Nurse, hospital matron, nursing administrator, editor, writer
Hester Maclean was born on 25 February 1859 in Sofala, New South Wales, Australia, the daughter of Emily Strong and her husband, Harold Maclean, a goldfields commissioner who was later sheriff and comptroller of prisons for New South Wales. Her mother died in 1860, so Hester was brought up by her stepmother, Agnes Campbell. She was educated at a private girls' school in Sydney, and enjoyed society life until her father's illness and death in 1889 prompted her to seek a more satisfying occupation. Inspired by the example of her father's nurse, she began nursing training at Sydney's Royal Prince Alfred Hospital in 1890, qualifying in August 1893.
Maclean worked as a private nurse for a year before becoming matron of Kogarah Cottage Hospital. In 1897 she moved to the Women's Hospital in Melbourne, working as a sister. In 1898–99 she was sister in charge of the Melbourne District Nursing Society, and was then appointed matron of the Queen Victoria Hospital for Women and Children, a position she held until March 1900, when she returned to the Women's Hospital as matron. She stayed there until 1904, the year she received her midwifery certificate from the Obstetrical Society of London. The following year she was matron of the Bay View Asylum in Sydney, and in 1906 she was sister in charge of the Sydney District Nursing Association.
At the instigation of her friend Dr Agnes Bennett, Maclean applied for and obtained the post of assistant inspector of hospitals in New Zealand's Department of Hospitals and Charitable Aid. She was to hold the position from November 1906 until her retirement in 1923. Following the 1920 Health Act she was designated director of the Division of Nursing in the new Department of Health.
Unlike her predecessor, Grace Neill, Maclean was not involved in general welfare administration, devoting her formidable energies solely to the development of nursing services. Her special responsibilities included nursing and midwifery education and registration. Until 1920 she was also assistant inspector of mental hospitals. Her influence was profound; for much of the time she had only two assistants, Jessie Bicknell and Amelia Bagley, to share the work, and she enjoyed a harmonious relationship with her superior, Thomas Valintine, who respected her ability and ideals. These ideals were conservative: Maclean believed that nurses had to willingly accept hard work, discomfort, and subordination to authority if they were to achieve recognition as members of a profession that gave 'practical service to mankind'.
Hester Maclean regarded it as her duty to safeguard probationer nurses from exploitation while ensuring that standards were maintained. Training, she believed, should be carried out in hospitals under the watchful eye of a carefully chosen matron and based on practical experience rather than theoretical knowledge. She advocated domestic as well as nursing work to teach endurance, neatness and cleanliness. Maclean supported the extension of the training period from three years to four, a move prompted by staff shortages after 1909, but insisted that boards should offer worthwhile additional instruction in return for the extra year of service. She suggested minimal pay for probationers, since they were receiving free professional tuition; but hospitals that failed to offer proper instruction in return for probationers' cheap labour were, in her view, guilty of fraud. She remained wary of the value of university education for nurses, but acknowledged the importance of new scientific methods and supported postgraduate training for nursing leaders.
Maclean did not accept that nurses' working conditions were unsatisfactory. She fought against the introduction of an eight-hour day, arguing that professional women must be allowed to adjust their hours according to the needs of patients. She supported the new regulation in 1920 that granted nurses a full day off each week, considering this to be more beneficial than a shorter working day. Maclean believed nurses were entitled to rewards once they had achieved registered status, although she continued to emphasise that nursing was essentially a charitable occupation. She campaigned for nurses' superannuation, achieving success in 1925, and supported payment according to merit and increased salaries for senior staff.
Maclean supervised a nursing service that was expanding rapidly. She oversaw the development of Plunket, tuberculosis, school and backblocks district nursing, independent midwifery, the Maori health nursing service and nursing training for Maori women. She also witnessed the opening up of careers for nurses as physiotherapists, health visitors, sanitary inspectors, child welfare officers and anaesthetists. Maclean actively encouraged her nurses into these 'schemes in the betterment of the race', urging them to 'assert their right to the work for which they were specially qualified', rather than letting opportunities slip into the hands of untrained women.
It was Grace Neill's view that Maclean had a rather exalted opinion of men, especially male doctors, and certainly she welcomed their involvement in nursing issues and education. Nevertheless, she maintained that nurses should regulate their own profession without interference, and argued for matrons to have full control over the selection and training of their staff. She once congratulated a nurse on her courage in pursuing a successful libel action against a doctor, and was particularly concerned to protect the rights of midwives, declaring it 'manifestly absurd' that a doctor should attend every confinement.
Maclean undertook work for the profession beyond her departmental duties. She had belonged to both the Australasian and Victorian Trained Nurses' associations, and after her arrival in New Zealand she was active in the country's four nursing associations. In 1909, anxious to promote a united body that would 'shape the future of nursing', she was instrumental in bringing them together as the New Zealand Trained Nurses' Association. Maclean was the association's first president and provided the link that gave nurses immediate access to government. She also served as vice president of the New Zealand Nurses' Christian Union.
Even more important, however, was her decision in 1908 to publish a nursing journal, which she called Kai Tiaki (guardian). It was to give nurses a 'bond of union, a common interest, a means of communication…and a road to improvement in their professional work'. Maclean owned the journal until 1923 and edited it from its inception until her death, producing almost every issue during that time. It provided a vehicle for her own views and through its pages she was able to promulgate an ideology of nursing.
The war years were probably the most strenuous but interesting period of her professional life. She had been appointed matron in chief of a proposed military nursing reserve in 1911 and fought for the right of nurses to serve overseas, strongly deprecating any suggestion that either untrained women or male orderlies should nurse soldiers. The New Zealand Army Nursing Service was established in 1915 and Maclean selected and equipped all army nurses during the war, making a point of seeing them off and greeting them on return. In April 1915 she escorted the first 50 nurses to Egypt herself, dealing with hospital placements, accommodation problems and disagreeable doctors and military personnel who refused to recognise nurses' officer status, a problem never fully resolved.
Maclean wrote wistfully of her desire to remain on active service but accepted that her duty lay in New Zealand, where she was occupied in keeping the country's hospitals going, despite desperate staff shortages. The influenza epidemic in 1918 and 1919 added further stress when, in the absence of other staff, Maclean acted as chief health officer, organising measures to combat the disease and working night and day. Maclean's wartime duties earned her no extra pay, not even travelling expenses. In June 1920, feeling that the position should no longer be an honorary one, she tendered her resignation as matron in chief but eventually yielded to official pressure and remained until her retirement in 1923, when she received a special bonus of £250. Her work was further recognised in the awards of the Royal Red Cross (first class) in 1917 and the Florence Nightingale Medal in 1920.
Maclean's retirement was particularly happy. She enjoyed her home and garden in Wellington, continuing to sketch and paint watercolours as she had throughout her life, contributing a chapter on nursing to The war effort of New Zealand (1923), and writing her autobiography, Nursing in New Zealand (1932). She maintained her interest in nursing through her editorship of Kai Tiaki and as an adviser. She was largely responsible for drafting the Nurses and Midwives Registration Act 1925, which gave nurses a more direct role in nursing administration, and it was with considerable regret that she declined to become a member of the new registration board.
She was also from 1925 a member of the publications committee of the International Council of Nurses, with which the New Zealand Trained Nurses' Association had affiliated in 1912 at her instigation. She submitted a variety of papers and reports for consideration. Her major regret was that she was never able to attend an ICN congress. She died in Wellington on 2 September 1932, having never married.
Maclean was not, as she said, 'a ready speaker'. Her power lay in her pen, which she wielded with skill to promote the interests of the profession she loved. This power was enhanced by the respect and devotion she inspired in her nurses, who remembered always her 'wise counsel'. Her life exemplified the self-sacrificing service that she demanded of all nurses but she never acknowledged that for the majority, whose nursing careers were brief, there might be other priorities. The constraints imposed on the profession by her narrow vision and inflexible ideals have hampered nursing aspirations ever since.