Nursing Leadership
Abstract
Caroline Wellwood is representative of a group of early Canadian nurses whose missionary ideals led them to innovative careers in other countries. Wellwood's visionary leadership laid the groundwork for the development of a modern system of nursing and nursing education in southwestern China.
Pragmatic Visionary
Evaluating the accomplishments of early missionary nursing leaders is no simple task. It is difficult to remember that they were a product of their times, not ours. The error of reading history backwards - that is, of evaluating their ideas and accomplishments within a contemporary context - creates the risk of minimizing or even overlooking their contributions to the profession. In the case of Caroline Wellwood, understanding the context within which she worked creates a deepened appreciation for the accomplishments of this pragmatic visionary.
Two powerful social forces, the social gospel movement and maternal feminism, influenced Wellwood's early years. The social gospel movement arose as a response to profound changes in Western society during the mid-to-late nineteenth century (Allen, 1966; Allen, 1973; Christie, 1990; Cook, 1985). The proposed solution, the 'Achievement of God's Kingdom in this Generation', created a complex and dynamic global evangelical movement (Christie & Gauvreau, 1996; Hill, 1985; Merkley, 1987). Mainstream Protestant churches, in particular, the Methodist church, played a dominant role in these efforts (Gorrell, 1988).
Evangelical Protestantism provided opportunities for women to move into professional careers such as medicine, social work and nursing. This development was supported by both the Methodist and Presbyterian Missionary Societies, who quickly learned that the women they sent to work in missions at home and abroad needed professional preparation for their work. (Hall, 1986). Even though most women missionaries were from modest middle-class backgrounds, they nonetheless, for the time, constituted a female educational elite. The mission field widened the scope of employment opportunities available to well-educated women, while the role of female missionary offered both respect and a challenging career option to spinsters. The women's foreign missionary movement created a socially sanctioned sphere of action in which talents for administration and organization could be exercised outside the home and in which women who sought meaning in life beyond marriage and the family could find an outlet for their ambition and energy (Brouwer, 1990).
The women's foreign missionary societies of Canada, Great Britain and the United States held goals consistent with maternal feminists, who believed that women were uniquely suited to the moral reform of society. They focused primarily on the plight of women and children, and established educational, health and social programs to assist them (Semple,1996; Flanagan, 1990). In foreign missionary work, the strategy to both convert families to the Christian faith, and to improve the health and social status of women and children was operationalized through 'Woman's Work for Woman'.
'Woman's Work for Woman' was based on a maternalistic, albeit idealistic, belief that non-Christian religions trapped and degraded women ... [it] aimed to put into place instruments of education, medical work, and evangelization that would 'raise' women to the status they presumably held in Christian countries. (Robert, 1996, p. 133)
The cultural imperialism implicit in such endeavours may create a sense of discomfort for contemporary nurses steeped in the ideology of transcultural nursing. However, 'Woman's Work for Women' has been identified as a positive legacy of Protestant missionary work, even in countries which remained non-Christian. (Hill, 1985; Robert, 1996).
Caroline Wellwood, like many of her missionary sisters, came from rural southern Ontario (Gagan; 1990). Born in Fodyce, Ontario about 1873, for most of her life she considered Wingham, Ontario her home. Little is known of Caroline Wellwood's early life, but by her mid-twenties, she had responded to the great missionary crusade of the late 19th and early 20th century and embarked on preparations for service as a medical missionary.
Like many determined and independent minded young women of her time, she chose to pursue nurse's training in the United States (Gagan,1992). In 1902, she graduated from the National Training School for Missionaries and Deaconesses in Washington, DC. Her preparation included two years of nursing training at Sibley Memorial Hospital and one year of Bible College in Philadelphia. Following graduation, she served as deaconess to a medical mission in Boston and was head nurse at the Boston Talitha Cumi Maternity Hospital operated by the New England Moral Reform Society. Representing an extreme wing of the American Protestant movement known as the Second Great Awakening, members of the Moral Reform Society believed in social action as a moral imperative and, in particular, conducted a vigorous crusade against the double standards of a male-dominated society (Rosenberg, 1971). Indignation against the subordination of women remained a compelling force throughout Caroline Wellwood's missionary career.
In 1906, at the age of 33, Wellwood was accepted as a candidate for the West China Mission by the Canadian Methodist Woman's Missionary Society [WMS]. Reaching the Mission in Chengdu involved a long and arduous journey. Caroline Wellwood sailed from Victoria on the Empress of China on Nov. 27th, 1906 and did not arrive in Chengdu until the following Spring in April 1907. Her initial appointment was to the Jenny Ford Orphanage, named in honour of another Canadian missionary nurse who died in China in 1897. In addition, she began studies in Chinese, a language in which she became fluently proficient. It was during this time that her decision to "give her life to establishing a nursing profession in China" was formulated (Beaton, 1948).
By 1908, Caroline Wellwood was working in the WMS hospital dispensary and training two young Chinese girls as assistants. The hospital was housed in a traditional Chinese building, which limited the scope and size of its activities. Caroline Wellwood's vision was to erect a modern Western hospital to serve the women and children of Chengdu and to establish the first formal training program for nurses in that region of China.
Caroline Wellwood's leadership and administrative skills soon become apparent. She petitioned the WMS Home Board to purchase land for a new hospital and, in a relatively short time, succeeded in obtaining their support. In 1909, she was appointed Secretary Treasurer for the West China Mission, conducting all of their business affairs. In addition, she became superintendent of the old hospital, and, together with another medical missionary, Dr. Anna Henry, engaged in negotiations to secure a site for the new hospital. In 1910 she was officially appointed as 'Builder' of the new hospital.
The 1911 Chinese Revolution forced the evacuation of all missionaries from Chengdu. Caroline Wellwood returned to Canada on furlough and seized the opportunity to confer directly with the Home Board about plans for the new hospital. Prior to returning to Chengdu in the Spring of 1913, she went to New York to purchase furnishings and equipment for the hospital. Throughout her life, she would remember this as one of her most precious memories.
Back in China, Caroline Wellwood assumed her previous responsibilities. Construction of the 60 bed hospital began in earnest, and for the next two years she oversaw virtually every detail. It was a task to which she gave, in the words of the Missionary Monthly (1948), "her unflagging zeal, administrative ability, and wise supervision" (p.74). The WMS Hospital officially opened on Sept.16, 1915 and served the women and children of Chengdu as their sole centre for medical care and treatment for twenty-five years.
With the completion of the hospital, Caroline Wellwood was free to focus on her second goal of founding a training school for nurses. Chinese nursing was in its infancy. The Chinese word for nurse, "hu-shih", did not exist until its invention and introduction by the Nurses Association of China in 1914 (Chen, 1996). Considerable powers of persuasion were required to convince parents that nursing was a respectable career for young Chinese women. However, Wellwood persevered and in 1918 the first class of four students graduated from a three year diploma program. Few teaching resources were available in Mandarin, so Caroline Wellwood translated available English textbooks and wrote new nursing textbooks. These remained in use for the next thirty years. A proponent of high standards, she was eager to have the nursing program attain national standing through registration with the Nurses' Association of China. Registration meant that students were entitled to write the examinations of the Association and would be recognized as graduate nurses anywhere in China (Asson, 1922). In 1920 she achieved her goal.
In addition to nursing, Caroline Wellwood had other interests consistent with her lifelong concern with women's education and their right to social and economic independence. During the mid 1920's she worked as an evangelist and established a school for Chinese women. Her own words provide insight into the strength of her beliefs:
Heretofore there has seemed to be only one avenue open to woman-that of gaining a husband who would be responsible for her support....many, many lives, with minds and personalities capable of being developed, have been sacrificed upon this alter....The numbers of women who seek an avenue of escape are many, and....who have a dream that by gaining an education they might become self-supporting, and thus be freed from slavery of both body and soul. (Wellwood, 1926, p. 627 ).
In the late 1920's she returned to work in the Hospital for Women and Children, supervising in the delivery room, teaching in the nursing school, overseeing expansion of the hospital facilities, and serving as hospital treasurer. After a furlough in 1935, she returned to China to take up evangelistic work again, this time in Chungking. The city was crowded with refugees fleeing the Japanese occupation of eastern China. Seeing their desperate need, Caroline Wellwood took charge and established a hostel for refugees in a vacated mission school. Although in failing health, she still found the time and energy to supervise building of the Nurse's Home for the Mission hospital in Chungking. In 1939, after several serious falls, she was literally ordered back to Chengdu by mission authorities. Here she again worked in the Hospital for Women and Children until its destruction by fire on the night of May 4th, 1940. This event, in her own words, left her "dazed, confused, and almost without heart to start again" (Wellwood, 1941).
In characteristic fashion however, Caroline Wellwood once again took charge. She became Superintendent of the WMS Hospital which was temporarily housed in a mission girl's school until it could move to a permanent location as part of the new University Hospital on the campus of West China Union University. As one of her last acts on behalf of nursing education, Caroline Wellwood served on a committee to establish a baccalaureate program in nursing at University Hospital. Under the leadership of her protegee Cora Kilborn, the baccalaureate program in nursing enrolled its first students in 1946. Caroline Wellwood retired in 1942 after thirty-eight years of service as a WMS missionary. The trip home through a war-torn world took almost 10 months. She died in 1947 in her seventy-fourth year.
In China she was greatly missed. A scholarship was established in her name and the new School of Nursing Building on the university campus was named the Wellwood Memorial Building in her honour. Her greatest legacy, however, was her students, many of whom went on to serve in nursing leadership positions in China. The nursing program she established survives to this day. A natural leader with the gift of humor and a passionate ability to make vision reality, she was happiest in the mainstream of activity, working toward concrete goals, supervising the erection of buildings, and pursuing her dream of uplifting Chinese womanhood. She is, to this day, best remembered by her Chinese name of Mai Shu Ying and respected for her high standards, personal goodness and inspired leadership.
About the Author(s)
Janet Beaton, RN, PhD is a Professor and former Dean of the Faculty of Nursing, University of Manitoba.
Marion McKay, RN, MN, MA is a lecturer at the Faculty of Nursing, University of Manitoba.
Acknowledgment
The primary sources used in developing this article were drawn from annual reports and minutes of the Woman's Missionary Society of the Methodist (later the United ) Church of Canada located in the archives of the United Church of Canada, Victoria University, University of Toronto.The authors also wish to acknowledge the work of Dr. Ina Bramadat for her collaboration in the collection of some of the primary source material used in this article.
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