Sixty Years a Nurse
In 1952, Putney took in about twenty new trainee nurses – mostly from Ireland, like me, but also from Holland, Germany, Hungary, Italy and England. There were strong unresolved post-war feelings and I’m sorry to say that racism abounded, unchecked. Matron, a small, intense woman called Miriam Sturgeon, said quite baldly to us that ‘I’ll take the Irish, because I need you, but I don’t have to take the coloureds.’ However, the Dutch would not sit down with the Germans, even if they were Jewish, and there was a hell of a lot of strife between them then, which I found quite bewildering at first. One of my first new trainee friends was a lovely Dutch girl called Hanse. She was nineteen and from Amsterdam, and she told me the most terrible story which explained her attitude towards the Germans. She said her family had been starving during the German occupation, and had had to beg, borrow or steal anything to eat. She had a twenty-year-old brother who would go out and forage for food, scavenging round the fields around Amsterdam or even dustbins. To disguise himself, he would put on one of Hanse’s dresses and a headscarf, and get on her sit-up-and-beg bike, and go and scrounge turnips from the fields for the family to eat.
Then one day he was actually stopped by a German soldier. The Nazi asked what ‘she’ was doing, then tried to rape Hanse’s brother, but when he discovered very quickly that ‘she’ was a boy, he shot him and left him in the gutter to die. As a consequence, Hanse would not sit down with the German nurses in the canteen, and hated being anywhere near them. She would stand up and eat, her back to the wall, and Sister would command, ‘Sit down, nurse,’ and Hanse would retort, saying, ‘No, Sister, I’m fine where I am.’ I’d be thinking, ‘Oh, sweet Jesus, she’s in for it,’ and I’d entreat her to sit down next to me. ‘I’m not sitting next to a verdammte Deutsche,’ she’d spit. I didn’t really understand the depth of her feelings or the reasons for them then at all. I was so naïve back then. But Hanse would say, ‘You know, Mary, the Germans killed us in Holland, just because we were hungry, so I’m not sitting down.’ Another Dutch girl, Christe Lemm, would say, ‘I’m also not sitting down next to those Germans. You can’t make me,’ and would stand staunchly next to Hanse. Infuriated by this insubordination, Sister would stride off and get Matron, telling her there was a war still going on with the prelim nurses; Matron would then march back in, alongside Sister, and snap at the Dutch protesters, ‘Have you no dignity, girls? Sit down.’ Unperturbed, Hanse would say, ‘Gott verdammt the lot of us.’ Matron would bark, ‘Well, you’ll all have to learn to rub along together. The war is over now.’ Indeed, on the wards she would not settle for anything else, despite Hanse’s and Christe’s painful feelings. We were told over and over we all had a job to do, and we had to get on and do it, regardless of any personal grudges or feelings. But the Dutch and the Germans were red rags to a bull, while the Irish were stuck in the middle with the English, for a change. For me, this was a real turn-up for the books.
My training as an SRN would take three years, with each year including three months of day duty, three months of night duty, and experience on specialist wards, such as tuberculosis (TB), which was rife at the time. I was also to do a three-month stint in theatre and I would have to do dreaded annual exams. For the first three months I was at school daily being trained, and then I ‘observed’ on the wards for a day a week. We were only unleashed on the wards, to do some basic or minor tasks with real patients, under the eagle-eyed gazes of staff nurses and sisters, after the first three months were completed satisfactorily.
Even then, once on the wards, a lot of my time was spent cleaning: swabbing, washing, scrubbing, wiping everything down scrupulously. There was an unrelenting fixation on cleanliness and disease prevention, so we disinfected and scrubbed everything in sight. It was second nature. One of my first jobs was cleaning a toilet, without a brush or rubber gloves, which was disgusting. I was crying all the time, and Sister snapped at me to ‘Stop blubbering and get on with it.’ I said, ‘My mother wouldn’t make me do this,’ and she said, ‘Well, tough, nurse. You’re not with your mother now, are you?’ My hands became raw from washing and scrubbing all the time, immersed in carbolic and disinfectant, but there was a zero tolerance to infection as little could be done, otherwise, to stop it spreading. We didn’t suffer from MRSA or C. Diff, which are the modern killers, but I’m convinced it’s because we were on our knees wiping down the beds, even the chair feet and bed wheels, cleaning taps, washing down walls, even light switches, door knobs and bed springs, night and day.
Men and women were segregated into separate wards back then, and there were two main categories: medical (which was general and covered lots of things) and surgical. Each long, rectangular ward had up to thirty patients each, in beds down the sides, with the nurse’s table at the double door end. There was usually a table for mobile patients to eat at down the middle of the room. The floors were wooden, and scrubbed constantly. There was a little side kitchen, where the nurses could make tea and toast, or squash, or fill vases and jugs with water. Also, there were balconies with iron railings outside the windows, and ‘isolation’ patients would be pushed out there in their beds to get fresh air (in which there was a great curative belief) during the day. There were a few side rooms for extremely ill or even private paying patients. Then, off the ward, there was the huge sluice, a big tiled room with huge sinks, for the metal bedpans and men’s glass wee bottles to be washed and disinfected in. We also did diabetic urine testing there.
The women’s medical ward, Corry, had patients in together with all sorts of different conditions from broken femurs with patients strung up on huge metal traction frames, to appendectomies, tonsillectomies (which were popular then), stomach ulcers and even women being treated for failed abortions. I was really amazed to see these poor women, of all ages, both married and single (which was shocking then), in with everyone else. Sister would ‘tut tut’ all the time, showing she did not approve of them, and they could be ostracised. Some of them came in in a terrible state, it was so cruel to see, with metal back-street abortion implements still stuck in them. But they got no kind words from Sister, no arm round the shoulder: she disapproved and she didn’t mind showing it. They’d be given Ergometrine, a drug to put them in labour, and they suffered dreadfully, poor things.
Then we would be told to swab the women down with Dettol, and we’d have to shave them ‘down there’. I’d never seen anything like this at all. The poor, bleak women would be rolled away to have a ‘scrape’ in theatre and then shoved back out by a very snooty Sister, as soon as she could discharge them. Then their ‘incomplete abortions’ would be lined up in metal bowls in the sluice for doctor to inspect. I was horrified. I’d see something baby-shaped, lying amid large liver-like clots of blood. She made the poor women feel very guilty about wasting her time and effort, and the Health Service money. It was a very bad business, a real eye-opener, and it made me feel very wary about getting pregnant, I can tell you.
The men’s surgical ward, Lancaster, could be equally as grim. Among the broken legs and car smashes were the hernias, appendectomies and the constipated men (‘who couldn’t go’). The men’s Lancaster Medical Ward was next door, and they had those ‘incurable patients’ with ‘growths’ (what we would now call cancer). It seemed so undignified and unnecessary to me for simple cases to be next to fatal ones. Then, if a man had to be shaved ‘down there’, I learned to beg Percy the porter to come and do it with a wet razor. Imagine my horror at being asked to exfoliate (yes, standard practice in disease prevention or pre-operative) a man’s privates, when, as an innocent seventeen-year-old, I’d never seen a boy naked at all. But there were times, during those first months, when I had to do it all alone, and I was a quivering wreck, hoping and praying to God that my hand wouldn’t slip at the wrong moment, and in the wrong place (I could hear Sister Margaret shouting at me that I was a ‘clumsy oaf and a silly girl’, which made it all so much worse).
So for the first three months in training school, being taught by Sister Tutor, I sat and took copious notes and absorbed as much knowledge as I could. It was all anatomy, physiology, hygiene and everything else thrown in. We had a large school room with a pink rubber woman dummy called Araminta that we had to practise all sorts of unspeakable things on. The walls were lined with shelves with things like a twenty-foot tapeworm suspended in formaldehyde, or miscarried babies in bottles. It could be a bit gruesome. But I soon got used to it, as I soon got used to everything else about hospital life. I can honestly say these months were spent swimming in blood, poo, vomit, wee and absolutely everything else that comes out of the body: it was a real baptism of bodily fluids.
3
Settling In
There was so much to learn in those first weeks and months that I was in a constant whirl of activity, confusion and, often, amusement and bemusement with my fellow trainees. We worked six-day weeks and there was a huge amount to learn, a great deal to absorb, mentally, and also to master, physically. For some reason, I was often clumsy, and I was also very naïve, although always very enthusiastic. So, I would find myself being barked at by the Day Sister Burton (‘No, Powell, you don’t do it that way, silly girl!’) or Staff Nurse (‘For goodness’ sake, Powell, you’re not wrapping a Christmas present – retie your bandage properly, now!’) It was like being with my mother or Sister Margaret all over again – I could never get things right, or so it seemed.
We had to observe the doctors’ rounds on the wards each week and I was absolutely fascinated by everything. We trailed behind the doctors and consultants in their crisp white coats and pin-striped suits, stethoscopes slung round their necks, as they pronounced on the patients and snapped their orders with military precision. We were like well-behaved little goslings following behind giant ganders. Staff and Sister would always be turned out perfectly, in smart navy uniforms, and would be beside the doctors, silently obedient, and at the ready, with notes and charts at hand, ready to answer their queries or to jump to it, as they talked loftily over the patients’ heads. It was all very formal, intimidating – and bewildering. We nurses had to make sure everything was tickety-boo before the doctors did their rounds: everything had to be spotless, tidy and gleaming; sheets neatly tucked in, patients washed and hair combed. Their lockers had to be clean, with fresh water in their jugs and their flower vases refreshed. Sometimes I thought we made the beds so tightly that I wouldn’t have been surprised if we had cut off the circulation in the legs and arms of the poor people strapped neatly into bed, like strangulated sausages in hot-dog buns.
Back in our training school on the ground floor of the hospital (safely away from the real patients) we had our large rubber dolly, Araminta, to practise clinical procedures on. She lay, smiling her unchanging red-lipped smile, on a bed, and she could be zipped open from chin to pubic bone, so we could take all of her plastic internal organs out: liver, spleen, stomach, intestines, gall bladder, kidneys, bladder, and so on. We spent quite some time taking Araminta apart and putting her back together again: it was quite a game. We also had to pretend to ‘bed bath’ Araminta, and change her rubber undersheet, which involved rolling her onto her side, sliding the ‘drawsheets’ out from under, and rolling her back again. She sometimes rolled onto the floor, which, obviously, we knew we’d have to avoid with real patients (if at all possible). However, Araminta didn’t object to her mistreatment and sometimes we felt quite sorry for the punishment we gave her as we also had to practise giving her injections, which I hated doing. Back then syringes were made of glass and metal, and had to be re-used, so they were boiled in big metal sterilisers, which were bubbling away in the corner of the medical rooms all the time. Everything had to be boiled and sterilised endlessly, and was rejected as sub-standard if it wasn’t perfectly clean.
Then one day, towards the end of my first three months, Sister Burton told me I was going onto the men’s surgical ward and I was going to give my first injection. I nearly fainted. A real injection into a real person. Not Araminta? No, surely not. I wasn’t ready, was I? Sister being Sister was blunt, business-like and to the point: ‘Nurse Powell, you will give the patient his injection – now stop fussing and get on with it. You know what to do.’ So I approached Mr Brown’s bed gingerly. I stood, holding the metal kidney-shaped dish with the syringe rattling in it, while he read his newspaper, totally unaware of my inexperience. He was a good-looking, fair-haired man of about thirty with a deep, badly infected cut on his leg from a work accident. He was sitting there, all innocence, in his striped pyjamas with no idea what was about to be unleashed on him – all-fingers-and-thumbs-me.
Mr Brown looked up and saw me looking at him fixedly, just as I felt a presence begin hovering behind me. I looked round and there was Sister, glaring. Oh my God, I had to get on with it. I pulled the screens round the bed on their squeaky wheels while I was frantically trying to remember what I’d done to poor old Araminta. Sister had told me the injection, which was a thick antibiotic mixture, had to go in the outer quadrant of Mr Brown’s right buttock. Buttock! Sweet Jesus, I’d never seen a man naked before and now I was going to be looking at this poor man’s bum, and inject him, to boot. Despite my nervousness, I tried to brazen it out: ‘All right, Mr Brown, I have to give you this little injection, so could you roll over and pull down your pyjama bottoms?’
I couldn’t believe I was saying this to a real, live man, and was even more amazed when he rolled over obediently, and did just that. Luckily, he couldn’t see my hand shaking as I got the large syringe out of the dish and prepared it for him. Little it was not. I swabbed his right buttock with antiseptic and cotton wool, trying not to take in the smooth brown and hairy skin of his muscular body. I was looking at a naked man’s posterior, my first, but was seriously trying to concentrate on the job in hand (as it were). I filled the syringe with the thick Streptomycin with trembling fingers, and pushed out the air bubble, just as I’d been taught. Surely nothing could really go wrong?
Thing was, I was terrified of hurting him and I stood rooted to the spot for a minute trying to remember all that Sister Tutor had told me when I was torturing Araminta. Mr Brown was perturbed by my hesitation. ‘Anything wrong, nurse?’ he asked, innocently, trying to peer round over his shoulder. ‘No, no, nothing, Mr Brown,’ I stuttered. ‘No, not at all – just turn round, lie there and relax.’ And with that I lobbed the heavy glass syringe at poor Mr Brown’s right buttock, rather like a dart at a dart board, and it went in a bit, and then hung out of his bum at a ghastly angle. I knew it wasn’t in right, especially as he yelped, then hollered, loudly, and to cover my embarrassment I just syringed the viscous fluid in as fast as I could. It should have gone deep in his muscle; instead I injected it all under his skin. Poor Mr Brown was groaning as I could see a ball forming under his epidermis, like a ping-pong ball. Oh sweet Jesus! I tried to make it better by rubbing his buttock a great deal, and sort of massaging it; then I asked him to turn over and hoped for the best. The poor man looked pained, as he pulled his pyjamas up, but I tried to cheer him up as I tucked him in tightly before getting away as fast as I could.
Next day, I was really for it. Poor Mr Brown had now developed a deeply infected buttock. I was taken back to him, by Sister, and made to look: his buttock had gone black, and the place I’d injected had formed an ulcer. There was now a large hole which had to be packed. Mr Brown got really ill after this. My terrible injection technique was causing him almost more trouble than the leg injury that he had come in for in the first place. I felt absolutely awful, and was in floods of tears. Sweet Jesus, I was hopeless, I would never make it – my mother was right, I was utterly useless. I apologised profusely to Mr Brown, and to my utter amazement he was quite accepting about it. ‘Never mind,’ he said. ‘It could have been worse.’ He could see I was genuinely distraught. Worse? I didn’t think it could be, and I seriously considered if I was really up to the job for the first time since arriving.
I was carpeted by Sister, who was a real dragon. ‘What on earth do you think you were doing, Nurse Powell?’ She went on and on, saying, ‘We obviously can’t let you anywhere near injections yet,’ as I blubbered in front of her, wanting the floor to open up. I explained that I hadn’t wanted to hurt poor Mr Brown, and instead I’d ended up giving him a whole load of pain. She barked at me to practise again on Araminta and stop whining. It was so humiliating as everyone on the ward knew it was me who had buggered it up and I imagined all the patients refusing to let me touch them from now on. Her? Oh, no, I don’t want her, Sister. Bring me a proper nurse. She’s the Devil incarnate. I could just hear it. Wisely, Sister moved me onto another ward the next day, telling me to ‘Toughen up, Powell.’ I certainly never gave another botched injection like that again; I learned I had to be firm and decisive from the start. Mr Brown recovered completely, I’m glad to say, and bore me no grudge. Luckily, patients didn’t sue in those days or I’d certainly have been up for the chop.
There was another time I showed myself up badly, too. We had to go to the morgue, which was also on the ground floor at the back of the hospital, and observe a post-mortem as part of our training. I was very nervous about this as I had not seen a dead body as yet, although Araminta had been taken apart and put back together like a giant female plastic Meccano set several times over. I was very intimate with her by now – but a real dead body? This brought back horrors of Clonmel cemetery and the terror I always felt there after dark with my wild imagination seeing grisly ghouls and hellfire and damnation everywhere. I was never very good with horror films, ghosts or anything spooky like that. Even the thought of the Putney Common convict ghost made me shiver, and I tried to put it out of my mind as much as I could.
So one cool winter afternoon eight of us trotted along to the morgue, feeling we were going to the gallows. We were all extremely nervous at what might be about to happen, and getting each other nervous, plus my overactive imagination was working away, as usual. I didn’t really know what I was in for until the mortician, a Mr Tayler, a lofty, serious-faced consultant, pulled back the shroud and there was a stark naked middle-aged man, the colour of putty: stone cold dead. I could feel my knees going immediately, so I crossed my arms and wrapped my fingers tight round my elbows to try to keep myself from falling over. There were lots of shiny, ordinary-looking surgical implements laid out, like a chisel, a carving knife, and then I espied something like a garden saw. Surely he wasn’t going to use those? I closed my eyes and swallowed.
When I opened them again, the mortician picked the saw up cheerfully and without further ado deftly hacked through the top of the man’s head. I stood there open-mouthed, and was amazed to see his brain fluid, like a grey, wrinkled, deflated football, which he scooped neatly in a silver bowl, explaining all the while about the nature of brain matter. Four of the assembled nurses went down immediately, like skittles, and one ran out, holding her hand over her mouth. Completely unperturbed, Mr Tayler continued his butchery, talking coolly all the while. I couldn’t really concentrate and could feel my gorge rising, but I was determined to see it through, so dug my fingers into my arms even harder. Then Mr Tayler got his scalpel and cut the poor man’s body from the neck to his pubes and suddenly all his guts were tumbling out, like miles and miles of grey sausages into a great silver tray alongside the slab … that was it, I was done for: I felt my knees buckle as the room spun round and I was sick as a dog on the floor.
When I came round I was outside on a chair, along with five other white-faced nurses, most of whom were bent double, holding their heads in their hands, and groaning. We were all told, in no uncertain terms, by a tough staff nurse, that we had to pull ourselves together straight away and get back in there. We were wasting valuable time, and this was part of our training – we were here to learn and we’d better get used to it. So after a few more woozy minutes and a sip of water we all had to troop back in and carry on watching as Mr Tayler cheerfully continued his controlled carnage, whether we liked it or not.
After a tough experience like my first injection, or the nauseating post-mortems, we took refuge in each other’s rooms at night to put the world to rights and, literally, let our hair down. I had begun to make some firm friends in those first few months: Rosie, Hanse, Magdelena, Christe and Susan, who would keep me sane over the next three years one way or another. We would all club together and nip out to the local pub and get us a couple of bottles of Merrydown cider, our favourite tipple, and a couple of packs of Woodbines (often from Bert the porter). This was standard fare for a good nattery debrief. We’d pile into my room (nearly always mine for some reason), and we’d be on my bed, cackling, gassing, recounting the horrors of the day until lights out, and beyond.
One night I drank a bit too much (as was my wont), and I was desperate for a pee. We had the windows open to waft the smoke out (smoking was totally forbidden, of course), and I realised I was too far gone to get up and find the lavatories at the end of the corridor. Being clumsy, I would probably alert Home Sister Matthews by staggering about, and then we’d all be for it. So, we closed the windows, giggling, and I decided I would pee in the sink to save time. This increased the suppressed laughter ten-fold, especially as I tried to hitch up my skirt and bum onto the tiny hand-basin and position myself to pee properly without flooding the floor. ‘Oh, Mary, be careful,’ Susan was just saying when there was an almighty ‘craa-aack’ and the sink came away from the wall, tipping me onto the floor, with my pants round my knees in a pool of water. The four witnesses fell off the bed in complete hysterics, and we all lay helplessly on the wooden floor for about five minutes until we heard Home Sister’s footsteps begin to clip down the corridor. ‘Sssshhhh,’ I said, and everyone mimicked, ‘Sssshhhh!’ and we all lay there, panting and trying to suppress our mounting hysteria, waiting for Sister to barge in with a torch. Luckily, we heard her feet pause, then begin to retreat, thankfully, once we managed to shut up.
However, next day I had to explain precisely why my sink was hanging off my wall at such a crazy angle. Home Sister fixed me with her beady eye. ‘So, nurse, you were saying about opening the windows?’ ‘Ah, yes, Sister,’ I went on, innocently. ‘Well, it was like this: I put my foot on the sink to get up to open the window as it was stuffy and, well, the sink just gave way …’ Sister peered at me critically for a moment. ‘It’s a considerable amount of weight to put on such a small sink,’ she said, pointedly. ‘Yes, Sister,’ I said, thinking, ‘Sweet Jesus, I’m for it, now.’ After another long pause she said, without looking up, ‘Well, kindly stop using your room as a climbing frame from now on, nurse.’ And that was it. She had bought my story, I think, particularly as I had a reputation for being a bit of a clumsy twit. This scene with Sister was recounted to my friends, over yet more Woodbines and Merrydown, and to the accompaniment of yet more giggles, gasps and ‘Oh, Mary’s’ later that night.