by Pam Weaver
During the time I worked in the nursery, the Sister left to get married. The council had thought they would fill her post quite quickly but by the time she had worked out her notice there was still no sign of a replacement. Miss Armstrong carried on for a couple of weeks without a full day off but by then it was becoming imperative that someone take her place. Although we all sent her away during the day to give her a few hours’ break, she was becoming very tired. That was when the council approached me and asked me if I would like to apply for the job. I much preferred the ‘hands-on’ life with the children because a more senior post would simply drive me into the office with a load of paperwork. On top of that, there were endless meetings at County Hall or with the child care officers and I just wasn’t prepared to do that. I did, however, agree to be ‘acting-Sister-in-charge’ so that Miss Armstrong could have her days off away from the nursery. The children’s officer was delighted and promised that the council would swell my wage packet for the duration.
‘It’s so much better than employing an agency nurse who doesn’t know the running of the nursery or the children,’ she said shaking my hand vigorously. ‘This way, we keep things as near to normal as possible.’
I had expected the arrangement to last a couple of weeks but in the event, I was acting-Sister for three months – less four days. Remember the four days: they are important.
My worst fears about the job were realised. It was endless office work, telephone calls and visits from authority figures. I did all right, and everyone was pleased with how it was going but mine was the loudest cheer when the new Sister arrived.
At the end of the three months (less four days), I was called into the office. The child officer thanked me for my help and shook my hand warmly but behind her back, I could see that Miss Armstrong was looking very pink and annoyed.
‘The council have agreed to give you three pounds a week as an ex-gratia payment for taking the responsibility while Miss Armstrong had a day off,’ she beamed.
I frowned. ‘But I thought as acting-Sister, I would be paid as such,’ I said. Judging by her furious nod, Miss Armstrong obviously thought the same.
‘Had you done it for the full three months,’ smiled the Child Officer, ‘the council would have agreed to that. But as it is, you didn’t complete the three months so I think this suits us well.’
‘I did three months less four days,’ I snapped.
‘Quite so,’ she agreed and that was that. I was furious, but what could I do? They had saved themselves an agency wage and got my services on the cheap. My only consolation was that Miss Armstrong had managed to have her allotted days off while I was covering for her.
After three happy years, I was saying my goodbyes again. The truth of the matter was that I became bored with doing the same thing for too long so I decided to do a one-year course in a premature baby unit in Birmingham to gain an accredited certificate. I left the nursery to take a temporary nanny’s post in Worthing. It was only for a month during the school holidays but it was very well paid. My charge was a little girl called Fleur. She had been born to her parents late in life and she already had two much older siblings, Addison and Gabriella. I didn’t see much of the two older girls so mostly it was Fleur and me. The family had a dog, Snoopy, which was rather overweight so whenever I took the baby out in the pram, I took the dog as well. We lived right along the seafront and I loved it. On my second day, I was walking along the path overlooking the sea when the pram canopy fell from the screw mooring it to the pram and it frightened Fleur. I put it back and comforted her but when I looked around for the dog, she was nowhere to be seen. Snoopy was a Golden Labrador and looking up, I saw her way off in the distance. Shouting her name, Fleur and I raced along the sea-front to catch her up. The baby thought running with the pram was great fun and laughed uproariously as we bounced along. Eventually, I reached the dog, who was still taking no notice at all of my frantic cries.
I grabbed her collar. ‘You bad dog,’ I scolded. ‘What were you doing?’
It was only then that I realised that ‘she’ had a brown collar instead of the red one she’d set out with and that ‘she’ was a boy! The owner looked rather startled. I apologised profusely and set off again to look for Snoopy. By the time I got back home for Fleur’s feed, I was almost in tears. Only my second day and I’d lost the family dog. I was bound to be asked to leave. Ah well, it was fun while it lasted.
As I turned into the driveway, who should be sitting on the doorstep but Snoopy. When I told my employer what had happened, she teased the dog mercilessly.
‘What did you do to Pamela?’ she would ask the poor dog. ‘What?’
As soon as she said it, Snoopy would go to the mat in the kitchen and sit there with her top lip curled in embarrassment and her head hung in shame.
They were a lovely family and I was tempted when they offered me a more permanent job, but the hospital where I had enrolled to do the course was reputed to be the best in its field and I was lucky to secure the position. My greatest love had always been looking after babies and I thought it would be a good idea to gain more skills. I also had a restless spirit – I liked a place for a while but I never wanted to become too comfortable. I was never brave enough to travel far from home, but if I had been young today, I probably would have gone abroad. As it turned out, I was going a little further up country because my next post was in a totally different area. In September 1971, I moved to Birmingham.
Chapter 19
Birmingham was a bit of a culture shock. It was big, busy and hot. The summer was glorious by the seaside but of course in a city, it feels close and humid. At that time, Birmingham, in the West Midlands, had the highest population in the country outside London. It had been a market town but it had swelled considerably during the eighteenth century as the Industrial Revolution gathered pace. The city suffered heavy bombing during World War Two but by the 1950s/60s it was already undergoing massive reconstruction. The most famous of these buildings was the Bullring and New Street Station. They were hailed as new and modern but quickly deteriorated and in later years they gained the reputation of being hideous concrete monstrosities. The city had also had a huge influx of people from the Commonwealth, which meant that its population was mixed and diverse. In the 1970s Birmingham was the most prosperous provincial city in Britain.
The hospital where I was to get my training had been a maternity unit since 1929. The only purpose-built buildings had been set up as an experimental premature baby unit in 1933 and the pioneering doctor who had started the work, Dr Mary Crosse, who lived from 1900 to the early Seventies, was awarded an OBE in 1948. She actually died of cancer in the hospital the year I was there. Although the place was a maternity hospital, the management committee gave Mary a room in one of the nurse’s homes, where she could spend the last few days of her life in peace, out of respect for the woman who had begun the work. The rest of the hospital and the staff quarters were housed in several Victorian houses set along two streets. In its heyday, the hospital had up to two thousand five hundred births every year and its eighty beds were in constant use. The hospital was also known for its successful human milk bank, where nursing mothers could donate their breast milk for the use of others. When I was there, the hospital was in one of the most seriously overcrowded immigrant areas in the country so the vast majority of the babies we looked after came from totally different cultures.
My room was at the top of a house, one of several houses where the nurses lived. I shared with another girl who had the same surname as me, although we were not related. She was a Geordie and at first I found it hard to catch what she was saying with her strong accent. I think she may have had the same problem with my Southern accent but we got on well and we also got on well with the other girls in our ‘set’. She and I would often host them in our room and give them a jacket potato and tea and cake in the evening. We would listen to music or sing songs together and generally while away a pleasant evening.
My enthusias
m for life was a little less happy when it came to being in the unit. To be perfectly frank, I hated the place from the moment I stepped over the threshold. I don’t really understand why. Doing the course was everything I’d wanted, but perhaps I had been trying to recapture the atmosphere of my previous premature baby unit and it was nothing like that place. Perhaps it was because I had come from a situation where I had been in charge of responsibilities and now I had to go back to being a student and behaving like one. Coupled with that, I annoyed Sister Booker, a large Scottish woman who ruled the place with an iron rod, on my first day. She was pushing a trolley of water bottles through a swing door when one door swung back and bashed the trolley. A bottle fell to the floor and smashed and in my first day nerves, I giggled. I went to help her and cleared up the mess but I could tell by the sour expression on her face that she wasn’t a happy bunny. Once again the old mantra, ‘we do things this way because we’ve always done it this way’ was prevalent. I quickly learned not to question anything but it frustrated me beyond words, especially if I could see a thing would work a lot better by adopting another method.
We ate our meals in the main hospital and the staff coffee room was there too, but we spent all our on duty times in the actual premature baby unit itself. There was a large open nursery downstairs on the other side of a set of double doors, and the milk kitchen, which was only used for the storage of the feeds, was next to it. The rest of the unit was made up of small rooms, where the stronger babies were cared for. There was an upstairs, which consisted of more small rooms and a couple of rooms kept for the mothers of babies who were almost ready to go home. We also had a larger area, which was used as a clinic for babies returning for check-ups and accessed from the outside via by a fire escape.
As a student, I had classes when I would take notes and be taught about the care of premature babies. We had a strict dress code: we wore white dresses and a nurse’s cap with a red band on it and were supposed to have a clean dress on every day. Whenever we nursed the babies we had to wear a white gown over our clothes. They were usually hung on a coat hanger on the back of the door and changed every day. Our hair was supposed to be short or tied back, and our nails had to be short too. Nail varnish, lipstick and other make-up was strictly forbidden. Every time we handled a baby we had to wash our hands. The washing, nappies and baby gowns were put into a pedal bin so that we didn’t have to touch the lids. We also had to adhere to a ‘dirty side’ and a ‘clean side’ when working beside the baby’s incubator. This meant that you fed the baby from one side of the incubator and changed his nappy using the other side. The floors had to be cleaned every day with a damp mop, as did the window ledges, sinks and door handles. This was done by an in-house cleaner. The cots and baby scales were washed every day as well, which was our responsibility. We took special care when cleaning the incubators. It was no bad thing because there was little or no cross infection, probably because the regime was so strict.
Babies’ bottles were sterilised with Milton solution (one part Milton to eighty parts water) and as in the previous nursery, everything had to be completely submerged for at least two hours before it could be used again. All the new mums had to attend a film given by the Milton people before they went home to make sure they fully understood how to use the product. Mrs Hyams could have done with seeing that!
The feeds were made up to order in a central milk kitchen and everything was autoclaved (a method of sterilisation by steam) and kept individually wrapped. It was sent to the wards to be kept in the clean milk kitchen until needed. Dirty milk bottles were washed in a separate area. They were thoroughly soaped using a bottle brush and then sent back to the central kitchen to be autoclaved before use.
We were taught how to properly wash the babies, taking care to clean the eyes, the armpits, the groin and buttocks, and the hands, which might be clenched, with water and a swab. This had to be done every day. The umbilicus was cleaned with a Hibitane and spirit mixture and then powdered with Ster-Zac powder each time the nappy was changed. It was important to keep it dry because moisture would encourage infection. Babies weren’t given a bath until the cord had completely separated. The babies were bathed in Infacare solution, the only bar soap in the whole nursery being the one used by the nursing staff. These stringent and careful measures were maintained to give the babies a better chance of survival and put them at less risk of infection.
Sometimes the mothers did some things which seemed very odd to us. One baby had something Sellotaped to his forehead. My friend went into his room to check on him and was so alarmed, she got the Sister. It turned out to be the dried-up umbilical cord, which his mother had taped to his forehead to ward off evil spirits! With the utmost tact, Sister explained that in our nursery that wouldn’t be needed and the mother duly took it off.
If we had a very sick baby, we were used to the vicar or minister coming to baptise the child or say prayers by the incubator but now I had to get used to people from other faiths in the nursery. The Muslim cleric would come to whisper words from the Koran in the baby’s ear and we had to tread carefully for fear of offending them. As ever, it was important to lessen the risk of infection so we had to limit the number of people coming into the nursery. Also, we had to devise a way of allowing the cleric to get close enough to the baby to whisper those all-important words without them feeling that he had been singled out for special treatment. Some of them were offended by a woman, i.e. Sister Booker, telling them what to do. It was a delicate balancing act.
One of the first procedures I was taught was how to use the dextrostix, a small flat spill with one end impregnated with chemicals. I had to prick the baby’s heel with a sterile prick and then smear some blood onto the dextrostix. After waiting a full minute I would wash the excess blood away with some sterile water and compare the changes in colour on the strip with the colours on the side of the jar. Matching the colours was only a rough guide but it told us if the baby had hypoglycaemia, which is low blood sugar. We also had to look for other symptoms like being slow to feed, or having cyanotic attacks (going blue) or if the baby made jittery movements. Even observing a ‘concerned’ look on the baby’s face made us step up our observations on the child.
Although we never made them up unless we were on milk kitchen duties, I learned how to calculate what feeds to give a baby. For instance, if a baby weighed two thousand, seven hundred and fifty grams and was four days old, I calculated that he needed one hundred millilitres of milk for every one thousand grams of body weight, which meant the baby would have a total of two hundred and seventy-five millilitres a day. That would work out that each feed would be fifty-five millilitres if the baby was on five feeds a day. Considering I was rubbish at maths in school, it taxed my brain a bit but I got there in the end.
We not only looked after the babies but we had to know how to instruct the mothers so that they were competent when their babies went home. We all took great pains to help them feel happy and know that they were able to cope once they were ‘on their own’, although in actual fact they weren’t really alone. There was always a back-up team ready to help them in the GP’s surgery or the Baby Clinic and the mums knew that if they were desperate, they could always ring the hospital even after they’d gone home. Instructing the mums on the care of their babies and how to make up the feeds and change the Milton solution was built into our everyday routine. They took home written instructions in case they forgot something but increasingly we were getting mums who couldn’t speak any English at all. This meant that the hospital had to employ interpreters to help us.
All our premature babies were given folic acid and Abidec drops at fourteen days old and Coliron from twenty-eight days. Abidec was a vitamin A, B and D mixture and folic acid was iron, as was Coliron. These prevented the baby from becoming anaemic. They were put into the baby’s feeds and the mums would be given a prescription to take to the chemist. The mums would also be advised not to let the baby get too hot or too cold. Because their babies were
so tiny, there was a temptation to overdress them, ‘in case they got cold.’ Keeping the room temperature at about 68°F (20°C) was best but clothing should be loose enough to allow free movement. Everybody advocated putting babies outside in the fresh air and in fact if we had a baby who was very small at birth and had been in the nursery for some time, provided that baby was progressing well, the hospital had a couple of coach-built prams and we would put the baby outside the unit in the warm sunshine. The babies in the other premature baby unit had been fed on Carnation milk to bulk up their weight very quickly but here, these babies were fed on Ostermilk 1.
Having given what must have seemed like a long and daunting list of dos and don’ts, the last thing Sister told the mums as they left was, ‘Give your baby lots and lots of love.’
The duty roster was a lot like it had been in my previous premature baby unit. I spent a lot of my spare time with the other girls in my ‘set’ and we used to go out en masse for meals. We loved dressing up in our glad rags and finding some pub where the meals were wholesome and not too expensive. The hospital was in a tree-lined residential area so we had to travel into ‘Brum’ (as the locals called it) for the pictures or a dance. On days off, we would get together and go to Warwick Castle or Coventry for the day. Even a walk along the canal was lovely, and yet all I wanted was to leave. Far from enjoying my time on the ward, I felt trapped. The routine was much the same as it had previously been but the atmosphere wasn’t nearly as nice. I wasn’t very keen on city life either. Although there were some beautiful places around Birmingham, being somewhere else began to dominate my thoughts. It’s hard to explain why. I suppose I was confused about what I wanted to do but one thing was for sure: I didn’t want to stay in the unit.