Museum of Health Care Blog

Nurses were expected to be proficient in both mental health and physical nursing, as well as to be knowledgeable of the various mental illnesses and how they may appear.

For the majority of the nineteenth century, trained nurses did not work at hospitals or asylums. The members of staff who interacted frequently with the patients and who were not doctors were commonly referred to as “attendants” or “keepers.” This group did not typically receive formal training, and was drawn from working class individuals, often with no other place to go.

During its early years, Rockwood Asylum employed an equal number of male and female attendants, each responsible for the care of their own sex. The duties of the attendants in the first decades of the institution were extensive and varied, including full responsibility for the daily care of patients.[1] Attendants were paid very little for their nearly constant efforts, with female attendants making 10-20 dollars less monthly than their male counterparts. Partially due to poor salary, the institution was unable to entice “attractive” individuals to the position and as a result, doctors treated the attendant population with disdain.

When Charles Kirk Clarke assumed the position of Superintendent in 1885, he petitioned the government to raise the attendant salary. He was successful in obtaining a twenty-five percent wage increase for the female staff in 1888.[2] In light of this event, Clarke decided that all female attendants would be required to undergo training at the institution. On April 12, 1888, the foundation of the Rockwood Training School for Nurses was announced.[3] The school advertised it was the first of its kind in North America due to its specified instruction for psychiatric nurses. The program was expected to attract “the most desirable class of girls.”[4] Applicants to the school had to be under thirty-five years of age and single.[5] They were required to pass a preliminary English exam, and provide satisfactory references. Once accepted, the program would take two years to complete, with nursing candidates expected to pass yearly exams with at least fifty percent in each subject, tested by an impartial city physician.[6] The first class of seven students from the Rockwood Training School for Nurses graduated in 1890, becoming the first specifically trained asylum nurses in the country.[7]

By the time Clarke left the institution in 1905, the school offered an extensive curriculum, taught by various professionals. Nurses were expected to be proficient in both mental health and physical nursing, as well as to be knowledgeable of the various mental illnesses and how they may appear. The students were expected to attend lectures, learn practical skills from demonstrations, and complete assigned textbook readings. Alongside their medical duties, nurses were instructed in basic housekeeping, vermin prevention, patient intake, and companionship.[8]

Clarke felt that graduates from the Rockwood program were of a higher caliber than nurses’ graduating from other hospital programs. He would write, upon leaving the institution in 1905, about the success of the training school:

“Few of those who were on the staff, when I came remain, but those who are still here will testify that the Rockwood of today, while far from the ideal we set out to attain, is so different from the crude and primitive Institution it supplanted. The greatest revolution was effected by the establishment of the Training School for Nurses, and when I look abroad and see how many of the graduates have reached success, I am indeed proud of the results achieved. If what is here known as the “Rockwood Spirit” has manifested itself anywhere, it is in the School for Nurses- the relation between nurse and patient is a very different thing from that between attendant or keeper and patient.”[9]

Nurses slowly replaced attendants throughout the country as the century progressed. Rockwood Asylum can today be remembered as the location where training of the first psychiatric nurses in Canada took place, a highlight of its history.

About the Author : Victoria Bowen

Victoria Bowen is the 2019 Margaret Angus Research Fellow. Victoria recently finished her undergraduate degree at Queen’s University, and has returned Queen’s University this fall to begin her Master’s in Art History. This summer, Victoria developed a manuscript that examines Rockwood Asylum in the late nineteenth century, focusing on the impact gender had on the experiences of patients at the institution. 

Citations

[1] Patrick J. Connor, “Neither Courage nor Perseverance Enough,” Ontario History 88:11 (December 1995): 252.

[2] Ibid, 263.

[3] Bruce R. Thomson, 125 Years of Keeping People Healthy (Kingston: Kingston Psychiatric Hospital, 1981): 18.

[4] Ontario Inspector of Prisons and Public Charities, Annual Report of the Medical Superintendent of the Asylum for the Insane, Kingston, Ended 30^th September 1888 (Toronto: Warwick and Sons, 1889): 63.

[5] Ibid, 63.

[6] Ontario Inspector of Prisons and Public Charities, Annual Report of the Medical Superintendent of the Asylum for the Insane, Kingston, Ended 30^th September 1903 (Toronto: Warwick and Sons, 1904): 56.

[7] Ontario Inspector of Prisons and Public Charities, Annual Report of the Medical Superintendent of the Asylum for the Insane, Kingston, Ended 30^th September 1890 (Toronto: Warwick and Sons, 1891): 93.

[8] Cheryl Lynn Krasnick Warsh, Moments of Unreason: The Practice of Canadian Psychiatry and the Homewood Retreat, 1883-1923 (Montreal: McGill-Queen’s University Press, 1989): 38.

[9] Ontario Inspector of Prisons and Public Charities, Annual Report of the Medical Superintendent of the Asylum for the Insane, Kingston, Ended 30^th September 1905 (Toronto: Warwick and Sons, 1906).