6. ‘beyond the dream’: A Legacy of Nursing at SickKids – Thoughts from Margaret Keating – 2007

Margaret Keating talks about the production of the DVD.

Article printed in “Alumnae News”, Fall 2007

Editor’s comments:  As members of the alumnae we have much to be grateful for to Margaret Keatings, Vice President Professional Practice and Chief Nursing Executive.  Margaret was the driving force and energy behind the DVD “beyond the dream”.  We are including some of Margaret’s comments and thoughts, in her own words, about the DVD and the process involved in making it.  A very special thanks and heartfelt appreciation to Margaret from all of us.

“beyond the dream’ was premiered on October 5, 2006.  The film is a retrospective of the immensely rich history of nursing at SickKids.  The documentary is a celebration of more than 130 years of dedication to the care of children and the evolution of the nursing profession.

The project has been a deeply affirming experience for me and for many of the talented and dedicated staff who have made something that started out as a vague idea into a meaningful and lasting reality.

It became quite clear to me after being at SickKids for a relatively short time, that part of the strength of its nursing culture is derived from a strong sense of history: a history that begins with its founder, Elizabeth McMaster, and has continued to embrace her spirit, determination and commitment to the health and care of children.  A little more than a year ago, just before Nurses’ Week, we started thinking about whether we could document that history and capture it for future generations.

While we were unsure of how it would unfold, we were certain that now was the time to do it.  I believed it would be essential to the integrity of the project to capture the stories of our alumnae, proud women who had spent their formative years as students at the Hospital for Sick Children School of Nursing and continue to influence the nursing culture at SickKids today.

It took almost 14 months to produce this documentary.  In the process 55 nurses, physicians, staff, Alumnae, and historians were interviewed, more than 26 of them on camera.  Much to our archivist’s delight, we now have more than 27 hours of original footage that will be available to future generations of nurses.  Add to that, 200 archival photographs from the hospital and the city of Toronto archives, 11 films from our archives and those of CBC, and you have a rich tapestry of material, all of which have shaped and informed the final product.

We are delighted by the overwhelming response to the film.  Many hours of labour have gone into creating this documentary, but the project really belongs to the many generations of SickKids nurses, past, present and future.  This is your story, and we hope you will find it enlightening, affirming and maybe even inspiring – I know it has touched many of us in different, but equally profound ways.  Yours is a legacy of compassion and caring for children and families, and dedication to evolving the nursing profession to unanticipated heights.

SickKids began as a humble two story house with 6 tiny cots and has become a world renowned paediatric academic health sciences centre and nursing has played a vital role in that evolution.  If nothing else, this film is an effort to make that statement, and to capture that truth for generations to come and to be a source of pride.

This attempt to pull together scattered pieces of our history and to tell a story that illuminated the past, helps us understand and make sense of our present, and inspires us to plan for an even more brilliant future.

I hope you enjoy the film, the look back at our history, and find that we have done it justice.

November 12, 2010 | Posted in: The School | Comments Closed

5. What’s Going On In Nursing Education in Ontario Today? – Elsbeth Geiger, 1966

Elsbeth Geiger, Director of Nursing, Hospital for Sick Children

Article from “Alumnae News”, Spring 1966

Elsbeth Geiger

“1965 was a decision year for Schools of Nursing in Ontario.  Certain definite changes were announced by the Government in mid-June and planning for these changes will have to go on during the next few years.

Due to increased demands for Nursing Services, to the increased numbers of hospital beds planned for Ontario, and to the increased usage of these beds, it was decided that the numbers of registered nurses graduated in Ontario must be doubled by 1971.  This accelerated output will put a strain on existing Schools of Nursing, on clinical facilities used for practical experience, on existing numbers of nursing instructors and on the cost of nursing education.  (The effect of this on Nursing Service was not mentioned!)

The proposed change in the pattern of nursing education is to a 2 + 1 year plan by 1971 and to the two year programme by 1975.  Many of the nursing educators are questioning the reasoning behind these changes, and have come to the conclusion that finances dictated this pattern of change.  The proposal for the 2 + 1 year plan includes a two-year educational programme during which time the theory and practice included in the Nursing course is correlated and completed and the registration exam is written.  During the third year, the student is assigned to Nursing Service and she has an opportunity to perfect nursing skills.  During this year she receives a salary or honorarium of $275.00 per month.

No matter how you look at this, the nurse is repaying part of the cost of her education during this third year, as she will be performing as a first level staff nurse but at a reduced salary.  Registration would be granted to the nurse at the completion of the third year.  After 1971, when the two year programme will be starting, the changeover could be quickly accomplished by dropping the + 1 or third year.

Confusion exists regarding the authority of the College of Nurses and the Ontario Hospital Services Commission in planning change.  The College of Nurses is responsible for approving any major change planned for an existing School of Nursing or a programme for a new School of Nursing.  Once this approval is secured, negotiations can proceed to finance the programmes.

The Minister of Health has planned for a 2 + 1 year nursing programme for the immediate future; yet the College of Nurses recognizes a two or three year programme, provided that certain criteria are met.  Another problem confronting us is the criteria of a two year programme and the resultant difficulty that Hospital Schools will have in meeting these by 1975.

The staff of our School is presently studying curriculum content and planning curriculum changes that will meet the proposed changes that are required of us.

Later this Spring, an Affiliate Conference will be held to start specific planning for the Paediatric Nursing Programme.  The problems involved here are monumental as numbers will double shortly and the quality of the experience provided at the Hospital for Sick Children must be safeguarded and motivation for specialization in paediatric nursing must be encouraged.

The implications for Nursing Service of the changes in educational patterns is only becoming evident.  Little has been planned to help service personnel understand these changes and to picture what the graduate of these changed programmes can do.  The need for qualified In-Service Education personnel must be recognized and steps taken to organize broad programmes to promote all phases of staff development.

It is an interesting time in the development of nursing and those of us privileged to work in Nursing Service and Nursing Education today have a responsibility to contribute to the changes that should occur during the coming decade.”

4. Is the Nurse Necessary in Modern Paediatrics? – Florence Erickson, Ph.D – 1964

Florence Ericson, Ph.D, University of Pittsburgh School of Nursing

Excerpts from an article that appeared in “Alumnae News” December 1964

Dr Erickson was speaking at a conference in 1964 on the role of nursing in the care of sick children.  Only a little of her speech is highlighted here, enough to give a flavor of changes that were beginning to occur in the role of nurses and would continue to evolve into what we now refer to as family centered care.

“One has only to look at the program for this conference to be aware of the tremendous advances the medical profession has made in saving the lives of children.  Accurate and early diagnoses, intricate surgical procedures, safe anaesthesia, fluid therapy, and the like have made it possible to deal with anomalies and illnesses which in years past have been virtually untreatable.

Modern paediatric care goes beyond keeping children alive or restoring their bodies and is concerned with the total effects of the illness experience on the child’s physical, social, and psychological development.  Psychiatry has shown that what happens to us as children, how adequately we learn to cope with the stresses of life determines largely our concept of self and our capacity to function in an adult world.  If we believe that children are the hope of the future then as adults we must be concerned with helping children to grow up unhampered by needless fears and phobias.

It takes more than the medical profession to do the job…………..As a nurse and nurse educator I am concerned with the role of nursing in modern paediatrics …..

………In summary, modern paediatric care makes many demands on the nurse.  It means she must be prepared in all aspects of child development to be able to detect deviations from the normal.  She must be skilled in how children cope with stress and able to reduce a crisis into stress with which the child can cope.  She must be able to communicate with children of every age as well as with parents, doctors, social workers, therapists, and administrative personnel.  She is in a sense the protector of the child, who knows him well and is therefore able to interpret for him how he sees the illness, when he has had too much, what his fears and fantasies are at the moment.  It is a large order.  Some of it is already being accomplished, the rest will come to pass as nursing raises its own sights and demonstrates that it can contribute to paediatric care.”

3. A Moment In Time: Sick Kids Nurses in Jean Masten’s Era – Kay Cowan

By Kay (Little) Cowan.  Article appeared in “Alumnae News”, Fall, 1999

We stood in a semi-circle, quietly at attention, proud of our blue uniforms and starched white aprons and bibs that shortly would be scrunched and wrinkled from cuddling and feeding our wee charges on Infant Medicine or the toddlers on Surgery with casts on various extremities whom we would bathe and feed.

Every morning after breakfast, which we were not allowed to miss, and before classes  or practice on the wards,  Miss Masten or Miss Gibson would lead us in prayers in that space between the beautiful rotunda and the cafeteria on the first floor of the brand new hospital. We were the first class to start in the 555 University Avenue location in 1952 and we were housed and protected from the city in the new elegant Elizabeth McMaster House.

The Nursing Department was run like a tight ship with Jean I. Masten as the Captain.  Our nursing leaders always seemed to have an accurate finger on the pulse of the place.  I recall one night as a second or third year student, working nights alone on 5A, the Cardiac Unit.  The cardiac resident had just arrived in answer to my urgent pleas to see a post-op charge, when Miss Kerr, the night supervisor, as if by magic, came sailing down the hall,  baptismal font in hand, saying “Do you need me?”, as I was about to page her.  Things seemed easier and less complicated then.  Everyone was trained in the same code of ethics, protocols and procedures.  Visiting hours were Sunday and Wednesday with viewing only on the infectious ward.  Yes, rigid, ruled and regimented.

This  was also the time of the “great ones”.  The legendary Dr. Alan Brown still made rounds on the wards and we students were stationed at bedsides, ostensibly to diaper, cuddle and tuck babies back in after the team was through, but encouraged and privileged to listen to the bedside lectures.

Dr. Bill Mustard was performing “Blue Baby” operations and later developed the famous surgery to correct Transportation of the Great Vessels.  Dr. Nelles Silverthorne gave intravenous and drug therapy to dehydrated babies on the infectious ward through his invention the Fletcher Drip, the precursor to IV therapy, saving babies with gastroenteritis and children with meningococcal meningitis.  We nursed children with hydrocephalus with huge heads until shunts were perfected much later by the Hendricks, Hoffman and Humphrey’s team.  Dr. Salter was a caring chief resident.

HSC had no ICU, the Metabolic Unit was only one room, and children with cystic fibrosis usually died before the age of four.  Polio patients were in iron lungs.  Equipment was all reusable – no pre-packaged disposables and everything was labour intensive.

This was Jean Masten’s domain.  She encouraged nurses from the hospital for Sick Children in Great Ormond Street London to come for post graduate experience and our nurses went to England.  Later nurses came from all over the world as did our patients. We began to learn and develop respect for those from cultures and customs different from our own.

We as students were given exceptional learning opportunities not available to today’s college prepared nurses, because we were immersed in paediatrics 24 hours a day, living, breathing, crying and sharing experiences with each other  –  essentially learning what went on in the emotional as well as the physical corners of the hospital.

But life in training was not all serious.  There were hilarious Christmas parties and baseball games with residents, staff doctors, nurses, all staff and students invited.  Jean Masten usually presided over our special occasions held in the beautifully appointed residence; our third of the way Black Band Dance and the Mother and Daughter  tea, Father and Daughter banquet and the party before graduation.

At the end of our three years, what  made us true paediatric nurses?  I believe it was the honing of out “reading” skills.  Reading body language, pain signs, interpreting infant cries, learning the nuances of facial expressions for all ages.  The smiles when you get it right are  the rewards that keep you trying.

2. Reflections on the Move to 555 University Ave – Dr. E.A. Morgan

Excerpts from address by Dr. E.A. Morgan to the Graduating Class May 1951- as printe in “Alumnae News”, 1952

“………….Great changes have occurred since the last graduating exercises.  We have moved into a wonderful new hospital but the change has been attended by mixed emotions and many of us feel as though we have left our hearts behind in the old building.  We have traded comparative squalor for spotless cleanliness but if I ever see a cockroach in the new building I think I will embrace it.  Instead of a building that was a veritable firetrap but which rarely had occasion to turn in a fire alarm, we now occupy a completely fireproof building to which the Fire Department is summoned once a moth.  We have traded cramped quarters for boundless space but possibly at the expense of an increased incidence of fallen arches.  We have traded one elevator, often out of commission but doing nobly its duty, for six elevators on whom the mantle of mechanical disruption has apparently fallen leaving them merely struggling.

………The atmosphere in the old hospital as I knew it as an interne was quite different from that of the present one.  Miss Brent – a combination of a stern disciplinarian and a very lovable character was superintendent of the hospital, superintendent of nurses and superintendent of the interne staff.  Philandering of any kind was stamped out as a venomous snake.  The real detective work fell to the lot of the night supervisor, who used to wear rubber soled shoes; it would not surprise me to learn that her activities were responsible for the coining of the word “sneakers”.

…….(Dr Morgan concludes with these important words)…….”We are in imminent danger of becoming a scientific, efficient and soul-less institution where intimate personal contact with the patient, such as we enjoyed in the old building, may be lost.  An atmosphere of home, embodying as it does an aura of security, friendliness and motherly sympathy is a tremendous therapeutic factor in restoring health to a sick and temporarily homeless child.  It will fall to the lot of the nurses more than to any other branch of the professional staff to see that such an atmosphere becomes a reality so that we may all progress with hope and confidence towards the goal we have all prayed for – that of doing the most good to the greatest number in the shortest space of time.”

1. Looking Back and Preparing for the Move: Jean Masten, June 1950

Jean Masten’s Report to the Graduating Class of June 13, 1950

Note:  This article appears in the 1950 edition of  “The Alumnae News”.  It provides a wonderful overview of life and times at HSC as staff plan for their upcoming move from College Street (1892 – 1951) to 555 University Avenue.  Many graduates will remember this transition, the rest of us will cherish our training and working days in the new hospital.  Some of us saw the addition of the Elm Street Wing, New ICU, and ultimately the addition of the Atrium patient care tower on Elizabeth St in 1993.

“Our Superintendent of Nurses, Miss Jean I. Masten, has become as versatile as Florence Nightingale was reputed to have been!  Not only does she keep the School on a steady keel throughout these testing times of uncertainty regarding the move to the new building, but she herself (if she had the time) could apply for her engineer’s papers, plumbing license, drafting diploma, architect’s assistantship, and degree in hospital management with a major in Ordering Equipment Which Is Advertised But Rarely Available.

Thus, as she speeds by with scrolls of blue prints under her arm, we the Editors hesitate to ask her to take the time to write a special message for you this year.  However, we have been able to obtain a copy of the Sixty Fourth Annual report which she presented at the Graduation Exercises on June 13, 1950, and with her permission are reprinting herewith certain excerpts which we know will interest you.

Jean I Masten

“……Some of the things that have been accomplished during the fifty-eight years that the old building has sheltered the hospital and the school.

When the present hospital was opened in 1892, seven nurses had graduated from the School.  During the ensuing fifty-eight years, 1288 nurses have received their training under this roof, including the thirty-seven members of tonight’s graduating class.  We believe we shall have a more substantial representation to move from the old to the new building later this year.

The two names that stand out in connection with the present building are of course those of John Ross Robertson, almost synonymous with the Hospital for Sick Children, and Louise Brent, Superintendent of the Hospital and the Nursing School from 1896 – 1913.  This was the era of great benefactors and great nursing pioneers and the Hospital for Sick  Children was wonderfully blessed in the team work of these two exceptional people who laid down the foundations for the Hospital and the Nursing School as solid and honest as the Credit Valley Stone, on which our staunch old building stands.

Miss Brent increased the nursing course from two years to three, established the first preliminary training school in Canada, established a short course for Nursery Aides, and was an outstanding figure in the Canadian Society of superintendent of Training Schools.  She also ran the entire organization.  Meanwhile, Mr. Robertson provided advanced facilities by building the finest nurses’ residence in the country and yearly making possible the addition of new hospital services and necessary alterations.

It is inspiring to read of these early and progressive years and the vision that inspired our predecessors.  Perhaps our greatest responsibility and challenge will be to carry over from the old to the new all those qualities of heart and brain established so soundly by these two as well as by the outstanding surgeons, physicians and nurses who, throughout the years, have built up our present hospital.

After the opening of the country Branch (at Thistletown), the Course for Nursery Aides was chiefly carried out there.  However, within the last few years the Provincial Government has set up an excellent course to train nursing assistants, and in view of this our course was discontinued last year.  At the same time we were approached by the Provincial authorities responsible for nursing education, and asked to extend our already large affiliate programme.  We therefore agreed to make certain alterations at Thistletown and accept a continuous rotation of twenty nurses for eight weeks experience on the wards there.  These students spend the last four weeks of their affiliation at the City Hospital.  ………………

A great deal of time has been spent during the year by members of the graduate staff in considering equipment and nursing methods for the new building.  It is impossible to realize beforehand how much detail must go into the selection of waste disposal units, paper towel containers, linen carries and such rather humdrum requirements, quite apart from the important pieces of hospital furniture and equipment.  Closely associated with this work has been Mr. Donald Long, the Head of the Carpentry Department, without whose inventive genius and technical skill infinitely less could have been achieved.  I think we all find it a tonic to go over to the new building and see the space, air, and sunlight on the ward floors, especially since the painting has begun.

No radical changes have been made in the student programme during the year, but some improvements in the integration of theory and practice have been achieved.  Facilities for experience in the nursing care of children together with a teaching programme (is provided for) student nurses from seven city and twenty-two schools in the Province. ………The teaching programme is carried on continuously throughout the year by the physicians and surgeons in addition to various types of nursing instruction…….We are looking forward to bettering our teaching in the new building.

Each year I am confronted with the difficulty of finding words to express my appreciation of the work carried on by the nursing staff.  The demands on their patience, strength, and skill continually increases, and yet they provide throughout the hospital the cushion that absorbs the sharp impact, serves the public and the medical staff, and most important of all, ensures a security for the patients, without which a children’s hospital could achieve little. ……………..”