Nursing Evolution in Jamaica

Evolution of Nursing: Regional and National Influences

• The presentation was delivered by Mrs. Racquel Burton-Edwards, with preparation by Hermi H. Hewitt, on September 16, 2014.
• Specific objectives for the session included analyzing historical and social influences on current nursing practice, explaining socio-economic and political forces shaping nursing's evolution in Jamaica, discussing landmark British Parliamentary reports on nursing, identifying internal and external influences on nursing's evolution, describing contributions of key individuals, and explaining national/regional progress and achievements in the 21st century.

Contextual Milieu (Physical/Social Setting)

• Influences include colonization, social class stratification, political events (adult suffrage), faith-based organizations, and European illnesses impacting indigenous populations.
• There was documented British slavery, with Admiral Penn and General Venables capturing Jamaica from 1655-1838.
• Revolt among WI territories and harsh economic times. British Royal Commission investigations were initiated.

Influence of British Slavery

• Developments included worst human atrocities, numerous plantation/slavery health services
• Field slaves lacked official health care; relying on herbs for treatment until death
• Female household slaves served as nurses for masters/mistresses.

Influence of Slavery (continued)

• Couba/Coubah, a former Cornwallis slave, had a "motherly lodging house" at Port Royal.
• She nursed Admiral Lord Nelson, who suffered from fever and dysentery.
• Sarah Adams, Matron of the Naval Hospital in Port Royal, was known as one of the best disposed, trustworthy women on the estate.

"Sick Nurse"

• An old woman of intelligence cared for pregnant women, infants, and young children.
• References to nursing practices, drawn from African tradition, were noted in Lady Nugent's diary.
• A black nurse tending to her child used herbs and charms to expedite childbirth; her experiences were recorded.

Influence of "Doctresses"

• Freed slaves served as nurses.
• Mary Seacole, (1805-1881) broke from the norm of her time by traveling and working wherever needed.
• Florence Nightingale was apprehensive of working alongside women nurses whom she had little control over.

Mary Seacole's Perspective

• Seacole highlighted her triumphs in medicine and saving lives.
• She valued the gratitude, particularly the glow of health, she saw in her patients after long illnesses.
• She noted the use of medical practices in the realm of dogs and cats. She experimented on herself with simples and essences for medical exploration.

Influence of Social Factors

• Poor public "nursing service" and the notoriety of Mrs. Judith Ryan, the hospital and lunatic asylum superintendent.
• Disclosure of poor nursing service from patient (Ann Pratt) letters, Dr. Bowerbank's letters/diaries (Richard Rouse).
• Despite compelling evidence of injustice, social disparity was still prevalent.
• Poor conditions in the hospital and documented cases of murder, suicide, and death from exhaustion.

Influence of Colonialism

• Midwifery training emerged at the Lady Berkley's Nurse Training Institution in 1856.
• The VJ Lying-in Hospital became a government responsibility in 1891.
• An apprenticeship system of training was established at the Kingston Public Hospital (KPH) in 1870.
• Selection for this training was often based on character, physical/mental stamina, and single status.
• KPH training expanded to rural hospitals, lasting until World War II in 1939.

Influence of Colonialism (continued)

• KPH's apprentice nursing training was deemed disorganized and criticized from 1892 onwards.
• Psychiatric nursing training commenced at Bellevue Hospital around 1925.
• Formalized training for nursing started in 1944 under the tutelage of Miss Ethel Thorpe of England and the matron of Bellevue Psychiatric Hospital.

Influence of the Anglican Church

• Archbishop Enos Nuttall encouraged young women from affluent families to join KPH's apprentice nursing training.
• He prompted the opening of a private nursing home due to poor conditions at KPH.
• Two English-trained nurses were brought to KPH late 1800s to expand medical/surgical wards and train young nurses.

Influence of Moyne Commission Investigation (1938) and Report (1940)

• The 1943 Public Health nursing training started in the field under the Rural Demonstration Scheme.
• Eva Lowe and Evadney Bailey, responsible for training, were qualified in English and US Universities, Masters degrees respectively.
• The Rockefeller Foundation granted funding to establish the West Indies School of Public Health and Sanitary Inspectors.
• Miss Thom (a Canadian tutor), and Mr & Mrs. Hill (England), administered programs.
• Trained Sister Tutors were recommended by the Moyne report to help Caribbean nurses prepare for their roles through various universities like London & Edinburgh.
• Sister tutors later pursued degrees at Toronto University and Columbia University.

Influence of Jamaica General Trained Nurses Association (JGTNA)

• JGTNA was formed in 1946 with goals of educational improvements.
• Registration via nursing law was established in 1951.
• Reciprocity of nursing education with England and Wales occurred in 1952.
• Recognition as a credible professional body arrived by international nursing community in 1953.
• Issues of responsibility and remuneration were prioritized in the 1950s and 1960s.

Influence of Tertiary Learning Institutions

• Excelsior Community College started the first nursing program in the Caribbean in 1974.
• Nursing education at Excelsior evolved from the vision of Gertrude Swaby and Dr. Hon. Wesley Powell, EXED founder.

Influence of Faith-Based Institutions

• Andrews Memorial Hospital in the 1960s upgraded nursing training at West Indies College.
• The generic baccalaureate nursing degree commenced in September 1970.
• This institution was the first in Jamaica/Caribbean to offer a nursing degree.

Influence of International Relations

• Relationships were forged with international nursing stalwarts, including Marjorie Houghton, Florence Udell, Sheila Quinn (England), Rae Chittick, Helen Mussalem, Verna Splane Huffman (Canada), Janet Thompson, Jean McKay, Isabel M. Stewart, Eugenia Spalding, Barbara Schutt (USA).
• Membership in the International Council of Nurses (ICN) was also established.

Regional Developments

• Established in 1957, the Caribbean Nurses Organization, led by Miss Mavis Harney-Brown, focused on raising standards of nursing education.
• The Federal Administrative conference in 1959 in Barbados discussed formation of the regional nursing body.
• The Regional Nursing Body (RNB) emerged in 1972.

Influence of PAHO/WHO

• PAHO/WHO conducted surveys and resurveys of Caribbean Schools of Nursing.
• Advanced nursing training at UWI was designed for nursing educators and administrators.
• A feasibility study took place in 1977.
• Dover document, curriculum change, and regional curriculum harmonization programs were instituted.
• A regional examination for nurse registration emerged in 1993.

21st Century Developments

• RNB Resolution (2000) set entry-point standards for professional nursing practice in the region.
• The Ying Report (1996) and Cabinet Decisions (1999) presented further developments.
• UWI began a BSCN program, expanding to UHWI (2004) and, later, MOH to UTech (2007, 2014) programs including areas like midwifery, critical care, and nurse anesthesia.
• CXC (Caribbean Examination Council) administered the Registered Nurse Examination in 2014.
• The data demonstrates a trend toward advancements in Caribbean nursing practice.

Progress Made

• Development from apprenticeship systems to university-level nursing education.
• Transition from ward service focusing to a more modern nursing model.
• Shifts in governance from foreign to self-governance models.
• The transition from foreign trained tutors to locally educated educators.
• Established national exams, and the development of regional examinations, and the expansion in nursing education from hospital training to university training.

Summary of RNB Objectives

• Identify nursing educational needs
• Set and maintain standards for nursing education in the region
• Establish a pool of examiners
• Inform the region of progressive education trends
• Stimulate nursing research
• Advise health ministers
• Collaborate with other bodies

RNB Achievements

• Accreditation of nursing schools established criteria for better nursing education.
• Spearheaded curriculum development reviews.
• Created regional examinations for nurse registration.
• Established panels of examiners.
• Promoted higher education in nursing.
• Provided advisory support and recommendations for nursing matters to CARICOM Governments.

Further Developments

• The presentation notes advancements at universities within the region including UWI and UTech.
• It also notes the first group of Caribbean nurses to England as part of training.
• Further details show first Caribbean Matron of the University College Hospital, the first President of the Jamaican General Trained Nurses Association (JGTNA), and the first Jamaican Chief Nurse in Jamaica.
• Key figures like Mary J. Seiwright, a pioneering Caribbean nurse, are mentioned (she served as a nurse advisor with the International Council of Nurses). Additional leadership roles were highlighted (1st nurse to be a potential candidate for President ICN, the 1st Jamaican nurse appointed for the Upper House of the Jamaican Parliament). A first West Indian to be the direct head of nursing functions within UWI is mentioned. The year of both her appointment and death are included.

This quiz explores the historical influences on nursing in Jamaica, focusing on significant figures and organizations that shaped the profession. It covers topics from early healthcare for field slaves to the establishment of nursing associations. Test your knowledge on Jamaica's nursing history and key milestones.