While in Christchurch, New Zealand over the past few weeks, I kept seeing these cute little ‘Nurse Maude Mobiles’/compact cars zipping around town with smiling community health nurses behind the wheel. I figured ‘Nurse Maude’ was just some quirky Kiwi name for a home healthcare agency. But then yesterday, while browsing in the New Zealand section at the Wellington Central Library, I stumbled upon the book Nurse Maude: The First 100 Years by Vivienne Allen (The Nurse Maude Foundation/Christchurch, 1996). Intrigued, I sat and read it through. Here’s some of what I learned about Nurse Maude. Or at least the things that impressed me the most and that have relevance for community health nursing back home in the U.S. (All quotes below are from Allen’s book).
Sibylla Maude, Nurse Maude (1862-1935), the daughter of a New Zealand sheep farmer, was the founder of the first district (community) nursing scheme in New Zealand. She was also the driving force behind New Zealand’s Nurse Registration Act of 1901, the first of its kind in the world.
She received her nurse (and midwife) training in England since there were no ‘professional’ nurse training programs in New Zealand at the time. She returned after her training to become the Matron of Christchurch Hospital where her reform-mindedness got her into trouble with the older staff nurses and with the hospital board members. She felt her true vocation was taking care of the poor and elderly in their homes, so she quit her hospital job in order to open up a one-woman community health visiting service. The Anglican Church sponsored her and with her “…black bag under one arm and wash bowl or bedpan under the other…” she walked around Christchurch providing nursing care. Demand for her services grew, so she got a bicycle for her rounds (the photo here shows her, fourth woman from the right). Then she started adding more nurses and also had a clinic and headquarters built (this building, sadly, was a victim of the latest earthquakes and had to be demolished).
Nurse Maude adapted her community health services to the changing political and healthcare needs. Her nurses responded to the TB epidemics accompanying waves of immigrants, to the 1918 influenza pandemic, to the returning soldiers from WWI, and to the growing need for hospice/palliative care.
In her book, Allen states that Nurse Maude “frustrated the health system as much as it frustrated her.” After she had established the community nursing service and had a solid reputation, she went public with her criticisms of the Christchurch Hospital Board for overworking the nursing staff, thus jeopardizing patient care. This time her reform efforts worked and the hospital was forced to improve working conditions for the nursing staff.
Nurse Maude had the attributes of a pioneer: “…a streak of hardness, inflexibility, and tough stance to achieve what she wanted.” She even had a public spat in the Lyttelton newspaper with the leading New Zealand suffragists Kate Sheppard and Ada Wells over their use (Nurse Maude claimed ‘misuse and misrepresentation) of the story of a local woman’s health plight for their own cause. New Zealand was the first country in the world to grant women full voting rights in 1893, but Nurse Maude seemed mostly indifferent to the cause, focusing instead on direct nursing care (an all too familiar trait for nurses even today in the U.S. at least).
Although Nurse Maude died of a heart attack in 1935, her work continues through the services of the private, not-for-profit Nurse Maude District Nursing Association, the largest provider of home nursing for the elderly, disabled, and for people needing home-based palliative/hospice care on the South Island. Their community health nurses drive to patient’s homes in the cute little nurse mobiles, and they provide telehealth services to home-based patients in rural and remote areas across the South Island. Go Nurse Maude!