Yes Sister, No Sister

by Jennifer Craig

  She hurries off and I enter Matron’s office. The first person I see is Miss Darcy, the Deputy Matron. ‘Well Nurse Ross, good to see you. My word, you do look brown! Where have you been?’

  ‘Austria. Skiing. And before that doing Midder.’

  ‘It’s disgusting to look like that in the middle of winter! Is this just a visit or are you back with us? I don’t remember seeing your name anywhere.’

  ‘I was supposed to start Part II Midder today but when I got there yesterday I was told I should have arrived on 2 March. I had phoned a few months ago to see if I could be two weeks late so I could get in a holiday and they said yes. But now I have to wait until June, so I’m out of a job.’

  Miss Darcy leans back in her chair and gives me a radiant smile. ‘The Lord works in wondrous ways! Sister Jenner on Ward 5 has just been diagnosed with glandular fever and is expected to be off for three months. Her perm leaves on Friday. I was at my wit’s end wondering what to do, when you show up. Sister Jenner’s replacement! When can you start? Now?’

  ‘I haven’t anywhere to live yet. And I’ve no uniform.’ Events are moving too fast for me. ‘Besides, I’m not sure I’m capable of taking charge of an adult ward – remember I was on Princess Mary before I left.’

  ‘Well that’s one thing I am sure of. You can live in until you find a place and I expect your uniform is still in the sewing room. Why don’t you go over and see while I do the paper work?’ She gets up from her desk and almost gives me a hug. ‘You’re the answer to my major problem.’

  I leave, in a daze, to go to the sewing room where Betty finds my uniform in two bags in a storeroom. I go up to sick bay to find a Home Sister to see about a room and find an unfamiliar figure wearing the head Home Sister’s uniform.

  ‘Hello, I’m Nurse Ross. I left here seven months ago to do Midder and now I’m starting again as a perm. I haven’t anywhere to live yet so Miss Darcy said I should live in for a while.’

  ‘I’m Sister Appleby. I just started here.’ She’s an older woman with prematurely silver hair and an open face. ‘Now let me see. We have a Nurse Sandstone just moved in. She’s a perm. Do you know her?’

  ‘Oh yes. We shared a flat for years and did Midder together. She doesn’t know I’m here – she thinks I’m doing Part II but it’s been postponed.’

  ‘Well this will be a nice surprise for her. She’s in East 221. I’ll put you in East 225 which is close by.’ She hands me keys, which I sign for, and then I collect my uniform and find my room.

  When I go back to Matron’s office, Miss Darcy says, ‘I thought you’d be in uniform ready to go on duty.’

  ‘Oh come off it!’ I say. ‘I can’t start yet. I haven’t got my clothes or anything.’

  ‘You’ve got your uniform haven’t you?’

  ‘Yes, but I can’t wear it barefoot.’

  ‘When can you start?’

  ‘How about one o’clock tomorrow?’

  ‘All right. I’ll let the ward know. You will have three days with Nurse Mason before you take over, so I’ll tell her to give you the same off duty as herself.’

  I sign various forms and leave for the dining room, as it is time for first dinner. I look for Sandy but she must be coming to second dinner. I can’t wait to see her face when she sees me back at LGI.

  Jordan arrives. I tell her about starting on Ward 5 and then say, ‘Tell me about the new Matron. What’s she like?’

  ‘Her name is Ann Wilks and she trained at Barts.’ She says ‘Barts’ with a long ‘a’ and at the same time, holds an extended forefinger under her nose. ‘We’re not allowed to say “poorly” anymore.’

  ‘That’s ridiculous! All the patients say they’re nicely or poorly.’

  ‘Yes, but we mustn’t use those words.’

  ‘She sounds as if she’s a nut case if she chooses such trivial things to worry about. Does she have any redeeming qualities?’

  ‘Hmmm. Well, she owns an orange mini.’

  ‘Really? What fun.’

  ‘Doesn’t go with the rest of her. She’s tall and thin and pale. When she first came, she wore a severe black dress that made her look as if she was death at the door. One day she did a round on Ward 1 and a patient said, ‘Ee luv, black does nowt for thee!’ We both laugh. ‘Now she wears navy blue. I don’t know whether that remark influenced her or not but she does look less funereal.’

  I am served a bowl of tapioca pudding and as I put a dollop of jam into it I say, ‘Where’s the Sod? There was a different head Home Sister when I went over there.’

  ‘Yes. Appleby. The Sod was so drunk one night she walked into AJ’s room by mistake and got into her bed while AJ was in the bathroom. AJ came back to find the Sod in her bed and vomiting all over her room.’

  I laugh with glee. ‘Was she fired at last?’

  ‘Yes. She’s gone to be dried out but we don’t think she’ll come back.’

  ‘What’s Appleby like?’

  ‘Really sweet. Well anyone would be after the Sod, but the Apple is lovely. She’s a widow. Her husband died not long ago so she came back into nursing until she retires. She’s got two grown-up children. Her daughter’s a nurse in Canada.’

  Jordan looks at her watch. ‘Must go. See you later.’

  I get a bus to Amma’s and after supper, take a taxi to carry my luggage and me to the Nurses’ Home. I could wait until morning but I want to unpack and settle in. I also want to surprise Sandy. I have almost finished unpacking when I hear her key in her lock.

  ‘Hi there, Sandy.’ She has just taken off her cap and is tousling her hair.

  ‘What are you doing here? Have they thrown you out already?’

  ‘Guess who is in charge of Ward 5?’ I bow.

  ‘What? Here, sit down and tell me what’s happened.’

  We talk well into the night even though it’s only two days since we parted. I hear about Sandy settling into the skin diseases ward that she requested. She gets a peculiar satisfaction from smoothing ointments over bodies and having her hands permanently stained with gentian violet. I tell her about going to the Nurses’ Home of the midwifery course only to find I couldn’t start training after all and that I had come to LGI expecting to beg for a job and been greeted with open arms.

  ‘Darcy wanted me to start stat. but I told her I didn’t have any clothes or anywhere to live so I’m starting tomorrow at one. My room is next door but one.’

  ‘We’ll have to find a flat as soon as we can,’ Sandy says. ‘After six months living at Charlotte’s, and now this…’ She waves her arm to indicate the room.

  ‘I’m supposed to start Part II on 1 June so it’s not worth it,’ I say. ‘This isn’t too bad. At least we don’t need late passes. We’re Big Girls now!’

  Ward 5 is a male medical ward where the consultants specialise in chest complaints. I go on duty after dinner and by the time the night staff comes on, I feel as though I have never been away. Mason leaves at the end of the week and after three intensive days with her, I think I can cope with running the ward. After all, it is temporary. If it was really my ward, I would make the changes I have been contemplating all through training but I’m sure Sister Jenner would not appreciate coming back to different routines.

  The day after Mason leaves I enter the ward at eight, alone. There are two staff nurses. Miss Darcy has promised a third, but I am the only perm. I walk to the centre table and all the nurses hurry over to it. We kneel and I read a prayer, randomly chosen from the cards that have been put out by the night staff. I feel a fraud. I am not a Christian and mouthing these words makes me feel insincere. But, I tell myself, it is part of the job.

  I take the report from the senior night nurse. The staff nurses, Isobel Dawson and Carol Klein, make no move to join me so I call them over. Although they are not perms, they will function as such until Sister Jenner returns.

  After report I say to them, ‘You two will be acting as perms until Sister comes back so that is how I shall treat you. You still have to come on
at 7.30 but otherwise we’ll have coffee in the sideward and share weekends off – that sort of thing.’ Their faces light up and I wonder what Jenner has been like.

  I go over the report with them and ask Carol to make out the work list. As she is the senior of the two, she is my replacement. I start a round which means dragging the mobile file carrier with me, finding out how each man feels, examining him if necessary and checking each chart to see whether lab or other results are back. There are 34 patients on this ward and most of them have that wan, strained look of people with breathing difficulties.

  Two patients have tracheotomies. A hole is made into the trachea and a small, metal, hollow tube is inserted and held in place by tapes that tie round the neck. An inner tube can be removed for cleaning. A spare is kept in hydrogen peroxide on a tray beside the bed. In most cases the inner tube is frequently blocked by mucous so it must be suctioned regularly. These patient’s beds are surrounded by equipment: the tray for cleaning the tube, a portable suction, a tray of tubes to suction with and oxygen, which is delivered through a mask over the tracheotomy opening.

  Before I have finished the round both ward doors are flung open and a large, florid man, in a blue pinstriped suit, strides in followed by an entourage of white-coated young men. It is Dr Harper, senior consultant on the ward. I go to meet him, trailing the file cabinet behind me.

  ‘Who are you?’ he asks without formality.

  ‘Nurse Ross. I am Sister Jenner’s replacement while she is off sick with glandular fever.’

  ‘Oh.’ Gimlet eyes stare at me and I stare back. I sense that here is a man who likes to intimidate. I refuse to be cowed. He gives way first and at his first bed his registrar takes the patient’s chart that I hand him. He explains to the chief the diagnostic test results, treatment and progress since his last visit. As he talks, Dr Harper stares at me with a thoughtful gaze and I feel like a mouse in front of a snake.

  He moves to the head of the bed and takes the patient’s wrist to feel his pulse. ‘How are you, my man?’

  ‘Nicely, thank you sir,’ the thin, breathless patient replies.

  ‘I’d like to listen to your chest if I may.’

  I pull the curtains and the group of medical students huddles closer to the bed. I help the patient off with his pyjama top so that Dr Harper can palpate and auscultate his chest.

  ‘Did you examine his chest this morning, Nurse?’

  I am taken aback by the question. Is he testing me? ‘Yes, I did.’ I do not add ‘Sir’; in Yorkshire we do not use the title.

  ‘And what did you hear?’ The eyes are boring into me again.

  ‘I heard rales at both bases and an irregular heart rhythm.’

  ‘What is his sputum like?’

  I take the sputum mug from the locker, open it and hold it out for Dr Harper to see.

  ‘Is he having physio?’ he asks.

  ‘Yes, the physiotherapist comes every day and we do postural drainage as well.’

  ‘What’s his appetite like?’

  I haven’t been on the ward long enough to remember every patient’s food intake but I say to the patient, ‘You’re not very hungry are you Mr Sykes?’ and bless him, he says, ‘Nay Doctor, I don’t feel like eating nowt even though t’nurses try to make me tackle summat. Just not up to it, tha knows.’

  ‘Good, good. Now you students, I want you each to listen to this man’s chest. Nurse Ross has told you what you’ll hear so I am going to watch your technique rather than hear your opinion.’

  I seem to have passed his test of me, as he doesn’t question me again. However, at the fourth patient, the round is held up because the patient’s X-rays are not back from the radiography department.

  ‘I will send someone to get them,’ I say. ‘They will be here before you finish so perhaps we can move on and come back to this patient.’ I get the gimlet stare again but he doesn’t say anything.

  This is the first time I have attended a formal round. The two Princess Mary’s consultants tend to breeze in and out and rarely do formal rounds. No one has instructed me on my role so I work it out for myself. First, I ensure that the patient’s privacy is respected and that he is left comfortable after the physicians and students have examined him. Then I must be familiar with each patient’s progress – how he sleeps, eats, moves and evacuates, and what the latest lab results show, or indeed, any other test. Finally, I must note all requests for further tests, such as stool or sputum examinations, blood work or X-rays, and make sure that requisitions and samples are sent. I must also arrange for discharge to home or to the Ida, and make appointments for other consultations such as with psychiatry.

  A major round is conducted every day by one or other of the five consultants who have beds on Ward 5. In addition, I do rounds with their registrars, and sometimes housemen, although they are in and out all day. I am beginning to find out that being in charge is not quite the picnic I thought it was going to be.

  Nurses decide how much a patient should be up, what he should eat or drink, whether he needs a laxative, how often his dressings are changed and when his stitches, if any, should come out. If a patient is ready to go home, it is the nurse’s responsibility to ensure that there will be adequate care and arrange for the district nurse or home help, organise an ambulance to take him home and call the Lady Almoner if there is financial need.

  I am gasping for a cup of coffee and as soon as Dr Harper and his firm have left, I head for the sideward. Sidewards used to he just that, places with one or two beds for patients on isolation, but now they are offices for sisters and perms and much of the ward business is conducted there over coffee or tea. I have just sat down when there is a knock at the door. I open it.

  A student nurse says, ‘Matron is on the ward.’

  Damn! I start to unroll my sleeves as I enter the ward to see a tall, thin woman in a navy blue dress and a plain white cap standing by my desk. She is completely shapeless; straight up and down with no curves where one would expect to see them. I immediately think of an African carving of a Zulu. Her face is round and flat like a plate, housing two pale blue, watery eyes. It is a kind face though, and I think I could like her.

  ‘Good morning, Matron.’ I grab my cuffs from the desk and put them on.

  ‘Good morning, Nurse Ross. I would like to do a full round.’

  I escort her to the first bed and tell her about the patient there. I feel annoyed; mornings are our busiest times and Matron and her staff usually visit in the afternoon or evening. She says, ‘Good morning, how are you?’ to each patient but makes no comment to me. On the last lap, we come to a large, heavy man who is slumped down in the bed.

  ‘I think he needs to sit up more, don’t you Nurse? I will help you lift him.’

  I take off my cuffs and we face each other on either side of the patient. I ask him to bend his knees and lean forward, and then we place our arms across his back and under his legs and grasp each other’s forearms. A nod and we lift. The patient nearly shoots out of the top of the bed! Some nurses never manage to synchronise their lifts and find the load heavy and a strain on the back. When two experts lift together, it is effortless and effective. I appreciate that this Matron is clinically able and I look at her with respect. Is it my imagination or is she looking at me in the same way?

  As she is about to leave, she stands at the door and says, ‘I think your ward could be a little tidier, don’t you nurse? And I noticed that one student’s hair was not completely within her cap.’

  She leaves. I feel like sticking my tongue out at her retreating figure. I want to say, ‘For heaven’s sake woman, how about an encouraging word for me? I’ve never been in complete charge before and all you can say is that the ward is untidy and someone’s hair is loose.’ I stomp into the sideward for my cold coffee wondering why I like her.

  Chapter 22

  3B Rosemount Crescent

  Leeds

  28 April 1958

  Dear Judith,

  Thank you for your
postcard from Portugal. That was a sensible place to choose for a honeymoon – the weather here’s been terrible.

  You will have got my long letter telling you about my hol in Austria and then coming back here. When I’d been back about a month, I decided to hell with Part II. Don’t need it. And the thought of being up all night then having to work all day was too much. You know how I love my kip!

  So, having made this big decision, Sandy and I found this flat. It’s really nice; two bedrooms and more modern furniture than the last place. We even have a tiny fridge and a Hoovermatic washing machine. Mind you, we pay more, but as we’re perms, we can afford it. We’re going halvers on a television – howzat for luxury?

  You know I told you this new Matron says we can’t say ‘poorly’? Well now she wants us to say ‘in’ a ward, not ‘on’ a ward! I try and find a reason to write ‘on the ward’ every time I send in a report.

  I am working with two staff nurses, Isobel Dawson and Carol Klein. Do you know them? We are having a lot of fun together and our sideward is where the men come for coffee now. I gather that Jenner is a bit rigid. I’m not looking forward to her coming back as I’m enjoying being in charge.

  What ho – I went riding last week for the first time since I got back. Livvy sends her love. She’s just the same. ‘Met this fella, Charles, at the Hunt Ball. I think he’s tightening his girth to pop the question. Don’t know what I’ll say. Pop likes him. Good seat. But there’s something odd about his tack. Wears strange cravats.’

  I miss you. Love Jenny

  3B Rosemount Crescent

  Leeds

  15 May 1958

  Dear Judith,

  Many thanks for your letter. I am so glad you’re applying for Cambridge. I do hope you’ll get in. The clinic job sounds lousy so I hope things look up soon. If you get into Cambridge, will Alan set up practice there?

  Sandy and I came off the scooter last week – I don’t know why. She was OK but I’ve fractured my scaphoid so my arm is in a cast. Thank goodness it’s my left arm so I can still write. The best thing about it all is I am under the care of Geoff Mitchell, the orthopaedic registrar. He is absolutely gorgeous! He is tall and wears cavalry twill trousers and check shirts. I get breathless when I see him!! I have to have this cast on for six weeks so it will still be on when Jenner comes back. He says to see him if I’m worried about the cast. Can you think of a good reason why I should be? I thought of ‘accidentally’ getting into the bath with it on, but then I thought he’d think I’m stupid. Do you know of a drug that makes your arms swell?