to drop out of training to nurse her sick mother. She started again and then had to drop out because of her own illness. While recovering, she had a chance to visit India with her sister, Dr. Jessie Allyn, and she wrote of this experience: "One day while I was there a poor Christian man and his wife came to the bungalow. We were at our dinner but my sister and her nurse co-worker went out to see the patient, and because of the pathetic wails I went out to see what was going on. There sat the mother stricken in her grief because of her ignorance. Her baby was dying because she had done as she was told and allowed someone to sear great scars on the baby's abdomen to relieve colic pains. Only in such a way could the evil spirits get free, she was 293 told. Such ignorance . . . a nurse would have the instruments in her hand to deal with such an emergency. Hence I hastened back to Canada and entered training again ... and graduated from the Royal Alexandra Hospital in 1917.'' She went to the Canadian Baptist mission hospital at Pitha­ puram in southern India. In 1922 she was superintending a school of nursing for Indian girls there, and in 1934 was joined at Pitha­ puram by another graduate of the Royal Alex, Enid Morrison. Laura Allyn remained in the field until the 1950's. The class of '23 graduated an outstanding nurse to the African medical missions. She was Florence Mahaffey, whose missionary activities began on the evening of October ninth, 1926. At six p.m., in Knox United Church, she married Kenneth H. Prior, a graduate in theology and agriculture from the Univer­ sity of Alberta. At eight p.m., Mr. Prior returned to the same church to be ordained into the ministry. At nine p.m., he received his commission as a missionary and at eleven p.m., the Priors left for Africa. They were gone twenty-eight years and returned in October, 1954, to receive honorary degrees from the University, the first couple ever so honored. Their first twelve years were spent at Angola, in Portugese West Africa, where Mrs. Prior requisitioned an old warehouse and put to practical grassroots use the skills she had learned in three years' training and three years' staff work at the Royal Alex. She converted the warehouse into the Ndondi hospital. The next sixteen years were spent at Asaba in Nigeria, where Mr. Prior ran an agriculture school modelled on the one at Olds, and Mrs. Prior supervised a mission-run nursing school and wrote a textbook for Nigerian nurses. It was titled: Practical Nursing Procedures for African Nurses. Mrs. Prior, in the golden anniversary year of the AARN, was one of six nurses with the title of Missionary Life Member in the Royal Alex alumnae association. The title comes with twenty-five years' service in medical missionary work. Others in the group were Laura Allyn; Florence Martyn, a 1915 graduate who went to India; Florence Adam (Mrs. W. Findlay), a 1917 grad who went to Nigeria; Elsie Gillies (Mrs. J. T. Cook) of the class of '28, who worked in the Hawaiian Islands; Joyce Blair, '33, and Enid Morrison, '34. 294 There are seventeen more on the list: Lottie Toews and Ida Wilkie who graduated in the thirties; Annie Russell, Bessie Find­ lay (Watt) , Gladys Becket (Tuck), and Janet MacDougall from the forties; and from the fifties: Doreen Haglund (Copeland) , Mary Moon, Beverley Redfield (Cheesmur), Iris Schlitt, Maxine Craig, Sylvia Sawchuk, Viola Engstrom, Ruth Eby, Irene Eng­ strom, Gladys Taranger and Margaret Prescott (Fehr). The Royal Alex has attempted a complete list of missionary graduates, from which, nevertheless, some names may be missing. Some schools have very sketchy records of their alumnae and many names which deserve mention do not appear in this chapter. Some will feel that it's unfair to list some names and not all but it would be a greater injustice to Alberta nurses of the mission fields if their story were not told as fully as possible. From this publica­ tion more names may be put forward for a later edition. ·In the golden anniversary year of the AARN, a graduate of Alberta's first school of nursing was working in a leper colony in India. She was Betty Ann Jorgensen of the class of '54. She was the first Canadian to go to the mission hospital maintained by the Lutheran church in the Santipara leper colony in Assam, northern India. She was nursing superintendent of the hospital. Betty Ann Jorgensen, like Laura Allyn and many others, came to missionary nursing through the church. Attending the Canadian Lutheran Bible Institute in Camrose she saw pictures of lepers in India and her decision was made. As she told a re­ porter for the Medicine Hat News when she was home on fur­ lough in 1962: "I was a missionary first and a nurse second. I felt that in bringing the gospel message to the Indian people I would be helping them in both spiritual and material ways." Lillian Prochnau, who graduated from Medicine Hat General in 1958, served four years in Honduras. Irene Prochnau, a Lamont graduate of 1953, went to the Moravian church mission service in Central America. Violet Stelter, a Lamont nurse of ten years earlier, went to Nicaragua with her missionary husband, Reverend John Befus. In September, 1965, she wrote from the Moravian mission church in Puerto Cabezas: "It seems that ever since I was a child I had a deep desire to become a missionary nurse and long before I began training, a scrapbook of our Moravian work in Nicaragua was a pet project. 295 Because I grew up in the Lamont area and highly respected the training school there, it seemed the logical place to study nursing." Although busy raising a family, of which the first daughter was a student at the University hospital at the time of writing, Mrs. Befus was able to help out on the teaching staff of the Moravian mission hospital at Bilwaskarma, which trained the first graduate nurses in Nicaragua. There is also plenty of public health work to be done. She wrote of this: "Though I did little active nursing, there were plenty of opportunities to teach, especially personal hygiene, care of infants, prenatal care and its importance, isolation technique for tuber­ culosis, etc. There were moments of emergency when I was very grateful for our fine training in a small hospital like Lamont. For example, a child came running to ask my help immediately because their baby was having violent convulsions. The mother was hysteri­ cal so a neighbor's wife assisted in preparing hot and cold alternate packs. After the baby recovered, the mother admitted she had never given the child any worm medicine, so I suggested she get some immediately and give it to the boy in the morning. Several days later she reported excellent results, her baby passed 'plenty worms' and didn't have any more 'fits'. There are many types of parasites here and we take medication routinely every six or eight months." Vera Boyd, a Lamont grad of '28, went to India as a mis­ sionary for the United Church of Canada. She spent many years there and during the second war was given India's high-ranking award, the Kaiser I Hjnd Medal. The first Lamont graduate to go to the mission fields was Ada Sandell, of the class of '22. Miss Sandell spent thirty-five years in Korea. She came all the way from Magog, Quebec, to study nursing at Lamont because she had volunteered for mis­ sionary work with the Methodist church and Lamont was the only church hospital with a school of nursing. Miss Sandell arrived in Korea in April, 1927, and her long missionary service there covered the progress of nursing educa­ tion from something only widows and deserted wives could enter, to a profession recognized by degree programs in four Korean universities. In 1929, Miss Sandell was at the Canadian mission hospital at Hamheung in the north. The forty-bed hospital was full all the 296 Alberta missionary Elizabeth Petkau, with customers at Mennonite nursing clinic, Nuevo Ideate, Mexico. Miss Petkau smiles for the baby while mother smiles for the camera

Jane Megarry with Indian girls at a summer camp at Waterton Lakes, about 1930 The Camsell Hospital in 1945. Handwriting is Dr. Lynn Falconer's First nursing aide graduation, October 1946

In front: Marion Dickson, Muriel Currie, Maybelle Calgon, Mary Moon Standing: Margaret Carney, Sally Jordan, Mabel Olsen, Louise Hawkins, Patricia Neilson, Agnes Short time and the nursing staff consisted of three missionary nurses, plus a young man orderly and two Korean widows who took turns at day and night duty in the women's ward. In November they at­ tempted to recruit six Korean girls for a school of nursing. They got four but one soon quit because she bad one more year of education than the others and would have lost face if she had con­ tinued with girls of less schooling. The hospital staff tried to ac­ commodate local custom as much as possible but the custom of the whole family of a patient coming and staying the night in bis room was not much help to the patient or the student nurses. The going was slow but the public gradually accepted the idea of leaving at nine p.m., the students made progress, and the next class, or­ ganized in 1930, attracted five girls. The first class graduated on March twenty-eighth, 1932, and people came from all over the province to see the ceremonies - the first in northeast Korea. Miss Sandell's last five years in Korea, 1957-62, were spent on "medical evangelism", a sort of Korean version of the Alberta district nursing and travelling clinic service. In 1965, Jiving in re­ tirement in Magog, Quebec, Miss Sandell wrote: "My training in Lamont gave me the right foundation for the work I tried to do in Korea. Being a church hospital we never had too much in the way of supplies and had to do a Jot of scrounging. Therefore it was not too much of a shock to find the same Jack in the hospital in Korea. "Nursing is now on the university level, there being four uni­ versity schools of nursing. No longer do parents refuse to let their daughters enter these schools, for, far from being the lowest form of occupation, it is now a respected profession and high school graduates flock to gain entrance to the classes. Now that I am retired after thirty-five years in Korea, I like to think that I had a little bit to do with bringing this about."

The Holy Cross has records on three graduates in missionary work. Helen Hourihan worked in the British West Indies. Others were Daisy Forelle and Mrs. Catherine Ball. And while the great state of Arizona might not appreciate being designated as mission country, Holy Cross graduate Blodwin Cole (Mrs. Earl Thode), had an unusual influence on health service in that state. She served several terms as a state congressman and in 1964 ran for state senator, topping the polls. Mrs. Thode brought her influence to 297 obtaining a children's hospital in Phoenix, a T.B. sanatarium in Tempe and a general hospital in Casa Grande. There is apparently no place so well-equipped with healtp services that an energetic Alberta graduate cannot improve on them. Calgary General has a record of fourteen missionary gradu­ ates - from Ella Foerstel, '24, who went to Japan and the Philip­ pines, to Sandra Falck, '59, who went to the Punjab. In between, Lucy Cooper, '30, worked in a medical center in south India. Ursula Burrows, '32, who, in 1966, was home on leave from her leprosy hospital in Maharashtra, India. Christina Lund, '32, who went to the Sudan Interior Mission in Ethiopia, and had the rare honor of being presented to Emperor Haile Selassie. Miss K. V. Metheral, '40, went to India. Winnifred Gray, '42, worked in the East Punjab. Florence Pletsch, '44, worked in a hospital in south India. Mrs. William Pietsch, '46, went with her missionary husband to West Pakistan. Irene Boris, '47, served five years in British East Africa. Gertrude Schatz, '50, went to Africa.Jone Feckley, '54, went to Nigeria. Elva Clapp, '56, worked in south India. And Winifred Frost, '59, was working in New Guinea. Miss Lund's letters from Ethiopia gave the alumnae some vivid pictures of her life there. Pictures not only of poverty but of the primitive. Pictures of heat, dust, rocks and grass. Of crawling into a mud hut to treat an ailing girl and then finding that the doors bad been tied shut by the grateful mother so the nurse would not leave until she had been given refreshments; of waiting inside for two or three of the hottest hours of the day and then being brought lunch in a basket sealed with cowdung and tea and milk in gourds that had been rinsed with cow's urine. As late as 1962 there was no hospital in Miss Lund's entire province and only three other whites. She wrote at this time: "I go out on two or three-week medical treks periodically to a village a day's journey from here, by mule. I rent a native house for myself and one for the clinic and we are extremely busy. We hope to have a motorbike soon so we will be able to travel more easily. So far our roads are very primitive but as in other things, much progress is being made." Ella Foerstel, the earliest Calgary General graduate to under­ take missionary life, went to Japan in 1934 with the American Episcopal Church. There she worked for seven years as O.R. 298 supervisor in a modern medical center in Tokyo. Then the immi­ nence of war forced her to transfer to the Philippines where she worked fourteen years in the most primitive conditions. Miss Foer­ stel wrote of her experience: "I arrived in the Philippines September eighteenth, 1941, and the war broke out December eighth. It is hard to believe but the bombings and destruction were actual. I was interned in Santo Tomas internment camp in Manila with four thousand others. These were years well to be forgotten except that I was never so thankful for my profession. It was one's life-saver to be kept busy and have others to think about. I lost sixty pounds. "I was repatriated in May, 1945, but returned again to the Philippines to try and serve those who had done so very much for us all during those war years. By this time I almost liked the heat and bugs. "There was much reorganization in our small hospital and we were so very busy as most of the hospitals had been destroyed, but this was all challenging and I continued my surgical nursing. How­ ever, having been an O.R. nurse for twenty-five years, and with the strain of the war years, I thought it well to make a change. I asked to be transferred to one of our out-stations and then began the most challenging and inspiring work I ever did. "It was two days by bus from Manila and then a twenty-five mile hike through jungles and forests to Balbalasang, Mountain Province, where the mission had a small dispensary. I had a few visitors each year; otherwise it took me three days to see another white person. But I loved these primitive folk and found they had much to teach me too. "After four years in Balbalasang, and on this cheerful note I came home on furlough to meet my good friend's brother to whom I was married after twenty-one happy years in the mission field." (The brother was Mr. W. L. Paddon.)

Not every nurse who works in a foreign country with meager health services can be classed as a missionary, but most who go to these countries have motives in common with the nurses in the village clinics and jungle nursing stations, motives more elevated than those of mere employment. Working with the World Health Organization, Alberta nurses have done organizational and research work which is a follow-up and logical consequence of the efforts 299 of the field nurses. As this was written, Rae Chittick was in the Congo on a project for WHO. In the 1950's, Kathleen Durrell, a University B.Sc. nurse of '47, was in .Bombay with a WHO team, conducting courses for Indian nurses on the operation of nursing schools. A spirit of adventure is also part of the missionary spirit and it was displayed by Margarita Reed, a University diploma graduate of '29, who, in 1936, was one of the first Canadian nurses to go to South Africa on a commonwealth exchange program promoted by the CNA. It was similar to the teacher exchange program in which teachers traded jobs. Miss Reed, an obstetrical nurse on the staff of the University Hospital, traded with a South African nurse and then remained in South Africa and later married there. About ten University Hospital graduates are known to have gone into missionary work, the first being Frances Buckles, '39, who went to India with the United Church and in 1966 was super­ intendent of nurses at the mission hospital at Indore, Madylda Bharst. Grace Hoppe, B.Sc. '44, went to Honduras in the Moravian service with her missionary husband. Dr. Sam Marx. After twelve years in Honduras they transferred to Nicaragua and at the time of writing, Mrs. Marx was still in active nursing. Doris Haslam went to Brazil to the Hospital Evangelic at Anapalis Garas. Ruth Ingram and Mrs. Myrtle MacDonald were missionaries, and Catherine Pitman Smith, '60, spent some years in Thailand. Although the Provincial Mental Hospital at Ponoka has graduated small classes, two graduates have done mission work. Eleanor Stark, '46, went to India with the Baptist Church in 1955 and was still there at the time of writing. Doris Schultz, '51, spent some ti.me in the Malay States. The Misericordia has records on only three of its missionaries although there are believed to have been more. Ivy Noonan, '55, studied Tagalog, a Philippine dialect, and went to the Philippines with the Overseas Missionary Fellowship Board. Two 1962 gradu­ ates, Mary LeClair and Marie Germin, went to Dominica in the British West Indies as lay aspostles in the social and medical center of the Mission Sisters of the Immaculate Heart of Mary. Germaine Quilichini, an Edmonton General grad who went to South Africa with the army, married aviator Peter Strong and stayed in Africa for some years after the war, found constant de­ mands on her knowledge of nursing. At one remote place where 300 her husband was operating an airline she used to perform first aid on tribesmen after drinking parties which featured native beer. The Strongs would see the parties going on across the river from their house and know there'd be native gentlemen with hangovers and wounds calling the next day. Mrs. Strong couldn't help much with the hangovers but she cleaned up and stitched many wounds that would have become infected. Her nursing saved the life of her three-year-old daughter. One Christmas in Natal, the little girl was bitten on the foot by a night adder. Maintaining professional calm in the face of rising parental panic, Mrs. Strong was able to inject serum from the "instant" snakebite kit and cut away the bitten flesh within five minutes. Two postwar General grads, Jane Wedman, '48, and Lorraine Sampert, '50, went to Honduras with the Moravian missions. Miss Sampert (Mrs. R. Riske) spent three years at Auas, a village cut off from the main part of the country by a high mountain range and accessible only by coastal steamer or the airplane operated by the mission service. Before going to Honduras, she spent two years at the Camsell and was surprised to find the Indians of Auas were closer to the Eskimos in temperament. The mission was a sort of outpatient clinic, from which she would go out to do public health work in nearby villages. There were no roads, only footpaths, and she was always careful to start home early enough so she wouldn't be walking the jungle trails after dark. Marylyn Steele, a 1960 graduate, went to Africa for a year with her husband, Dr. Louis Pazder, for the World Health Or­ ganization. Agnes Loiselle, of the same class, became Sister Joseph Andre of the White Sisters of Africa, and after taking special ob­ stetrical training, was in the mission field in the golden anniversary year of the AARN. In the post-war, the Galt school began sending graduates into the foreign missions. Margaret Bums, of the class of '53, went to India with the Anglican Church. Seven others were members of the Mennonite Brethren and went to church missions and nursing stations in Mexico, Cuba, Bolivia, Taiwan, India and the Congo. The first of the Mennonite girls was Nettie Berg, of the class of '45, who worked in the Congo. She wrote a story of one incident in her work in a letter to the alumnae. Here is Nettie Berg's story:

301 "Is Mama Berg not coming let?" was the emphatic, not too patient enquiry of Mama Sona from the case room, directed at the curious women crowding outside the.door. "She is coming, she is coming very fast" they responded in chorus. By then I was trying to wedge my way through the crowd and to close the door securely behind me, much to the disappoint­ ment of those who thus found themselves shut out from the in­ teresting drama inside. In their villages no one was barred from seeing such a common performance as the birth of a baby. Why couldn't they watch? By the light of the kerosene lamp I took in the situation in a moment, even before Mama Sona, the native midwife, had handed me the tiny, lifeless baby. "Oh Mama, it breathed one time and now it doesn't breathe again." At these words big tears glistened down her shiny, black cheeks for Mama Sona was every inch a midwife. A mother's joy or sorrow was always hers as well. "Mama Sona, you tell the women outside to call Laurent to come and give the baby a 'tunga' (injection) right quick. Then you heat some water while I start the artificial respiration. Is the mother all right?" I began. Soon the little lungs were expanding and relaxing regularly and a faint trace of pink gradually replaced the bluish pallor of the baby's lips. My thoughts went back in gratitude to Dr. Madill who had taught me this mouth-to-mouth method of artificial respiration when I was a student nurse at the Galt. "Now you try, Mama Sona." "But Mama Berg, I don't know how. I tried it before you came but the air didn't go in." "Try again. See, you close the baby's nose with this hand and hold its neck up well with that hand, then cover the whole mouth with your mouth, like this. Then you blow." A triumphant smile lit up her troubled face when her second try proved successful. When the baby gave its first breath, closely followed by another, joy knew no bounds. An hour later I was wending my way home down the moonlit path, tired but grateful that mine was the privilege, the difficult but wonderful privilege, of being a missionary nurse in the African jungle.

302 Following Nettie Berg, among the Mennonite miss10naries graduated from the Galt, was Mary Willms, '49, who went to Santa Cruz, Bolivia; Helen Toews, '50, who went to the Congo; Helen Willms, '52, to Taiwan; Helen Barg Reimer, '53, to Cuba; and Helen Dueck, '54, to India. The last, Elizabeth Petkau, '57, went to Mexico. Elizabeth Petkau was born November ninth, 1934, in a depression-struck two-room house in Waldheim, Saskatchewan. She grew up on a farm near Vaux.hall, in southern Alberta, where her family moved in 1937. She began her nursing as a teen-ager when she dropped out of grade eleven for a year because of the illness of her mother. Finishing high school she entered the Galt school in 1954 to become a graduate nurse. She was a cheerful, but shy and timid person, and compared leaving her family to a Gethsemane experience. However, she had a strong sense of purpose and gained strength from her association with her church. Like many people who are unsure of themselves she would seek a quotation from a hymn, scripture, or a poem, to express her own ideas. She graduated from the Galt in 1957. She spent three years at the Mennonite Brethren Bible College, worked at the Taber municipal hospital and the Bethesda home at Vineland, then volun­ teered for the missions. She studied Spanish in Costa Rica. On September twenty-fourth, 1964, she was commissioned by her own church at Vaux.hall and went to the Mennonite clinic at Nuevo Ideale, Mexico. All doubt and misgiving overcome, she was be­ ginning a life of a missionary. Four months later, age thirty, Elizabeth Petkau was dead. It was the bite of an insect, a fly carrying anthrax. Working where a common household bug can be more dangerous than the wildest beast or vilest reptile, she had faced the risk taken by all nurses who go out to repay the debt owed by Alberta to the nurses of its own missionary days. She had taken the risk and lost. She knew it was there and was not deterred. Her grave in Durango City, Mexico, is not a symbol of death but of life at its full meaning.

303 CHAPTER TWENTY-FOUR The modem era of nursing in Alberta began on November thir­ teenth, 1945. On that date, in the former air force wireless school on the north hill in Calgary, there opened the first course for cer- tified nursing aides. This was the first step in a trend that would cause the re- structuring of nursing; a trend that would lead to the AARN telling the provincial cabinet in 1964 that nursing is no longer synonymous with nurses; a trend that would result in twenty-two people a day coming to the bedside of a hospital patient with only three of them being nurses. Twenty years later the program would be turning out six hun- dred certified nursing aides a year from schools in Calgary and Edmonton, but at the start it was not recognized as anything significant; no more significant than any other post-war training course for veterans intended to last eighteen months. It was set up to be temporary, and give girls who had been medical attendants in the army, a comparable trade to take into post-war civilian life. But the full implications of the post-war were but dimly realized in 1945, and the program became permanent. And a permanent credit to Alberta nursing. It started with Joe H. Ross, regional director of the Canadian vocational training plan - for veterans re-entering civil life. There had been requests from former medical attendants for a course that would help them make use of their army experience. To or­ ganize the course Mr. Ross enlisted two nurses who had served overseas with casualty clearing stations. They were Frances Fer­ guson, Royal Alex '38, and Irene Ritchie (Mrs. Theakson), a Cal- gary General graduate. On November thirteenth, Miss Ferguson and Miss Ritchie moved into a wooden barracks hut that had survived the war in 304 scarcely better shape than some buildings in the battle zone. (When a demonstration stove was set up in one corner the floor collapsed under it.) They shared space with training programs for plumbers and painters, and they operated under no less than four branches of government: the federal departments of labor and veterans affairs and the provincial departments of education and health. When the veterans finished passing through in 194 7, the first three departments phased out and the program became the permanent and growing responsibility of the department of health. Sitting down to work out the first program of its kind for nur­ sing aides, Miss Ferguson and Miss Ritchie worked in the logical direction. They worked backwards. They decided first what a nur­ sing aide was, and then worked backwards to a program that would prepare her for the role. 1bey decided that a qualified nursing aide would be able to work in either the hospital or the home. To work in a hospital, she'd need some nursing and first aid; to work in a home, she'd need some knowledge of cooking and home management. From these basic, practical premises they laid out a nine­ month course to open in January, 1946. Former medical attendants came from across Canada to take it because it was the only one, and the first student to enroll was Louise Hawkins who rose to the position of executive housekeeper at the University Hospital. The first affiliations came slowly as hospital authorities were unsure how to work the aide trainees into staff patterns. But they were accepted at the Central Alberta Sanatorium at Keith, and then at the Colonel Belcher, and then at the Red Cross Children's Hospital. As the post-war need dictated the continuation of the pro­ gram, many Alberta nurses contributed ideas to the concept of the role and responsibilities of the nursing aide. Rae Chittick, Elizabeth Bietsch, Kathleen Connor, Sister Leclerc, Florence Reid, Ann Hebert, Jeanie Clark, Margaret Shaw and Loretta Shantz were some who participated in the permanent floating forum on the subject. As the chronic character of the post-war R.N. shortage be­ came more apparent, nursing aides were accepted as a permanent addition to hospital staffs. When this happened, hospital authorities then saw the advantages of a central school where aides could be trained to work in any institution; a great improvement over on- 305 the-job training in the system of a single hospital. Hospitals began giving their ward aides leave of absence to take the course. The new certified nursing aides (the term 'certified' was added when provincial legislation granted certificates) could do more things than the old - style ward aides. They could free registered nurses for duties the new age was requiring, and as their numbers increased, there evolved the concept of the nursing team. The nursing aide program made a new pool of people avail­ able for nursing because the educational requirement was lower and the age limit higher than for a registered nurse. At the start, the maximum age was forty but that soon disappeared and physi­ cal and mental fitness were the only requirements. Some women in their fifties were very successful. There were two mother-and­ daughter teams in early courses. The grey uniform, with the white apron and armband, and the grey cap with the white flashing, be­ came part of every hospital scene in Alberta. By the golden anniversary year of the AARN, the two schools for nursing aides were turning out six hundred a year, about the same number of registered nurses as were graduating from the twelve schools of nursing. In the early years, an opportunity to start a program for male nursing aides was missed by the provincial government. In Holland and Belgium, with Number Six Casualty Clearing Station, Miss Ferguson had worked with many soldiers who were out of the battle line temporarily. She had seen the good work they did and knew male nursing aides would be useful for work in urology and other special areas. She worked out a program for male nursing aides, complete to arranging affiliation with hospitals, but the government did not act on the program and the opportunity was missed. But the other program grew steadily, and after Miss Ferguson went off to Ceylon in 1955 to start a similar program under the Colombo Plan, a second school was opened in the old Garneau high school in Edmonton. By this time the shortage of nurses had been accepted as permanent - and the AARN had recognized the implications of this permanent shortage. At the annual convention in 1955 the AARN recognized the existence of "the nursing team," with a panel discussion arranged by the institutional nursing section (Jessie Morrison, chairman). 306 The chairman of the panel, Margaret Street, opened the discussion showing a chart of the simple hospital ward situation of 1900, and then another showing the ward situation in 1955- a complex setup in which "many persons have now come to share in service to the patients". A spokesman for each of the groups involved in the new ward situation then spoke on his or her duties. In addition to registered nurses there was a ward maid, Mrs. Hilderman; a ward aide, Miss Inge Lemke; a ward clerk, Mrs. Margaret Clements; a certified nursing aide, Miss Hilda De Pass; and an orderly, Mr. Charles Crowburst. The panel was one of the earliest illustrations of the point that nursing was no longer to be synonymous with nurses.

There should be little surprise in the fact that people took so long to realize that the post-war shortage of nurses wasn't like the post - war shortage of apartments or electrical appliances. The shortage was contrary to all logic, or at least what would have appeared logical in 1935. In 1935, when a capable graduate of Medicine Hat General was working as a waitress because there was no market for the skills she bad learned, think what would have happened if you had gone to an expert and told him you had some advance in­ formation on the future. You could tell him some definite facts about the future and you'd ask him to sketch in the rest of the future from these known facts. If you'd been able to tell him that something called "wonder drugs" were going to eliminate the watching and waiting over in­ dividual patients that bad been the chief connotation of the word, 'nursing'; and if you had told him that auxiliary personnel would hold half the jobs in hospitals; and if you bad been able to tell him that sick people would be spending only half as much time in hospitals, the expert would have predicted that nurses would be obsolete in a dozen years. He would have predicted with dead certainty that nursing would be a shrinking profession, offering almost no hope for a girl who fought her way through the three-year training period. Even if you'd been able to tell him that by 1947 nurses would be working eight-hour shifts instead of twelve, he would still have recommended that all but two nursing schools be closed because 307 the graduates wouldn't be needed, and he would have recom­ mended a study of other uses for the hospitals that would close. The expert would have been in~gant if you'd told him the exact oppos•ite would happen, but it did. And by 194 7 there was such demand for nurses that the Canadian Press reported the Cen­ tral Alberta Sanatorium was thinking of bringing in twenty Polish nurses from refugee camps in Europe. The same report would say there was a possibility of Canadian hospitals importing three thousand European nurses altogether. Mrs. Arthur Stonhouse, who will be remembered from Chap­ ter Ten, noted the demand for hospital nurses as she travelled around the province with her husband. In the post-war decade he was doing assessment projects in different areas and would locate in towns for periods of weeks or months until a project was con­ pleted. Where thirty years before it had been a farmer neighbor arriving with a lantern in the middle of the night who appealed to Mrs. Stonhouse to come and help, it was now the matron of the local hospital. Sometimes the Stonhouses would be in their new hotel only an hour before the phone would ring and the matron would be asking her if she could possibly help out at the hospital. In one town she worked until the morning of their departure. Everywhere they went they saw new hospitals under construction, and older ones being expanded. It was to take even longer for people to realize that hospital construction, like the nursing shortage, was also to be chronic. In 1950, this writer attended a meeting of the Edmonton city council at which a representative of the provincial government tried to talk the council out of extending the Royal Alex. He said they wouldn't need it. With the government taking such an interest in hospital con­ struction, and supplying such handsome grants with its new oil money, and studying the needs of communities, and trying to be helpful with its new oil money, it was obvious that the new hos­ pitals would be bigger, better and more fully-equipped than before. It was also obvious that with hospital construction buttressed by such guarantees and security, the old-time adventure would go out of it. However, the adventure of old still popped up in places where development came too fast for orderly procedures. It happened around Hinton in the mid-fifties when the North Western Pulp & 308 Power Ltd. moved into Hinton. As Dr. Ian Reid recalled the boom: "In 1955 well over a thousand pulp-cutters were cutting pulp (and themselves) in the bush. In late November Mrs. Mary Eagles, R.N., came to work out of a first-aid station, eight feet by ten. For two years the two ends of town fought each other over the location of the hospital. Meanwhile the company clinic was set up like a five-bed hospital. The nurses (Margaret Reis who succeeded Mrs. Eagles and Ethel Dragland who came after her) had to do a lot of treatment themselves and did it very well. There were many lacerations and broken bones. There were many sore heads and upset stomachs. At long last (in 1957) a site was chosen but it was too late to do much before winter."

The number of registered nurses increased. It increased by three-and-a-half times while the population of Alberta was not quite doubling. But it wasn't enough. In 1947, when a fire in the Northern Hardware Building drove the AARN office to new quarters in the Reynolds Building, on 102nd Street south of Jasper, and Mrs. Clara Van Dusen began a thirteen-year term as executive director, there were nineteen hun­ dren active nurses among the seven thousand registrations. In 1953, when the office was moved across Jasper Avenue to the Jackson Building, there were 2,686 active. In 1958, when the Association moved into a new hundred thousand dollar building of its own at 10256 - 112th Street, and Lottie Hunter, one of the founding twelve, cut the ceremonial ribbon, the list had grown to four thousand active, with fourteen thousand registered. In 1960, when Mrs. Helen Sabin, a graduate of the Univer­ sity of Alberta degree course with public health experience, suc­ ceeded Mrs. Van Dusen, there were 4,382. At the start of the anniversary year, there were 63 hundred active among 21 thousand registered. An increase of 350 percent. Not nearly enough to meet the needs of a population that increased less than a hundred percent. The news that the nurse shortage was incurable was broken in 1949 by Rae Chittick, then an assistant professor of education at the Calgary branch of the University. Midway in 1949 she made a study of nursing services in Alberta for the Alberta health sur­ vey committee and pointed out the problem. Other post-war short- 309 ages could be cured by shifting production from tanks to refrigera­ tors, but it wouldn't work with nurses. The schools had been producing nurses at full capacity thr

It was realized only gradually that the best source of nurses to make up the shortage was to be found in the profession itself - among the inactive members. In 1949, Miss Chittick reported that in the previous year, forty-five percent of the nurses who had left the profession had done so to get married and there was no sug­ gestion that these nurses were anything but lost forever to the profession. But attitudes towards married nurses changed. They changed first in the towns where the matrons of hard-pressed muni­ cipal hospitals, who couldn't compete in the hiring of free agents, recruited married nurses living in their towns. By 1963 the Scarlett report found that fifty-three percent of active nurses in Alberta were married, and by 1966 some estimates placed the figure as high as sixty-five percent. Married women were being accepted by schools of nursing and being granted pregnancy leaves. By this time the AARN and several hospitals had programs to help in­ active married nurses to return to the profession. The beginning of reactivation as an official policy of the AARN may be dated 1958. In that year the executive of the AARN asked Sister Mary Geralda of St. Mary's Hospital, Cam­ rose, to write an outline of a refresher course that could be spon­ sored by local chapters of the association to help nurses in their districts return to work. The association had become aware of a growing interest among inactive members, some of whom wanted to keep up with new developments in the profession, and some of whom wanted to return to it. Refresher courses had been one of the first objectives of the AARN more than forty years before. In preparing the outline it was recognized that continuing education is a responsibility of the professional association, and that reorientation is a responsi­ bility of the employer - in most cases, a hospital. The course could serve as a refresher only, or could lead to re-entering active work. In sponsoring a course a local chapter would usually ar­ range for nurses wanting to work again to have the necessary clinical experience at the local hospital. 311 Sister Mary Geralda, who drew it up, is not to be confused with Sister Mary Gerald, so long identified with St. Mary's. Sister Geralda was operating room supervisor at the hospital. In 1954 she had been elected president of the Camrose chapter of the AARN anc! was familiar with the problems of the returning nurse from the viewpoint of the nurse and of the hospital which em­ ployed her. The course was based on fifteen to twenty hours of lectures which could be taken over a period of two to eight weeks, the shorter the better. There would be clinical reorientation afterwards, depending on how long the individual nurse had been away. In 1961 the bylaws of the AARN were amended to require that a nurse inactive more than five years, spend time working under supervision in an active treatment hospital, and obtain a satisfac­ tory nursing service report, before being return to active status. This is a protection to both nurse and employer. The refresher courses were sponsored by AARN chapters at their local hospitals and by alumnae associations at their alma maters and sometimes the interest exceeded the facilities. This happened in March, 1962, when the University Hospital adver­ tised a course, expecting thirty-five applicants. They got the thirty­ five plus two hundred. The AARN, and the Scarlett committee, said the hospitals themselves would have to take the initiative in the re-recruiting of inactive nurses, and, in the fall of 1962, the University Hospital began its nursing reserve program, the first of its kind in Canada. The nursing reserve idea was later adopted, and adapted, by Ed­ monton General, and Calgary Foothills went into operation with it. The idea was based on the reserve formations of the armed forces, in which former members, some trained at great expense, are able to keep up their skills with part-time participation through the year and a period of full-time practice in the summer. The reserves keep skills up-to-date, give the armed forces extra people to call on in emergencies and also to help out in holiday periods. The idea of applying this concept to nursing originated with Dr. J. D. Wallace, medical superintendent of the University Hospital, and a former air force officer. The nurses who joined the U.A.H. reserves nicknamed themselves "Wallace's Warriors". In starting the program, Dr. Wallace knew there were twelve hundred inactive nurses in the Edmonton area, and although all 312 had family responsibilities which came first, he felt that a woman who had been keen enough on nursing to become an R.N., would regard a chance to return to nursing part-time, the way a former RCAF pilot would regard a chance for week-end flying and a re­ sumption of his connection with the air force. Dr. Wallace described the program as "one means of over­ coming the chronic shortage of professional nurses that interferes with the efficient operation of a hospital". As coordinator of the nursing reserve program, the hospital appointed Mrs. Eva Mack­ lam, a U.A.H. graduate, and the first appeal was made to the alumnae and to wives of staff doctors, many of whom had been nurses. In the first course of seventy, about two-thirds were alumnae. The second course of fifty, was about half and half, and the third course of forty-one, in 1964-65, was one-third alumnae. The program was worked out by a hospital advisory board and a nursing advisory committee. On the nursing committee were: Mrs. Macklam the coordinator; Geneva Purcell, the hospital's di­ rector of nursing; M. Jane Lees, associate director of nursing ser­ vices; Ruth Thompson, associate director of nursing education; Dorothy Taylor and Mrs. Helen Cotter, clinical instructors; Mrs. Margaret Ferrari, a charge nurse; and three representatives of the nursing reserve: Mrs. J. F . Elliott, Mrs. R. A. Macbeth and Mrs. J. C. Dale. The first course consisted of eighteen two-hour lectures, taken one evening a week, plus two weeks of clinical experience taken in the mornings. The lectures were given by the medical and nur­ sing staff, with the doctor' talks all entitled "advances" - in sur­ gery, medicine, drugs and treatment of heart disease. The nurses covered new developments in nursing procedures. The course prompted one student to write a parody on the tune Kansas City. It went: "Everything's up to date in U.H. City, they don't use mus­ tard plasters any more. . . . " The courses finish early in May so the graduates will be ready for summer relief in the hospital. The reserve plan was adopted by the Edmonton General in 1965, on a course worked out by Mrs. Winnifred Reid, director of in-service education. The General course added its own ideas to the problem of bringing inactive nurses back to active level. The forty-four hours of lectures cover advances, but they also provide a basic review for nurses 313 who, in the first course, had been away anywhere from two to thirty-five years. The Calgary Foothills planned to begin 1966 with an inten­ sive refresher reserve course for about eighty applicants, so they'd be ready for clinical experience when the hospital opened its doors to patients in May, 1966. The returning nurses have brought more than technical pro­ ficiency to the hospitals where they work. They have brought dedication. They have also brought maturity, from what might be called clinical experience in life. Their return has been made pos­ sible by two changes in attitude: the first, an acceptance of the married nurse; the second, a willingness by the hospitals to in­ corporate part-time nurses into staffing patterns. And a great im­ petus to the change of attitudes was provided by the boom in auxiliary hospitals in the 1960's.

This boom had its ancestral beginnings in 1958 when the Alberta Hospitalization Benefits Plan came into effect. This plan, combined with the aging of the population, put pressure on hos­ pitals, and in 1961, the government made an attempt to sort out what was happening through the Alberta Hospitals Act. Recognizing the realities of what had happened, the govern­ ment decided there had to be some level of institution between the active-treatment hospital and the nursing home. So it defined, by law, the auxiliary hospital as the step between, the place between the active-treatment hospital where a person needed professional care and the nursing home where he needed personal care. The auxiliary hospital was for people who needed some combination of both. And in Edmonton and Calgary there appeared another step between the active-treatment and the auxiliary, with the Glenrose, and the convalescent rehabilitation wing of the Calgary General. This was the first attempt in north America to define the roles of all nursing institutions in a province-or-state-wide area. It had a marked effect on nursing, especially in the newly-defined auxiliary area. In these hospitals the R.N.'s gave treatments, medi­ cations and dressings and were on call in emergencies, but the bedside nursing was taken over by certified nursing aides and ward aides, trained on the job. As this book was written, the full implications of the new wave of auxiliary personnel were not yet known. 314 At the start of 1966, it was estimated there were 9,750 active treatment beds in Alberta and 2,300 beds in auxiliary hospitals. There were 113 active hospitals, 25 auxiliaries and 30 nursing homes, plus nine provincial institutions. The auxiliaries had round­ the-clock nursing service, the homes had one nurse on staff. In the Allan Gray Auxiliary Hospital in Edmonton, there were fifty beds, with a duty staff of five R.N. 's and seventeen certified nursing aides and ward aides. Aides ciid the bedside nursing - bathing, feeding, walking and turning - for people with arthritis, terminal cancer and advanced sclerosis, and assisted in physio­ therapy. It was repetitious work requiring character and personality rather than technical training and had in it much of the personal quality of nursing of an earlier day. As nursing is a response, this was the response to people living longer. The creation of the auxiliary hospitals was a government "command decision" in which nurses had little say if any. But as this was written, the techniques and procedures for nursing in them were being worked out at the local level by the nurses. Here the registered nurse was again working in a leadership role and was a credit to the profession in Alberta.

While re-recruiting inactive nurses proved a necessary factor in meeting the chronic shortage, it was, of course, more important than ever to keep bringing young girls into the profession for even­ tual re-recruitment. A nurse can't be attracted back into the pro­ fession if she wasn't attracted to it in the first place. As noted by Miss Chittick in 1949, many industries were trying to draw from the pool of youngsters with the necessary high school credits. And in the academic year of 1964-65, no less than sixty-five spokesmen for different industries and professions gave career talks to the students of one Edmonton high school. The spokesmen, of course, included one from the nursing profession. In 1956 the Alberta government became the first and only province to appoint a nursing recruitment officer in the de­ partment of health. This appointment followed a two-year experi­ ment carried out with federal funds, to see if active recruiting might improve the calibre of students entering schools of nursing. Frances Ferguson, of the certified nursing aide program, was chosen for the experiment. She worked with "Hap" Aldridge, then director of guidance for the department of education, and went 315 around the province talking to high scbool girls. In this experiment, Miss Ferguson found she had to contend with a Frankenstein of her own creation. The nursing aide.program seemed so attractive that she had to sell girls, who were able, on the advantages of going for the R.N. rather than the C.N.A. Miss Ferguson left for her Colombo Plan project in Ceylon before the experiment was completed but the government was con­ vinced, and in January, 1956, Madeleine Quirk, a graduate of the Royal Vic and University of Toronto, was appointed to the dual post of registrar-consultant for nursing aides, and nursing recruit­ ment officer. Miss Quirk was recruiting until 1962 when she went to Red Deer General as director of nursing and was succeeded by Mrs. Kay Porterfield. During this time, nursing recruitment settled into a spring offensive, with the big push coming in March, April and May, when all the high schools in the province began having their career days. The recruiting talks were given by Miss Quirk when possible, as many as sixty a year, with help at other times from local public health nurses or the director of the nearest school of nursing. Miss Quirk produced a film called, Careers in Nursing, with Ab Douglas as commentator. The scenery was authentic. It was shot at the Holy Cross. The recruiting has been a two-way street, giving the profes­ sion useful intelligence on the attitudes and views of the rising generation on nursing. There is no valid means of assessing the results, either for quantity or quality, and the original object of the experiment was quality. However, between 1949 and 1965, the population of the province ahnost doubled, from 830,000 to 1,500,000. And the number of girls in nursing schools almost doubled too, from 1,100 to 1,944. (In December, 1964.) And it's significant that the number of girls in the schools was only forty below their stated capacity. The attitude of the schools towards the students had to change very quickly to respond to the times. The matron of the twenties, who used to frighten students, would have depopulated the schools. A girl would go out and accept a position with one of the sixty­ four other callings that recruit in the schools. The practice of de­ ducting total breakages on a pro rata basis from the students' stipends, disappeared. In 1948, one nurse got twenty cents one month, but this stopped shortly after. It was no longer in the spirit 316 of the times. And another demonstration of the changing spirit oc­ curred in June, 1950, when student nurses from across Canada attended a meeting in Vancouver to discuss formation of a na­ tional student nurses association. Mrs. C. W. Hergott, then a student at Edmonton General, was a delegate and recalled that there were four delegates altogether from Alberta. One school of nursing was added to the Alberta list in the post-war. It was in 1953, at Lethbridge St. Michael's, and it was given a green light after considerable soul-searching. The hospital wanted to open the school to staff a new wing of eighty-nine beds. Anyone who shows up nowadays and wants to open a school on that basis , gets a welcome like the hog-rancher who shows up at the child welfare division and wants to adopt three healthy fourteen-year-olds who aren't too bright. Many in nursing thought it was a retrograde step just when the profession was beating the apprenticeshlp image of nursing education. But the Lethbridge doctors, in a hearing before the University senate, said their work would be hindered if St. Michael's failed to build the new wing, and the hospital authorities said they were unable to compete for graduate nurses. So it boiled down finally, to whether or not the proposed school would be a good one. And the answer to that question boiled down to the personality and background of the sister who would direct it. She was Sister Beatrice McMahon, a native of Antigonish, Nova Scotia, who had trained as a nurse at St. Michael's in Toronto, had come to Alberta in 1933, obtained a teacher's cer­ tificate from the University of Alberta and taught school in the province for ten years. Between 1943 and '49, Sister Beatrice ob­ tained certificates in hospital administration in the eastern states, then returned to Alberta as superior of the sisters' hospital in Banff. She came to St. Michael's in 1952, when the new wing was under construction. Sister Immaculata, the superior, said: "They say I'm unwise. I won't be able to get graduate nurses." Sister Bea­ trice said: "Would it help to have a school?" The school talk started then, and based on the need, and on the qualifications of Sister Beatrice, approval was given with re­ luctance. The first half of the first class came in on the afternoon of January fifth, 1953, right on the heels of the painters. And the question of whether St. Michael's would be a good school, was answered finally three years later when the first class wrote the 317 R.N. exams. All seventeen passed. Whi:!n the second half of the first class wrote theirs, all twenty-six passed. In 1959, an important change in procedure ended the tradi­ tional tension and competition over how many graduates of Al­ berta schools would pass the R.N. test. The order was changed. Instead of graduation-registration, it became registration-gradua­ tion, as the students began writing the conjoint examinations of the National League for Nursing. The N.L.N. is an American organiza­ tion centered on education. It sets examinations for American R.N.'s and they are used in several Canadian Provinces including Alberta. They are written during two days. At first, Alberta nurses exercised their traditional originality by writing them in three days, but after some pressure, agreed to write them in two, like every­ body else so the exams really would conform to Webster's defini­ tion of conjoint: United, carried on by two or more in combination.

1965 brought a new school of nursing to the Alberta scene. It was at Calgary Foothills. The school opened in September, eight mo!lths before the Foothills hospital was to take in its first patients. The school opened with seventy-six students, twenty-five of whom came from points outside Calgary and a further seven from points outside Alberta. There was a teaching staff of eight, headed by Mrs. Alice McKinnon, associate director of nursing education. The ratio of instructors to students was to be one to ten in clinical situations, and one to fifteen in the classroom. In starting a school brand new, the Foothills' director of nur­ sing Jeanie Clark (by now Mrs. Tronningsdal) was able to dis­ pense with some of the traditions that clutter up nursing education and with which the profession is loath to part. The bid-and-apron was banished in favor of a one-piece uniform. The capping cere­ mony was to be replaced by something else after five months. And the Foothills became the first school of nursing to abolish the stipend, that relic of apprenticeship servitude which adds up to big expense for a school and which students like to receive even if it is a symbol of ancient slavery. At the time this was written three new educational plans for members of the nursing team were being proposed for 1966: the introduction of a four-year degree program in nursing at the University's Edmonton campus: the start of a two-year diploma 318 program at a junior college in Alberta; and the start of a school for nursing orderlies sponsored by the provincial government. The school for orderlies was an adult, vocational, education project. It was to start in temporary quarters in the Riley Building, in Edmonton, with a first course of twenty-five. The AARN was consulted on the physical layout of the school. At the time of writing, the curriculum was being drawn up, and the AARN had been asked to nominate someone to the curriculum committee. The school for orderlies was advocated by the association as early as the convention of 1955. The developments in the B.Sc. and R.N. programs had been advocated much longer. And opposed just as strongly. In these programs, student nurses go through their entire training under an educational institution (uni­ versity or junior college) rather than a service institution (a hospital). This is not really a new idea; although many ideas of Florence Nightingale continue to strike people as new. New or not, many people inside and outside nursing don't like it and have opposed it bitterly. They feel that living in the environment of the hospital is an essential part of a nurse's education and that a program run from an independent school tends to be too theoretical and down­ grades the patient. Advocates of independent schools deny this with equal vigor. The B.Sc. and R.N. programs, starting in 1966, will serve as demonstrations to help settle the arguments, and what happens after that will be dictated by public need. The four-year degree course was a revival of a program started in the early fifties and abandoned in 1954 when the Uni­ versity hospital school of nursing went from control of the Univer­ sity to an independent civic board. Two classes went through on the first try. In the five-year course, students spent their first and last years under the University of Alberta's school of nursing and the three in-between years under the hospital school. In the four-year plan, a nurse's education is directed all the way by the University. She is like any other University student, pays her tuition, buys her books and uniforms, and gets clinical experience in different hospi­ tals arranged by the University. Critics say it's too theoretical. Supporters say it's an educationally sound program at university level. 319 This program was to start in September, 1966, with an en­ rolment limited to twenty-five. At the same time a program at junior college level was proposed for Calgary-also with an enrol­ ment limited to twenty-five. To institute the program, Mount Royal Junior College en­ gaged Jean Mackie, a graduate of the Royal Alex, McGill and the University of Washington. Miss Mackie was familiar with the Calgary situation, having been with the Calgary General from 1954 to 1963, the last year as director of nursing. The experiment had the support of the AARN. In 1962, the AARN told the Hall commission that new schools of nursing should be independent, using local hospitals for clinical experience. The Hall commission supported experiments in this line. And to the provincial cabinet in 1964, the AARN had said that no new hospital schools should be opened until other alternative programs had been studied and tested. The testing of the alternative pro­ gram at Mount Royal Junior College also had the tentative ap­ proval of the committee on nursing which advises the University's coordinating council. The cost to the student would be four hundred and eighty dollars a year, plus expenses, with lectures at Mount Royal and clinical experience at Calgary hospitals without schools of nursing: Grace Hospital, Rockyview General, Alberta Children's Hospital, auxiliary hospitals and nursing homes. The ratio of instructors to students was to be one to ten in class, and one to six (or possibly eight) in clinical areas. The impetus for the Mount Royal program came from the college itself. Mount Royal is affiliated with the American Asso­ ciation of Junior Colleges and some of the directors were im­ pressed enough by what they'd heard of two-year nursing programs in the United States, to engage Miss Mackie for a program at Mount Royal. During 1965, Miss Mackie also made a study of the Red Deer district to see whether the Red Deer junior college and the general hospital had the facilities for a two-year program and whether the district had a large enough population to provide the students. The cost of the study was shared three ways by the junior college, the hospital, and the AARN. At time of writing, the authorities were discussing action on Miss Mackie's favorable report. 320 If successful, the two-year program would reduce the time needed to give a nurse the information to pass R.N. exams Whether or not two years is enough to give a nurse the mental and psychological maturity for successful nursing, will be established by the results. The effect of not living in residence will also be established. The girls' dormitory atmosphere of the nursing school residence, although cherished by students and valuable in their education, may be an obstacle to older women coming into the profession. It is certainly an obstacle to men becoming nurses. The results will be watched carefully from both pro and con points of view. As the AARN entered its second half-century, the controversy over the two-year program was typical of the time. It was a time of questing and testing. A time of innovation and partisanship over ideas and misgivings about the loss of values. It was a time in which new problems were subtle and complex; answers were not easy to find and often less easy to explain; and generalizations didn't help at all. It was a time when many old things had to disappear; and that included some good old things that everybody loved.

One of mariy things which began to disappear in the post-war was the frontier. It rolled back slowly for a long time and then receded quickly in the sixties, and the effect was, that by 1966, there were only two mission hospitals and twelve district nurses in Alberta. The missions were at Lamont and Cold Lake and the district nurses were all in the north. The oil prospectors did the most to put all of the province on a highway. In 1953, when they burst into the bush around Drayton Valley, they found the Lady Agnes Farren Memorial Mission still ministering to the health of the district. The one nurse was not an R.N. She was Margaret Cording, a bishop's messenger, who had taken a three-month course in practical nursing at the Anglican church's training center in Lansing, Ontario. This course provided some clinical experience at a downtown Toronto hospi­ tal and a few practice' runs with the V.O.N. As Miss Cording (Mrs. Stordalsvall) wrote later: "This very brief training didn't provide any certificate, and certainly very little confidence in one's self, but there was a knowl­ edge of a few essentials, and stacks of notes for which I was most grateful when St. John's first aid or Dr. Spock didn't have the 321 answer. Many times in answer to prayer the notes turned up the very procedure needed to fix a one-two-three enema or give a hypo to relieve a cancer patient. The training proved useful when a patient returned either from hospital or a doctor and needed dressings changed. At that time Dr. Pelletier was at Evans burg and he was most helpful if one could get him on the phone. There was one line open to Evansburg from eight a.m. to five p.m.-if it was working. "With the coming of the oilfield workers in 1953-54, the work increased and changed. Welders' flashes were unknown to me and there was no mention of them in any notes I had. I was floored when an oil company official came, asking what medical facilities were available and what equipment was needed, as they would be glad to supply some. Well, everything was needed, also somebody to use it, a doctor and a nurse." Late in 1954 Dr. Theodore Brooks set up an office in a skid shack and the next year plans were being made for a Drayton Valley municipal hospital and another chapter in pioneer nursing was ended. The passing of time was noted by Gretta L. V. Gauld, matron of the Katherine Prittie mission hospital at Bonnyville, in her report for 1947. She wrote: "An old man came in off the train one night. He had had a stroke, his speech was thick and difficult to understand, and his memory was very hazy. But he had lived in this district years ago and knew of this hospital. He stayed quite happy until he died a few weeks later." Miss Gauld also noted the increasing number of old people in a country which had once seemed all-young. She wrote in this report: "One old man left us in tears to go to an old folks' home. He knew our hospital and staff and this was home to him. This is a constantly-recurring problem and is increasingly so in this and every other district." Alberta was still attracting nurses with missionary spirit in 194 7. One was Jane Y oeman, like Agnes Miller of the Medicine Hat General's early days, a graduate of the Royal Edinburgh in­ firmary. She came to the United Church mission at Manning (also known as Notikewin or North Star), as an act of thanksgiving. It was a result of the bombings on London. During one of the heaviest raids, Miss Yoeman pledged to spend some time in mis­ sionary service if her life was spared. She came to Canada and 322 in 194 7 was appointed matron at Manning, which was ninety miles north of Peace River, and apparently at the end of everything. But by 1957, Manning was on a highway to the north and the mission hospital was taken over by the municipality. In that year of 1957, the passing of time was also noted by Leah D. Rogers, matron of the John Neill Hospital at Cold Lake, in her annual report to the mission board. From the district Iva Marshall had once ridden on horseback, Miss Rogers flew to Ed­ monton with the only recorded case of its kind, a woman suffering continuous muscle spasms from an overdose of a new drug. The air force DC-3 flew from the giant new base of the RCAF at Cold Lake, a jet-age colossus that would have been unimaginable in Iva Marshall's early days there. On the flight to Edmonton, Miss Rogers kept the patient alive with constant intravenous injections, a procedure which only a doctor would have attempted in Iva Mar hall's time. And on the way to Edmonton, the ambulance plane flew past Bonnyville, where, forty years before, the nurses • had kept a light burning outside the hospital at night to guide settlers coming through the bush. The next year the new John Neill Hospital was built at Cold Lake, but in 1962, the Bonnyville mission went to the community and by 1966, only Cold Lake and Lamont remained under church auspices.

The district nursing service, which had contributed so much to the health of the frontier, was longer in feeling the passing of time. As late as 1958, there were still thirty-two district nurse but from that date, the nurses began to disappear along with the rutted trails and by 1966, there were only a dozen, the most southerly being at Fort Assiniboine on the Athabasca River. Even at this re­ duced scale, the service was unique in being government-operated. There were nursing outposts in Saskatchewan and northern On­ tario but they were maintained by the Red Cross. Through much of the post-war era, the district nurses worked as the first of their line, the Misses Conlin, de Turbeville and Hall had worked. There were still the same stories. In 1956, Elna Morgan, a '55 graduate of the Misericordia, was sent to the station at Tulliby Lake. Tulliby Lake was in the bush, forty miles north of Lloydminster, and there were at least a few barbed-wire fences 323 in the district because a cow one day caught herself in a fence and Miss Morgan sewed her together with fifteen stitches. Then there was the time Miss Morgan left the medicine at the crossroads. This was arranged on a very cold day in winter to aid the baby son of a rancher. The child had pneumonia. There was telephone communication with the ranch, an isolated place at any time of year and more so in winter. At this time the only way out was by sleigh over a hay trail. Miss Morgan arranged to have the school bus driver take her along the nearest road to the point where the hay trail came out. She left the medicine on a fencepost at the crossroads. The rancher found it there in the wind and snow and the baby improved quickly. From 1958 on, the district nursing service dwindled sharply as roads, doctors and hospitals became available in former frontier regions. There were still a dozen nurses in 1966 but their houses were now being built as small clinics, with the idea of resale to a doctor when one came into the district. It's progress. All the events of this chapter are progress; or at least they reflect the progress of the times. But progress has its price, like anything else, and the price is something personal. There are few Elna Morgans in the history of the period 1945 to 1966. Earlier chapters of this book are full of Elna Morgans working on their own, person to person, but the nurses who are prominent in the closing chapters are the organizers, the coordina­ tors, the administrators and the educators. And sometime in this era, someone for the first time, used the expression: "She's only an R.N." Nurses who worked in the earlier, personal time, aren't happy with the changes. When they are patients in modem hospitals, they are unimpressed by having twenty-two people a day come to their bedside. They don't like nursing-by-committee. They feel they're involved in group processes in which the committee knows more about the patient but cares less. They long for an earlier time of individual attention and personal responsibility. However, for better or worse, the forces of the times are moving us into a collective society, one in which all activities are done by committee and the precise contribution of an individual is hard to identify. The individual feels less important wherever he is: in the big school, the big apartment block, the big traffic 324 jam or the big hospital. Nursing by committee is a product of the times. It must be remembered, too, that the loss of the personal touch works two ways. There is less satisfaction for the nurse. Meeting this loss is a new challenge for the profession.

325 CHAPTER TWENTY-FIVE If the present began in November, 1945, in Calgary, it may be said that the future began in June, 1954, in Banff. In Banff, the Alberta Association of Registered Nurses, for a third time, was host to a national convention of the Canadian Nurses' Association, and the theme of the convention was "Pathways to the Future". From this point on, attention was shifted away from "im­ proving conditions" as they existed and focused more on condi­ tions the accelerating economy would produce in the future. The convention, which ran from June seventh to eleventh, had a pecial Alberta touch in the presence of Helen McArthur, by then national director of nursing services for the Red Cross, who was completing a four-year term as president of the CNA. The rush of events that was bringing on the future can best be judged by the quaintness of some of the reports. There was, for example, a statement read on behalf of the Hon. Paul Martin, minister of national health and welfare. Mr. Martin was outlining the government's policy on Salk vaccine. The message said Salk would be tried on an experimental basis in Canada but widespread use of it would be delayed until results of tests were known. Of more significance was the minister's statement on matching grants for hospital construction. In it, the government announced that matching grants would now be made for construction of new training facilities. The government could see a lot more nurses in the country's future than there was space to educate them. This convention ushered in the era when committees and commissions would try to read the future. In hearings and caucus, in studies and surveys, among briefs, presentations and subtle cam­ paigns for this or that, committees and commissions would try to evaluate all the pathways that led to the future and pick the best ones - although the pace was accelerating so much that the path- 326 ways were becoming bobsled runs. You can turn off a path, or go back, but once committed to a bobsled run, there's no retreat.

The future of nursing in Alberta is contained somewhere in the published findings of the committees and commissions which worked in the fifth decade of the AARN. However, the reports are often contradictory and one is often a refutation of another so you can't find agreement on the implications of these reports. Then there are bound to be ramifications of the implications which are not fully foreseen, and there are bound to be unpre­ dictable amplifications of certain ramifications, and then there are bound to be complications caused by the interaction of certain implications, and then, inevitably and worst of all, there will be attempted simplifications of the coIPplications. The historian who writes the hundred-year history of the AARN will, with the ad­ vantage of hindsight, be able to work back and pick out the exact phrases in these reports that predicted the pathway to the future. At this stage, a full comparison and analysis of the contra­ dictory views, with their supporting material, would fill a five­ foot shelf. Since the reports are all available for study, by future historians and interested parties of the present day, the most worth­ while contribution of this book will be a companion to the reports: the sequence in which they came about; who worked on them; and how the reports interlock. The age of committees and commissions began quietly enough in November, 1956, when the AARN was invited to present a brief to the Alberta hospital insurance planning committee on the nursing implications of hospital insurance. 1958 was the golden jubilee year of the Canadian Nurses' Association and the CNA undertook an evaluation of nursing schools across Canada. The AARN participated in the project. The report took two years to write, and was published as Spotlight on Nursing Education. It sparked an interest in studies of this type. In 1959, when the CNA project was underway, the provincial government commissioned Dr. J. D. Wallace to report on the nur­ sing care available in Alberta hospitals which had no nursing schools and fewer than one hundred and eighty beds. The AARN was one of the bodies participating in the study. The Wallace report was published in the fall of 1961, at which time there were two big new developments in the campaign 327 to map the future. The federal government set up the Hall com­ mission on health services and an AARN task committee was formed to write a brief. The provincial government moved for a survey of nursing education in Alberta and commissioned Dr. E. P. Scarlett, former chancellor of the University, to conduct it. The task committee had only six months to get its brief ready for the Hall commission but it defined so well the ideas and goals of the AARN in so many areas, that there bas been little to change. The Scarlett committee's report on nursing education was two years in the making, and in the meantime the AARN formed a new task committee to study an important development in Ontario. This was the college of nurses, a coordinating agency to license nurses and nursing assistants and approve programs for their education. The Scarlett report was published while the task committee was still working and the Scarlett committee made its own recom­ mendation about a coordinating body for the different agencies in nursing. The report of the AARN task committee then became a commentary on both the Ontario plan and the Scarlett recom­ mendation and its view the official position of the AARN. Views defined by the AARN's task committee were confirmed in a presentation to the cabinet in 1964 - in a publication entitled Standards of Professional Nursing Practice. They were confirmed in resolutions passed at the annual convention of 1965. And at the time of this convention, the provincial govern­ ment was ordering a third report on a subject involving nursing. This was a study on public health, recommended by the Scarlett report, for which another AARN task committee prepared a brief. Somewhere in these reports the pathways to the future are clearly recognizable. Or anyway, they will be to the historian of the year 2016.

The AARN entered formally into the "pathways to the future" quest in 1956 when the executive prepared a submission for part of the study of the federal-provincial hospitalization scheme. In connection with the scheme, the hospitals division of the department of public health in each province set up a planning committee on hospital insurance. To the Alberta committee, the AARN pointed out that an insurance plan would guarantee a cer­ tain amount and quality of service, much of it nursing. A plan would require long-range budgeting and a large part of the pro- 328 jected cost would be for nursing service and education. The AARN felt that the plan as drafted was based on recent costs at individual hospitals without a check on the quantity or quality of nursing service given within the cost. Before adopting a plan, the AARN urged, there should be a cost accounting, and provision made to establish - and maintain - desirable standards of both nursing service and education. This brief was presented November seventh, 1956. In 1958 the AARN joined other provincial nursing organiza­ tions in a project to evaluate schools of nursing in Canada. This was a golden anniversary year project of the Canadian Nurses' Association, and was directed by Dr. Helen K. Mussallem, whose doctorate was in nursing. The AARN contributed $3,133 towards the $40,000 study, and two Alberta nurses participated by visiting schools of nursing in other provinces. The aim was to decide whether the cause of nursing education would be served by accreditation, with the CNA granting accreditation to a school of nursing. The investigators visited twenty-five schools across the coun­ try, two in Alberta. Although the names of the schools were sup­ posed to be secret, it is safe to say that they were the Calgary General, in the large (or more than two hundred students) divi­ sion, and Ponoka mental hospital, in the small (or less than one hundred students) division. From Alberta, Margaret Street, asso­ ciate director of nursing at Calgary General, visited the two selected schools in British Columbia and Jeanie Clark did the same in Sas­ katchewan. Helen McArthur and Rae Chittick were also involved in the planning at the national level. After two years, the project produced a report entitled Spot­ light on Nursing Education.

While the CNA's two-year project was underway, the Alberta government, in 1959, set up a Nursing Care Survey committee, which also worked two years. This committee worked under a mis­ nomer because it was more truly a survey of PATIENT care, and was asked to find out what care, in both quantity and quality, was available to patients in hospitals with fewer than one hundred and eighty beds and no school of nursing. Dr. J. D. Wallace, director of the hospitals division in the department of public health, was chairman. Bodies designated to 329 participate were the department of public health, the As~ociated Hospitals of Alberta, the College of Physicians and Surgeons of Alberta, and the Alberta Association 0f Registered Nurses. AARN members were: Sister B. Knopic of Our Lady's Hos­ pital, Vilna; Mrs. E. Harvie of the Lacombe municipal hospital; and Jeanie Clark. Only some of the recommendations concerned nursing. One was that schools of nursing have affiliation programs with small rural hospitals to give students experience and orientation in the work of these institutions. The committee found places where the best u e was not being made of nursing personnel and recommended that courses be or­ ganized to train nurses to administer nursing units. It further recommended a salary differential to encourage nurses to become qualified. In some hospitals the committee found that poor ad­ ministration was leading to failure to use proper nursing procedures. It recommended a minimum of five graduate nurses for the staff of any hospital, and that all nursing units be supervised at all times by a registered nurse. The Wallace Report officially defined the nursing team - as consisting of graduate nurses (and students); certified nursing aides (and trainees); ward clerks, ward aides and orderlies. It recommended that the department of public health define the duties and responsibilities, and the limits of responsibility, for the members of the nursing team, and that doctors be made familiar with them. The Wallace report was published in November, 1961, and in the months just previous there had been two new developments, in Ottawa and Edmonton. The government in Ottawa set up the Hall royal commission on health services and the government in Edmonton ordered a survey on nursing education in Alberta to be directed by Dr. E. P. Scarlett, former chancellor of the University.

In August the Hall commission sent out a call for briefs, briefs which would be heard early in the new year. Since there was no time to waste, the AARN didn't waste any. Elizabeth Bietsch, an Edmonton General graduate and director of nursing at Medicine Hat General, agreed to chair a quickly-assembled J:ask committee. The committee included the president, Claudia Tennant of Leth­ bridge Municipal; Helen Sabin, executive secretary of the AARN, 330 who sent out the call for, and collected, ideas from all existing committees of the AARN; Sister Cecile Leclerc, of Holy Cross, on nursing services; Madeline Larson, of the Lethbridge social hy­ giene clinic, on public health; and Marguerite Schumacher, on education. The committee met in Edmonton, Lethbridge and Medicine Hat, trying to define the views the membership wanted to place before the Hall commission. There were eighteen submissions. Credit for the literary style of the brief is given to Miss Bietsch, the chairman, and it was finished in time for presentation in hearings which opened in Edmonton on February eleventh, 1962. However, the views did not seem so important at the time as they did later, when the report of the Scarlett committee was published, and so many conflicts were disclosed. The Scarlett committee to survey nursing education in Alberta was forming at the same time as the task committee. For the education survey, the government named as chairman, Dr. Earle P. Scarlett of Cal­ gary, former chancellor of the University. The government's aim was a study of education for the entire nursing team. It was not a study in the abstract, but an appraisal of nursing education as it existed in Alberta, with an evaluation of its effectiveness in meet­ ing the current and future requirements of Alberta. It was also to give opinions on current ideas about nursing education, judging them on whether they were feasible or desirable here. There were two nurses: Margaret Campbell, assistant profes­ sor of nursing at the University of Alberta who had come from British Columbia in 1957 and whose specialty was public health; and Ida Johnson, Royal Alex '25, whose long experience included the post of superintendent of nurses at her alma mater, (a big hospital with a school of nursing) , and then the post of adminis­ trator of the Olds municipal hospital, a smaller rural hospital. The other members were: L. R. Adshead, administrator of the Calgary Foothills Hospital, then in the planning stage; and Ed Mather, of the hospitals division, provincial department of public health. The Scarlett committee held a great many spirited sessions in a year and a half and produced a report printed in hard cover and available from the Queen's Printer. It's very readable, as readable as Nurse Wylie's Dilemma, or Nurse Crowe's Dilemma, or Nurse Appelbaum's Dilemma, or any of the paperback publications on 331 nursing which are deplored by the profession and are obtainable at the CNIB booth in any hospital. The Scarlett report makes a stimulating book and the fact that it has stimulated a great deal of disagreement and rebuttal, and that its publication was not followed by a move to confer on Dr. Scarlett special membership in the Alberta Association of Registered Nurses, does not impair its value. There was one area of complete agreement - where the com­ mittee wrote: "Concerning the extension of post-graduate education, this we believe is the keynote to future nursing development." But unanimity did not proceed beyond this point. The Scarlett report said the existing system of hospital schools in Alberta was doing a good job of producing nurses for the needs of the province and should be continued. It said, "antagonists of hospital schools had failed to prove a case", was cool to propo­ sals of a two-year program, and rubbed it in a bit by recom­ mending that someone "from the service side of nursing" be added to the committee on nursing at the University of Alberta to guard against the curriculum becoming "too theoretical". The Scarlett committee found that education of all members of the nursing team was moving in the right direction, and sug­ gested that there must be some proper ceiling at which to fix the ratio of professional to auxiliary personnel. Noting that in 1962, two schools graduated 460 nursing aides while eleven nursing schools were turning out 510 registered nurses, the committee suggested the ceiling might be sixty certified nursing aides to forty registered nurses. The Scarlett group ruled that, based on the realities of the situation as it saw them, there had not been a case made for pre­ paring nurses in independent rather than hospital institutions. Whatever the theoretical advantages, the practical considerations dictated the continuing of hospital schools. However, within three years there would be three new nursing education programs pro­ posed in the province and two of them would be independent of a hospital. The Scarlett committee attempted to answer a question which some say is unanswerable as long as nursing schools are operated within the framework of a hospital administration. The question is: How much does it cost to educate a nurse in a hospital school? The committee came up with an answer of $1,132.22. 332 It first arrived at a cost of $1,440.74 as the cost of maintaining a student for a year. For three years this came to $4,322.22. The service the student gave in return was e timated to be worth $3,190.00, and this was deducted from the cost for a net figure of $1,132.22. There are critics who say this figure is unrealistic and does not consider alternatives. In 1965 the advisory committee of a hospital school of nursing circulated a questionnaire among other nursing schools in Alberta and found that accounting methods differed so much it was not possible to make valid comparisons and arrive at a price tag for an R.N. Florence Nightingale, who liked "to bite into a hard statistic", would have enjoyed this controversy. The difficulty in agreeing about the future might be eased if everyone could agree on the present. However, between the Scarlett committee and the AARN, there was agreement on an im­ portant principle involving the future. Both subscribed to the prin­ ciple that there should be coordination of the agencies doing nur­ sing in the era when "nursing was no longer synonymous with nurses". They agreed on the principle, but not on the extent and fonn of the coordination, nor the powers of the coordinating agency. The Scarlett committee thought the future lay in a provincial council of nursing, drawn from organizations within the nursing team. It said the council "would attack the problems of nursing from within, and thus escape the slow and less efficient method of advance dependent upon the compulsions of external pressures". The council would bring together the AARN, the Psychiatric Nurses Association, the Alberta Nursing Aide Association, and the Alberta Association of Nursing Orderlies. It would regulate the work of people in nursing but not their education, and on this point it would differ from the College of Nurses, set up in Ontario in 1962. The Scarlett report, as you'll remember, came out as the AARN's task committee number two was reporting on the impli­ cations of the Ontario scheme so the McClure committee reported on both the Ontario and Scarlett plans and its view became the official policy of the AARN. The chairman of task committee number two was Ruth Mc­ Clure, of the department of nursing, University of Alberta, and the 333 members were Jean Mackie, associate director of nursing at Cal­ gary General; Edith Kemp, Provincial Mental Hospital, Ponoka; Geneva Purcell, director of nursing at University Hospital; and Miss Sikora, the secretary. They held their first meeting on Novem­ ber thirtieth, 1962, on a weekend. In the next year they spent half a dozen "free" weekends meeting and other "free" evenings writing their reports, and from their work emerged the AARN's concep­ tion of the council that could best coordinate nursing in the era in which nursing was no longer synonymous with nurses. The task committee objected to the Ontario system because it separated the functions of licensing and professional welfare, and because the college took charge of everything, including education; education should stay with the University. It objected to the Scarlett plan because it saw a danger of some educational functions being assigned to the council of nursing; and because the council would have more power than necessary to achieve the purposes set for it. In the AARN's conception of the council, education would remain under the University. Licensing of all members of the nur­ sing team would be mandatory, but the council would have no control over licensing standards of the AARN and the AARN would keep its autonomy. Members of the council would be nomi­ nated by the autonomous agencies within it. The council would provide liaison among groups within the nursing team, would advise the government on nursing problems and assist in long­ range planning and research on nursing problems. The AARN's views were made known to the cabinet on two occasions and were confirmed by a provincial convention, and the government's first action on the council did not reject these views. In December, 1965, health minister Dr. Donovan Ross decided to establish an advisory council on nursing, a council that would "act in an advisory capacity to the minister of health in all matters pertaining to nursing practice in Alberta". The make-up would be much as recommended by the Scarlett report, and associations representing components of the nursing team were invited to nominate people from whom the minister would appoint the council. The council was to be set up by April, 1966. The AARN's first presentation to the cabinet was made in April, 1964, with a report titled Standards of Professional Nursing 334 Practice. This report stated fifty-four recommendations on points raised by the Hall commission and the Scarlett report. Seventeen of them concerned post-basic education, agreeing with the Scarlett report that the extension of post-basic education is the keynote to future nursing development. And with this presentation the AARN went on the offensive to keep the "graduate registered pro­ fessional nurse" from being run over in the rush to project the future. In 1964 the association said: "We believe that the nurse is besr qualified to assess nursing service problems and has an obligation to seek solutions in the best interests of this service." In 1965 the wording was a little stronger: "We believe that nursing as an organized profession has the right and the responsi­ bility to identify, appraise, and propose solutions to nursing problems."

In this period, viewpoints became positions to be held, or causes to be advanced. The AARN became an action group and to strengthen it in this role the convention of 1965 authorized a study of the structure of the association. Stevenson and Kellogg, the management consultants, were hired to study the set-up and sug­ gest ways to achieve better communication within the membership of the AARN and get more nurses actively involved in the business of their profession. By this time the AARN was working with a set-up that was eighteen years old and a product of the immediate post-war. It dated from the provincial convention of 1947 when the "district" plan of 1936 was abandoned in favor of "chapters", built around active-treatment hospitals in cities and towns. The chapters retained the numbers their districts had held under the 1936 plan. So the Athabasca chapter was chapter num­ ber one; the Ponoka chapter was number two; Calgary was three; Medicine Hat, four; Drumheller, five; Red Deer, six; Edmonton, seven and Lethbridge, eight. It was felt that a greater number of local organizations would have more strength than the straggling districts. By 1965 the chapter numbers were up to forty-nine. To improve communication between headquarters and the chapters, the AARN Newsletter, started in September, 1945, as a mimeographed sheet circulated to groups of nurses, was made a printed magazine sent to each member. This began with the News 335 Letter of March, 1948, and the issue opened with the lines: "Thi is the first time we have knocked at the door of each active mem­ ber of the AARN and we hope we are welcome." By 1965 the chapter concept was found to be short on re­ sults, like any model of anything designed in 1947. Stevenson and Kellogg found that more than fourteen hundred active registered nurses were not members of a chapter and therefore did not par­ ticipate in the election of the executive or have delegates repre­ senting them at AARN conventions. They recommended a direct mail poll of all active members in AARN elections, and a com­ bination of the chapter system with a revival of the district system, set up by Kate Shaw Brighty in 1936. Chapters and all active nurses would be grouped into five districts. ' The new structure was approved in February, 1966.

'*-- The 1965 convention authorized a new role for the AARN, a role into which it had been coming by degrees for twenty years. The convention decided that the AARN should become bargaining agent for its members in contract negotiations with hospital em­ ployers, and that the provincial government should be asked to amend the Registered Nurses Act to make this possible. The legis­ lature gave the AARN the necessary power in April, 1966, just in time to be included in this history. This brought to its conclusion a movement that began with the end of the war and which was written about in the October, 1945, issue of Canadian Nurse by Barbara Beattie. Miss Beattie, pre ident of the AARN, was director of nursing at the Ponoka Mental Hospital. (Twenty years later she was retired in Nova Scotia, doing a lot of gardening and occasionally doing private duty at hospitals.) In an article entitled Alberta Looks To The Future Miss Beattie reported that a committee of the AARN had been appointed to work with one from the Associated Hospitals of Alberta, to set a schedule of maximum and minimum salaries for all cate­ gories of nurses. The schedule would cover yearly increments, paid vacations, sick leave, sickness and pension plans. It would also ... cover hours of work. Miss Beattie observed that during the war years the nurses had been reluctant to criticize conditions while hospitals were burdened with extra work and less staff, but "we now feel that the time is ripe for action. . . ". 336 The AARN had no powers of bargaining and enforcement, but it was authorized to intervene on behalf of its members where the welfare of a member was involved. The registrar, later execu­ tive secretary, Mrs. Van Dusen, was empowered only to request meetings with hospital boards and administrators and present the association's view. The AARN was a body to which members could appeal for support in a grievance or dispute and Mrs. Van Dusen gave valiant service in this way. However, this meant that only the direct contact the AARN had with many hospitals wa<; as a third party to a grievance which had already developed. The AARN was able to move away from this role with the development of staff associations inside the hospitals. Calgary General and the Royal Alex had active staff association in the early 1950's and in 1963 the AARN gave convention support to the principle with a resolution that a staff association be formed in any institution where three RN's are employed. In 1961 the increasing interest of the association in the em­ ployment, as well as professional standards, of the members, re­ sulted in a change in the stated aims of the AARN. In addition to the aims of pr9moting the honor and status of nursing, advancing educational standards and elevating standards of nursing practice, was added the promotion of sound employer-employee relations. The convention of 1965 took two steps in support of col­ lective bargaining to promote sound employer-employee relations. The convention approved the idea of staff associations being cer­ tified under the Labor Act and staff groups at Calgary General, Lethbridge Municipal and the Royal Alex were certified by the end of the year. It also approved the idea of the AARN itself being able to act as agent in collective bargaining and in April, '66, almost on the fiftieth anniversary of the first Registration Act, "t_ the act was amended to make this possible. L Many did not like the trend and resented it as unprofessional and unbecoming but it was approved by a majority, and at the time of writing the Alberta plan was being watched with great interest and some envy by nurses in other provinces . .,, The convention which authorized these major developments -and they were not changes, but developments-was held in May, two weeks after the government had called for a third survey in­ volving nursing. This was to be a survey of preventive health ser­ vices, the word "preventive" having replaced "public" as being more 337 to the point. This survey grew out of the Scarlett report, and was, in fact, one of its recommendations. The chairman was Dr. George Ball, medical health officer of the city of Edmonton. Two of the members were rural MLA's - Mike Maccagno and Mrs. Cornelia Wood. The other two were members of health unit boards - E. F. Pittman and Camille Cammaert. There was another call for briefs and the AARN formed a third task committee to present its views . Chosen as chairman was Gwen Law, Calgary General and McGill grad, senior nurse in the Sturgeon health unit, and the committee brought a cross-section of views on public health nursing. From the provincial government (Mrs. Janet Bailey); the University (Margaret Campbell) ; the V.O.N. (Mrs. Marion Ilsley); industrial nursing (Irene Robert­ son) ; the Indian service (Winnie Roscoe); city health service (Mae Wray of Edmonton); rural health units (Molly Policha, of Leduc); and Mrs. Sabin. The committee found that of 294 nurses doing public health work in 1965, only 182 had public health preparation. The lack was especially evident in the rural health units where only half the nurses were qualified. It recommended that government grants and bursaries be made available for occupational health nurses to ob­ tain public health qualifications. The Law committee recommended that the universities at Edmonton and Calgary, and also the junior colleges, offer credit courses for nurses with public health diplomas to work towards degrees. It also recommended a reorganization and expansion of the nursing division of the department of public health.

A report by a committee may be an undramatic note on which to end a history, a history of such dramas as Nurse Fulcher's mid­ winter ride to the headwaters of the Red Deer. For drama, com­ mittees and reports are hopeless, and yet the results of this report, this distillation of the judgment and experience of Alberta nurses in a special field, can have far more dramatic results than Nurse Fulcher's ride. Unfortunately, the drama will be viewed only through further reports by further committees, and this is one of the unsatisfying aspects of the new age, an age in which won­ ders haven't ceased but people have ceased to wonder at them be­ cause they're too broad and too intermixed with other wonders. 338 Until the post-war, nursing used to provide stories of indi­ vidual battles against overwhelming odds. Now the big stories are efforts to give direction to overwhelming forces. Many nurses who worked in the old days feel sad and left out by the change, as though it has made meaningless their work. Of course the change does not make their work meaningless any more than a jet airliner lifting off two miles of concrete, makes meaningless the work of Alberta's flying pioneers. What they did is history. It was the correct response to the needs of their time. It formed the heritage of service on which the present and the future are based. As this was written, nursing was moving into areas as un­ known as those into which the Grey Nuns were travelling in 1859 when they made the long trek from Winnipeg to start nursing in Alberta. Alberta of 1859 was unsurveyed, and that can't be said of the future which has been surveyed to a faretheewell. But in some ways the Grey Nuns had it easier. There was only one trail they could follow. By 1966 there were many pathways to the future and as many arguments over which was the best to take. Although the historian who wraps up the next fifty years will have the advantage of hindsight, he will be plagued by the fact that nursing is no longer synonymous with nurses. The history to this point has been simplified by nurses doing nursing but the his­ torian of 2016 A.D. will have to contend with all kinds of people doing it. In the next half century there will be times when the many choices will lead to indecision. The pathway taken will often be the path of least resistance or the most insistence. People who think clearer will lose out to people who talk faster. Prophets will be unhonored and good people may lose heart. And mistakes, like everything else, will cost more. But it will come out all right because every fall there will be signs in the photographer's window. These signs of hope used to appear in the spring, before conjoint examinations pushed gradua­ tion into the fall and the order of graduation-registration was re­ versed. But these signs will appear without fail in the fall when the photographer decorates his window with the newest graduates of Alberta's schools of nursing. 339 Each ornament to the photographer's window will carry with her the entire tradition of nursing in Alberta. Behind her expression of confidence will be the work of every nurse in this book. The Grey Nuns on the trail to history. The first probationer at Calgary General watching the entire hospital on her first night as a nurse. Nurse Fulcher riding the winter trail to the headwaters of the Red Deer. Sister Michele Jesus getting her steam engineer's papers late in life. Iva Marshall sitting up for nine nights with the pneumonia patient. Kate Shaw Brighty riding the speeder to Slave Lake. The nurses who engineered the Weir report. The nurses who returned to the profession in time of flu, polio or general need. Elizabeth Petkau, the Galt graduate dying of anthrax on mis­ sion service in Mexico. The twenty-one thousand nurses who were registered from 1916 to 1966; the hundreds who worked in Alberta before then. The girl in the window will represent all of them. She will have from them a heritage of service, a heritage of finding solu­ tions, that will win the future.

340 Presidents of The Alberta Association of Registered Nurses

1916 -1921 - Miss Victoria Winslow 1921 -1924 - - - Mrs. Catherine Manson 1924 -1926 - - - Miss Margaret McCammon (Mrs. Allen) 1926 -1927 - - - Miss Beatrice Guernsey (Mrs. Tooke) 1927 -1928 - Miss Sadie Macdonald 1928 -1932 - Miss Eleanor McPhedran 1932 -1936 - - - Miss Frances Munroe 1936 -1940 - Miss Kate Brighty 1940 -1942 - - - Miss Rae Chittick 1942 -1945 - - - Miss Ida Johnson 1945 - 1947 - - - Miss Barbara A. Beattie 1947 -1949 - - - Miss Blanche Emerson 1949 -1950 -- - Miss Jeanie Clarke (Mrs. Tronningsdal) 1950 -1953 - Miss Frances Ferguson 1953 -1955 - Miss Helen Penhale 1955 -1957 - - - Miss Elizabeth Bietsch 1957 -1959 - -- Miss Margaret Street 1959 -1961 -- - Mrs. D. lune Taylor 1961 -1963 - Miss Claudia Tennant 1963 -1965 - Miss Marguerite Schumacher 1965 - - Miss Frances Moore Honorary Members of The Alberta Association of Registered Nurses

1964 - Miss Blanche Emerson

1965 - Mrs. Kate Shaw Brighty Colley

1965 - Miss Lottie Hunter

1966 - Dr. Rae Chittick

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