An Emancipatory Vocation: Nursing in Quebec, 1912–1974

Established in 1967, the first Royal Commission on the Status of Women, also known as “the Bird Commission,” emerged following pressure from women’s groups calling for an inquiry into the status of women in Canada. The commission and its 1970 Report of the Royal Commission on the Status of Women in Canada was a major step for the Canadian women’s movement. On the fiftieth anniversary of its report’s release, however, an old refrain reemerged. When asked about the Commission’s report, some Canadian feminist historians resurrected the rather negative opinion about the nursing profession once held by their predecessors. In early December 2020, Quebecoise historian Camille Robert claimed on Francopress that the Bird report included “proposals against wage discrimination and access to more careers so that [women] would no longer be relegated to secretarial or nursing jobs.” Robert seems to believe that a rejection of these “ghetto-type” jobs for women, as they were labeled in the early 1980s by the group of Quebecoise feminist historians known as the Clio collective, is a necessary part of women’s liberation.^[1] Robert maintains the idea that Canadian women needed to be saved from this fate, which consisted of having to choose between marriage or a nursing job, as if the latter were inevitably demeaning, degrading, and undignified.

It must be said that, in nursing literature and historiography, the nurse embodied, and maybe still embodies, the very model of the subordinate who is fully subject to the orders of the male doctor. Even worse, she is the one who has made this submission her vocation! However, and without even mentioning that more women than men have practiced medicine in Quebec since 2018, nurses have frequently been autonomous health-care representatives and full-fledged agents in the advancement of knowledge and care and treatment technologies, particularly in Canada. Hence, it seems as unfair as it is inaccurate to convey this image of submissive women, confined to a reluctantly chosen subordinate position as a nurse, when the nursing profession, religious or secular, has been a place of affirmation, of fulfillment – in short, of empowerment. But old habits die hard and, despite numerous studies by nursing historians proving otherwise, it remains difficult, particularly for nurses opposed to the historians, to associate vocation with emancipation.

To attempt to finally deconstruct this preconceived notion, we will reflect on the careers of two Quebecoise nurses, one religious and the other secular, both passionate about pedagogy, who both became managers, and who, each in her own way, helped to pioneer psychiatric nursing in the province: Sister Augustine (1873–1963) and Charlotte Tassé (1893–1974). To the first, we owe the creation of the first nursing school at a psychiatric hospital in Quebec; to the second, the first training course in psychiatric nursing leading to a qualification and recognized by a university.

In 1896, Clémence-Amélie Filteau became Sister Augustine, one of the Sisters of Providence responsible for the Saint-Jean-de-Dieu Hospital, the largest asylum in Quebec, situated in the east end of Montreal. First a hospital nurse, then an officer in charge, in 1912, she ultimately became director of the nursing school she created, which, in addition to offering a training program in line with those of the general hospitals, also offered “neuropsychiatry, mental hygiene, and psychotherapy courses.”^[2] Quickly recognized by provincial professional bodies, most notably the Association des Gardes-Malades Enregistrées de la Province de Québec (Quebec Association of Registered Nursing Schools), this school became known as a crucial site for nursing students wanting specialized training in the treatment of nervous and mental disorders. Moreover, in addition to its own students, it drew trainees from other schools, who came to specialize in psychiatric nursing. Beginning in 1945, more than twenty hospitals, primarily in Quebec, sent their students to Saint-Jean-de-Dieu to complete a practical training program that also included forty hours of theoretical training in symptomatology, personality development, mental processes, or clinical case presentations. During the 1950s, hospital nurses trained nearly two hundred trainees each year.^[3] Made mandatory in 1960 by the Quebec Nursing Association, this training program for affiliated schools hosted no less than 446 students the following year.^[4] Sister Augustine, who, after graduation from Saint-Jean-de-Dieu, had taken “a series of nursing courses at the University of Montreal, to obtain a bachelor degree in science, in higher education, in social sciences and administration,”^[5] encouraged her colleagues to pursue their education, first to specialize, but also to keep up with the latest advancements in nursing and psychiatric knowledge. In her eyes, vocation and education were not incompatible, as attested by her commitment to caring for the sick for more than fifty years, as well as to the education of her religious and nursing colleagues.

Although deeply religious, Charlotte Tassé chose the secular path to nursing. Graduating in 1917 from Notre-Dame Hospital in Montreal, she decided to specialize at the famous Bellevue Hospital in New York the following year instead of pursuing private practice. Dr. Albert Prévost (1881–1926), a Montreal neurologist who had just opened a small private sanatorium on the banks of the Prairies River, recruited Tassé in 1919 upon her return to Quebec. Her first move was also to open a nursing school to train nurses likely to care for those “nervous patients, sometimes difficult to satisfy, but always so captivating due to the variety of their symptoms.”^[6] Little did she know that she would spend almost forty-five years at the Prévost Sanatorium, becoming director and owner in 1945. She actively worked for the development and institutionalization of psychiatric nursing, both at the institution and with the journal La Garde-Malade Canadienne-Française (The French-Canadian Nurse), which she began managing in December 1927. Consequently, in 1938, she created a course at the sanatorium specializing in neurology and psychiatry for registered nurses and third-year students from all hospitals. Comprised of twenty-two lessons given three times a week by the establishment’s neurologists, this training brought together forty-five volunteer nurses, of whom sixteen would eventually earn a degree in neuropsychiatry.^[7] In 1953, Tassé established her dream program of permanent training in psychiatric nursing. This advanced course in psychiatry, free and conducted over the course of a year, involved 157 hours of instruction from nurses and doctors from the Prévost Sanatorium, and also included three months of mandatory training at the Saint-Jean-de-Dieu Hospital, as well as completion of a thesis defended before a jury of professionals.^[8] It was, at long last, validated by the University of Montreal’s Faculty of Medicine. On October 13, 1954, Rachel Gagnon became the very first “I.L.P.” (Infirmière Licenciée Psychiatrique, registered psychiatric nurse) in Quebec, receiving her diploma from the Dean of the University of Montreal, as well as a newly created professional badge, designed for the occasion by Charlotte Tassé.^[9] Two years later, it would be Tassé’s turn to be honored when she received the annual grand prize in Quebec from the Canadian National Committee for Mental Hygiene, thus highlighting her major contributions to the development of mental health care in the province.^[10]

Thus, in contrast to the subordination to which we too often relegate nurses, in particular with respect to the notion of vocation, the careers of Sister Augustine and Charlotte Tassé illustrate that the nursing profession could be a place of fulfillment and realization for Quebecoise women during the first half of the twentieth century. Far from being an educational dead end, chosen out of frustration, a nursing career allowed those who pursued it to acquire power, responsibility, and even public recognition. It thereby allowed them to fulfill their ambitions while contributing fully to the advancement of the profession, as well as the emancipation of their colleagues. Largely forgotten today, the trajectories of these full-fledged leaders in the field of nursing invite us to rethink women’s history and liberation by finally attributing to nurses and their vocation the central role they have played.

Quebecoise nurses, both secular and religious, have contributed greatly to the professionalization of their occupation, as well to the emancipation of Canadian women. In asserting themselves publicly as autonomous women, actively contributing to the development of not only the practice but also the science and the profession of nursing, they have paved the way for the emancipation and autonomy of several generations of women, all the while making their presence indisputably felt in the public domain. As such, it is a matter of urgency to integrate the major contributions of Quebecoise nurses into nursing literature, as well as Canadian feminist history, to transcend both the domination of the historical role model of Florence Nightingale in nursing history, as well as some feminists’ dismissal of nurses to the rank of simple subordinate, submissive to her profession. Since the early decades of the twentieth century, nursing has become an important and emancipatory profession for Canadian women, in particular thanks to contributions by Quebecois leaders who have been completely forgotten today. The recognition of their essential contributions to Canadian nursing history, as well as to the history of Canadian women’s emancipation, would right a profound historiographical injustice and, by reappropriating its history, allow the nursing profession to replace and renew its role models.

Alexandre Klein

Dr. Alexandre Klein is a philosopher and historian of science, specializing in the history of health. He is adjunct professor in the School of Nursing, Faculty of Health Sciences at the University of Ottawa, and facilitator of the Nursing History Research Unit. He is also associate member of the Centre interuniversitaire de recherche sur la science et la technologie.

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Marie-Claude Thifault

Dr. Marie-Claude Thifault is a historian specializing in the history of psychiatric institutions and mental health care in Quebec and Canada. She is full professor in the School of Nursing, Faculty of Health Sciences at the University of Ottawa, head of the University of Ottawa Research Chair in Health and the Canadian Francophonie, and director of the Nursing History Research Unit.

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