Eighty years of Queen's nursing

Growing up in a refugee camp in the Democratic Republic of Congo (DRC), Daria Adèle Juüdi-Hope dreamed of becoming a healer. 

Poverty and suffering were all around her. A beloved aunt died in her 30s for want of the simple medication that would have treated her chronic illness.

She did not expect to find that same need in Canada.

“As a refugee and an immigrant coming to this part of the planet, I grew up not knowing there are people suffering here,” says Ms. Juüdi-Hope (NSc’11).

“I thought of myself as a healer,” she says in a phone call from Sioux Lookout, Ont., where she oversees nursing care in several isolated First Nations communities.

“My goal was figuring out how to become that and then go back home where people are suffering. I thought I’d finish up school and go back to DRC or Africa, anywhere there is poverty.

“I didn’t know much about the Indigenous situation here.”

Ms. Juüdi-Hope and other graduates of the Queen’s School of Nursing are making a difference in ways that would seem unimaginable to the young women – and they were all women – who entered the school’s first class, 80 years ago this year.

Back then, changing dressings and emptying bedpans made up the bulk of nursing work. Today, a nurse is just as likely to be providing front-line medical care in a remote community supported by video links to a big-city hospital. He may author academic papers at the forefront of medical research. She may develop and implement preventative policies to keep people from becoming ill or teach a new generation of health-care providers in Canada or anywhere in the world.

“Even when I started in nursing in 1986, when a physician walked into the room I had to stand up,” says Dr. Erna Snelgrove-Clarke, director of the Queen’s School of Nursing since 2019.

“Now we walk in together. Collaboration and teamwork have changed immensely. Nursing was a task-based profession. When nursing moved to the university, it became a theory-based, evidence-informed profession. It’s a different mindset from what we used to do,” she says.

“Nurses aren’t just those who provide patient care anymore. Nurses are educators, they’re researchers. They’re administrators. They work with homeless persons. They work in prisons. They work rurally.”

When Sue Williams graduated from Queen’s Nursing in 1971, she wore the nurse’s uniform of apron, bib, collar, and cap. The uniforms would go within a few years (“when we stopped wearing the starched collar, it took a year for the ring around my neck to go away,” she says), but nurses were still regarded as “the physician’s handmaiden.”

“Career planning wasn’t big back in the day,” says Ms. Williams, who would go on to become director of the Ryerson School of Nursing and is past president of the Registered Nurses’ Association of Ontario. “That’s very different now. Nursing students think more broadly about what opportunities are out there for them and what education might be needed to accomplish those goals.

“The vision is wider now. The opportunities are wider.”

And, like the job, nurses themselves have changed.

“That’s one of the things that is ever more exciting about nurses,” Dr. Snelgrove-Clarke says. “They’re a bit more disruptive. They’re a bit more willing to challenge the status quo. They demand a different form of education. It’s not as didactic as it once was. It’s dynamic and it’s interactive. Gen X is different from those previous generations.”

Male nurses are common in Kenya, where Adan Abdi grew up, but he was one of just a handful of men in his BNSc class of 2007. He remembers his time at Queen’s as the best years of his life.

But Mr. Abdi says it’s impossible for any school to teach all he needed to know when he took his first job in the isolated Cree community of Kashechewan on the Albany River near James Bay in Northern Ontario.
“As a northern nurse, you are a generalist,” says Abdi, an Ottawa--based assistant director of nursing for Indigenous Services Canada’s First Nations and Inuit Health Branch.

“You’re really doing the job of a physician. But what you need to have is critical thinking and Queen’s really helped with that. It’s the idea of going up north and not having all the answers, but knowing your resources and who you can reach out to,” he says.

“The work there was different than the traditional work in a hospital. In hospital you may provide care to a specific patient population and medical supports are readily available if required. But in the north, you do everything. Sometimes you’ll be asked to do things that you’re not comfortable with. 

“Someone can walk you through it over the phone and then you just have to do it. Literally, the life of that person depends on you.”

Now an administrator, Mr. Abdi sees his new role as effecting change.

“You have the ability to influence change and advocate on behalf of nurses. You have the ability to change the profession.”

Change is occurring within the school as well. Dr. Snelgrove-Clarke says the school’s new strategic plan rests on three pillars: the latest trends in care and nursing practices; student mental health and wellness; and, under the direction of Dean of Health Sciences Dr. Jane Philpott, EDIIA – Equity, Diversity, Inclusion, Indigeneity, and Accessibility.

To help students cope, the school has a wellness coach and this year added a mental-health counsellor.
No longer are nurses expected to endure violence and trauma, then be expected to bury it deep inside and show up for the next shift as if nothing had happened. That awareness starts in school.

“People need to talk about how they’re feeling,” Dr. Snelgrove-Clarke says. “We live in an era where people are much more comfortable saying, ‘Hey, I have anxiety.’”

Putting the school under an EDIIA lens requires some unflinching honesty, examining the program as closely and objectively as one would a patient. One aspect of that is “decolonizing” the curriculum, Dr. Snelgrove-Clarke says.

“It means looking at the syllabi to see how we can unlearn past practices and learn new and more inclusive ways of supporting other persons, not only in the classroom, but also in the content of the curriculum,” she says.

That means being open to other cultural practices. The importance of smudging for Indigenous Peoples, for example, or the need in some cultures to include aunts and grandmothers in the birthing ritual.

“It’s being aware of those practices in some cultures and asking what matters. It means finding ways in our communication to make sure we’re meeting other people’s expectations and needs, and not being afraid to ask those questions.”

It was a surprise for Ms. Juüdi-Hope when she took a job as a northern nurse in Fort Albany, Ont., on James Bay, to find the similarities between her own African culture and that of Indigenous Canadians.

“I didn’t know much about the Indigenous situation in this country. Once I learned about it in school and by doing my own learning in the library, I related to some of their struggles – racism, discrimination, and the aftermath of colonization. I felt for the population and their struggles,” she says.

Nor has she forgotten her own roots. After a few years of experience as a northern nurse, she began to consider working overseas. It was hard to balance the needs of those in her old home with needs in her new country. 

“I wish I could send myself in many directions,” she says. “I thought, ‘Does it really make sense for me to go to work there [in Africa] when we need help here?’”

She wanted to do more than a short stint of clinical work where “you go into these communities for two weeks and do as much as you can, which is emotionally draining, then you pack and leave after two weeks and those folks won’t see you again until you come back in a year.”

Ms. Juüdi-Hope decided the best way to have a lasting impact would be to become a teacher herself. She joined a global health NGO to teach nursing and pre-med students while providing medical and dental care in rural in Kenya and Uganda.

“I worked for that organization specifically because there was an educational component. As a person who’s been there and gone through all that and wanting to help my people, I felt that what I could do, since I cannot be there, is to teach the others what I know and sharing and exchanging knowledge.

“I think the best thing to do is to support those communities and sponsor students and they stay home and practise there.”

It’s a vision that the founders of the School of Nursing 80 years ago would recognize. And one still imbued in the school today.

“Eighty years have brought change in uniform, change in diversity and education, from the kind of person who comes into nursing through to how we provide care and help to other people,” Dr. Snelgrove-Clarke says.

“When you think of the 80-year trajectory, I don’t think we talked about climate change and the impact of the social determinants of health when nursing began in the hospital,” she says. “But the issues have evolved immensely.”

It’s a spirit summed up in how Dr. Snelgrove-Clarke describes how the School of Nursing adapted to the COVID-19 pandemic.

“Our last 18 months have been ones of acceptance and commitment,” she says, “and changing it up when we needed to.”