How health professions work together, or fail to work together, is one of the fundamental questions facing the Canadian health care system in the current period of reform. In Canada, the introduction of health care providers such as nurse practitioners and licensed practical nurses and the “re-emergence” of midwifery have prompted questions about “appropriate” tasks, levels of education and training, and, of course, compensation.¹ Established professions are trying to reassert their jurisdiction over elements of health care delivery from which they have been alienated.² Even physicians are not immune to these pressures.³ Creating, defending, and negotiating professional boundaries, in Canada...

To understand laboratory work, it is necessary to understand the development of the institutional structures. As suggested in the introduction, there have been few studies of the laboratory in Canada. It is therefore necessary to provide some description of how and why laboratories were created in the Maritimes. This chapter explores the development of institutions, leaving the discussion of the workers to subsequent chapters. Institutions provide the context for work, creating relationships among staff members, among services, or between settings. Laboratories in the Maritimes were not among the earliest and were not innovators. Instead, they were created in a national...

In 1920 Margaret Low left the Dalhousie medical school to begin work at the Pathological Institute.¹ She initially earned seventy dollars a month. Low was remembered as a stern person, although a “nice old soul.” Relatives remember that she would on occasion bring nieces and nephews to the laboratory to play with the animals. She was also independently minded and not above raising Cain with the doctors who would come into the lab smoking. Low was allergic to tobacco smoke and “wouldn’t allow it if she had anything to do with it.”² Often, as in other facets of her working...

In the United States in 1875, there were 661 hospitals, a number that had increased to slightly over two thousand by 1900. From 1900 to 1929, hospitals were established at the rate of two hundred per year.¹ Although no annual data on hospitals were collected in Canada before 1932, Ontario experienced a similar expansion. The number of public general hospitals in that province increased from fifty-one in 1900 to 139 in 1930.² Hospitals were founded throughout the Maritimes in these same years, to augment the few that were built in the late nineteenth century. In the dangerous mining district ruled...

Laboratory workers in Saint John or Halifax, and those who staffed the benches in rural hospitals around the Maritimes, came from a variety of backgrounds. Some were nurses, others held university degrees, while still others received training in the laboratory following secondary schooling. All laboratory workers learned new procedures at the bench and occasionally they were sent elsewhere to become skilled in the latest techniques. Workers from rural hospitals would travel to Saint John or Halifax, while workers from those cities would occasionally go to Toronto or American centres. There was a baffling array of expertise and personnel within any...

In 1931 the Canadian Tuberculosis Association (CTA) and the provincial government of Prince Edward Island were attempting to recruit personnel for the newly established public health department.¹ But, as in New Brunswick and Nova Scotia, there were limits to what the province could afford. The development of public health in PEI depended upon funds from nongovernmental sources. In 1930 the PEI government spent a mere twenty-four hundred dollars on public health and the total expenditure on the island, from all sources, was just under nineteen thousand dollars.² The CTA brokered a deal with the Canadian Life Insurance Officers Association to...

In April 1950 Albert Deutsch published an article entitled “Menace in the Medical Labs” inWoman’s Home Companion. The brief article, focusing on America, raised concerns about “substandard” laboratories that were committing “fatal errors.” The article began dramatically, noting that “Your health - even life itself - often depends on the skill and care of laboratory technicians serving your doctor or hospital. Many are wonder workers, indeed. But a nation-wide survey reveals a frightening increase in error and carelessness - a betrayal of trust that can kill.” This ominous message, which impugned laboratory and education standards, caught the attention of...