Autobiography Outline & Introduction

In the 1990s, Helen Mussallem worked closely with Elizabeth Crawley to record Helen’s personal stories in an autobiography. They intended to address all of Dr. Mussallem’s life, from her childhood in Maple Ridge to her retirement years.

Only parts of sections 5, “The CNA Years,” and section 6.1.4., “Commonwealth Nurses Federation”, were written. The original outline (click to view) reveals their intentions for the autobiography project. The text went through several handwritten and typewritten drafts, with corrections and revisions by Helen Mussallem and Elizabeth Crawley. This website version of their work contains all of their completed text, arranged in chronological order.

Elizabeth and Dr. H.K.M.
Elizabeth Crawley and Dr.Helen K. Mussallem

Outline – click headers to view page

Pilot Project for Evaluation of Schools of Nursing  (5.1.1)

      • Initial Planning 5.1.3

Survey of 25 Schools of Nursing (5.1.4)

      • 1957
      • Writing the report 5.1.5
      • Presentation of Final Report 1959-1960  5.1.6

Appointment as Director of Special Studies, CNA  (5.2)

      • Plan to Implement Pilot Project Recommendations  5.2.2
      • Royal Commission on Health Services  5.3

Executive Director, CNA  (5.4)

      • Special Projects (Library, Statistics)  5.4.3
      • First International Initiatives 1963  5.4.5
      • CNA Initiatives 5.4.6
      • CMA/CNA/CHA Joint Committee of Nursing

Canadian Nurses Foundation

CNA Activities 1965-1966

      • CNA House
      • Study of RCHS Recommendations 1964-1965
      • Journals Editor
      • Committee on Social & Economic Welfare
      • New Brunswick Association of Registered Nurses, June 1965

PAHO/WHO Project in Commonwealth Caribbean 1964-1965  (5.4.5)

International work 1964-1965  

      • WHO Expert Study Committee . . . for International School for Advanced Nursing Education (Edinburgh)
      • Lebanon
      • ICN in Frankfurt
      • Commonwealth Medical Conference, Edinburgh, October 1965

International Work 1969-1975  

      • Regional Nursing Body of Caribbean Commonwealth
      • Montevideo
      • King’s Fund Summit Seminars
      • Australia

International Initiatives in Cuba 1973-1984: Encounters with Fidel Castro

Commonwealth Nurses Federation – West Africa, 1981



Pilot Project for Evaluation of Schools of Nursing (5.1.1)

In 1960, when Helen Mussallem wrote the preface to Spotlight on Nursing Education: The Report of the Pilot Project for the Evaluation of Schools of Nursing in Canada, she noted that only factual information was presented in the report and that “…someday the other part of the story may be written.” Someday is here. Helen’s adventures and experiences, during this exciting and critical professional journey, provide a unique, fascinating glimpse into the turbulent world of nursing education in the 1950s.

Does Canada need a national program of accreditation for diploma schools of nursing? When this question was first asked, decades ago, at a CNA biennial meeting, Helen Mussallem was serving with the armed services (WWII) and such matters had never crossed her mind. Indeed, in her early years of nursing practice, she was convinced that such subjects were best left to the “old maids” in the profession. Resolutions “approving the principle of accreditation” were passed almost biennially until 1955 when a significant step was taken. Nursing leaders of the day looked with approval at the U.S. accreditation system and believed that such a program would have a great positive impact on Canadian schools of nursing.

Accreditation was the main theme at the 1955 CNA General Meeting. Helen remembers it well: a hot, stuffy room for approximately 150 delegates –air conditioning was a luxury in those days! The opening session, although well planned, ran into some minor obstacles. When the minister did not arrive to deliver the opening prayer, some kind soul found a prayer in her purse and gave it to the president to read. Unfortunately, also during the session, the president, G. Sharpe, lost her front tooth and the organist lost the music for the opening to God Save the Queen. CNA was one of the first professional health organizations to provide translation services to its members but this also proved hazardous as so many people tripped over the electrical connections laid across the floor that they had to be disconnected.

Discussion on accreditation raged on. Helen was sitting in a pool of perspiration when she heard the president ask Miss Mussallem for her opinion. She remembers somehow getting to the microphone and saying that there should be an accreditation program as soon as possible. How profound! As director of Canada’s then largest school of nursing, she was sure a more scholarly statement had been anticipated.

For Helen, life at the Vancouver General Hospital School of Nursing continued as busy and exciting as ever until, unexpectedly, Trenna Hunter, president of CNA and fellow resident of Vancouver, asked her to become Director of the Pilot Project. No hesitation here! Helen’s response was a quick and positive … “No!” although she would be willing to serve as a Regional Visitor. “No” was her only possible answer because both her parents had serious health problems and because she had become inextricably linked with her young niece, Lynette, who taught her the meaning of “unconditional love”. Professionally, she enjoyed her work at VGH School of Nursing and had implemented some exciting and innovative curriculum changes. Why leave all of this for two years?

As time passed, Helen began to feel considerable pressure to accept this assignment and, reluctantly, a positive answer emerged. “Yes.” Little did she know how much that response would change the whole course of her life.

Arrival in Ottawa  (5.1.2)

It was agreed that Helen would begin her work on the Pilot Project for Evaluation of Schools of Nursing in September 1957. As her first working day was to be the day after Labour Day, she arrived at Uplands Airport in Ottawa on Sunday and was whisked away to her home away from home, the Bytown Inn. As she travelled through the city, she couldn’t believe her eyes and thought she had been transported back to the Middle Ages. There were old street cars rumbling all over, everything looked old and dingy. The Bytown Inn was an old wooden structure and her room was on the ground floor. The only view to be had was of a gas station and her nose was constantly assaulted by fumes from the garage. If it had been possible to return home then and there, she would have been ecstatic! The next day, she begged to have her room changed and, finally, one was found for her on the second floor. When she had looked around, she asked curiously what the rope was for and was told that, in case of fire, she was to use the rope to slide down to the ground floor! To add to her welcome to Canada’s capital, a staff member from CNA called later to say that she had forgotten to meet her plane. What a feeling of gloom and doom!

Initial Planning of Pilot Project for the Evaluation of Schools of Nursing  (5.1.3)

Helen was tense meeting the staff at CNA’s office at 270 Laurier Avenue. The four senior staff were gracious and kind but, oh, the loneliness of it all! The next day she was off to Toronto and Montreal to meet members of the Special Committee for the Project, all well known and respected Canadian nurses. They were all so clever and knowledgeable that she was almost paralyzed talking with them. She remembers wearing the “proper” suit bought for the Project: navy blue with detachable collar and cuffs, the latter to be washed and pressed each night –no wash and wear in those days. Also, as so few women travelled in the 50s, attaché cases were great, heavy ones made for men. She was justifiably proud of her genuine leather, hand-crafted briefcase but it weighed so much, even empty that she suffered from a sore arm for ages.

What was CNA Headquarters like? Friendly … after at time. But Helen had grown up in a different professional milieu. Since she was from B.C. – a leader in Canada in the Union movement of professionals — she was thought to be painted pink or red, or at the very least to be a Union sympathizer. The word “union” was unacceptable in the professions but all knew that the last meeting Helen had attended as an RNABC Board Member was held to decide if the nurses in one of the inland hospitals should go on strike when the hospital would not honour the decision of the government arbitrator. Helen remembers discussing the situation until 3 AM, until it was decided that nurses would withdraw their services in all but essential areas. This was a first for nurses in Canada. She remembers leaving the meeting in downtown Vancouver, in the early morning hours, so exhausted that she walked straight into a puddle up to her ankles and felt nothing until she returned to her suite to find water and mud oozing from her boots.

Helen’s first months at CNA were hectically busy, but she did not mind as she had few social engagements in the evenings. Occasionally, she would sneak across the river to Hull for a change of milieu. What was on her plate as Director of the Pilot Project for Evaluation of Schools of Nursing?

– development of criteria for the evaluation of the schools

– preparation of preliminary information schedule

– role of National Office in the survey

– preparation of list of data required at the time of the survey

– preparation guide for the survey week

– preparation of a format for writing the report in both English and French

Most daunting of all, was the schedule prepared by National Office to: first, visit all officials in national and provincial health departments as well as a one-day visit to each of the 25 schools to acquaint them with the project and to show that Helen Mussallem did not have “two heads”. There was much anxiety across the country as this project was, incorrectly, viewed as an accreditation program; and, second, to prepare a cross schedule.

Travel in the ‘50s was more difficult than it is in the 90s and hotel accommodation in smaller communities left much to be desired. On the first series of one-day visits, there were many surprises. Helen remembers getting off the train in a small Ontario town in mid winter. Emerging from the train, there was only one taxi to be had so all four travellers squeezed in. Helen told the driver she would like to go to the “X” Arms Hotel. Silence. All other passengers left –one by one. When the driver began to drive into the outskirts of town, Helen became suspicious and asked if the “X” Arms was a good hotel. “Yes,” said the driver. When he stopped, a startled Helen saw, through the dark night, a two-story, run-down building with a huge dog out front. Again she asked if this was a good hotel and again the driver replied in the affirmative. The Project Director will never forget the scene that greeted her as she walked into the hotel: a densely smoke-filled room with drunken men chasing women around the room. She was asked to sign an ancient book and then was pointed to her room. Unbelievable! Panel in door ripped off, etc. She recalled her orientation at the Nursing League for Nursing and their advice that, in such a situation, one should go to the phone and call another hotel. She ventured into the main room again only to be told there was no phone in the hotel and that the nearest phone was two blocks away. Nothing to do, but to place the half clean towel over the bedspread, covered with dog hairs, and lie down. What a night! Women screaming and men running up and down the halls ALL night. She stayed fully clothed on the bed and, as dawn broke, splashed water on her face, paid for her room, and set out on foot to find the nearest phone. A gas station about two blocks away permitted her to phone “the best hotel” in “X”; a cab was dispatched and she arrived at a lovely, modern hotel and made for the dining room. All white linen, flowers and well dressed people. Life was real again. Across the dining room, Helen spotted a VON nurse she had met in Ottawa. When she told her story, the nurse said” Wait a minute. A student of yours is a VON nurse here and I want you to tell her about last night.” Helen did. The former student opened her big, brown eyes and said, “Miss Mussallem, did you stay there ALL night?” “Yes,” Helen replied. “Tell me what kind of hotel is it?” “Well,” said the VON nurse, ”we hold a clinic there from time to time.” Enough said.

Then there was the time when Helen’s plane to St. John’s, Newfoundland arrived very late. Ten men and Miss Mussallem lined up at the Hotel Newfoundland for their rooms. Helen was at the end of the line as her luggage slowed her down ascending the stairs. There was great shouting at the front desk when the reception clerk announced that they would all have to share rooms. They all shrieked about “confirmed reservations” but there were no rooms to be had as there had been no flight out for departing guests. Almost as a person, they turned and looked at the lone female. Helen just stood there and waited only a few minutes. A porter came and whisked her to a lovely single room overlooking the harbour.

Those were also the days when, leaving an elevator, you made sure you had your keys in hand as there was usually someone following. Strange were those days when few females travelled on business. At another school of nursing, on a one-day visit, the director of the school arranged for a corn roast in the evening. All the teachers and local members of the professional association were present. Corn was passed around. Helen decided that, instead of presenting a speech, she would ask for questions. The audience sat quietly as someone asked a question, then as Helen paused before replying, all simultaneously chewed across a row of corn. What a sight –speaking to 20 cobs of corn! So, while the audience was formulating questions, Helen joined in the chewing of the corn.

The North Bay visit will always be remembered by the Director for the sleepless night spent at her hotel. A convention of salesmen had decided to spend the night on the main floor, drinking the hours away. Despite Helen’s frequent pleas to the management, it was 6 A.M. before the noise ceased. Although in no condition to conduct a proper orientation visit the next day, the Director did her best.

Having completed one-day visits to the 25 large, medium and small size schools of nursing, located in all provinces, the Director selected the various types of diploma programs to be surveyed –the three-year diploma hospital program, the two year plus one year internship program, and programs with close university affiliation. The goal of the survey, “To determine if Canadian schools of nursing are ready for a program of accreditation and if it is feasible at this time to initiate such a program”, seemed more daunting than ever.

The achievement of this goal was, of course, not the Director’s sole responsibility. There was, as always, a committee structure set up to assist the Pilot Project Director. This “democratic process” was meant to ensure that CNA members felt involved and would be able to claim some ownership of the finished product.

The first committee struck was the Special Committee which the Executive Committee of the CNA Board of Directors charged with initiating work on the project until a director was appointed. Although little preliminary work had been done when Helen arrived in September of 1959, the Executive Committee continued to Special Committee “…to advise the Director of the Pilot Project, upon her request, on matters of administration and policy”. Members of this committee were leaders in nursing education in Canada: Sister Denise Lefebvre, Rae Chittick, Sister Mary Felicitas, Margaret Street, Katherine MacLaggan, and six more. They were all eminently knowledgeable and well-recognized in the Canadian nursing community and they scared the new Director to death! Helen says, “Even though they treated me as a competent person, I’m not sure I was. I said many times that I may not be an expert in the field but I had a strong sense of commitment to achieving the goals of any work I undertook. This trait was acquired from my parents. We learned that we must work hard and only play after the job was done”.

The Special Committee soon determined that there was, and would continue to be, a need for interpretation of the project to allied professional agencies. Hence, a Liaison Committee was appointed. Members came from the Canadian Joint Committee on Nursing (equal representation from Canadian Medical Association (CMA), Canadian Hospital Association (CHA) and CNA, plus a representative from the Canadian Public Health Association, the Canadian Association for Adult Education and two members of the Special Committee on the Pilot Project. Meetings were infrequent and often held at CMA headquarters in Toronto. Helen remembers entering the CMA building by a side door and meeting in a room with inadequate heating and no air conditioning, which was considered a luxury in those days. She has a clear recollection of being “allowed in” the side door of CMA headquarters but, in 1962, when she had completed her doctorate, the front door suddenly swung open and, from that moment on, the Director was allowed to use the front door.

The times being what they were, it was difficult to assess how well this committee succeeded in interpreting such a “massive project on Canadian nursing education” to the seven national organizations.

The nature of the pilot project required that a qualified Board of Review study the survey reports, written by the Project Director, and pass judgment on the educational programs of the schools survey, i.e., using present criteria, if a program of national, voluntary accreditation were in place, would the school be accredited?

This was an incredibly hard-working committee. Each member of the Board of received a copy of each completed report as soon as it was duplicated at national office. They then studied the reports before the committee’s final meeting in May of 1959. To prevent any possible bias, schools were identified only by a code number.

Although not a committee, Regional Visitors were an integral part of the surveys. Following the National League for Nursing pattern, two regional visitor surveyors were selected for each school of nursing. This was intended to ensure that the report would provide a balanced judgment of each school. On each visit, the Director acted as senior visitor and the regional visitor as second visitor. For French-language schools of nursing, a third person –the senior bilingual visitor –played an integral role. She, with the assistance of a second bilingual visitor, was responsible for conducting surveys in the five French-language schools. The Director also participated on this team. Not only did she have overall administrative responsibility for surveys in these schools, but she translated the French language reports into English.

Little did Helen realize, when she agreed to be Director of the project, that she would be faced with such a formidable task of planning, organizing and directing the Pilot Project as well as coordinating all activities related to it. Her responsibilities included:

– Travelling to all 25 schools across the country on a preliminary visit; interpreting the Project to directors of the schools, and orienting them to the process of the survey;

– Conducting orientation workshops for regional visitors and an orientation program for the Board of Review;

– Taking overall responsibility for the surveys of the schools by:

– organizing each field survey trip;

– writing the survey report with the regional visitor

– validating, clarifying and supplementing information;

– setting up an organizational structure;

– providing guidance to schools within the field of her competence; and

– interpreting the project to hospital personnel;

– Establishing all procedures and organizing meetings of the Special and Liaison Committees;

– Interpreting the purpose and scope of the Project to deputy ministers of health, education, allied professional groups and the general public, via press, radio and television media.

How the new Director gained the skills necessary to conduct such a massive survey is a story in and of itself. As CNA had decided that a Canadian nurse should direct this Project, after one short week in Ottawa, Montreal and Toronto, Helen was sent to National League for Nursing headquarters in New York to become a competent surveyor. The time allotted for this training was four months!

This intense orientation program was invaluable to the fledgling Director’s future work. To make the indoctrination to the accreditation process as thorough as possible, no effort was spared by National League for Nursing staff. Helen was asked to serve as one of two accreditation visitors on six full-fledged accreditation visits in various geographical areas in the United States. Each of

these six surveys was carried out with a different National League for Nursing visitor to enable the new Canadian Director to study variations in survey techniques as well as the personal, philosophical variations of National League for Nursing staff. Surprisingly, Helen’s problems as a National League for Nursing visitor were unrelated to her expertise. She had a Canadian accent! Should the school being surveyed learn that one of the visitors was a Canadian and if perchance, the school did not receive accreditation, the whole process might have been condemned. Helen was continually reminded to say “OWT” and “ABOWT”, etc. and, luckily, as she had obtained her master’s degree at Teachers College, Columbia University, she was aware of the required accents. Frequently, the staff of the schools surveyed asked where she came from and Helen always replied “the Pacific Northwest” which was true as Vancouver was home. At each school, she always asked, immediately, some personal question like, “Where did you receive your basic education?” or “Have you always lived here?” She had quickly learned that most people are always happy to talk about themselves. Only once did she find herself being grilled and, thankfully, the senior National League for Nursing visitor saw her predicament and called on her for advice. Whew! She had another tense moment when some nurses in Duluth, Minn. took the National League for Nursing visitors for a drive and wanted to take them across the Canadian border. What to do? It would be a bit hard to explain Helen’s Canadian passport! Some miles from the border, the senior visitor again came to the rescue by advising that they really didn’t have time for such a long drive. Saved again!

The novice Director soon became accustomed to the pressures involved in conducting a survey. Each survey was one week in duration: five and a half days were spent on the survey with the remaining time being allocated for travel to the next school to be visited. One full day and evening (Monday) was spent at the hotel studying all written materials describing the program. Three days (Tuesday, Wednesday, and Thursday) they were at the school, visiting and each night and all day Friday was spent writing the report. Helen vowed, there and then, that she would develop a tool to assist in writing the reports as she found that, by ten or eleven P.M., their minds were so numb that they could hardly think of one decent descriptive noun or even the correct verb. Eventually, her “tool”, used in Canada, was so successful that it was adopted, with revisions, by her National League for Nursing mentors. The report was read to the school and hospital staff on Saturday morning, with opportunity allowed for correction of errors. The completed report was shipped to National League for Nursing headquarters and then it was on to the next survey. At National League for Nursing, after six surveys, the visitors took one week off. This luxury was not possible in Canada as staff was very limited and the entire project was conducted over such a short period.

Helen’s first stop as an National League for Nursing visitor was in the hot, humid Delaware city well known for being the Dupont headquarters. She recalls leaving Delaware on a stiflingly hot day and standing on the platform waiting for the train to her next post. The platform was level with the train entrance but, as she entered the train carrying bags in both hands, her shoe got wedged between the station platform and the train. Not knowing what else to do, she stepped on board, dropped her bags, and then turned to retrieve her shoe. Unfortunately, the train had started and her shoe was swept away. So, there she was, sitting in the back seat, one shoe on and one shoe off contemplating how to get a pair of shoes out of her luggage. The train stopped at the next station but the aisles were full so, off the train and into Penn station she limped –an unusual sight in 1957, but no one stopped or even stared. In the Ladies Room, she retrieved another pair of shoes from her suitcase and discarded the lone shoe in a wastebasket.

Each town –like DuPont in Delaware –seemed to have some special claim to fame. When Helen was posted to Little Falls, Minn., she was sure there would be nothing there. In fact, she even had difficulty finding it on the map. Imagine her surprise when she met with the faculty, and guess what? They proudly pointed out that Little Falls was the birthplace of Charles Lindbergh!

On Helen’s return to New York, work at National League for Nursing headquarters was intense. She formed many warm, rewarding relationships with National League for Nursing staff during stressful times spent preparing for the Board of Review and reporting to committees, etc. When it was time to return to Canada in early January 1958, she was sad. After such warm camaraderie at National League for Nursing, she was again on her own.

The new Director’s orientation was complete. The next step: the long awaited survey of 25 Canadian schools of nursing.

Autobiography Outline



1.1.1. Mussallem Family
– historical & current
Parents (SM escape from Lebanon)
Siblings (p.136)
Relatives – Mussallem & Bassette

1.1.2 Prince Rupert – the beginning (SM p.75)
-sidewalks – stores – reading – church – S.S.Prince George – carried on board
-Ocean Falls
-Howe Sound

1.1.3 Vancouver
-Why Vancouver? – SM “could not abandon country of his childrens’ birth”
-SM’s training in motor repairs
apprenticeship years
-soap enterprise (86)

1.1.4 Maple Ridge and Port Haney
– Establishing home
-Establishing Haney garge
-Began school
-Church, sporting, organizations, public library, post office (federal)
-SM in municipal politics (107)
Reeve/mayor for 22 years
-A.M. and the Queen (115)
-Pre-school activities
-School – Haney Public School






5.1.1 Appointment as Director of Pilot Project for Evaluation of Schools of Nursing in Canada
-Leave of absence for 2 years from VGH

5.1.2 Arrival in Ottawa (44 lbs. baggage)
-stay at Bytown Inn

5.1.3 Initial Planning -Meeting with Special Committee of Project in Toronto and Montreal
-Selection of Schools for Pilot Project -Selection of Regional Visitors
-Appointment of Liaison Committee -Publicity for project
-Familiarization trip across Canada
-Meeting with Minister/Deputy Minister of Health and/or Education & Chief Nursing Officer
-meeting with directors of schools to be surveyed and administrative personnel of hospital/university
-meeting with nurses organizations in the community

5.1.4 Survey of 25 schools of nursing in all to provinces (Fr. & Eng.)
-Personnel in schools
-data provided
-survey techniques
-unusual incidents
-interim meeting with executive committee (Board of Directors)

5.1.5 Writing of report in Ottawa and Maple Ridge

5.1.6 Presentation of Final Report to Executive Committee (B of Dir) 1959-60
-4 months Teachers College in New York
-presentations to annual meetings

5.1.7 Halifax June 1960. ”Elle a gagné ses épaulettes”
-acceptance of 4 recommendations

5.1.8 Personal approaches to fill other special positions (see 5.2)
-Director of Special Studies 1960-63

(return to Teachers College in New York to complete doctorate)


5.2.1 Appointment as Director of Special Studies (condition of appointment
-extension of VGH Leave of Absence)

5.2.2 Development of Plan to Implement 3 of 4 recommendations of Pilot Project
-Directors of project recruited
-Rec. 1 Kasper Naegle -study of whole field of nursing education.
-Rec. 2 School Improvement Program (G. Rowsell)
-Rec. 3 Evaluation of Quality of N.S. (L. Campion)
-Supervision of Special studies: Rec. 1, 2 and 3
-Assistance with writing and publication


5.3.1 Death of Kasper Naegle. CNA Project (Rec. 1) and RCHS project on Nursing Education combined

5.3.2 RCHS Project Director
-defined purpose of project
-planned survey of university schools of nursing and diploma schools of nursing
-on-site visit to university schools of nursing 16 basic (p.75)
-?? Personal


5.4.1 History of CNA

5.4.2 Appointment as Executive Director

5.4.3 Special Projects (Library, Statistics)

5.4.5 International initiatives
-ICN (CNR) – speaker and chair sp. Sessions Frankfurt, Montreal, Mexico, Tokyo, Nairobi, Los Angeles, Tel Aviv, Seoul, Madrid
-Red Cross
-WHO (U of Edinburgh)
-Commonwealth Caribbean (Reg.Nsg.Body)
-Government Delegations
-Middle & Latin America
-Summit Seminars
-Caracas, Venezuela
-Commonwealth Nurses Fed. (1971)
-Montevideo, Uruguay
-Expansion of International Programs (CIDA)
-30th WHO Assembly
-World Federation of Public Health

-Schools of Nsg. To Education system
-CNA House
-Status of Women
-ICN Congress ‘69
-Chain of Office
-CNF (1962)
-Research Unit
-Letters Patent
-Briefs & Position Statements
(Physicians’ Assistant)
-Brief Putting Health into Health Care
-Doctoral preparation for Nurses (Seminar)
-Expanded Role for Nurses
-Health Promotion Program
-Special Advisor to Cdn. Nurse delegation and offices at ICN meetings Geneva, Frankfurt, ??, Montreal, Dublin, Mexico City, Tokyo, Nairobi

5.4.6 Personal Etc.
-Honors & Awards (OC)
-Social Life


6.1.1 Transfer of responsibilities to CNA & CNF to new Executive Director, Feb. 81
-Board of Directors
-allied health professionals
-records (social wants)

6.1.2 Consultant to new Executive Director
-planning and problems
-relationship with staff

6.1.3 ICN – Election as member of Board of Directors (July 1981)
-Board meetings in Geneva 81-85

6.1.4 Commonwealth Nurses Federation
-Lectureship in West Africa – Nigeria, Ghana, Liberia, Sierre Leone, Malta and Cyprus
-Lectureship on PHC (“Continuing Education: an essential to nursing strategy and networks in primary health care”)
-Model lecture and special description in each country and WACN
-Relationships with governments and professional nurses associations
-Caribbean P.H. Association (founding member)

6.1.5 Other International Assignments
-Project Hope – Virginia, USA – Keynote Speaker ‘81
-World Congress on P. Health Care – speaker ‘83
-Consultant and speaker Nursing & Health Cuba ‘81
-Official ICN Representative to second World Congress on Nursing
-Chair, Planning Session, World Federation of Public Health ‘87

6.1.6 National commitments and participation
-Economic Council of Canada (1971-1990)
-VON Board & President
-CPHA Int. Review & eval. Committee -1993
-Premiers Council on Health Strategy – 199?
-Human Rights Institute for Canada – Board of Directors, 1981 –
-St. John Ambulance – Chair Nsg. Advisory, Advisor to Chancellor, Nurse to Jerusalem Project
– CIDA (NGO Division)
-Caribbean Regional Nursing Body
-Cdn. Society of Assoc. Executives
-Consultant to YM/YWCA Discussion Club
-Cdn. Lung Assoc./Cdn. Nurse Pers?
-Law Reform Commission
-Coalition of National Voluntary Organizations (& Board of Directors)
-Ont. Occ. Health Nurses Association (Cert. Ctee)
-H & W Canada – WHO fellowship selection ctee
-Canadian Cancer Society – Fellowship Cttee
-Friends of Rideau Hall – member
-Friends of Canadian Museum of Civilization
-National Gallery of Canada
-National Arts Centre

6.1.7 Personal
-social life
-courses taken
-special projects

Survey of 25 Schools of Nursing (5.1.4)

During the Director’s orientation in New York, a previously-prepared questionnaire was sent to the director of each participating school of nursing. The questionnaire had been adapted from the Application for Accreditation (diploma program of National League for Nursing) and its purpose was:

– to obtain as clear a picture as possible from the school of its educational program for those who would make the visit and those who would evaluate the program; and

– to assist the faculty in making a critical evaluation of its program.

Later, many schools indicated they had derived great value from completing the questionnaire and, if the Pilot Project had gone no further, they would have found this step a most helpful one in the evaluation of their school. This response was gratifying. Every one of the 25 questionnaires, with requested additional material, was returned to National Office by November 1957 –prior to the return to Canada of the Project Director.

The main portion of the preliminary phase of the Pilot Project, however, was the one-day visit to each school across Canada which participated in the Project. During this phase, it was deemed advisable that a one-week survey visit also be made to one school so that the necessary alterations to the evaluation process could be made prior to phase two –the survey of the remaining 24 schools of nursing.

This complete, one-week survey was to serve as a trial run. There was some concern that the detailed evaluation process might not be appropriate as this was an entirely new educational process in Canada. On completion of the trial survey, the Director was gratified to find that the process worked very well. In fact, only minor revisions were necessary. She remembers that, when they read the report of the first one-week survey to members of the school of nursing and senior hospital staff, they were amazed. Their school was considered to be one of the best and most innovative in Canada and they had anticipated a glowing report. The regional visitors had written in as objective a manner as possible and the summary contained a listing of “Areas of Strength” and “Areas Requiring Study and Improvement”. The director of the school, who was also a member of the Special Committee, was appalled at the number of weaknesses listed but none were challenged. Helen found the process to be extremely uncomfortable. This, the first school to be surveyed, was located in one of Canada’s largest cities and their living facilities, therefore, were better than those found in many of the smaller centers. The second regional visitor for this survey was a religious sister. As there was a bar in the dining room, Helen was so embarrassed at the thought of Sister looking at a bar, that she always seated herself facing it. On completion of the survey, during dinner, Helen suggested to Sister that this was a time for celebration. Much to the Director’s surprise, Sister recommended they have a sherry and, being so relieved to have the first survey over, they even managed a second one with a brandy to finish off the evening. Helen was very glad that she had packed her bags for early morning departure before dinner as she could just barely make it to her room. In those days, as a result of her “Presbyterian upbringing”, she had rarely consumed alcohol.

The four-month preliminary phase of the Pilot Project concluded with an interim report to the CNA General Meeting in Ottawa where the Director also chaired a panel presentation “Guidelines for the Future”. The continuing task of keeping CNA membership informed throughout all phases of the project was still a priority. Press releases were prepared, articles were published in The Canadian Nurse and memoranda were sent regularly to executive secretaries/directors of each provincial association, the Special Committee, the Executive Committee and selected governmental and non-governmental agencies.

The intermediate phase was spent primarily in completing the survey of the remaining 24 schools of nursing across Canada. In the Preface to The Report of the Pilot Project, Helen wrote, “… items that should be recorded when travelling ‘from Cape Race to Nootka Sound’. There was ample opportunity for the unusual to happen…” And happen it did. Then she went on to say, “The modes of travel and accommodation were many and did not lack variety.” When the survey was finally completed, over 57,551 miles had been travelled and cross country interviews had been conducted with 1,759 people, exclusive of contacts at meetings of nurses and allied professional groups. Additionally, there were numerous contacts with press, radio and television media.

The one-week, comprehensive survey of the 25 nursing schools was as varied as the size and the geographic location of the school; the control; the type of program –three year diploma, two year plus one year’s internship, programs with a university affiliation, and even a diploma course within a psychiatric hospital. Also taken into consideration was the ratio between anglophone and francophone schools. At the time of the Pilot Project for Evaluation of Schools of Nursing, there were 174 diploma schools of nursing in Canada. Selection of the schools to be surveyed was made using scientific sampling techniques which were later validated by nationally-recognized researchers.

The data obtained from the schools surveyed during the Pilot Project is carefully documented in Spotlight on Nursing Education: The Report of the Pilot Project for the Evaluation of Schools of Nursing in Canada. As stated in the preface of that publication, “Someday the other part of the story may be written.” This is the “other part” of that unique and fascinating story.

1957 Prince Edward Island

My first trip to Prince Edward Island was fascinating. As we approached the Island, I could see great stretches of red earth from my plane window. It seemed to cover a huge part of that little province island. I also noted, with pleasure, the long stretches of sandy beach but, as it was early spring, I was not consumed with the idea of going swimming.

On landing, the ANPEI President and Executive Secretary met me at the foot of the airplane steps. They welcomed me most hospitably and insisted on driving me around Charlottetown, by car, before checking me into my hotel. I was worried, unnecessarily, that my hotel reservation would be cancelled if I arrived too late. Little did I know then that, on the Island, “everyone knew everyone else.” Many of them were, in fact, related through families which had lived in PEl for many generations.

As we drove along, my companions were not impressed by my enthusiasm for the red earth. It is, apparently, iron-saturated clay which sticks to one’s car and anything else with which it comes in contact. Our first stop was the historic Parliament Buildings. As we approached the front steps, my companions greeted, by his first name, a tall, distinguished gentleman -Premier Matheson. What a rare experience for me to meet the Premier of a province minutes after my arrival! After greeting the Premier, I was given a tour of the Parliament Buildings and the historic chambers where the debate, which led to Confederation, was held. A Commissionaire had been charged with showing us all the details of the Chambers. Despite being well informed, the rum on his breath was sufficient to intoxicate a bystander. Reverently, we read the well-known inscription, “Providence being their guide they builded better than they knew”. Our guide then insisted I sit in the chair once occupied by a Father of Confederation. So many times I have seen the picture of the gathering of the “fathers” after the signing, but the photograph really came to life for me as I viewed the windows always seen in the background. We drove along the beautiful coast to Cavendish to see the home of Anne of Green Gables. This was 1957, years before the marketing of Anne and the emphasis on tourism. The Islanders, although cautious of publicity, were aware of the need to keep the economy viable.

“Let Us Pray”

During the PPESN years, it was customary to have a prayer before each CNA meeting. Sometimes, the Lord’s Prayer was recited and, at other times, one of the religious sisters or a CNA officer led another prayer. I was rather sorry when this practice ceased as it gave all of us a quiet respite before the furore started. It was also an excellent way of calling a meeting to order.

When Sheila Nixon, Regional Visitor, and I had completed writing the report of the survey of a large, well-recognized school in a large metropolitan city, we discovered that the school was not nearly as well organized as we had thought. Nor did the school have the quality of education one would expect. It was, in short, a poor program. On Saturday morning, as was the schedule for all surveys, the completed report was to be read before the entire faculty and others in the school who wished to attend. One of the main reasons for reading the report was to allow those involved with the educational program to correct any misunderstandings that had been written into the report.

The Director of the school was very apprehensive so I decided to wait a few moments, until everyone was settled, before proceeding. While we waited, Sheila, not knowing the microphone was on, said, in a loud voice, “I think it is time for a good prayer”. I was not amused, nor was the school’s director. After hearing the report, I’m sure she thought the Sheila’s remark had been planned.

“The Owen Sound Incident”

During a school of nursing survey, the views of students regarding their educational program were not overlooked. They made a significant contribution by describing to us various aspects of their program. Usually, our conference with the students was scheduled for one hour but, frequently, it continued much longer. The group of students, selected by the president of the students association, was usually comprised of officers of the student organization together with students from each class in the school. Members of the faculty were requested not to attend this discussion so that it might be informal, with as free an exchange of ideas as possible. As the students discussed, informally, various aspects of their courses, it was possible to identify the real philosophy of the school and the degree to which the program was planned for, and with, the students. It also opened up new visions of what the students perceived as their role as graduate nurses in the whole health care system.

The faculty usually accepted our reasons for wishing to speak with the students alone, although some were more gracious than others. At one school in central Ontario, I had just begun the discussion with students when I had a tickle in my throat. I signalled to the Regional Visitor to carry on and, not wanting to disturb the group, tiptoed quietly to the door to get a drink of water outside the room. When I opened the door -lo and behold -there was the Director of the school, a very tall lady, bending down with her ear to the keyhole, trying to catch every word. Never have I seen a more startled look on the face of a Director. I quietly excused myself and carried on down the hall. She didn’t follow or ask if I needed assistance. I was embarrassed for her and, as there was no way of rectifying her action, I never mentioned it again. I must confess, however, that this incident tainted the remainder of the survey for me because neither of us was at ease with the other.

“Wash My Horses”

The survey of the school of nursing in Rimouski, Quebec was unique for me as it was my first experience in a completely francophone environment. I hadn’t appreciated that this city and its hospital and school of nursing was so isolated from Anglophone Canada. When we met with the students, not one spoke English fluently. These were all bright young girls in their late teens but they seemed completely unaware of any major events in the rest of Canada. The students urged one of their number to speak with me in English — and she really tried. All the other students were consumed with gales of giggles at her efforts as her English was almost unintelligible. I found out later that this was not unusual in French Canada of that period. The opposite was, of course, also true in Canada’s Western provinces and in most parts of Ontario.

On these surveys, I was very fortunate to have Sister Denise Lefebvre as senior bilingual evaluator and another Francophone sister who acted as Regional Visitor. I was responsible for the overall survey arrangements and translated the French-language report into English for the Board of Review. I attended all of the French-language interviews but, wisely, did not interfere with Sister Lefebvre’s comments, etc.

As sometimes happened in the Gaspe, there were difficulties with transportation and we were forced to stay in Rimouski until Sunday. I told Sister that I was going out to make a hair appointment for Saturday. When I returned triumphantly with an appointment for 11:30 a.m. the next day, I proudly explained how capable I felt, having negotiated all the arrangements in French. Sister doubled over with laughter. Apparently, I had asked to have my horses (chevaux) washed and set instead of “mes cheveux”. My French communication skills were very limited in those pre-CNA days.

Based on the National League for Nursing model, we always insisted on staying at hotels rather than accepting hospitality from the hospital or school of nursing we were evaluating. This, we believed, would ensure that the survey visitors would not feel indebted to the hospital which might color the objectivity of the report.

In one town in Nova Scotia, however, there was no suitable hotel — in fact, no real hotel at all. This was a preliminary visit and I was alone so I was housed on the private ward of the hospital. After several sessions with senior administrators, faculty, etc., I had dinner and returned to my room on the private ward. While reading my notes, I saw a young student pass my door and look in –but she said nothing. A few minutes later, she walked by again, rather slowly. When she went by a third time, appearing to hesitate in front of my half-opened door, I went to the door and greeted her. She immediately asked, “Would you please help me?” “Of course,” I replied. She explained, rather timidly, that the patient in the room next to mine looked rather strange and would I please come and have a look. I could tell immediately that the man was dead –very dead. I instructed her to call her supervisor while I remained with “the patient” until she returned. “Oh, no,” she quivered, “I’m afraid of the supervisor. She will be very angry with me.” When I told her that she had no alternative, she started crying but, again, I insisted that she call the supervisor RIGHT AWAY. With tears streaming down her face, she reluctantly left the room to call. I remained until I heard the supervisor approaching and then left the dead patient’s room via the bathroom we shared in common.

This incident raised many questions for me. Why had a student, in her sixth month of training, been left in charge, on the evening shift? Why was the young student able to communicate with me, a stranger, but afraid to call her supervisor? How could one ever condone such a situation — first from the patient’s perspective and, secondly, was this “nursing education”?

“Sterile Glasses”

When we were conducting the survey of the Glace Bay, N.S. school, we resided at the “Island Hotel”. It was touted by John Fisher, “Mr. Canada,” as the only hotel in Canada at that time to hang pictures of Canada on its walls. It was a comfortable hotel with the best sanitary features –especially in the bathrooms – sterilized drinking glasses, toilet seats, etc. I had always wondered how all this sterilization took place but I was soon to find out.

As my plane had been delayed, the hotel had allowed me to remain in my room until flight time. As I was resting in the room, the maid came in and started cleaning the bathroom. After exchanging a few pleasantries, she enquired, “Would you like to see how we fix our sterile glasses?” Of course I would. So, with my own eyes, I saw how she ran the glasses under very hot tap water, wiped them dry with my used bath towel and put on the “Sterilized Glass” paper cover. Likewise, the toilet was sterilized. I was appalled. Should I apprise the management of this practice — but I didn’t. In retrospect, I’d rather I didn’t know what might go on in any hotel purporting to have “sterilized bathrooms”.

Writing of the report in Ottawa and Maple Ridge (5.1.5)

The final phase of the pilot project included a detailed evaluation by the CNA Board of Review and the writing of the report for the entire project. In retrospect, it boggles the mind that the final report was ever written. It was so hot that long-ago summer in Ottawa –no air conditioning –that Helen was permitted to go home to B.C. to write. So it was in the spacious recreation room of her mother and father’s home in Maple Ridge that the landmark report was written. Helen wrote every day and almost every night. After breakfast with her parents, she took the reports of the 25 schools, minutes of meetings, correspondence, etc. from under her bed and went downstairs to write. She kept these priceless documents under the bed because, in case of fire during the night, she could rescue all the survey data. No photocopiers in those days!

Because of the nature of the report and the many tables she had developed, the Director worked with pen and pencil and a manual typewriter. As each section was completed, she toyed with the idea of mailing it back to National Office but was intimidated by the dilemma of writing new material in a descriptive report without being able to refer to previous chapters.

Helen remembers well, during the intensive writing process, hearing her father say to her mother, “I think Helen has taken on too big a job.” Her mother replied, “Don’t worry. She’ll get it finished.”

Each report –the record of joint observations and study by two visitors to each English-language school and three visitors to each French-language school–averaged 13,000 words and included approximately 14 tables for each school. Helen had little help in determining the format to be used in compiling this massive amount of raw data. Flashes of inspiration were essential and assistance from family members with a scientific background was a great value.

When the rough draft was completed, the long hours of fascinating work and the tight deadlines had all been worthwhile. The completed report was then typed, duplicated and sent, with much trepidation, to the Board of Review well in advance of their scheduled May 1959 meeting.

Presentation of Final Report to Executive Committee and Board of Directors (5.1.6)


When Board members met in Ottawa to discuss the report, they compiled a list, for each school, indicating areas of strength and areas requiring study and improvement. They also decided, on the basis of criteria used, which of the schools surveyed would have met the requirements for full accreditation, had such a program existed at that time. The voting of the Board of Review was believed to be significant in determining whether or not Canadian schools of nursing were ready for an accreditation program. It was recognized that the criteria used to evaluate the schools were not formulated by Canadian nurses. Following evaluation of the 25 schools, Board members were asked if they considered the criteria used to be applicable to diploma schools of nursing in Canada. There was consensus that, generally speaking, these criteria were applicable.

To review the survey reports, Board members used the criteria as a basis for judgment in evaluating each part of the program, using as a guide the booklet prepared for this procedure. This booklet, as well as all other materials and the survey report, was divided into the following sections of the educational program:

1. General Information on the School and the Controlling Hospital

2. Philosophy and Objectives of the School

3. Organizational and Administrative Aspects of the School

4. Instructional Personnel

5. Student Personnel Services

6. Curriculum

7. Evaluation of the Program and the Student

8. Library

9. Setting for the Educational Program

10. Records, Reports and Announcements

Under each section in the booklet were the statements of criteria used for evaluating each school. After studying the written report, each statement was considered and each member indicated whether or not this criterion was met by the school. If the data were not clear, this was indicated and an explanation was later provided by the senior visitor (the Project Director).

To provide as clear and detailed a picture as possible of the decisions of the Board, the data were presented in table form. These data indicated the total of number of schools, as well as the number of schools according to size, which met the criteria.

Although all members of the Board of Review did not vote the same way on each criterion, a very large percentage agreed of whether or not each criterion was met. When a member did not vote due to the fact, for instance, that she was a member of the school staff being visited, a record was made only of the number of Board members voting. In all cases, a substantial majority was required before a criterion was considered to have been met or not met.

In June 1960, the entire report was presented to the CNA Board of Directors and the report, and recommendations were presented to the annual general meeting of the Canadian Nurses Association held in Halifax.

Helen recalls, so vividly, the day in February 1960 when she presented her report to the formidable Board of Directors. When she had completed her presentation, she sat down with a sigh of relief. Unbelievably, the cold, calculating, critical members of the Board rose to their feet, as one, and gave her a standing ovation! Never, in anyone’s memory, had that Board given a standing ovation to anyone. Indeed, they rarely clapped or hardly cracked a smile, no matter what the issue. The President gave the Project Director such a moving tribute that the tears dripped down onto Helen’s clenched hands. Nurses of that generation never cried but, after the project’s long, convoluted journey, emotions just took over.

A four-month hiatus had been planned between the presentation of the report to the Board of Directors and presentation to the General Meeting in June. There was no money to pay the Director for this period. Helen decided to return to Teachers College, Columbia University, where she had earned her Master’s degree. A new semester was starting when she arrived, so she made an appointment to see her adviser, Dr. Anderson. Dr. Anderson had heard about Helen’s Canadian triumph and told her, then and there, that she was to earn a doctorate. One never said “No” to Dr. Anderson, but Helen thought she would do only one semester’s work until the CNA meeting in June. Dr. Anderson, however, knew she had gotten through to Helen and continued to goad her on.

Halifax June 1960  (5.1.7)

In June, the Director returned to Canada –first to Ottawa to touch base with CNA and then to Halifax to present her report to the membership. Sister Lefebvre, the Chair of the Special Committee, gave the first presentation and called Helen “Miss Accreditation”. Replying in kind, the Director addressed Sister as “Mother Accreditation” –that was ~ acceptable. When Helen had laid bare all of the findings of the national two-year study and had pounded home the recommendations, the entire body of French-speaking delegates rose, en mass, and sang “Ellea gagne ses epaulettes, malleuron malleurette….” Not to be outdone, the English-speaking group rose and sang “For she’s a jolly good fellow….” What a glorious ending –or was it the ending –of an exciting professional journey!

That biennial meeting in Halifax will always stand out in Helen’s memories. The report was not only accepted enthusiastically by CNA members but the media made it into a national event. CBC Halifax carried interviews with the Director on its newscasts and relatives and friends in Vancouver were able to view and listen. She had car and driver at her disposal and enjoyed the VIP treatment which came from all sides. While staying at the Admiral Beatty Hotel, where service was generally excellent, Helen remembers calling room service to order breakfast. To her request, room service replied, “Popper rice?” Mystified, the Director repeated, “I wanted to order my breakfast”. The operator repeated, patiently, “Popper rice?” Helen tried again –same response –and finally gave up. At breakfast the next day, she discovered that room service was asking if she wanted pop or ice!

Appointment as Director of Special Studies, CNA (5.2)

Now the study was completed, the report presented to membership at the 1960 Biennial meeting, and three of the four recommendations were approved by the Executive Committee at their post convention meeting. I was asked to stay on CNA staff for one more year to implement the three recommendations of the Pilot Project.

I advised the Executive of my plans to return to Teachers College to complete my doctorate. I knew my financial resources were very slim but I was determined to complete the remainder of the two year doctoral study. They agreed that I should return to Teachers College for one semester and, when needed, fly to CNA for meetings to implement the three projects. This I did.

The amount paid for those days at CNA assisted greatly in buying books and food. My return trip to Teachers College was made with the now president Helen Carpenter, also a student at Teachers College.

The 1960 biennial meeting was over and an exhilarated Helen started on her return to Teachers College for the fall semester. She decided that the two Helens should go by bus to see the Acadian country and visit her relatives in Yarmouth. On their arrival, however, Helen Carpenter developed a serious chest condition and her uncle, a physician, ordered her to stay in bed. The doctor, a delightful gentleman of 91 years, was still practicing medicine and administering anaesthetics too. He told Helen Mussallem that he still used chloroform by the drip method. She was duly impressed –and amazed. Helen stayed with the Carpenters for an extra day but, as her friend was not improving, decided to try and figure out a way to get from Yarmouth to New York in time for registration and classes. She took the ferry to Portland Maine, getting incredibly seasick on the voyage, and eventually, via bus and train, made it to Whittier Hall in New York.

Whittier Hall was strictly a women’s residence, but Helen chose to live there so she would not be distracted by the many social activities at International House, and besides, she was closer to the library. Studying at the doctoral level was going to be a full-time job –especially as Dr. Anderson had mapped out a plan “to get her through” as quickly as possible. Helen was aware of her many commitments in Canada. She had completed one semester and was now returning for the second. She would then return to Canada for one year to collect data for her dissertation and carry out her new responsibilities as Director of Special Studies tor CNA, including implementation of three of the four recommendations of the Pilot Project.

Development of Plan to Implement 3 of 4 recommendations of Pilot Project  (5.2.2)

On her return to Canada, project directors were recruited. Dr. Kaspar Naegle was engaged as Project Director for;

– Recommendation 1: “That a re-examination and study of the whole field of nursing education be undertaken”.

– Recommendation 2: “That a school improvement program be initiated to assist schools in upgrading their educational programs.”

Helen recruited Glenna Rowsell, already on CNA staff. Lillian Campion was persuaded to assume the position of Project Director to implement

– Recommendation 3: “That a program be established for evaluating the quality of nursing service in areas where students in schools of nursing receive their clinical experience”. As Director of Special Studies, Helen was responsible for the overall supervision of these projects.

– Recommendation 4: “That a program of accreditation for schools of nursing be developed by the Canadian Nurses Association” was held in abeyance pending completion of the other three projects.

Royal Commission  on Health Services (5.3)

CNA Project and RCHS project on Nursing Education combined  (5.3.1)

At this time, there was also general concern about the whole health care system. In 1961, a Royal Commission on Health Services was established with Justice Emmett Hall as Chair. It was the Commission’s intention to include an examination of the whole field of nursing and nursing education. It seemed logical, therefore, that Recommendation 1 on the whole field of nursing education be assumed by the person carrying out the examination for the Royal Commission. Dr. Naegle was a superb sociologist and scholar and Helen was delighted that he would be directing the project on nursing education for both CNA and the RCHS.

Royal Commission on Health Services Project Director (5.3.2)

The study for the Royal Commission on Health Services in Canada was an exciting and rewarding experience for Helen. The territory was familiar, but greatly expanded, from the report of the Pilot Project. It included not only diploma schools of nursing but university schools, nursing assistant programs, psychiatric nurse programs, operating room technician programs and midwifery courses. She especially enjoyed the field work which required many trips across Canada and her working relationship with researchers and RCHS staff, to whom she was responsible. Helen had been seconded to the RCHS by CNA from the summer of 1962 to May of 1963. The final report was published in 1964.

During the summer of 1962, CNA received a grant from Kellogg to create a Foundation and award fellowships. Applications were received from students and immediate awards needed to be made or the money for the current year would be lost. Katherine McLaggan, the prime mover in obtaining the grant, was responsible for forming a Selections Committee and, as it was August and no one else was readily available to meet with a committee, Helen was recruited.

She met with Katherine in her room at the Chateau Laurier in Ottawa where all the student applicant files were piled on the bed. While they were developing selection criteria for the awards, Helen was called to the Daly Building to meet with the Director of Research for the Royal Commission on Health Services and sign the contract for her study. While there, she met Mr. B. Blishen, Director of Research and Dr. Malcolm Taylor, Research Consultant. Dr. Taylor wished to speak with her at length and seemed slightly annoyed when Helen told him of her other responsibilities with Katherine McLaggan. When she related her encounter with Dr. Taylor to Katherine, she was told to phone him immediately and invite him to dinner. As he was already booked for dinner, Helen invited him to the Jasper Lounge for cocktails, where Katherine McLaggan used the encounter to great advantage, immersing him in the grave problems of nursing education. Helen’s role was to see that drinks were served without question and to be discreet about paying the bill. This being the pre-credit card era, she gave the waiter a $10 bill –ample for drinks in those days. She instructed the waiter carefully to serve as many drinks as requested. He did –but only one each –and, before Helen could get up to retrieve her change, minus tip, he brought the change to their table and plunked it down in front of her.

Helen was so embarrassed and Dr. Taylor was not amused. In those days, men always looked after the bill. After the drinks fiasco and dinner, Helen and Katherine went for a walk through the quiet Ottawa streets. Helen asked if Katherine had ever seen the face of the nurse at the back of the War Memorial. She hadn’t, so they scrunched around to get a better view. Just as Helen was pushing Katherine up the monument for a better look, the loud voice of a policeman shouted, “You ladies get down immediately or I will turn you in!” They both slid down ignominiously and vanished into the night. Up to the time she died, Katherine would recall this incident with great glee. During this period, and on into the 70s, Helen received many offers to assume the deanship of a university school of nursing or to become director of nursing at several large hospitals. She found only one offer tempting –to be director of the School of Nursing at the University of British Columbia. Even though CNA was planning to host the 1969 International Council of Nurses Congress in Montreal, Helen was assured CNA would wait for her. Negotiations continued.

As the School of Nursing had been on the UBC campus since 1916 and as two other health science faculties had been created at the university, the faculties of medicine and pharmacy, one of Helen’s requirements, an important one, was that the UBC School of Nursing also become a faculty. The negotiator sadly advised her that no change could be made as there already were too many faculties on campus. Finally, he arrived with what he termed “good news”. The Board of Governors had agreed that if Helen returned to UBC, the School of Nursing would become a faculty. Helen was delighted and asked to have the promise in writing.

This was impossible as the Board of Governors did not write such letters relating to the hiring of faculty! So Helen never accepted the UBC position and often wonders, if she had, what a different life she might have led. But that’s skipping way ahead of 1962. Let’s back up.

Executive Director – Canadian Nurses Association (5.4)

Helen’s secondment to the Royal Commission was a stimulating and memorable time for her but she had barely completed writing her final report when she was approached to become Executive Director of the Canadian Nurses Association. With alacrity, she refused to assume that “old maid job”. When negotiations with another candidate failed, Helen was asked to become “acting Executive Director for four months” , until a suitable person could be found. The minutes of the 21-23 of February 1963 meeting state:

(Minutes of the Executive Committee Meeting – 21,22,23 Feb 63)


It was moved by the Rev. Sister Decary and seconded by Miss Agnes Maloney

“‘That the President be authorized to name the committee to implement the resolution.”



The meeting recessed at 12: 30 p.m. for lunch which was served in the Basement Board Room.



Acting Executive Director: The President called the meeting to order at 1:55 p.m. and advised the Executive Committee that Dr. Helen Mussallem, had consented to be the Acting Executive Director, following Miss Stiver’s retirement on April 30, 1963, until the new appointment of Executive Director is made.

I.C.N. Board Meeting: It was announced that the President would be attending the Board Meetings of the International Council of Nurses, in Geneva, in August, 1963. It was unanimously agreed that Dr. Mussallem would accompany Miss MacLennan to the Board Meetings.

Red Cross International Study Centre: The President reported that the Red Cross International Study Centre was being held in Lausanne, Switzerland, August 19-23, 1963. The members of the Executive agreed that Dr. Mussallem should attend the Red Cross International Study Centre which is being held following the I.C.N. Board Meeting.

World Federation of Mental Health: The Executive Committee authorized the President to represent the Canadian Nurses’ Association at the Sixteenth Annual Meeting of the World Federation of Mental Health in Amsterdam, The Netherlands, July 22-26, 1963.

Report of Selections Committee: On the President’s request, Mrs Isobel MacLeod took the chair and the President as Chairman of the Selections Committee presented her report, for the information of the Executive.

It was reported that at the meeting of the Sub-Committee of the Executive Committee on October 18, 1962, the elected Officers were named as a Selections Committee to consider the replacement of the Executive Director. This committee met on October 18 and gave consideration to the names of several persons. The Chairman was authorized to invite letters of application from these persons.

Subsequently, it was felt advisable to publicize the vacancies in national office more widely and an advertisement was placed in The Canadian Nurse Journal and letters were sent to the Executive Secretaries of the Provincial Associations and Directors of University Schools of Nursing.

A roster of names has been compiled and these applications are presently being processed.

The President resumed the chairmanship of the meeting.

DATE AND PLACE OF NEXT MEETING: The next meeting of the Executive Committee, Canadian Nurses’ Association, will be held in Ottawa, Canada, on February 13, 14~ 15, 1964.

ADJOURNMENT: There being no further business, the meeting adjourned at 2:05 p.m. on motion of Miss Claudia Tennant.


Again, Helen requested an extension of her leave of absence from the Vancouver General Hospital and again they complied.

While in Vancouver in late April 1963 to give a keynote address to the Registered Nurses Association of British Columbia annual meeting, Helen went home to Haney for the weekend.

There she saw in the Vancouver Sun (or Province) a large picture of herself announcing her appointment not as “Acting Executive Director” but as Executive Director of CNA. She cried, quietly, “Foul!” On her return to National Office, Helen asked Penny Stiver, the incumbent Executive Director, what had happened. Penny said that she had consulted with Gordon Henderson, CNA’s legal counsel and a highly respected lawyer, nationally and internationally, about Helen’s appointment. Mr. Henderson advised that, as CNA was involved with purchase of land, etc. for a new headquarters, the photo should bear the name of the executive director. So, without consultation, the change was made. Helen understood.

The big day –May 1, 1963 –arrived. With trepidation, Helen sat in the Executive Director’s Chair at 74 Stanley Avenue for the very first time. She felt so alone. Then, the phone rang and it was Laura Barr, Executive Director of the Registered Nurses Association of Ontario. How supportive and how heart-warming! As the day wore on, more and more calls were received –not only from nurse colleagues but from other health organizations, government officials and a large number of nongovernmental organizations.

The die was cast –for four months. All went well until Helen asked the President, Elect MacLennan, to whom she should turn over the Executive Director responsibilities on completion of her term. Electa was so convincing. She asked the Acting Executive Director if she could stay on just until the 1964 biennial meeting in St. John’s, Newfoundland. What a blockbuster meeting that was! CNA outsmarted the Canadian Medical Association by having Mr. Justice Emmett Hall address CNA’s meeting -which just happened to coincide with the CMA meetings. He could have addressed the CMA but he chose CNA. What a coup! Also, Mr. Canada, John Fisher, came to inspire CNA members about Expo 67. Dr. Naegle was there too, addressing the membership on the proposed study of nursing education in Canada. Little did they, and Helen, know that it would be the last time they would see him.

Appointment as Executive Director of the Canadian Nurses Association  (5.4.2)

Helen remembers well her trepidation and enthusiasm that first day as Executive Director of CNA. As it was only a four-month appointment, she did not have an orientation or a position description. In those days, there was little emphasis on such frivolities –one just got on with the job.

The fledgling Executive Director had no idea of all that the position entailed but there were a few onerous tasks which loomed on the horizon in addition to the day-to-day “running of National Office”. A search for a suitable site on which to build a CNA National Headquarters was required, and Helen was determined to persuade the President and Executive Committee of the need for a national library resource which she had sorely missed while completing the Pilot Project. She also perceived a very great need for a proper statistical program. There had also been a very strong lobby for the Canadian Nurses Association to host the 1969 Quadrennial Congress of the International Council of Nurses. All of these projects were formidable, of course, but Helen was excited to be getting on with some interesting projects.

CNA had recently undergone a structure study in which the National Office at 74 Stanley Avenue was reorganized. At that time, CNA rented space from the Royal College of Physicians and Surgeons headquarters where it occupied the second floor. Space for staff was reasonably adequate and the Board room was available for CNA use when the College wasn’t using it. This could be quite inconvenient. Another irritant was that there were only two toilets for CNA’s 16-29 female employees. Undaunted, the new Executive Director would use the toilet (forbidden to CNA staff) that was reserved for the College President.

One day, while using the forbidden toilet because she thought the President and everyone else was away, Helen heard three men speaking as they entered the washroom. She was frantic! There she was, seated on the john, trapped! As the men entered, the ever-resourceful Executive Director got off the seat, put her two feet on top of the toilet seat and hung on for dear life. One of the men was Dr. Graham, position, the other, the President and the last was the head of the Finance Committee. As the men performed the necessary functions and were chatting away, Helen thought, “Oh boy, if I make a sound… Dear God, don’t let me slip!” When the three men left, having completed their ablutions, a trembling Helen climbed down off the toilet and never used it again. Sometime later, she told this story to Dr. Graham and he thought it was very funny but, at the time, it was anything but humorous to her.

Alternate unedited version of the preceding story:

There were other humorous, and not so humorous, events that could be recalled. As tenants on the upper floor of the magnificent building owned by the Royal College of Physicians and  Surgeons (RCPS) there were certain restrictions imposed. The large office space was completely ours to use as well as the en suite bathroom. But the elegant Board Room had to be booked well in advance for our (CNA) Board meetings. Even then we were not always certain that the College might not have an emergency meeting and we would have the onerous task of rescheduling our meeting. Another area that I was told, on several occasions, was not for our use was the Presidents (RCPS) washroom. As we had only two toilets for our entire female staff I used The Presidents Toilet that was adjacent to my office, always ensuring first that the RCPS President was not in the building. One day I was too busy to look over the railing down to the executive offices to determine if the president was in Ottawa. When seated on the toilet, that was sectioned off in the president’s washroom with partial walls that were opened about 40 cm from the floor up to about 1 1/2 m, I heard three male voices. Yes, they belonged to the president, the general secretary and the executive secretary. What to do: I couldn’t escape without being noticed and by the time I did that, the flies would probably be unzipped. So I crawled up the toilet and put one foot on either side of the toilet and hung on by grasping—with finger tips only—the top of the partial wall. I heard all the noises and conversation and then they left. I climbed down cautiously and dashed back to my office, never to use that toilet again—well almost never. The RCPS Staff were very impressed with my interest in the visit by their president. They thought I was anxious about the extension of the lease and assured me that I was not to worry.


When I was thrust into the post, in May 1963, I had some doubts about my preparation for the position of chief executive officer of a large national organization. My experience as Director of the Vancouver General Hospital School of Nursing; my doctoral studies in the administration of higher education; and my doctoral dissertation had been opportunities to hone my administrative skills but I was apprehensive about my ability to administer such a large, complex enterprise. There was no center, at that time, for additional preparation of CEOs but I believed the principles I had learned during my educational preparation could be applied. This was true to some extent but the role of the CEO was a relatively unknown field in those days.

In 1963, I wrote at the back of my daily calendar:

– A function of management is to establish policies for the control of activities in general and, by way of contrast, to the functions of management, those of the administrator spring from converting policy into practice.

– A good administrator must make the most effective use of existing or available skills.

I found no “existing or available” management skills at CNA headquarters in 1963 so I greeted, with great enthusiasm, the arrival of Lillian Pettigrew on 3 February 1964. She had been Executive Director of the Manitoba Association of Registered Nurses. In our first interview, Lillian told me that one of the great joys of her life was to prepare and finalize the minutes of meetings. Glory halleluiah! There was nothing I could do less well than prepare and write minutes. I was always more interested in action “-in the meetings themselves, the strategy, etc.

And Lillian wrote exquisite minutes.

During my visit with family in Haney, it became obvious that my father’s health was gradually deteriorating. Although he had Parkinson’s Disease his primary health concerns were now related to his abdominal condition. Dad was very proud of my achievements and, especially, of this latest appointment. Fortunately, he was a very successful businessman –and politician –so finances allowed for a permanent practical nurse/housekeeper to help mother meet his health needs. Both were positive and uncomplaining. Occasionally, however, mother was distressed to realize that, after working so hard all their lives, now, when the time had come to enjoy the fruits of their labours, Dad was unable to do so. This visit was the last time I saw Dad alive. I continued to telephone every week (usually Sunday) when possible, and did so on 23 June 1963. Dad was in hospital so the nurse brought him the phone. His voice was clear but weaker.

He told me that my three brothers and two sisters had been in touch with him that day. His last words to me were “Carry on”.

Although I was now CNA Executive Director, I was still required to appear before the Royal Commission on Health Services. My last “interrogation” was scheduled for 24 June 1963 and, although full of grief, I was determined to keep my appointment. I asked Mr. Bleshin, Director of Research, not to tell anyone about Dad’s death as I was afraid I would break down should anyone offer sympathy. The discussions went well and, when they were completed, Mr. Bleshin accompanied me to the elevator. I was too numb to talk. CNA staff were so very supportive.

Georgina Clarke, Director of Administration, had parked her car on Wellington Street so that I could be immediately whisked away to the airport.

Special Projects (Library, Statistics)  (5.4.3)

One goal which CNA’s new Executive Director was determined to accomplish was to establish a National Library so Canadian nurses and others would have access to the resources she had so desperately missed while completing the Pilot Project for the Evaluation of Schools of Nursing in Canada. The first task was to find a suitable Librarian. The Executive Committee gave permission for CNA to hire a part-time Librarian and Helen interviewed all of the applicants. One person –Margaret Parkin –stood out above all the rest. Margaret, however, wanted a full-time position with a specialty library. As it turned out, she was the most suitable candidate for the position and was eventually hired.

When Margaret Parkin came to National Office at 74 Stanley Avenue, CNA’s Library was a pile of 350 outdated books stacked in the corner. Together, Margaret and Helen established a library that today serves not only nurses but the whole health community and others from all across Canada.

Helen’s second self-appointed task was to find a person qualified to establish a statistical program. She was very fortunate to recruit Lois Graham Cumming who had married a Canadian and had recently relocated from Washington, D.C. where she had been with NIH. Lois developed a tremendous statistical program which was the envy of other associations and was used extensively by governments and others.

Helen recalls many humorous events which took place at 74 Stanley. She remembers, vividly, two visiting nurses from Africa who had come to CNA as part of a world-wide tour. On the day of their visit, it was Ramadan and, of course, they were not allowed to eat between sunrise and sundown. The older nurse was obviously very devoted and went on talking with Helen all morning and until noon and past. Sandwiches, which were made by the superintendent’s wife, were delivered but she didn’t eat. The younger visitor finally asked Helen if she could speak with her in the washroom. She said, “I am so hungry. Don’t tell my friend but I would like to have something to eat.” Helen brought her some sandwiches which she ate in the toilet. That evening, CNA’s Executive Director invited the international visitors to dinner at the Chateau Laurier Grill which was one of the best dining places in all of Ottawa. It was a glorious meal with a huge hind of beef served on a gorgeous silver tray with a great silver cover on it. Both ladies ordered the roast beef. The famished senior nurse quickly polished off her dinner and then said she would like to have another piece of beef. Helen informed the waiter. The waiter called the head waiter who asked Helen to speak with him away from the table. Apologetically, he advised that if the lady had another piece of beef, he would have to charge her for two meals. “Well, go ahead,” said Helen. So, CNA’s African visitor made up for the meal she missed between sunrise and sundown and was probably surprised that her companion was satisfied with the meal that had been served to them.

Then there were the visits of Ottawa Mayor, Dr. Charlotte Whitton. The first time she came to my office, she simply barged in. No appointment — no nothing. She plunked herself down in the chair opposite mine and inexplicably said, “I bet Queen Victoria wouldn’t know what to do with a pregnant soldier.” I hardly had time to turn this sentence around in my mind before she told me she was producing a film of interviews with “prominent Ottawa women” and I was to be one.

Enough said — I was interviewed. It was a long, time-consuming assignment. Dr. Whitton always called me at 6:30 P.M., often when I was preparing dinner for guests. One never said “no” or “I’m too busy now” to Charlotte Whitton. Our conversations would take up to half an hour so I learned to put the phone on the kitchen counter and say into the receiver from time to time, “very interesting Dr. Whitton”. I eventually learned that her comment about Queen Victoria referred to the her significant role in arranging for assistance for women in the armed services, from overseas or in other locations across Canada, who became pregnant out of wedlock and required rehabilitation.

Throughout the period 1 May 1963 to 1 April 1966, I was fortunate to lead a very hard-working and supportive staff — two of whom at the time of writing (1995) are still valued CNA staff members, namely, Pat Mohr and Pierrette Hotte. Both have advanced to senior positions and their supervisor, Beryl Darling still maintains contact. Others who contributed, significantly, were Lillian Pettigrew (now deceased) who was Associate Executive Director; June (Ferguson) Graeme Fraser who was Public Relations Officer; Georgina Clarke (now deceased) who was Office Manager, and Mr. Ernest Van Raalte, who conducted the Stevenson-Kellogg study on the structure of CNA and later became General Manager. His structural plan was approved by the Executive Committee but was never readily understood by me. Its main purpose was to integrate the staff of The Canadian Nurse/L’infirmiere canadienne with CNA staff. The integration was successful but I found that having professional staff report to me through a non-nurse was not workable. Many modifications were made and approved by the Executive Committee. Already mentioned were two senior staff members who made a significant impact on Canadian nursing, namely, Margaret Parkin, Librarian and Lois Graham-Cumming, Statistician. Although I had authority to hire only a part-time Librarian, when M. Parkin came along and would work only full-time, her expertise was essential to develop the kind of library I had envisioned so I brought her on staff and my decision was not questioned -especially when her sterling qualities became known to the Executive Committee.

These were some of the staff at the 74 Stanley Avenue location but, in the beginning of my tenure at CNA, both professional and support staff were very small in number.

First International Initiatives 1963  (5.4.5)

My first, major responsibility as CNA Executive Director was to attend two international meetings. I had hardly warmed the seat of my chair when I accompanied the CNA President to the Grand Council Meetings of International Council of Nurses (now Council of National Representatives -CNR) held in Geneva, Switzerland in 1963. I remember well the tiny room in John Mott House where representatives met. John Mott House is located just a few meters from ICN’s present headquarters at 3, place Jean-Marteau (rue de l’ancien port). One of the most controversial subjects at that, my first ICN meeting, was related to the move of ICN headquarters from London to Geneva. Much emotion was attached to this issue as ICN began in the U.K. where great leadership had been provided in ICN’s initial and formative years and, indeed, up to 1963. Other items of interest to me were the ICN program relating to nursing education and nursing service. I was fascinated to hear the comments of member presidents from far away countries in Africa, South America, India, the Middle East, etc. This was the very first time I had ever been in a room with so many international nurses and I was excited and intimidated. Little did I know, at that time, what the future held for me. The financial reports were also intriguing as we tried to work with both British Pounds and Swiss Francs. The move of ICN staff to Geneva was also cause for tension. Pence and francs were carefully guarded. My main role was to advise the CNA President, Electa MacLennan, but I did speak up when I had something to add to the debate. At that meeting I also learned of the high regard with which the Canadian delegation was held, due in no small measure to the reputation of Lester B. Pearson.

Immediately following the ICN session in Geneva, I attended meetings of the International Red Cross Society in Lausanne, Switzerland, This time, I was on my own, representing Canada with a senior member of the Canadian Red Cross, Helen MacArthur. Helen was well known in international circles and was very highly respected. Once again, I was thrilled with the international milieu. Discussions were fascinating and touched on all aspects of the work of the International Committee of Red Cross Societies and the Red Crescent. I was much impressed with the discussions on the Rights of Nurses under the Geneva Convention as I had little knowledge then of the many critical situations facing nurses at that time.

As always, then and now, there were a number of elaborate receptions. I recall one that was hosted by the head of the Canton of Viau. He spoke with me in French and uncertain English, and I responded in English and uncertain French. He insisted on driving me, and three others, to our hotels. He dropped the other three off, one by one, and, in doing so, passed my hotel twice. Each time, I said “Chez moi,” but he kept driving. When my colleagues had all left, he parked the car and my worst fears became a reality. Now, how does one handle this situation without creating an international incident? We had a real tussle but he eventually gave up and, as he drove me back to my hotel, he said three times, “You are a wet blankette”.

Despite his lack of fluent English, he managed to convey his summary of me very well!

Instead of returning directly to Ottawa, my staff persuaded me to “take a week off” as I had been working a seven-day week of mostly ten to twelve hour days. I chose to go to Paris and then on to London. All was arranged by Cooks Tours.

I saw everything a tourist should see in Paris –Le Louvre (so disappointed with the Mona Lisa; I liked Winged Victory much better); VersaiIle, the Eiffel Tower, the Left Bank, the magnificent cathedrals, Place Pigalle (wow!) etc.

One of my main objectives in Paris was to follow the advice of my hairdresser at Friemans Antoinne Salon in Ottawa and visit the world’s master hairdresser, Antoine, at 3, rue Cambon, in Paris to buy a really superior wig. We wore them often in those days … real wigs made from real hair. I used wigs, complete with hat box, when travelling during the Pilot Project for the Evaluation of Schools of Nursing. What an experience! I arrived at Antoine’s at 09:00 and sat in a posh area awaiting THE MASTER. Around 10:00, a tall, fashionably-dressed man, with painted fingernails and outlandish shoes, breezed in followed by an entourage of young men who adoringly watched his every move. He passed the glass coffin (readied, I was told, for the Great Man Himself) and went to the etageres returning with three wigs. Without saying a word, he came to where I was seated, passed his painted fingernails through my hair –and said something like “ugh”. He then flourished each wig next to my hair, as the spellbound young men looked on, until He finally decided on one of the three. He asked that I be “preparer” for the transformation. My own hair was washed and dried with the entourage looking on. Then THE WIG was put on and curled on my head!?! I, and my wig, sat under the dryer and, when the appropriate time came, I was pulled out. All the while, I wondered how much all of this would cost as I had a limited amount of money with me and no credit card. Well, when I emerged from under the dryer, complete with wig, I must admit it all looked good –very good. Delicately, I asked for “l’addition” –$300 U.S. That was like $1,000 Canadian today and, luckily, I had exactly $300 left in traveller’s cheques. I departed. No receipts. No nothing. Not at Chez Antoinne!

On arrival at Heathrow Airport in London, I looked for a uniformed Cook’s representative as I had in Paris where he had spotted me right away. In London, however, I looked around and, as no representative approached me, I picked up my luggage and headed off to hail a cab. Noticing a man in a Cook’s uniform, I casually asked if he knew who had been sent to meet Dr. Mussallem. Startled, he responded, “It’s me!” When I told him I was Dr. Mussallem, Executive Director of CNA, he apologized and said he had been looking for someone who fit the picture of an Executive Director of a women’s organization –someone “much older”. He had seen me deplane but was sure this chic young lady in mauve chiffon and beautifully coifed hair was not his person. What wonders Antoine had worked in Paris! My driver escorted me by Cook’s private limousine to the elegant Mayfair Hotel and “the nightingales sang in Berkley Square”. He told me that his evening was free and he would be delighted to take me out “privately”, i.e., at his own expense. Amused, I said I was very tired after Paris (I wasn’t) but perhaps another time. He gave me all the coupons and mounds of material for my London stay –and departed.

As I thought I might not see London again (my first visit had been during WWII when all the guards were in khaki), I saw all the usual tourist sites and was impressed with the reconstruction since the bombings I had witnessed during the war. One humorous incident took place on my last “free” day in London. It was a grey, drizzly day and, as I had planned to go to ICN’s headquarters on Dean Tench Street, I thought I should wear some sort of protection for my shoes so I would not soil the carpets. I had seen pictures of the entrance hall of ICN’s London headquarters and I didn’t think mud would look too good on those antique carpets. On Regent Street, I spotted two middle-aged ladies waiting for a bus and asked them, very politely and innocently, where I might buy some rubbers. Dressed in my raincoat, I followed their directions and walked three blocks down, turned left and found a chemist’s shop. It was not until I got there that it dawned on me that the ladies had misunderstood what I meant when I asked for rubbers. Even though we speak the same language in both countries, there are flaws in our communication.

On my return to Canada and CNA, there was a great accumulation of correspondence awaiting attention, documents requiring study and action, many articles to be read, and decisions to be made. Staff members with problems required immediate appointments, reports had to be written for the Executive Committee, meetings of external committees must be attended, and some social functions required my attendance. In short, there was what was to become the usual post-field trip, back-breaking workload to deal with.

The dust had scarcely settled when I received a call from Lyle Creelman, Chief Nurse at the World Health Organization, asking me to attend a WHO Scientific Meeting on Research in Nursing. She made it quite clear that this was a highly-prestigious meeting attended by only a few select experts, worldwide. As this was a WHO Scientific Group on Health, three especially-qualified public health doctors must attend and, as it involved nursing and research, there would also be three nurse experts in research in attendance. I was asked to be the member from the Americas. The public health physicians were selected from the U.K., the Middle East and Greece. I remember so fondly my flight to Geneva. It was first class all the way, such a contrast from flying “steerage” on the old North Star planes. That meeting, convened at WHO Headquarters in Geneva, remains in my memory one of those extra special events. We gathered the first morning to find one of our delegates, Dr. Ewing from the U.K., missing. Dr. Candau, WHO Director-General, greeted us at that initial meeting and asked that a chairman be elected. After his greeting and a general outline of the goals of the meeting, he called for nominations and the election of a Chair. First thing I knew, my name was proposed and I was asked if I would accept the Chair. Modestly I responded, “Yes, if I am elected.” He replied, “You have just been elected. Please take the Chair.” What I didn’t know then was that all of this had been arranged ahead of time. After I mumbled a few words, Lyle Creelman advised that we should wait for the U.K. representative to join us so I called for adjournment. This gave me an opportunity to review the agenda and to determine what my responsibilities would be during the week’s session. We reconvened about 11:00, with Dr. Ewing present, and I made a few introductory remarks. Dr. Ewing then asked for the floor, and floored us by advising that he was late because he failed to see the reason for the meeting. “Surely,” he remarked, “you don’t think nurses do research. Nursing is not a pure science.” Flabbergasted, we tried to remain calm and provide him with a rational explanation, i.e., that nursing was an applied science and, indeed, was a subject for research. He just sat there, in a state of gloom. When we recessed for lunch, I rushed over to the smartest and cutest member of the group and told her that she must invite Dr. Ewing to lunch and enlighten him on nursing research. He was more compliant after lunch, and my co-conspirator later told me he had been resistant but listened well.

The WHO meetings were intense, with much heated debate. I recall, during one discussion, Dr. Vellorous of Greece came forth with what I thought was a good point. As Chairman, I asked “Dr. Vellorous, would you like to throw out that idea?” “No, Madam Chair,” he said “I want to throw it in.”

In addition to the lengthy and exhausting sessions, each day we had to check the report being written by the rapporteurs for accuracy, style, etc. It was a trying job but, eventually, by Saturday morning, we had concluded the meetings and a rough draft of the report had been written. As a reward for all of this sustained labour, we were invited to spend the weekend at Lyle Creelman’s chalet at Champery, in nearby France. What a glorious time we had with Lyle and Margaret Scott-Wright. We did have some difficulty in getting to the chalet, however, as part of the road was washed out and we had to crawl along on logs with our supplies strapped to our backs. When I arrived at the end of the log, Lyle was hysterical with laughter. She said she couldn’t believe that the First Scientific Group on Nursing Research had fallen to the level of crawling on logs across deep ravines –such a contrast to our lofty and proper posture at the WHO meetings in Geneva!

The return trip to Ottawa was on Swiss Air, First Class. Life doesn’t get much better. As soon as we reached cruising altitude, the steward came to me with a silver tray loaded with Iranian caviar and champagne. I, of course, immediately looked at my watch but he reassured me that it was proper to drink at that hour as, in the air, time didn’t count. That was my first real taste of caviar and I have loved it ever since!

CNA Initiatives (5.4.6)

My first two international assignments (ICN-Geneva and Red CrossLausanne) gave me a peek into the expansive, wonderful and intriguing world of health at the national and international level. When I returned to Ottawa and National Office internal and external work seemed to be progressing reasonably well, I reminded the CNA President that my four month commitment to CNA was nearing an end. She assured me that the Executive Committee was searching for a replacement but would I consider staying, just until the June 1964 biennial meeting. There was still much work to be done following our presentation of briefs (in 1963) to the Special Committee on Aging, the Royal Commission on Bilingualism and Biculturalism and the Canadian Conference on Mental Retardation. As I was able to get an extension of my leave of absence from Vancouver General Hospital, I agreed. Little did I know then that there were many exciting projects coming up and that I might soon have an Associate Executive Director to share the increasingly-heavy burdens of my office.

A whole new world opened for me in 1964. CNA seemed to plunge into high gear. Among the activities which stimulated CNA and its staff were:

– Three projects arising from the recommendations of the PPESN were getting underway: The School Improvement Program being directed by Glenna Rowsell; The Evaluation of Quality being directed by Lillian Campion; and the Study of Nursing Education headed by Kaspar Naegle.

– Initiation of the statistical program, involving all provincial associations in the collection of data on the total nurse population in Canada. (Prior to this, the only statistics available were the number of nurses who belonged to their provincial nurses’ association.)

– Reactivation of the Nursing Research Index. Initial work on this project revealed that there were over 100 known studies on nursing in Canada. These were collected and listed in a card index.

– The CNA/CMA/CHA Liaison Committee agreed that, whenever possible, a tripartite approach should be made to the federal government.

– CNA established a Standing Committee on Social and Economic Welfare. Its establishment was fraught with opposition from those provincial associations which strongly believed that collective bargaining was “not professional”. They were deeply concerned that nurses might even contemplate “going on strike”.

– A very active National Office Auxiliary kept me busy in an effort to find suitable tasks for them. They were a sincere, knowledgeable group but I was unsuccessful in setting up a meaningful program.

– An unofficial communication from the National League tor Nursing (NLN) in the U.S. conveyed the serious news that the NLN was considering the withdrawal of NLN exams in jurisdictions outside the U.S. An ad hoc committee was appointed to look at ways and means of solving this problem. Perhaps six provincial associations were using the exams for students seeking registration in their province.

– Legal matters relating to the use, by White Sister Uniform Company, of the new CNA logo — the leaf and the lamp – on their uniforms.

– CNA was asked to participate in Expo ’67.

– My doctoral dissertation was published with the title Development of Nursing Education Programs Within the General Educational System of Canada. It sold for $3.00 each and was reprinted twice.

– A strategy was developed to propose Alice Girard as President of ICN. I sent letters, requesting support for the nomination of Alice Girard, to 58 ICN member countries. (At the 1965 Quadrennial Congress, she was elected by acclamation.)

On invitation, Alice Smith and I worked very hard to develop a Centennial Project. The plan was to have nurses from the southern belt of Canada exchange positions with northern nurses for a two-week period so more nurses might be attracted to “north of 60”, where they were really needed. Alice developed an exquisite plan and presented it to the Board, using suitable visual aids. The Board raised all sorts of obstacles, and our inspired project, which we called “Northern Lamp”, was snuffed out.

CNA 1964 Annual General Meeting St Johns Newfoundland

Joint Committee of CNA/CMA/CHA

As Director of Special Studies, I soon realized that there were of number of “external” boards or committees on which I sat by virtue of my position as CNA Executive Director. Two of these ‘Joint” boards were the Nursing Unit Administration program (CNA and CHA) and the CMA/CNA/CHA Committee on Nursing. In 1964, at the request of CNA, the CMA/CNA/CHA Committee on Nursing changed its name to the Joint Committee of CMA/CNA/CHA to reflect a change in focus and to facilitate discussion on matters relating to all three organizations, rather  than on problems which dealt only with nursing.

The Nursing Unit Administration (NUA) program was unique in North America as it was sponsored by two national, voluntary organizations. It began, prior to my tenure as Executive Director, in response to a recognized need to upgrade the management skills of nurse managers (head nurses) in acute care hospitals. When I became Executive Director, the course was still in its formative stage but, due to the expertise and skill of the director of the program, Kathleen Ruane, the program progressed “on course” and was meeting its objectives. When I attended my first NUA meeting, I detected tension between CHA and CNA representatives. CHA members believed that they should have sole authority in setting the direction for the course since it was directed at head nurses in “their hospitals”. This was a futile posture, however, since the Kellogg grant which initially founded the program had been adamant that CNA should be an equal partner in the program.

The CMA/CNA/CHA Joint Committee on Nursing, renamed the Liaison Committee of CMA/CNA/CHA, was, to some extent, a revelation of the emerging importance of CNA in the tripartite world of health. CNA had equal, joint, permanent representation with CHA and CMA on this committee.

I remember well my first meeting with this tripartite group. The entire agenda was compiled of a list of problems in nursing which the other two organizations were going to solve. I should state, parenthetically, that this committee first came into being during periods in WWII when there was a severe shortage of nurses in hospitals and the medical and hospital associations discussed this problem at great length, with questionable success. When I became CNA Executive Director, I became aware of the joint committee discussions through minutes of meetings and other documents. I was, however, shocked to find that CNA was being placed in the position of accepting advice from CMA and CHA as to action it should take in relation to nursing’s problems but that CNA’s advice on the problems facing medicine and hospitals was neither sought nor wanted. Without previous discussion with my president, Electa MacLennan, I innocently — and boldly — asked why the problems of medicine and hospitals were not being discussed at the meeting as well. Dr. Young, the external chair of the committee, replied that those problems could be discussed at the next meeting. I became concerned that I might have caused a disruption of the committee which might have serious consequences. At our next meeting, CHA representatives appeared at the appointed time but CMA members were absent. About 15 minutes late, in they marched — in single file, and sat down. Before the meeting could be called to order, CMA stated its position: they were unwilling to have any discussion of CMA concerns brought to the meeting. They would withdraw first! After somewhat cordial, if tense, discussion of agenda items, the CMA President, Dr. Frank Turnbull, said that he did not know the real value of the committee other than it provided an opportunity, twice yearly, for the presidents and executive directors of the three organizations to sit across the table and have a good, free-flowing discussion. This, he believed, was worthwhile. The day and the committee was saved. Subsequent, recorded actions of this committee suggest that Dr. Turnbull was right.

Canadian Nurses Foundation

My relationship with the Canadian Nurses Foundation (CNF) was interesting and varied from great hope to despair as to its future and its goal of providing selected nurses with the opportunity to pursue graduate education. My commitment and dedication to this goal was another spin-off from my cross-Canada surveys of nursing education in both hospital and university schools of nursing. I knew that, if nursing service was to improve, the education of nurses for that service must, likewise, be improved. Along with many other “senior” nurses, I recognized that advanced education for nurses was imperative if nurses were to be accepted as an equal voice in the decision-making circles of the health care system. A personal note adds validity to this statement. As CNA’s Director of Special Studies (1960-63) I attended the CMA CHA CNA Committee meetings to report on the status of nursing education in Canada and to describe to the committee the projects undertaken by CNA which had been initiated as a result of the recommendations of my Pilot Project on the Evaluation of Schools of Nursing. The first meeting I attended was held at CMA headquarters in Toronto. The group from CNA entered the committee room through the side door. All other representatives seemed to come from somewhere else. At the next meeting, after I obtained my doctorate in 1962, I was met at the front door by the CMA General Secretary. I was astounded to be ushered in, to walk on the richly-carpeted hallway, and to be told that the CMA president would like to see me. Three times I was referred to as DOCTOR Mussallem. Then, I was taken to the committee room at the rear of the building. I was suspicious that my doctorate (the first earned by a nurse in Canada) might have been responsible for this unusual gesture and the CNA Executive Director, Penny Stiver, confirmed my suspicion.

In 1961, while I was Director of Special Studies, the CNA Executive Committee -influenced, perhaps, by the findings of the Pilot Project for Evaluation of Schools of Nursing –decided that “… the time had come when the Canadian Nurses Association should consider establishing a foundation”. A Special Committee, called the Canadian Nurses Association Foundation, was created in 1961 to work out the details necessary to establish such a foundation.

In February 1962, the Special Committee, Canadian Nurses’ Association Foundation, presented its report. The Executive Committee decided at this meeting that the Foundation would be known as the Canadian Nurses Foundation (CNF), and that its purposes would be: to provide financial support in the form of awards to nurses pursuing graduate studies at the masters and doctoral levels; to provide grants for nursing research; and to administer funds donated to the Foundation for the above purposes. CNF came into being in 1962 when the Kellogg Foundation awarded CNA a donation of $150,000 (U.S.). The preparation of the brief for the Kellogg Foundation requesting $150,000 (U.S.) for the establishment of CNF (and the accompanying strategies) and CNA’s success in obtaining these funds – to be spread over a five year period –was due primarily to the expert and scholarly work of Katherine MacLaggan. The CNA Executive Committee was preparing to have this Foundation set up within CNA but as the Kellogg Foundation required a receipt from a “charitable” agency for income tax purposes, a foundation was created by CNA to facilitate this request. In the early years of the Foundation, office space and administrative services were provided by CNA.

When the Kellogg grant arrived in Ottawa, CNF was advised that the amount allocated for 1962 scholarships must be awarded before the end of August 1962. Word of the new scholarships was disseminated and a number of applications were received at CNA headquarters. Then, I gather, a Selections Committee needed to be appointed. As it was early August, few staff or other suitable persons were available. I had just successfully defended my doctoral dissertation at Columbia and had returned to Ottawa, as promised. On arrival, I was advised that I was to work with Katherine MacLaggan to select the first “scholars”.

At the appointed time, I met with Katherine in her room at the Chateau Laurier. We worked very hard to develop criteria and to assess each application. A decision had to be made. Should all applications be ranked and scholarships awarded to only the top few, or should we ensure that each application was “worthy of an award” and spread the money over the qualified candidates? After assuring ourselves that each candidate merited an award, we chose the latter option. Two applications were rejected due to incomplete documentation. All the monies for 1962 were disseminated and, in retrospect, I believe we did an exceptional job.

In May of 1963, when I became CNA Executive Director, I inherited the responsibility for the administration of CNF. The monies from Kellogg were well used on fellowship and scholarship awards as, initially, CNA bore the entire administrative costs. However, the CNF Board, composed of half CNF members and half CNA members, had great ideas about CNF’s potential as a free-standing organization without CNA connections or controls. The CNF Board was appointed, and the part-time Executive Director (Lois Graham-Cumming) designated a member in each province as a CNF representative. The provincial associations were by-passed and, indeed, CNF attempted to set up an organization as “strong and powerful” as CNA. They would be free to solicit large sums of money for CNF and not “be hampered” by CNA. This “completely separate” organization did not survive for long and, in 1966, CNF became more closely allied with CNA while maintaining its separate identity as required by the Letters Patent. I later became Executive Secretary/Treasurer of CNF.

One of CNF’s perennial problems was always to find sufficient funds to maintain the scholarship program. The need was very great and hardly any other monies were available for nursing students studying at the masters or doctoral level. When the Kellogg money ran out, great efforts were made to obtain more funds but results were dismal. Each Selections Committee was faced with the problem of making awards with shrinking budgeted funds. One year, in the early 70s, when Glennis Zilm, Assistant Editor, was writing an article for The Canadian Nurse, she asked me what would be done at the next Selections Committee as funds were so low. I said, “Let’s go for broke!” She published my remark and, due to the efforts of provincial associations (some gave a yearly donation based on membership), the funds grew and then stabilized. It was a real roller coaster ride and I spent many of my precious “extra hours” doing CNF work. Often, I was asked why I worked so hard for CNF. My answer was honest and simple. When I studied for my masters and doctoral degrees with a very small income –having to decide between buying a book or eating dinner –I became dedicated to doing what I could, in my lifetime, to prevent others from facing similar circumstances.

2012 On the way to CNF Annual Gala

1965 – 1966 CNA activities and CNA House


CNA Executive Director Helen Mussallem

As we moved into the mid 60s, approaching Canada’s centennial year, there was a significant increase in the number of national governmental committees and commissions. I seized the opportunities offered and advised the President and Board that CNA should take advantage of the opportunity to participate. This suggestion was not always received with great enthusiasm. There were the inevitable questions about how much will it cost, who will do it, should CNA risk being in the midst of controversy, and so on. I knew, however, that if CNA was to gain status as a national organization and elevate the status of nurses while enhancing their ability to provide better nursing and health service, we had to seize every opportunity. This meant that I was often left writing the brief – in consultation with the president, Isobel MacLeod. She was a wonderful person to work with and she gave me full reign.

The four major brief and submissions went to:

– The Senate of Canada Special Committee on Aging

– The Royal Commission on Bilingualism and Biculturalism

– The Canadian Conference on Mental Retardation

– The Canadian Centennial Council and Centennial Commission

For the Senate Brief on Aging, CNA recruited Trenna Hunter of Vancouver, who was knowledgeable in this area, to assist in writing the brief. Trenna and I appeared before the Special Committee . We were well received. Senator Ferguson, the interrogator, was very thoughtful and sympathetic to our point of view.

The CNA Brief to the Royal Commission on Bilingualism and Biculturalism was not a stellar effort. I canvassed all members of the Executive Committee for their points of view and, guided by the terms of reference, wrote the brief CNA appeared before the Royal Commission and was well received.

The other two submissions, to the Canadian Conference on Mental Retardation and to the Canadian Centennial Council and Centennial Commission, were written, to a large extent, by members of the Executive Committee who had expertise in these areas. No strong positions were taken in either of these submissions.

Centennial fever was rampant and all non-governmental organizations were asked to submit project proposals. CNA decided to produce yet another film on nursing. The most impressive CNA centennial project, however, was the establishment, on site at Expo ’67, of a nursing station of the future. It was completely high tech and, in 1967, it boggled our minds. In less than 20 years, our high tech station has become a reality. Staffed by Rita Lussier and Viola Aboud, who created the exhibit, it was a popular display at Expo. The students and staff who worked at this Expo ’67 exhibit formed close personal ties and continued yearly meetings in the subsequent decades.


CNA House finally got its start with the digging of a massive hole in the ground at 50 The Driveway. It was a long, convoluted road which led to the construction of this “house” financed and built by and for Canadian nurses as their national headquarters. I must confess that, in the beginning, I was not very enthusiastic about this project as I thought it might take an undue amount of time away from CNA’s main objectives. We had already spent a great deal of time negotiating with the owners of two lots at the corner of Laurier Avenue and Charlotte Street.

Ottawa’s then mayor, Charlotte Whitton, said that she would oppose our purchase of this site as “the Catholics” who owned the lots on either side would eventually expropriate our property. We had been forced to bow out at that point even though our architect, Mr. James Strutt, had already submitted a very classic design for a building which would have met CNA’s current and future needs. A House Committee took responsibility for finding a new site. I admit that I begrudged the time the committee took for meetings which I was required to attend, with little apparent outcome. Eventually, our architect, Mr. Strutt, advised that Capital Storage, at 50 The Driveway, was selling and we began to negotiate. New designs were submitted to fit the new site. The south side of the proposed building had to be made to fit into the adjacent NCC property and that is how CNA House got its jagged silhouette. In the end, we had been able to trade the back portion of our lot for the NCC land on the south side of the site, but by then it was too late to change the original design. We had been delayed in acquiring the necessary property as Mrs. Murphy, the property owner, knew we wanted it and held us for ransom. We paid dearly for that small wedge of land and the house on it which had to be demolished.

Alternate version of the CNA House story:

. . . she approached the problem of developing plans for a new National Office. First of all, a site had to be found and, eventually, a very desirable property next to Le Cercle Universitaire and the Newman Club was located. However, when Ottawa’s mayor, Charlotte Whitton, heard that CNA was attempting to purchase this land and the buildings thereon, she was absolutely enraged. “Don’t you dare buy those,” she said. “Those Catholics on either side will expropriate and you will not have a place for your building in 10 years time.” As it happens, the mayor was wrong –30 years later the houses are still there. But, as mayor, Charlotte Whitton would not give CNA permission to build on that site. Luckily, an architect who had submitted drawings for that particular location knew of another site at 50 Driveway, where Capital Storage was located. CNA negotiated with Capital Storage and all went well.

Negotiations with the National Capital Commission who had property behind and at the side of the site were also successful. Then there was Mrs. Murphy! She had a small piece of land between the front and back part of the property CNA was buying and she held CNA to ransom for this little slice of soil. She would not sell her house unless she was paid an exorbitant sum. CNA, reluctantly, paid.

During the previous year, when the Executive was about to meet and while I was having dinner with the President, Electa MacLennan and the PresidentElect, they asked to see the site of CNA’ s new home. During this visit, we decided to have a sod-turning ceremony with all members of the sub-committee of the Executive present. We needed a shovel, so I telephoned Georgina Clarke at home and she agreed to bring one. Georgina had class. Next day, 1 April 1965, she arrived at the meeting with a gold-painted spade. Such was the commitment of CNA staff.

That same year, I thought it would be a great idea to have a time capsule embedded in the walloutside the Board Room. Once again, when the time came, staff came through for us. They procured a metal box and placed inside it copies of The Canadian Nurse and L’infirmiere canadienne, minutes of board of directors meetings, postage stamps, coins, letterhead and envelopes etc. for cementing into the wall. Perhaps in 1996, 30 years after the opening of CNA House, CNA could have a celebration marking this event.

Before CNA House was officially opened, we were staggered by three deaths (reminiscent of the triple crown of deaths over the original Board Room). They were: the Chairperson of the House Committee, Mildred Walker; President Katherine MacLaggan; and Governor General Georges Vanier. The latter was to have presided at the official opening of the building -invitations had been printed — and then all the arrangements had to be changed.

CNA House opening with Governor General Roland Michener


When, as CNA Director of Special Studies, I was able to persuade Dr. Kaspar Naegle to carry out approved Recommendation One of the Pilot Project for Evaluation of Schools of Nursing in Canada: “That are-examination and study of the whole field of nursing education be undertaken,” I was absolutely delighted. He had all of the required qualifications and then some. He met with the CNA Board of Directors on two occasions and I met with him, in Vancouver, on three other occasions. He was brilliant. Without question, he was the pre-eminent sociologist in the health field and we worked well together. In fact, I was always learning from him. His preliminary papers, submitted to the Board of Directors, had been well received. Then, on 6 February 1965, we got the news of his tragic death, by suicide. I was saddened beyond words. Apparently, a series of mistakes in judgment by his psychiatrist and hospital staff and allowed this tragedy to occur. I remember him so very well. These few words which follow are my reflections on a great man:

“..Modest and humble in the extreme. He perceived others with clarity and compassion but could not see in himself the greatness of his gifts. This was his tragedy and now it is ours. .. He asked us to live to the last minute and then at that moment we would see our equations written out. We can say that for him all actions were symbolic. These were statements. And he has made a statement, discrete and final, and it is true.”

The papers he wrote for CNA were compiled into a booklet, “A Course for the Future”, published in 1966. It is a rare gem.

Strangely, the death of Kaspar Naegle opened another door for me. Dr. Naegle had been asked by the Royal Commission on Health Services to carry out Recommendation One of the Pilot Project for Evaluation of Schools of Nursing in Canada and to carry out A Survey of Nursing Education in Canada. On his death, I was asked to take over both of these tasks. My survey of nursing education for the Royal Commission was published in 1964. I believe it is the best survey and report I had completed yet, strangely, most researchers refer to Spotlight on Nursing, A Report of the Pilot Project on Nursing Education in Canada.

An alternate version of the preceding:

It seemed logical, therefore, that Recommendation 1 on the whole field of nursing education be assumed by the person carrying out the examination for the Royal Commission. Dr. Naegle was a superb sociologist and scholar and Helen was delighted that he would be directing the project on nursing education for both CNA and the RCHS. His abrupt and untimely death was a devastating blow! The Director of Special Studies was asked to step into the breach and undertake this project. Although sure she could never produce a study the quality of one directed by Dr. Naegle, Helen agreed to do her best. The final report, when completed, was well received by the Royal Commission.

Study of Recommendations of Royal Commission on Health Services, 1964-1965

A study of the recommendations of the Royal Commission on Health Services revealed that 79 of the 200 recommendations were “of concern to nurses”. Fifty-nine had direct implications for nursing.

This study was carried out “… with a view to establishing its own position and course of action.” It is impossible to calculate the effectiveness of the thousands of person hours that were expended on this study. At that time, however, a “position and course of action,” as well as a study of the recommendations, was required. In retrospect, I believe more time should have been spent on strategizing these studies.

Of great interest to me are the discrepancies between my recommendations in the survey Nursing Education in Canada (1964) and the recommendations of the RCHS. I recommended that the control of diploma nursing education be removed from hospitals and moved into the educational stream. The Royal Commission recommended only that the budget of the school of nursing and the hospital be separate. This was, in my view, unacceptable. The change suggested was only cosmetic and did not address the root of the problem.

Journals Editor, 1965

When I arrived at CNA, Margaret Kerr was the long-time, respected editor of The Canadian Nurse . She had been one of my teachers when I was a student at Vancouver General Hospital, and I stood in awe in her presence. I recall that, when she came to teach our classes, she wore a hat as was the dress code of the day. Each class, after about one minute, she removed her hat, with much verbal condemnation of the practice. Horrors! A woman with her head bared!

Margaret Kerr, as editor of CNJ, had fought hard to have her position considered equivalent to that of the Executive Director of CNA. She had had an on-going feud with the previous Executive Director, Penny Stiver, and she had won and, in so doing, had become Executive Director of the Journal. Margaret Kerr made it quite clear that she was at least on an equal status with me. As always, I was speechless.

When her retirement became imminent, we searched for a replacement. I was not satisfied with the recommendations of Mr. McGuire (PR counsel) and Ernest Van Raalte (General Manager). Suddenly, while talking via telephone with the two gentlemen, I had a flash of inspiration. We already had two great assistant editors, Virginia Lindabury (English) and Claire Bigue (French).

Why not have two editors –one English and one French? Mr. McGuire and Mr. Van Raalte were silent for a while but finally agreed to get back to me. Apparently, they discussed the idea with Margaret Kerr and she adopted it as her own. Great! So, on Margaret Kerr’s retirement, we replaced her with two editors. It seemed to work satisfactorily but was finally discontinued.

Committee on Social & Economic Welfare, 1965

When I arrived in Ottawa in 1957 for my two-year project, I was warmly received but whenever nurse’s salaries were discussed, I knew that I was viewed with suspicion. The west coast of Canada at that time was the militant promoter of UNIONS. Horrors! The Registered Nurses Association of British Columbia had authority to bargain collectively for nurses and was actively doing so. Other provinces lagged behind but gradually the “union movement” was gaining recognition — especially in Saskatchewan.

Louise Miner (Saskatchewan) was aware of the need to have national recognition of “collective bargaining” for nurses. After many meetings and much soul searching, the Executive Committee, in 1965, finally took a brave step forward and established a “Social and Economic Welfare Program”. The words “collective bargaining” were carefully omitted.

New Brunswick Association of Registered Nurses, June 1965

My first visit to St. Stephen, N.B. was to attend the annual meeting of the New Brunswick Association of Registered Nurses (NBARN) 2-5 June 1965. CNA’s President Elect, Katherine McLaggan, of N.B., was an important figure at these meetings as she was at all provincial, national and international nurses’ meetings. Katherine and I attended the meetings together as we planned strategy for convincing delegates that all nursing education belonged within the system of general education. Katherine was an inspirational leader and, at this meeting, she quoted liberally from The Little Prince by Antoine de Saint Exupery. I have used these quotations on many other occasions:

“It is only with the heart that one can see rightly; what is essential is invisible to the eye;” and

“You become responsible, forever, for what you have tamed.”.

Following the meetings, Katherine had made arrangements for me to see the Ganong Chocolate Factory. On the way over, she told me that what she really wanted was not chocolate but jelly beans. At the factory we were met by no less than the President of the company, who insisted on taking us on the tour himself. It was fascinating. Very early on, Katherine told the company president that she would like some jelly beans. Poor man, I thought he was going to have a stroke. He was adamant “no jellybeans”. He was not proud of that product and confided that the company only produced them because of demand. As we progressed, Katherine continued to whisper to me that she “must” have some jelly beans. At one point, I excused myself and headed for the ladies room with a detour past the jelly bean sections. I gather the president -or someone – had instructed that jelly beans were not to be given to the distinguished visitors. I held firm. Finally, the supervisor said that, if he was not looking, I could take some candies from the tray. I did. Thank goodness, too, because, after we left, the first thing Katherine asked, with fire in her voice, was “Where are my jelly beans?” I produced them and she gave me, in return, the chocolates the president had given her. The story does not end there, however. Katherine told me much later, in Ottawa, that the president knew that I had taken some jelly beans and he was not amused. Each time I see the ashtray given to me by the Ganong president that day, I am reminded of jelly beans. And that was in the pre-President Regan era!

PAHO/WHO Project in Commonwealth Caribbean 1964-1965 (5.4.5)

My next project was to assist World Health Organization (WHO) personnel in developing an evaluation of schools of nursing in the 13 countries of the former British Caribbean territories, later named the Commonwealth Caribbean. My title for this Pan American Health Organization/World Health Organization (PAHO/WHO) project was “PAHO/WHO Short Term Consultant”.

I was responsible for the development of the entire project under the general direction of the zone nurse, Janet Thomson. The PAHO/WHO project nurse was Nita Barrow. This project -PAHO/WHO Survey of Schools of Nursing in the Caribbean Area –followed the same methodology I had developed for the PPESN in Canada. The first phase, as in Canada, included visits to all countries and territories to interpret the project to ministers of governments, members of board controlling nursing schools, matrons, teaching staff other nursing personnel and, where requested to do so, the local nurses’ associations, general nursing councils and medical associations. During these one-to two-day preliminary visits, we interpreted and distributed a questionnaire designed to obtain some basic information about each school of nursing, prior to the survey. In this initial phase, it was also necessary, as it was in Canada to have an Advisory Committee, a Board of Review, and Regional Visitors. There were three persons intimately involved in the project: The Project Nurse, Nita Barrow, who was recruited from her post as Principal Nursing Officer in Jamaica. Nita Barrow and WHO had tried to convince me to become the project nurse but I was unable to commit myself to working in the Caribbean for two years. Despite pressure to change my mind, I held firm and recommended Nita as having all the necessary qualifications to become Project Nurse. At that time, WHO had a policy that no national could be employed to carry out a project in his/his own country. In the end, we prevailed and, despite the roadblocks, a national, Nita Barrow, was given permission to be a senior member of the WHO team.

The Zone Nurse, Janet Thomson, was a highly competent American WHO nurse stationed in Caracas. The Short-term Consultant was a position I eventually held for almost 10 years. My original assignment was a two-year appointment but I carried on for an additional seven years. For seven weeks in the summer of 1964 and, again, for six weeks in the summer of 1965, I worked on the project. (See p. 16-19 of the report “Survey of Schools of Nursing in the Caribbean Area” and “Spotlight on Nursing

Education: The Report of the PPESN in Canada” p.13-17.)

Nita Barrow (far right)

As noted earlier, preliminary visits were made to 13 countries and 23 schools of nursing. Later, one week surveys of the 23 schools were carried out to collect data for the final evaluation. Air travel to the 13 Caribbean countries, each on its own island~ was a fascinating adventure. We would “take off” across a wonderful, blue, sparkling sea only to land in a very short period of time on another tropical island. This was my very first trip to the tropics but not by any means, my last.

At work in Dominica

Many memorable events occurred on various stops. One visit, especially, I shall always remember. It is difficult to forget looking for yourself -for almost an hour! Apparently, Nita Barrow had asked a very efficient Chief Nurse in the Public Health Service to look after me, despite the fact that I didn’t feel I needed “looking after.” After she greeted me warmly at the airport, the Chief Nurse asked if I would help her locate a physician from Canada who had been on my plane. Pleased to assist, I recovered my bags and began checking the passports of deplaning passengers. I approached an elegant man with a Canada passport and asked if he was a doctor on a PAHO/WHO assignment. His response, a very rude “No!” I persevered.

Eventually — there were 100 passengers on the plane — I spotted a very business-like person with the appropriate passport and asked, very politely, if he were coming to St. Lucia for an assignment with WHO. He looked suspiciously at me and proceeded to the baggage claim area. In those days, you could move freely through the terminal, so I followed him only to be told that he was NOT with any organization. I reported back to the Chief Nurse who was still chatting with Nita. I suggested that she ask the airport officials to page the doctor over the public address system, lest our Canadian doctor had slipped through our net. Booming over the loudspeaker came the message, “Would Dr. Mussallem from Canada please identify himself to the station manager.” Well! After almost an hour of looking, we had located the missing Canadian doctor!

In the meantime, Nita had been reclaiming her luggage. Unfortunately, her suitcase was a disaster. It was as full of holes as a grate, and was seemingly held together by a few tattered bits of fabric. A young man, carrying a cardboard box, approached us. He told us that he had left Antigua with 12 reptiles and now there were only two in his box. Had we seen any? An airport official wanted to open Nita’s bag there and then but Nita refused. After all, one doesn’t wish to have one’s personal items exposed to public gaze.

Before we began our survey in each country, we attended an elegant reception complete with government officials, clergy, PAHO/WHO personnel, staff, from hospitals, schools of nursing, press, etc. St. Lucia was no exception. This was a very formal occasion with many speeches. After the formalities, the Zone Nurse and Project Nurse spoke outlining the project and, finally, I contributed a few words about my role. I always tried to have “a little special something” in each presentation. On our flight into St. Lucia, I had spotted a rainbow which made a complete circle. Wow! It was so spectacular that I thought it merited waking Nita to see it. (Nita always sat by the window and went into a deep sleep before the plane took off. When we landed, she awoke fresh and rested.) At my prodding, she opened her beautiful, dark eyes and took a good look at the rainbow and then promptly fell into a deep sleep again. I jotted down a few notes thinking that I could use this extraordinary sight in my speech. Eloquently, I likened the rainbow circle to the value of nursing in the Caribbean –encompassing the whole spectrum of society and its commitment to prevention of disease, the maintenance of health, and the education of nurses to meet health goals.

At our welcoming reception, dignitaries spoke, the Zone Nurse spoke, and then Nita spoke. Imagine my surprise when she gave a moving speech based on the circular rainbow she had seen from the plane. There went my speech, although I did manage to scrounge a few snippets out of what I had prepared. Nita Barrow, I should mention, was, and is, one of the most gifted speakers I have ever heard. Although many Caribbeans seem to have a talent for public speaking, Nita is head and shoulders above the rest.

With the Minister of Health, Barbados

At the time of our surveys, Nita’s brother was Premier of Barbados and one of the most outstanding dignitaries in the entire Caribbean. Nita, however, never took advantage of her illustrious brother’s position.” Well, perhaps on one occasion, and that was when a companion stepped on some sea urchins. Nita asked a police constable to get help and, when he did not obey, she “let him have it”. For such a dignified, calm person, she could “fight like mad” whenthe occasion demanded it.

I recall the extraordinary preparations made for us prior to and during our survey visits. Every effort was made to have all documents and schedules ready and waiting for us. What a wide range of quality and ingenuity we encountered! I remember, with some amusement, the diagrams of the female genitourinary tract presented to us at one school of nursing. Before us were drawings, in color, of all anatomical parts -but with a new twist! Around the uterus, kidneys, bladder, etc. was pasted exquisite lace. Never before or since have I seen those organs looking so festive!

The curriculum in most of the Caribbean schools of nursing was an exact copy of the syllabus in the U.K. These were former British colonies and senior staff were expatriates or recruits from the U.K. Additionally, nurses graduating from Caribbean schools wished to have reciprocity with the U.K. and this could be accomplished only if the U.K. syllabus was followed. When I asked in school after school for a copy of their curriculum, I became very discouraged when all that was produced was a copy of “The Syllabus”. It was music to my ears when I heard, at the 1972 Seminar for Tutors, the Director of one of these schools ask, “When are we going to produce nurses who are qualified to meet the needs of the Caribbean people?”

The one-week survey visit to each school of nursing was an intensive process, usually planned as follows:

Monday was devoted to studying the information provided in the Preliminary Information Schedule and the 21 additional items of written materials describing the program, requested at the time of the survey. Tuesday, Wednesday and Thursday were spent in visiting the school, the hospital and one affiliating agency, and in interviewing individuals and groups directly connected with the educational program. Each evening and all day Friday were spent writing the report, and Saturday morning the report was read back to the faculty and other interested members of the hospital staff. A total of approximately 65 hours was spent by each visitor on the survey and the writing of the report.

Helen K. Mussallem and chauffeur

Rule No. 1 was that absolutely no evenings were to be spent in other than writing of the report, discussions, etc. related to the relevant survey. One week, when we were in Antigua, the country where the Project Director was headquartered, I noticed some unusual activity. Maids and porters were kept busy delivering small and large packages which Nita put on top of the fridge. By Thursday, I was becoming really suspicious. I said to Nita, “I hope we are not having guests before we finish on Saturday.” No reply. You didn’t push Nita, no matter what your authority. All day Friday, while we were writing the report at Nita’s place in Sugar Hill Flats, activity increased and Nita divided her time between receiving parcels and writing her share of the report. At 7 p.m., I was still busy writing when guests started to arrive. Nita had recruited the assistance of maids and waiters of friends and, together, they whipped up the best party ever–about 60 people came. After putting the report together in my flat next to Nita’s, I joined in the fun. The main focus was a BBQ with a pig’s head rotated on a spit and cooked to a turn. As Nita’s flat became the main venue for the party, one maid, Valentino, was assigned to wash dishes in my flat. Dear Valentino was so pregnant but, as everything was set up for her there, she managed just fine.

Despite my misgivings, I enjoyed the party immensely. Nita had prepared some absolutely luscious Caribbean dishes and her friends and brought others. Rum and other spiritus frumenti were in ample supply but there was no sign of any intoxication. I had consumed very little myself, as I knew I had more work to do that night on the survey report. Food was laid out buffet style but, from somewhere, Nita had recruited two waiters so everyone was well looked after. We were a friendly, happy group which included most of the Island officials and doctors and their wives from all over the island.

When the party ended at about 11 p.m., there were no words of protest from me. Nita knew I had enjoyed the festivities. The waiters cleaned the flat and Valentino was washing dishes in my quarters. When I returned to my flat -the kitchen was the first room you entered –Valentino said something like, “Dotah mam des a moh n yo ba”. Perplexed, I replied, “I can’t understand you Valentino. Please speak more slowly”. Again, I failed to understand her. Not wanting to be insistent but now very curious. I again asked, “Valentino, please speak more slowly –one word at a time”. Still no luck. By this time, I was so tired that all I wanted to do was to get to bed. The report could be finished in the morning. Slowly, she enunciated, “Dotah ma’m des a man in yo bed”. Comprehension slowly dawned but I still thought I must have misunderstood something. By now, I was screeching at poor Valentino who became so frightened that she turned the small garbage pail upside down, sat on it, and began to cry uncontrollably. I proceeded, hesitant1y to my darkened bedroom and, sure enough, there was a man asleep on my bed. I stepped back, yelling at him to get out of my bed and house. Not a move. I shouted louder; still no movement. Creeping closer to the bed, it became obvious that he was completely unconscious from indulging too free1y at OUR party. I dashed over and got Nita but, even with her assistance, it was impossible to rouse our intruder. I returned to Nita’s flat where we argued for a while as she wanted me to sleep in her bed but I won and slept on the couch. As we readied for bed I rehearsed how I was going to severely reprimand that impossible man who had stolen my bed.

I woke early and walked outside where I could peer in through my bedroom window. The lifeless figure was still there. I returned at intervals but when he hadn’t awakened by 7 a.m., I rapped on the window waking him with a start. I dashed inside and confronted the dazed man, “telling him off” in no uncertain terms. He tried to get in a word of explanation and, finally, I listened. After showing me his identification, he explained that he was from NASA and had been working steadily for 48 hours on the launch of GEMINI. Full of compassion, I invited him to Nita’s flat for breakfast. Nita looked puzzled as I led him in.

I’m sure she was wondering what had happened to the fierce speech I had prepared. After working so many hours, he explained, when his relief finally arrived, he dragged himself to his room at the Sugar Mill Motel–just down the hill from our flats. Too tired to sleep, he heard the noise and music from our party and walked up the hill to see what was going on. Next thing he knew, someone handed him a drink and he was swept into the party. When lack of sleep and fatigue finally caught up with him, instead of going back to his room, he thought he would rest for a bit in my flat before returning to the party. My bed looked just right for a quick nap and that was the last thing he remembered until I banged on the window. Why Valentino let him into my bedroom is something I still don’t know but I presume she thought he was one of our party.

Unexpectedly, Nita and I found out something about the tracking of satellites and, to this day, when a space ship is launched, I remember –and chuckle.

The Board of Review, composed of eight well-qualified senior nurses from eight of the 23 countries had the onerous responsibility of evaluating, in the light of factual information presented to them, the 23 nursing schools. I recall so well their August 1964 meeting held in the open garage of the Barrymore Hotel. Voting on every aspect of every report was awesome –a soul-searching process. Two of the group stood out head and shoulders above the rest and led the evaluation to a credible conclusion. I reflected back on the PPESN Board of Review meetings in Canada and felt sure that the commitment and quality of the two groups was not that far apart. The process was a Canadian one and I was fascinated to note how readily it was accepted by these exceptional nurses in the Caribbean.

The contrast in the settings of our meetings was remarkable. In Canada, we had a suite at the Chateau Laurier. In Antigua, we met in the open garage. Each time there was a tropical downpour –and there were many –we had to recess the meeting, so loud was the noise from the rain. Despite all this, the quality of both groups was, in my opinion, equal.

It was during this first sitting of the Board of Review in Antigua, while I was accompanying Mrs. Chagas (Chief Nurse, PAHO/WHO, in Washington), that I had an unusual experience. As Nita, and her car, were already engaged, I volunteered to accompany Mrs. Chagas, by taxi, to the meeting at the Barrymore. On arrival, I insisted on paying for the taxi. Much to my chagrin, when I opened my wallet, I didn’t have any BIWI dollars. The night before, I had visited the bar at the Sugar Mill Flats expressly to exchange Canadian travellers cheques for local currency. The bar was full but I managed to complete my transaction and returned immediately to my suite. That night there was a most horrendous storm which I had hoped would relieve the debilitating humidity. There was a ceiling fan in my room but it offered little respite so, as was my custom in the tropics, I lay on top of the bed without my nightdress. When I attempted to pay our taxi fare, I realized that I had been relieved of my BIWI currency, but said nothing. With alacrity, Mrs. Chagas paid the tab. I was disturbed, however. Why were there Canadian travellers cheques and Canadian dollars in my wallet, but no BIWI dollars.

In the midst of our deliberations at the Board of Review meeting, I suddenly realized what had probably happened. During that unbelievably noisy storm, someone had entered my room, opened my purse, and removed my BIWI dollars. Foolishly, I had opened my purse in the bar that night and, presumably, all could see the contents. The next day, after the meetings, I told Nita about my “robbery”. My news so disturbed her that she had what seemed to me to be an asthmatic attack. On our return to Antigua, Nita reported what had happened to the hotel and, believe it or not, I was put in the Honeymoon Suite –three rooms and three locks! In addition, Nita had two police officers on duty outside my room- very reassuring except that the policemen’s voices kept me awake all night.

Relaxing in Barbados

Another evening that remains indelibly etched in my memory is the night a hurricane was headed for Antigua. That day, we had completed the survey of the Antigua School of Nursing. (This was done in 1964 as a model for the surveys to be carried out in the remaining 22 schools when I was back in Canada.) The hurricane watch was a devastating experience. I know the Matron of the school believed she had a good school of nursing-but that was far from reality.

The survey was conducted according to plan and, on Saturday morning, the report was to be presented to the faculty of the school of nursing and other interested members of the hospital staff. When I arrived in the room where the report was to be read, I realized we had an exceptionally large audience. I took my place at the podium with Nita on one side and the Regional Visitor (a religious sister) on the other. The Matron, despite my urging. chose to sit behind me. By this time, the room was full to overflowing. On one side of the room were about 20 nursing sisters, dressed in white with their blue belts and stiffly-starched veils; on the other side were 15 or more doctors also dressed in white suits. What an imposing sight! I could detect great tension in the room so I started out by saying a few pleasant words, attempting to put the group at ease. The report sat squarely in front of me … but I did not start reading until I told a small, whimsical story which was received with polite laughter. Finally, I opened the report and, as I began to read, a strong gust of wind burst through the window and howled across the room to the windows on the other side taking with it almost all of the report except for the few pages I managed to hold down. Almost all of the doctors– some of whom were cricketers (I found out later) and many of the young nurses dashed outside to rescue my sheets. Nurses and doctors brought back page after page -some pages had gone into the sea and the tall doctors had waded in and rescued them. They handed them proudly to me saying, “I has page 82 and 19 ma’m, and the Chief of Surgery has four sheets.” I collated the tattered report, keeping my hand steadily on the pile which was still being battered by gusts of wind. Nothing could have put the group more at ease than this calamity. When Nita and I completed reading the report, we went back to our Sugar Hill Flats to correct the report and put it in order for the typist.

I spent most of that afternoon working on the report as Nita had to do some other work for PAHO/WHO. When I was satisfied that it was in proper shape, I wondered how it could be protected should the rumoured hurricane become a reality. As I recalled seeing pictures of a hurricane’s aftermath when all that was left was a stove and refrigerator, I wrapped the survey report carefully –it was the only copy in Antigua and these were the days before photocopiers ~-and put it in the oven. About an hour later, Nita asked, “What is that peculiar smell7” I told her that I had put our survey in the oven in case a hurricane struck Sugar Mill Flats. For the first and only, time, Nita screamed at me. “What’s the matter with you!! Don’t you know there is a gas pilot light in the stove???” Rescuing our treasured document, we put the slightly-singed report in the refrigerator.

Dame Nita Barrow

As the afternoon wore on, the winds grew stronger and the radio kept blasting out reports of thehurricane heading for Antigua. Nita’s friends and relatives came to our flats, high atop the mounds by the sea, and, one after the other, begged Nita to leave our flats and stay with them  for the night. Nita refused to go but pleaded with me to leave. Stubbornly, I said, “I won’t go if you are staying.” I did, however, move into Nita’s flat.

We telephoned constantly for hurricane updates until all electricity went out and we were left without communication of any kind. I stretched out on the couch and watched as huge trees bent over to touch the ground in the eerie light that preceded the hurricane. Nita sat up all night trying to make contact – with anyone. Impossible. I have never, in all my years of knowing Nita,  seen her so fragile. About 10 p.m., a jeep made it halfway up the hill to our dwelling only to find the road washed out. Junie walked the rest of the way and tried, for the last time, to get Nita and I to leave. We stayed. Finally, at about 6 a.m., there was a beautiful, quiet sky. The devastation was awful but we were fortunate that the hurricane had veered away from Antigua and struck Guadeloupe where it hit very hard. Guadeloupe suffered many deaths and massive destruction so we were fortunate after all.

International work 1964 – 1965 (5.4.5 cont.)

WHO Expert Study Committee to Advise on the Program for the International School for Advanced Nursing Education (Edinburgh) – 1964

For me personally, and Canadian nursing generally, the three international I projects I completed in 1964 added to the beginning of CNA’s involvement in the world of health and gained for us some stature on the international scene. In addition to my responsibilities as CNA Executive Director, I completed the projects under the auspices of the World Health Organization.

The first assignment was as chairman of the WHO Expert Study Committee advising on the program for the International School of Advanced Nursing Education at the University of Edinburgh. The one-week project began 16 February 1964 and I can, to this day, recall how cold I was when I arrived at my room in the Bruntsfield Hotel in Edinburgh. I thought I would never be able to sleep that first night in my cold, damp room which was 10 feet wide by 24 feet long with a ceiling at least 14 feet high. My bed was a cot fitted with knitted nylon sheets top and bottom, and one comforter. At one end of the room was a very small hot water heater. When I got into bed, the cot was so small and the nylon sheet so tightly drawn that I just kept slipping out. In desperation, I pulled the one heavy chair in the room over to the side of the bed to at least keep me on the bed. The next morning, when I complained that my room was too cold and my bed too small, the management assured me that I had one of their best rooms!

The entire first four days in Edinburgh were spent on curriculum development for the yet to be established WHO International School for Advanced Nursing Education. After the first few days, although I was chair of the meeting, I had to intervene to support the North American model of developing aims and objectives based on philosophy. Miss Stevenson, Director of the School, was adamant in her resistance to our “stupid” proposals. She was of the school of thought where a syllabus was followed. The syllabus had no relation to the school’s philosophy (there was none in writing, but one did exist) and, certainly, aims, objectives and anticipated outcomes were never considered. Our meetings became a tense “we” and “they” struggle which I handled as tactfully as possible. Eventually, most of the University’s faculty “saw the light” and became enthusiastic and supportive. We all became such good friends, in fact, that I was invited out one evening to hear Andy Stewart, a favourite of mine. Due to pressures involved in writing the report each night, I regretfully declined but we did agree that Saturday was possible. We had a wonderful evening. One faculty member was assigned to sit next to me in our box seats “to interpret”. Despite the thick Scottish accent, no interpretation was necessary when he sang, “There was a soldier, a Scottish soldier….”

During my week in Edinburgh, I wrote in my room each night using the day’s discussions to gradually develop the curriculum in readiness for a final presentation. After the first day, Miss Stevenson would absent herself “to attend to pressing duties”. Writing in my room was a chilling challenge. It was so cold, I wrapped myself in my Newfoundland seal coat and wore lined gloves. Writing this way was very awkward so down I went to complain, again, to the hotel manager. I was told there would be more heat –there was none. After another hour of frigid room and cold, slippery bed, I complained again. This time, a maid brought me two hot stone pigs. A little better, but still tricky trying to sleep cuddled around the stone pigs. Despite the large chair I had placed next to the bed to restrain me, I kept slipping off my cot. After another hard day of meetings, I decided that enough was enough. I would not spend another night in my chilly room. Down I went, yet again, to see the manager. “If you don’t do something, I shall take a chill,” I warned. Those must have been magic words because, when I arrived back in my room, a large, electric heater had appeared. What bliss!

The final curriculum outline for the International School was completed Friday evening in readiness for presentation the next day to the Director of the School and others from the clinical setting from both inside the hospital and from the community (public health nursing). I remember that Saturday morning, seated at the head table in the Conference Room with Miss Stevenson, the Director on one side, and Lyle Creelman, WHO, on the other. I outlined the curriculum –starting with philosophy, aims and objectives as developed by the faculty of the school (minus Miss Stevenson) and the WHO consultants. Just before I commenced our presentation, Miss Stevenson said to me, “I disagree with everything you have done. ‘Noon’ will approve.” Facing a roomful of WHO personnel, staff of the university school, ward sisters in full uniform and public health nurses in their regalia, I started off with a full explanation of the project and how we had developed it. After 15 minutes or so, I began to outline the curriculum and our rationale for it. Then silence. Although Miss Stevenson chose not to speak, all the others were more supportive than I could have ever imagined. The chief public health nurse even said that it was the first time she actually knew what the program was all about. Two of the sisters, in their fetching bonnets agreed. Miss Stevenson, with palpable reluctance, agreed to “try it out”. She did and the program became a great success. Reports still refer to our work on the curriculum “way back in ’64”. It was, in fact, more than the development of a curriculum it was the establishment of the first English-language WHO nursing education program for post R.N. nurses world-wide: the very first program having been the French-language school for Advanced Nursing Education in Lyon, France.

When our presentation was complete, we were invited to explain our proposal for the School of Advanced Nursing (SAN) to the medical faculty. We proceeded to the faculty’s new and modern building and, although it was winter outside, it was a bright, warm day inside. All of the senior, rather imposing members of the medical faculty were seated at the head table, with Lyle Creelman at one end. I was seated at a side table. After the introductions, I was asked to make the presentation. The room was very warm and, when I was finished speaking, sweat poured down my face. I had worn an attractive, pink wool dress which was appropriate for the occasion but not for the heat in that sun-baked room. I eyed the raised Venetian blinds which were letting in the hot sun and decided to sidle, unobtrusively, to the window and lower the blinds. With everyone’s attention elsewhere, I pulled the cord to release the blinds. Unfortunately, it was the wrong cord and only half the blind released with the most awful clatter. I held on to the cord for dear life. The Dean of Medicine came to my rescue saying, “Steady, lass. Steady. What are you trying to do?” Although I thought my intentions were obvious, I hesitantly explained. Lyle looked away in agony but, with the blinds down, the room was somewhat cooler. All of the members of the medical faculty, except one, were not too impressed with our presentation and listened to us with polite disdain. One member of the faculty, however, spoke with great enthusiasm about our new approach to nursing education. After our presentation, we were invited to the office of the President, known in Scotland as Principal. We were offered sherry but I declined. At the urging of the President, who wanted to toast the completion of the project, I relented and hoped that, on an empty stomach, I would not feel the results too soon. The Principal was a fascinating man who, at that time, was one of the world’s top scientists in the field of space exploration. He asked if we had any questions and, of course, I had one. “Was it necessary,” I asked, “for the head of a university to have been an academic?” I was interested as, in Canada, the physician administrators of our hospitals were being replaced by “lay administrators” who were graduates of hospital or business administration programs. The President paused for about 10 seconds … it seemed forever … and replied in a Scottish brogue, “Yes, it is important to have been a professor in a discipline so that you can speak the language.” I have never forgotten his reply and have used it to advantage over the years.

Lebanon -May 1964

After intensive work at CNA following the project in Edinburgh, I was invited, by WHO, to conduct a survey of schools of nursing in Lebanon. I was also asked to give one major speech and to be a member of a panel discussion at the First Middle East Nurses Assembly to be held in Beirut, Lebanon. The CNA President approved these field trips saying that probably no one would notice that I was gone. I was excited to be visiting the land of my ancestors. When the initial correspondence came early in 1963, I shared it with my father. He was so pleased but, sadly, he died in June 1963 and never heard the great stories I could have told him about my visit. Although Dad rejected the land of his birth –he wanted to be a real Canadian and do his best for Canada –he was interested in Lebanon and so pleased that his daughter would see “the old land”.

Although there was a long lead time prior to my departure for Lebanon, communications were very poor. It was difficult to receive WHO authorization for my flight and to be informed about hotel reservations in Beirut. I did put together notes for my speech and preliminary plans for the survey of schools of nursing but the information I received was so slim that I felt ill-prepared. Despite telegrams, I did not even know the name of my hotel in Lebanon but I decided to go anyway.

The flight was long -Ottawa/Montreal/London, England -with a long wait for a connection to Beirut, via Frankfurt. The planes were slow so I slept most of the time after leaving London. I woke at one point and saw snow-covered mountains. For a moment, I thought I was crossing the Rockies on my way home to Vancouver. Then, I started to worry about how to find accommodation for the first night as we were arriving after dark. When the aircraft stairs were lowered, I was first off the plane. As I walked across the tarmac, I felt very lonely. Unexpectedly, I heard a faint, “Dr. Moo sell um” –the Arabic pronunciation of my name. Relieved, I approached the lady and gentleman and said, ”I’m Dr. Mussallem, from Canada.” A swarm of at least 20 men with flash cameras came out of the darkness and the night turned into a great, white flash of light. An elegant man approached and bowed from the waist saying, “Welcome to Lebanon, land of your father.” He was the Lebanon Minister of Tourism. Next came the Minister of External affairs, then Mme. Sultan, Director of the Red Cross School, and then other government officials. I was whisked into the VIP Lounge where arak and other liqueurs and wines were offered. My passport and luggage tags were handed over to airport officials while I sat with the welcoming delegation and talked, and talked. The Lounge was very warm and I had, as usual, travelled in a woollen suit. Eventually, a baggage handler appeared to announce that my luggage was not on the plane. “Find it!” shouted the ministers, clapping their hands in the typical Middle East clap command. We waited and waited but no luggage arrived. Finally, I was escorted to my hotel, The Orient Prince. A kindly nurse from the American University generously offered to lend me a night dress and slippers. Although she was about twice my size, I didn’t care. I slept soundly. In the morning, I was awakened by the sound of a jet overhead and then heard prayers from the Mosque, followed by the voices of vendors far below my window loudly extolling the virtues of their attractive1y-arranged carts.

At 6 a.m., a waiter, in fez, arrived with my breakfast. He knocked and, at my invitation, opened the door and stood there with my tray, screamed, put my breakfast on the floor — and ran. His startled eyes were as large as billiard halls. When I sat up, I did not realize that my night dress, miles too big, had slipped completely off.

My first day in Beirut was a busy one. Dressed in my now perspiration soaked suit (my luggage arrived two days later), I met with senior officials in the health department. Immediately after each introduction, the official would ask, “Are you Christian or Moslem?” In Lebanon, for every senior position in the entire government, there was always an equally ranking person of the other religion. I was also introduced to my national counterparts. The one that accompanied me everywhere was Christian but, when we went on distant trips to Tripoli and Tyre, my Moslem counterpart came along as well. Her English was limited as was my Arabic. My driver was Moslem. I recall so clearly the exciting ride back from Tripoli along the beautiful coast of Lebanon. There were no guardrails along the road despite the sheer drop into the Mediterranean on one side. I was especially frightened when the driver and my Christian guide got into a heated argument and several times, in his anger, the driver almost drove over the cliff.

There were many things my guides did in the name of my father. We visited the Cedars of Lebanon. “We take you there in the name of your father,” my guides said. On the drive to the coast, we visited the tomb of Kalil Gibran. At that stop, a Lebanese lady was asked to prepare chicken for us. She had just killed the chickens by wringing their necks and spices were rubbed into the meat with her bare hands. When we were ready to eat, I noted that the chicken was not well cooked and I feared that all the bacteria had not been killed. My counterparts and the driver, however, ate their portions – and mine, as I was “not hungry”.

I recall returning to my hotel that afternoon (work began at 8 a.m. and ended at 2 p.m.), to find the lobby filled with men in Arab headdress. The hotel manager said all of these men were relatives –all Mussallems.

My arrival had been reported, in English, French and Arabic, in the 30 daily newspapers. My “relatives” had read of my arrival and had come down from the mountains to welcome me. The oldest man spoke no English but, through an interpreter who accompanied him, told me how he was related to my father. I had no way of verifying this information but I thanked him, graciously, for coming. Likewise, when I was in Zahle, my counterpart called “a cousin” who took me to her home. In less than half an hour, every room in the house was filled with Mussallems or Moussallems (as it is spelled in French). They all claimed to be relatives. Mussallem, in Lebanon, is as common a name as Smith or Jones is in Canada.

The main reason for my visit to Lebanon was to conduct a survey of schools of nursing and hospitals as I had done in Canada for the PPESN. I started with the three main schools and hospitals in Beirut the Red Cross School of Nursing, The School of Nursing at AUB, and the Moslem School of Nursing –an Arabic School and Hospital. The entire survey process and techniques used were modified from those of the PPESN (see Report, p.94-137).

We then proceeded to Tyre, Sidon and Tripoli. In all, 11 schools of nursing were surveyed. Almost half of the schools were privately run by doctors and standards were very low. Survey results revealed that only two of the schools –AUB and Red Cross –met the desirable standards.

During our travels outside Beirut, tensions were mounting and there was a real threat of war. I remember, so vividly, sitting in the back of our car, alone, traveling to Beirut. My counterpart sat in the front with the driver. Six soldiers stopped the car and –three on each side –pointed their bayonets at us. Tremulously, I volunteered, “I have my Canadian passport.” “Shaddap!” said my companion. I understood Arabic well enough to surmise that my companions were attempting to explain our trip and tell the soldiers that we were all government officials. Apparently satisfied, the soldiers shoved a bayonet into the car as though to push us on –and off we sped.

There were, however, many pleasures in Beirut: looking out over the Mediterranean; sampling the best of Lebanese food; taking pleasure trips on Sunday to remote villages or casinos; and eating strawberries at the St. George’s Hotel patio. (As WHO personnel, I was forbidden to eat the strawberries but I did –only three times. They were worth dying for.) Many quaint items were sold on the streets of Beirut but I was particularly intrigued by the never-ending boxes of Chiclets offered for sale by grown boys. One night, at dusk, a very large boy approached me brandishing his Chiclets. I said “La” (no) but he kept following me, shoving the gum in my face. In desperation, I yelled “Rhou min hown”, the equivalent of “Get to h— away.” He really ran. I suppose he had never expected such language from a lady in European dress.

Leaving Beirut was another sad, if memorable, experience. We left the hotel at 3 a.m. to allow time for all the required clearances. On the way to the airport, we were again stopped by armed soldiers. They made us get out of our car, opened our suitcases and picked through everything — especially the negligees. We could do nothing but keep quiet and watch the charade. Later, as we approached the airport, the sun rose and bathed the beautiful hills of Lebanon with glorious light. Such a contrast from my noisy welcome: men dancing the Dabke in the streets; record players and radios blaring out music; and hordes of people lining the streets –some in Arabic costume, some in European.

After the Lebanon survey, I participated in the First Middle East Nurses Assembly where I presented a major address on Research in Nursing, chaired a panel, and gave many press interviews. These were unique events as they were conducted in three languages, English, French and Arabic, with volunteer interpreters. The equipment was rather primitive but, somehow we managed.

1999 Reunion with American University of Beirut Nursing Faculty

ICN in Frankfurt 1965

I arrived back from St. Stephens N.B., on Saturday, 5 June 1965, just in time to prepare to travel to Frankfurt for ICN meetings 10 June to 1July. What a flurry of activity! Meetings with staff, the Canadian Council on Nutrition, CNF Selection Committee, etc. Also important, of course, was assembling my wardrobe for the many working and entertainment functions. I certainly remember the hat I wore for the trip to Frankfurt as were taken as Isobel MacLeod and I boarded the plane. It was an extremely large black hat –about 12 inches high –with massive black flowers adorning the crown. There was plenty of room for a bullet to pass through the crown of that hat without it touching a hair on my head.

On arrival, we began on Saturday with ICN briefings. On Sunday, Monday and Tuesday, there were meetings of the Board of Directors. As was often the case, we strategized with our U.K. and U.S. colleagues. At the Board meeting, the CNA President issued an invitation to hold the 1969 ICN Congress in Canada. Mexico had lobbied hard for the Congress and, I must confess, I was hopeful that they would be successful. The invitations were, of course, put before the Grand Council.

At the opening ceremony in Frankfurt, after each speech by a dignitary, a grand symphony orchestra would play a beautiful rendition. It was magnificent. The music breaks also gave one a chance to catch ones breath amongst all the pomp and ceremony.

A number of critical international issues were discussed at this meeting. These are well documented in Sheila Quinn’s ICN publication.

One of the highlights for Canada, at the Grand Council, was the election of Alice Girard as the first Canadian ICN President. Even though she was the only nominee, it was necessary to follow the elaborate ICN voting procedure where each country, one by one, approached the podium to have their credentials checked. They were then handed a ballot and voted. The whole process took almost two hours. When ballots were tallied, Alice Girard was proclaimed President. It was then my duty to dash over to the communications center and first telephone, then cable, the news to Canada. That took another one and one-half hours as there was some confusion finding the country code as Canada was, of course, spelled Kanada in Switzerland. The next day, the vote was taken on the site for the 1969 Congress. Canada won by a wide margin. Then and there, the CNA president asked that I remain on staff until after the Congress.

I agreed and, later, my appointment was confirmed by the CNA Board.

President of CNA, Louise Miner, at international meeting

The next week (20-26 June) was chock full of plenary sessions with many relaxing activities running concurrently. One great day was Sunday, 20 June, when we went sailing on the Rhine. The Canadian delegates were in the lead ship with the Federal Republic of Germany’s President, Ruth Elster. Three other ships followed carrying Congress registrants –about 8,000 nurses in all! What a glorious day. When we reached the Lorelei, I was deeply moved. All during our stay, we had watched the boats sailing up and down the Rhine, with entire families on board hanging out washing, etc. It was a real “working river”.

On Monday, 28 June, 200 Board of Directors and council members were urged to accept the invitation of the West German government to visit Berlin. We were airlifted to Berlin where a very full program of activities had been arranged. It was very political. In Berlin, we were loaded into a bus and, after a short ride; we stood facing a high wall and armed soldiers. It was THE Berlin Wall. Afterwards, we were taken to see a church in the center of Berlin “The Wilhelm” which, except for its stained glass windows, had been completely destroyed by “the enemy”. The enemy was us, we were told frequently by the East Germans. They were both sad and belligerent. Then it was on to the great new hospital where we were told that a special musical concert had been prepared for us. I looked so forward to hearing Mahler, Bach etc, but, when we arrived and the choir of two rows of “interestingly uniformed” nurses began to sing, guess what? Their selection was not Mahler or Bach but “Vot shall ve do mit a dronken sailor?” That was the choir’s only English song, for which I was very grateful.

Following the concert, a tour of the hospital began. Isobel and I decided to skip the tour and found our way to a side door in the hopes of finding a cab to take us back to our hotel. We had hardly left the hospital when a young nurse came after us. She understood no English. Over and over. I tried to explain what we wanted to do but to no avail. She insisted on returning us to the hospital –and I kept saying “nein”. She won the argument.

On my return to CNA, the month of July was a hectic time of trying to catch up on the backlog of work, meeting with staff: meeting with the architect regarding our new headquarters and getting my life in order to be ready to travel to Antigua 28 days later to continue the Caribbean project.

Commonwealth Medical Conference – Edinburgh, 1-14 October, 1965

The day Dr. B. Layton telephoned to ask if I would become a member of the Canadian Government delegation to the First Commonwealth Medical Conference was a pleasant interlude in a continuous, intensive round of work as CNA Executive Director. I was invited to participate because of one item on the agenda –“Nursing Education in the Commonwealth”.

What an exciting professional and personal assignment! I worked long and hard to complete CNA assignments and be ready for this long, overseas project. When finally on my way, I was overjoyed to be seated in a quiet First Class seat –alone. I ate well and sampled many different spiritus frumenti offered. After dinner, I was given blankets and pillows and quickly dropped off into a deep sleep. During my slumber, I could occasionally discern incomprehensible conversation in the aisle but paid no attention. Next thing I knew, I woke alone in a foreign land.

It was frightening! The airplane was on the tarmac, away from the air terminal, and not one other passenger remained on board, Bravely, I rose from my seat and went to the flight deck. The captain said that we had to remain until he could get “some juice” to start the plane. Less fearful but still perplexed, I realized that I was so very thirsty. The Captain asked me to return to my seat and, presently, he brought me some wilted grapes –which tasted like ambrosia. In response to my query, I was advised that we were at Shannon Airport.

Eventually, we got “some juice” and taxied to the terminal where we were cheered by some passengers, although most were still occupied in buying duty-free items. Then, it was on to London — late. At long last, I caught my connecting flight to Edinburgh. On arrival — very late — two gentlemen greeted me at the foot of the aircraft stairs. They wore morning suits -wow!

I was escorted to the VIP Lounge where counters on four sides were loaded with every type of food and drink imaginable – including real caviar! My escorts begged me to at least have some shortbread or haggis –or a scotch or? I simply could not rise to the occasion.

Without a doubt, the Commonwealth Medical Conference was one of the most elaborate and elegant international conferences I ever attended –and well organized too. Our working environment was always bedecked with the most fantastic floral arrangements. The committee room, which seated about 50 persons around a square table arrangement, did not have a gaping, vacant area in the centre of the room. That space was always filled to the limit with huge masses of oversized chrysanthemums, orchids, roses and other exotic blooms.

Our delegation head was Judy LaMarsh – replaced after day two by Dr. John Crawford. Dr. Crawford was 6 foot 4 inches in height and a gentleman of the old school. The other members of our delegation were three doctors who brought their wives along (the wives did not like me) and three others who were not accompanied: Dr. Jack McCreary; Dr. Basil Layton (who had proposed my name as the conference was to discuss the education of nurses); and myself.

Canada was assigned a meeting room at the Conference. The six of us gathered there the first morning and chatted a bit. Dr. Crawford had been assigned, by Dr. Layton, to look after our delegation. He handed us a list of events and told us we could attend whichever meetings we wished -except that I must attend those relating to nursing education. In all of the delegations, there were only two nurses in attendance -Dossieh Kisseh of Ghana and me. Also in the meeting room each morning were our invitations for the day. Wow! There were six to eight receptions held each evening and our great decision of the day was how many receptions we would attend before dinner and how many after dinner.

The three of us (Dr. McCreary, Dr. Layton and I) usually went to the receptions together and thus used only one car and driver. As a matter of courtesy, these social events were compulsory and, after almost 10 days, one became rather exhausted by the social round – not to mention gorged with food!

Dr. Layton, as head of the Canadian delegation, was required to attend meetings to draft the final communiqué. He asked me to attend with him, as an advisor. I was seated directly behind him and was, I believe, very helpful on some matters.

The second morning of the conference, most members of our “working” delegation were absent and not to be found. I was irritated when I learned that they had each taken their cars and drivers that day and had gone sightseeing or shopping with their wives. Other delegations were holding planning meetings each morning to ensure that all important conference sessions were covered. I suggested to Dr. Layton that Canada should get organized as well. To my surprise, he left the organization of our delegation to me! I wrote notes to the Canadian delegates advising that they should meet in the Canada briefing room at 9 A.M. daily to receive instructions. Each morning, I met with Dr. Layton before 9 A.M. to make assignments. So, each day, as each delegate arrived, I handed out their assignment and asked for a brief note on their daily findings. They complied –almost like small boys –and were diligent with their assignments.

Our last meeting in that room is a precious memory. Someone had bought a pseudo medal from a “five and dime” store and attached to the “medal” was a citation for the “Medal of the Order of the Eager Beaver”, I was deeply touched. I kept that medal for many years and have given it, along with my service medals, to the CNA Archives.

The entertainment and social events for the entire Commonwealth group was spectacular. I had seen Edinburgh Castle before but never with all the accoutrements — Highland dancing, haggis, music and all the other facets of Scottish hospitality. When it was time for the Canadian delegates to leave, we would spot Dr. Crawford, whose six feet four inches made him tower above the crowd. Together, we would wait at the gate for our cars to arrive. It was stirring to hear “Canada” shouted out as a limousine, with Canadian flag flying, stopped for us. I did like all of that.

On Sunday, a glorious, sunny day, we were taken, by bus, all the way to Stirling Castle. What a sight! We were greeted, again, with food, flowers and entertainment. What glorious scenery … what great days!

The day before, Saturday, we had had the afternoon free and three of us were taken, via the Canadian limousine, for a four-hour tour of the Scottish countryside. I remember so well the Firth of Forth Bridge and I recited, with great glee, the poem about the Inchcape Rock.

Perhaps the most memorable reception I attended was the one at Holyrood Castle. Our Conference was the very first in the history of Holyrood to use the Castle without the presence of a member of the Royal Family. I saved my fanciest and fluffiest gown – a pale jade chiffon –to wear that night and it looked great. I remember feeling uneasy going down to the hotel lobby that evening, as I had been receiving notes from a man in one of the Commonwealth delegations who wanted to meet me. He did not identify himself in the notes so I showed to notes to Dr. Layton, and he and Dr. McCreary said they would keep an eye on me that night. As I left the hotel, the “three Canadian wives”, who were seated in the lobby, glared at me. One of them had used my car and driver that afternoon and, when Dr. Layton told her she did not have the authority to use the car for shopping she told him that she had as much right as Dr. Mussallem. I suppose Dr Layton straightened her out but, even on our return to Canada, we never warmed up to each other. Oh well.

Our entrance into Holyrood Castle was memorable. Our limousine, flag flying, was opened by a man of the Black Watch –dressed in 16th Century garb. His white gloved hand assisted me in exiting the limousine. Highland music piped us in as we walked through hall after hall of the historic castle and dined as the ladies and knights of old did — but with all the conveniences of modern living. The Scottish entertainment was spine tingling. All in all, an evening I shall never forget.

Reality returned on the trip back to Canada. We were delayed in leaving Edinburgh so we knew our connection to Ottawa would be lost. Dr. Layton, however, knew all the immigration and customs officials at Dorval Airport and he cabled them. Never have I been whisked through an airport more expeditiously.