Agnes Warner and the Nursing Sisters of the Great War (2 page)

Chapter Two

New Brunswick Nurses Go to War

In 1914, the occupation of “nursing” as we know it today, with all the hard-won trappings of a genuine profession, was relatively young. Certainly, women had been providing medical care for their families and communities for centuries, but this work was not recognized as professional, skilled work. Rather, it was considered domestic, innate, and inherently feminine. Women were predisposed to care for and heal others as a result of their “natural calling,” not by virtue of any special training, knowledge, or certification. Those who nursed full time tended to be members of religious orders or were effectively domestic servants, caring for ailing people in private homes or central hospitals that served the poor. Gains famously made by Florence Nightingale in the mid-nineteenth century sparked a vision of occupational rigour that moved pioneers on several continents to begin establishing nursing schools and pushing for occupational standards. But even as late as the 1870s, women working in North American urban hospitals typically were untrained, working class, and accorded lowly status by both the medical profession they supported and society at large. Nursing under these conditions held little appeal for promising young middle-class Maritime women, to say nothing of their parents.

But by the time Margaret Macdonald, Agnes Warner, and the other Canadian women who would eventually serve in the Great War first considered nursing as a career, perceptions had changed. Thanks to the persistence of the pioneer female administrators of hospital-based nursing
schools in applying Nightingale's model, the standards of classroom and on-the-job training had risen sharply in the 1880s and 1890s, and along with them the expectation of decorous and professional conduct. An exacting and military-like discipline governed most training schools, where first-year probationer nurses endured long days cleaning their wards and feeding and bathing patients before they were accepted into the intermediate ranks and given ever-more sensitive responsibilities with patients. Academic study filled the hours between gruelling shifts on the hospital floor. By the turn of the century, programs in Canadian and US hospitals had turned out multiple classes of proud graduates for whom a career in nursing meant a respectable and fulfilling profession that not only paid good wages, but also offered an unusual opportunity for administrative power and personal autonomy.

Not unexpectedly, this transition left many behind, for one of the drivers of this push for professionalism was the elimination of uncertified competition. The survival of the educated, professional nurse depended on replacing the notion that
any
woman could be a nurse with the conviction that only the brightest, the formally trained, and the socially upstanding could be entrusted with the job. Partly in reaction to the longstanding perception of nurses as disreputable, even morally suspect, nursing leaders promoted a new image of nursing school graduates who came from “good” families and whose dedication to caring for others had carried them through the fires of a rigorous training program. It wasn't difficult for a probationer to get herself ejected for showing poor aptitude or violating the strict behavioural code. Nursing programs thus became more and more elitist, even more so in Canada and the United States than elsewhere.

This gleaming new image became an important part of nurses' participation in the First World War. The graduate nurse's certificate served as an endorsement of her character and her ticket to independent adventures both at home and overseas. With Britain's declaration of war against Germany in early August 1914, a move that automatically involved Canada, the possibilities for service abroad exploded. After that point, provided she met the qualifications for training and age (the minimum age varied from twenty-one to twenty-five years), the trained Canadian
nurse could offer her services and be readily accepted in Britain, where administrators were busy setting up an International Nursing Corps and where the Queen Alexandra's Imperial Military Nursing Service (Q.A.I.M.N.S.) had been staffing British military hospitals efficiently for ten years. Or she could sign up with various branches of the Red Cross in virtually any country touched by the growing conflict. Many Canadian women made it overseas through their own arrangements and on their own dime, joining whatever organization could put them to work.

As the scale of the fight surpassed all imagination, it quickly became apparent to the Canadian military that Britain needed more than Canada's troops on the front line; medical personnel were also in great demand, and that included nurses. Before August 1914, there were only five nurses in the Permanent Army Medical Corps in Canada and some fifty-seven on the reserve Army Nursing Service list. There was no difficulty finding new recruits. Throughout August, applications from graduate nurses poured in by the hundreds. From these, an initial one hundred trained nurses were to be selected; inoculated; hastily trained for army service (if they were not army-trained already); outfitted with a sky-blue work uniform, navy wool dress uniform, and camp kit; and sent off with the staffs of two general hospitals that accompanied the Canadian Expeditionary Force (C.E.F.) to Europe in those early months of the war.

At least nine nurses from Saint John, New Brunswick, went with this first contingent to work in the No. 1 General Hospital, commanded by Colonel (Dr.) Murray MacLaren of Saint John. Among them were Miss Grace Domville and Margaret Parks, who was actually a medical doctor in civilian life. No female doctors or male nurses were recruited, though a few female doctors circumvented the red tape and cooperatively founded special non-military hospitals, like Saint John doctor Catherine Travis's baby hospital in Serbia. Moreover, no female staff went with the stationary hospitals and casualty clearing stations of the C.E.F. in the first contingent. These hospitals, located closer to the front, were in danger of enemy fire and their personnel had to be ready to evacuate at a moment's notice. The larger general hospitals, though, were accommodated in abandoned schools, donated mansions, or other reasonably suitable buildings in safer zones.

Before conditions convinced military authorities of the need to install nurses at advanced hospitals, a wounded soldier had to pass through several gruelling stages before he even saw a nurse. From the place he fell, he would have to wait for stretcher bearers to find him under cover of darkness and take him to the nearest first aid post, or try to crawl there by himself. From there he might be sent to an advanced dressing station or be conveyed by horse-drawn or motorized ambulance over appalling roads to a main dressing station to have his condition classified. If gravely wounded, he might be operated on immediately, then sent further back to the casualty clearing station as soon as he could be moved. If the wound was less serious, he would have an opportunity to recuperate somewhat before returning to the front. Casualty clearing stations (C.C.S.s) were set up on railway sidings less than five miles from the front. Earlier in the war, their staff chiefly dressed wounds and loaded casualties onto trains bound for larger hospitals in the rear: the (misleadingly named) stationary hospitals, with up to five hundred beds but designed to be mobile, or the
larger general hospitals, with a thousand to fifteen hundred beds and as many as a hundred nurses. Before long, however, C.C.S.s evolved into advanced surgical hospitals that provided life-saving operations before wounds became infected beyond hope. An obvious need for nurses trumped any lingering misgivings about putting women in harm's way, and before long select nurses held coveted positions in the casualty clearing stations, too. Duty so close to the firing line demanded the utmost efficiency — the best of the best — and nurses considered it a personal honour to be assigned to this work.

Back home, Canadian nurses continued to sign up in droves for active service. Applications flooded the desk of Matron-in-Chief Margaret Macdonald — too many to process, never mind accept, in 1914. As the front settled into a static line of trenches stretching from the Belgian coast to the Swiss border and casualty numbers mounted, the demand for Canadian nurses grew steadily but still could not keep pace with the number of applicants waiting anxiously to find out if they'd be next to
steam across the Atlantic. Colonel Guy Carleton Jones, head of what was by now called the Canadian Army Medical Corps (C.A.M.C.), did his part to dissuade fair-weather recruits. Addressing a meeting of the Ottawa Graduate Nurses' Association, he sternly warned that “Active service work is extremely severe. A very large proportion of regular nurses are totally unfit, physically and mentally, for it.” If his caution gave some women pause, it did not appear to curb interest. And no wonder: with slogans such as “Come on Boys!” and “Your King and Country Need You,” Canada was enjoining its young men to enlist and face unknown horrors. For nurses, too, the call to defend civilization resonated loudly
in both the conscience and the imagination. Here was an opportunity to stand on the same ground as their countrymen and restore them with comfort and healing if they fell — to serve the nation in a way for which nurses were uniquely qualified. There is little doubt that the active service posters targeting Canadian men struck nurses more forcibly than messages pleading women to knit furiously and economize on the home front. What is more, nurses were free to go. The vast majority were unmarried, with an unusual degree of independence and a salary, and although most would never have considered international travel before, the war now facilitated their going and there was nothing standing in their way. Canadian army nurses would see service in England's cities and countryside, France's coastal resort towns, Belgium's villages, scorching eastern Mediterranean islands, and even, for four “fortunate” women, Russia in the midst of revolution. As Canadian soldier recruits rushed overseas with enthusiasm, so did Canadian nurses. One nursing sister put it very plainly in retrospect: “I wanted to be in the Army because I was curious; I wanted to see what it was like.” Once contracted, most nurses were locked into service “for the duration” of the war, and only personal illness, daughterly duties (such as those resulting from death or illness in the family), or matrimony could release them. Few nurses traded service for marriage during the war, but it was not unheard of.

For some nurses, the impetus to serve abroad came from a deeply personal need to be physically close to beloved fiancés, friends, and relatives as they struggled in the fight of their lives. Matron Macdonald recognized this motivation as an important one for keeping C.A.M.C. nurses in good spirits, and wherever possible she arranged for her nurses to work near loved ones posted with the C.E.F. For those who had lost dear ones already, the busy-work of nursing offered a way to overcome their private tragedies, feel more worthy of their beloved's sacrifice, and keep from drowning in personal despair.

The call to service also struck a chord with the ideology of their profession. Nurses had always protected individual humans. Now they were called to protect humankind with the angelic self-denial and maternal purity that went hand-in-hand with the ideal of the “true” nurse. Images
of mother-nurses bearing angel's wings cradling wounded men figured prominently in recruitment posters on both sides of the Atlantic. Such chaste and noble depictions also reassured families back home who feared the unwholesome effects of globetrotting and army coarseness on their daughters. Nurses themselves reinforced their maternal role by referring to the wounded as “lads” or “boys.”

Then there were the perks. Besides the sense of importance that came with participation in active service, which excluded most other women, a C.A.M.C. nursing sister's position came with paid room and board, amounting to about $2.60 per day, and beautiful blue uniforms that earned Canadian nurses the cheery nickname “Bluebirds” and incited envy from grey-clad Imperial and Red Cross nurses everywhere. Canadian nursing sisters loved their C.A.M.C. uniforms. The cornflower blue workday outfit with full white apron and shoulder-length white veil gave them the look of schoolgirls, nuns, or ministering angels — perfectly in keeping with the “Sister” moniker that was a carryover from the days when religious orders did full-time nursing and aptly implied exclusive membership in a carefully guarded club. The darker blue dress uniform boasted two rows of brass buttons, a scarlet-lined cape, and brimmed dress hat. It was altogether a sharp outfit, but one feature of particular significance glinted from the shoulder and distinguished the C.A.M.C. nurse from her British counterparts: the two stars of a lieutenant. For nearly a decade, C.A.M.C. nursing sisters had enjoyed officers' rank: lieutenant for nurses, captain for matrons in charge of hospitals, and major reserved for the matron-in-chief. Army officials justified officers' ranks for nurses (albeit without a command or full commission) on the basis of nurses' social origins, their higher education, and the propriety of elevating them a respectful distance above the rank-and-file soldiers whose bodies they mended. C.A.M.C. historian J. George Adami recognized that the nurses' rank was a somewhat contentious subject when he defended it in 1918: