celebrating the evolution of nursing regulation in british columbia 100 Years of Nursing Regulation 1912 - 2012

In the beginning

To understand why Helen Randal and her colleagues were so concerned about nursing registration in the early 1900s, we need to understand the primitive state of health care at the time.

In the mid-1800s, British Columbia was a rugged land, home to First Nations and young men drawn by necessity, or adventure, or opportunities in fishing, mining, logging and fur trading. Then came two gold rushes – the first along the Fraser River in 1858, followed four years later with another in the Cariboo. In 1885, the transcontinental railroad was completed – linking British Columbia, which joined confederation in 1871, to the rest of Canada.

In those early days, Fort Victoria (later to become Victoria) was the supply base and outfitting centre for miners on their way to find their fortunes of gold. It was also the location of the Royal Hospital (now the Royal Jubilee Hospital), established in 1859 and the first hospital in British Columbia.

Three years later, a second hospital – the first on the mainland – was built in New Westminster, the capital of the colony. The Royal Columbian Hospital was designed to care for 30 male patients. Women, children, and "the incurable and the insane" were excluded. It was replaced in 1889 with a 50-bed hospital staffed by 10 people. In 1901, it amalgamated with the Women’s Hospital of New Westminster, the maternity hospital organized by the Women’s Christian Temperance Union.

It was not until 1886 that a hospital (of sorts) was established in Vancouver. The nine-bed tent, which was intended to treat Canadian Pacific Railway workers, was lost in the Great Fire that destroyed Vancouver on June 13, 1886. It was replaced by a small shack with only a few beds until the new 35-bed Vancouver City Hospital (now Vancouver General Hospital) opened in 1888. St. Paul’s Hospital was opened in 1894 by the Sisters of Providence who had earlier established St. Mary’s Hospital in New Westminster in 1887.

A challenge at each of these hospitals was the lack of trained nurses, so they began their own schools of nursing. Royal Jubilee Hospital appears to be the first hospital in the province to establish a training program, followed by Vancouver City Hospital’s Training School for Nurses in 1899 and Royal Columbian’s Nursing School in 1901. St. Paul’s Hospital School of Nursing graduated its first class of 11 students in 1910.

Few women in those days worked outside the home, and those who did were most often employed as domestic help. Many “schools of nursing” did little more than provide the hospitals with cheap labour in the form of student nurses. These young women were immediately sent to work on the wards under the supervision of matrons and doctors, with their “education” considered incidental. Because the work was hard and the wages (and status) low, nursing tended to attract women with little education, mostly from poor families, who were desperately seeking ways to advance themselves.

Despite the onerous conditions, nursing continued to draw women committed to providing quality care, and with great pride in what nursing was and could become. They also began to see – perhaps influenced by the success of the suffragette movement – that more would be accomplished if they banded together to form a provincial nursing association that could speak for all of them. What they wanted was registration for nurses in British Columbia.