Abstract
During the First World War, 2,845 women served as nursing sisters with the Canadian Army Medical Corps. Although the majority of those who enlisted had pre-war training, these experiences did not prepare them for the severity of the injuries they treated, the relentless pace of the work, and the pressures of working within a warzone. How did these women cope with the traumas they witnessed during their service when they returned home? Of the 842 nursing sisters who applied for a pension, 143 (16.7%) reported ongoing mental and nervous illnesses. The postwar experiences of these women reveal some of the traumas and challenges that military nurses faced overseas and when they returned home.
Daisy B.* was a healthy, 25-year-old woman when she enlisted with the Canadian Expedtionary Force (CEF) in March 1917 to serve as a nursing sister with the Canadian Army Medical Corps (CAMC). Over the next three-and-a-half years she worked at several different hospitals in England. 1 Just before Christmas 1918, B. fell while decorating one of the wards to brighten the holidays for her patients at Bramshott. She took a few days off before returning to work but she continued to experience health problems in addition to her back pain. In January, she said she was feeling weak and experiencing shortness of breath. Despite the discomfort, she was able to “carry on” until 1920. 2 Once back in Canada, B. gave up nursing, got married and had two children but health troubles continued to plague her daily life. Cold and damp weather aggravated her back which in turn made her more irritable and nervous. To compensate for the injury, she was awarded a 25% pension at $26.25 monthly and offered medical care through the Department of Soldiers’ Civil Re-establishment (DSCR). She underwent frequent treatments, but the pain continued to worsen. So, too, did her mental state. On 3 March 1930, she went to the pension office and was ordered to report to the hospital the next day. Although she was being admitted for treatment, B. believed that the department considered her as a malingerer. This feeling caused her so much distress that one hour after leaving the office she left a note for her husband on the back of a pension department envelope: “Goodbye Daddy my darling, I have been so much trouble to you, so will end it all. Please marry Mary…Can’t bear going to the hospital – they act as if I am putting it on – and you know what I suffer.” 3 B. died from suicide at the age of 38.
Before her death, she had frequently remarked to her doctor that “a person would be better off dead than to suffer so much.” 4 The doctor believed that her back pain and subsequent neurotic condition were attributable to her service. B.'s pastor reported that she had developed a cynical attitude toward society that he believed developed from her work overseas. Three years earlier there had been a similar case where a private had also committed suicide after suffering from prolonged back pain caused by his service. His wife and children were awarded a pension; B.'s husband and two sons were not. Although the Board of Pension Commissioners (BPC) believed that “the deceased was a lady of fine character who had done her ‘bit’ in the war,” the appeal was denied. While the deceased had believed her back problems were tied to her service, they argued that her condition developed postwar. Although the “fatigue of war played an important part” it was “not enough to bring about the state of mind that eventually led to this lady's melancholy.” 5 Her death was ruled not attributable to service.
B. was one of the two First World War nursing sisters to commit suicide after the war. 6 While these women represent a small fraction of the 2,845 nursing sisters who served, their cases are part of a larger group of female veterans whose wartime pension files reveal that a number of them struggled to return to civilian life. Although many nurses welcomed the chance to finally return home once the war ended, they had been away for so long that their former lives now felt strange and unfamiliar. 7 In her history of Canada's nursing sisters, Cynthia Toman found that “part of the transition back to civilian life involved coming to terms with the experiences that had shocked and terrified them, and brought so much grief.” 8 But this is a process that we know little about as few nurses went on to write about their experiences after the war. When they did, most nurses did not talk about the personal costs of the war and instead focused on the work that they had done and the opportunities that the war had afforded them. 9 As Melanie Morin-Pelletier has shown, some nurses were able to parlay their wartime service into successful postwar careers. 10 For others, however, the transition back to “civvy street” was long and arduous, but these stories have been more difficult to access through traditional archival sources.
The digitized pension files available at the Laurier Centre for the Study of Canada allow us to understand the lasting impact that wartime service had on military nurses. These records provide detailed accounts of the lives of First World War veterans years after their official discharge and often until their deaths. Pension files created by the BPC—the precursor to the Department of Veterans’ Affairs—contain a wide array of documents including medical reports, neurological examinations, applications for vocational training, personal accounts, and letters from family and friends. After the war, 842 (29%) of nurses applied for a pension. Of these, 143 (16.7%) applicants reported having nervous or mental problems that they believed were a result of their time overseas. Although most of the women who enlisted were trained nurses, the nature of modern warfare fundamentally changed the nature of their job and the severity of soldiers’ injuries, the pace of the work, and the operational pressures of military nursing pushed the limits of their pre-war training. Nurses were able to rise to the challenges of their roles, but it is clear from the pension files that their work exacted a heavy emotional and psychological toll. The long hours, challenging environments, and constant exposure to the horrors of war created conditions that could cause long-term psychological trauma. Long after they were discharged, former nursing sisters reported that they suffered from nervous and mental conditions that hindered their ability to re-adapt to civilian life. Their experiences show the trauma that can impact medical personnel working within a warzone, which is especially significant as we know very little about how the trauma of their service affected the postwar lives of nursing sisters. 11
Working in a Warzone
The collective history of Canada's nursing sisters was once a glaring omission within the otherwise expansive military historiography of the First World War in Canada, but has since benefitted from several studies that have examined their contributions and experiences. 12 Nursing became a permanent part of the CAMC in 1904, having demonstrated its importance during the South African War. 13 While their role within an active warzone remained something of an open question at the beginning of the war, nursing sisters quickly became an integral part of the CAMC as their presence helped the Canadian government to fulfill its obligations to the nation's soldiers. 14 Military nursing was a unique space as women needed to prove themselves in a male-dominated world while also retaining their femininity. 15 This duality provoked some anxiety among the male-dominated military and medical circles over questions of rank and exposing them to the condition of war. 16 Nurses were initially banned from serving close to the front until the complexity of medical care coupled with staffing shortages necessitated a change. Working near the front was intense and challenging. The letters and diaries that nurses wrote during this period show how they dealt with the death and dismemberment they witnessed, how they understood duty and sacrifice, and the physical and emotional toll of their work. 17
The experiences of these women while on active service have been well documented through both official military records and unofficial personal accounts, but the postwar lives of Canada's nursing sisters have been difficult to uncover through these same sources. Military records focus on higher-level activities or consist of personnel records that only show their lives while in military service. While personal accounts offer insight into individual experiences, they also tend to privilege those who were able to adapt to postwar life. 18 Where postwar memoirs do exist, the writers generally look back on their wartime experiences fondly, focusing on the adventures, comradery, and sense of purpose that they found in their jobs. 19 Toman posited that this happened because “nursing sisters, for the most part, came to understand their wartime experiences as but one chapter of their lives—a significant but temporary chapter. Any inconsistencies in memories or alternative explanations faded away because it was easier to recall a less complex story.” 20 But these few postwar reflections may not be representative of all those who served. Even though the war was ultimately a short period, it no doubt affected their postwar lives as they returned to professional nursing or took on more traditional roles as wives and mothers. 21 The unique stresses of battlefield medicine have an intense emotional and physical impact on those tasked with providing life-saving care to wounded soldiers.
The numerous studies on shell shock have examined the way medical and military officials treated soldiers who exhibited a wide range of physical and psychological symptoms including crying, twitching, and extreme fatigue for which there was rarely a clear, objective cause but most of these histories focus on the experiences of the patient over those of the practitioner. 22 The personal narratives of medical professionals in theaters of war have been largely overlooked notwithstanding their historical importance. 23 Carol Acton and Jane Potter argue that their recent work on the experiences of military medical personnel “positions [them] as both witnesses to and participants in the carnage of war and nowhere, arguably, is the relationship between sufferers and healers more intense.” 24 Despite coming into the war with medical experience, this training did not prepare medical personnel for the paradoxical nature of wartime medicine. Doctors, nurses, stretcher-bearers, and orderlies soon found themselves in the contradictory role of helping to heal men so that they could be sent back to the battlefield. 25 In doing so, they realized that their work might help hasten the re-injury or death of their patients. In combat zones, medical staff developed an acute understanding of the conditions and experiences of the battlefield as their work was informed by the same shortages, chaos, dangers, and regulations that their patients faced. 26 Combat casualty care providers suffered deeply from the emotional and physical impact of dealing with wounded and dying soldiers. 27
Women at War
From the moment they donned their veils, nursing sisters felt a sense of apprehension and excitement toward their new military roles. Their reasons for serving, much like their fellow servicemen, were varied. For some women, it was a rare chance for adventure. Many British-born Canadian nurses were also eager to provide humanitarian aid to their homeland in its fight against Prussian tyranny and aggression. “It is all very wonderful to me that I should be a part of such a tremendous movement,” Canadian Nursing Sister (NS) Sophie Hoerner told her friend shortly after arriving in France in late May 1915. 28 Laura Holland, a nurse from Toronto, echoed those sentiments as she told her mother, “I’m really awfully pleased to be on the way towards helping…However let's hope it won’t be for too long.” 29 But as the war dragged on, and the casualties mounted as the two sides found new ways to inflict damage on one another, the mood changed. Hazel Hutchinson argues that writings by some well-known contemporaries such as Vera Brittain shows that “the initial sense of purpose and liberation experienced by mobilized women often gave way to a more nuanced response of dismay, horror, and resignation—suggesting that their emotional experience was not so very different from that of mobilized men.” 30
The early excitement and anticipation of these nurses felt were quickly replaced by feelings of fear and hopelessness as they endured the realities of modern warfare. In later letters, Hoerner shared with her family and friends the immense challenges of delivering medical care behind the lines. She told her friend, Molly, “The doctor tries to repair and make good the best he can, but our best is too often of little avail. One man completely blind, another with a knee joint blown open. I am witnessing dreadful suffering.” 31 Even when sharing these unfiltered views of wartime, most nurses chose to temper their thoughts and feelings to reassure loved ones that they were safe. 32 Hoerner told her mother that “The patients are so ill in my ward and suffer so terribly that before afternoon came I thought I should scream myself. I am seeing the grimness of war and it's awful. My feet and back ache like a tooth-ache some days” but she was also quick to let her know, “but I’m here and I am happy.” 33 The vivid descriptions of the horrific cases she encountered and the unrelenting pace of the work were always followed up with a line letting them know that she was grateful for the opportunity to use her training to help the war effort.
War provided nurses with a unique opportunity to demonstrate their skills and abilities as the increasing complexity of medical care necessitated the need for trained, skilled individuals to administer medication and treatments. 34 Nurses arrived in Europe well-versed in the prevailing principles of scientific management and germ theory that served as the foundation of their training. 35 This experience was beneficial as they adjusted to their new roles; although they quickly learned that wartime medicine was vastly different from civilian practice. The recent integration of military medicine into the army's operational structure and planning had been mostly pragmatic as military commanders had finally come to see the benefits of keeping their troops healthy while in the field. 36 The military command, however, still largely privileged stopgap methods over the more long-term holistic care that nurses were trained to provide. In civilian practices, nurses generally treated their patients from beginning to end, which allowed them the chance to forge a close relationship and see a person through to recovery, whereas battlefield nursing involved triaging and evacuating patients from Casualty Clearing Stations and to the rear to make way for the seemingly endless barrage of incoming wounded. 37 Even within this limited purview the medical branches of the military—much like the rest of the branches—came into the war unprepared for the scale and scope of the conflict. Medical units, especially in the early days, often had to scramble to prepare for incoming casualties, which greatly impeded the work of the nursing sisters. 38
Holland quickly became frustrated by the military hospital system. “The only way to look at it,” she explained to her mother, “is that in spite of many mistakes in the long run an immense amount of good is really done, & one can’t help but feel now is not the time to raise a hue & cry. But just dig in & do the little one is permitted to, in the best way [one] can.”
39
Nurses had little choice but to make the best of the difficult role they had been assigned. The constant shortages—made worse by the fact that Holland was working at Canadian Stationary Hospital No. 1 in Salonika at the time—made it nearly impossible to deliver the high standard of care professional nurses had been trained to give. She also told her mother that …at present we only have accommodation for 350 patients & I believe we have 475, so it means a shortage of everything. However no doubt things will straighten out before long—in the meantime there is more or less confusion, everyone is over worked, the place is not…kept up [to] the usual standard, consequently criticism is the order of the day & everyone feels a little peevish & nerves more or less on edge. I worry less & less everyday, which is a good thing for my health if not for my conscience. But it is heart-breaking to be able to do so little for the men—the shortage is appalling.
40
The kind of emotional detachment that Holland describes here made it easier for nurses to perform their tasks in the face of the horrors that they encountered regularly. She believed that medical staff built up resilience from the belief that they had to control their own emotions to effectively help their patients. 41 Pre-war nursing training had taught these women to manage their feelings in order to maintain the professionalism and objectivity required to carry their duties and this focus on work, courage, and purpose allowed them to make sense of the carnage that they witnessed on an almost daily basis. 42 Even so, the combined emotional and physical effects of their service negatively impacted their mental health. Medical personnel, like the soldiers they treated, suffered from nervous and mental conditions brought on by the emotionally and physically draining nature of their work. Even the great Florence Nightingale had been invalided back to England with symptoms associated with psychological trauma after her time in the Crimean War. 43
Canadian NS Estelle W. arrived overseas in April 1915 and spent the majority of her four-year deployment in France. She did not have any problems overseas but once back in Canada, W. began to exhibit signs of a nervous disorder. The medical officer conducting her medical exam reported that “for six months she always feels tired whether she is working or not, and is easily ‘upset’ after which she had laughing and crying spells.” 44 It was clear to the doctors at the BPC that her long and arduous service had worn her down. “It is needless to say that she was obliged to many hardships,” the person in charge of her case wrote, “As a result Miss W.'s health has been considerably impaired and she is barely able to work. Is [sic] a pension could be paid to her under such circumstance.” But since there was no evidence that W. experienced any difficulties during her time in uniform, other pension officials were more skeptical of her claims. She was never hospitalized nor was she ever placed on leave for an extended period, which suggested to them at least that her problems had not developed while she was with the CAMC and, therefore, the state was not obligated to look after her. 45 While service records were always used in determining the level of treatment or material help owed to a veteran, these files did not always capture the hardships that nurses like W. endured while overseas.
Nursing sisters often found themselves within the range of enemy fire, which was responsible for the deaths of six Canadian nurses when the hospitals that they had been working in were bombed. 46 Doctors reported that these air raids caused considerable “fright and nervous strain” among nursing staff that led to several being sent back to England on account of shock. 47 “We had another air raid,” Laura Gamble wrote in her diary while stationed at Salonika in 1916, “This time the bombs were dropping all about us. Everyone was more or less terrified and indeed one cannot soon forget the horrible whizzing noise of those bombs coming through the air and the noise of the explosion.” 48 NS Almira B. developed a nervous condition after she experienced an air raid in Etaples that killed three of her fellow nursing sisters. She spent twenty-eight days in the hospital but was eventually discharged back to duty in England. In January 1920, while still in uniform, she was hospitalized for two weeks with hysteria. 49 Following her demobilization in May 1920, B. took a position as a private nurse but soon after she suffered another nervous breakdown and was off duty for a year. B. went back to work but continued to have difficulty concentrating, a situation that got progressively worse over the following year. She eventually asked for leave from her job; her request was denied and B. thought she would have no other choice than to resign but she still tried her best to manage her condition and carry on. Although B. appeared exhausted on her days off, instead of resting, the other nurses noted that she frequently went into town. They figured that “she was going on her nerve and had to be on the move.” 50 When her condition finally began to affect the quality of her work, she was finally recommended for leave but while hospitalized, she passed away from a cerebral hemorrhage at the age of 46. 51
The strenuous nature of their work also led to breakdowns among nursing staff as providing medical care within a warzone was a physically demanding job; shifts were typically long and time off depended on the arrival of incoming convoys and the number of casualties. During a pension tribunal hearing for one nurses’ pension application, one doctor testified that “We must give consideration to her exceptionally long service in France. Only those who know the work in the Hospitals there can fully appreciate the strain these nurses were under. Clearing Stations and Hospitals during times of action were scenes of agony, distress and confusion.” 52 While on duty at No. 2 Casualty Clearing Station near Flanders in France, Mildred Forbes shared with a friend that “At present Lollie [fellow NS Laura Holland] & I are on night duty, a necessary evil, though I don’t really mind it here except for the lack of sleep. Three hours in the day is my maximum, & that soon makes one feel rather tired & ‘nervy.’” 53 This fatigue followed many nursing sisters as they returned home. Even after months to recuperate, the emotional toll of their time overseas lingered. Lizabeth A., a Canadian, enlisted in 1915 with the Imperial Forces. 54 She spent a year in Malta before going to France where she served for two more years before transferring to the Canadian Nursing Service in 1918. In her file, it was noted that in 1917 she suffered a nervous breakdown and was given leave in London. Upon hearing about her condition, her sister visited A. in London where she found her “very much upset, extremely depressed with a hopeless outlook.” 55 In spite of her emotional and mental state, A. returned to duty after ten days and she served for another two years.
Within the dangerous and challenging environment of combat casualty care, nurses were also expected to take on caregiver roles that were emotionally draining. Their explicit duties included assisting with urgent medical treatments, clerical work, and administering follow-up care, but nurses also provided invaluable emotional support that was necessary for patients to recover from their trauma. 56 As Bridget Keown has shown, discussions surrounding the contributions of nursing sisters “emphasized women's traditional role as caretaker, praising their service without acknowledging specifically the emotional labor such work required.” 57 These women offered the type of maternal care usually assumed by patients’ absent mothers, wives, or sisters, but taking on this responsibility carried a tremendous psychological toll. 58 In a letter to her mother, Hoerner shared that “One man told me he had been lying forty-eight hours with a dead man on top of him. Watched him dying for three quarters of an hour. He said he never expected to be picked up…at last they got him, but he had gas gangrene and had to have his leg amputated.” 59 She spoke of another one who had minor injuries “But [his] nerves [were] gone; saw his brother shot and his best friend die an hour after by a sniper right through the eye.” 60 These women listened to the stories of wounded men thereby validating their experiences and emotions, which was an essential part of the healing process. But as Christine Hallett has argued, “the prices nurses’ themselves paid for preforming this exhaustive mental work, alongside the hard physical work of caring for their patients, were considerable.” 61
In his official history of the CAMC, Sir Andrew MacPhail noted the psychological and emotional toll of nursing in a warzone, arguing that “to witness this suffering which they could so imperfectly allay was the continuous and appalling experience of nurses at the front and at the base.” 62 Working under these grueling conditions, some nursing sisters began to break down, which manifested as the physical and psychological problems often associated with shell shock. Much like male soldiers, women experienced objective symptoms such as shaking, debility, and myalgia as well as more subjective problems like nightmares, difficulty sleeping, and emotional irritability, which negatively impacted their ability to perform their duties. 63 But these types of incidents were often kept under wraps since it was feared that the image of nurses breaking down would undercut their professionalism. These cases also raised questions since women working that close to combat challenged conventional norms, but the need for nurses near the front necessitated this concession. 64
Despite the arduous nature of their service, nurses exhibited a strong sense of duty that often privileged the needs of their patients over their own distress. 65 As part of their supervisory role, matrons did their best to ensure the emotional and physical well-being of their staff under these conditions. 66 When one of her nurses “lost her nerve in France,” Matron-in-Chief Margaret Macdonald sent her to convalesce in England. 67 This level of concern also meant that women may have tried to hide their problems so that they were not removed from their duties. Sharon Ouditt has argued that “the last thing they wanted was to be sent home as ‘unsuitables’ and thus to prove to the world that women were incapable of acting sensibly in time of emergency. This would have been equivalent to cowardice—and women, of course, not suffering physically as much as the men did, were constantly encouraged to remember this.” 68 The result was that many nurses choose to hide their nervous conditions and mental exhaustion to fulfill their professional obligations.
After nearly two years in France, Kate C. began to develop tremors in her hands. She claimed that one of the doctors at No. 1 Canadian General Hospital in Etaples where she was stationed, gave her a small bottle of strychnine (a common pesticide that was once used to treat a variety of human ailments) to take occasionally and also recommended the use of sanatogen (a supposed nerve revitalizer popular in the early 20th century) to treat her condition. 69 He also told her that he would speak to the matron in charge of her unit to say that C. needed some rest as she had been working too hard. She made him promise that he would not “for I would be sent home and I certainly did not want that.” 70 In the fall of 1917, she left France but continued to serve in England. By summertime the following year, she had lost weight, become weak, developed pain in between her shoulder blades and was unable to sleep. She convalesced for nine days and was returned to duty until being discharged in September 1919. Although C. successfully hid her condition, and thus avoided being transferred away from the front or back to Canada, as we will see later, she unknowingly did so at the expense of future claims to treatment and compensation from the state after the war. For nursing sisters like C., the stress of providing essential wartime medical care caused neuroses and psychoses that did not always abate once they returned home.
Return to Civvy Street
How nursing sisters were affected by what they endured depended on their personality, experience, proximity to the front, nature of the wounds they treated, and the support of friends and family. 71 In her examination of the experiences of American nurses, Potter found that “Going home, though welcome for many nurses, was also traumatic and bewildering, far removed from the life they considered normal for so long.” 72 The challenges that male veterans faced in Canada after the war and the effect their plight had on the development of Canada's sociopolitical landscape have been well documented. 73 These men demanded restitution in the form of pensions for lost wages and retraining after career-ending injuries, which led to the rise of the welfare state. Less is known about the experiences of female veterans whose transition back to civilian life and pre-war nursing jobs were just as difficult. 74 Like male veterans, the lasting mental and physical trauma of their service made it difficult to return to work or fulfill their familial responsibilities. Nurses had been told in 1917 that they would not receive help through the DSCR to find work after the war, but women who were unable to return to their nursing practice did receive some assistance in the form of job re-training as well as disability pensions and medical treatment. 75 Even with this limited assistance, civil re-establishment proved to be a difficult journey for many former nursing sisters.
Some nurses might have been able to suppress their problems while on active duty but symptoms often resurfaced once they returned home. Kate C. had managed her symptoms in France but continued to experience uncontrollable shaking after the war and her condition eventually forced her to give up nursing. It also prevented her from finding other work. Unable to support herself, C. lived with her parents until they passed. By 1939, without an income or relatives to support her, C. was left destitute and forced to apply for a pension. After tracking down the doctor whom she said had advised her usage of strychnine and sanatogen, the man claimed that he could not recall the incident in question. He insisted that if C. had been ill, he would not have treated her as she would have instead been sent to the Sister's Hospital at Paris Plage for treatment. The appeal board noted that the doctor's “recollection is somewhat hazy, which is not to be wondered at as he doubtless had to deal with a great number of sisters on the nursing staff.” 76 Given her record of excellent service, the board said they were “agreeable” to grant entitlement if she could prove continuity, which meant she needed to show her condition had started during her time with the CAMC. But since she had not sought treatment through official channels while on active service, C. could not. In the end, her condition was ruled not attributable to service and she did not receive a pension. 77 Cases like C.'s show that the lingering effects of nurses’ service, much like those experienced by their male counterparts, could have negative implications on their livelihoods and even survival following their discharge. 78
With few positions available with the military after demobilization, the vast majority of nurses returned to civilian life and practices. While jobs other women had taken on during the war were generally cut once men had returned home, government officials expected nurses to continue their work in the private sector. 79 For some women, according to Potter, the ability to “work again, was a necessary salve.” 80 It gave them a sense of purpose and normalcy after months or years away from home and near the firing line. Despite breaking down on service, Lisbeth A. resumed work as a private nurse after the war but it was not long before her nervous troubles resurfaced. Her brother told the BPC that when his “sister first returned from overseas service she was very much depressed but he did not consider that it was anything more than what was to be expected after very strenuous service.” 81 She experienced another two-week episode in 1919 and again in 1923 while working as a nursing superintendent at the Brandon Mental Hospital. Her doctor advised her to give up the position as the patients were wearing her down. A. suffered from depressive episodes on and off over the next several years before eventually being hospitalized at the Hospital for Mental Disease in Selkirk, Manitoba. One of her friends told the BPC that after returning from the war “the applicant was in a [sic] extreme nervous condition, very much depressed and with an apparent hopeless outlook.” 82 After reviewing her file Dr. J.P.S. Cathcart, a prominent military neuropsychiatrist, said that although A.'s manic depressive episodes had likely existed for years they were triggered by her service with the Imperial Forces in France with whom she had served for over three years before transferring to the CAMC in 1918 for the last year of her enlistment. However, given that her tenure with the Canadian Forces was considered “uneventful” her pension was denied. 83 A. did not file an appeal even though it was unlikely she was able to continue nursing in the private sector owing to her experiences overseas.
Although many Canadian nurses (43%) worked in the private sector in the interwar period, Morin-Pelletier found that few former nursing sisters were employed as private nurses. Instead “qu'elles privilégient des emplois de responsabilité dans les hôpitaux et d'infirmières de la santé publique, qui offrent de nouveaux défis, de meilleurs salaires, des horaires de travail plus stables ainsi qu'une plus grande sécurité d’emploi.*” 84 In some cases, the skill sets that they had honed under wartime conditions made them better suited for assisting with procedures or working as supervisors and administrators. 85 Public health care offered former nursing sisters new opportunities and several women, such as Mary F., chose to take advantage of re-training offered through the DSCR to transfer to public health, a now burgeoning new field that had been ushered in by the 1918 flu pandemic. 86 After the war, F. complained that she found regular nursing too strenuous as she became easily fatigued and short of breath, which was diagnosed with Disordered Action of the Heart—a chronic condition similar to Soldier's Heart. 87 She was recommended by the DSCR's vocational services for an eight-month course in Public Nursing at the University of Toronto. While in training, F. was given a pension for a 15% disability at $11.50 a month for hypertension and arthritis. Upon completion of the course, F. found work at Toronto General Hospital but even so, she continued to draw a small pension, which was later increased to 30% in 1926. 88 This suggests that despite career training—and taking on a less physically and emotionally demanding public nursing role—F. still had difficulty adapting to her postwar work and life.
Several of the women wanted to re-train as public health nurses because it offered shorter hours, lighter duties, and no night shifts. Recent changes to public health practices in Canada had altered the nature of private nursing. “As conditions exist today,” one neuropsychiatrist explained, “in the nursing world, the hours having been shortened by an Act of Parliament, it is customary for people of moderate means to nurse their sick friends in the daytime and to employ a professional nurse to do the night work, this of course were they not able to afford two nurses. So, it means that nurses today must expect to spend most of their time on night duty.” 89 Former NS Frances W. found these nighttime nursing shifts taxing and wanted to take a fourteen-week course in Public Nursing at the University of British Columbia. Her request, however, was denied by the department as the consulting neuropsychiatrist believed that there was “only a subjective statement of effects of night duty” and that her nervous condition was not connected to her military service. 90 It is not clear from the files whether W. continued nursing or found work in another field without the assistance of the DSCR.
Like W., some of the women wanted to return to some form of nursing but found that lingering health issues from their service prevented them from doing so. During this period, most social welfare and charitable agencies assumed that women's economic fortunes were tied to their male relatives and thus were not overly concerned about women's unemployment. 91 However, as nursing sisters had entered the war as working professionals it appears that there was some recognition that even if they did not continue their work as nurses these women still needed—or were owed—jobs. Mary M. trained at St. Luke's Hospital in Ottawa before heading overseas with the CAMC in 1916. After contracting influenza in 1918, she began to suffer from nervous spells. Despite these episodes, M. was determined to continue nursing after the war. Upon her return to Canada, she took a job at the Coburg Hospital treating mental cases. The nature of the work there, according to the physician looking after her case, likely hastened the re-appearance of her nervous condition after her one-and-a-half-year stint there. M. told the BPC that she was “too nervous to carry on work as a nurse” because her hands were simply “not steady enough to handle surgical instruments.” 92 Instead, she opted to take advantage of the vocational training available through the DSCR to become a stenographer. The philosophy of the DSCR in these cases was to place veterans in working training programs that utilized pre-existing skills to create a smooth and successful career transition. 93 From the perspective of the DSCR, this job would require the same attention to detail and clerical skills that M. developed during her time as a wartime nurse.
Other nursing veterans made no attempt to return to their former careers and instead opted to utilize the programs offered through the DSRC to immediately parlay their skills and experience into new careers. Mina C. spent five years as a nurse before she enlisted with the CEF in July 1915. After working for five months in England, C. was sent to Salonika, one of the most difficult postings of the war. 94 Hunger was frequently mentioned in the diaries and letters of the nurses who were stationed there along with the challenges wrought by weather conditions, sanitation, flies, and mosquitoes that were compounded by limited supplies and the number of patients. 95 While in Salonika, C. suffered several bouts of debility and a blood test revealed that she had likely contracted malaria at some point. After ten months in the Mediterranean, she was returned to England for the remainder of her service. 96 Shortly after her discharge in 1919, C. applied for vocational training offered through the DSCR. The BPC doctor found her to be “very tired and discouraged. Prefers stenography to nursing on account of being off her feet. Tires much more quickly when on her feet…Is nervous. It does not take much to put her on edge. Cannot stand the worry of nursing.” C. was approved for a stenography course at Sprott-Shaw College in Victoria. Along with the training, C. received a 10% pension for the residual effect of her bout with malaria. 97 C. was able to use the resources at her disposal when she found she was unable to return to nursing after the war but the small pension that she was afforded acknowledged that she had paid a physical price for her service. Even when nurses were able to return to work and resume their pre-war lives, they still had to contend with the protracted effects of their time overseas.
Conclusion
Following their experiences overseas, a number of former nursing sisters continued to suffer from wartime trauma which, much like male veterans, hindered their re-establishment. Nurses entered the war as experienced medical professionals but no amount of training could adequately prepare them for the sheer number of horrifically maimed young men that they treated regularly. 98 The personal narratives of nurses describe their commitment to professionalism and duty in the face of this unending tragedy but the unrelenting pace, wartime conditions, and the emotionally charged nature of their work wore them down. Although most did not openly display their emotions or difficulties during their enlistments, the memories remained with them long after the war had ended. 99 The tremendous pressures of putting bodies back together—just to send them back out to the battlefield—took an immense physical and emotional toll on caregivers that followed them home.
Almost twenty years after the war, while undergoing a medical examination at Colonel Belcher Hospital in Calgary, former NS Florence C. told the attending physician that “I don’t know whether you think I’m foolish or not. It is just one patient that has bothered me in these last two years. It is like an apparition, I can see him walking. He died very hard from a wound in the chest. I didn’t neglect him or anything. I don’t know why he should come back to me in these two years, unless it's these high winds that affect my nervous system.” 100 The sights and experiences of wartime nursing stayed with them long after they left the front, which for many women made the transition back home exceedingly difficult. The challenges that these women faced postwar parallels contemporary studies that show that military nurses have reported experiencing a sense of disconnect from civilian practices. 101 Even today, the change in pace and medical procedures coupled with colleagues who are unable to fully understand the weight of military service makes the transition difficult. However, the reintegration of nurses following wartime deployment is an important issue that has received less attention than other facets of the challenges facing military medical personnel. 102 The postwar experiences of Canada's First World War nurses offer important insights into some of the trauma and challenges that military nurses face when they return home.
