大象传媒

This has been typed on behalf of Cissie Ridings by Age Concern East Cheshire and in her presence.

Leaving home

The day came for me to leave home, the parting was tearful, it was as if I was going to another country instead of a mile away. It had been difficult for my mother to buy me the necessary clothes. I was expected to have black duty shoes, black stockings, dressing gown and bedroom slippers. I had never possessed a dressing gown or bedroom slippers. After reporting to matron's office, I was introduced to the assistant matron, she accompanied me to the nurses' home, sister also appeared to be stern, did anyone ever smile here I wondered. Her hair was grey and severely styled, her face looked scrubbed clean, she wore a white coat like the doctors wore and a white crisp starched cap. The conversation was mainly questions about my education, not about me as a person. She was probably concerned I may not pass my exams.

The nurses' home was a modern two storey building, quite a contrast to the surrounding buildings. I was shown the sitting room, the bathroom and lecture room, which included a skeleton hanging from a stand, I was not too happy about that. Someone told me later it was the skeleton of a Frenchman, whether true or not it didn't make it any more acceptable. My bedroom was upstairs, how wonderful it was to have a room of my own. This had never been possible at home, though I was later to long for the comfort of snuggling up to my two sisters. There was a fitted unit and wardrobe along one wall. A bedside cabinet and overhead bed light, also a full length mirror and I had never seen myself full length before, what luxury.

Sister then instructed me not to unpack, but to change into uniform. This was in a neat pile on the bed, there was also a long navy cape lined with red. Sister informed me she would return to take me to the ward on which I would be working. I was disappointed in the uniform, it was not at all what I had expected. It was on the style of a dentist's coat. Later of course I knew why, it was for practical reasons, as this was a fever hospital, for highly infectious diseases, and most of the time we wore gowns over our uniform. Sister returned and I was given a quick inspection including my fingernails. There was no introductory course, but in my ignorance I did not think it unfair.

Introduced to Astley

On our way to the ward, sister pointed out the different wards, they were single storey brick buildings mostly following in a line from each other, with a good space between each one. The top and bottom were different from the others, being new and divided into cubicles, six cubicles on each side of the kitchen and treatment room. The top cubicle block had a small theatre attached. The bottom cubicle block was where the iron lung was situated. This looked like a cream metal coffin with port-holes, it was on a metal frame. This was for patients who suffered from poliomyelitis and who had developed respiratory paralysis.

Each cubicle was self contained with a large window separating each one, there was a single bed and wash basin in each cubicle also a hook rack for two barrier gowns. Covering the entire front of the cubicles was a glass veranda with double doors these could be opened in the summer allowing the beds to be wheeled outside into the fresh air. It was in these cubicles that patients with diseases other than Diphtheria and Scarlet Fever were nursed. I learned later that Tuberculosis was not nursed at Astley, but in a special hospital, this was Peel Hall hospital which was about two miles away. Whenever there was an outbreak of Typhoid a ward would be opened specially and staff from other wards would be assigned to this ward.

Until now I had not been informed about on duty or off duty rotas, where was the dining room? who did my laundry? and when? however I learned this and much more on my first ward. Also something else I hadn't thought of - professional etiquette, all this and more I learned from my assigned nurse. There was so much to remember, on duty 7:30am, in bed by 10pm night sister did a round of all bedrooms and then locked the main door. Of course the fire escape door was not locked and I learned later it was used by the most daring. We had one half day off duty per week and one day off each month, this included your half day. We were entitled to two weeks holiday annually. All lectures were held in our off duty time. In school we were taught professional etiquette but were expected to practise it before being instructed formally. Some of this I remember:-

(1) You never run except in case of fire.

(2) Always stand when a senior member of staff enters the room.

(3) Always open the door for the doctors.

(4) Never overtake a senior member of staff on the stairs.

(5) No make up on duty.

(6) Hair not to reach your collar.

(7) Nails must be short.

(8) Black stockings only when on duty, and no ladders in them.

(9) Low heel shoes.

Bombed

We were at war with Germany. All the wards had red crosses on a white square background, painted on the outside roof. When I asked why, I was told it was to inform the enemy planes that this was a hospital. However it didn't prevent them dropping two bombs, one just outside the back gate and close to the nurses' home. The other one near the orchard. They were probably looking for the Manchester ship canal to destroy communications.

There were no air raid shelters for either patients or staff. Patients, if possible, were put on their mattresses under the beds. Sometimes we would have to take the day report from the nurse in charge whilst lying under the bed. Whenever there was an air raid the staff who were off duty were to collect in the cellar of the big house. The first time I spent a few hours in the cellar of the big house was the last. I disobeyed and stayed in my room. My fear of entombment was greater than my fear of matron. Of course that was the night the Germans decided to drop the bombs. All I remember was being wakened by a huge thud as if a massive boulder had been dropped from the sky. I was shaken vigorously, my bed moved and almost seemed to tremble. My toiletries slid along the length of the dressing table onto the floor. I waited, wondering what had happened, never thought it was a bomb so I went back off to sleep.

Of course no one knew I was in the nurses' home alone until the following morning. I was summoned to matron's office, matron was furious because I remained adamant that I would not go into the cellar. Finally I had to sign a paper to that effect. Absolving the authorities of their responsibility for me. This was the first time I disobeyed matron.

No information was given publicly about where specifically the bombs were dropped. Probably so as not to inform the fifth columnists (spies) how successful the targets had been. On reflection these bombs could not have exploded or I would have been killed. The nurses' home being only yards away.

My first ward

We reached my assigned ward and I was ushered into ward sister's office. What a difference, ward sister actually smiled. She welcomed me and informed me that the children on her ward were suffering from Scarlet Fever. A nurse was summoned to her office. I learned later this was her "BEST" nurse. I was to be with her for three days. The only place on the ward I was allowed to go without her was to the toilet. The way I was feeling this arrangement suited me fine. In teaching methods this is called "sitting by Nelly" (copying what you observe). Later on in my nursing career whenever the different methods of teaching and learning were discussed, I smiled at the term sitting by Nelly, from my own experience this method has a lot of merit, if Nelly is good.

The ward seemed so big with lofty ceilings, huge long windows, and dark wood parquet floors. There was a grand stone fireplace in the centre of the ward surrounded by a high metal fireguard, the brass trim surrounding the top gleamed brightly. Situated in line with the fireplace was a long solid wooden table, in the centre was a glass vase of flowers. The beds were equally spaced, all the bed casters were turned inwards, everything was so clean and regimental and I was conscious of a very pleasant smell of furniture polish.

The top sheets on the beds were folded over the counterpanes, all the same width. Did they have a ruler I wondered. When I queried this I was told the fold had to be sixteen inches and a good guide until you became expert was to measure from fingertip to elbow. Beds also had a narrow mackintosh made of reddish brown rubber, this was covered with a draw sheet, when I asked why a draw sheet I was told because of its function. If a child wet the bed, or to create a cool area the sheet was long enough to be drawn forward and tucked in the opposite side.

At the entrance to the ward was a small washbasin. The hand towel was white cotton and arranged like a fan, this was for doctor's use only. The sluice was beyond the far end of the ward. The sluice walls were covered entirely with white tiles. It was our duty to wash these regularly.

We had a ward maid who also wore uniform. One of our duties was to assist the ward maid by pulling the beds and lockers away from the half tiled walls. The bed frame, locker and windowsill we damp dusted. We also polished the long table. Squeaking casters were not tolerated. The ward maid polished the floor once a week with what was known as a dummy and Ronuk polish. The dummy resembled an old type non electrical carpet sweeper but much heavier. Pieces of old blanket were placed under the base to apply the polish and then another piece of blanket to make the floor shine. The coal fire was lit daily during the winter by the ward maid. Everything necessary for the fire and fireplace was contained in an oblong wooden box with a handle. There was a hand brush and pan, black lead brush and black lead polish for the iron grate, sticks, paper and matches. I feel sure the coal fire reminded the children of home. There was no vacuum cleaner.

There was no practical room in school. The teaching of practical skills was taught by the nursing staff on the wards. I learned quickly and avidly not only what I was expected to learn but I observed all that was being done, and just how it was done in case I should be asked and found wanting. Sister did not teach practical skills, her role was that of manager, and she did this superbly, nothing escaped her notice, the ward ran just as smoothly whether sister was there or not. No one entered the ward without her permission that is of course with the exception of matron. Doctor was always accompanied. Learning was sometimes quite stressful, instructions were seldom repeated and fear of being thought inadequate prevented me from admitting I had not fully understood, or had forgotten some of what I had been told. I always kept notes in a little book of vital details throughout my training. I vowed silently that when I became a sister I would remember fear is destructive, it prevents learning taking place, it blocks the path to remembering or retaining information.

The ward staff seemed happy and friendly, there was no unnecessary talking to each other when on duty. As lunchtime approached I was really hungry. The dining room was in the old house, also the boardroom, telephone room, matron and doctor's office. Upstairs was matron's flat and the maids' bedrooms.

Teaching and learning was taking place all the time, even in the dining room there were more rules. Seating arrangement was in order of seniority, the most senior nurse at the head of the table. They were served first by the dining room maid. As a junior nurse you could not ask the maid directly for more potatoes for example, you asked the senior nurse present, she then asked the maid. The sisters were seated at a separate round table, they had white damask napkins and silver serviette rings. I aspired to that. At the end of the first day I had learned so much, physically and mentally I was so tired, as I lay in bed that night I felt so lonely until I remembered the children on the ward. My experience of children was totally different from those I had nursed on my first day. These children were so quiet, so subdued and obedient, some were quite poorly but still it wasn't natural. Usually the children were in hospital from four to six weeks and in some cases even longer. No visiting was allowed unless a child was dying in which case one visitor only was allowed though not in the ward. There was a small window in the kitchen with a good view of the ward. The child would be in the first bed under the window and the visitor would look at the child through this window. Difficult now to reflect how we accepted this, though even at the time myself, and I feel sure other nurses thought how awful not to be able to cuddle or hold your child's hand.

Dr Davidson had introduced a system that at first I thought was a good idea. According to the severity of their illness an oblong slip of gummed paper was attached to their chart, red for patients who were dangerously ill, blue for patients who were seriously ill and yellow for patients who were progressing favourably. This system was good for the nursing staff as we could see at a glance the patient's condition. If all was going well this was no problem, but on reflection the reverse did sometimes occur when a patient who had been progressing favourably developed a complication and the yellow sticker would then be replaced by the blue and then maybe the red. Would the children have known? I feel sure they did. This information would have been passed on by the other children and if they knew what red, blue, yellow meant I feel sure they could work out what yellow, blue and red meant. If we were cruel it was in ignorance.

Each Saturday family and friends could leave sweets, comics and toys for the children. There were few toys as these could not be taken home on discharge. Also the community from which they and I came from was a mining and cotton mill area, quite poor. These gifts were put in large wicker clothes baskets at the lodge, on Saturday afternoon. Later they would be delivered to the appropriate wards. All fruit and sweets were divided equally daily. Toys and comics were given to the individual children for whom they were intended. The children's food was good, if not in variety. It was mainly minced beef and mashed potatoes, with rice pudding for the sweet, in most cases this was better food than at home. No fancy crockery - enamel plates and mugs, the type used in camping today. The rice pudding was also served in these tin mugs. It really didn't matter about that the pudding was good. There was always jelly and blancmange for the poorly children.

There was nothing to indicate that it was a children's ward. No big soft toys, no nursery rhyme border, at that time this did not seem strange. There would be few toys and books at home. I had my very own first book, it was of fairy tales, probably, when I was eight years old. I can still recall how cross my mother was when she discovered I had read it in total on Christmas day. She said it should have lasted me longer.

On this first ward I had learned a great deal and was beginning to feel very confident. The cleaning had not been a problem, I was used to that at home, and the principles were the same, though the area was larger. That is not to say I enjoyed it.

I was proud of the skills I had acquired:-

(1) Taking nose and throat swabs.

(2) Testing urine. This was a lengthy procedure as some of the tests involved boiling the urine over a spirit burner.

(3) Bed making, I loved this.

(4) How to give a bedpan properly. There was no bedpan washer, the cleaning was done by a small hand mop. Soiled linen was sluiced by the nurses.

(5) How to take a temperature properly. We were not taught heat made the mercury expand and rise, enabling it to register body temperature. We faithfully did exactly as we were shown.

Verminous heads were not uncommon. They were treated with sassafras oil. Firstly, Vaseline was smeared on the forehead to protect the eyes, also sassafras irritated the skin. The head was then covered with a capeline bandage, which seldom stayed on, especially mine, as I was not very good initially at bandaging. The children were distressed, they felt ashamed. The smell was atrocious. We didn't use screens very often, which was as well because the frames were made of solid wood and there were no casters for easy moving, but we did use screens when doing this procedure, though the screens were no barrier in this instance to the smell.

Ottorrhoea (discharge from the ear) was not uncommon. Ears were swabbed with hydrogen peroxide daily, for as long as the hydrogen peroxide bubbled. When I asked why, the answer was as long as the solution bubbled, pus was present. Fascinating! Then the ears were mopped out with saline.

A rare complication in Scarlet Fever would be if the streptococcus affected the kidneys. Kidney failure could occur, the patient would die. A relative of mine did die from this complication, she was nine years old. I was nursing on the ward at the time. These patients would be nursed between well worn blankets.

In scarlet fever desquamation fascinated the children. The skin would peel off around the third week, quite large pieces. All desquamation had to be eradicated before discharge. The scarlet cheeks, the circumoral pallor, (this is a creamy white area around the nose and mouth), in stark contrast to the flushed stained cheeks. The strawberry tongue and that rash were unmistakable in scarlet fever.

Child psychology was never mentioned so love for children and common sense were important factors in care. An example of one instance I remember. When I was on night duty a little boy wet the bed, he was so distressed in case the other children found out. Common sense gave me the answer. Every morning I went to him before the others were awake, washed and changed him, no one ever knew.

Whenever the opportunity arose, we cuddled the children, so we had progressed from when I was a patient. Always, careful of course, not to let the hair come in contact with the child. Whilst on this, my first ward, I attended a few lectures, these of course in my off duty time. We were first taught the long bones of the skeleton, every process, every notch. I must confess I spent some of the time wondering about it (the skeleton) being a Frenchman, and thinking, do they look like us? Up to this time I had never met a foreigner, never seen a black man. Great emphasis was also placed on the art of bandaging, although there was little need for this in fever nursing. But very necessary, IN ORDER TO PASS EXAMS! My time on this ward was at an end, I have been here for three months, and time has passed so quickly. I have been happy and now feel quite experienced and confident. No one has died during this time, though I was now aware that sometimes children died on the next ward. This filled me with fear and I wondered what it would be like and how I would cope.

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