Ivy Dunn

Here, we publish Ivy's introduction to the North American launch of the Tidal Model on the 7th November 2003.

It is indeed an honour to be here and participate in this 2003 Ivy Dunn Research Day and the North American launch of the Tidal Model of Psychiatric and Mental Health Nursing Practice.

I thank the organizing committee for honouring me and Carolyn Whitelaw for her kind introductory remarks.  My years as Director of Nursing at the Royal Ottawa Hospital were, for the most part, very rewarding and also, at times, very difficult and stressful, as many of you know.  Although I did not say it often enough, I was always extremely proud of my R.O.H. nurses.  Working over the years with so many wonderful staff and watching them learn, grow and develop professionally gave me a great deal of satisfaction and many intrinsic rewards.  Also rewarding was  knowing, during the most difficult times, that the majority of the staff were supporting me.  It would have been easy to quit but I always felt I would be betraying a trust and therefore could not go.  Today, you have assured me that I was right to stay.  And stay I have, but in a volunteer role now.  My first reason for going into psychiatric nursing was to care for patients.  Administration took me away from those direct contacts.  I am now almost back where I started.  As a volunteer driver I can help patients get to their appointments and chat with them at the same time.

 Now will you allow an elderly (not old) nurse to reminisce for a moment?

 It was 50 years ago this year that I decided to make psychiatric nursing my career choice.  Hence, I headed to Douglas Hospital in Montreal to take a six  month post-graduate course in psychiatric nursing.  Following the course I decided to stay on staff at Douglas Hospital.  I expect none of you have seen, and most will have difficulty imagining a building housing 100 female psychiatric patients sitting or lying on the floor all day, refusing to wear clothes, incontinent and being given pureed food from metal bowls at meal times.  Only  spoons for cutlery.  This building was called East House.

About three years after my course finished three things happened that affected the patients in East House.  First, the  “miracle” drug  chlorpromazine was brought to North America and Douglas Hospital by our clinical and research director Dr. Lehmann.  But as we  know  medication  alone would never resolve all the problems of the East House patients.  The next positive thing that happened was the sixth month assignment of a committed, eager beaver resident for the patients and the third change was the promotion of yours truly as Supervisor of Nursing.

I developed, with the full cooperation of the resident, an “I expect” nursing approach to patient care which was taught to all nursing staff.  In a way it could have been called our “nursing model”.  Daily morning rounds were conducted by the resident and myself to all patients.  They consisted of a “Good Morning, Mary” (a handshake and a gentle pull off the floor if needed).  “I expect you to sit on a chair – be dressed – use the toilet” as appropriate.  Dietary were asked to supply regular food, dishes and cutlery and expected dining manners were re-taught.  A piano was obtained for Sunday hymns and prayers and sing-a-longs and activity programs organized.  In six months 98% of the patients wore clothes and were continent; resistance to care was almost non-existent; table manners had greatly improved and the building had open doors.

 None of the above could have happened without enthusiastic, devoted and committed nursing staff who believed in our “model”.  You may wonder why I went back 50 years.  I wanted to show you that I have come a long way and participated in many great changes all of which make this honour that much more meaningful to me.  I also wanted to show you, from an extreme example, that the key to success of any new endeavour, approach, practice or model is the enthusiasm, belief in and commitment of those using the model.  Did we not prove that at the ROH with primary nursing?

 My career in psychiatric nursing was spent in two great hospitals that opened doors of opportunity for me that, had I not taken them, I would not be standing here before you today.  Therefore, it pleases me that there is to this day, still two connections, as it were, of those two career experiences.  There is Cathy, who I first met at Douglas Hospital when she was a teenager.  Whenever our paths cross at the Royal we have a short chat, often of people we knew back then when she and I had a therapeutic relationship.  Then there is Margaret Tansey who I first met at Douglas in the 60’s when I hired her as supervisor for an adolescent unit…I have been proud to have been able to watch her professional growth and development since the Douglas to the Royal Ottawa today.

 And, so as not to take any more time away from the Barker’s who you really came to hear I must stop talking even if Marg told me I could say as much or as little as I wanted.  I wish you every success as you launch the Tidal Model in North America and look forward to participating in today’s conference.  Thank you again for honouring me with this special research day.