History of Nursing in Pacific Canada

[Address to staff and pupils of the Training School and Members of the Training School Committee of the… Johns, Ethel 1919-10

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(by Ethel Johns, upon her becoming Director of Nursing
of Vancouver General Hospital in 1919)
Dr. MacEachern: Staff and pupils of the Training Schools
Mashers of the Training School Committee:
If X had not already realized the seriousness of the
task I have undertaken in coming to this Training School
as its Director, I should he dull indeed if X did not
realise it now. Dr. MacEachern brought it home to me
very vividly a few days ago when he explained to me his
reasons for discarding the title of Superintendent of
Nurses in favor of the title of Directress of Nurses. He
said that to him the word director meant action as well
as supervision, that we were going somewhere and not just
marking time. I think he is right, but I also think we
must suggest to him that he change his title also, for
his forward looking policy for this hospital is recognised,
not only all over Canada, but to the south of us, and if
ever there was a 'Director' in his sense of the word, -
he is one.
For myself I am not here tonight to tell you what I
am going to do with you - I am more concerned about what
you are going to do with me. During the coming months you
will judge me and appraise me, and it will appear whether
I am fit to be your director or no • I am content to wait
for that verdict, and to stand or fall by it, only I will
ask you to be patient - to remember that I come to you as
a stranger not knowing your traditions, your customs,
your prejudices - I have all that to learn and I propose
to try to learn it as rapidly as I can, but It will take
time. In order that I may get into closer touch with you,
I am going to ask you now that you are all together and I
have the opportunity, to appoint a Students Committee, so
that we may hold conferences from time to time. I will
ask you to appoint four members from each class, and I
will ask each class to see to it that these members are - 2 -
truly worthy of representing them, and not to choose them
haphazard. I would like the names of that committee handed
to me two weeks from today, and I will ask the senior of
each class to see that the necessary meetings are called
for the purpose of electing these representatives. In
order that there may be no misunderstanding on this point,
I will post a bulletin concerning it, but here and now and
at the very beginning, I want to get into personal touch
with you. That will be the function of that committee to
carry the current from you to me, and from me to you - so
see then that you choose live wires.
My object in calling this meeting tonight was to put
before you a brief outline of the aim and purpose of the
new experiment in nursing education which is to be made in
this Training School and in others throughout this Province
In conjunction with the University of British Columbia.
Since upon you will rest much of the responsibility for
the success or failure of this experiment, it is only fair
that from the outset you should clearly grasp just what it
is, - why it is necessary and what we hope will come out
of it.
First as to what it is - We do not yet clearly know
just what it is • at least we know only in part. All we
are sure of at present is that for the future there will
be two groups of pupils in this Training School - first
the student nurses as at present constituted, and second
a much smaller group who will take what, for want of a
better name - we will call the combined course - that is
to say they will take a certain number of years of Univer*
sity work, and a certain number of years of training In a
hospital. At the conclusion of this combined course these
students will not only be granted their diploma in nursing,
they will also have conferred upon them a degree in nursing
from the University. On the surface it might appear that
there is nothing very remarkable about this and that the
only result would be that we shall develope a small group
of nurses possessing better academic training than most of 3 .»
us can boast of. We might even fear that this group might
hold themselves apart as a sort of aristocracy and be a
little inclined to be patronizing, a sort of highbrow element as it were, which would be most objectionable.
Fortunately this surface aspect of the question is far
from being the true one. I only mention It to you at all
so that you may be prepared when unkind critics emphasize
it unduly • the real implications are much broader. Before
we can understand what they are we must review briefly our
own beginnings. We have Jtmate a long and upon the whole,
an honorable ancestry. The first mother was the first
nurse - nursing is the oldest profession in the world. No
matter what heights we may scale, no matter how scientific
we may become, let us not forget that in the last and best
analysis, nursing is an expression of the maternal instinct,
that we alone of all the occupations open to women most
nearly approximate the divine function of women - motherhood,
But it was inevitable that as civilization advanced and life
became increasingly complex that some of the multifarious
duties of mothers came to be delegated - among these,
naturally, would be the care of the sick • among the Greeks
and Romans as you know, nursing was done by slaves and there
have been times in my nursing career when I have wondered
whether these old far off unhappy things have quite passed
away. It is true that we no longer work like slaves, but
we think like slaves when we think at all. That is the
result of the kind of education we have had up till the
present. But we are going to change all that.
At the beginning of the Christian Era we find the
stirrings of a new spirit. We find a different conception
of womanhood - something worlds apart from the pagan view
point - woman not as a toy nor a slave, not as property
but as a human entity. We find here, also, for the first
time, the impulse to lead a life of self sacrifice, to do
difficult and even disgusting tasks as a religious duty -
In short a conception of nursing as life offered up -
Certain good women we are told in the Bible devoted them*
selves to such work • the deaconesses of the early Church. a  4  *
These did not at first withdraw themselves from the world *
there were among them wives, widows, and maidens• Later it
is true the cloistered ideal prevailed and we find the mins
devoting their lives to the care of the sick, these of course
taking eternal vows of poverty, chastity and obedience.
During the middle ages magnificent work was done by these
women in fact it endures until this day. Then with the refer*
mation came great changes, the convents were swept away and
in England at least, nursing entered upon its dark ages* The
religious ideal had vanished for the time being and the
scientific ideal had not yet appeared* This was the time of
Sairey Gamp with her bundle and her bottle to which she put
her lips when ffso disponed" - Dickenfs immortal caricature
is exaggerated of course, but it was painfully near the truth.
Devoted nursing of sick persons was still undertaken by the
women of the family, but for those for whom such service must
be hiredf for the poor, for the wretched, there was only the
service at best of kindly disposed but ignorant women, at
worst of the idle, drunken and vicious. We think of such
things as though they happened long ago* It was not so long
ago as we think. When I was in New York five years ago I
had the privilege of meeting Miss Louisa Schuyler, a woman
of nearly eighty, but as young as any of us here. This woman
was one of the few survivors of a noble group which during
the American Civil War did what they could to mitigate the
atrocious suffering among the sick and wounded of the Federal
Troops. At the conclusion of the war, they were much impressed
by the need of some better scheme of army nursing service,
and turned their attention to the civil hospitals especially
to Bellevue Hospital, New York. Miss Schuyler was one of a
bold little band that bearded the authorities of that hospital
in their dens, who looked beneath the surface order and cleanliness and found aursing being done byMWomen from the Island1* -
to use the Mew York phrase • that is to say by women who had
been sentenced to prison for short terms for drunkeness and
vice and who had been allowed to Berve  out their sentences in
this way. To tell how all this was altered would take too
long, but it was altered, and why? * because Florence nightingale had come into the world, and because she like Joan of Arc
had her voices and was not afraid to do their bidding.
The popular conception of Miss Nightingale as a gentle
sweet spirit who went about carrying a lamp and smoothing
brows, is very far from the truth. Florence Nightingale
was one of the greatest sanitarians who ever lived. She
was also, as she herself put it, "a passionate disciplinarian" and above all she was a great educator. She
detested sentimentality, she loathed publicity - she was
one of the most practical of women. When the boat on which
she sailed to the Crimea was approaching Scutari some
romantic soul among her helpers rushed up to her with shining
eyes and said "dear Miss Nightingale, we shall soon be able
to make some of those poor dear soldiers comfortable and
happy", only to get the cold reply of "I am afraid we will
all have to lend a hand at the wash tubs first." But with
it all she was a mystic and had her voices. She passionately
believed that the art of nursing, (she would never call it
a profession) was one to be practiced by women of education
and refinement, that these women need not necessarily with*
draw themselves from the world, and that they might seek in
it an honorable means of livelihood. The question arising
from her creed was "where can such women be tralnedf" Her
answer was, the Nightingale School for nurses at St. Thomas
Hospital, London which she founded and endowed with the
money granted to her as a reward for her services in the
Crimea by the British Government. The influence of Miss
Nightingale and her school spread rapidly to every country.
It reached Bellevue Hospital, New York early. Miss Schuyler's
group got in touch with Miss Nightingale and a treasured
possession of that school today is a plan drawn up for its
organisation by Miss Nightingale herself. I saw that plan,
and I saw Miss Schuyler. See how close we are to it. See
how far we have come in a little more than fifty years.
How far may we not go in the next fifty? But we are concerned
with here and now and with the future why dwell on the past?
For this reason • we must study the future In the light of
the past. We must judge of what is good in the past and see si  Q m
.Ms^mee  if by any means we may still hold to it, reaching
out at the same time to the broader opportunities of the
future, and one of these opportunities being the experiment
we are undertaking to make here.
Now why is that experiment necessary? Nurses are rendering good service as things are at present. This school
ranks high among Canadian Training Schools - why not leave
well enough alone? If you will allow me to be personal for
a few moments I will try to illustrate the reason. For the
past three years it has been ay privilege to serve upon a
Royal Commission appointed by the Province of Manitoba to
enquire into the public welfare - institutions and organize*
tions of that Province. Part of the task assigned us was
to investigate and report upon the Status of Nursing and of
Nursing education. To my sorrow and surprise, it began to
dawn upon me as the sittings of the Commission progressed
that the public at large were not so well pleased with
nurses and nursing as we had been led to suppose by enthusiastic and complimentary gentlemen who addressed us at
Graduating Exercises. Suddenly I found myself a prisoner
at the bar with the other eight Commissioners * all men but
one, ranged against me as prosecuting attorneys. What they
said summed up, amounted to something like this. "We are
looking to you nurses for leadership In health questions,
we are looking to you for teaching, we are expecting you to
prove yourselves a vitalizing force in our community life,
but you don*t lead. We push you in front of us. You give
us service, yes devoted, kindly but not as intelligent as
it should be. Now what are you going to do about it? I
cannot conscientiously say that all this was news to me. I
had suspected a good deal of it for some time and furthermore,
I had done a little thinking about it on my own account, and
at a subsequent meeting of the Commission I asked my prosecuting attorneys the question they had asked me - "What are
y.u going to do about it?" If the Community expects the
nursing group to carry the almost intolerable burden, they
are thrusting upon us, then let the community see to it that we are prepared adequately for our task. I have yet to hear
of a single penny being spent by any government for the
betterment of nursing education. In Manitoba we have an
Agricultural College which cost the province several millions,
and it was money well spent, but the men who authorized that
expenditure were horrified at the idea of an appropriation
of two thousand dollars for the education of nurses. There
was a time when they would put the lives of their dearest
and nearest into our hands without a question as to our fitness for such responsibility. They took us for granted,
just as men always take their womenfolk for granted, and let
it go at that. But the war has changed all that. It is an
extraordinary thing that one of the by products of wars in
recent years has been an improvement in the Status of Women.
This war and the epidemic which followed It her$ focussed
public interest upon nurses especially, and in the bright
light of that interest our virtues and faults are revealed.
The community at large has come to realize that life transcends property and that every conserving factor we possess
must be pressed into service If we are to repair the monstrous
wastage of war. Now where do we come in? Is there a single
phase of life from the cradle to the grave where we do not
come in? We see the curtain rise on life * we serve at every
succeeding stage from Infancy and adolescence through
maturity to old age, and at the very end we watch the curtain
fall forever. There is no avocation not even medicine itself which transcends ours in its intimate association with
life. Do you think any preparation too broad and deep for
such a task as this? Do you think we can rest satisfied with
what we have • it is good • yes, but not good enough. Now
what are we as nurses going to do about it.
Well first of all we are getting a new conception of our
chosen life work * we have sketched tonight the progress of
nursing development from Its beginnings in the maternal in*
stlnct • through the religious ideal, the military ideal,
the humanitarian ideal. Now we come to yet another - the
educational ideal. Do not think that we have discarded these
ideals as we passed through them • not that, we have pondered
them like Mary of old * in our hearts, and what of this last - 8 •
development? And from now on I aa going to be very plain and
Calls are being made on the nursing profession for leadership as well as for nursing service. Are we answering these
calls? And if not - why not? Nursing is becoming highly
specialized - our ordinary nursing course no longer can
qualify us for all of these specialties. You have recognized
that already here • I understand that pupils from this school
are taking special courses in surgery and in pediatrics.
Now in addition we want specialists in nursing education, and
we are going to develope them here. We are going to take the
nursing course as at present being given In this school and
add to it certain things and take from it certain things. We
are going to see to it that women taking it will not only be
good nurses, but will be soundly and thoroughly educated so
that a few years from now when nurses possessing University
training are needed for certain work, they will be forthcoming
and the demand for them will, judging from present indications, be overwhelming.
Now what are you in the Vancouver General Hospital Training School for Nurses going to do about it? But you say "It
doesn't concern me very closely" - this group you say will
only be a small one at first • it will be five years before
they finish - five years more before we can judge whether they
are any better than the ordinary graduate nurse, why all this
fuss? No, - that is not the point - the point is this • that
the University of British Columbia has granted recognition to
Nursing education. It has gone farther - it has inaugurated
a department of nursing • the first of its kind so far as I
aa aware, In the British Empire. There are several experiments of this kind now in progress to the south of us •
they have shown us the way. There are two • possibly more,
shortly to be inaugurated in the other Canadian provinces,
but the honor of being the pioneers rests with this Province
and in a certain sense with this hospital and in a special
sense with the man at the head of it • the amount of interest
which is being taken in all parts of Canada la the Vancouver
experiment is far greater than you realize here. I had a « 9 •
letter a few days ago from a woman who is prominent in
National Nursing affairs in which she said, "We in the East
will let you people out there go ahead with this thing. You
can make all the mistakes and the blunders, and then we will
come along and profit by them and show you how it really
should be done" • I wrote back to her and I said, "Yes we
shall be content for you to do that thing, but we shall have
blazed the trail, we are the pioneers." What she says is
true • they will some day do it better, but they will never
do it first. Still I see you looking at me and saying yes, •
all very fine, but where do we come in - we are not special
students, we are not taking the combined course * what are
we for? - the rank and file of the staff and pupils * this Is
where you come in. The University has agreed to accept a
certain period of time spent in this training school as having
a definite value. As being part payment as it were for their
degree. Do you suppose for one moment they would do this if
they did not feel reasonably well assured that the work done
in this hospital is thorough and honest and worthwhile. Do
you suppose that Dr. McKechnle, the Chancellor of the University
and Dr. MacEachern, your Superintendent would have gone bail,
for us, as it were, pledging themselves for the outcome of this
experiment unless they had faith in you * and in your work.
This hospital is to be one of the laboratories, as it were,
in this province where the new experiment will be tested out.
The public will not be so much interested in the record of our
special students in the University • what they will ask Is
this - "Are patients in the Vancouver General Hospital well
cared for? Do they carry over their teaching into their daily
work, or is it all talk - is it all theory with nothing back
of it but emptiness?" There is the acid test, that is where
you come in. You have got to demonstrate to the University
and to the public that work done in the wards of this hospital
by the rank and file of the staff and pupils is so good that
it is worthy of University recognition. No other department
in the University has to submit to such a searching test as
this. The Department of Nursing will be under judgment as - 10 -
to results from the moment of its Inception, before a single
student shall have received her degree. If the work done
here in the wards is only mediocre, then we shall have failed.
The University and other bodies will set standards - we must
live up to them, or we shall be thrust aside. Remember this
is not the only hospital in the province which will aspire to
University recognition - to be the largest is not enough -
the largest is not always the best, you will have rivals and
it will be good for you to have them, but I do feel that you
are going to be the best. You must be because you have such
wonderful opportunities - I do not think I have ever heard of
a hospital which could offer more in the way of clinical
material all the way from the Infants' Hospital to the Marpole
Annex, from the cradle to the grave - If only we turn it to
account. Then again this is one of the few training schools
in Canada where the eight hour system is in operation, and
above all you have the direction, the support and the encourage*
ment of your General Superintendent and the leading medical
men of the Province, Do you know that in some parts of the
country the most serious opposition to advances in nursing
education comes from the medical profession. You can hardly
imagine that here can you?
There is one question I know many of you will ask - and I
will anticipate it - it is this. Is it going to be possible
for nurses who have completed their training to take some
academic work at the end of their course instead of at the
beginning and obtain their University degree? To that question,
I must answer - "We do not know yet" - Remember the University
has not had an opportunity to judge us • they are not prepared
to give a decision on this point for the present. This whole
plan Is in the making but I still hope that if we can show the
University that we are worth-while they may consider this phase
of the question seriously. But even if they never should see
their way to this concession, it does not lessen your responsibility. To retain even the measure of University connection
which we now have we have got to maintain the nursing service
of this hospital on its present high level and more than that
we have got to raise that level. No one can do that but you - - 11 -
and remember you are not doing it for yourselves alone, you
are doing it in a Canadian School for Canadian Nurses, in
every part of this Dominion. If they can do this thing in
Minnesota, in New York, in Ohio and in Missouri, we can do
it here. And we will.
A few days ago I attended a conference with the University
authorities - it was not easy for me, I was a stranger, unproven,
untried. They were very kind, but beneath their kindness they
were critical and they had a right to be. As I sat there I
happened to glance down at the University calendar In my hand
and on the cover was the seal with its motto, two Latin words
meaning "It is thine" - somehow that comforted me - I took It
as a sign - I think when I came here one of your papers stated
I was a Canadian by birth.  I cannot claim that honor - I am
half Welsh and half Cornish and therefore, Incurably superstltous,
and I am going to accept that motto as an omen for good. "It
is thine." The opportunity has come to you to lead the way for
Canadian nurses. See that you prove worthy of it. If some day
you come to feel that I am worthy of the great trust reposed
in me, I will ask you to change that motto a little and to let
me say - "It is ours".
Speech by Miss Ethel Johns. Original copy
given to Mabel Gray "by one of the three
Directors of Nursing of the Hospital during
the time I was at the University".
Miss Gray gave this with other historical
material about the School of Nursing to
Miss McCann on January 7, 1969.
Miss Street, with Miss McCann's permission,
gave the original document to the Woodward
Library for safe keeping with other Ethel
Johns papers.


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