“Such a Many-Purpose Job”: Nursing, Identity, and Place with the Grenfell Mission, 1939–1960

In July 1947, Nurse Jean Smith wrote in Grenfell Mission's quarterly magazine, Among Deep Sea Fishers:When I leftEngland two years ago I little expected to have such a many-purpose job. The trained staffof one has a variety of duties to perform, among which are those of housekeeper, cook, farmer, butcher, gardener, painter, carpenter, general overseer and handyman, clothing-store-keeper, accountant, nursing and dentistry besides.1For nurses posted to nursing stations of Grenfell Mission in Newfoundland and Labrador, Smith's statement was not an exaggeration. Because of demands of nursing on isolated stations, nurses became adept at changing hats and assuming whatever role was necessary for provision of health care and smooth running of station. Their formal hospital-based training only went so far in preparing them for range of duties they would perform, duties that were required out of necessity because of physical geography and sparse settlement pattern of region and decentralized structure of mission.The Grenfell Mission was established in 1893 by British physician Wilfred Thomason Grenfell in response to lack of basic health care he witnessed in Labrador during his 1892 visit. Under Grenfell's direction, mission became an enduring health care organization designed to reach people living in isolated coastal communities in northern Newfoundland and Labrador. For almost 90 years, it operated an extensive health care system along hundreds of miles of rugged and thinly populated coastline. During time of this article (1939-1960), this system included one large hospital at St. Anthony; two small hospitals with resident physicians at Harrington Harbour and North West River; and between 6 and 13 nursing stations staffed by one or two nurses who were often trained midwives from Britain. The mission founders had considered it impossible and impractical to have trained surgeons available on [the] coast2 for two main reasons: small communities of northern Newfoundland and Labrador were not attractive destinations for many physicians who preferred to practice in larger centers for personal and professional reasons, and mission could not justify expense of hiring physicians for small isolated settlements. As a result of this decentralized structure and lack of physicians outside few hospitals, nurses on stations enjoyed a degree of professional responsibility that was unusual in larger, more conventional medical institutions. And mission came to rely heavily on services of these nurses. As a medical superintendent, Charles Curtis pointed out in 1946: the main care and diagnosis of serious illness [depended] . . . on nurse in outlying district in a small nursing station who [was] intimately connected with people and [saw] a case early.3But what did it mean to be a nurse in Western society during 1940s and 1950s? What was required of a nurse with Grenfell Mission, and how did that differ from image of a nurse according to training programs and conventional hospital standards? Did job requirements of mission challenge nurses' notions of professional identity? This article addresses these questions by examining work experience and personal recollections of nurses with Grenfell Mission in northern Newfoundland and Labrador between 1939 and 1960. Grenfell nurses performed various non-nursing and even nonhealth- related duties that were not typical nursing responsibilities according to educational and professional standards of 1940s and 1950s, including diagnosing and treating outpatients, dentistry, administration, agriculture, and station or hospital housekeeping. By exploring nurses' own writings during time they nursed in these unique circumstances, I argue that nursing with Grenfell Mission, because of physical geography and decentralized structure of mission, did, indeed, challenge nurses' professional identities and their understandings of what it meant to be a nurse. …

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