No Rules for Doctors?
First of all, what was the community like in 1863? The population was between 1200 and 1500 and there were about 300 buildings in the town, including churches, warehouses, hotels, stores and private residences. There was one fire hall, a court house, several other public buildings such an assay office and Government House (remember that New Westminster was the capital of the mainland colony of British Columbia), and of course, the Royal Columbian Hospital.
The hospital opened October 7, 1862 with room for 30 beds, but by January 31, 1863, only 19 patients had been treated and 5 remained in hospital.
Who were the patients?
Of the original 19, only 7 were from New Westminster. But these were not the shopkeepers, contractors or leaders of the community. They were miners, loggers, sailors, or “the indigent sick” – men who had no home or family, and who could not afford to hire someone to take care of them. Most local residents were cared for at home – the doctor would come to the house every day, leave instructions and the family (usually wife or mother) would then carry out those instructions. Women were almost always cared for at home unless surgery was needed, and then she stay in the hospital only until she could be moved to her home. In 1870 Elizabeth Kelly was paid $12.50 for “attendance to female patient March 22 to April 30”, indicating that when a woman was admitted to the hospital, another woman was hired to care for her. Occasionally the steward’s wife cared for a female patient along with her other duties.
The conditions for which they were treated included various injuries, frostbite, pneumonia, syphilis, typhoid fever and the most common ailment, diarrhoea.
Who were the nurses?
Well, not the trained women in long white uniforms floating gracefully through the hospital with a lamp, gently soothing fevered brows as seen in Hollywood movies. The Royal Columbian Hospital School of Nursing did not start until 1901, and there were no “trained nurses” as we understand that term today before then. “Nurses” hired by the Board of Management in the early years to care for individual patients, might be men who had had some experience as medics in the Crimean War, but more often were men who simply were able to follow the doctor’s instructions. Those instructions dealt most often with specific food to be given to the patient, “Extra milk once a day. Beef tea once a day”, or basic treatment, “linseed meal poultice to be applied to hands”. At least one nurse signed the receipt for his pay with “his mark – an X” indicating that he was illiterate. Most patient care was delivered by the steward and his wife, who did the cooking, laundry and cleaning.
Who were the physicians?
In 1863, when the Rules for Nurses, Visitors and Patients were published, there was only one doctor. Dr. William McNaughton Jones, a native of Cork, Ireland came to New Westminster late in 1862 and remained until 1866. He was appointed medical officer at the Royal Columbian Hospital just before it opened in October 1862 and all applications for admission to the hospital were to be addressed to him. He offered his services free to the hospital until the institution was in a more favourable financial position.
In 1864 the Board of Management arranged for the daily visit to the hospital by one of the two doctors then in New Westminster – Dr. Jones and Dr. Black, who visited the hospital on alternate months for an annual salary of $250 each, later increased to $375.
Knowing that the nurses were men with very little if any medical training, and that the patients were frequently sailors, loggers and miners who were treated with bedrest, better food than they had eaten for some time, and brandy, gin and whiskey for painkillers, makes the published rules seem very different, doesn’t it? It also explains why there were no matching rules for physicians – there was only one doctor and he was doing the best he could with very limited resources and very little support.