|Carol Helmstadter, University of Toronto||The UKAHN Bulletin|
|Volume 8 (1) 2020|
Maria Machin (1842-1908) was a Canadian who trained at the Nightingale School in London in 1873 and went on to a distinguished but very difficult career, first as lady superintendent of the Montreal General Hospital, then matron of St. Bartholomew’s Hospital in London, then a missionary nurse in the Orange Free State in South Africa, and finally a military nurse in the Boer War where she won the Royal Red Cross. In all of these positions she was remarkably successful but she appears in two highly regarded monographs as a failure.1 This article studies her experiences at the Montreal General Hospital where Monica Baly believed she had an unjustifiably high turnover of staff, was unable to adapt to the Canadian situation, and could not deal with the disloyalty and intrigue of some of her staff.2 Relying on Baly, Mark Bostridge described her as high-handed and undiplomatic.3 Archival research indicates that these conclusions are inaccurate. They illustrate a central historiographical challenge: historians are severely compromised when for whatever reason, they fail to access important archival records. Reasons are varied; the records may be geographically remote, or the historian may be unaware of their existence, they may be closed to the public or otherwise difficult to access. By necessity therefore, sometimes historians have to rely on secondary sources for background and context. Machin’s historiographical record provides an excellent illustration of these problems.
Machin’s father was a clergyman in the Brockville area of Ontario when she was born in 1842. As a teenager Maria helped her mother and sisters run small schools for girls, and later she taught in Quebec City. From 1869-72 she was principal of the Anglican Ladies College in Ottawa where she was extremely well connected.4 One of her brothers became Assistant Treasurer of Ontario and she could provide references from the wife of the prime minister of Canada.5 Armed with such impressive recommendations, Machin travelled to Darmstadt (Germany) to study hospital nursing, aiming at becoming lady superintendent of a hospital. There she met the Baronness de Bunsen, the widow of the ambassador to the Court of St. James and a close friend of Florence Nightingale. de Bunsen was impressed by Machin’s warm, well educated, gentle, lady-like character.6 The Baronness recommended her as a lady pupil to Nightingale and Machin duly entered the Nightingale Training School on 25 March 1873. Nightingale soon discovered this highly talented probationer, and before she finished her year of training, Machin was promoted to Home Sister, the nurse responsible for training the probationers.7
Nightingale’s first Home Sister, Miss Torrance, had left within six months to be married and her replacement, Miss Parkinson, was not entirely successful; Nightingale found her ‘wooden, not morally attractive’ and quite ineffective.8 Parkinson could teach reading and writing to some of the ‘sadly deficient probationers,’ Nightingale said, but she gave no Bible classes, and the probationers did not keep case records or ward diaries.9 Still, Nightingale continued, she achieved ‘order, punctuality, cleanliness, regularity at prayers – a certain degree of outward propriety,’ but she had no moral influence over the probationers.10 At this time Nightingale and Bonham-Carter were having dreadful problems with Sarah Wardroper, matron of St. Thomas’s since 1854 and who had sole direction of the training school. As Monica Baly demonstrated, although the Nightingale Fund was paying all the school’s costs, it had absolutely no say in any of its arrangements.11 Wardroper was declining into dementia and unable to manage the school. Although she acknowledged that no (lady) sister would stay under her direction and she was frequently very confused, Wardroper refused to give up her position as sole director of the training school.12 ‘If we could get a good Home Sister who had both Mrs Wardroper’s confidence & ours,’ Nightingale posited, matters would improve.13 Nightingale’s standards and expectations were obviously extremely high, perhaps unrealisable, but Machin fulfilled her hopes. She was one of only two nurses who could work successfully with Wardroper, an indication of her diplomatic skills.14
Machin’s team of nurses
However, Machin had only begun her first year as Home Sister when, in February 1874, the Montreal General Hospital began negotiations to appoint her their lady superintendent. The negotiations were lengthy but the Nightingale Fund Council finally agreed to send Machin to Montreal with a team of four nurses, and they started work in October 1875. McGill University’s Faculty of Medicine staffed the Montreal General Hospital and the doctors had been pressing for better nursing since the 1860s, in response to rapid developments in medical science.15 Furthermore the hospital’s introduction of Lister’s antiseptic practice in 1877, added even more work for the nurses.16 Montreal was the most important commercial and industrial center in Canada in 1871 with a population of 107,225. The Montreal General received some small government subsidies but was largely financed by donations and subscriptions. Just before the Nightingale nurses arrived, the worldwide agricultural depression of 1873-96 struck, severely diminishing the city’s commercial and industrial production, and consequently the hospital’s fund-raising ability.17 This would have a profound impact on Machin’s efforts to reform the nursing there.
Within a month of their arrival the board reported that the Nightingale nurses had exceeded even their most sanguine hopes while the doctors were pleased that the nurses understood their cases and were interested in them.18 Machin’s team consisted of a lady, Helen Blower and three working-class women, Martha Rice, Maria Sealey, and Emma Randall. Blower acted as a sister and the three working-class nurses as head nurses. Machin made all responsible for teaching and training the Canadian assistant nurses. Blower had just finished her one year of training but she had the most patients and the greatest number of assistant nurses to teach. Machin considered her skill, management and unwearied devotion exemplary and she proved an excellent assistant, managing the ‘many irregularities’ in her wards, well. She was also training the doctors to treat the nurses with respect, and the doctors complimented her on the improvement in their patients. In March 1876, there was a terrible outbreak of typhoid fever and Martha Rice, who had just finished her training and was an excellent nurse, succumbed and died. Blower was so overworked, thin and pale that Machin sent her to Peter Redpath’s home for a few days’ rest.19 Redpath was a noted industrialist and financier, the son of the founder of McGill University, and president of the hospital’s Board of Governors.20 He and Machin were personally good friends and worked closely together.
Maria Sealey and Emma Randall were experienced nurses. Sealy was 27 when she entered training in 1870 and Machin found her to be a kind and thorough nurse, skilful, calm and self-possessed in emergencies and at operations. Her patients liked and respected her and she had improved in ward management and in training the Canadian assistant nurses. However, her lack of education made it difficult for her to understand the rationale for nursing practices and hard for her to impart abstract ideas to the assistant nurses. Sealey became over-impressed with her own abilities. She hoped to replace Machin as lady superintendent by sowing discontent among the nurses and sent a letter to the Committee of Management declaring Machin a poor manager. The Committee fully supported Machin and told her not to re-engage her when her contract expired.21
Emma Randall entered the Nightingale School in 1871 at the age of 26. Machin thought her a clever, active nurse who knew how to manage critical cases. She was popular with the majority of her patients but her fellow nurses disliked her because she became conceited and ‘deteriorated’ as Machin tactfully put it. Her wards became less satisfactory during the last four months before she absconded to be married on 30 November 1876.22 Conceit and the belief that, as English Nightingale nurses, they were superior to the colonials, was a major problem among the Nightingale Nurses sent to Australia in 1868 under Lucy Osburn’s superintendence, and would remain a major problem long afterwards.23 Pre-reform nurses were primarily maids-of-all-work and many were unreliable and irresponsible. Much as Nightingale bewailed the earlier Home Sisters’ failings, the introduction of discipline and a measure of propriety, made a big improvement in the new nurses’ effectiveness. Machin keenly felt the difference between the Nightingale nurses and the best of the untrained Canadian women.24 Their greater efficiency gave the trained nurses their sense of superiority.25
As a result of the typhoid epidemic the nurses were so overburdened that Machin and Redpath asked the Committee of Management if they could send for more Nightingale nurses. The committee authorised four who arrived in August 1876.26 Unlike Randall and Sealey, all four, Anna Marsh, Jane Masters, Jane Cross and Ellen Webb, had all only just completed their one year of training.27 Machin found Cross managed her wards and assistant nurses well and happily. She was a cheerful, upright little woman and a pleasant nurse to direct and supervise. She exercised a motherly care over Webb and Masters and would have done the same for Marsh if Marsh had let her. Webb had a right-minded, gentle, forbearing disposition and her housework and the order of her ward were improving. She was not clever, but she was anxious to learn and Machin thought that with experience she would become a valuable nurse. In their second year in Montreal, when Machin was unable to give a reasonable amount of supervision and support, Cross and Webb did even better under very trying circumstances. Masters and Marsh were less satisfactory. Masters was discontented, insubordinate and constantly fought with the day nurses when on night duty, another commonly held characteristic of the old nurses. Machin thought she did not give herself a chance to learn. Working nights she had become ‘very queer’ so Machin gave her lighter work and transferred her to days where she seemed to become more rational. Machin hoped she would leave of her own accord, ‘creditably, on the grounds of poor health’.28 She tried to avoid collisions with her but noted that under any other circumstances her insolence would have demanded immediate dismissal. She eventually had to fire her. Marsh shared Masters’ discontented frame of mind; for a while she seemed to improve, but following a bout of typhoid fever, she left voluntarily.29
After Marsh and Masters left, Peter Redpath approved the engagement of two Nightingale nurses to replace them.30 Without consulting the Committee, Machin arranged for them to come in September 1877. She apparently thought that because they were replacements and Redpath had approved them, she did not need the Committee’s approval. The new nurses, Jane Styring and Laura Wilson, were both excellent: well-suited for positions of responsibility, conscientious, skillful in the manual work of a nurse, and clever and judicious in the management of their wards. With Cross, Webb, Styring, Wilson, and Blower, Machin felt she finally had an excellent team. The doctors praised these five nurses for their patient care and the intelligent way in which they carried out medical orders for many varied and critical cases. Machin noted that the medical officers never lodged a single complaint about them, implying they had complained to her about the other nurses.31
Machin and her staff got on well with the Canadian nurses. For example, Martha Rice worked with a ‘queer old lady’ who had been a nurse in the hospital for ten years.32 She seemed steady and was willing to accept Rice as head nurse. On the other hand, Machin feared the Irish widow she was training to be head night nurse was not discreet or quite faithful, but for lack of better she accepted her failings. At the same time, one of her assistant nurses, who died in a diphtheria epidemic, had been with Machin for a year and a half and had come on well with the training the British nurses gave her. She was loyal, conscientious, and faithful.33
The Sub-Committee for Retrenchment
The economic depression which gripped the city hit the hospital’s fund-raising hard and by the end of March 1877 its operating deficit stood at $4200. The governors began pressing both Machin and the Medical Board to reduce their budgets. Machin made real efforts to economise, most notably laying off the housekeeper and taking her duties on herself.34 In the spring of 1877 there had been a succession of terrible industrial accidents leading Machin to request two more Nightingale nurses, a request which the Committee refused. In May the governors commissioned a Sub-Committee for Retrenchment to overhaul the budget, making major reductions in hospital expenditures. The following month Redpath left for one of his frequent trips to England leaving Vice-President Charles Alexander to chair the Committee of Management. Alexander was an ill-educated, first-generation immigrant who thoroughly disapproved of women in positions of authority. One of his fellow committee members described him as ‘a well -disposed, illiterate, incompetent blunderer’ who occupied a position he was incapable of filling.35 Machin described him “as a dreadful drag to progress”.36 Perhaps not surprisingly, Alexander immediately began bearing down on Machin for acting too independently. As well as bringing Styring and Wilson without its authorisation, the Committee censured Machin for giving her staff leaves of absence without its permission. In August Machin asked for a month’s leave of absence but the governors gave her only two weeks.37
A month later, just when Machin and Blower thought the hospital finally running well, the Retrenchment Sub-committee released its report. Both Redpath and Treasurer Andrew Robertson were away, which was no coincidence. The Report was in large part a vicious, dishonest attack on Machin’s management. It claimed her extravagance and inadequate supervision was primarily responsible for the hospital’s deficit which now stood at $10,000. Also Machin had not established a formal training school, one of the main objects in bringing her to Montreal. The report admitted she had made major improvements in the nursing but recommended replacing her with an old style, non-nurse, housekeeper matron. Four days later the Committee of Management adopted the report wholesale. A new efficient matron was to be hired immediately, five housemaids were to be cut to three, five laundresses to three or four, the cooks to three and the 25 nurses to 20.38 Convalescent patients and nurses were to clean the wards as they had before Machin arrived. Machin was stunned. As she noted, she had sent her wages list to the Committee every month and they had never once questioned her additional staff or suggested that she was being extravagant. She thought the whole report a plot of Alexander.39
Machin’s staff had indeed increased during the two years she had been in the hospital. She had added thirteen Canadian women: one day nurse, three night nurses, two assistant nurses, a seamstress, a laundry maid and five housemaids.40 Additionally, her view of what was always referred to as the ‘comfort of the patients’ entailed expenses which the former matron had thought unnecessary — blankets, shirts, coal scuttles, counterpanes, hair mattresses, iron bedsteads, bedpans, candles, soap, nurses’ scissors, and laundry for the nurses.41 The new nursing with its emphasis on cleanliness made all these items essential. Unlike Redpath, Robertson, and other more progressive board members, Alexander and his supporters had no understanding of the complexities of the new nursing. It was difficult for them to understand why so many housemaids were needed when they thought of the nurses as maids-of-all-work.
The governors on the retrenchment committee were especially disappointed that Machin had not established a training school but Machin felt that, having taken on the housekeeper’s duties, she needed more help to do this.42 She and her whole staff had always made clinical training of the Canadian nurses a priority because the old nurses gave very poor patient care — in serious cases it was usually the medical students who did the night nursing.43 Under these circumstances, Machin could not leave the nurses unsupervised in order to recruit probationers, organise doctors’ lectures and teach classes herself.
However, from Alexander’s point of view (and that of his supporters) the lack of a training school meant one thing: they were less concerned about having well-trained nurses in their hospital and much more disturbed by the lost opportunity to reduce costs, by replacing the paid Canadian assistant nurses with unpaid probationers. But Machin stuck to her ground: she was a very experienced teacher, principal and Home Sister and was not prepared to ignore the educational aspect of a training school which is why she felt she needed extra help.44
Machin sent a dignified and diplomatic letter to the Committee explaining that she was not writing to justify herself but to correct the erroneous impression that she had not followed the orders of the Board. Lack of cooperation with the Board could not be further from her wishes. She had tried to decrease hospital expenditures but she did not think her trained nurses would stay if they had to revert to the old system of cleaning the wards themselves, a job they neither desired nor had time for.45 As soon as Robertson and Redpath returned they began fighting the retrenchment program. Robertson was angry that the sub-committee issued the budget without his approval as treasurer. He demonstrated that the sub-committee had made many errors, especially in failing to take into account the number of beds added to the hospital between 1875 and 1877. Most egregiously they did not understand accounting principles — they mixed capital with operating expenses which, because of extensive renovations and a land purchase, severely distorted the financial picture.46 The whole medical staff and a large majority of the governors gave Machin their full support.47 Four days after Redpath took control, the board vindicated Machin. However, she was distressed that the Committee did not feel it owed her an apology and the general atmosphere became so poisonous that seven months later, in June 1878, Machin resigned and returned to England.48 The Committee tried to persuade her four working-class nurses to stay but, Machin wrote, they were ‘firm in their conviction that they should leave with me’.49
Of the ten nurses who accompanied Machin to Montreal one died and four were failures. Machin fired Sealey and Masters, and two left of their own accord. The four departures were not caused by Machin’s high-handedness; she was very sympathetic and supportive of both her Canadian and British staff and dealt kindly and effectively with the three disloyal nurses. Her record is better that of Lucy Osburn who dismissed all five Nightingale nurses she took to Australia.50 Machin accepted the Canadian situation and her dealings with the hospital governors were diplomatic, and it can be argued that the real cause of her failure in Montreal was the inability of some governors to understand the new nursing and their disapproval of women in positions of authority. Reliance on secondary sources, lack of access to Canadian archives and, in London, a failure to consult the Nightingale Training School records and the Nightingale correspondence with Machin in the British Library arguably caused Baly’s errors in interpretation. For Bostridge, for whom Machin was a minor detail, the problem was reliance on secondary sources. Machin’s experience in Montreal indicates how, as new information is uncovered, revisionism is required and, as historians, we are all subject to it.
- Monica E. Baly, Florence Nightingale and the Nursing Legacy, 2nd edn (London: Whurr, 1997); Mark Bostridge, Florence Nightingale: The Making of an Icon (New York: Farrar, Strauss & Giroux, 2008).
- Baly, Nursing Legacy, 143-44.
- Bostridge, Nightingale, 451.
- Eastern Township Gazette [Quebec], 2 May 1856; Quebec Mercury, 24 August 1866; Quebec Directory 1866/67, 236-37; Ottawa Times, 7 September & 13 November 1869; Cherrier and Kirwin’s Ottawa Directory for 1872/73, 152.
- Marc Vallières, “ROBERTSON,JOSEPH GIBB,” Dictionary of Canadian Biography, vol. 12 (University of Toronto/Université Laval, 2003), accessed December 16, 2019, http://www.biographi.ca/en/bio/robertson_joseph_gibb_12E.html; de Bunsen to Nightingale, 31 January 1873, British Library Additional Manuscripts (BL) 45803 fols 36-37.
- The wife of Henry Bonham-Carter, Secretary of the Nightingale Fund Council, later also commented on her charm. Sibella Bonham-Carter to FN, 26 May , BL 47717, fols 78-81.
- Probationers’ Records, London Metropolitan Archives (LMA) H01/ST/NTS/C4/1, 65.
- Nightingale (FN) to Henry Bonham-Carter (HBC), 2 February 1873, BL 47717, fols 226-27.
- Baly, Nursing Legacy, xi-xii.
- FN to HBC, 22 April& 20 June 1873, BL 47718 fols 62-63 & fol.101; LMA/H01/ST/NC/1/72/16 10 June 1872 fols 1-2 & 9 November 1873, fols 12-13.
- FN to HBC, 29 July 1873, BL 47718 fols 151-2.
- Ibid., fols 151-55.
- For further discussion of the impact of medical developments on nursing practice, see Carol Helmstadter and Judith Godden, Nursing Before Nightingale 1815-1899. (Farnham, Surrey: Ashgate, 2011), 4-8, 22-23.
- Styring to FN, [May 1883], BL 47747 fols 241-45.
- Paul-André Linteau, Histoire de Montréal depuis la Confédération, 2nd edn (Montreal: Boréal, 2000), 13-16.
- Montreal General Hospital (MGH) Committee of Management (CM), 11 November 1875; Machin to FN, 16 October 1875, BL 477745 fols 63-65.
- Mrs Wardroper’s Report 1876, LMA/H01/ST/NTS/A3/1, 15; Machin to FN, 16 October 1875 & 28 March 1876, BL 47745 fols 63-65 & 68-72.
- Linteau, Montréal, 26-28.
- Probationers’ Records, LMA/H01/ST/NTS/C1/2, 20; Mrs Wardroper’s Report 1876, LMA/H01/ST/NTS/A3/1, p. 15.
- Judith Godden & Carol Helmstadter, ‘Woman’s Mission and Professional Knowledge,’ in Social History of Medicine, 17/2 (2004), 167-68; Crossland to FN, 20 May 1883. BL 47738 fols 286-91.
- Machin to FN, 28 March 1876, BL 47745, fols 68-72
- Helmstadter and Godden, Nursing Before Nightingale, 39-45.
- Ibid.; MGHCM, 29 May 1876.
- Matron’s Book 1860-82, LMA/H01/ST/NTS/C1/2, 23.
- Mrs Wardroper’s Report 1876, LMA/H01/ST/NTS/A3/1, 15;
- Ibid.; Machin to FN, 29 June & 13 July 1877, BL 47745 fols 83-90; Helmstadter & Godden, Nursing Before Nightingale, 20-22.
- Machin to FN, 29 June 1877, BL 47745 fols 83-86.
- Mrs Wardroper’s Report, 1877, LMA/H01/ST/NTS/A3/2.
- Machin to FN, 16 October 1875 BL 47745 fols 63-65.
- Ibid., Machin to FN, BL 47745 19 October 1877, 28 March 1876 & 19 September 1877, 68-72, & fols 97-101.
- MGHCM, 16 October, 27 November 1876, 5 February, 26 March, 4 June 1877.
- David Watt to HBC, 18 April 1878, LMA/H01/ST/NC18/13/42.
- Machin to FN 11 May, , BL Add Mss 47745, fols 78-81; Godden & Helmstadter, ‘Woman’s Mission, 171-72.
- MGHCM, 18 June, 23 & 30 July, 6 August 1877.
- Andrew Robertson, Treasurer, Letter of Hospital Expenditure Addressed to Peter Redpath, Esq., (Montreal: Gazette, 1877),6-18.
- Machin to FN, BL 47745, 19 September 1877, fols 91-95; MGHCM, 24, 26, & 28 September 1877.
- Robertson, Hospital Expenditure, 4, 13.
- MGHCM 8 November, 13 & 20 December 1875, 13 March, 5 June & 7 October 1876.
- Machin to FN, 29 June 1877, BL 47745, fols 83-86.
- For a description of ‘old style’ nursing at the hospital, see H. E. McDermott, History of the School of Nursing at the Montreal General Hospital (Montreal: Alumnae Association, pp. 8-9.
- For a discussion of the probationer nurses system at St Thomas’s see Monica E. Baly, ‘The Nightingale Nurses: The Myth and the Reality,’ in Vern Bullough, Bonnie Bullough & Marietta P. Stanton eds., Florence Nightingale and her Era: a collection of new scholarship, (New York: Garland, 1990), 44.
- MGHCM, 10 November 1877.
- Robertson, Hospital Expenditure, 1-16, 19-20, 28-29.
- Machin to FN, 19 September, 19 & 26 October 1877, BL 47745, fols 91-95,97-101.
- Machin to FN, 9 September & 11 May 1877, BL 47745, fols 97-101, 105-11.
- Mrs Wardroper’s Report 1878, LMA/H01/ST/NTS/A3/3/1.
- Ibid.; Godden & Helmstadter, ‘Woman’s Mission,’ 172-73.