Yes Sister, No Sister

by Jennifer Craig

At six o’clock we go for supper. As the Sod said nothing about wearing uniform, all but Marie go in mufti.

  ‘Let’s go to the pictures,’ Sandy says. ‘It’s probably the last evening we’ll ever have off together. The Quiet Man is playing at the Odeon. I heard it’s really good.’

  ‘What’s it about?’

  ‘An American ex-boxer goes to Ireland where he was born. John Wayne’s in it and I love him. That chunky look – mmmmm!’

  We all go to the Odeon where the long evening of entertainment starts at 7pm. After ‘God Save the Queen’ there is a ‘B’ picture, news, a cartoon and then an interval, during which an organist plays on an organ that rises up out of the floor. We buy ice-creams from an usherette who walks round with a tray hanging from her neck displaying sweets, chocolate and choc ices. Then comes the main picture. We are all so engrossed, we completely forget the time and the fact that we need a late pass to be back after 10pm. It is after 11pm when we reach the Nurses’ Home. The three wings of it are almost in darkness with only one or two windows still with lights shining through.

  ‘What are we going to do now?’ someone asks. There is silence.

  ‘We can go round to the front door of the hospital and ask to be let in,’ Marie says, ‘Let’s just own up and take the consequences.’

  ‘Don’t be so daft! Get into a row on our first day here? Not likely! Let’s see if we can get in before we have to do that,’ Sheila says. A high wall surrounds the whole of the Nurses’ Home. We skirt round it but cannot find a gate or any way in.

  ‘Give me a leg up.’ This is Judith reaching up to the top of the wall. I bend down and cup my hands for her foot. She is astride the wall in a second.

  ‘What can you see?’

  ‘Not much. But if someone else comes up here we can both jump down and do a recce,’ Judith whispers.

  ‘How will you get back out again?’

  Suddenly a window above us opens and a head appears. We fall silent. Judith, still balanced on the top of the wall, freezes. She stands out like a sore thumb, silhouetted against the sky.

  ‘What are you doing?’ the head whispers.

  ‘Trying to get in,’ Judith replies. ‘We’re the new peaks and we haven’t got late passes.’

  ‘Can you all get over the wall?’ the silhouette asks. If you can, I will let down a rope ladder.’

  ‘I’ve just paid two and six for new nylons and I’m not ruining them by climbing a wall,’ someone says.

  ‘Take them off then.’

  ‘Good idea.’ We all lift our skirts to undo our suspenders just as a motor bike roars up the street. Its headlight reflects a group of young women with their shoes off, bending down to take off their stockings.

  ‘What’s this then, t’Folies Bergere?’ a male voice asks.

  ‘Nay, they think it’s the seaside and they’re goin’ paddling!’ His friend laughs.

  ‘Come on – give us a dance.’ He starts to sing, ‘Knees up Mother Brown, knees up Mother…’

  ‘Shhshhh – you’ll have us fired. Instead of making daft remarks make yourselves useful by giving us a hand up the wall,’ Sandy says to them.

  ‘Right you are luv, anything to oblige.’

  We are all hoisted up to the top of the wall, jump down the other side and end up in a privet hedge. We scramble through that to find the foot of the rope ladder. It is not easy to climb an unanchored rope ladder but we all manage somehow. As it is dark, we cannot see who our rescuer is but we thank her profusely.

  ‘Where are we?’ someone asks.

  ‘You’re on the second floor of the east wing. Where are your rooms?’

  ‘The second floor of the north wing,’ I reply.

  ‘Go out in twos and threes, turn left, then right, go up a short flight of stairs, through a double door and you’re there. And be quiet! The night sisters go to sick bay about now,’ our unknown friend says.

  We creep out in small groups and make our way back to our rooms without incident. We never did find out who our saviour was but Sheila goes to an outdoors shop on her next day off to buy a rope ladder that we all chip in for. She calls a meeting to discuss how to arrange for unexpected and emergency entry into the ‘Virgin’s Retreat’, as it is known.

  ‘Pam and I walked all round the Nurses’ Home in daylight. We found a place where you don’t have to climb the wall. There’s a low wall that used to have railings in it that I expect were taken out during the war. It’s on Curzon Street and it looks as if you are going into the building where the Lady Almoners are, but if you go round their building, you are in the grounds of the Nurses’ Home.’

  She draws a map on the back of an envelope. ‘There’s a hedge here,’ she says, pointing to her map, ‘but there’s a gap in it so you go through that and then you’re outside the north wing. We have to use a window on the west side or else we’re opposite where the sisters sleep. You all better find the way while it’s light. Now, we need to arrange how to get in when no one knows you’re out there. Any ideas?’

  ‘We can throw stones at a window.’

  ‘We can get the front hall porter to wake someone up,’ Marie suggests.

  ‘Don’t be silly.’ Judith is scornful.

  ‘Can we hide the ladder somewhere?’

  ‘Then how would we get it up to the second floor window, stupid?’

  ‘It isn’t going to work. The only way it will work is if we know we are going to be late and make sure someone is awake to let us in,’ Sheila says. ‘All the people on the west side will have to take it in turns, set an alarm to wake up at an arranged time, and let down the ladder.’

  ‘Why can’t we just let down the ladder before we go to bed and then it doesn’t matter what time we come in,’ I say.

  ‘Brilliant!’ Sheila says. ‘That’s it. If you know you’re going to be late, you have to arrange with someone on the west side to let the ladder down before they go to bed, after it’s dark. Then you climb in, pull up the ladder and hide it in your room until the next time.’

  ‘What if more than one person is going to be late?’

  ‘Then you’ll have to leave the ladder until the last person is in. You’ll just have to arrange that with each other. There’s nothing we can do if you are locked out in an emergency – we were just lucky to find that person awake.’

  Having made these elaborate arrangements, we never use them, as at that time we have no idea how exhausted we are going to be after a day on the wards when a bath and bed are the only things we want.

  Chapter 7

  Urine Testing

  • Note the colour and appearance.

  • Dip litmus paper into specimen to see whether it is acid or alkaline. It must be acid for further tests. Measure the specific gravity. The result should be 1008. Dilute if necessary.

  • Test for blood. Put 4cc of urine into a test tube. Add 3–4 drops of Tincture of Guaiacum, shake the tube and then pour in about half an inch of ozonic ether. If blood is present, a blue ring appears at the junction of the two fluids.

  • Test for sugar. Light a Bunsen burner, pour 5cc of Benedict’s Solution into a test tube, add 10 drops of urine with a dropper and boil the result. Urine with no sugar does not change colour when boiling, but the presence of sugar makes it change from blue to green to yellow to red, depending on the amount of sugar.

  • Test for albumin. Boil a test tube three parts full of urine, and add a few drops of acetic acid. A cloudy result means that albumin is present.

  I REPORT ON DUTY at 7.30am to begin my probationary period on Sister Curtis’s ward. The most senior of the student nurses organises us to make beds or to get ready for breakfast or to test urines. I am relieved to see that Watkins is still there and she is instructed to show me how to test urine.

  We are in the freezing sluice room for this task. A row of glass containers, which look like long drink glasses, hold yellow liquid with an almost enticing resemblance to cider. Bunsen burners, a crate of test tubes and bottles of testing solution lie on
a workbench. Watkins produces matches from her pocket. ‘You can never find any matches around here, so I bring my own,’ she says as she lights the Bunsen burners. ‘You do all the tests for albumin and I’ll do the sugars.’

  She looks behind her as if a sister might pop out from behind the bedpans before saying, ‘You’re not supposed to do this but I take a sample from each urine and then test the whole lot for sugar. If there’s none, that’s OK. If there is sugar I have to test them one at a time to find out whose it is. I make a game of it. Guess the patient. Sometimes I’m right first time.’

  ‘Can I do the same thing with the albumins?’ I ask as I wave a test tube in and out of the burner flame.

  ‘No. Doesn’t work because you need a nearly full test tube of urine. It works for sugar because you only need a few drops.’

  ‘This is going to take ages,’ I say as finally my first sample boils and I add acetic acid.

  ‘Yes, it’s a heckuva job to get this done by eight,’ Watkins says, ‘and usually I’m still stuck in the sluice room during prayers.’

  Promptly at 8am Sister Curtis and the permanent staff nurses (perms) enter the ward. We all gather round the central table.

  ‘Good morning, nurses,’ says Sister. ‘Let us pray.’

  We kneel while Sister reads out a prayer. Then we say the Lord’s Prayer in unison and many patients do the same.

  Sister and the perms receive the report from the night charge nurse while we serve breakfast. Then comes a bottle round, followed by the first of several rounds of ‘lockers’. The job of lockers involves setting a trolley with a basin of carbolic (a disinfectant), a cloth, a small pail for rubbish and a large jug of fresh water. Each locker top is wiped with carbolic, which means manoevering around bottles of Lucozade, glasses of water and get well cards. Sweet papers, old newspapers and other rubbish are removed, ashtrays emptied and wiped. Finally the drinking glasses are topped up with water. Our visit is an opportunity for patients to ask us to do small things such as find something in their locker or take a letter to put in the post.

  Half of us go to first coffee while the other half begins the morning tasks. Sister has made out a work list. I am down to do ‘beds and backs’ with a third year nurse called Tomson. Two others are also doing beds and backs, one is doing treatments and a staff nurse is giving out medicines.

  Tomson sets a trolley with piles of clean linen, a basin, a jug of warm water, soap, small towels, methylated spirits and talcum powder. We are to do one side of the ward while the other pair does the other. Some of the patients have been designated to get a bedbath.

  ‘We’ll start with those who have to be turned every two hours,’ says Tomson, wheeling the trolley to one of the beds. ‘What’s your off duty?’

  ‘I don’t know,’ I answer.

  ‘You don’t know!’ She looks incredulous. ‘Don’t you know where the book is?’ I shake my head. ‘The most important book on the ward and you don’t know where it is! Here, I’ll show you.’

  We go to Sister’s desk. She takes a hard-covered exercise book from a drawer, opens it at the current week and shows me a hand-drawn calendar with the names of all the nurses down one side. My name is at the bottom of the list.

  ‘You’re a two-five today and tomorrow, then you have your half-day and day off, then a five-to, then a ten-one, then a two-five.’

  I hardly know what she is talking about and say so.

  ‘A two-five means you go to second dinner at 1.30 and come back at five. A half-day, you go to second dinner and then you’re off.’ She pauses to say ‘Just a minute, Mr Forbes,’ to a patient who has called her.

  ‘A five-to means you go to first dinner and work until five, and a ten-one means you go to second coffee and come back on at one having had dinner. That’s the worst because you still have to get up in the morning and you only work two hours before being off. Sister Curtis is pretty good about off duty. If you want a particular evening or day off, you write it here,’ she says pointing to a page. ‘You have to keep checking the book and remember when you are off as no one will tell you.’

  We go back to the trolley and start beds and backs. Each patient has his sacrum, heels and elbows washed with soap and water, then rubbed with methylated spirits to harden the skin, and finally dusted with talcum powder. Each time I open the bottle of meths, the fumes settle in my throat and make me choke and the smell seems to linger long after the bottle is closed.

  Some patients wash themselves, some sit in an easy chair for an hour or two and some we bedbath. I like bed bathing patients. There is an intimacy about the procedure that leads to confidences that we otherwise would not hear. Instead of the patient in bed six, he becomes Albert Jones who takes his grandsons fishing in the canal and breeds racing pigeons.

  Bedbaths are an opportunity to examine patients. Tomson shows me how to test for pitting oedema. ‘You press the skin over the ankle like this, not too hard, hold it for a few seconds and then release your finger. If a dent remains, that’s pitting oedema and you need to tell Sister.’

  The mouths of helpless patients are cleaned with glycerine and lemon after we remove their dentures. I have never had to deal with false teeth before and holding slimy plates and brushing congealed food from between teeth is revolting. I keep thinking of my grandfather’s ill-fitting teeth, which clicked as he ate so every meal was accompanied by a sound like castanets.

  We come to one bed where the patient is lying in what looks like a cowpat but without the sweet odour of hay. The sight and smell are appalling. I want to pull the bedclothes back over him and walk away. Tomson appears unmoved but I can feel my stomach heaving. ‘I want to be sick,’ I whisper to her.

  ‘Nurse Ross, would you go and get me some more tow (a type of cotton wool), and fill this jug with hot water,’ she says, glaring at me. She hands me an enamel jug.

  I leave with relief and go to the sluice room. For once I am glad that it has only mesh-covered windows as I take big gulps of fresh air. I do not want to go back. If I wait long enough Tomson will have cleaned up the horrible mess. Then I feel guilty. ‘Pull yourself together,’ I say to myself and go back. I will never become a nurse if I can’t learn to control the repulsion I was taught as a child about bowel movements.

  When we have finished and the old man is looking clean and comfortable, Tomson says, ‘You’ll soon get used to it. The important thing is to keep your respect for the patient. They can’t help it and would be just as revolted if they knew.’

  ‘Never talk to each other over patients,’ is another instruction from Tomson. ‘It’s rude for one thing, but don’t assume they can’t hear even when they seem unconscious. So if you’re turning an unconscious patient, tell him what you are doing and also tell him what day it is, what the weather is like – that sort of thing.’

  Noon is time for the patients’ dinner. The big, heated trolley is wheeled into the middle of the ward and plugged into a floor plug. Sister and the perm put on their cuffs to serve each meal, as we stand with trays ready to deliver them. Sister seems to know how much each patient can eat and what sort of diet is required. Helpless patients, who need to be fed, are served last. Then we go round with a trolley to collect and stack the dirty plates and cutlery. While half the nurses go for their own dinner, the other half do a bottle round, followed by yet another round of wiping lockers.

  The evening routine is much the same. As the most junior nurse I get the supper dishes ready, wipe lockers, serve suppers, feed helpless patients, do a bottle round and help turn the patients who have to be turned every two hours. During visiting hour, which is actually half an hour, I wash rubber draw sheets with carbolic and clean the sluice room. When the night staff comes on at nine o’clock, we can go off duty if our tasks are completed.

  Judith, Jess, Blinks, Sandy and I meet in Sandy’s room to compare notes but we are all so tired, no one says much. We go to bed as soon as we’ve finished our cocoa. No one has done anything that I have not and it sounds as if the routines
on every ward are the same.

  The days that follow are much like the first, though one day Sister Curtis stops me while I am wiping a locker to ask if I have given an intramuscular injection yet. I tell her I haven’t.

  ‘Well, I have just the patient for your first injection. He is very, very fat and won’t feel a thing!’

  We go into the sterilising room to take a glass syringe and some needles out of the small steriliser with forceps and put them into a sterile kidney basin. At the worktable, Sister hands me a glass bottle, about two inches tall, filled with thick white fluid and with a rubber stopper in the cap.

  ‘This is penicillin,’ Sister says. ‘You can see how thick it is, so what size needle will you need?’ I point to a two-inch needle with a wide bore.

  ‘That is the right size of bore but as he is so large, I think a three-inch will be better. Now show me how you will draw up 2cc of penicillin.’

  I put the syringe together being careful not to handle the inside part of the plunger, and attach the needle to the outer part. Then I wipe the top of the phial with a cotton ball moistened with alcohol, insert the needle into the rubber stopper, hold the bottle upside-down, withdraw 2cc of the white fluid and push out air with the plunger. I lay the syringe in the kidney basin with the needle resting on an alcohol swab.

  ‘Now, before we approach the patient, what are you going to do?’ Sister asks in her usual gentle way.

  ‘I’m going to tell him it is time for him to have his penicillin, draw the curtains, and ask him to roll over and pull down his pyjama bottoms. Then I will swab his skin with an alcohol swab and holding the syringe perpendicular to his skin, I will, I will…’ I indicate the motion rather than try to explain it.

  ‘Very good. But what part of him will you inject?’

  ‘The upper, outer quadrant of his buttock.’

  ‘Why that part?’

  ‘Because the sciatic nerve runs down through the inner part of the buttock and you can damage it if you hit it with a needle.’

  ‘Yes, come on then. I think you know what you’re doing. Don’t tell him you have never done it before. Just go to the bed with as much confidence as you can.’