Un malaise flou en héritage : la construction du savoir infirmier enseigné au Québec.

Introduction : A discussion paper based on a teaching experience, and presenting a reflective viewpoint developed as part of the university nursing course Theory in Nursing.Context : A critical look at the historiography and reference works used in nursing courses.Objectives : To shed new light on the foundations of the nursing discipline by seeking to better integrate the participation of religious communities in the development of nursing knowledge.Method : Analysis of articles from Recherche en soins infirmiers and a reflective approach influenced by an interdisciplinary perspective linking nursing science, history, and the contribution of Pierre Bourdieu’s work.Results : Observation of the complete absence of contributions to nursing knowledge before Florence Nightingale (1820-1910) and of a century-long silence after her.Discussion : Analysis of the observed reflex to disavow the legacy of nursing sisters in Quebec through the analysis of three aspects : the Nightingalian episteme, the historiographical positioning of nurses and historians, and the construction of knowledge based on the experience of the Sisters of Providence at the Hôpital Saint-Jean-de-Dieu.Conclusion : By ignoring the Franco-Catholic origin of the scientific field of nursing, this disciplinary knowledge deprives itself of a powerful nursing model.

Les infirmières psychiatriques témoins d'un mouvement d'humanisation au cours des premières et deuxièmes vagues de la désinstitutionnalisation au Québec (1960-1990).

Introduction : This study examines the humanization movement at the Saint-Jean-de-Dieu psychiatric hospital between the 1960s and the 1990s.Context : Conducting a historiography of psychiatric deinstitutionalization in Quebec during the twentieth century shows that the institution was a place of social control and, above all else, a place where psychiatric patients were neglected and dehumanized.Objective : While the historiography since the 1960s has focused on a largely one-dimensional and critical reading of the way in which deinstitutionalization took place in Quebec, I have instead chosen to focus on the changes that took place within the Quebec hospital's walls.Method : In addition to the medical records of the patients who were interned in 1961, I conducted interviews to examine the experiences and emotions of nurses who worked in the psychiatric hospital between the 1960s and 1990s.Results : The examination of medical records revealed patients' reluctance and resistance to reintegrate into society. The interviews with nurses revealed that they often felt close to their patients.Discussion : The words and memories of nurses enrich and deepen the complexity of the history of psychiatric nursing practices, extend the existing historiography, and open new avenues for research in the field.Conclusion : The deinstitutionalization movement promoted mental health policies that transformed the old psychiatric hospital. This new analytical approach contributed to renewing the history of psychiatric nursing practices.

Travailler auprès des familles indigentes : les gardes-malades catholiques à l'avant-garde de la santé communautaire au Canada (1934-1959).

Several articles in the Bulletin des gardes-malades catholiques and the Bulletin des infirmières catholiques du Canada refer to the personalist philosophy. In this article, we posit that this philosophy influenced the "social sense" promoted by the Church among nurses from 1934 to 1959 and that it enabled the transfer from a charitable model to one challenging the social order. We present the Bulletins as agents of resistance to a science perceived as being devoid of morality, in the face of a growing administrative technocracy seen as detrimental to human beings' living conditions. These sources allow us to give a different interpretation to nurses' contribution to the modernization of care given to the poorest families. We contend that it is beyond institutions and inspired by personalim that French-speaking Catholic nurses laid the groundwork for community health in Canada.

Plusieurs textes du Bulletin des gardes-malades catholiques et du Bulletin des infirmières catholiques du Canada se réfèrent à la philosophie personnaliste. Dans cet article, nous faisons l'hypothèse que cette philosophie a influencé le « sens social  ¼ promu par l'Église auprès des gardes-malades de 1934 à 1959 et qu'elle a favorisé le passage du modèle charitable à celui d'une contestation de l'ordre social. Nous présentons les Bulletins en tant que moteurs de résistance face à une science considérée comme dépourvue de moralité et face à la montée d'une technocratie administrative représentée comme nuisible pour les conditions d'existence de l'humain. Ces sources nous permettent d'interpréter différemment la contribution des gardes-malades à la modernisation des soins dispensés auprès des familles les plus démunies. Nous soutenons que c'est à l'extérieur des institutions et inspirées par le personnalisme que les gardes-malades francophones catholiques ont jeté les bases de la santé communautaire au Canada.

[Psychiatric nurses experiences of the humanization movement during the first and second waves of deinstitutionalization in Quebec (1960-1990)]. / Les infirmières psychiatriques témoins d'un mouvement d'humanisation au cours des premières et deuxièmes vagues de la désinstitutionnalisation au Québec (1960-1990).

Introduction : This study examines the humanization movement at the Saint-Jean-de-Dieu psychiatric hospital between the 1960s and the 1990s.Context : Conducting a historiography of psychiatric deinstitutionalization in Quebec during the twentieth century shows that the institution was a place of social control and, above all else, a place where psychiatric patients were neglected and dehumanized.Objective : While the historiography since the 1960s has focused on a largely one-dimensional and critical reading of the way in which deinstitutionalization took place in Quebec, I have instead chosen to focus on the changes that took place within the Quebec hospital's walls.Method : In addition to the medical records of the patients who were interned in 1961, I conducted interviews to examine the experiences and emotions of nurses who worked in the psychiatric hospital between the 1960s and 1990s.Results : The examination of medical records revealed patients' reluctance and resistance to reintegrate into society. The interviews with nurses revealed that they often felt close to their patients.Discussion : The words and memories of nurses enrich and deepen the complexity of the history of psychiatric nursing practices, extend the existing historiography, and open new avenues for research in the field.Conclusion : The deinstitutionalization movement promoted mental health policies that transformed the old psychiatric hospital. This new analytical approach contributed to renewing the history of psychiatric nursing practices.

« Imaginaire et sensibilités ¼ : la mise en récit de la déshospitalisation psychiatrique en Ontario.

This paper proposes a historiographical discussion based on the article « Les contrecoups de la déshospitalisation psychiatrique. L'exemple du parcours transinstitutionel de Françoise ¼. Françoise's transinstitutional journey presented in the collective publication La fin de l'asile ? Histoire de la déshospitalisation psychiatrique dans l'espace francophone au XXe siècle, gives me the opportunity to reveal the subtext of this article, and to describe the method and the historical reasoning that gave life to the psychiatric journey of an anonymous person named Françoise. This process is organized around three main points: my positioning as a researcher, the issues related to my narrative approach, and a statement on my historical reasoning in an interdisciplinary perspective. Influenced and inspired by the work of Alain Corbin, George Duby, Roy Porter, Natalie Zemon Davis and Arlette Farge, my approach focusses on the feelings and emotions hidden in historical sources. I remain connected to a subjective intuition, and stay away from positivist reflexes. Based on my research experience with psychiatric records, my conclusion explores the renewal of historical writing , in which I suggest that it is possible to write the history of ordinary people while telling stories with sensitivity.

Ce texte propose une réflexion historiographique basée sur l'article « Les contrecoups de la déshospitalisation psychiatrique. L'exemple du parcours transinstitutionel de Françoise ¼ tiré du récent ouvrage collectif La fin de l'asile ? Histoire de la déshospitalisation psychiatrique dans l'espace francophone au XXe siècle. L'auteure revient sur cet article, afin de mettre au jour le sous-texte et de raconter la méthode ainsi que le raisonnement historique qui ont donné vie au parcours psychiatrique d'une anonyme nommée Françoise. Cet exercice s'articule autour de trois points d'ancrage : son positionnement en tant que chercheure, les enjeux concernant l'approche narrative qu'elle explore et un constat sur le raisonnement historique intriqué dans une perspective interdisciplinaire. Influencée et inspirée des travaux d'Alain Corbin, George Duby, Roy Porter, Natalie Zemon Davis et Arlette Farge, l'historienne insiste sur sa démarche inéluctablement tournée vers une approche soucieuse de repérer dans les sources des traces de sentiments et d'émotions tout en étant connectée à une intuition subjective, loin des réflexes positivistes. En guise de conclusion, en lien avec son expérience dans les sources avec lesquelles elle travaille le plus ­ les dossiers psychiatriques ­, une réflexion sur le renouvellement de l'écriture historienne et sa conviction qu'il est possible d'écrire l'histoire des gens ordinaires tout en les racontant avec sensibilité.

[The Gang of Six Demands more Freedom. Juvenile Offenders Interned in Saint-Jean-de-Dieu, Mid-20th Century]. / La bande des six réclame plus de liberté. Délinquants juvéniles internés à Saint-Jean-de-Dieu, milieu 20e siècle.

In recent years, we have worked with many psychiatric records kept by the Archive Services of the Institut universitaire en santé mentale de Montréal (IUSMM). The proposed article is focused on the February 12th 1959 document Assemblée des médecins located within the records of six illegitimate children admitted to the Hôpital Saint-Jean-de-Dieu in the late 1950s. Our study, inspired by the work of historian Roy Porter and his approach from below, contributes to the historical discourse seeking to incorporate patient's voices, in this case, a gang of young offenders identified by a life course shaped by repeated institutional experience.

Historical thinking and the shaping of nursing identity.

Nursing history was a core component of nurse training programs as early as 1907, when American Adelaide Nutting published her three-volume history. However, it had all but disappeared by the end of the 20th century, supplanted by other subjects. The University of Ottawa Nursing History Research Unit developed two online nursing history courses, in English and French, respectively, which proved popular and prompted substantial interest in the reintroduction of nursing history to our curriculum. This article presents findings of a study that examined the concept of "historical thinking"-what it is, how it develops, and what it contributes to practice-based professions-based on student postings in these courses. Analysis suggests that primary sources and critical appraisal skills are keys to the formation of historical thinking, and that these courses fostered a strong sense of professional identity among participants who often lamented lack of previous exposure to nursing history. Online nursing history courses can capitalize on e-learning technologies, and fit crowded curricula and student learning styles, while extending the reach of historians beyond traditional university walls.

The social integration of the mentally ill in Quebec prior to the Bédard Report of 1962.

This article on the first initiatives of social integration of the mentally ill, using the example of Saint-Jean-de-Dieu Hospital, explores the implementation of dehopsitalization (the transition between hospital and community care) in the early decades of the 20th century. Our study is part of the recent historiographical stream that offers a reinterpretation of the period just prior to the Quiet Revolution in Quebec. We aim to contribute to this research by showing that the policies, strategies, and practices of the Sisters of Providence and the psychiatrists of Saint-Jean-de-Dieu already comprised a deinstitutionalization system that was reintegrating patients into their families as early as the 1910s--half a century before the first wave of deinstitutionalization of the 1960s was orchestrated by the authors of the Bédard Report.

Supporting work practices through telehealth: impact on nurses in peripheral regions.

BACKGROUND: In Canada, workforce shortages in the health care sector constrain the ability of the health care system to meet the needs of its population and of its health care professionals. This issue is of particular importance in peripheral regions of Quebec, where significant inequalities in workforce distribution between regions has lead to acute nursing shortages and increased workloads. Information and communication technologies (ICTs) are innovative solutions that can be used to develop strategies to optimise the use of available resources and to design new nursing work practices. However, current knowledge is still limited about the real impact of ICTs on nursing recruitment and retention. Our aim is to better understand how work practice reorganization, supported by ICTs, and particularly by telehealth, may influence professional, educational, and organizational factors relating to Quebec nurses, notably those working in peripheral regions. METHODS/DESIGN: First, we will conduct a descriptive study on the issue of nursing recruitment. Stratified sampling will be used to select approximately twenty innovative projects relating to the reorganization of work practices based upon ICTs. Semi-structured interviews with key informants will determine professional, educational, and organizational recruitment factors. The results will be used to create a questionnaire which, using a convenience sampling method, will be mailed to 600 third year students and recent graduates of two Quebec university nursing faculties. Descriptive, correlation, and hierarchical regression analyses will be performed to identify factors influencing nursing graduates' intentions to practice in peripheral regions. Secondly, we will conduct five case studies pertaining to the issue of nursing retention. Five ICT projects in semi-urban, rural, and isolated regions have been identified. Qualitative data will be collected through field observation and approximately fifty semi-structured interviews with key stakeholders. DISCUSSION: Data from both parts of this research project will be jointly analysed using triangulation of researchers, theoretical approaches, methods, and results. Continuous exchanges with decision makers and periodic knowledge transfer activities are planned to facilitate the dissemination and utilization of research results in policies regarding the nursing recruitment and retention.

Hell in the family: married women and madness before institutionalization at the St-Jean-de-Dieu Asylum, 1890-1921.

Research in Montreal's St-Jean-de-Dieu Asylum archives has revealed a number of letters from family members and local physicians pleading for asylum care for married women between 1890 and 1921. When added to other admission documents in patients' medical files, these letters allow an intimate glimpse into private lives of families and highlight the pain and distress of dealing with mentally ill people in the home before the introduction of community mental health services. Far from easily abandoning a spouse or mother, close-knit French Canadian families struggled until they could no longer cope before seeking help. To comply with asylum regulations, family members (primarily husbands, who were often illiterate) and local physicians were required to justify their applications for admission, but they did so in different ways.

[First initiatives for social integration of the mentally ill in one phase of pre-deinstitutionalization. The example of Saint-Jean-de-Dieu, 1910-1950]. / Premières initiatives d'intégration sociale des malades mentaux dans une phase de pré-désinstitutionnalisation. L'exemple de Saint-Jean-de-Dieu, 1910-1950

This article on the first initiatives of social integration of the mentally ill, using the example of the Hôpital St-Jean-de-Dieu, explores the implementation of a period of deinstitutionalization in the early decades of the 20th century. Our study is situated in the recent historiography that offers a rereading of the period just prior to the Quiet Revolution in Quebec. We intend to contribute by demonstrating that the policies, strategies and practices of the Sisters of Providence and the psychiatrists of St-Jean-de-Dieu developed a system of deinstitutionalization that reintegrated patients into their family as early as the 1910s, half a century before the first wave of deinstitutionalization of the 1960s was orchestrated by the authors of the Bédard report.

[Sexual stereotypes of institutional confinement in Quebec, at the turn of the 20th century]. / Les stéréotypes sexuels de l'enfermement asilaire au Québec, au tournant du 20e siècle.

This paper concerning the men and women patients of the Hôpital Saint-Jean-de-Dieu investigates gender stereotyping in mental disorders during the late-19th and early-20th centuries through an analysis of quantitative sources from over 8357 admissions. The asylum records (Registre des idiots de la Providence and the medical record, Form C) reveal that there were few differences between the medical diagnoses given and the behaviours of the patients who had been judged insane by their families. Nevertheless, a number of interesting contrasts emerge. The evidence also indicates gender distinctions; in general, the applicants tended to deny feeble-mindedness in men but recognized it as natural in women.

[Psychiatric nursing at the Hospital Saint-Jean-de-Dieu School of Nursing: striking a balance between the spiritual and the technical sides]. / Le nursing psychiatrique a l'Ecole des gardes- malades de l'Hôpital Saint-Jean-de-Dieu: "le côté spirituel en tête du côté technique".

The art of taking care of the insane developed and solidified at the Hospital Saint-Jean-de-Dieu after a School of Nurses was created there in 1912. Founded by the Sisters of Providence, this new school participated in the transformation of the asylum into a regular hospital. The archives of the Sisters of Providence and the monthly magazine La garde-malade canadienne-française allow us to analyze the discourse of nursing leaders, which was based on the importance of professional training. Scientific discoveries and new technologies were at the heart of the care process at Saint-Jean-de-Dieu, where students were introduced to a technical, as well as a spiritual, education. This article first considers the marginal status of psychiatric nursing training within the larger nurses' professionalization movement. In a second step, it describes the socio-religious context between 1912 and 1962 within which the School of Nurses of the Hospital Saint-Jean-de-Dieu evolved.