Nursing History Digitization Project - Formal Training for Nurses, the Beginning

Formal Training, the Beginning

Formal Training for Nurses, the Beginning

Before the emergence of formal training for nurses in Canada, nursing skills were passed down from one generation to the next by female relatives and neighbours through both verbal instruction and compiled manuals of domestic and herbal remedies. With the advancement of industrial and urban growth, along with advances in medicine in the late nineteenth century, it became more and more difficult for female relatives to care for the sick in their homes unless they could afford to obtain medical and surgical care. Those who could not afford to obtain medical and surgical care in their home were often sent to a hospital for treatment. These hospitals were usually financed through charitable funding, had low medical standards, and were generally staffed by working class women who had no formal training as nurses. In fact, many of the women only became nurses because they had been dismissed from their previous employment due to drunkenness and misbehaviour, as nursing was not generally considered a desirable employment.

In the late nineteenth century many hospitals began to transform their image from a place that generally only cared for the lower classes of society because of their low medical standards, to places of successful medical care that would serve all classes of society. In order to allow this transformation to occur, it became evident that something needed to be done so that the hospitals would be staffed with qualified and competent staff. The result was the establishment of training schools for nurses where students would be taught the proper procedures for patient care. Dr. Theophilus Mack established the first nursing school in Canada in 1874 at Mack’s General and Marine Hospital in St. Catharines, Ontario. In Nova Scotia the first training school for nurses opened in 1890 at the Victoria General Hospital in Halifax.

At first enrolments in nursing schools were very small, but by the beginning of the twentieth century it became apparent that the hospital trained nurse would dominate the field and the number of nursing schools and nursing students quickly increased. The greatest expansion of nursing schools in Canada occurred in the first three decades of the twentieth century. In 1901 there were 65 nursing schools across the country and a total of 280 nurses and student nurses, by 1930 there were 218 nursing schools and over 9000 student nurses in training.

Hospital administrators immediately began to recognize the improvements the trained nurses were making to patient care, and began to replaced their untrained nursing staff with student nurses, who spent two or three years working in the hospital wards in exchange for training and certification. This system of staffing hospitals and training nurses not only enabled the hospital to improve their patient care, but it also enabled them to keep up with demands for increases in patient services. As more nurses were needed, the number of students admitted to the nursing school increased. This system continued as the dominant system for staffing hospitals in Canada until the 1940s and was the basis of training nurses until the 1970s.

The first university based nursing school to appear in Canada was established in 1919 by the University of British Columbia, in Vancouver, where they offered a basic nursing degree program. Other universities soon opened their doors to graduate nurses (nurses who had already graduated from a hospital based nursing school) offering one year courses. Dalhousie University in Halifax, was the first of these, opening its program in February 1920.

With the beginning of formal training, trained nurses struggled to distinguish themselves from untrained nurses. In order to make the distinction clear trained nurses began to use the term 'graduate nurse' which was later replaced by the term 'registered nurse'. Nova Scotia held their first provincial examinations for the registration of nurses in May 1925, making the distinction between trained and untrained nurses complete. All graduates of recognized nursing programs were then able to legally call themselves registered nurses. The registered nurse requirement remained the mandatory entry into the nursing profession for the rest of the twentieth century. At the close of the century this changed and a Bachelor of Science in Nursing degree became the mandatory entry requirement.

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