Sixty Years a Nurse
1952, the year I hit Putney, was also the year that the first espresso coffee machine came to London. It became ‘cool’ to frequent coffee bars, which were thought to be almost illicit dens of iniquity and heinous vice. In Putney there was a wonderful coffee house called Zeta’s, which was a large shop on the corner, where we would all go on our day off. There was also Mario’s, a lovely old Italian place, that did huge knickerbocker glories, which I thought were marvellous. We would sit there, nursing a coffee in a Pyrex glass cup and saucer, and someone would put music on the Wurlitzer, and it all seemed very sophisticated and grown up to be out alone, spending my own meagre earnings on coffee, Woodbines, cake, ice cream and music. We were always hungry, always thirsty, but we had to live within our means, which were very tight, so there was no other way.
Of course, I loved shopping. Window shopping, mainly, as I had little money and none to spend on clothes. Putney High Street was a broad, posh, leafy road, with lovely shops, and I liked nothing better than to stroll up and down it, lusting after goods. I remember longing for a pair of red stilettos in Saxone’s that cost £3.00 and wondering how long it would take me to save for them. I knew I would have to save for weeks, even months, as, in those days, if you didn’t have the money, you simply didn’t have something you wanted. You had to ‘save up’ and that could take ages and ages. I thought ‘I’m going to have those’ and, eventually, after weeks of saving hard, I did.
I liked fashion a great deal. Back home I had been used to my mother being able to run up anything. She made my fabulous pale strapless green evening dress, which I wore at sixteen to my first grown-up dance in Clonmel, which doubled as my leaving ‘do’. In those days you had one good frock, and one good pair of strappy evening shoes, and they lasted you for years, too. I brought the green dress with me to Putney, in the hope I’d have occasion to wear it one day, and I was always amending it: putting some ribbon on it here, or a corsage or bow, or a little flourish, there. It’s what we did in those ‘make-do-and-mend’ post-war years.
I also bought my first proper two-piece suit in Richard Shops: it was pale grey with a pleated skirt. It was all the rage to have big skirts with net under-petticoats, and to wear gypsy-style blouses on top. Everything was waisted and girly, and I knew I looked good as I had a tiny waist back then. It would all be topped by having a ‘shampoo and set’ at a new, modern hair salon on the High Street, which had those dome hairdryers we sat under in rollers (although this would only happen on very special occasions). I would have to save for a cut and set, and would have one maybe every two or three months or so. Meanwhile, I would snip my fringe myself and, being me, it was usually lop-sided once I’d finished hacking at it in the bathroom mirror.
During these first few months of settling in, I would write dutiful letters home, making my London life sound busy and meaningful, and would make my job sound important (which it was to me). I certainly didn’t tell of the men I saw naked, or the cigarettes and booze, or even what I had encountered on the wards. My mother would write back, telling of local and family news, but would ask almost nothing of my life in England or as a trainee nurse. She simply didn’t want to know. This hurt me, but I knew how proud and stubborn my mother was. So I had to rely on my sisters for the real news from back home. I felt very nostalgic thinking of the lovely rural countryside, the orchards, and my dear sisters, brother and father, and the dogs, but I didn’t miss either my mother, really, or the nuns. And of course, I never asked for money. I certainly knew I would never get any for wasting my time in that ‘Godforsaken Protestant country’, so I didn’t bother asking. I knew that I had to make it on my own, and I was utterly determined to do so, no matter what it cost.
4
Bring Out Your Dead
Hospital life is all about disease, birth and death, so I knew, sooner or later, I would have to be dealing with all these things first hand. I was quite trepidacious, but also curious. Plus, after my disgrace of fainting away in the morgue, I had begun to get used to seeing all sorts of things on the wards, although we were usually given very menial tasks to do, which were still mainly about scrubbing everything in sight with carbolic and Dettol, or rolling up bandages, emptying bedpans, folding linen and mopping the floors. However, after a few months we were being given more challenging, albeit still fairly basic, tasks to do. Fairly soon after I started, I was on a stint of night duties, which was also all very new to me. In charge was a horrible woman, whom we nurses called ‘the Beetle’. She was small, dark, with a tight bun, and she scuttled around, keeping us in check. We were terrified of her, and Sister Morten became ‘the Beetle’ thereafter: someone we always had to keep our eyes open for, but who would often surprise us by appearing and scaring the life out of us.
It’s often the way that people die in the early hours of the morning, something to do with our bodily rhythms, whereby people reach a low ebb in the middle of the night. Thus it was I was confronted with handling my very first dead body one dark mid-winter night. It was three in the morning, and I was already feeling exhausted, when Sister came and told me that Mr Johnson had died. He was a retired ex-policeman, a nice old man with a big handlebar moustache, rather like Jimmy Edwards, the popular entertainer. That night I was on the ward with twenty patients, all of whom needed things like bedpans, fresh water jugs or more medication. The nurses would sit at the end of the ward at a little table with a light on, doing paperwork and keeping watch. It was quite a quiet night, until Sister came up to me and whispered, ‘Nurse Powell, go and lay out Mr Johnson.’
The flowery curtains were already pulled round Mr Johnson’s bed when I arrived on the scene, jittery as a kitten. I felt quite spooked by what I might see, and hesitated for a moment, feeling anxious. Luckily, the twenty other patients on the ward were snoring away, but I was alone, as the other nurse had gone on her ‘lunch break’ (which was a meal in the middle of the night). I was very nervous as I drew the curtains and saw him lying there, in the half light. I sort of half expected he might sit up and start talking, like in a horror film, so I watched him to see if he was really gone for a minute or two. There was no breathing, so that was it. Next, I had to wash him down, so I got a bowl of soapy water and a sponge, then starting at the top of his head worked my way down all the way to his toes. This turned out to be a very long way as Mr Johnson was about six foot five, with his huge bony feet hanging over the end of the hospital bed.
I felt so sorry for him having died that I started crying. I was uncontrollable. Poor old Mr Johnson, I was thinking to myself, dead and gone. His life was well and truly snuffed out. What would his family be feeling? Would they miss him? As usual the tears were flowing, and mixing with the soapy water as I washed and wiped away at his poor old body. I actually felt quite horrified by what I was doing. I’d never touched a dead body before, although I’d seen the headless monster in the morgue. I was curious at the icy marble texture of his skin and how his face had begun to sink in as his jaw slackened. I saw his eyes had sunk into his head and I shook involuntarily, feeling quite spooked out by it all. He now looked very different from the Mr Johnson who had sat up in bed while I took his temperature and pulse, only yesterday. There was an eerie silence in the ward around me as I washed my way down the poor old man’s body. I noticed, slightly squeamishly, that he had started oozing from his orifices and I had to plug them with cotton wool as I worked. It felt so weird to do this to what had been a warm human being only a few hours earlier: he had been a sentient being, with a history and feelings. Now he was like a waxwork, although he’d never be an Araminta, I thought wryly.
Anyway, the worst part was to come, when I got to his middle, or rather, to his ‘private parts’. I had no idea what to do at all. The poor man had a catheter sticking out of his penis and I had absolutely no idea how to get it out. There was no one around to ask, and I couldn’t bear the idea of going to ask Sister, in her hidey-hole office, who would bite my head off as soon as look at me, so I got the rubber tube and started yanking, then pulling, then wrenching, trying to get the damned thing out. Poor Mr Johnson’s body was going this way and that, and his head was bobbing up and down, in a very undignified way, as his willy was yanked hither and thither by me. I was desperate to get that tube out. I could feel my heart racing, while my mouth was dry, as panic was rising. I bent over the poor man’s penis, and was examining the tube close up, yanking and pulling all the while, when I suddenly heard a fierce whisper hissing behind me, ‘Nurse Powell, what on earth do you think you are doing?’
I stood up, red-faced, tube in hand, and Mr Johnson’s body did a ghastly jump, led by his willy (which was still firmly attached to his catheter). I must have looked a total sight, tears still pouring down my panicked face, with my hands going all over his private parts. Sister stepped forward and got out her scissors on their little chain and neatly snipped the rubber tube and the catheter slid out, nice as pie. I stood open-mouthed, feeling such a fool. ‘Next time, use your common sense, will you, Powell,’ was all Sister snapped as she turned and left me alone again with the battered body. So undignified. I said sorry to Mr Johnson right there and then for all I had put him through, and cried some more tears of sympathy. I said a little prayer for his soul … and, of course, the other parts that had got a rude walloping from me.
Then I had to lay him out, which is what all of us nurses were taught to do, as preparation for being taken to the morgue. When he was finally finished, I called Staff Nurse to check him over. It had taken me an absolute age, since I had had to keep stopping to blow my nose throughout as I had found the whole thing traumatising. Staff came along briskly and emptied his locker of his worldly goods. There were a couple of packets of Woodbines in there, packs of twenty, which, amazingly, patients were allowed to smoke on the ward. Back then it was thought that smoking calmed their nerves … there was no thought of cigarettes being a health hazard; in fact, quite the opposite. To my horror Staff said, ‘Let’s take these Woodbines. His relatives won’t notice,’ and with that she pocketed them. I was amazed at her attitude, but I didn’t object. I’d been in enough trouble for one night. However, I thought it was a very bad thing to do, and I didn’t feel comfortable being ‘party’ to our crime. Yet, once we were on our break, and Staff got the fags out, I smoked a couple. I really needed a smoke after all that – I was gasping.
I think during that first year I was often naïve about the rules, or I failed to follow the strict regulations, as I was used to always trying to skirt round them back home. It was force of habit for me to be a bit rebellious, I suppose. Also, a means of survival. I tried to be good, and tried to be the best trainee that I could possibly be, but I had a mischievous streak and often acted on impulse or said things without thinking them through. However, I was still really desperate to prove my mother’s prediction about me being hopeless and a quitter was wrong. I was not going to be sent home, tail between my legs. I was going to succeed: I had to, as it was a matter of life and death. Thankfully, some of the more experienced nurses took pity on me. Sometimes we spent hours hunched over the sinks on night duty scraping poo and vomit off sheets with our scrubbing brushes and bare hands, which got sore and rough. We were scrubbing and cleaning endlessly; one of my more experienced nurse friends, Beryl, used to joke that pushing the enormous floor mop would increase her breasts, so we all sang a comical ‘I must, I must, I must increase my bust’ with every strenuous bush stroke across the floor.
We would also spend hours folding linen in the linen cupboards, and if I was on nights it would get very warm and soporific in there. I had a pal, a third-year nurse, Sandy, who surprised me one night by clearing a space on the enormous second shelf (which was about ten foot long and two foot deep) and telling me to get up on the shelf, and lie down to take forty winks. ‘No,’ I protested. ‘If the Beetle finds out, she’ll have my guts for garters.’ ‘Go on with you,’ Sandy encouraged. ‘You’re all in. Have an hour. I’ll wake you up.’ I could see she meant it, so I did. It became a regular occurrence after that when I was on nights. I’d clamber up, and be out in two shakes of a lamb’s tail (as we used to say). Sandy would be shaking me and I’d be down a dark tunnel, back in Clonmel, trying to avoid the whack of my mother’s large wooden spoon over my head. ‘Get up, Mary, you lazy girl,’ Sandy would be whispering. ‘Time to get up – you’ve had an hour’s kip.’ For a moment I’d think it was one of my lovely sisters, Una, and then I’d focus on starched sheets and pillows in neat white piles, and it would all come flooding back to me. Sweet Jesus, I was in that linen cupboard. However, those snatched naps were a real life-saver.
Putney Hospital, being on the edge of Barnes Common, which was a huge geographical area, meant we got all sorts drifting in, night and day. Tramps, children, couples, basically anyone who had come to grief in the open air or on the road, some way or another, were brought in. The ambulance men (and they were mainly men then) were aware that I was a ‘new girl’ and sometimes took advantage of it, especially when I was left on duty in casualty all alone. Another bitter cold night in the middle of winter during my first year it turned out that I was the only nurse in casualty left on duty. It was sometimes like that, as we were often not that busy at night. Putney Hospital had been set up originally to serve the local community, so it was not a really hectic place serving central London, like Barts (St Bartholomew’s) could be. It was part of Westminster Hospital, so we did send patients there when necessary, such as when a case was more serious or needed more complex equipment or nursing.
However, this evening Night Sister was at dinner and the house doctor had gone to sleep in the downstairs ‘on call’ bedrooms allocated to night staff. He could be called and woken up in an emergency, and Sister floated round the hospital at night, but I was supposed to cope the best I could with most situations, on my own, otherwise. When an ambulance turned up at the entrance the rule was that I had to go out to it and see who was being brought in. Usually the ambulance men would say, ‘Got a heart attack here, nurse,’ or ‘It’s a car crash,’ or whatever. I think this night they saw me coming. It was freezing and I’d thrown on my cape, but was shivering terribly in the wind. The rule was I wasn’t supposed to accept any patient without seeing them first in the ambulance. The ambulance men, George and Charlie, whom I’d seen before on nights, indicated that because it was so bitter cold they hadn’t got the time or inclination to let me clamber aboard and check out their patient. I was also rapidly turning into a human icicle, so I went back into casualty as the two men carried in this fella on their stretcher all wrapped in a red blanket. ‘Found him on Hammersmith Bridge,’ explained George. ‘Think it’s a heart attack, probably.’ And with that they were gone.
So I was stood there, next to this man, wrapped in a red ambulance blanket. He looked frozen, poor old chap. He had grey whiskers and bushy grey eyebrows, and was in a brown raincoat and suit. I folded back the sides of the blanket and thought, ‘Sweet Jesus, he looks really terrible,’ so then I felt for his pulse. Nothing. I felt again, and then put my head on his chest, listening for his breathing. Not a sausage. Oh my God! He was dead! Oh Lord, what should I do? Sweet Jesus, I was really for it now! I looked around the casualty department and absolutely no one was around; it was like a ghost town, as it was now four in the morning. Thing was, the rule was I was not authorised to take in a dead body; it was absolutely against regulations. This had been drummed into us as trainees over and over and over again. Had I been listening? Well, obviously not.
I was supposed to go out to the ambulance and assess the patient, then if they were deceased they were termed Brought-in-Dead (BID) and I was supposed to decline them, so they went straight to the morgue, or even to another hospital altogether. We had been told many times that it was too much paperwork, as a BID involved the police, the mortuary, the coroner, tracking down relatives and so on. If they were found dead in the street or died in the ambulance they were never brought in. That was the rule. It was a huge job and we were not supposed to touch it with a barge pole. So there I was with a dead body on a trolley to dispose of – a poor old BID – and I hadn’t the foggiest where to start sorting out such a mess. I could feel the panic rising: Who could I turn to? Where would I start? I pulled the blanket down further and saw his grey, frozen face with icy whiskery eyebrows. Dead all right. As a doornail. Jesus, what was I to do? In those days there was no resuscitation equipment, like defibrillators or anything like. I stood there, panting quietly – what on earth should I do next? I couldn’t go and get Night Sister and say casually, ‘Oh, by the way, Sister, I have a dead body in Casualty.’ She’d absolutely kill me. So thinking quickly now, I wrapped him up again in his nice red blanket, so that he looked like a giant Christmas cracker on his trolley, and then pushed him into a corner, trying to hide him to buy some more thinking time. Suddenly I heard Night’s Sister’s clipped tones behind me: ‘Any developments, nurse?’ I jumped out of my skin. ‘Sorry? … Er, no, Sister, everything’s fine … This man … I don’t think he’s very well … actually, Sister …’ But it was no good, Sister was already peering past me curiously at the red-wrapped bundle that I was desperately trying to hide behind me all the while.
I couldn’t stop her as she advanced towards the stretcher. ‘What on earth is this doing here? That’s an ambulance blanket – why didn’t you give it back when they brought him in?’ And with that she pulled the blanket down: ‘Jesus Christ, he’s dead,’ she said. ‘He’s not,’ I said, covering wildly, ‘surely not. The ambulance men just brought him in. I was just … I didn’t realise …’ ‘Brought him in?’ She was shouting now, and I could see her eyes beginning to pop out in their characteristic way. ‘Nurse, you know that you are supposed to go out to the ambulance to assess the patient. Rigor mortis has set in – this means this man died two or three hours ago! He was brought in dead – B-I-D. You know better than this, Nurse Powell, or you really should do by now.’ At her angry words my usual waterworks started flowing. I was soon crying helplessly. It was a nightmare; I was in trouble, all over again. I’d be back in Ireland in a wink, with my mother ‘told-you-so-ing’ me to my father over my head. ‘For goodness’ sake stop snivelling, nurse.’ Night Sister was incandescent and she went on and on and on about procedures and rules. Then she went on and on about needing to uphold standards and follow correct regulations and what would happen if we didn’t (the end of the world, obviously). Suddenly she marched off and got Percy the porter and instructed him in clipped, frosty tones to take the poor dead man down to the mortuary. She didn’t even look at the body, poor thing, or try to work out who he was. What a way to end his life – I felt truly sorry for him. Then Sister was back, facing me, eyeballs popping: ‘I’ll see you in my office, Powell, ten o’clock sharp, tomorrow morning, no nonsense.’ And with that, she turned on her heel and was off. Standing there, wiping my eyes, I realised that the ambulance men, as nice as they were, had pulled a fast one on me. I was a gullible greenhorn, a real eejit, and it showed.
So I was there next morning, exhausted and trembling, and it wasn’t just Sister, but Matron, too, I had to face. I had to have a clean apron on, and stand, with my scrubbed hands behind my back, like a very naughty schoolgirl. Matron wiped the floor with me. ‘You know there are rules, nurse? And rules are meant to be followed … blah-di-blah-di-blah …’ I wanted to disappear between the floorboards. However, to be fair to her, she did stop and say, towards the end, as I was blowing my nose loudly, that she would have a word with Night Sister as I shouldn’t have been left entirely on my own while I was training. So she was actually quite fair to me in the end, and I had to learn yet another painful lesson in the importance of sticking to the damned rules … My mother would have been so proud.
There was a more tragic death one night, however, which made me very sad and again made me realise how important it was to be thorough and observant as a nurse. A young lad of about fifteen was brought in after having a fall on the Common; it wasn’t clear how, but he was probably larking about with some friends and had fallen out of a tree and broken his ankle badly. He was taken to the men’s medical ward, but mysteriously got worse, as he developed a very high temperature. His ankle was set, but still he worsened, and we discovered he was dying from tetanus (lockjaw), which was incurable at the time. However, it was only when he was examined during the post-mortem that it was found that he had a deep graze on the back of his head. This has gone horribly septic and had done for him. It was appalling to us all that this injury had been missed. More importantly, it felt terrible that such a young life was snuffed out so quickly from something that should have been dealt with at the time, and which, today, would be so easily treatable with antibiotics. This kind of tragic incident affected me deeply, as I was only a teenager myself, and made me feel that life was somehow, sometimes, hanging only by a very fine thread. It also made me realise how important it was to be thorough in the medical profession, and how the smallest thing could turn out to be important, especially if it was neglected. This made me feel much more responsible, and assiduous, when dealing with wounds after this experience.
Sister Tutor, who was a very kindly woman, could see that we were deeply affected by this kind of encounter with death – a boy who had died too soon out of both an accident and human frailty. She would tell us that we would have to get used to seeing all sorts of things in our hospital lives, and that dealing with death was a major part of it all. Sometimes we would see things that would upset us for days, other times we’d see something that would stay with us for life. Even though some of the sisters and staff nurses were quite callous and hardened, and barely paid any attention to the dead and dying, they nonetheless respected that there needed to be a dignified way of dealing with the passing of life.
Helping people to die was seen as an important aspect of the job, and so Sister Tutor taught us how to approach it with human kindness and thoughtfulness. One day, shortly after the incident of the youth dying from the hidden head injury, she sat us all down and said, ‘Don’t ever let someone die alone. We didn’t come into this world alone, and we should never leave this world alone. When someone is approaching their final hours it’s so important to sit and be with them as they go, especially if they have no family.’ Indeed, she taught us to sit and ‘mop their brows, comfort them’, she would say, ‘hold their hands and soothe them’. She taught us to care, to spend time with people, to make them comfortable, to talk to them and to ease their passage into death. She was a wonderful, sweet influence and a nice woman, to boot, and her important lessons about something that had frightened me a great deal, at first, have stayed with me all the rest of my nursing life.
5
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