The Life of a Cottage Hospital
by John K. Crellin

Working with nurses

District nurses had much of the responsibility of a primary care practitioner, certainly until transport and communication improved in the 1960s. As Jane Hutchings, the district nurse at Cow Head, wrote in 1965: “In the days before the road and telephone to the hospital, I was an ‘apology for a doctor and a dentist.’ Today, I am a nurse working in co-operation with, and under the direction of the Department of Health and the doctor at Norris Point Hospital.”

A constant worry for the nurses, especially in the wintertime, was how to get patients to the cottage hospital. Accounts of tremendously difficult journeys, along with many stories of hazardous house calls by physicians, make a significant contribution to Newfoundlanders’ sense of self-sufficiency and the respect for physicians and nurses of the past. Jane Hutchings tells a story of a harrowing boat trip to Norris Point with a woman, who, probably suffering from eclampsia, was intermittently unconscious and semi-comatose.31 Another nurse, Myra Bennett at Daniel’s Harbour, who became one of Newfoundland’s best-known nursing “heroes,” faced similar difficulties from time to time. Murphy said of her: “Many, many in her area owe their lives to her and all of them have enjoyed better health because of her care and health education.” Bennett’s biographer offers a clear sense of the varied problems she faced medically, surgically, and dentally (she pulled hundreds of teeth over many years.)

One of the many stories surrounding Bennett was the heroic journey with a patient who, in a terrible accident at a lumber camp, literally had his ankle joint sawn through. As it was nighttime, she had to wait until morning to telegraph the physician at Bonne Bay—this was in February 1926, before the time of the hospital—to come to complete what seemed a certainty, an amputation. In the meantime, she stitched the foot back and waited. The doctor’s reply, however, was that as it sounded like an amputation the patient would be best taken to him. So Bennett, her husband, and the patient, who was in fact her brother-in-law, embarked on a perilous sixty-mile journey, a journey graphically described in her biography. The outcome was that the foot was saved, though the ankle did not recover full function.

Patients would sometimes arrive at the hospital with letters such as the following for Dr. Robert Dove (first physician from 1939–1944) from the nurse at Port Saunders; it was dated July 31, 1942, in the days before penicillin was available.

I’m very sorry to bother you, but this young chap [name deleted] has a nasty cut across the bridge of his nose and near his left eye and I didn’t feel like interfering and also a few bits of wood in the nose and I was afraid I would not get it all.

Many thanks for the gauze, we needed it badly as we were all out.

Relationships between doctors and nurses have long been both a fascinating and contentious issue in the history of institutions and of health care in general. Indeed, conflict and romance have become one of the staples of Hollywood, television, and other aspects of popular culture. Undoubtedly, long hours, the stress of patient care, and inevitable human errors often precipitated a disagreement, perhaps conflict. Jean Lewis, who held positions at the Department of Health from 1949, including regional supervisor for cottage hospitals, remembers in connection with all the cottage hospitals that the Department faced constant difficulties in finding nursing staff and the need to resolve personnel problems, some linked to a nurse being “an individual” who “can’t be working 24 hours of seven days every week.” Long hours are remembered by those who worked at Bonne Bay, though with relatively few incidents of difficulties with people. Rarely did cottage hospital situations erupt into public view as when, in 1963, a nurse, without informing a physician, countermanded his prescription for ergotamine intended to speed what the physician considered were inevitable spontaneous abortions in two women admitted with uterine bleeding. Ultimately with the nurse refusing to apologize, heavy-handed intervention by a consultant to the Department of Health, and the resignation of two doctors, this “Burin situation,” as it became known, involved the media, the Newfoundland Medical Association, and the Department of Health.

As in all small hospitals, difficulties had to be resolved. Mutual respect among staff was a prerequisite, although this was shaped by a clear understanding of duties and of a hierarchy of authority among hospital staff, which, interestingly, was partly sustained by uniforms: physicians wearing white coats, and nurses and nurses’ aides in distinctive dresses and caps. It is noteworthy that some older nurses regret the loss of a distinctive uniform and sometimes suggest this contributes to what some view as a declining public image of nurses.

Doctors, atop hospital staff hierarchies, had particular responsibilities with their authority. Many recognized this. Noel Murphy always remembered, with great admiration, the community nurses who interacted with him. He visited each of them, as well as other communities, at least once a year from 1945 to 1954, a practice continued by James Gough. Nurse Jane Hutchings recollected that in 1948 when, as newly trained, she was on her way to be district nurse at Cow Head—within the hospital’s district—she met with Murphy. He gave her an orientation with additional experience in obstetric deliveries, as well as pulling teeth, which was a commonplace activity for nurses at the time: “I learned to infiltrate the Novocain around the tooth and then pull it out. I became very good at pulling teeth afterwards. And he [Murphy] taught me a little about suturing. So suturing, and deliveries and pulling teeth were all learned in there.”

One story told by Murphy underscores that nurses invariably became an integral part of their communities. When the residents of Trout River looked as if they would physically prevent their nurse leaving to work at the Bonne Bay hospital—on the orders of the Department of Public Health and Welfare that decreed where nurses worked—it took the diplomacy of janitor Martin Bugden to avert a difficult situation.