dovegreyreader scribbles

Who'd have thought it...

Downalong the nine years that I have been writing dovegreyreader scribbles I have occasionally revisited my days as a student nurse, with the posts gathered under the heading The Sufferings of a Student Nurse; you too can click on that link and share in the pain of it all if you are feeling up to it.

Today however is a special day, so forgive me for resurrecting and rejigging an old post from that collection and yes...its' time for the picture again... go on have a laugh at that cap while I cry over that waistline...

8pm January 25th 1975 I trudged onto Royal Ward (men's surgical) at the London Hospital to start a week of night duty.

I loathed night duty.

My body clock never learnt to deal with it and the first night was always the worst.

I was 21 and in the 3rd year of a 4 year combined training and the plan was to emerge as RSCN (Registered Sick Children's Nurse) and  SRN (State Registered Nurse, now simply RN) after my finals the next year, which I did. In order to complete the adult part of our nurse training we had been sent on a year's secondment to The London from our beloved alma mater, Great Ormond Street Children's Hospital and the world of sweet little uncomplaining babies to fend for ourselves amongst big, heavy, hairy, moany grown ups.

This all meant I was living in Whitechapel which in 1975 was very different from Bloomsbury in ways that I won't elaborate on.Coupled with the misery of being the cuckoos in the nursing nest, a recent and very depressing twelve week slog on Gloucester Ward (neurosurgery) all over Christmas and New Year coupled with the sad news at home that my brother was terminally ill with leukaemia meant it was not a blissfully happy time.

Suitably starched and pristine, the night shift gathered in Sister Royal's office for inspection (hair off collar, shoes polished, no ladders in black tights that sort of thing) and to be given the ward report. The naming of the Sister was a London Hospital tradition; all Sisters baptised in fire and branded across their ample bosoms with the name of the ward they lived and breathed and ruled.Patient allocation commenced.

I was assigned a leading ballet dancer who had been admitted with a drink problem and now had a bad case of the delerium tremens; there were no beds anywhere else in the hospital so he'd been tucked up on Men's Surgical. The word was I would have to keep an eye on him, he'd spent hours standing by the lift doors waiting for the doors/curtains to open so that he could make his entrance.

Next two chaps, one with an abcess on his right buttock, one with an abcess on his left who'd been put into beds next to each other so they could chat. Mistake.They were big mischief and causing the mirth and turmoil you expected on Men's Surgical.

A few more post-op cases and then this....

"Nurse" she said fixing her icy gaze on me "please familiarise yourself with the patient in bed number 4, you will be looking after him all week, he will be having major chest surgery tomorrow and you will need to be competent in the management of chest drains, please revise". 

I groaned inwardly.

We hadn't been on the best of terms, Sister Royal and I, since I'd caused a minor treatment room explosion alert and brought shame on her very ship-shape ward. It had involved the excitement of the Fire Brigade turning up and official reports and all because I'd put metal instruments in a machine and turned it on and walked off, failing to notice the large sign saying "No metal instruments in here". She had definitely been wreaking her revenge ever since and was now handing me a clutch of very short straw assignments.

First port of call was always the kitchen to see what food the day staff had managed to save you. Night duty seemed to reduce the palate to mere basics and we would happily eat cold roast dinners at 3am.

But oh dear, I was needed, the performance had begun....

Grande jetes down the middle of a men's surgical ward are not to be encouraged; half the patients were splitting their stitches laughing, the rest thought they were hallucinating, whilst one or two definitely thought they had crossed the bar (or should that be barre?) So, having done a neat pas de deux with the ballet dancer steering him towards his bed and some sedation, "Come on we're doing Sleeping Beauty tonight", and dealt with ribald remarks from the abcesses, I headed off to see what was in store for me in bed number 4 and there he was, Bookhound, looking just a little nervous.

"I'm really used to babies and nappies but don't worry" I said "I'm just going to look up chest drains now. I think it's only a problem if they block, which they always do, or if I lift the bottles up off the floor air sort of rushes back into your chest". 

This didn't go down in quite the amusing way I had thought and I had to go and make him a cup of tea to calm him down.

The surgery went well and the week was spent with him groaning and me crawling round under his bed coaxing those wretched chest drains into action.

"Can I take you out to dinner when all this is over?" this weak little voice said at about 3am one morning when I'd had yet another allelulia moment with the tubing. 

Student nurses in the 1970's on £12 a week never refused free meals so I made sure this patient lived.

Next thing to find out, how big was the boot of his car?

My flatmates and I spent our lives moving around London with our belongings in tow, a boyfriend with a Hillman Imp was next to useless. Ford Escort, yes that would do.

The Tinker jokingly said I had to stop taking my work home with me the first time they met, I said it was nurse-patient follow-up...

Forty years ago today...who'd have thought it.

The Children's Nurse - The True Story of a Great Ormond Street Nurse ~ Susan Macqueen

Yes, it's time to drag out the 1976 funny-hat-blue-belt photo again (fourth year of training, finals taken, results awaited) and tag another post under The Sufferings of Student Nurse collection, and If I'd known then what I know now I think I would have been rightly terrified at the mere thought of my student nurse ward allocation to Cohen CD, Infectious and Skin Diseases at Great Ormond Street, on March 10th 1974. My last ward before heading off to secondment at the London Hospital for the SRN part of the training that combined RSCN (Registered Sick Children's Nurse) with it.

I know the exact dates because (this being me) I still have my Pink Book with all my ward experience logged and signed. It was on Cohen CD that I worked under the tutelage and eagle eye of Sister Macqueen, (the author of The Children's Nurse - The True Story of a Great Ormond Street Nurse) for the next twelve weeks. Tucked in my Pink Book I have even discovered a scrap of paper with some of the Cohen patient names and diagnoses, obviously an attempt to drill it into my head in readiness for a ward round, and reading it now I am even more retrospectively terrified at how my twenty-year old self gaily dealt with such things as tubercular, e coli and meningococcal meningitis and herpes encephalitis amongst other things, and with never a thought that somehow I might catch something. And then the young teenager with epidermolysis bullosa, a debilitating conditon where the skin blisters and falls off at the merest touch... her distress was not surprisingly manifest in tantrums and teenage angst, and the daily bath sheer, unmitigating torture for all concerned.

But imagine my delight when I heard news that Sister Macqueen, known to us then as Sue ( though never to her face of course, heavens the earth would have opened up and swallowed us) had written a book (with the help of a ghost writer) about life as a nurse at Great Ormond Street. Being a completist with regard to my shelf of books about G.O.S I ordered a copy there and then, but this being me and wanting it yesterday, I downloaded the Kindle version too.

Sue Susan Sister Macqueen (old habits etc) had actually completed her initial nurse training at Addenbrooke's Hospital in Cambridge where she first encountered the GOS nurses out on adult secondment as part of their combined adult and children's nursing course...

'... their GOSH uniforms marking them apart from everyone else...the pink nurses were renowned for their attention to detail, not only in the way they looked, but in the way they cared for their patients..'

It was all enough to convince Susan (OK, I'm over it now, I'm sixty this year after all) that she wanted to do her post-registration paediatric training at GOS and that is where she headed at the earliest opportunity. With her nerves in shreds (no...I can't imagine this, she was a formidable ward sister) Susan walked onto 1A, the ward that would put the fear of god up most of us bright young things, Cardiac. 

It is an indication of the terror that Susan, though already a qualified nurse, felt out of her depth amid the noisy hubbub that was an old GOS ward. The wards in our day, now almost obsolete, were a rare mix of medical and nursing care of the highest standard to the backdrop of the laughter and shrieks of children playing and riding tricycles up and down the corridor, and with the radio singing along in the background.

Do you remember that song Lullaby of Broadway, a hit again in 1976. Wiz and I were both staff nurses on the same ward, 2DE (metabolic diseases and burns) and as soon as we heard that song on the ward radio we'd all head for the corridor for the tap dancing bit...no matter what you were holding...baby... potty... syringe. 

Sister Macqueen might have had a bit of a conniption and of course that would not have been possible on Cohen where she became sister in 1972, the year that I arrived at Great Ormond Street to start my training. Cohen was all about barrier nursing... masks, gloves, gowns and hand-scrubbing a way of life, and your hands were even more sore than usual. Susan recounts many tales of life on the ward, the small details all very familiar to anyone who worked at GOS during that era...Z-beds in the waiting room...'specials' providing one-to-one nursing care...the old Engstrom ventilators...

Amongst all my own memories of Cohen ward several stand out....

The day that I was supervising a nurse more junior than I was, though she was considerably more confident, and made that very plain indeed. She was getting her first taste of caring for a baby in an incubator and we had run through what she needed to do, it was only changing a nappy and I had said I'll join you in a minute and probably nipped off to do some observations or something. Imagine my horror when I returned to find that she had lifted the lid of the incubator and put it on the floor (germs...OMG) in order to handle the baby. When I pointed out that this wasn't what we did her reply was priceless...

'Dont be ridiculous, you don't expect me to be able to do anything through those stupid holes in the side do you?'

I think I was more terrified that Sister Macqueen would come around the corner and see this debacle in progress, and I often wondered quite how long it was before Confident Student was cut down to size...she would have been, no question.

'I tried to be firm but fair with the nurses and students who worked under me...I demanded a lot from them. If my nurses worked hard, I made sure I praised them and made them feel at ease...'

Conversely, step out of line or slacken off and you would be told in no uncertain terms. No risks can be taken in the hospital environment full-stop, but on Cohen ward any short-cuts could lead to further infection for a child already compromised, or to a nurse catching a serious illness. We learned the form very swiftly indeed.

Susan Macqueen put all that experience of infection control on Cohen to good use, eventually becoming the hospital's leading expert on the subject, and responsible for ongoing excellent outcomes in the management of hospital-acquired infections in children, before also working at the Department of Health, all of which is charted in the book. In that case I now feel quite reassured by the fact that it was Sister Macqueen who examined me on the first of five practical assessments completed during our training. My Aseptic Technique under her watchful eye (2nd April 1974) must have been up to snuff because I passed and I have her signature to prove it (click on this picture, it should enlarge) and I would still use it now and did, even on the cat's stitches.

Susan describes herself as a firm but fair ward sister and interestingly, before I had even opened the book I was pondering my experience of working with her and, in my mind, had used the exact same words. She talks in some detail about that role and I found it fascinating to hear about it from the other side, ward sisters were slightly terrifying goddesses in our eyes, little did we even imagine they had a social life...or a home...or a boyfriend. Surely they slept, immaculately uniformed and poised in a cupboard on the ward before jumping out and apparating right next to you the very same second that you'd decided to cut that corner, or touch that door with your hand, or...or... And who knew about the love-hate ongoing battle of words and sparring with Dr Marshall, the Australian ward Consultant, who was also the physician for the Chelsea football team.

I have another lasting memory of Cohen too...

It was night duty and the ward desk had a line of visibility through to the vase of flowers in the front hall of the hospital. There were always white flowers in the arrangement, and one would be collected by a nurse when a child had died to be placed in the child's crossed hands when they were laid out. On one particular night I saw Wiz, my flatmate come down to that vase not once but three times, it's a salutory reminder of what we were all dealing with at the age of twenty, though thankfully with the support of each other and sisters like Susan Macqueen to guide us through it all.

A lovely book which it has given me much pleasure to read, though I am aware this may also be because the old alma mater is so close to my heart. But if you are enjoying the current run of nursing and midwifery memoirs then certainly add this one to the list.

 

 

Related articles

Happy Birthday to...

The Reunion...

It's that time again and now forty years on we will all be gathering at Great Ormond Street today for the October 1972 set reunion, and to celebrate forty years as nurses. No matter what any of us may have done since, once you have trained as a Great Ormond Street nurse you stay as one for ever, and for those who may have missed the posts on dovegreyreader down the years, well... if you have a few hours to spare you will find them all here under The Sufferings of a Student Nurse.

Here we were, one day into uniform, rookies all and probably with little idea of what lay ahead once the days of Preliminary Training School were completed six weeks later ready to be sent off to our first ward allocations.

I was sent to do twelve weeks on Private Patients, which gave me a completely unrealistic expectation about the standard of snacks that might be available in a ward fridge at any one time.

By the time we were released onto the wards we had learned amongst other things...

How to do temperature, pulse and respirations whilst staring at the fob watch,

How  to take blood pressures on tiny people,

How to test urine,

How to collect a stool sample, 

How to fold and change towelling nappies, bath a baby and dress them appropriately,

How to feed a baby,

How to put on a gown and wash our hands and remove several layers of skin in the process,

How to make up a Milton sterilising tank 

How not to put dirty flower water down any other sink but the sluice (pseudomonas aeruginosa)

How to work a sluice and a steriliser,

How not to touch a door to go through it but to nudge it with your shoulder (still do it now going into shops)

How to make a cot so that the nursery rhyme pictures on the counterpane faced the child (blue for boys, pink for girls)

How to wear a cape with panache (easy)

How to wear a navy gaberdine rain coat and storm cap with panache (more challenging)

How to fold those hats and keep them on our heads (one lean into the steriliser and all starch gone)

How to button the collar to the dress and then cope with blisters on the neck from the starch,

How to ditch the recommended K skip shoes and replace them with something slightly more becoming,

How to get out of bed the minute the alarm went and be on duty for 7.45 am,

But above all we learnt how to laugh and I am sure there will be a great deal of that today.

We also all quickly accumulated the GOS student nurse's badge of office, a clutch of nappy pins fixed just above the bib of the apron next to the fob watch, and to be worn with pride for the next four years and this being me of course I still have mine, in my little nursing memory box...

Imagine my surprise when I wound up that forty-year old Sekonda watch this week and that tiny second hand started ticking.

'Oh look, let me take your pulse,' I said to Bookhound (that brought back a few memories)

At which point I realised that were I ever to go back into uniform and have do this again my fob watch would need to be pinned to the hem of my apron, not the bib.

Tempus fugit and with it the 20/20 vision etc 

In search of the London Hospital Museum...

Having spent a few hours wandering around Spitalfields a few weeks ago, and with about an hour to spare before I needed to be somewhere else, I decided to set off in search of The London Hospital Museum.

It will always be The London to me, I can't be doing with any of this Royal stuff, but seconded to the hospital from Great Ormond Street for a year to do our general training we had been taken around the museum back in the 1970s, and I was keen to find it again. It was the squeamish person's worst nightmare, shelves of unmentionable, unbelievabale things floating in formaldehyde, but fortunately we all had cast-iron stomachs. We gazed in awe and wonder (and I'll own up also with some young, unseemly and womanly mirth) as we realised there was nothing, and I mean nothing of the human anatomy which couldn't be pickled and put in a jar.

I was convinced I knew the way to the hospital and so wasn't phased by the fact that the maps in my Moleskine London book assume that I won't want to stray beyond Aldgate East. Mr Butt had already given me instructions from Brick Lane but I had only half-listened because I felt sure I knew, but as I reached the top could I remember whether I should go left or right and then where??

No I couldn't.

So I trekked on in one direction and was waylaid by The Whitechapel Gallery which all seemed hopeful.

After a wander around there I emerged and had completely lost my bearings.

Right??

Left??

... and everyone I asked pointed in different directions.

And can you believe it was a roasting hot early March day and I was getting hotter and hotter.

In the end I slid into Aldgate East and did one stop on the tube to Whitechapel because for sure, once I walked out of the station there would be the hospital bang opposite me, I'd remember where East Mount Street was and I'd be sorted. In fact I had London completely upsidedown in my mind and thought I was approaching from the east not the west.

Why won't Bookhound be suprised to read that.

So as I emerged from the tube station imagine my surprise when faced with this...

The old place completely boarded up.

I then succumbed to a state of even more confusion.

No access to the front of the building, or the main steps where the 'tramps' (as they were then called) would throw themselves down as we showed them out of casualty after stitching up their head wounds. This was in order to try and really do some damage and score a bed for the night, even though we had done our best to get them a Sally Army hostel bed before they left ...so sad when I look back on it. Mostly men and with ex-Cambridge professors amongst them... whatever happened to Mr Sunshine, Henry, I often wonder. Sufficiently inebriated and thus requiring no local anaesthetic, the suturing was always given to us students as practise, which made a change from the polystyrene head that we had already smocked and quilted. We did a careful job for which they always seemed unfeignedly thankful, promising us the earth in kind if rather incoherent blessings, and I always felt much more capable and comforted knowing that they really couldn't feel a thing.... and I got quite good at stitching in the process.

I see my Pink Book training record shows that I also dealt with a sub-ungual haematoma, which means I heated a straightened paper clip and stuck it into someone's finger nail to release the blood underneath ...and I also partook of gastric lavage, which would have either been someone who has overdosed or jumped in the Thames or both....and would have involved carrots and cabbage...they always did.

I'm not sure I can envisage myself doing any of that now, how odd that I did it all so willingly in this building at the age of twenty-one.

I am grateful to the security guard who opened the gate to let in a lorry and let me in too as I begged to be allowed to pay homage to Edith Cavell in light of my volte-face recounted here, and  take a picture of this on the front wall...

But where on earth had the hospital gone...what about all those old wards..Charrington, Paulin, Royal (where I met Bookhound) Turner...

Nor could I see any sign of East Mount Street or Cavell Nurses Home, but as I followed the 'Royal London Hospital has moved' arrows and rounded the corner, nor was I expecting this...

or this..

The hospital completely rebuilt and no one had told me.

It is a very arresting site, quite astonishing in fact and almost beautiful in that way that Victoria Findlay's book Colour, Travels Through a Paintbox is making me so much more aware of colours chapter by chapter. Unfortunately this sight came during 'Black and Brown' week but I have stored it up in my mind's eye for the 'Blue' chapter. I must have looked a complete dork with my jaw on the floor staring at it for ages whilst thinking 'There's a quilt in that'.

But plus ca change, it was still a hospital and this I knew because there were patients walking outside in their pyjamas and gowns cussing and swearing about their bowels and having a smoke. I passed a very rubicund old gentleman, who looked and behaved very familiarly and of the 'No Fixed Abode' genre I remember of old; he was patiently steering himself around in circles in a wheelchair, singing at the top of his voice, one arm clutching a bottle of unknown origin or contents, one good leg paddling the ground and doing the work, one plastered leg not helping. 

Now hopelessly lost and in danger of going round in circles myself, I just sort of wandered, so it was luck more than any good sense of direction that saw me on the doorstep of the museum tucked away here.

But it was really worth the visit if only for one thing alone, the 1968 recruitment of nurses film, more of which soon and I think I was quietly relieved to discover that the pickles are now stored in the Medical School.

And afterwards, as I walked back around, uncertain whether I would even be able to find Whitechapel station again, I thought about Edith Cavell's plaque and hoped it would be re-homed somewhere prominent on the new build, and as I passed that towering blue edifice there was my friend, still singing and still going around in circles.

 

 

 

Dickens and me...

Well after toasting the Queen it's now time to charge the glasses again and let's hear it for dear old Charles, two hundred today and doesn't look a day older for all the love he's getting right now....

and I'll be shot for this desecration of the sacred image, but something tells me that the Charles Dickens I am getting to know quite well this year might just have smiled and quite enjoyed a bit of merriment amidst all the serious eulogizing... before writing me a stinker of a letter about the visual humiliation to which his attention has been drawn.

Except I hope he might have read the rest of the post and felt the respect, because, having asked lots of people to write about their own experience of Dickens I have been wondering, and pondering and thinking... what does Dickens really mean to me. Surfacing unbidden every time and before any thoughts of the books, is his Great Ormond Street connection and now well-documented on here, my nurse-training at the alma mater. That hospital connection will see me in London for the October 1972 set's fortieth reunion later this year, and I hear friends are travelling from America and Australia to be there so I'd better hie me to London for that weekend.

I never cease to be amazed by the circularity of reading either because my attentions are also currently guided in the direction of sick children thanks to Linda Grant's recommendation on Twitter at about 7am one morning last week that I read Pilcrow by Adam Mars-Jones. The joy of the Kindle is the instant gratification of the downloadable sample, swiftly followed by the book in this case, because it makes such compelling reading from the off. It's the 1950s and a late diagnosis for little John Cromer of Still's Disease starts yet another Great Ormond Street train of thought, Sir George Frederic Still, a clinical assistant there in 1894 and eventually to become one of London's most popular paediatricians.

I also buy every book I see and hear of about Great Ormond Street, but my favourite remains a slim volume published in celebration of the hospital's centenary in 1952, an apposite year for us on here this week, and written by Senior Surgeon, Thomas Twistington Higgins. Mr T-H makes a very prescient observation in 1952 that seems no less relevant now...

'There is a remarkable parallel so far as the hospital is concerned between 1852 and 1952. Then as now, the national environment was charged with revolutionary change. Our forbears had to plan their new hospital venture in a changing world in which the tumultuous developments must have made it exceptionally difficult for them to look ahead...'

I find it harder and harder to imagine, given twenty-first century communications, the constraints of effective information sharing back in the nineteenth century, and how great must have been the impact of having a figure like Charles Dickens on your side if you were a small, impecunious team setting up such a mammoth venture as London's first proper hospital for children. Not unlike asking Stephen Fry (almost four million followers) or Neil Gaiman (lagging behind with only a million and a half) to re-tweet something for you on Twitter these days perhaps, and requests to do so apparently come back with warnings about making sure your own website can cope with the potential volume of traffic.

So when Charles Dickens made his legendary speech in April 1852 at the first Great Ormond Street Festival Dinner, a fund-raiser to acquire further premises in Gt Ormond Street , and then published his article Drooping Buds in Household Words, news spread fast, and to many who hadn't even know of the existence of the hospital. The dinner alone raised enough to buy the premises and with plenty left over.

In searching online for this I made a very fortunate discovery, has anyone else come across the Dickens Journals Online Project??

A team of volunteers have scanned and transcribed every edition of each of Dickens's journals and after a quick registration process they are accessible free online. I was staggered at the scope of the undertaking and apparently the plan is that every one will be completed by today...98% there on Saturday, so congratulations to them for a fantastic endeavour and the provision of a brilliant resource. I have already been sidetracked into reading other articles so beware, it is slightly addictive.

Jenny Hartley's recent volume of The Selected Letters of Charles Dickens, published by OUP, also reveals that in March 1852 Dickens had written to his closest friend John Forster ...

'...My Highgate journey yesterday was a sad one. Sad to think how all journeys tend that way. I went up to the cemetery to look for a piece of ground...in a foolish dislike to leaving the little child shut up in a vault there, I think of pitching a tent under the sky...Nothing has taken place here: but I believe, every hour that it must the next hour...'

Charles and Catherine's eight-month old daughter Dora had died the previous year and the birth of their next baby is imminent. Of all men Dickens knew that his family would not 'be exempt, as to our many children, from the afflictions of other parents,' and it is not difficult to imagine how acutely this may have focused his attentions on his speech on that April evening or the article that followed.

But those famously melodramatic lines had the desired effect on the public consciousness...

'Oh! Baby's dead and will be never, never, never seen among us any more!'

along with the news that one in three coffins made in London is for a child, and with some religious overtones added in, Dickens, who surely never lost touch with his own 'inner child', cleverly appealed to all the right people and the donations poured in.

Just looking at the infant mortality rates gleans a perspective, currently standing at 4.6/1000 live births per year here in the UK in children under a year old, and though Dickens quotes the figures for children up to the age of two, the figures in 1852 add up to 240/1000.

As a cause the Hospital for Sick Children, as it was known until very recently, rapidly captured the hearts and souls of the wealthier Victorians for whom philanthropy and religion were comfortable soulmates, whilst there is much evidence that the Anglican church also benefited from an alliance of opposing high and low church factions, offering good opportunities for some extra displays of holiness and moral earnestness and a chance to pull together.

But the motives for giving were genuine too,

'...it is above all things the charity which, in the old scriptural words, beareth much and is kind. Children cannot repay.'

said the London Journal in 1875, and the plight of London's children, whose health had been sorely neglected for too long suddenly achieved much greater prominence.

Working as one of the first doctors at the hospital with Charles West was Queen Victoria's physician William Jenner, and surely it is no coincidence that Queen Victoria announced royal patronage within two weeks. Dickens's fund-raising legacy continued apace and by 1868 the endowment of cots had became an established money-maker; for £2000 wealthy Victorians or collaborative groups could see their names in perpetuity over the head of a sick child, and by 1880 120 beds were thus favoured.

I have dragged countless friends through Great Ormond Street to look at the hospital chapel whenever we are in London and passing. It is a dazzling microcosm of Victorian ecclesiastical decoration... even Oscar Wilde moved to acknowledge its beauty and spirituality.

Tiny child-sized pews and astonishingly intricate and colourful frescoes, stained glass and a rich and elaborately painted dome depicting the pelican in her piety, an image of self-sacrifice, surrounded by the angel choir peering down on the little people below.

And there, to one side of the chapel, a plaque dedicated to the man who surely helped give the hospital the financial start it needed...

Charles Dickens1812-1870
Honorary Governor
Inspirer and Champion of the Hospital for Sick Children
"Charles Dickens the children's friend, firstly fairly set her
on her legs and in a few eloquent words which none who heard can
ever forget, gave her the gift that she should win love and
 favour everywhere."

 

 

 

 

 

A volte-face...

I can't deny that back in 1974, and halfway through my student nurse training at Gt Ormond Street Children's Hospital in the heart of Bloomsbury, I wasn't bitterly disappointed to discover that the expected secondment for the year's State Registered Nurse training sandwiched into our Registered Sick Children's Nurse course was to be at the London Hospital in Whitechapel and not, as we had been led to believe, Addenbrookes in Cambridge.
Not that the two other choices held that much allure either, with apologies to Watford General and the Hammersmith.
I'd always fancied a taste of the Cambridge life and a bit of punting on the Cam, even if it was as a nurse rather than a university student, but any pleadings were to no avail. With hopes of getting out of the city dashed, and defeated by the cost of rent and transport, we gave up our flat next to Haringey Dog Stadium, and my friend Wiz (later my bridesmaid and probably reading this and laughing) and I moved into the most dire and depressed looking nurses home known to mankind (second only to the one attached to GOS in Guilford Street that is, where it was common to find pigeons nesting under your bed if you left the window open) in the heart of London's East End.
This was the mid-1970s, we would be slum-dwellers, the Monopoly board told us as much.

Cavell Home in East Mount Street.
Despite the blurred result of this Kodak Instamatic picture, (taken on the bridge that crossed from Cavell Home into the hospital so you didn't actually have to risk setting foot in the East End in uniform,) I think it's still as plain as a pike staff that despite those nice flared jeans I wasn't impressed...

Cavell Home was dark and forbidding and when I pitched up with my luggage including a trunk now full of books, and porters bursting a blood vessel getting them up the steps, you could almost see the ancient cage lift shudder at the mere thought of what was ahead. The rooms were tiny, you had to trek miles to the bathroom and your washing was always getting pinched, plus needs must, we were going to have to nurse moany old grown-ups, instead of sweet and lovely little babies.
We were going to have to whisper on night duty for fear of waking them up when we had been used to having the radio on in SCBU.
We were going to have lift twenty-five stone people in and out of bed, not cradle and smile at 3lb babies in our arms.
No more reading children bedtime stories before you went off to supper on a late shift.
Grown-ups did unexpected things like have heart attacks and embolisms when you least expected it and you still couldn't run.
Women seemed to want bedpans and cups of tea and bedpans and Horlicks again and again in an endless 24/7 cycle.
No more sweet little cots and pink or blue counterpanes with nursery rhymes on them, instead thirty great big beds to strip, change and remake every morning, big heavy mattresses and a thing called a 'donkey', a sandbag wrapped in a sheet, that you placed strategically in front of a patient's feet to stop them sliding down the bed...which admittedly did save you the trouble of constantly having to lift them back up the bed.
And then three months of night duty in Casualty pumping out stomachs ...always cabbage ...always carrots ...sorry but true.
There were small advantages of course, like Mens Surgical and medical students, and cheap stereos and black and white TVs out on the market stalls but there's no denying it, we were unsettled and perhaps it was all blighted the more for me with the death of my brother halfway through the year.
Worse were the draconian Cavell Home rules and regulations imposed on us after the freedom of our Haringey pad, a watchful warden who ensured we signed in any male visitors and signed them out again by 10pm. But I guess at least we felt safe because after all we had all been brought up to know this as Kray and Ripper territory, brown end of the Monopoly board just past 'Go' and definitely not the bit of London you traversed voluntarily, let alone lived in.
How times have changed.
It was clear when we set foot in the London that we were working in a hospital laden with a tradition and history to match that of Gt Ormond St, but could we haven given a fig for it and who was Edith Cavell anyway?
Shot during the First World War, Anna Neagle in the film?
No, we were homesick for what we now realised was the light and joy of the Alma Mater and if discipline could have been stricter anywhere than Gt Ormond Street it was here at the London, where the ward sisters were called by the name of their ward as if they had entered a sort of marriage contract with it, and we appeared having been thrust upon them to throw the orderly betrothal into chaos, cast the two asunder and unplight the troth with our ineptitude....sorry, I had to run with that image for a minute there.
Sister Paulin would hold morning prayers (as if calling on all the help she could muster to cope with us) in the bit of the ward called The Big End, clutching the wooden prayer board, akin to an outsized table-tennis bat, with the London Hospital prayer inscribed on it.
Here's Sister Paulin's Big End in the 1930s, little had changed by the 1970s.

I watched Sister Paulin and that prayer board for eight weeks and by the end of that time had mastered the little cross-thumbed way she held it, niftily doing a sign of the cross with said thumbs and all without dropping the board, and all to a ward full of Jewish patients.
The London Hospital nurses wore uniforms incorporating vast acres of lilac check fabric all gathered in most unflatteringly at the waist, so even if you had no hips you didn't stand an earthly, leg of mutton sleeves that blessed you with bingo wings regardless, and dresses which almost touched the floor, all in stark contrast to our rather skimpy pink and white stripes.
But we all muddled along, frequently incurring the wrath but they tolerated us, and we made the best of it and I mustn't grumble because I did meet Bookhound there, so we stuck out our year before returning 'home' for our final year's training.
So that's how I've felt about all that for ...hmm... thirty-five years or so now, hard hard work, essential training, occasionally exciting (the famous ballet dancer who Sir Anton Dolin came to visit and Dame Margot sent flowers, or the day Evel Knievel was brought in after didn't make it over the buses at Wembley Stadium) and I'm wondering if it's too late to take all that slight sense of unimpressed disenchantment with the London back?
Is my fifty-something self allowed to do a bit of a U-turn on the twenty-one year old me?
Do a complete volte-face?
Best do it publicly and get it over with in that case.
Because having just finished Edith Cavell by Diana Souhami, how immensely proud I now feel to have unwittingly walked in London Hospital-trained Edith Cavell's footsteps.
I'll be sharing my thoughts about the book very soon, but it's a long time since I have read a biography which has moved me quite as much as this one, and how impossibly hard I found it to read through to an ending that is barely imaginable and one that had been least expected by everyone at the time including Edith herself.
Cavell Home was being built during the First World War (I knew it, you could tell ) financed from a fund raised by the Daily Mirror , and following the execution on October 12th 1915 of Edith Cavell by German occupying forces in Belgium, Queen Alexandra requested that the name be changed from the Queen Alexandra to the Cavell Home, which it was.
Strange how little my callow self appreciated these things at the time, and how refreshing to discover that age and a book can inform and impose a different order on a period of my life I thought I knew so well.
Better late than etc.

Children First and Always...

I wonder whether anyone else watched the programme on Great Ormond Street Children's Hospital on BBC 2 on Tuesday evening?
Children First and Always the hospital motto and the old Alma Mater didn't disappoint as the cameras, with their unrivalled access to the work of the cardiac surgeons, created a programme that I personally thought was superb for so much, but especially for its demonstration of the moral and ethical dilemmas that medicine faces in the 21st century.
I think I will carry with me for ever the words of the surgeon who said 'Living is a gift', and paused, holding the camera's gaze from behind his mask; that gaze investing those words with deep and manifold meanings as he was about to operate on Blessings, a beautiful newborn baby with a complex cardiac anomaly. There were real risks and uncertainties about survival and long-term prognosis if this tiny baby made it through what would be the first of many operations.
For her parents this was their only hope.
Sadly Blessings didn't make it.
We witnessed the cardiac team at those usually closed meetings where peer group discussions and supervision allow for evidence-based, informed decisions to be made; harsh-light- of-day, life and death decisions made with consummate technical skill and expertise, but also with honesty and humility.
I was seriously impressed with the open acknowledgment and acceptance of the existence of the emotional attachment between the surgeons and their young patients and their families...

'Without it we have lost out humanity'

said Professor Martin Elliott.
The transparent recognition that this is an attachment that could so readily cloud good judgement and the trust between colleagues to be able to admit to that takes years to build, as do the recognised pathways in place for seeking other opinions from around the world in order to decide what is really in the best interests of the child and the family and their future quality of life.
The family who have clearly stated they will sell everything to seek surgery in the US in a final attempt to save their child's life if Great Ormond Street won't reconsider their decision not to operate...this self-induced poverty brought into the debate but not allowed to compromise any decision about whether to operate or to allow for a natural progression.
But who can forget little eight year old Brian, wide eyed behind his oxygen mask, sitting down and listening to consultant Philip Rees (who was there in my day I'm sure) as he gently explained the logistics of performing a heart transplant and answered Brian's questions so appropriately and kindly, and above all honestly...
'Will I be asleep?'
'Where will you get a heart from?'
'Why won't that person need their heart?'
'What will you do with my old heart?'

It was some of the most moving television I have watched in a very long time and how well I remember, even back in the 1970's and perhaps the trickier days of cardio-pulmonary bypass, being on night duty when the whole hospital would know that there was child undergoing lengthy open heart surgery. Often a child who had been an in-patient for months, and so one with whom many who had worked on the ward had formed an attachment and usually got to know the parents well too. By that unique form of hospital osmosis, the chat over meal breaks, we all knew their name and a particular sort of hush would descend... as of one all holding our breath during those hours of darkness through to dawn and collectively willing that the surgeons would be able to get the baby off the by-pass.
We'd go to dinner at midnight... baby still in theatre.
To tea at 3am...still trying to get the baby off the by-pass.
The phones would ring around the wards through the night...have you heard anything yet?
If you worked on Cohen ward (Infectious Diseases and Dermatology) on the ground floor you had in your line of vision the vase of white flowers that were ever-present in the front hall of the Southwood building of the old hospital. It was to this vase that the nurses laying out the body of any child who had died always went to collect a white flower to place between their crossed hands.
You did not want to see anyone coming down from Ward 1A (Cardiac) on the floor above you and going to that vase during that night.
Then going to breakfast after that interminably long night shift and hearing that the child was back on the ward and all of us heaving an enormous sigh of relief as we fell asleep exhausted over our cornflakes.
Sadly eight-year old Brian's new heart failed to work properly and he died two weeks after his surgery, and I suspect as those bleak words came up on the screen, the nation as of one was heartbroken and hopefully vowing to carry donor cards, but had also come away with a real understanding of the work and the dilemmas and difficult decisions that face the medical profession today.
There is always a price to pay for progress and the surgeons made the difficulties of that abundantly clear, but how amazed Charles Dickens, one of the hospital's founding fathers, would have been to know that his rather flowery sentiments in Our Mutual Friend continue to hold true, there may not always be 'cures' but it is still Children First and Always.

“[A] place where there are none but children; a place set up on purpose for sick children; where the good doctors and nurses pass their lives with children, talk to none but children, comfort and cure none but children.”

Direct Red - Gabriel Weston...again

Sorry about Monday but this is what has happened since I picked up  Direct Red - A Surgeon's Story by Gabriel Watson, it's all come flooding back, I promise we'll stick to the book today.
I'd only really viewed the surgical gods from considerably lower down in the food chain, so I was interested to see what life might be like for a woman supposedly on an equal footing but working

'in a world dominated by alpha males...where a certain moral ambiguity and clinical detachment are necessary tools for survival.'

Indeed they are, but Gabriel Weston bravely and honestly challenges those pre-conceptions and her own thinking around many of the situations she finds herself in. The result is many portions of humble pie consumed and a self-effacing account of life at the cutting edge (sorry) as Gabriel Weston walks her reader through many of those staple scenarios of the TV hospital drama, but with a personal touch that debrides (sorry, I can't stop myself,  it's all begging for it) those surface layers to see what really may lie beneath in the mind of the doctor.
There's the inevitable kudos of those first days of being a medical student until the first resuscitation is required...and forget that promise because it's all reminded me of our first day in uniform.
We'd been nurses for about three days (and I discover that Gabriel Weston would have been about two years old in 1972) all standing chatting on the platform at Russell Square underground waiting for the train to take us back to our nurse's home in Belsize Park. There was a bit of a commotion and then the crowd of passengers around us parted like the Red Sea to allow us to take command of the situation and decide what to do next about the person who had jumped under the incoming train.
Whiter shade of pale doesn't come close and you know those emergency stairs at Russell Square that they tell you not to take because there are so many of them...
But in many ways this is what made this book so special for me, situations of my own that I could identify with, but it matters not whether you are medical or otherwise because so many of the central observations of Direct Red translate willingly to other life scenarios. It's a book about people and how they react to one another and what we all do to try and protect ourselves, whether being done to or doing unto others, this is humanity plain and simple.
Be ready with a strong stomach if this is not your thing because Gabriel Weston doesn't couch (sorry, that was unintentional) any of this prettily or euphemistically. There is plenty that will certainly make your eyes water, one scenario in particular an object lesson for Gabriel Weston in professional pride and quite how we may all compromise our integrity in its preservation whilst convincing ourselves and others that we are doing the right thing.
And prepare for great sadness too, expect to read what it might really be like to suffer a miscarriage for example, but any account that avoided such moments would not be truthful and nor would it have that ring of sincerity and honesty that Direct Red does which explains why it was longlisted for the Guardian First Book award last year.
Meanwhile here's an observation from Gabriel Weston and perhaps something to bear in mind if you ever find yourself in need of surgical attention.

'It is no longer enough to be technically proficient; nowadays, we need to be nice. And this presents the modern surgeon with a great challenge: how to combine a necessary degree of toughness with an equally important ability to be gentle.'

I think I'll just settle for them being stunningly brilliant and proficient at what they do, I always like to check for a steady hand too, neat needlework skills are a bonus and then I'll be thankful for such small mercies and acts of kindness that may come my way, and to be honest, I'll forgive the rest.

Direct Red ~ Gabriel Weston

 I've been in a wallow of gritty reminiscence since reading Direct Red - A Surgeon's Story by Gabriel Weston so it's time for this photo again to set the scene and give you a Monday morning smile....yes, yes, the hat...I know it's very odd.
It's perhaps a lesser known fact that there was a time when I thought my future nursing career rested not in a staff nurse's uniform but in the operating theatre.
Even I can hardly believe that at the age of twenty-three and that lifetime of wanting to be a nurse, all that saving lives and dedicated patient care and interaction with living (hopefully) awake and breathing people I had dreamed of, was about to be exchanged for the role of a scrub nurse. Letting my hair go frizzy as the autoclave door swung open, wearing a mask all day long, passing cutlery and needlework accoutrements to a surgeon, counting swabs and ministering to completely unconscious patients.
It was a bit of a one-way street and not what I had intended at all, though to be fair I think my nursing career and my life were both at something of a crossroads.
I'd enjoyed theatres as a student mainly because I'd done my placement in the smaller more intimate learning environment of Gt Ormond Street's branch hospital Queen Elizabeth, Hackney Road. We'd do on call and sleep in sort of flowery bower of a 1930s bedroom next to the theatre and it all felt very important and dramatic to get that 3am knock on the door to get theatre ready for Mr D to operate on an emergency.
I can still remember the cases, 4am and us all clustered around a newborn baby with intestinal obstruction which turned out to be caused by Apple Peel Syndrome when the surgeon finally got in to have a look...the intestines coiled and shaped like the complete peel off an apple.
Mr D was a real gentleman too, quite gave me a false impression about surgeons, talked to everyone as if they were a human being just like him.
Sorry... where was I...was I supposed to be talking about a book?
Anyway I loved it all so just imagine it, a few years later, qualified and looking very Holby City in my nice green scrubs and white clogs, first scrub as a staff nurse in theatres at Gt Ormond Street, bit slow off the mark and the surgeon threw some tonsils at me because my hand wasn't ready to receive. The surgeons were really higher even than the gods in the hospital heirarchy, many of them world pioneers but there still seemed no need to fling some throaty detritus at me.
Mr D would never have done such a thing.
Fielding tonsils was not to be my bag, I was over my love for theatres very quickly after that and hastily went back into starched uniform as per above, staffing on the metabolic unit for the few months I had left to work. I would be leaving to get married and moving to Devon where I had a place to train as a midwife.
That wasn't right either, didn't even make the first day because by this time I had decided I was fed up with hospitals and my future lay as a Clerical Officer in the DHSS as it was known.
That lasted a few months until I had to resuscitate someone who'd collapsed after being told they weren't entitled to benefits.
Then I realised I did like saving lives after all (yes he lived and was probably entitled to everything after I'd finished with him) but perhaps not quite this dramatically and the rest is well-documented history here, health visiting and the great outdoors it was for me.
Sorry...
I got a bit carried away and you will too if you have even a hint of any hospital experience (either side of the bedside, if you see what I mean )
I promise I'll talk about Direct Red tomorrow....no sorry it'll have to be Wednesday I must catch up with Endsleigh Salon tomorrow before the next one.

Country Doctor Tales of a Rural GP by Dr Michael Sparrow

It's not often a book comes along and I know the person who's written it, as in written by a doctor I'd worked with, but when I saw Country Doctor Tales of a Rural GP by Lifton GP Dr Michael Sparrow in the Constable catalogue I just couldn't resist asking for a copy...well how could I not?
Truth be told, though I provided holiday cover and disaster back-up for the Lifton practice for about fifteen years I was rarely called on, having been blessed with an exceptionally fine Health Visitor colleague possessed of that precious gift of prediction, plus the innate ability to avert most disasters for the two weeks she'd be away.
Basically the families loved her so much they could invariably hold off a crisis until she got back.
I'll perhaps gloss over the visit I had to do to the family living in the house decorated inside and out to match the parrot perched in the centre of the living room, but apart from that, no, nothing too dreadful comes to mind.
Over the years we did a lot of joint visits and I saw a lot of the families but I doubt Dr Sparrow really knew of my existence until my colleague moved on and I slotted into Lifton thinking I'd like a change which in fact, in the end, I didn't.
I had to increase my hours to cover it and though the surgery and the staff were lovely I couldn't manage the vast amounts of driving through holiday traffic way down into Cornwall to Egloseverywhere and TreperranalongtheA30 to see the patients.
I had enough trouble locating Devon Social Services, let alone getting to grips with Cornwall's and it was clear I'd be needing to find them.
But the first thing I saw when I walked in the surgery was a poster for this book. I'd toyed with the idea of fessing up about dovegreyreader scribbles (which very few people I worked with knew about) and scrounging a free copy but thought better of it.
Dr Sparrow did not seem too happy at the loss of his much-loved and respected Health Visitor, I was a poor substitute who would probably have to prove herself over the next fifteen years or so. This was going to take time but in many ways it felt like Lifton history repeating itself for me.
There's a great deal in the book about Mike's medical training all hilarious (we did almost get on first name terms, perhaps not quite, I moved swiftly on after a very long, hot and demoralising summer in 2007) , but what intrigued me most was his account of how he took on the Lifton practice from the long-established, dedicated but unusual  team of Dr Christopher and his wife Dr Margaret (renamed by Mike but we all know who they were)
Drs C & M had arrived in Lifton (incidentally also the home of Ambrosia rice pudding) in 1954 and established a practice that changed not a jot in the face of successive government edicts, becoming something of a famed local institution and well, how can I put this, they were not really truly sure what a Health Visitor was for when I found myself allocated to their practice in my rookie years back in the 1970s, long before Dr Michael arrived.
These were the olden days of health visiting when all families had my home phone number and I'd effectively be on call unpaid for 24/7 in gratitude for the Health Authority paying the rental on the phone, and therefore getting calls at 3am because 'the baby wouldn't sleep'.
And before you ask, yes, I'd go out and help sort it, because in those days in rural Devon we did and I can hardly believe that now. You haven't lived until you've paced around a muddy farmyard at 3am with someone else's screaming baby wondering quite how you got yourself into this job.
So there we were in those halcyon newly married, pre-children times, packed up and ready for a day at the beach early one Saturday morning and I was more than disconcerted when the phone rang ominously.
Bookhound answered,
'It's Dr Margaret for you.'
'For me? Really? Dr Margaret wants ME? But I've been there a year and I don't think she really knows who I am, let alone wants me for something.'
It felt in that split second like a bit of a moment.
I was newly qualified and keener than mustard about 'preventing ill health and promoting good health' and now Dr Margaret 'wants' me', perhaps my work had shone and I was 'in' that was it.
Respected, accepted this was indeed good news all round.
Gosh this would be a coup with the senior HVs on Monday...oh yes, by the way, I took a call from Dr Margaret at home...absolutely unheard of to be needed like this.
I was all nervous trepidation when I picked up the phone until I discovered it was to tell me quite authoritatively that a patient had locked themselves in their bedroom, please would I go and talk to them and persuade them to come out. I fancy there was even a touch of controlled panic in her voice but that could be my imagination, perhaps Dr Chris and Dr Marg were packed up for the beach too?
Suddenly I could hear the rolling Atlantic waves, feel the sand between my toes, smell the egg sandwiches and besides I'd never heard of this patient living in the very back of beyond, no babies or children involved and all on a scorchio Saturday morning just as we were going to the beach for the day.
I was a rookie it's true and my instinct was to please, but on this day I learned one interpretation of being put upon and proceeded to practice a skill that I was forever trying to perfect with GPs for the following thirty years,
'Actually Dr Margaret, that's really not my remit, I think perhaps you'd better ring Social Services yourself about that one.'
I was shaking like a leaf when I put the phone down.
Dr Margaret had that way about her, Mike's right, she did look just like the Queen and things had definitely got a bit frostier than usual. Bookhound and I leapt into our old Renault 5 and shot off to the beach in a flash where I sat and fretted about this person locked in their bedroom all day, imagined Dr Marg in her tweed skirt up a ladder at the window negotiating and, much worse, what she might have in store for me on Monday.
Needless to say nothing was said and I was too frightened to ask about outcomes, but then that was no different to the usual and we rubbed along regardless, me keen and eager, Dr Marg largely unaware of my existence until I eventually sloped off unnoticed to have babies.
Who knows what best friends we'd have become if I'd obliged, but somehow I doubt it.
When some years later Dr Christopher died during morning surgery as local legend has it and Mike recounts this, Dr Margaret took a deep breath and went in and finished his surgery for him remarking
' they would only have come back in the evening.'
They were definitely made of very stern stuff in those days.

Marmite madness and mayhem

Wales and Sister Beech are in agreement, except Wales have panicked and the Marmite will not be saying hello to the bread at all.

"Ceredigion Council in Mid Wales has taken the yeast extract product off the menu at their 51 clubs within the county because of a "high level of salt."

The makers of Marmite responded by saying only a small amount was needed to make "toast tasty" for children."

Shame, I could have gone round and done a Safe Marmite Use demonstration, set up a whole new department even, I think it would have caught on big time

"The Marmite should just say hello to the bread"...big advertising campaign, come on Unilever get it sorted!

Retirement update

I'd better keep you up to date with the retirement process if only because the knock-on effect is that it's all seriously eating into sane,settled and calm reading time at the moment with a trillion and one things to do both at home and at work.
Most importantly and of highest priority we have been moving the entire house around to re-accommodate my "sock knitting quilting" empire in readiness for the "used to be a community nurse in her spare time" moment. This has involved walking a marathon as all the books, notions and accoutrements from the spare bedroom shift to one end of the lovely warm wood-burner-heated sitting room. I've also purloined other bits of furniture on the way but more about that soon.
You'd think with the number of NHS employees who must be grabbing the dosh and running retiring and taking their pensions right now (I hope to goodness the NHS didn't dabble in Iceland) that management would know exactly what to do. Advise you about the paperwork, what's required, who signs what, who needs photocopies of what, where to send your inside leg measurements that sort of thing. But this is the very fledgeling Devon PCT which after two very unsettled years still seems to be shaking down and please don't ask me what all this must have cost because I get cross. With offices constantly moving to scattered locations around the county, one minute Personnel Human Resources is in Exeter, the next minute they've moved to the airport (the airport?) Pensions was in one place, now it's somewhere else entirely and with new phone numbers.
Malcolm in Pensions has been marvellous with his forecasts and general advice, he and I became good phone buddies when I actually declared a vague undecided intention to retire back in June, just to start the paperwork ball rolling, with the proviso that I could stop the ball rolling if it all gathered too much momentum and I panicked about things like how we'd pay the gas bill. And yes true to say it has been a tortuously hesitant and difficult process in the deciding of, and then once you've made the decision you want to leave yesterday, can't bear to work another minute.
I seem to have spent an inordinate amount of time going back over the forms yet again, more phone calls, more photocopying of birth and marriage certificates, more signatures from witnesses, finding a manager to complete the Termination of Employment form that says officially that I will be leaving and then there's the annual leave entitlement.
Good grief and heaven forfend, has she taken too much of the year's April to March entitlement? You can only keep one week until after Christmas so it's inevitable that by October it's whittling down.
The granted sum is 175.5 hours including pro-rata 27.5 hours for Bank Holidays.Divided by 12 and multiplied by 7 gives a figure beyond which I must not have exceeded by the end of October.
Hmm.
But here in my diary is a careful log of all the extra hours I've worked in the last six months which you owe me.
More hmm
I think it might have been far simpler to just go off sick on full pay and stay off sick until I'd accrued enough annual leave to clear the balance sheet.
Then things get really complicated because as a "gift" I get £10 for every year of selfless and dedicated (!) service which will arrive in the form of vouchers of my choosing. This is usually M&S, John Lewis or Gardening vouchers and you have only yourself to blame if you don't declare a preference otherwise someone buys you a "picnic set for your caravan" . I've already selected John Lewis so that at least I can keep myself in Rowan wool for the forseeable future but now there's the thorny issue of 'exactly how many years count'.
The upshot is some poor soul is going to have to locate my personnel file and rummage through it and heaven knows where that's ended up.
It will have started it's West Country life back in 1977 with my health visitor training sponsorship and subsequent employment by Devon Area Health Authority (based at HQ Exeter), which then begat a smaller baby named Plymouth Community Services NHS Trust (based at new HQ in Plymouth, new management structure)  which then begat an even tinier baby (tiny has definitely been best, happy valued staff providing an outstanding local service) named South Hams and West Devon Primary Care Trust (based at new HQ in Totnes, new management structure ) which then begat a great big behometh-like whopper of a baby named Devon Primary Care Trust (back where it started, based who knows where but at new HQs sprawled all over the county, new management structure). Next year it will begat something else entirely as the whole provider split happens (I really haven't been paying much attention to this knowing I'm going) but I gather we could be managed by Boots PLC (bound to be new HQ, new management structure).
Bless the little file probably now dog-eared, rusting paper clips holding together tissue thin sheets of paper, bursting at the seams and wrapped in rubber bands, it's been roving around for thirty years and I wonder what happens to it next?
Do they toss it on a bonfire and say good riddance? Is it placed in a museum of ancient NHS artefacts? Heavens just look at this a carbon copy typewritten letter, good lord.
My word a Gestetner print out.
Quit while I'm winning? I think I've escaped in the nick of time meanwhile talking of tiny babies, here's me right back at the start of my nurse training and doing something I clearly enjoyed, he was called Fred and he really was very very tiny indeed.

The Other Sister Beech

I must make a correction.

So there were two Sister Beechs at Great Ormond Street, they were actually siblings and Sister Betty Beech who died recently we now discover is Night Sister Beech not Ward Sister Norma Beech so I must right the mistaken identity. As students we never knew their first names, much like school teachers, they were just The Sisters Beech to us and both worked at the hospital at the same time.
But I have as many memories of Night Sister Beech as Ward Sister Beech.
In fact it's worse than the Milton - Tasting / Hello - Marmite saga. Much worse, I could have been struck off before I was even on.
It was Night Sister Beech who came upon me on a ward round at about 4am, short-staffed and run off my feet on the ward on my own because the agency Staff Nurse had gone to tea, it was paediatric neurology, I remember that much. There was always a vast amount of work to do before the day staff came on and no flimsy excuse about being short-staffed ever cut any mustard, so thinking I was being clever I had proceeded to start dressing the children at about 3.30am and tucking them back under the bedclothes fully clothed. Now  in fairness I was acting under orders but I know I know, sick children need their full whack of sleep in their pyjamas, however it seemed like a really good idea and I was impressed. We'd be way ahead of the game by 6am drug round, feeds and observations and on the home run by breakfast time at 7am and ready for report to the day staff at 8am and off home to bed.
I hadn't expected a ward round from Sister Beech quite so late into the night. We all thought they dashed round and then went off and had a sleep or drank pots of tea in a secret location after about 2am, so it was a bit of a stomach churner to hear her speedy footsteps tip-tapping along the corridor, the swing of the door and hey-presto she apparated before my very weary eyes.
If only children didn't have that habit of flinging off the bedclothes in their sleep because they are roasting and sweltering, overheating and sweating profusely the deception would have gone undetected I'm certain. Except they would then have been likely to have a febrile convulsion or be nudged into status epilepticus given that paediatric neurology is that sort of ward.

Nope, I can't even begin to tell you what happened next, my gizzards are entering a state of flux just thinking about it.

The Decision

What a momentous few weeks it's been here at dovegreyreader scribbles and time to roll out this picture again and have you all laugh at 'that' hat once more.
Egged on by Bookhound I'd been building up to The Decision and somehow a trip to France with clear thinking time in the sunshine clinched the deal, so on the Monday that I returned to work I handed in my resignation. Even posted the letter Special Delivery which cost £4.50.
After thirty years trained as a Health Visitor and eighteen plus years on this contract, I am fifty-five tomorrow and in a few weeks time to be a Health Visitor no more. Well, other than the occasional 'locum' shift here and there (really ' in my spare time' for once) next year perhaps, but first I'm going to have a few degrees of separation from the recent turmoil that has been the government-directed 'modernisation of the profession'.
You might recall that particular resignation Monday and perhaps you wondered what was really behind the mega-collapse of the world's financial markets, the downfall of Lehmann Brothers?
Yes well I hadn't intended to cause quite such a stir and many thanks to the friend who questioned my sanity at throwing in the towel on secure employment the day we all thought we might not be able to afford to eat the following week.
Sometimes though you reach tipping point and the moment is exactly right to get out while your heart and soul remain intact and you haven't compromised your standards; quit while you're winning in fact. So I finally draw a line under my NHS career.
We have had a very special family moment out of it all.
It was The Tinker (father of dgr) who delivered me as a student nurse to Great Ormond Street and into the hands of the NHS on this very day, September 25th 1972 and so it seems meet and right that he should be the "member of the electoral roll but not your spouse" who signs my pension forms to rescue me at the other end and some thirty-six years later. Now of course wishing I hadn't drawn out all that superannuation, as it was then called, to buy a stair carpet when the word pension seemed light years hence.
In the way that these things often happen, yesterday, on the day that I finally convinced everyone that I really meant to resign and I now have a finishing date, I had another piece of news. I received an e mail from a member of Sister Beech's family to tell me that they had found a mention of her on here and that sadly she had died a few days ago. When you look back over a long career in nursing there are bound to be many memories, some of them stick like glue because you learnt something from them and many of my most memorable 'learning' moments involved Sister Beech.
Sister Beech was of the old school, as I think am I these days, but taketh not a short cut and expect to get away with it if Sister Beech caught you out. It was Sister Beech who caught me sloshing Milton by guesswork into the baby bottle sterilising tanks as I did a locker round, and then accompanied me around the ward to taste each one just to demonstrate the error of my ways. I was a very strict and accurate measurer and diluter of Milton to the millilitre everafter.
But there was another lesson never forgotten. One junior nurse task was to make the children's afternoon teas, I doubt this is in the job description of a student nurse these days but Marmite soldiers were de rigueur on Sister Beech's ward and again I was a bit profligate with it all. The summons wasn't long in coming,

'Nurse Chester, to the kitchen please!'

It's no good being sentimental about all this, at times it really was awful, no question, and fear did by this time grab my very entrails because once Sister Beech had caught you pulling a fast one she kept a most watchful eye on you. Expect her to pop up in the sluice just as you were slopping something unsavoury out in the wrong sink, ('scoop it out nurse and put it where it belongs') or perhaps the Treatment Room as you by-passed washing down that trolley or caught you with your head in the linen cupboard eating a dry Farley's rusk (we were always starving, I've drunk a bottle of Cow & Gate baby milk before now).
This time I quite thought it was going to be about the wodge of ice cream I'd just bolted down behind the fridge door, (hospital ice cream for some strange reason absolutely delectable) because now I'm completely convinced that Sister Beech is also capable of seeing the semi-digesting contents of any passing stomach, but no, it was the soldiers. As she surveyed my plate of lovely sticky lavishly blessed Marmite soldiers Sister Beech looked me in the eye, fixed my gaze firmly on hers and uttered the immortal words,

'Nurse, these are a disgrace, think of the sodium content...the children's kidneys, the Marmite should just say hello to the bread.'

I was too terrified to laugh and Marmite has done no more than say a very brief 'hello' to anything in my hands ever since. I will always be thinking of your kidneys when I offer you a Marmite soldier.

Looking back I know that I have much to thank Sister Beech for including the fact that a jar of Marmite can last as long as five years in this house, but joking aside I learnt another invaluable lesson; that it would always be inexcusable and unforgivable to compromise the high nursing standards that I learnt at Great Ormond Street, no matter how I was called on to use them, no matter where I worked or what job I was doing, because it could cost lives and that would always be a huge stain on my conscience.

As I said, quit while I'm winning.

Courage

More bookish synchronicity as I start reading Courage by Gordon Brown alongside Sisters in Arms British Army Nurses Tell Their Story by Nicola Tyrer and that in turn makes me get Grey & Scarlet : Letters From the War Areas by Army Sisters on Active Service back down off the shelf too. Quite a nice matching set now I look at those covers.
Gordon Brown (yes that Gordon Brown) 'explores the lives of eight outstanding twentieth-century figures, in order to better understand courage' and the list is part predictable and part eclectic and unusual, Dietrich Bonhoeffer, Raoul Wallenberg, Martin Luther King, Robert Kennedy, Nelson Mandela, Cicely Saunders, Aung San Suu Kyi and the one I was immediately interested in, Edith Cavell.
Edith Cavell trained at The London Hospital in Whitechapel, as in part did I, and where I had the dubious pleasure of living in Cavell Home in East Mount Street. It was ancient back in the 1970's, tiny rooms, lifts with metal cage doors, all men signed in and removed by the Home Sister at 10pm sharp. I knew little about Edith Cavell beyond the film version (Anna Neagle?) but I now see that she was made of very stern stuff indeed and to be honest you'd expect nothing less of anyone who trained under the formidable Matron Luckes (Luckes Home was yet another spartan nurses' billet)

'Her courage at the moment of death, when she forgave her executioners, is perhaps the best-remembered aspect of her life, yet everything beforehand can be seen as preparation for that one moment, her courage springing from a dignity and strength of character demonstrated again and again through a life lived in the service of her principles.'

Edith Cavell born in 1865 certainly following in the still visible footprints of  Florence Nightingale, Eva Luckes had been in correspondence with Florence and continued to maintain the high standards now being established for nurse training.
I feel certain 'uncompromising dedication to duty, vocation and pride' in the profession still echoed around us back in the 1970's and perhaps that's why I still strive but struggle within the constraints of NHS 2008 to adopt anything less than best practice. We were trained in the unwavering belief that second best was most certainly unacceptable and would be potentially damaging somewhere along the way if not life-threatening.To this day I just can't do it.I always imagine Sister Beech is waiting round the corner to swoop and come in for the kill.
I've tried to forget that Gordon Brown is the Prime Minister and may be trying to offer any covert message or ideological stance about his own governing principles with this book, cynics might argue that it's an attempt to gain more gravitas, reap some political kudos by association, but I'm not quite a hard-boiled cynic yet and so am reading the book on its merits alone.
Royalties from the book go to The Jennifer Brown Research Laboratory (the Brown's first child who died soon after birth) and I am trying to extract the essence of what Gordon is saying. Indeed I think it will be along the lines that second best wasn't good enough for any of these lives either and courage was and is about standing up and saying so and staying true to your principles along the way.
More soon about Sisters in Arms where second best most definitely would not do, and don't miss Romanov Day on here all day tomorrow, with Helen Rappaport chatting in comments about her latest book Ekaterinburg.
It's blinis I've got to cook apparently... where's Cornflower when you need her?

Nightingale Part Two : The Fountain Pen

OK breath deeply, contain your gag reflex and I will proceed.
There is a surgical procedure, preferably performed under anaesthetic, for those who suffer from recurrent bouts of sinusitis in which the maxillary sinus is pierced via the nasal cavity, flushed out with saline and hey presto you wake up being able to breath again. When I scrubbed in ENT theatres it used to be called an antrum washout but probably has a completely new and fancy name now, like post-nasal irrigational lavage or something but William Hague was entirely thankful to have his done by this method whilst he was Prime Minister Leader of the Opposition (thanks Maureen!) and it made national news headlines that day.
I hated working in ENT theatres by the way.
Scrubbed up one morning and doing the slapping of forceps into the hands routine I was a fraction off the pace with an instrument, only the merest milli-second I'm sure, and the surgeon threw the tonsil he had just extracted at me in temper and with instrument attached.
It bounced off me and across the floor, then he shouted at me and of course it was all downhill after that.
Uncalled for I'd say and these days I'd probably throw it right back at him, catch him a glancing blow across his masked mandible and then sue for damages, but thirty years ago the disgrace was all mine and led to my demotion to counting swabs, filling and emptying and filling and emptying the autoclave and damp dusting for a week.
But where was I?
Ah yes, Peter Dorward's fountain pen in Nightingale.
Now I'm not sure what happens when an antrum washout is performed spontaneously, even on the spur of the moment and in anger shall we say, using a left oblique italic nib via a Mont Blanc pen tanked up with a nice permanent black Diamine ink, (my embellishments) but it's probably not pretty; so much so that I can't bear to go back and check the details but I think it was Horst who most definitely didn't see that one coming.
Hope that doesn't spoil anyone's day or anything and don't let it put you off this excellent book, you can skip that bit.

I wasn't there...

I see Evel Knievel has made his final leap into the great blue yonder, so where were you on May 25th 1975?
The day Evel tried and succeeded in jumping the thirteen double decker buses at Wembley Stadium but catapulted over the handlebars of his bike when he landed and somersaulted into a heap on the concrete.
I wasn't there because I was walking across from the Edith Cavell Home in East Mount Street to go on duty at The London Hospital, Whitechapel with my best friend Wiz.We had been seconded there for a year from Gt.Ormond Street to do our general nurse training.After tiny babies and little children who never complained, grown-ups were proving a bit of a challenge.
Suddenly we were nearly mown down by a trolley surrounded by hundreds of people and all we could see were Evel's feet and did I imagine his distinctive star-striped helmet sitting on the end of the trolley? Sorry, I've made it sound as if he was separated from his feet, he wasn't, as far as our acutely honed nursing skills of observation could tell they were still joined to him.
Now to be completely honest I can't remember what Wiz and I said, but knowing us and our mood it was most likely along the lines of "mmm, that didn't go so well then." We were completely unseduced by the notion of celebrity.We'd nursed quite a few celebs in our time and quickly discovered that when they are ill they are just like the rest of us, what goes in comes out just the same way as it does for you or I. Dare I say it, they can also be a tad more demanding?
However London had been buzzing for weeks with the excitement of a man jumping over thirteen double decker buses on a bike, which just goes to show how different life in the metropolis was in those days.
Nowadays, first find thirteen buses in a row.
We didn't know if  he was dead or alive until we heard a distinctly American voice from the trolley.Now, hands up, I can't remember what Evel said either, but it was most likely along the lines of 'flippin' nuisance this'  and thinking back there was no one jumping up and down on his chest and they weren't exactly sprinting that trolley along so we guessed he was OK. All in all we felt it was probably one of those strangely memorable days, and it must have been because I haven't forgotten it.
I went on duty onto Paulin Ward, Women's Medical and this is the very same ward some forty years earlier. I'm sure sister must have been the same, probably still there now aged 154, but possibly some of the students had moved on and there were never this many of us, but this is how I remember it. At the London this bit of the ward was called The Big End (which seems lacking in imagination to me) and we still knelt for The London Hospital Prayer every morning. So I didn't get to take Evel's pulse or mop his brow, which was a shame because it would have brightened the day no end. With apologies to all women, when there were thirty of you on a medical ward back then you were not the jolliest of crowds, even the information that Evel was in the building didn't perk you up and the hourly cups of tea you required whilst bed-bound translated into one heck of a lot of bedpans required over an eight hour shift.
Men's Surgical? Now that was a different matter entirely, I've never laughed so much before or possibly since.
So RIP Evel Knievel and if you can bear to watch it here it is.

Jonny Kennedy

I remember the programme being broadcast and me thinking I wouldn't watch it because very naughtily I often shy away from work-related-medical things on TV in the evenings. In the end it won thirteen awards including an Emmy and some BAFTA's.
The Boy Whose Skin Fell Off was about a young man called Jonny Kennedy with a skin condition called Dystrophic Epidermolysis Bullosa. Probably something not many people have heard of but of course something any GOS nurse from the 1970's would be very well-acquainted with.It's a genetic condition where the skin lacks the "glue" that holds the layers together, the slightest knock or minor abrasion will cause a major injury and blistering which can take months to heal.Sufferers spend their lives in agony and swathed in bandages.
As we moved around our twelve week ward placements there were some very exciting stints and some that we  used to dread.
Plastic surgery was a plum draw and very high tech for then because the first Tessier facial reconstruction operations were being performed, plus the ward sister was lovely.
Likewise cardiac surgery always a bit dramatic and involving.
Neurosurgery also legendary for some high speed action.
Private patients always worth it for the standard of food in the fridge.
Then there was dermatology.
Cohen Ward, and I can tell you that I was assigned to Cohen for a hundred years but actually only from March 10th to May 19th 1974.There I passed my Aseptic Technique assessment under the very watchful eye of Sister McQueen who continues to maintain the highest standards of infection control at Great Ormond Street to this day.
Cot after cot of itchy, scratchy, irritable children and many in isolation cubicles, so slightly muted soundwise but still very itchy, scratchy, irritable children.This was the only ward in the hospital where you could expect to end your twelve weeks with the softest hands you would ever have in your life because many hours were spent immersing children in warm emulsifying baths.For those who may not know, this was a mixture of a very gloopy substance (still prescribed) which you dissolved in the bath and which leaves a very soothing moisturised layer on the skin.
The children with Epidermolysis were particularly difficult and I'm not sure that as young student nurses we fully understood just how challenging life was for them.They were children who may have spent months and months in hospital and not surprisingly they hated every minute, not least the excruciating pain of the daily baths.Behaviourally they were a nightmare, entirely understandable it has to be said, and there we were barely out of our teens ourselves and trying to deal with it all.
So I was very grateful to Tonto Press for a copy of Jonny Kennedy, The Story of the Boy Whose Skin Fell Off.
If I was only going to gain a real insight into just how difficult life must have been for these children it would be worth reading, but I've also read about a remarkable life lived under constraints it is almost beyond normal thinking to comprehend. Events most of us take for granted in daily life were a major achievement for Jonny and his struggles are all carefully chronicled here.
Roger Stutter initially wrote the book with Jonny, and has completed it since Jonny's death at the age of 36 in 2003 and now published.
It does make for challenging reading because Jonny is nothing if not honest about the horrors of his daily life, and by his own admission he could be very difficult to live with, all of which seems like his prerogative given his situation. But shining through it all is a matchless and life-warming spirit that touched everyone who knew him and after the TV programme was broadcast resulted in over half a million pounds being donated to Jonny's memorial fund.
It puts any amount of your own woes into a very neat perspective and is a very fitting memorial to a very brave young man.

A special London day

A special day in London last Saturday and one that usually only comes around every ten years but as we get older is now happening every five, the Great Ormond Street October 1972 set reunion.
Thirty five years since forty of us, eighteen years old and very nervous, pitched up with our trunks packed full of sensible things.Very sensible things, black K Skip shoes, a hot water bottle and textbooks such as Modern Nursing by Winifred Hector ( ours the edition after leeches went out of fashion,) equipped to embark on our nursing careers.I think we've probably been good value for money because I don't think our training can have been that costly. We were a pair of hands from day one, very cheap labour at  £10 a week and, apart from occasional weeks back in the School of Nursing, we were members of staff, rostered in, vital cogs in the running of the sluice hospital and learnt on our feet.
We quickly learnt one basic fact which we all agreed has underpinned our working lives ever thereafter, the hospital motto Children First and Always and the pride I felt the day I qualified and collected my silver enamelled hospital badge remains undimmed.
We went through hell and high water together all those years ago and the reunion always takes the same format. We meet somewhere in the hospital and there's a strange ten minutes or so as everyone remembers names and recognises each other. We get the original set photo out and quickly it's as if we have never been apart, the chatter levels rise and the laughter begins.
Then in small groups we are whisked off around the new hospital to see how it's all done nowadays.
Gt Ormond Street now an absolutely state of the art children's hospital and should be the pride of the nation and set to become even more so with massive building plans in the offing.We learnt that many millions has had to be spent bringing in power lines from outside the city, London's grid apparently sapped in its efforts to cope with the demands of a hospital where you meet an MRI scanner at every turn.
We were delighted to hear that the old Guilford Street nurses home is soon to be demolished and hopefully that will deal with the pigeons one girl in our set found nesting under her bed, to say nothing of the dancing cockroaches. Even in 1972 my friend and I took one look at our rooms there, said no way, and opted to share a room over in an outpost across Russell Square in Bedford Place.I can't believe it's still standing.
We hire a room in a favourite restaurant in Southampton Row for the afternoon and sit down for a special lunch, toast absent friends, two of our number have died and we remember them and then the memories start pouring out.Two of my three flat mates there and so we went at it non-stop...
Remember the time you (as in me)arrived back off a late duty carrying a "borrowed" and still lit road lamp to provide mood lighting for one of our parties and tucked it under your gaberdine raincoat? (Raincoat N206A in fact)
Walked in and produced it with a flourish, like a rabbit out of a hat?
Wondered why no one said anything because we'd been after one for weeks?
And my (as in flatmate's) new boyfriend was sitting there quietly?
His uniform gave it away and you'd failed to notice the Panda car outside, introduced himself as a policeman and very seriously got his notebook out?
Then it's the customary set photograph as we try and get into the rows we were in all those years ago, a selection of words to get that co-ordinated smile and this year it was flatus tubes, enemas and things just got worse after that. I'm afraid you can expect no better from a group of nurses,
Then just time to say farewell and good fortune to everyone until we meet again (Deo Valente) for our fortieth in 2012, London Olympic Games year.

Francoise Sagan

Francoise Sagan, well there's an author to conjure up from my youth.1970's to be exact and these actual books did the rounds of our student nurse's flat time and time again.
Four of us lived on the middle floor of a house in Haringey, round the corner from the dog stadium and though it seemed palatial to all of us after the confines of a Nurse's Home it was probably nearer to squalid than we cared to admit. We did fly at it with lashings of lurid paint which compensated somewhat but waking up to find mouse droppings on your pillow was a sign that perhaps all was not well.
The house belonged to a very large Greek family who lived like sardines on the ground floor and were always excruciatingly helpful in the most persistent ways. If ever they caught us lugging our washing off to the launderette they insisted, absolutely insisted that we used the very ancient rusty old pram that they kept expressly for the purpose.
Yes it was me you saw looking like a furtive bag lady in Haringey High St in 1973.
The arrival of a pristinely new copy of The Unmade Bed by Francoise Sagan from Hesperus took me right back to those days.
We were all avid readers in our humble abode and books would whizz around us all at the rate of an infectious disease.Nurse training at a top London teaching hospital in the 1970's required A Level standard education and we'd all interestingly done English Literature and loved it whilst flogging wearily through Human Biology.This did not bode well for the hours and hours of Anatomy & Physiology we had to embrace and so recourse to fiction was our salvation and our escape from a world that had suddenly narrowed alarmingly.
I often look back and have to remind myself that we were only nineteen but all dealing with tragedy on an enormous scale and on a daily basis.Serious illnesses and frequently the death of our young patients and we were only young ourselves.You needed to learn very quickly how you were going to cope with all that.Most of our schoolfriends were whooping it up at university, it was often very tempting to go and join them.
Reading fiction was and still is an incredibly precious resource.
Some books are etched on my consciousness from this time.There was one called Harvest Home by Thomas Tryon that we were almost killing each other to get our hands on.
H.E.Bates, John Galsworthy,Nevil Shute, Joseph Heller all had their day but  favourites were the Francoise Sagan's, Bonjour Tristesse, Aimez-Vous Brahms..., La Chamade, The Heart-Keeper. All so precious that I still have my old 25p Penguin editions.
Every time I think it's time to throw them all out I can't.They are too faded, foxed and yellowed even for a jumble sale but the covers so of their time I only have to see them on the shelf to be back there...sitting in the launderette on Haringey High Street hoping against hope that someone, anyone would steal that rusty I'd pram left outside.
Honest as the day was long they were in Haringey in those days.

Nightingale Nurses

I've always felt duty-bound to keep an eye out for books on the history of nursing and so my recent bout of hyper-Crimea-itis has had me scurrying back to them with a greater interest than usual.
I seem to have inadvertently strayed into the world of medical reading of late and I have to say I do usually try to avoid anything that connects with my working day when it comes to reading for pleasure.
After so many years I feel as if I've given the profession my bone marrow and I need a bit of space from it in my "other" life.
But try as you may it's inevitable, in the end one life informs the other and you can never quite take off that metaphorical starched cap and apron when you analyse something.
Here's the Staff Nurse pic again for those who missed it last time round...no laughing at the hat.
I was probably one of the last generation of nurses to be trained along Nightingale lines with a formality and discipline that has long since disappeared. Preliminary Training School (PTS) felt like an initiation, a rite of passage into this strange world that you were going to live and breath day and night for the next four years and you felt honoured to be part of it.
We were broken in gently and all 40 of us were billeted together in a large house, Rosslyn Lodge in Belsize Park, and travelled into the Gt Ormond St School of Nursing daily for those first 6 weeks.The object was for us to bond as a group and make friendships which would become our support networks and we did. 35 year reunion coming up this year.
You did have to polish your shoes, your hair did have to be off your collar and you did wash your hands so many times a day that they really were raw.Thermometers had mercury in them, babies all wore towelling nappies and bottles were sterilised in Milton.
Reading about the nurses in the Crimea you realise that drunkeness and debauchery were the biggest problems that Flo faced in disciplining her staff and despite chronic shortages she regularly dismissed and sent home the women who fell short of the mark. No wonder draconian training measures were required and I think they were still in place in 1972 though we'd probably learnt how to keep our drunkeness and debauchery a secret.
Ward Sisters were fearsome and you were terrified of them, as for Night Sisters...well I'm sure I've mentioned The Big Bruiser here before.Great Ormond Street counted many of the Nightingale school among its number, yet all of them were utterly dedicated to the profession, the hospital, the children and ultimately to their student nurses.
They knew exactly how to get the highest standard of nursing care out of us and sloppy habits (how we loved our sloppy habits) were just driven out of existence; humiliation worked a treat and it became pointless not to do a job properly first time.Always the first thing that was pointed out to you was that you had somehow endangered a child's life in the process. Even down to touching a swing door to open it, never touch a swing door, you push it with your backside...

"Gather round everyone, this nurse will now list the bacteria she may have left on that door with her hands?"

"Thank you Nurse...now would you like to spell them for us?

We learnt to work to the highest of standards and it has stuck through years out in the community, though I have trained myself not to reverse through every door I go through.I can also spell staphylococcus aureus on a good day and pseudomonas aeruginosa when I want to show off.
The moment of truth was when you had to go in to Sister and collect your report at the end of each 12 week ward placement. My worst ever ward, 12 weeks of pure, unadulterated misery, day and night and a harridan of a Sister who I thought hated my very being.I was expecting a drubbing.
How wrong can you be? She gave me an A and actually asked me to go back and be her Staff Nurse.I was so flattered and taken aback I almost accepted, then I saw sense...er that's very kind but no thank you.

Carl's Christmas GIFT Challenge : Tradition

My third post for Carl's Christmas GIFT Challenge and here's Tradition.
Working + Christmas + hospital is not an ideal combination but if you had to endure it anywhere in the early 1970's there can have been no better place than the world's greatest (I'm biased I know) children's hospital at Great Ormond Street.
I'd started my four year nurse training on my birthday in September 1972 and so it was with some trepidation that, following 6 weeks of PTS (Preliminary Training School), I was off to my first ward placement.7th floor, ENT & Private Patients and I would be working over my first Christmas.
Emerging with new found skills such as making up cots with the pictures on the counterpane facing towards the child, how to mix a Milton steriliser, umpteen ways to fold a nappy (you wore a clutch of nappy pins attached to your pocket with pride) and the art of bathing a baby it was a thrill to finally set foot on a ward and you quickly realised that they were very special places.You were stepping into a world of traditions and customs that you felt had probably been handed down from one generation of nurses to the next since Charles Dickens first campaigned for the hospital to open in 1852.
In the run up to Christmas we were quickly drawn into the excitement and more traditions.
One room on the ward was designated as the staff Christmas cubby hole and decorated to the hilt.On Christmas Eve we then headed off to the old Covent Garden market at 5am where all the traders generously sent us off laden with enough fruit to keep an army on the move.The problem of getting it back to the hospital was solved by the police who transported us back in the old Black Maria vans, always an experience.
By Christmas Eve you knew which childen would be staying in and all the usual arrangements were made for Father Christmas and the reindeer and of course being up on the top floor of the old hospital we had the perfect view as he made his way around the capital.
We must have been a familiar sight as we walked across Russell Square from our nurse's home in Bedford Place in our starched pink and white striped uniforms, caps and navy blue capes but on Christmas Day you traditionally wore your cape red side out.
When you arrived on the ward there was another ritual.Junior nurses swapped uniform frills with seniors for the day.Staff Nurses were goddesses and we had started to covet these accoutrements on day one, frilled cuffs, petersham belt, badges and a strings cap.
Eventually, and several years later, as you can see I did get a set of my very own.
The cap thankfully minus the strings tied in a bow under your chin, came as a large oval shaped piece of starched and goffered linen.It was a feat of magnificence with needle and thread and cardboard to assemble and then keep it on your head through a day of caring for children.An encounter with a steam steriliser or an oxygen tent with added humidity could prove fatal.
Bees knees wasn't in it, we spent Christmas Day bursting with pride over our new found seniority, until there was an emergency of course and everyone thought you were in charge of the ward.
Then you couldn't hand it all back fast enough.

Blood, Sweat and Tea by Tom Reynolds

I was going to do Endsleigh thank yous today but then this book came steaming up the outside lane, blue light flashing (yeah, bet they're late for their tea break. cardiac arrest probably)and everything else had to pull over.
I've been waiting a while to get my hands on Blood, Sweat and Tea by Tom Reynolds and published by The Friday Project because if there is one thing us nurses like reading occasionally it's an authentic but accessible take on some behind the scenes medical stuff.
I'm off Casualty on the TV at the moment (too much Strictly X Factor Dancing) but I'm a nightmare to watch it with when I do. I insist on utilising what I mistakenly believe is my vast medical knowledge which in reality translates into some very hit and miss diagnostic expertise. I've been a health visitor for nigh on 30 years remember, nappy rash and developmental milestones my speciality, don't often do open heart surgery, but like to think I haven't forgotten it all.
Anyway Casualty is great for some revision practice, I declare outcomes on any impending and inevitable medical crisis the minute I spot a sign and in true health visitor fashion I spot them early, yes, weeks beforehand.
"Ah yes, there you go, his mother's just put some sweets in his bag, he's diabetic, precautionary sugar in case of hypoglycaemic attack, just you watch"
or this.
"Did you see the way he purposefully picked up that Bic biro and put it in his pocket? Bet someone needs an emergency tracheostomy in the street and he'll use that and a swiss army knife, mark my words"
Blood, Sweat and Tea started life as the blog of an Emergency Medical Technician with the London Ambulance Service and now it's a book and it makes great reading.Tom takes no prisoners so ensure your breakfast has really gone down before you start reading it.
In fact let's all revise shall we, so by that I mean past your pyloric sphincter and heading into your duodenum (good eh) which is hopefully getting beyond the point of no return and used to take 3 hours or so but I expect new research has changed that.
I share an office with four community nurses so I'm fine. I have a cast-iron stomach that can cope admirably with wound exudate conversations whilst eating brie and cranberry sandwiches, but if that's just made you grimace and you are of a delicate and refined disposition you may want to stop reading this blog post right this minute because I know it's not my usual fare.

I'll even create a gap to help you make up your mind and give you the chance to go off and look at Susan Hill's blog, go on, look there it is over there>>>>>>>The worst you'll be faced with is lethal crossbow injuries >>>>>>>>>

Well don't say I didn't warn you, you had your chance.
I did an interminable placement as a student nurse in the Casualty department of the London Hospital, Whitechapel back in the olden days so I have seen life at the stomach-pumping/vomit pebble-dashing the walls end of the health care spectrum.It's a lesser known fact that whenever we had to pump out someone's stomach they had always been eating cabbage and if they threw up all over you I'm sorry but it was always carrots, we ran a book on it.They knew how to eat well in 1974.
My fondest memory was suturing practice on a large polystyrene globe in the corner and then we'd march out and confidently do the real thing on real heads.Thankfully most people were so drunk local anaesthetic was surplus to requirements and I got quite good at it, well it's only smocking and quilting if you think about it.
Anyway all this is minor compared to Tom's accounts, he dishes up all the gory details in vast but fascinating quantities, so if all that hasn't put you off be prepared to wear yourself a big metaphorical plastic reading apron and some wellies or something (you might as well get the mask and gloves too) and get stuck into the realities of the underbelly of city life from beneath the flashing blue light in excellent Tom Reynold's style. And be nice in future about pulling over for that blue light event, of course they are not late for their tea break, who on earth had that idea?
I promise you won't be disappointed by Blood, Sweat and Tea but you might not fancy your lunch right away.

Our September 11th

Gather round because today I'm going to tell you a very true story.It's longer than usual blog posts, so if you have time to read it you might want to make a cup of tea.
8pm January 25th 1975 I trudged onto Royal Ward (men's surgical) at the London Hospital to start a week of night duty.I loathed night duty.My body clock never learnt to deal with it and the first night was always the worst.I was 21 and in the 3rd year of a 4 year combined training and the plan was to emerge as RSCN (Registered Sick Children's Nurse) and  SRN (State Registered Nurse, now simply RN) after my finals the next year, which I did.
To complete the adult part of our nurse training we had been sent on a year's secondment to The London from our beloved alma mater, Great Ormond Street Children's Hospital and the world of sweet little uncomplaining babies to fend for ourselves amongst big, heavy, hairy, moany grown ups.
This all meant I was living in Whitechapel which in 1975 was very different from Bloomsbury in ways that I won't elaborate on.Coupled with the misery of being the cuckoos in the nursing nest and a recent and very depressing 12 week slog on Gloucester Ward (neurosurgery) all over Christmas and New Year meant it was not a blissfully happy time.
Suitably starched and pristine, the night shift gathered in Sister Royal's office for inspection (hair off collar, shoes polished, no ladders in black tights that sort of thing) and to be given the ward report.The naming of the Sister was a London Hospital tradition; all Sisters baptised in fire and branded across their ample bosoms with the name of the ward they lived and breathed and ruled.Patient allocation commenced.
I was assigned a leading ballet dancer who had been admitted with a drink problem and now had a bad case of the delerium tremens; there were no beds anywhere else in the hospital so he'd been tucked up on Men's Surgical. The word was I would have to keep an eye on him, he'd spent hours standing by the lift doors waiting for the doors/curtains to open so that he could make his entrance.
Next two chaps, one with an abcess on his right buttock, one with an abcess on his left who'd been put into beds next to each other so they could chat.Mistake.They were big mischief and causing the mirth and turmoil you expected on Men's Surgical.
A few more post-op cases and then this.
"Nurse" she said fixing her icy gaze on me "please familiarise yourself with the patient in bed number 4, you will be looking after him all week, he will be having major chest surgery tomorrow and you will need to be competent in the management of chest drains, please revise".
I groaned inwardly.
We hadn't been on the best of terms Sister Royal and I, since I'd caused a minor treatment room explosion alert and brought shame on her very ship-shape ward. It had involved the excitement of the Fire Brigade turning up and official reports and all because I'd put metal instruments in a machine and turned it on and walked off, failing to notice the large sign saying "No metal instruments in here". She had definitely been wreaking her revenge ever since and was now handing me a clutch of very short straw assignments.
Little did she know what a pearl was nestling in there.
First port of call was always the kitchen to see what food the day staff had managed to save you.Night duty seemed to reduce the palate to mere basics and we would happily eat cold roast dinners at 3am.
But oh dear, I was needed, the performance had begun.
Grande jetes down the middle of a men's surgical ward are not to be encouraged; half the patients were splitting their stitches laughing, the rest thought they were hallucinating, one or two definitely thought they had crossed the bar (or should that be barre?) So, having done a neat pas de deux with the ballet dancer steering him towards his bed and some sedation, "come on we're doing Sleeping Beauty tonight", and dealt with ribald remarks from the abcesses, I headed off to see what was in store for me in bed number 4 and there he was, the bookhound, looking just a little nervous.
"I'm really used to babies and nappies but don't worry" I said "I'm just going to look up chest drains now. I think it's only a problem if they block, which they always do, or if I lift the bottles up off the floor air sort of rushes back into your chest".
This didn't go down in quite the amusing way I had thought and I had to go and make him a cup of tea to calm him down.
The surgery went well and the week was spent with him groaning and me crawling round under his bed coaxing those wretched chest drains into action.

"Can I take you out to dinner when all this is over?" this weak little voice said at about 3am one morning when I'd had yet another allelulia moment with the tubing.
Student nurses in the 1970's on £12 a week never refused free meals so I made sure this one lived.Next thing to find out,how big was the boot of his car? My flatmates and I spent our lives moving around London with our belongings in tow, a boyfriend with a Hillman Imp was next to useless.Ford Escort, yes that would do.
The Tinker jokingly said I had to stop taking my work home with me the first time they met, I said it was nurse-patient follow-up and the rest as they say is indeed history.
And here we are, September 11th 2006, 30 years married today.
It's always been our quietly special day until our Silver Wedding anniversary 5 years ago when, everything changed and suddenly our day became 9/11 and we've had to share it with a tragedy.
That of course will never be forgotten, but it's still our special day and while I'm ripping the house apart looking for that elusive pearl something or other I know he's hidden here somewhere, the bookhound has been busy drawing his version of events which sort of match mine.

Me and my shadow

According to Booktrade info there is copyright trouble brewing for Great Ormond Street on the Peter Pan front again as a new graphic novel The Lost Girls has Wendy up to some rather unchildlike activities and not much sewing involved by all accounts.
Great Ormond Street Children's Hospital, London has been the recipient of royalties from Peter Pan since J.M.Barrie made a gift of the copyright in 1929 with the express wish that the sum derived should never be disclosed.Lets hope money isn't squandered in prolonged legal battles and whatever the outcome the spirit of Barrie's bequest is upheld. Few can have predicted how crucial this income would be for the hospital all those years ago, though if I'm sent a bill for scanning this picture from my ancient old copy I might just say I think I paid my dues.
It is little known that within the precints of the hospital there is the most dazzling little Victorian chapel completed in 1875 and dedicated to St Christopher. A mere 30ft square but highly ornate and gilded to within an inch of its life in the High Church ecclesiastical style, first impressions are of a microcosm of grandeur and sumptuous opulence.
The pews are tiny child-sized ones and as very junior student nurses we were often delegated to take patients down there for an afternoon service where we sat, with our knees touching our chins, trying to keep our little charges in order. In the late 1800's all families attended a service of thanksgiving in the chapel before a child was allowed home.
I didn't appreciate the beauty of the place then, it seemed a bit tasteless and vulgar to me back in the 1970's, but I visited again a few years ago and was completely awestruck by what I found.
It really is worth a peek around the door if ever you find yourself nearby.

Don't forget to look upwards, The Pelican in Her Piety surrounded by the Angel Orchestra adorns the perfect miniature dome above your head.

Old Friends

Being shameless I have sent  blogwarming party invites to just about everyone I have ever known, whose e mail address I may ever have had for whatever reason. The result has been some unexpected contact from long lost friends and I do wonder if the optician, the vet or the dentist may have dropped by
And now I must beg your indulgence as it was with much delight that I have just heard from my 1970's student nurse flatmate Wendy, married to a minister who is now the incumbent of a very beautiful church in  Philadelphia.
Wendy and I lived for some time in a nurse's home in Bedford Place just off Russell Square. I don't think we fully appreciated the literary nuances of a pad in central Bloomsbury, but we must surely have taken London by storm as we teetered around on our cork wedge sandals and wearing our £6.30 full length Laura Ashley dresses. Death by escalator snarl up was never far away. I still have mine and think it would fetch a good price as vintage on ebay now.

More legendary was Wendy, on a stint of night duty and in search of a tan, deciding to sunbathe out in Russell Square rather than do the boring thing and fall into bed. When she woke up 6 hours later things were not looking good skin wise and the sun had also dyed her blond hair streaks green.
To her eternal credit she went on duty that night as usual, but was summarily sent off in disgrace by a terrifyingly irate night sister we had fondly and appropriately dubbed The Big Bruiser.
Not as you might surmise to get emergency treatment for the death defying third degree burns, but for sporting the highly illegal green hair.
Did we laugh or did we laugh?
Happy days and perhaps, in future, the occasional anecdote on The Trials and Sufferings of a Student Nurse.