by Mary Hazard
The third year in the hospital was all about learning about the wider areas of nursing, which we might consider specialising in. I did a bit of maternity and midwifery nursing, which I didn’t really take to, and after the TB ward I was asked to visit a local mental health institution. This was an area of social stigma, and one that was feared mightily and seldom spoken about, as mental health institutions were still thought of as ‘loony bins’ or asylums, and were often depressing, dark, old-fashioned, intimidating places exerting fear over young imaginations. Thus in my third year I also had to visit a local mental hospital as part of my training. It was not something I particularly felt comfortable about, as I had all those prejudices about the unknown and madness, but I was curious, nonetheless. The hospital was in Tooting Bec in South London, and was a big, sprawling, somewhat intimidating Victorian building that gave me the heebie-jeebies just to look at it, quite frankly. However, what I saw there, even on a day visit, really put me off mental health nursing for life. The wards were long and soulless, and with a really scary, heavy atmosphere. I could hear people screeching and groaning, and it sounded a bit like a horror film. The cemetery in Clonmel came to mind, somehow, with the ghouls of the night which I was always terrified of. Sister walked around with a huge silver ring in her hand, with keys hanging off it, as every patient was either locked in their own room, or locked in the day room. It felt like a prison, or a really bleak institution, with a terribly oppressive atmosphere. We were shown the padded cells, which were rooms with walls covered in a thick cream covering, like a sofa, and I could see through the peephole on the door that some patients were writhing on the floor in white straitjackets. These were jackets with arms that could be tied around their backs with tapes, to stop them from either harming themselves or lashing out at the staff. It looked utterly terrifying and barbaric to me.
However, the last straw for me was seeing electroconvulsive therapy or ECT. We had to watch an ‘operation’ whereby a patient was wheeled into the theatre, then injected with a relaxant, and then electrodes were placed on their temples, and huge amounts of electric current were forced through their brains and bodies. The treatment looked absolutely dreadful, really medieval, like torture, as the patient’s body writhed and convulsed on the table, and they bit down hard on a piece of material. The nurses had to hold their bodies down so they didn’t bounce off the table or break something. It was so gruesome, I couldn’t believe it helped at all. The patients grimaced, convulsed and pulsed. I really couldn’t believe that it did any good, although the sister told us that the patients got great benefit from it – largely because it blanked out their memories. But how good was that, really? It seemed utterly barbarous to me, and I hated the whole atmosphere of the place and the ECT procedure in particular. I could see other patients rocking themselves backwards and forwards, with vacant eyes, and others wandering around the wards barefoot, with their gowns open at the back, showing off their bottoms to the world. They were like lost, crazy children. It was a terrible place, and only when I got out of there and back to the relative safety and calm of Putney Hospital did I realise how much my own mood had been affected. I realised on that day visit that mental health nursing was really not for me. I’d be certifiable within a month.
13
Carbolic, Drugs and TLC
After my six-month stint away at St John’s on the TB wards and in the mental health hospital I felt very relieved indeed to be back in Putney Hospital: it felt like a real homecoming. It was also great to be back with my nurse pals, and we shared many a gruesome and hilarious story about our respective placements, after hours, hunched on my single bed, over the usual Woodbines and Merrydown. The laughter and the camaraderie were always wonderfully restorative and I realised how much I valued my friends and how much I’d missed them. In my third year I’d become a staff nurse, if I completed my exams successfully. I’d have a different hat to wrestle with making up first thing in the morning (I never really got any better at that), as well as a new royal blue belt with a silver buckle, and a little bow under my chin, all denoting my new status.
In my second year I felt I was definitely making progress in my chosen career. I was beginning to feel some pride in having survived, and succeeded, and actually stuck to my vocation. I knew, obviously, that I still had a long way to go, as there was always so much more to learn. And I wanted to be a really good nurse. However, I felt I had definitely shown my mother I was made of something stronger than she thought I was, and I always had her, and the likes of Sister Margaret, at the back of my mind as I washed out bedpans, cleared up vomit and so on. Sadly, my mother had virtually cut all contact with me, once I went to England, but my two closest sisters, Una and Betty, would write me letters about home, telling me all about the local shenanigans, and I would gobble up the news about my father, my brother, P-J (who had opened a pub, and went on to be the Mayor of Clonmel, twice), and about Clonmel itself. It was always great to hear about our neighbours and old friends, even the church, and sometimes I’d feel very tearful and nostalgic for home. My mother, however, kept a stoical silence as I think she still expected (and hoped) for me to fail. She never visited me in Putney during the first couple of years, or wrote to me to ask how I was doing, or what I was learning. And this did hurt me, deep down – I think it was meant to, of course. She showed her disapproval of my choice of career, country and life by continuing to cut me dead. ‘I’ll show you,’ I thought, defiantly, as I scrubbed a sink with carbolic. ‘Even if I am a bit of klutz sometimes, I’m determined I’ll get there. I’ll show you that I’ll get there in the end.’
As a trainee, I had seen many things now that had opened my eyes: the six months on the TB ward had been really taxing, and the mental health visit had really unnerved me. The whole six months had tested me emotionally as well as physically, and sometimes the TB wards had all seemed so utterly hopeless and desolate. All I could do for the poor patients was give out pills, check temperatures and pulses, comfort them and try to make them comfortable. And, of course, when they were finally gone and at peace, I would lay out their poor emaciated bodies for their final destination. All the time I had been thanking my lucky stars that Una, Betty and Joan had survived TB and I knew now, deep inside of me, what an utter miracle that had been. I vowed to be as good a nurse as I could be, to relieve suffering wherever at all I could, and to bring to the job all my firm resolve and good humour, as I hated to see people in distress, and with no hope. I realised that nursing was my vocation, my life, and I loved every minute, even when I messed things up. I had been on a huge learning curve since that first day, stepping off the plane at Northolt.
So, being back in Putney Hospital again felt like I was back somewhere hopeful, where I could do something positive and really make a difference. I knew there was more to nursing now than a bar of stinky carbolic or bottles of pongy Dettol, and endless scrubbing; there was an important job of applying as much TLC (tender loving care) as I could, and I vowed to do so at every opportunity. I had seen that there were definitely some nurses, staffs and sisters who became very cold-hearted and hard-bitten: they could be real tough bitches. There was no other word for it, really. I never wanted to be like that, if I could help it at all. Anyway, I was always too soft for my own good, but I thought I’d rather be a softie than be a tough old boot, who didn’t care a toss about patient welfare or quality of life. The patient came first – and that was my personal motto. And it has stayed with me, for my entire nursing life, which has spanned over 62 years, all told, in the NHS.
After my finals I would have to do a further probationary year in order to complete my training. This was compulsory. We had to stay on at Putney, and it was like a consolidation year. Only at the end of this were we allowed to be called SRNs, and wear our special belts and badges, denoting our professional status. I had come this far and I really wanted to complete the process. During my third year there were times, however, on the women’s wards, when I felt sorely stretched and when I felt I need
ed to challenge authority (which didn’t go down very well with the higher-ups). This was difficult to do, but after seeing the treatment of the poor African woman and her baby something had changed inside of me – I had definitely lost some of my wide-eyed innocence. I had also gained more confidence as I went on through my training.
There was one woman in her forties, called Marjorie Green, who had final-stage ovarian cancer. She was in a corner bed, near Sister’s desk, and she was in terrible pain. The only treatment was morphine, which was administered every four hours. When patients were very sick, or nearing death, they were positioned near to the nurses’ desk, so they could be visited frequently and monitored easily. Marjorie was in absolute agony, and would start wailing and groaning: ‘Is it time yet? Can I have another injection, nurse? Pleeeeeese.’ It would only be a couple of hours since her last injection, and morphine was not allowed to be given in less than four hours. But I would think, ‘The poor woman is dying. What does it matter? Surely it can’t hurt to give her any more, at this stage? Why can’t we relieve her pain, for goodness’ sake?’ I was appalled that she was left in so much agony. I thought, ‘We would put a dog or cat down if they were in that level of pain, then why not a human being?’ I went to Sister and asked if we could give her anything to help her. Sister looked at me coolly and said, ‘Nurse, you know full well it’s not four hours yet.’ ‘But, Sister, she’s in terrible pain. Can’t we give her anything at all?’ Sister just brushed me off coolly with, ‘You know the rules – just get on with it, nurse. You have plenty to do.’ I felt like hitting her, and once in the lavatory I had a good cry. I couldn’t bear to see such suffering. So I would go and sit next to her and hold her hand, and mop her brow with a cool cloth, or talk to her to try and distract her, or moisten her lips with some water on cotton wool. I wanted to comfort her in her suffering, poor thing. Sadly, I was eventually washing down Marjorie Green’s body, and laying her out, and thinking how terrible her last days had been, with so little respite, as she only lasted a couple more excruciating weeks after that. I cried the whole time, as I prepared her poor emaciated body, thinking how wrong it was that we could not relieve her pain any more effectively. I thought it was an awful way to go. It felt so terribly sad, especially as she was so young and attractive. I really thought, as I washed her thin limbs, that the medical profession could surely come up with something better to help people have less agonising ends to their lives. It seemed so undignified somehow. Pain and death seemed to diminish everyone; it took no prisoners. Luckily, during my lifetime in the NHS, changes have now happened, as modern drugs and new procedures give proper pain relief until the end. However, it was all fairly barbaric back in the early 1950s, and watching someone suffering a long, slow, painful death was a real life lesson for me. It made me even more determined to look on the bright side and to help people wherever I could – even if I was a bit clumsy about it sometimes.
When I had time on the children’s ward, it got even more challenging emotionally at times. The children’s ward was downstairs, and was a large, airy room with wooden floors and white walls, with a frieze of nursery rhymes round the top, with about fifteen beds. It had large bay windows at one end that looked out over the Common, and the mobile children would get up and peer out wistfully at the other children playing on the grass, or watch others free to play ball with their friends or families. I’d feel sorry for them, particularly because my own childhood had had so much wonderful freedom in it to roam around our large, leafy garden, in the fresh air with the apple and plum trees. I had been out playing all day, pushing my little pram, scrumping apples, collecting pop bottles, larking about, climbing trees, getting muddy, and then I’d look at these poor little mites, all bored, sick, lonely and sad, and see many of them only had a visit from a mum, dad or gran for an hour a day, if they were lucky. A lot didn’t even have visitors as travel to the hospital wasn’t that easy, and not many people had cars back then. Otherwise the poor children were seen and not heard in bed with absolutely nothing to do. In those days children had to be tucked flat in and quiet (‘Arms under the blankets, please’), and they might do a puzzle or read a book, but there was no TV, no radio, no internet or video games – nothing like that at all – and the rest of the time they were simply bored or suffering, lying there. So I would sit and read to them or tell them stories and sing little Irish songs and ditties to them, or simply amuse them by pulling silly faces. I’d do anything to raise a smile, basically.
I got particularly fond of a lovely little girl, Megan, with red ringlets, who was only three. She was such a sweetie, and she was so small and delicate that she was still in a cot. She had cancer, poor thing. She had a little ball of cotton wool that she would play with and talk to. I got her a little teddy and she would cuddle it to herself for comfort while I told her stories. When she was in pain, she would lie very quiet, and stare at the ceiling. I found it dreadful to watch her in so much agony. Or she would cry and groan incessantly, and it was a terrible sight to behold. When little Megan died, she was not even four yet. I remember picking up the little ball of cotton wool that had been her constant companion, and holding it to me, and not being able to stop crying myself. I could hear my father’s voice in my head saying, ‘There she goes again. Her bladder’s in her bloody eyeballs, crying over everything,’ but I felt crying over a dying child was actually appropriate. I did seem far softer than most of my friends, however, who seemed to take suffering, death and dying more in their stride.
Of course, there were also back-breaking, yet poignant, moments that went along with certain aspects of the job. On the women’s ward we had all these poor old girls with broken bones hung up on huge metal tractions which were constructed round their beds like scaffolding. They had broken hips and broken femurs, or fractured legs all swathed in heavy white plaster casts. Or there’d be broken pelvises hung up in slings, like the stork brought the new-born babies in. Some would have screws through their knees or hips, linked to straps and contraptions, keeping everything in place. Back then patients were kept fairly immobile for long periods as the risks of thrombosis was not really understood like it is today. So patients with fractures were strung up on traction, which was like metal scaffolding, and could be in hospital for weeks, even months. If they were on traction, say with a broken femur, we had to give them bedpans by heaving them up and on to them; it usually took two nurses, one each side, to do that. There were basic handle hoists then for patients to pull themselves up on, but it was the nurses’ backs that took the strain, and many went off with quite serious back injuries, pains and strains as a consequence. Quite often the bedpans would spill over, so we had to change all the sheets under them, with the patients still attached to their traction, and then bed-bath them all over again, so it was quite a palaver. You had to watch the older ones as they would often not tell you that their bed was wet, because they felt too embarrassed about it, or they might be so far gone that they did not even know themselves. They were also at risk of suffering from bedsores, also known as ‘pressure sores’. These were not simple things that we could ignore; bedsores could become infected, and if they went deep, over time they could actually kill a patient. So we had to make sure that the immobilised patients were treated properly, and every time they were on the bedpan, and had their bottom washed, or they had their daily blanket bath, we also had to treat them with surgical spirit, so that it would harden the skin on their bums. We also put surgical spirit on their elbows, heels and shoulders for the same reason. It took time and effort to do this for every patient, but it was preventative medicine, proper nursing care, as we knew they needed to stay well. All this had to be fitted into our busy day, and was seen to be an essential part of the job. Caring for the patient, making them comfortable, preventing sores and keeping them clean and hydrated, even putting flowers in a vase when relatives visited, was a real act of daily TLC. We didn’t just leave them in bed to fester; they had to be turned, or moved, or talked with to keep their spirits up, and
their beds always had to look spotless and clean, ready for Sister’s or Matron’s twice-daily, spit-spot inspections.