Nursing Leadership
Profile of a Leader: Pioneer Government Advisor: Laura Holland, RN, RRC, CBE, LLD (1883 - 1956)
Abstract
Laura Holland, nurse and social worker, became one of Canada's first official "nurse advisors" to government when she was appointed Advisor to the B.C. Ministry of Health and Welfare from 1938 to 1945. Before that appointment, she had served, with distinction, as a Nursing Sister in World War I, brought innovative Red Cross and public health advances to northern Ontario, reformed Children's Aid services in Vancouver and B.C., and started a new department that combined nursing/social work in the field during the Great Depression of the 1930s. She was an extraordinary leader.
Laura Holland was a pioneer in promoting the importance of the "broad concept" in nursing - an awareness of the subtle social, emotional, economic, and family needs and conditions that impede or prevent recovery or successful rehabilitation. The importance of this broad concept in nursing was still being discussed when the International Congress of Nurses met in Vancouver in June1997. Bertha Harmer in her early textbooks on The Principles and Practice of Nursing (1922, 1928, 1934) briefly discussed the importance of family and community factors, and her later co-author Virginia Henderson defined the broad concept as "the invisibles" in nursing care. Ethel Johns (1947/48) used the expressive term "the intangibles" in her series of pamphlets Just Plain Nursing written in the 1940s. But perhaps no-one was more dedicated to ensuring that these principles were maintained than Laura Holland when she helped introduce the combined department of health and welfare in B.C. during the Great Depression of the 1930s.
Laura Holland was both a nurse and a social worker, and maintained active participation and a leadership role in both professions at national and provincial levels. She received many honours and awards for her achievements. It is difficult to do justice to her outstanding leadership and to her influence on health and social policies and services in Canada. As one of the first nursing advisors to government in the 1930s and 1940s, she helped shape the visions that led to Canada's health and social legislation of today. Her innovative approaches were vital to the well being of people of all ages from infancy to adulthood.
Born in 1883 in Toronto, Laura Holland first studied music and briefly considered a career as a concert pianist (Cooke, 2000). She then entered nursing and graduated from the Montreal General Hospital School of Nursing in 1914. She joined the Canadian Army Medical Corps in 1915 and served with distinction in England, France, Melelaus, Lemnos (where she served throughout the Gallipoli campaign), and Salonika. For her dedicated service, she was awarded the Royal Red Cross medal, first class, the highest distinction given to nursing sisters ("Montreal nurse gets ...," c1919). On release from the Army in 1919, she went to Boston and qualified in social work at Simmons College.
Her career and achievements in Eastern Canada from 1920 to 1927 were outstanding. As Director of Nursing Services for the Ontario Red Cross, she made surveys of the needs in outlying areas and established the province's first four Outpost Hospitals (in Wilberforce, Dryden, Haileybury, and Englehart). At the time of the disastrous Haileybury fire before the hospital was established there, she was on the first emergency train to supervise the work of the Red Cross nurses who had volunteered. She then became Director of Social Work for the Toronto Public Health Department until 1927 when she accepted an invitation from B.C. to reorganize and coordinate the Vancouver Children's Aid Society, which looked after child welfare throughout the province.
Children's Aid Reformer
The Vancouver Children's Aid Society had obtained funding from local service clubs to carry out a survey of the whole field of child welfare in B.C., which was in serious disarray (Angus, c1951). Charlotte Whitton, at that time executive secretary of the Canadian Council for Child Welfare, consented to lead the survey. The report identified many serious problems, including a lack of coordination and cooperation between agencies, lack of trained workers, and failure to try to keep children in their own homes rather than putting them into institutions; the institutions themselves came in for harsh criticism (Angus, c1951). Laura Holland's name topped the list of recommended reformers to help introduce changes.
After her arrival, Laura Holland endured harsh criticism from officials and others in the community who supported the existing system of underfinanced "orphanages" for children without parents and for neglected children and the use of "industrial schools" for confinement of children in trouble with the law. She was referred to as "the wise woman from the East who presumed to impose Eastern methods on the West" (Paulson, 2000). She quietly persisted despite the difficulties and successfully reorganized the system of child welfare. She revolutionized the Vancouver Children's Aid Society, including changing arrangements for financing the care and maintenance of its "wards" so that it was, as recommended in the Survey Report "financed entirely by the government, provincial or municipal as the case may be" (Angus, c1951, p. 32). She also opened new, smaller, cleaner buildings (moving out of ones that had been condemned), brought agencies together, improved the health of children in care, and initiated and found foster homes. "What she did for our agency in four short years might be compared to the achievement of the town-planning engineer who, bridging the space between the primeval forest and the modern city, outlines in a general plan the way in which the new city may develop" (Angus, c1951, p. 34).
During this time, the University of B.C. also began offering courses in social work and Laura Holland taught in this program as well as providing social work lectures for the relatively new degree and public health certificate programs of the UBC School of Nursing.
She also shepherded three revolutionary Acts through the provincial legislature: the Infants Act, the Adoption Act, and the Children of Unmarried Parents Act. She spent many hours in court to support the unmarried girls who faced this crisis in their lives alone. In 1932, she was appointed by the B.C. government as Superintendent of Neglected Children and in 1933 was Deputy Superintendent of Child Welfare. She was named Commander of the British Empire by King George V in 1934 for her outstanding work in Ontario and British Columbia. At that time she was also president of the Canadian Conference on Social Work.
Innovative Public Service
The next important venture for Laura Holland also came in 1934 when Dr. G.M. Weir was elected to the B.C. legislature and was committed to bringing in a health insurance plan for B.C. He combined the departments of health and welfare - in his words, two closely related problems, with poverty and ill health always plaguing the same families and individuals. Major problems of the time were tuberculosis, venereal disease, mental ill-health, and the quality of the existing social services for mothers and child welfare. A qualified staff to provide a generalized service for the entire province was necessary. Laura Holland was the ideal choice to select and prepare qualified applicants for this general service for all provincial health and social services.
Applicants had to write an examination on which those qualified would be selected. The exam was devised to eliminate political patronage, which had previously been found in appointments of unqualified women for the Mothers' Pensions staff (Paulson, 2000). Laura Holland selected and interviewed the successful applicants and arranged six-month orientations with health divisions and social agencies according to the individual needs of the social workers and public health nurses. The recruits for this Welfare Field Service were then assigned to large districts with headquarters in a large town in the area. The new workers were welcomed and accepted by the government agents, provincial police, and doctors of the districts, all of whom had been responsible for the health and social problems in the past.
Laura Holland's visits to the districts were welcomed and enjoyed by both her staff and the local community officials who appreciated her understanding advice and supportive counseling on community problems. Her visits were highlights for the communities and she was much in demand as a speaker to service clubs, church groups, and local Farmers' Institutes. Her graciousness, charm, and broad understanding were apparent and respected ("Prominent social worker speaks ...", c1933).
Laura Holland left the Welfare Field Service when it was well established in 1938 and was appointed Advisor to the Ministry of Health and Welfare. She maintained active participation in the nursing professional association. For example, she was chair of a committee to explore the possibility of a system of "branches" on a province-wide scale. Such a plan was adopted in 1941 when she presented the plan for districts and chapters in her usual clear and inspirational manner (Paulson, 2000). Later in the 1940s, Laura Holland had an active role in development of the innovative Placement Service and the Labour Relations programs of the Registered Nurses Association of B.C.
She was involved in almost everything of policy significance in health and welfare and social services throughout the province. Harry Cassidy, Deputy Minister of Social Welfare during these times, wrote on her retirement in 1945: Laura Holland was an indispensable advisor and consultant in conjunction with reorganization of the tuberculosis programme, with venereal disease control, with the development of new records and reporting systems, and with other aspects of the health programme. She planned the social work programme in the tuberculosis and venereal disease fields and she was largely responsible for the choice of personnel for these new ventures. She was in the inner council when the Residence and Responsibility Act was being drafted. She played a significant part in the planning for an improved system of hospital inspection and administration of grants. It was largely from her that the ideas emerged which were later incorporated in the Welfare Licensing Act. When the Act was adopted she shifted to a new phase of administrative activity and built up the inspection and licensing programme.
Well before she moved to Victoria during the war period [1939-1945] as advisor on social welfare policy, she had been filling this role. Literally, Laura Holland was a consultant and advisor on all major matters of welfare policy years before she was given her ... title. Her wise counsel, her fine ideals, and her far-sighted vision are enshrined in the legislation and the regulations which have built the present system of services for health and welfare in British Columbia, the system which is certainly, I think, now the finest in Canada. (Cassidy, 1945, pp. 2-3)
Following her retirement, she remained active with the RNABC and also helped found a social housing program in Victoria for seniors, at that time a far-sighted project. In 1950, she was awarded an honourary degree of Doctor of Laws from the University of B.C. in recognition of her contribution to the health and social welfare fields in B.C. and to the development of the School of Social Work at UBC. She died in January 1956 at age 72.
About the Author(s)
Glennis Zilm and Ethel Warbinek are executive members of the B.C. History of Nursing Group, members of the Canadian Association for the History of Nursing, and co-authors of a book and a number of articles on history of nursing.
Acknowledgment
Esther Paulson knew Miss Holland, who hired Esther as a member of the original Welfare Field Service nurses in 1934, and who became a mentor and friend throughout her life. Esther Paulson went on to become Nursing Director of the Tuberculosis Division, B.C. Department of Health, and then, as well, Director of Nursing at Pearson Hospital, Vancouver, until her retirement in 1966. She is a former president of the Registered Nurses Association of B.C. (1951-1953) and an honourary life member of the B.C. History of Nursing Group.References
Angus, Anne Margaret. (c1951). Children's Aid Society of Vancouver, B.C. 1901-1951. [Vancouver: Author.]
Appointments. (1937, February). The Canadian Nurse, 33 (2), 71.
Cassidy, Harry M. (1945, Nov. 21). Laura Holland. Carbon copy of typewritten speech for the editor of the Bulletin of the Provincial Secretary on the occasion of Laura Holland's retirement. Original in Laura Holland papers.
Children's Aid Society of Vancouver, B.C. (1929). Twenty-seventh annual report for the year ending December 31, 1928. Vancouver: Author.
Children's Aid Society of Vancouver, B.C. (1930). Twenty-eighth annual report for the year ending December 31, 1929. Vancouver: Author.
Children's Aid Society of Vancouver, B.C. (1931). Twenty-ninth annual report for the year ending December 31, 1930. Vancouver: Author.
Clarke, G.B. (1956, May 1). Looking backward. Canadian Welfare, pp. 25-32.
Cooke, Kathleen (Kay) [Mrs. Dewar Cooke]. (2000, March 24). Personal communication. Meeting between Glennis Zilm and Mrs. Cooke at her home in Vancouver. Mrs. Cooke's father was a cousin of LH. A collection of Laura Holland's personal papers (letters, clippings, photographs) is held by Kathleen Cooke.
Harmer, Bertha. (1934). Text-book of the principles and practice of nursing (3rd ed.). New York: Macmillan.
Heads conference. (n.d. [c1932/3]). Unidentified newspaper clipping, dateline Winnipeg, June 9. Original available Laura Holland papers.
Holland, Laura. (1944). A better world for the children of tomorrow. Canadian Welfare, 19 (8). Reprint available in Laura Holland papers.
Interesting people. (1946, March). The Canadian Nurse, 42 (3), 229-230.
Johns, Ethel. (1947/48). Just plain nursing (Vols. 1, No. 1 to Vol. 2, No. 2). Montreal: J.B. Lippincott. (A series of small pamphlets produced occasionally - about six times a year - and later bound and distributed by the publisher. Johns talks about the "intangibles" in Vol. 1, No. 1.)
Memorial service set for Dr. Laura Holland. (n.d. [c1956]). Undated, unidentified newspaper clipping from Laura Holland papers.
Montreal nurse gets high honor Royal Red Cross. (n.d. [c1919]). Undated, unidentified newspaper clipping from Laura Holland Papers.
Nursing profiles. (1950, June). The Canadian Nurse, 46 (6), 462.
Parker, Ethel Dodds. (1927, June). An important appointment. Social Welfare [Journal of the Canadian Association of Social Workers], pp. 447-448.
Paulson, Esther. (2000). Laura Holland. Handwritten manuscript available B.C. History of Nursing Group Biographical Files, RNABC, Vancouver.
People. (1934, January). The Canadian Nurse, 30 (1), 34.
Prominent social worker speaks here: Miss Laura Holland addresses Rotary Club. (n.d. [c1933]). Undated, unidentified newspaper clipping from Laura Holland papers.
Social workers convene. (n.d. [c1933-34]). Undated, unidentified newspaper clipping of editorial cartoon showing nine B.C. social workers, including Laura Holland. Original available Laura Holland papers.
University of British Columbia. Senate. (1950). Citation for honourary degree (LLD), conferred at Congregation, University of British Columbia, May 12, 1950. UBC Special Collections/ Archives.
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