Yes Sister, No Sister

by Jennifer Craig

  The Dragon sends for me a few days later to sign my report. All the ticks are in the Poor column. The overall assessment is Poor. She has written, ‘Nurse Ross has no promise as a nurse. She is surly and unwilling to accept direction. She has no team spirit and is reluctant to help other nurses or to take on additional work.’

  I take the piece of paper and where it calls for my signature I write, ‘Over.’ On the back of the page I write, ‘This report is as unjust as my treatment on this ward was. This Sister is a despot and is not suited to be in charge of either patients or student nurses.’ In the background I can hear her asking me what I think I am doing. I sign beneath my writing, pick up the report and prepare to go to Matron’s office with it. I am not going to leave it with the Dragon as she can easily re-write it and leave off what I have written.

  ‘Where do you think you are going with that?’ she screams.

  ‘To Matron’s office.’

  ‘How dare you, give it to me, come back at once.’ I can hear her shouting as I triumphantly march out of her ward.

  I expect a call to see Matron but it doesn’t come and I forget about it. I don’t know what happened to the report or whether Matron saw the Dragon rather than me. All I know is that I am not going to put up with that sort of treatment again. Nor will I be like that when I am a sister.

  Chapter 12

  The following articles would be prepared on a tray for a medical fomentation:

  • Chest blanket

  • Jug of boiling water

  • Fomentation wringer

  • Large bowl

  • Bandages

  • Safety pins

  • A square of flannel cut to the appropriate size

  • A square of oiled paper slightly larger than the flannel

  • A square of brown wool larger than the oiled paper

  • Cover for the tray

  The patient’s bed is screened and he is told what is going to happen. The part is exposed and the patient kept warm with the chest blanket. The nurse then fetches her prepared tray and the jug of boiling water. The square of flannel is wrapped in the fomentation wringer and placed in the bowl with the ends of the fomentation wringer hanging outside the bowl. The boiling water is then poured into the bowl. The fomentation wringer is wrung tightly to squeeze out as much water as possible. It is opened and the hot square of flannel placed on the part. Before putting it on the patient it should be tested on the back of the hand or the patient may be burned. The oiled paper is then placed over the flannel, the brown wool over the oiled paper and the whole lot is firmly bandaged on. If the fomentation is not prepared at the bedside, it should be taken to the patient between two heated plates.

  ‘I FEEL AS IF we should put up a memorial plaque,’ Judith says as she looks around the classroom on the first day of a block of classes. ‘We can list all those who fell while answering the call of duty.’

  ‘No. It should be a monument to those with enough savvy to leave,’ I say.

  Of the 33 who started, 17 remain. Although some of those at the starting gate were not cut out to be nurses, some have left as the direct result of the actions of sisters. Jean Smith, for example, should never have been sent to a mortuary in the middle of the night when she had only been in the hospital for three months. Barbara Young left in the first two weeks. She had been found sitting in the kitchen by the Sister, who asked her why she was sitting down and why she was not on the ward. Barbara said her feet ached. She received such a hail of invective that she got up and walked out. Neither of these two girls handed in their notice but simply packed and departed. Others had gone to Matron’s office, as I had done, but where I had been persuaded to stay, the others had not.

  The education, for which we labour 58 hours a week, consists of three months in Preliminary Training School and six weeks in each of the three years. These six-week periods, known as ‘blocks’, are held in that part of the Nurses’ Home which houses classrooms, practical rooms and a library. Classes run from 9.30am to 4.30pm, but so that we will not think that a day’s work is for seven hours, we go on the wards from 7.30am to 9am and from 5pm to 6pm every weekday and on Saturday mornings.

  We look forward to our first block as a relief from what is becoming a relentless routine of menial tasks and also because we have weekends off. It is a time when we will be all together again for a change. We rarely see each other even though our rooms are in the same corridor. By the time we have come off duty, often late, walked over to the Nurses’ Home and had a bath, we have no energy left to do anything but flop into bed.

  The senior Sister Tutor, Agatha Japp, walks in. We all stand. So does she. From the front of the class she gazes at each one of us but as she is smiling, we do not feel intimidated, merely puzzled. It is a warm smile, which exposes extraordinarily large front teeth with a gap between them. In her bonnet, with strings tied beneath her chin, she reminds me of Jemima Puddleduck.

  ‘Please sit down,’ she says. We sit. She continues to gaze at us and I realise that her classes will be held at a much slower pace than our usual rushed routine.

  ‘Who is Jennifer Ross?’ she asks. I stand. I can feel my face redden. What on earth have I done?

  ‘Are you related to Wendy Ross?’

  ‘Yes, Sister, she’s my aunt.’ My father’s youngest sister had trained at LGI just in time to be propelled into the war.

  ‘And are you going to be as good a nurse as she was?’

  Inwardly I curse Wendy as I say, ‘I hope so, Sister.’

  Her gaze continues but finally she says, ‘Good. Please sit down.’ She then outlines our timetable, which, except for the absence of field trips and cookery, is much the same as in PTS with one major exception. Medical staff give many of the lectures. As they take pride in being asked to lecture us, they also take the trouble to prepare well and, generally speaking, we find their lectures enjoyable and informative.

  When surgeons are introduced to us, we are told to always address them as ‘Mister’ if they are Fellows of the Royal College of Surgeons, not as ‘Doctor’. To become an FRCS is an arduous business; recognition of this feat with the title of ‘Mister’ acknowledges that the noble art of surgery began in barber’s shops.

  AJ, as Sister Japp is known, gives us lectures on nursing and materia medica. With another Sister Tutor, she also teaches us in the practical room. She seems to have been nursing for a very long time and we are convinced she served in the Boer War. In fact, she is one of those people of indeterminate age, but she is probably in her late forties.

  She is short and round and her belt holds up her enormous breasts. When she laughs, which she does frequently, her bosom wobbles like ambulatory custard. Her laughter turns into rasping wheezes and coughs as she gasps for breath. At the same time, her face gradually turns blue and her eyes water. Fascinated by this display, I diagnose her as a case of emphysema and chronic bronchitis, forgetting that she would hardly be working if she had such serious conditions.

  ‘Nursing is the art of making a sick person comfortable in bed,’ she pronounces. Although she trained at a big London hospital she is always telling us that we are the best nurses in the world and how proud she is of all the LGI nurses who work in many different countries. She owns a pair of glasses that fold at the nosepiece. Her habit of standing in front of us folding and unfolding them has a mesmerising effect on us all, as instead of listening to her, we sit wondering which way the glasses will unfold next. She tries to instill in us a sense of dignity but as most of us are 19, it is an uphill task. ‘You must always behave in a seemly manner and not let your profession down. Remember, it is a privilege to be a nurse.’ This phrase becomes part of our vocabulary. When someone tells us about being puked on, for example, we say, ‘Remember it is a privilege to be a nurse! Ha ha.’

  It is during first block that we begin to worry about Blinks. The dilemma presented to us in PTS about a colleague who smells faces us in the form of Blinks. Whereas we routinely have a bath after coming off duty
, Blinks goes straight to bed. She tells us she prefers to bathe when she gets up but we soon find out that she does not bathe at all. Judith, Sandy, Jess and I take it in turns to run a bath for her and then tell her it is ready. In her usual good-natured way, she thanks us and ambles off to the bathroom.

  One day, I run a bath for her and she dutifully goes to the bathroom. In a couple of minutes she is back saying someone else is in there. It is Marie.

  I knock on the door. ‘Marie, this bath was for Blinks.’

  ‘Well, no one was in it when I came so as far as I’m concerned, the bathroom was unoccupied.’

  ‘That’s not fair, Marie, Blinks was only going to be a minute.’

  ‘What are you doing running a bath for her anyway? Why can’t she run her own bath?’

  I don’t answer. Another bathroom becomes free and I run a bath for Blinks there.

  The days speed by. In the practical room we learn how to apply leeches. Judith is astonished and says so. AJ accepts her comment philosophically. ‘Application of leeches is still a requirement of the General Nursing Council and although it might, as you say, seem archaic, leeches are still used in the treatment of glaucoma – with good effect, I might add.’

  AJ takes a small piece of flannel and cuts a tiny hole in the middle of it. ‘You place the flannel on the patient with the hole over where you want the leech to suck, like this.’ She rolls up her sleeve and places the flannel on her arm.

  Three horrible, purple, worm-like creatures live in a stone jar partially filled with water. One of them has slimed its way to near the lid. AJ extracts it with a pair of forceps and places it on the flannel on her arm. There is a general ‘Urrgh,’ from us all as we stare in horror. The leech finds the small hole immediately and we watch it swell until it finally starts to move. At this moment, AJ picks it up again and replaces it in the jar.

  She looks at our faces, all registering varying degrees of disgust. ‘Really nurses, there is nothing to be so squeamish about! People in jungles all over the world get leeches on them all the time even though they aren’t the same type as these. You don’t feel anything.’

  I walk into Blinks’s room after supper one evening to find her looking like a Mad Woman in a gothic movie. She has not been brushing her hair, but as her cap usually hides the tangled thatch, we have not noticed it before.

  ‘Blinks,’ I say, ‘let me brush your hair for you. It looks awful.’ Blinks grins at me and sits down to allow me to attack the tangle.

  ‘Blinks, are you feeling alright?’ I ask.

  ‘Yes, of course I am. Why? Don’t I look alright?’

  ‘Yes, you look fine but you seem to be forgetting things lately.’

  ‘Do you wonder? This place is enough to make anyone lose their mind!’

  In addition to making sure she has a bath we take it in turns to do her hair and we check that she has her glasses and textbooks with her before we go to class.

  We learn to set trays and trolleys for more advanced procedures such as catheterisations, tepid sponging and medical and surgical fomentations. Fomentations are the application of heat to reduce swelling; a surgical one is sterile, used when the skin is broken, and a medical one is not. We also learn how to pass a Ryle’s tube. This long, thin, rubber tube is pushed up a patient’s nostril and down into the stomach to obtain specimens of stomach contents, to give feeds, or as preparation for gastric surgery.

  ‘This is an unpleasant procedure for the patient,’ AJ says, ‘so you must learn to do it gently. First you must ensure the tube is patent, that is, not blocked. You can see that there are three holes at the bottom of the tube and they can easily become blocked.’ She passes a tube around for our inspection.

  ‘These are the things you need.’ AJ indicates a tray on which sits a kidney dish, a bowl, lubricant, a syringe, litmus paper and various cotton wool balls. ‘First you tell the patient what you are going to do, of course. It is better to do this before you arrive with the tray or else you might be chasing the patient down the corridor!’ She starts to laugh. After the paroxysm of coughing ends, she carries on. ‘You examine the nostrils and select the biggest. I don’t suppose you know that one nostril is always bigger than the other do you? Well, turn to your neighbour and have a look.’ We all look up each other’s nostrils and sure enough, they are different sizes.

  ‘You then clean that nostril with these swabs. You lubricate the catheter and insert it into the nostril. After about an inch you will meet some resistance. At that point, you ask the patient to swallow. Then the tube should slide down the throat into the stomach.’

  I have watched this procedure on the wards and know it is not as simple as it sounds. AJ fails to mention how the tube makes the patient gag and how sometimes it comes out through the mouth making the patient look like a gargoyle.

  ‘How will you know the tube is in the stomach?’ AJ asks.

  ‘Fluid should come back up the tube,’ Wee Jess says.

  ‘Yes. You attach the syringe, withdraw some of the fluid and test it with litmus paper. What colour should it turn?’

  ‘It will turn red because the stomach contents are acid,’ I answer, ‘but how do you know that you are not in the lungs?’

  ‘That is a very important question. You know the tube is not in the lungs because you would not be able to obtain any fluid. Also the patient would cough. If the tube is in the lungs and you give a feed, what would happen?’

  ‘The patient would drown.’

  ‘Exactly. Now I want you to be able to set the tray and it is up to you to find an opportunity to pass a Ryle’s tube while a sister watches you.’

  Not content with this directive, I go back to the practical room later to put a Ryle’s tube down myself. I am always imagining what it feels like to be a patient and I believe that we should only do to patients what we have experienced ourselves. Someone has already told me which is my largest nostril so I carefully lubricate it and the tube. I poke the tube up my nostril but after about an inch it will not go any further. I poke and prod until the pain makes my eyes water. Good grief, I’ll never be able to do this to someone. I take some deep breaths and push the tube so hard it finally goes down into my throat. I gag, but swallow hard until the tube slides down into my stomach.

  At this moment AJ walks in to find me with a bloated face and a rubber tube protruding from my nose.

  ‘What on earth are you doing, Nurse Ross?’ she says. She isn’t smiling.

  ‘I wanted to know what it felt like,’ I croak.

  ‘Does this mean you are going to perform every procedure I teach on yourself? Are you going to catheterise yourself? Put stitches in yourself so you can take them out? I won’t be able to leave you alone!’

  I am in no position to make a dignified reply. Tears are streaming down my red and swollen face. A large globule of viscid fluid that increases in length by the second and threatens to drop onto my crisp, white apron, now accompanies the rubber tube dangling from my nose.

  ‘No, Sister,’ I manage to gasp.

  AJ’s voice is cold as she says, ‘Take that tube out, Nurse, wash it and put it away.’ She leaves the room. I can hear her wheezing.

  I gingerly pull out the tube and thankfully sink my face into a basin of cold water. I feel mortified. I had not expected to be found by a sister but as I had, I think I should receive some commendation for wanting to experience what a patient goes through, not a rebuke.

  Judith tells us an alarming story one day. She was talking to Blinks at breakfast and found out that Blinks thought it was Wednesday instead of Thursday.

  ‘Nothing wrong with that,’ I say, ‘I often forget what day it is.’

  ‘Yes, but Blinks couldn’t remember anything that had happened the day before, that was what was so funny. Well you know I am on the ward above her, so I talked to her staff nurse and found out that Blinks had not shown up for duty on the Wednesday. No one seemed to worry too much; they didn’t even go and check her room. Typical of the way they care about us.’


  ‘Where was Blinks? Did she take a day off?’

  ‘No. I think, and so does Blinks, that she slept the whole time. She went to bed on Tuesday, didn’t get up on Wednesday, slept all day and all night, and got up on Thursday thinking it was Wednesday. Now, don’t you think there is something wrong?’

  I tell Judith about the time Blinks barged into my room without knocking and screamed at me. ‘You have been poking around in my room, haven’t you? Where is it?’

  ‘Where’s what Blinks? I haven’t been near your room.’ I was alarmed.

  ‘My pocket watch. You came and took it.’

  ‘No I didn’t, Blinks,’ I said gently, ‘it’s in your pocket.’ I could see its chain behind the bib of her apron.

  ‘Oh, yes. How silly of me. I’m sorry.’

  When I talk to the others, they relate similar experiences. It doesn’t occur to us, nor to the sisters, that there can be something wrong with Blinks. Now that we are in block and see Blinks every day, we notice how much she has changed. She is so forgetful that if we don’t escort her to class she will go without the things she needs. She barely passes the weekly written tests and because she can’t remember what goes on the various trays and trolleys, she fails the practical tests. AJ seems worried about her. She confides in me and tells me she is going to ask Blinks to set a tray for a medical fomentation in a test the next day.

  ‘I think she just needs some encouragement and I would like her to get something right for a change. Will you go over the tray with her until she knows it inside-out?’

  Blinks and I come back to the practical room after supper to practice setting trays and trolleys. I make sure Blinks sets the medical fomentation tray until she gets it right. She is delighted when she gets full marks next day and AJ gives me a conspiratorial smile. Blinks gets enough marks to scrape through.

  We go home for a few days after block and when I return I notice that the door to Blinks’s room is open. I see one of the Home Sisters packing up her things. A bare mattress stares at me with the same aura of death as a stripped bed on the wards.