Forty Years Of Caring

I felt so bad for my patient, the poor man was sweating buckets, his skin clammy and pale, his grip on my hand crushing. As I watched Sister and Doctor Swift prepare the skin for the needle for the bedside liver biopsy, I could feel myself swaying. I pulled myself upright and focused on holding the eyes of my patient. “Sorry nurse,” my patient said gesturing at my hand with his eyes. “You squeeze as hard as you need to sir, Dr Swift will be finished very soon. Just focus on me until we’re done.” 

As soon as the procedure was over and my patient resting I knew Sister’s sharp eyes would fall on me. “Douglas, my office, straight away.” I had learned very early in my chosen career that I would not hear my given name at work and had no right to expect even to be given the title of “nurse” by a senior, I’d always have to answer to some pseudo militaristic style of address. This was the late 1970s and I was training to be a nurse in sunny Scotland. 

Unfortunately Sister Dewar had noticed my unsteadiness at the bedside, I knew I was in trouble. “Douglas! I understand you are new, but you have to adjust to working hard, long hours at all times in order to be able to succeed as a nurse.” “Yes Sister,” was the only required response, only allowable response. I had been working for ten days doing alternate shifts in no particular pattern. We students were slotted into the staff schedule, to cover as aides to the qualified staff: learning on the job. Between working a mix of day and evening shifts and studying for our eight week stint in college that was coming up, my entire group of students were feeling pretty washed out.  

 “Right Douglas, carry on,” was the advice. “Thank you Sister.” At least I wasn’t to be on Matron’s report this time. I turned and headed back into ‘men’s surgical’ and checked on my patient, who was a little less pale now, but still in some discomfort. As I helped him sip some water and gave him a warm blanket he smiled and nodded his thanks. “Hey nurse,” a cheerful voice beckoned me over, I grinned at Mr Soames, “Did you get it in the neck then? From the dragon?” he chuckled. “We all think you’re doing a grand job lass, you young nurses fair brighten our day in here with your smiles and the patience you all have with looking after us old crocks and putting up with “The Dragon,” 

“Oi less of the old you,” chipped in Mr Beck, “you speak for yourself. Some of us are still young enough to know a thing or two.”

“Aye” grinned Mr Soames, “but it’s still being able to do “a thing or two” that keeps you young at heart .” That set all the patients in the ward chuckling and joining in. This was the reason that all of us, myself included persisted in our training. Staying in a job that treated us like uneducated skivvies was hard, but the rewards were well worth it, knowing that the patients felt better in any way because of our presence made even the toughest day worthwhile.

 I began training as a nurse in the 1970s, at the grand age of 17 years. Until then I had worked as a waitress and as a child care assistant and factory hand. My training was very military in nature: stand up when a senior staff member, including doctors (even medical students) enters the room, speak only when addressed first by senior staff. Never question a physician, always try to stay out of sight during Doctors rounds, make sure the patients are lying in bed for rounds and are “at attention” for the doctor visits. Always address peers by their last names and senior staff by their “rank.” 

Adherence to the strict dress code was paramount; no hair could touch the collar, or you risked having your hair pulled by sister/matron or anyone else who saw fit. A white knee length dress, white tights, white shoes and a white (stiffened) paper cap, no adornments, no outdoor clothing (not even regulation cloaks or cardigans) allowed. Absolutely no jewelry (except a wedding band) and no makeup at all. One advantage of the dress code was that one could very easily and swiftly identify who was who in the strict hierarchy and so could hide in a room to “do some cleaning” if you spotted matron before she spotted you.

The training I received was a blend of bedside nursing and classroom work, with the biggest focus on practical skills and we all of us had our favourite areas to work in. And areas that all of us swore we would never work in once qualified. My no go area was to be surgical and operating room work. There was nothing in this world that would have or could have induced me to return to either area after doing my student practicum in the surgical hospital in my first year of training. Maybe if I’d gone there at the end of my three years, it may have been different, but I remain unconvinced. The one thing it did do for me was help me grow a skin against people who rejoiced in tormenting junior staff. We had to “take it” or leave it in training because at that time there was no other choice. The days of hearing your last name bellowed up a long ward or hallway are gone forever. Nor is it likely that students of today would be placed in a circle to stand silent witness whilst one or more of their peers is verbally abused by senior staff. But in the 1970s Britain all this was common practice, even seen as essential to “weed out the weak ones.”

What kept us going? Each other and the patients who were almost always very supportive of us, even if all they could do was offer up a tut and “that’s just the dragon lass don’t listen to her, you’re doing fine.” Most of us stayed because of the patients. 

In time I was moved from men’s surgical upstairs to the women’s ward; surgical and gynaecological. That would provide a whole other set of challenges. 

On my first day I was asked to “special” a lady who was recovering from bowel surgery to remove bowel cancer. To “special” someone as a first year student then meant to stay with them for your entire shift, taking temperatures, offering fluids and giving any personal care needed. I was happy to help this pleasant lady, who was so very articulate and intelligent, we chatted as she was able and she seemed to enjoy that. As did I, and though this was unknown to me at the time, it was to herald my eventual specialty. Anyhow, Mrs Jones was a very proud lady, very particular in her appearance and now had a colostomy to deal with. The first time that she was conscious when it was to be cleaned I happened to be the one to do the cleaning. Never having had to manage this before I had a senior staff guide me, but I was expected to do the procedure. I was mindful of Mrs Jones watching me and worked hard to get it right. The staff nurse seemed happy with my work and left, but it was Mrs Jones’ response that still stays with me even today. She looked at me, straight in the eyes and said that she had expected that we would recoil from the sight/odour of the colostomy, but because I hadn’t done so it gave her hope that she could eventually manage it. Over the next few days I worked with Mrs Jones, helping her figure out her best way of coping with her new challenges and at the end of her stay Mrs Jones sailed out of the ward with a smile on her face and a hug of gratitude for me.

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