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Plucky rural nurses in Atlantic Canada had their own rhythm, wisdom and stamina.

In the early years of the 19th century, decades before England's Florence Nightingale brought recognition to the nursing profession, Atlantic Canada had its own Lady with the Lamp. Elizabeth Innes, born in 1786 in Saint John, NB, travelled city streets caring for soldiers, sailors and civilians. Risking cholera, typhus and smallpox, she went quietly about her tasks, doing what she could to ease pain and conquer illness.

Elizabeth Innes didn't achieve the fame of Florence Nightingale, and would have gone to her grave forgotten, had it not been for an extensive diary she maintained throughout her nursing life. That diary is currently housed in the New Brunswick Museum.

Regardless of the dedication of Elizabeth Innes and her ilk, early health care was crude. Doctors could do little more than pull teeth, set bones and amputate limbs, with a stiff drink of Jamaica Rum as their only anesthetic. Women who tended patients often trudged through heat, cold, wind, rain and snow, on foot, snowshoes, horseback or dog sled, to get to their patients' bedsides. Not until the work of Florence Nightingale during the Crimean War came to public notice did they begin to receive the respect and recognition they deserved.

Soon a spin-off of the Nightingale legend arrived in New Brunswick. Bishop John Medley of Fredericton, a widower with five children, returned to England in 1863 to take as his second wife a 42-year-old nurse named Margaret.

Nurse Margaret Medley is believed to have been a contemporary of the Lady with the Lamp in Crimea. According to Mrs. Medley's long-time friend and correspondent, Juliana Ewing, Mrs. Medley horrified residents when she first arrived in Fredericton by using chloroform to relieve pain. Apparently, though, her revolutionary treatment gradually gained acceptance, and soon local doctors asked her to assist them by administering it to their patients during surgery.

During Mrs. Medley's era, more women with medical training arrived in New Brunswick. In September 1868, six Grey Nuns came from Quebec. Acting as nurses and pharmacists, they took over the administration of the leper colony in Tracadie. One nurse, named Amanda Vigar (1845-1906), began to train local women in medical work, but it wasn't until 1887 that formal education for nurses began in a hospital-based school, in Saint John.

More advances in nursing followed. In 1897, Lady Ishbel Aberdeen, wife of Canada's governor general, founded the Victorian Order of Nurses because she was concerned about the plight of women and children in isolated areas. Her nurses worked long hours to cover their extensive territories. In 1919 the VON staff in Fredericton consisted of one individual - Miss Patterson - who made 187 visits in her first six weeks on the job, using a bicycle as her mode of transportation.

Red Cross nurses came to New Brunswick during the First World War. "With the establishment of the Red Cross in New Brunswick in 1915, nurses began to make healthy living an equal concern along with the treatment of illness or accident," says Dr. Linda Kealey, author of "Delivering Health Care in Rural New Brunswick: Outpost Nursing in the 20th Century."

"The Red Cross was also responsible for establishing the first outpost hospital in New Brunswick, at St. Leonard, in 1926."

Not all nurses who served rural areas came under the banners of either the Red Cross or VON. Some served their communities for many years voluntarily. Muriel Buchanan Wishart, RN (1900-1975), for example, returned to her home community of Tabusintac in northern New Brunswick in 1940, after a nursing career in the US and the Caribbean. She became the local Lady with the Lamp for the next 30 years.

Muriel is remembered for staging a one-woman sit-in at the local Department of Transportation in an effort to get the bridge over the Tabusintac River plowed after each snowstorm. This would allow residents an open road to the nearest hospital. A petite woman perched primly on a straight-back chair, she stubbornly refused to move until the people in charge acquiesced.

In Newfoundland and Labrador, nurses frequently served alone or with a staff of two or three at one of the 14 cottage hospitals built in outposts between 1936 and 1952. With minimal medical equipment and drugs, these women relied on innate cleverness, common sense, inventiveness, and raw courage to see them through their challenges.

One Newfoundland nurse renowned for her dedication to duty was Dorothy Cherry. Born in Lancashire, England, she'd accepted a position at the outpost of Lamaline on the Burin Peninsula, only 11 months before the Grand Banks earthquake on November 18, 1929, rocked the entire region.

The earthquake, which had a magnitude of 7.2, occurred in the Atlantic Ocean, off the south coast of Newfoundland. Reports told of three to four metre waves, travelling at speeds of up to 140 kilometres per hour, upending houses in Point au Gaul and Taylor's Bay.

In the ensuing tsunami, 28 people died, many of them swept out to sea in their houses, lamps still burning. Ten thousand were left homeless. Most families lost their entire winter's food supply.

The lone health-care provider amid this sea of devastation was Dorothy Cherry. Realizing that it could be days before help arrived, Nurse Cherry did what she could for the survivors in Lamaline, then set out on horseback for the other overwhelmed communities along the Burin Peninsula. By the time the rescue ship SS Meigle arrived with supplies, she was in an exhausted, but unbowed, condition.

"It must have taken a superhuman effort for her to make her way from one stricken community to another through icy wind, snow, rain, and mud," Dr. Mosdell, Chairman of Newfoundland's Board of Health, wrote later.

Prince Edward Island had its own versions of these altruistic Nightingales. Try the Goose Grease!, a book written by Mary Isabel Tuplin, offers insights into private duty nursing in rural PEI in the era of the flu epidemic, from the First World War up to the Great Depression. Born in 1894, Dolly, as Mary Isabel was affectionately known, took her nursing training at Prince Edward Island Hospital.

Although she called her book a novel, she wrote: "Most all the incidents described are my own. A few are those of other nurses."

Her book describes nurses' struggles to convince people to accept modern treatment methods, instead of using traditional remedies such as goose grease. This folk cure was both rubbed on sick people and poured down their throats.

She wrote about working on farms where the entire family was down with flu. The nurse not only had to care for the sick, but she had to feed the animals, milk the cows, and act as housekeeper. Nurses, she explained, sometimes had to baptize dying babies when a clergyman wasn't available, and lay out these infants and others who passed while under their care.

Nurses in Nova Scotia faced equally challenging circumstances. In the 1980s, Barbara Keddy, Professor Emerita at the School of Nursing at Dalhousie University, in Halifax, began chronicling the stories of her province's nurses.

On March 16, 1983, Dr. Keddy interviewed 81-year-old Greta MacPherson, who had trained and worked at the Glace Bay Hospital, in Cape Breton. During her years at that facility, Mrs. MacPherson treated many injured miners.

"A lot of smashed up miners came in with back injuries, broken bones, and worse," she recalled. "Some died, some with spinal injuries never worked again. But a lot of Glace Bay people are of Scottish descent and had a strong community spirit that made them ready to help friends and neighbours in need."

Dr. Keddy also interviewed women from the Black nursing community. Among them was Sue Edmunds, born on December 13, 1942. She told of being brought up by an amazing grandmother, who ministered to both the minds and bodies of those in their community near New Glasgow. Ms. Edmunds' ancestors had immigrated to Guysborough County as part of the Loyalist influx.

"One of my earliest memories of my grandmother is of her going to homes in our community that had sick people and helping out…bathing the person, cooking meals, and taking things they needed," Ms. Edmunds told Dr. Keddy. "I remember women coming to our house to talk to my grandmother when they were having problems with their marriage or children. She was a sort of counsellor."

Of course, long before any official health-care facilities were established, First Nations people had their own approaches to administering care. While tales tell of Charlotte Taylor (1755-1841) assisting native women during childbirth in northern New Brunswick, it seems likely that they, in turn, shared some of their cultural wisdom with her.

A photo taken circa 1904 on the Tobique Reserve names one of the subjects as Elizabet Francis, further identified as Doctalies, or "Little Doctor." Elizabet served as a valued midwife practitioner to her people around the turn of the 20th century. Later, trained nurses such as Margaret Levy of the Metepenagiag First Nations would distinguish themselves. Margaret, a tireless community worker, received an award for excellence in nursing in 2007.

Health care has come a long way since the days of Elizabeth Innes. One aspect, however, has remained the same: the spirit of caring and dedication integral to their work has never wavered.

This is the second in a two-part series about rural nursing in Atlantic Canada. The first story, "Grace Under Pressure," ran in May/June 2010.

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