Becoming a Nurse in the NHS

It was the middle of the night and, shaking with fear, I was standing by the bedside of a good looking young man. Nigel, the nurse in charge, had ordered me to collect the steel kidney dish from the treatment room and follow him to Bay C Bed 2. Along the way he had nodded at the dish and said “Right. You can give this one.” Immediately I felt my stomach clench with apprehension and my hands had started to shake. Inside the dish was what appeared to be a very large metal syringe topped with a long needle. This equipment contained what was going to be the first injection I administered and, at that moment, I wondered whether I had chosen the wrong career. It was one thing to stick a needle into an orange in a class full of other nursing students and quite another to push it into the attractive rear end of a guy with whom I wouldn’t refuse a date if we had met under different circumstances. How had I ended up in this ward full of acutely ill people with the prospect of no nights in my own bed for the following ten days? My career path appeared to be leading me into a situation out of my control.

As a child born in the 1950’s I had been raised within the almost euphoric bubble of the freedom years of the late sixties and early seventies with experimental music, a more accepted open approach to love, and the relentless encouragement to develop one’s creativity with or without the use of external substances. Dressed in a daily uniform of jeans and always accompanied by a folk guitar, I had an almost hippie-like ethos and my ambition in life was to write for my living. I entered higher education believing that I would win prizes for journalistic reporting. To my great dismay however, university study required some measure of discipline and I was a true product of my era, free spirited and rebellious. I wanted to have fun and experience love and, most of all, to return to the UK where my current boyfriend resided. After only one year in university I dropped out and made the move to Europe where I quickly moved on to another man and an unexpected working role. At the age of 19 I became an au pair, working as a lowly paid cleaner and child minder for a family of three spoilt children and their parents, a couple with a penchant for perfection. The fall down to reality was abrupt and it didn’t take much time for me to realize that I would be unhappy if I thought that I had to remain in servitude forever.

One of my friends in the weekly French class I attended is responsible for my entry into that wonderful community of health workers. Her own application to study nursing at a famous London hospital had been accepted and she would be starting her training later that year.

“Why don’t you go into nursing? You love people and seem to be a caring sort of person.”

“Oh yes. That sounds like a good idea. My parents would be really pleased if I had a career.”

With those few sentences my future was determined. There was no long term planning, no vocation, no history of playing doctors and nurses. The choice to enter nursing was a practical one. I needed to find work that I was good at and also that would enable me to eat. End of story. I took the first nurse training place available at a hospital in small rural city in England.

One can only imagine the difficulty I had fitting in with the other 40 student nurses when I first started my training. At that time the nurse education programme in the English National Health Service used to last for a period of three years with alternating periods of about six weeks spent in the classroom followed by six weeks on the wards. We all met in a large classroom on that first day in the School of Nursing, conveniently located in the hospital grounds. The group consisted of 39 girls and 1 boy (he only lasted about six months as he was teased relentlessly and left) and I was the eldest of them all. Every student nurse had to live in the accommodation provided by the hospital, with the exception being one girl whose mother was terminally ill dictating that her daughter’s support was needed at home when she was not at work.

Every one of those students had always wanted to become a nurse through childhood and I immediately felt out of place in the group of the dedicated young people. Nonetheless, I was held in some regard as a widely travelled woman of the world, and I blustered my way into the group with stories of my adventures. Yet, as impressed as they were by me, I was in awe of them. In my estimation they were the ones who knew the difference between a bedpan and a commode.

As a good student, I performed well in the classroom, always eager to show off my new knowledge and thereby to win the hearts of most of the teachers. No sooner would they finish their questions than my hand would be waving in the air. The other students didn’t often stand a chance to demonstrate their knowledge when I was around. Once I left the education setting and moved onto my first ward for some practical training however things became much more difficult.

I donned my new uniform with pride. It was a simple blue checked dress with a coloured belt which indicated the year of my training. On my perfectly groomed head was a starched white linen cap which had to be folded in a precise manner and attached to the hair with white pins. For winter days I had a heavy woollen navy blue cloak lined in red, which I loved so much that I kept it for 25 years until the rats ate it when in storage in my attic. I was so keen to get everything right that I was dressed two hours early for my first ward shift in the hospital. Until that day our only exposure to the wards had been several hours of practice making beds. These were done within precise guidelines including sheet corners folded and tucked in correctly and pillow case openings all facing away from the room entrance.

A busy surgical ward was my first placement and I arrived at the ward enthusiastic to demonstrate everything that I had learned thus far.

“You do not wear your cloak on the ward Nurse! Get rid of it this instant!” A voice that I would come to recognize very quickly boomed out across the 36 bedded long ward as I entered through the swinging double doors.

With bright red cheeks I hurried back out through the doors and felt lost as I thought about what I should do next. There had been nowhere obvious to hang the cloaks near the ward entrance and I hadn’t walked past any lockers. Fortunately a door opened to my right and one of the more senior student nurses came to my assistance, directing me to the staff room. After I had divested myself of the offending cloak, she accompanied me into the ward and, as she advised, I followed her into an office where everyone had gathered to hear the night report about the patients. In a suitably submissive manner I took a seat in a vacant chair near the desk. All of the gathered nurses sat quietly waiting for the night staff to appear. When the phone located at the side of my elbow began to ring and no one picked it up, my automatic reaction was to answer it straight away. This small infraction of the Ward Sister’s privilege earned me the remainder of the day in the sluice room scrubbing metal bedpans and vomit bowls. The irony of my situation was quickly apparent to me. My desire to work in a profession where I would be valued and not be treated as a servant had brought me to a room cleaning the worst kind of human waste I had ever had to deal with.

Exhausted by the second week, I was ill prepared for the moment that the nice old Mr Brown’s heart decided to stop beating while I was trying to wash his nether regions. This was not the effect I had anticipated having on my patients and when I had realized that no amount of shaking was going to wake him up, I ran out from behind the bed screens crying. One of my colleagues said that all she saw was my back as I disappeared running out of the ward to seek refuge in the staff bathroom. It took an understanding senior staff member some time to persuade me to return to the ward. That day was a day of firsts. First cardiac arrest; first exposure to the resuscitation team with the numerous trolleys and high tech gear; and sadly, the first time that I had to prepare a person to go to the mortuary. The Ward Sister did take pity on me on that occasion and assigned a senior nurse to show me my duties. Thanks to the instruction of that wonderful nurse I learned about how to give good care to a person even when they were no longer alive to acknowledge it.

In my room that night I cried myself to sleep and it occurred to me that maybe I wasn’t strong enough emotionally to deal with the sorrow that nursing can bring. My image of a caring angel who cured all of my patients’ problems and sent them home to live another day had been shattered. Until that day I had never seen a person die and, for a self focused young woman, it was horrible.

The following day I entered the ward with trepidation, wondering what new shocks were in store for me. As I took my seat in the office for the report the ward sister spoke my name.

“Good job yesterday Nurse. I couldn’t have laid out Mr Brown any better myself.”

There was no mention of my quick exit from the ward during the resuscitation attempt and at that moment I realised that maybe I wasn’t as bad at the job as I had thought. Later that day I was allowed to assist the senior staff nurse in dispensing the meals. In that era the food arrived in a huge heated trolley and it was the responsibility of a senior nurse to serve onto each plate a nourishing mix of food suitable for whichever specific diet the patient required. I was given the task of ensuring that each patient had the ability to feed himself and if not, I assisted. Food and fluid intake and output were carefully monitored for every single patient. I soon developed a special whispering voice for asking that sensitive question “Have you had your bowels open today?”.

No student nurse did a spell of night duty until he or she had finished the first six weeks of ward experience. By the end of this period essential skills would have been acquired such as bed making, patient washing, dispensing of bedpans and toilet assistance, and performing patient observations such as pulse, temperature, respiration and blood pressure. My first night duty ward experience took place on an acute surgical ward of 36 patients. It commenced at 8:00 pm and finished at 8:00 am. Once I started on that first night I worked the following nine nights culminating in a glorious four nights off before starting the whole ten night span of duty once again.

I arrived at the ward at 7:45 pm. My fellow staff members were an untrained nursing axillary, Blossom, who had many years of experience working night duty on that particular ward, and Nigel, a tall young man and the only trained member of staff. After report handover by the day staff, Blossom and I started a round of preparing patients for sleep, offering them the toilet, giving them a wash of hands( and anywhere else deemed necessary) and administering a quick rub of the bottom with talcum powder as a bedsore prevention tactic. While Blossom and I carried out our administrations, Nigel dispensed medications and did patient observations. This routine set the pattern for every two hours during the twelve hour shift. No sooner had Blossom and I finished our first round of tasks than she put the kettle on for a cup of tea, collapsed in her chair and removed her knitting from a tapestry bag at her side. The first patient bell rang one minute later and, to my amazement, Blossom had suddenly become deaf. By the time I had answered four bells and Blossom had knitted an entire sleeve of a baby’s cardigan, I realized that, as the newest member of staff, my night duty shift was likely to be extremely busy.

The first night flew by and I was startled when the sun came up during the sixth round of patient care. I left the ward feeling tired but satisfied with the work I had done. Falling into bed I had no doubt that I would sleep the entire day. When the alarm went off at 6:00 pm I had managed a total of about one hour of uninterrupted slumber. At 7:45 pm I arrived once again at the ward for my twelve hour shift but on this occasion I felt as though I had jet lag and was beginning to doubt that I would make it through the night. I struggled through performing the two hourly patient care rounds in a fog like state. Every time that I checked my watch, convinced another hour had passed by, the reality was that the minutes were dragging and many hours still remained of the long night duty shift. By the time the morning staff arrived the next day I could barely make my way back to my bedroom. I had no problem sleeping that day and at 6:00 pm the alarm clock rang for so long before waking me that my neighbour banged on my wall and shouted at me to shut it off.

As I settled into the pattern of daytime sleep and night time work Nigel trusted me to perform more advanced nursing duties. He went to the staff restaurant for his half hour meal breaks leaving me in charge of the 36 patients and Blossom. One night as I sat waiting anxiously for his return, praying that nothing out of the ordinary would happen, I heard the soft closing of the ward doors. Matron (the nurse in charge of the hospital) arrived without any warning except a clicking of heels on the hard tiled floor. Before she had arrived at the nursing station in the middle of the ward, Blossom’s bag had miraculously disappeared along with the tell tale tea cup.

“Follow me!”, she ordered and I ran along behind her to the bedside of the first patient. Ever mindful of the need to wait for the senior nurse to issue orders I remained quiet. We stood there observing each other for several long minutes. Finally she spoke.

“Well!” she barked.
“Sorry Matron?” I questioned with my most respectful voice.

“Patients, Nurse! Name. Diagnosis. Treatment. Quick. I haven’t got all night you know.”

Whilst silently cursing Nigel, I tried to recite everything that I could remember from the patient handover. We made our way from patient to patient and more than one of them complained at the flash light which she shone in the face to check out for breathing or other signs of life. Patient call bells began to ring incessantly as the general disturbance of the ward intensified. We had just arrived at the eighth bed when Nigel returned from his break. I was incredibly thankful that my reprieve was imminent. It is impossible to describe how disappointed I was when Matron turned to him and ordered him away, explaining that the student nurse would continue the ward round with her.

I came to dread those nights when the tell tale click of heels down the corridor signalled her arrival and the subsequent inquisition. One night I heard the sounds of the door but no heel taps. Out of the darkness appeared in front of me another student from my set, also doing her first turn of night duty.

“Staff Nurse Jones has sent me for a neck tourniquet.”

I looked at her in disbelief. “Sorry, what did you say?”

“Neck tourniquet. Do you have one?”

I looked over to Nigel who was shaking with laughter. He disappeared into the treatment room and returned a few seconds later with a covered bowl.

“Tell her we don’t have one but I have sent her a set of fallopian tubes instead.” We all just about controlled our laughter until she left the ward. Even Blossom roused herself to join in and surprised us both by offering to make a cup of tea.

I remember that night well as it was also the night that I gave my first injection. Nigel was in a mischievous mood and chose the youngest male patient as the recipient. At 2:00 am the two of us drew the curtains around the bed and turned on the overhead night light. The patient barely acknowledged me accepting that, because I was wearing a uniform, I knew exactly what I was doing. As instructed he turned onto his side.

“Now John, I am just going to give you a little prick.” I told him in my most comforting voice.

“I hope not!” he said as the three of us roared with laughter.
That injection was the first of many but the memory will stay with me forever. During my long career as a nurse and midwife I tried to never forget that a sense of humanity, whether it be through humour or compassion, was the most effective means of gaining the trust of those in my care. The rewards of developing those relationships meant that my career gave me a happy and successful working life.

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4 responses to “Becoming a Nurse in the NHS

  1. This all sounds very familiar,

    • For some reason your comment didn’t show up Michael so I apologise that it has taken me so long to reply. I’m interested that you know what I was referring to. Were you in a related profession?

  2. This is a terrific and very informative account! I hope you’re making it the first chapter in your book. 🙂

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