Bedside Matters: The Transformation of Canadian Nursing, 1900-1990

Cynthia R. Comacchio is an associate professor of history at Wilfrid
Laurier University and the author of Nations Are Built of Babies: Saving
Ontario’s Mothers and Children.

Representing the first scholarly analysis of nursing as both culture and
profession, this long-awaited monograph covers four generations of
changes and continuities in training, on-the-job experiences,
professionalization and organization, public image, and the problematic
nurse–doctor relationship.

From the author’s perspective, the difficulty of classifying nursing
as a profession derived from the gender-typing of the work involved.
Perceived as a fundamentally “feminine” job, nursing was devalued
and categorized largely as a form of domestic labor performed in trying
conditions for low pay and little status. In their ongoing struggle to
upgrade their public image and professional reputation, nurses were
caught between (largely male) doctors, who were unwilling to relinquish
any professional territory, and untrained or subsidiary patient-care
assistants, who were themselves often further marginalized by race and
ethnic origins. It is fascinating to see how this struggle so often
played itself out not between nurses and doctors, but among the various
ranks within the nursing hierarchy itself.

McPherson’s detailing of the transformation that has taken place in
Canadian nursing since the turn of the century is sustained by her
careful and adept use of archival material and oral histories. A
theoretical first chapter reconceptualizes the history of nursing to
establish the centrality of class, gender, ethnic, and racial relations
in the structuring of both nurses’ work and the larger health-care
system. McPherson’s “generational” organization of the material
allows for a coherent presentation of both changes and continuities in
nurses’ lives and experiences during the 1900–1990 period.
Particularly fascinating are the two chapters in which she steps out of
this generational framework to provide an imaginative and original
examination of the culture and content of nursing. Chapter 5, “The
Case of the Kissing Nurse,” is a lively exploration of the
gender/sexuality issues involved in performing work that demands both
intimate personal contact and the maintenance of professional detachment
from patients and practitioners alike.

Although the wide time span covered by Bedside Matters allows readers
to see the “transformation” that McPherson has set out to
trace—with respect not only to nursing care also to Canada’s
health-care system as a whole—the sheer breadth detracts from the
story that unfolds. (Concluding this study with the third generation of
nurses [1942], and leaving post–World War II developments for another
volume, would have been a good alternative.) Nonetheless, this book is a
significant contribution to the social history of medicine, as well as
to the history of women’s work in general and nursing specifically.