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The Francis report on the Staffordshire hospital makes disturbing reading and sets
me wondering how nursing could have changed so much since I trained in the 1950s and 1960s.
As an outsider it is difficult to understand how things could have changed so much. I know that today’s nurses work in a very different environment (new drugs, hi-tech equipment, more advanced techniques etc.) from that we enjoyed, but surely the basic ethos of caring should still be there.
I think (as with many professions) that the chain of command has become far too complicated, so that it is much easier to “pass the buck” when things go wrong.
We had a simple, and easy to understand, structure. Matron was at the top and made sure she knew what was happening throughout the hospital. She and her deputy matron visited every ward every day. One day she would take the even numbered wards and the next the odd numbered wards. She went round every patient, and woe betide the nurses if a patient was in a soiled bed or had a genuine complaint.
We had one sister and just one staff nurse on most wards and they alternated their off duty. They were very much in evidence at all times. They went round as soon as they had received the report from the night staff, they did the medicine rounds and served the dinners and many of them rolled up their sleeves and worked on the ward. They somehow managed all this as well as mentoring the student nurses, ordering supplies, arranging the off-duty rotas and writing reports etc. They also accompanied the consultants on their rounds. Visiting times were more regulated then and either the sister or the staff nurse was available for any queries from the relatives.
When I was in hospital a few years ago the only time I ever saw the sister was when the lady in the next bed to me inadvertently pressed the emergency bell and the “crash team” rushed in through the door with all the equipment for resuscitation.
I think successive governments have had ministers with ideological missions, who have added more and more layers of authority, who have taken the authority from the clinical staff. Then in the 1980s Mrs Thatcher and Ken Clarke brought in the idea of “market forces” and put a price on everything and thought that patients would behave like commodities. Sorry MPs but patients are people and people behave differently! Some are textbook cases and “follow the rules” but many others don’t and cannot be put into groups and get all sorts of complications which go far beyond their “price range”
The other scheme in the 1980s was to privatise the domestic service. Before this we had an orderly and a ward maid on each ward. They took great pride in “their” ward and the wards were spotless. One of the orderley’s duties was to clean and refill the water jugs at least twice a day so no one had to drink water from a flower vase! They were accountable to the sister but now no one knows who is going to be doing the domestic work, this has also taken away the satisfaction the old domestic staff could take from looking after “their ward”
We have all seen how this cost cutting exercise was a false economy when the spread of secondary infection caused so much harm.
The reason sisters could manage with one staff nurse was that all the nursing staff, even the lowliest junior, had at least 12 weeks training before they set foot on the ward and most had had considerably more.
We ranged in experience from those just out of the preliminary training school in 3 month sets to those within 3 months of their final exams. There was a new intake of nurses “sets” every 3 months, so, as well as giving us a wealth of experience, the wards were well staffed.
I think one of the best piece of advice I got was, “However dirty, manic or disagreeble the patient may appear this may be part of the illness and you must treat them all with as much compassion as as you would like your own relatives to be treated”. This stood me in good stead when faced with a patient who wet the bed as soon as you had changed it, handed you a present of faeces, or tried to pinch or thump you!”
I have still to be convinced that a university degree is necessary for all nurses, could there not be a different title for those who would be quasi doctors and leave the nurses to do what they are best at, caring, keeping the patient comfortable, fed and hydrated and carrying out the apprpriate nursing procedure efficintly and professionally.
It should be mandatory for politicians, business managers and such individuals to actually work at the business end before they are allowed to make major changes.
As patients we should be more careful when complaining or taking legal action. Of course when there is a valid complaint it should be investigated, but not all patients will recover however dedicated and skillful the medical team, and every time frivolous complaints are made it gives the bureaucrats an excuse to add more paperwork. Very often all the patient wants is a polite and rational explanation. They just want to know that they have had the best care and attention.
Iknow that there are many younger people who will argue against our method of training, but the general consensus among those who trained this way is that we would have more cofidence being nursed by the old style nurses than by the new method. Judging from the presents of chocolates, tights, biscuits etc. left by the majority of patients, I would say that the patients were happy with their treatment.


Jennie and I went to see Anton and Erin, from “Strictly come dancing”, when they came on their annual visit to St. David’s Hall last month. This was the third year we had seen them and once again we had a magical evening, superb dancing (how do they do it on such a small stage?), great music, singing from Lance Ellington and interesting  and humerous chats from them about the show.

Erin and the other two female dancers had some beautiful dresses and that triggered one of my memories from over 50 years ago when I went to Matron’s Ball.

This was an annual event at the General Hospital Birmingham, a formal affair held in January. All the nurses and doctors who were off-duty were invited but there were rules. The nurses had to be accompanied by a male escort. We had to take the name and address of our proposed escort to Matron’s office and assure them that our parents approved of said escort (we didn’t reach the age of maturity until 21 in those days and Matron considered herself in loco parentis!)

Matron then sent a formal invitation to the boy.

My friend Chris and I decided that we would like to go and fortunately we were both due to be off duty. We were on junior night duty and worked nine nights on and five off and January 6th came during those five nights so we made preparations. I had a suitable boyfrend but Chris was between boyfrends so I introduced her to one of the fifth year medical students who was working as a dresser on Casualty where I was doing my night duty. The medical students were not automatically invited so they were going around being extra nice to the nurses and hinting that they either owned or could acquire an evening suit!

Dress was formal evening wear and my parents paid for my dress for my Christmas present. It was silver and blue brocade with a full skirt. The top was fitted and had shoestring straps. I managed to get matching blue and silver long gloves, made a blue velvet bag to match the bit of blue velvet along the neckline and had satin shoes dyed to match.

On the morning of the ball we went back to the nurses home and spent most of the day pampering ourselves ready for the great occasion, scented baths, hairdos, facepacks etc. Those of our friends who were not going all joined in the fun of getting us ready.

The nurses home was carefully  guarded in those days by the warden and home sister so the male escorts had been shepherded into the visitor’s room on the ground floor. When we opened the door to this room all I could see was a sea of black and white and hastily backed out. Fortunately our escorts had seen us and followed us out. My boyfriend’s father was waiting outside and transported us the short distance to the Grand Hotel.

Matron and one of the consultants were wating inside to welcome us. Most of the consultants were wearing the very formal “white tie and tails.”

It was interesting to see the sisters and staff nurses in their finery (and to make critical remarks about them). After the half time interval the most senior staff (Matron and the senior consultants) tactfully withdrew to a side room and everyone loosened up a bit, and by midnight some of the housemen were getting quite boisterous and belting out popular songs, I seem to remember”Ma he’s making eyes at me” and “Michael row your boat ashore”.

It was my first formal ball which is why I suppose I remember it so clearly. There were other balls, January for the General Hospital, and May for the Queen Elizabeth. The nurses home at Q.E. had its own ballroom in the home built by Lord Nuffield. I enjoyed them all but the first made the biggest impression, even more than the last one at the General where we all had the added adornment of a small dressing on our arms thanks to the emergency vaccinations we had had to have a few days previously due to an outbreak of smallpox in the neighbourhood.

I don’t know whether they still hold these balls now, but I think we had a lovely family atmosphere then and were not interfered with by bureaucrats, who would probably want to bind us with red tape and charge us for the privilege.

Fifty three years ago today I started my Nursing career!

I arrived in Birmingham not knowing a soul. I had only visited the city once before, about 2 years earlier when I went for my day-long interview. I must have made the right impression on the formidable panel of interviewers (the Matrons from the three main hospitals in the group and the senior tutors from the nursing schools) because they had written and offered me a place in the January 1958 school. They had explained to me that they were starting a new scheme of training which would incorporate the training schools into one which would become the Queen Elizabeth School of Nursing and we would gain experience from all the hospitals with their different specialities.

The PTS (preliminary training school) was housed in two large houses in a quiet road in the suburbs. I was in Priorsfield and found that I was in a six bedded room with a lino floor and minimally furnished. I was the second to arrive, the first was a very pretty Turkish Cypriot girl and during the afternoon we were joined by two girls from the West Midlands, one form Yorkshire and one from Leicestershire. The other rooms filled up with girls from all over the UK. Quite a number were from the West Midlands and I found the accents quite difficult to understand at first.

We had tea at 4 pm and then went to the school room where we found that there were 76 of us—75 females and 1 male! In those days it was very much a female dominated profession. Most of us were straight from school and all were unmarried. The tutors spent the first half hour telling us how fortunate we were to be there and that a high standard of behaviour was expected from us and that the three months we would spend in the school was a probationary period for us and that if we did not match up to their standards then our training would be terminated! They then went on to tell us how our time would be organised in the next 12 weeks.

The day started with breakfast at 7.30, prayers at 7.55, cleaning from 8-8.30am (gasps of horror from a few of the “posher” students), to whom it was explained that we couldn’t expect to organise cleaning on the ward if we had not done any ourselves, (it also cut the cost of running the nurses home :)) Lectures 9am-1pm, one hour for lunch and then practical lectures in basic nursing or visits, eg waterworks and sewage works,until 5pm when we would be free to go out or write up notes etc. The door was locked at 10 pm and lights out at 10.30pm. This “lights out” was rigidly enforced by the house warden, who I think must have been an air raid warden in her younger days so practised was she in calling, “Put that light out!”

This was our programme Monday to Friday. Saturday 1pm- Sunday 10pm we were free to go home or relax in the home. We also had an extension to the day by being allowed out until10.30pm!

Most of us survived the three months (one left after two weeks  because” it was nothing like the TV shows”) and another one left at the end of the three months to get married and we were not allowed to get married during our training.

The strictness of the school prepared us for the discipline of the hospital which was run on military lines. We complained (to each other) about this, but it did mean that the hospital ran smoothly and everyone knew what was expected of them.

I don’t think I would like to be nursing now. When I was training Matron was in charge, she organised the staffing levels and policies of the hospital, no faceless overpaid bureacrats, and she or her deputy visited every ward every day. The different disciplines, medical,radiography,physios,pharmacy etc  respected and worked together as a team. From what I read now they are all set against one another and fighting one another for funding.

Maybe because they remembered the time before the NHS, most patients were grateful and co-operative as were their relatives. Relatives only rang with enquiries at set times unless a patient was gravely ill and Sister was available after visiting hours to answer their queries in person. Now it seems to be a constant battle between “them” and “us”, each side feeling aggrieved.

The hospitals were run as economically as possible (most of the Sisters and Matrons had trained when hospitals relied on public subscription and patient contribution so were used to making every penny work.) but there were no bureaucrats telling the Sisters how to run their wards.

The wards were cleaned by dedicated ward maids and orderlies, who took great pride in “their” ward. Now that accountants run hospitals the cleaning is contracted out to private firms who tend to cut costs by cutting cleaning times and the cleaning may be done by people who have no particular interest or pride in the work and the there is no one taking any reponsibility for it.

Meals were served by Sister and handed out by the nurses and orderlies and any lack of appetite was reported back to Sister so no one starved! Now the food is sent up ready plated and no one notices if someone is not eating and so we get reports of malnutrition in the media!

During my training we had to work long hours for very little pay and study hard, but I made many friends, grew up, gained confidence and, most importantly, got a lot of satisfaction from the job. We felt valued and respected, something which, from what I read, is lacking now. We also felt secure in the backing we had from the sisters and Matron again this seems to be lacking today.

I am glad that I trained 53 years ago.:)

When Jennie was small she had a set of books called “A story a day” and I am reminded of these when we hear the news and the coalition government seems to put out a policy a day. I don’t know whether they are trying to get into the Guiness book of records  for the most policies in three months, or whether they are just too excited by getting into government again!

They are churning out policies just like we used to in the 6th form debating society. Some of them are new plans and others seem to paraphrase promises we have heard before.

 Today it was about single sex wards and I heard some woman say that it is difficult to convert the old hospitals to all single sex wards. This puzzled me as, during my time working in NHS hospitals in the 50s and 60s I never worked on a mixed sex ward and some of the hospitals were very old.

At the General Hospital Birmingham, (which was built in the 18c), the sexes were not only on separate wards but at opposite ends of the corridor!

Even in the small cottage hospitals I worked in they didn’t have mixed sex wards so I don’t know when they were introduced. Was it when the accountants took over the management and found that it was more economical to mix the sexes? It sounds like one of the crazy ideas from the business men who took over the running of hospitals and were more interested in “market forces” than patient care and patients became “units” rather than sick people. They doubtless gave a presentation with power points illustrating the advantages of mixed wards.

 I just wish that they would slow down and think through their pronouncements before they make them public, maybe then we would have “joined up” government and would not spend the next 20 years undoing the policies which don’t work.

When I babbled childish  nonsense my Great-Aunt Clara was fond of pointing at my ears and saying, “You have two of those and one of those” (pointing at my mouth), “Use them in the same proportion” i. e. listen twice as much as you speak!

What a pity that some of the MPs had no Great-Aunt Clara.:)

When I started nursing, on January 6th 1958, the hospital world was quite different from todays hospitals.

The hospital was run by THE MATRON and the senior consultant doctors. Bureaucrats were very much in the background and just dealt with the business side of the hospital. We were never aware of a CEO or any other highly paid bureaucrat having any say in how the hospital was run and the only targets were set by the nursing and medical staff.

The domestic staff were under the authority of one of the assistant matrons, who also controlled the supply of domestic goods (cleaning materials, linen etc.)

There was a good working relationship between the nursing staff, medics and other front line workers i.e. radiographers, physios, dieticians etc. which led to the  smooth running of the hospital.

There were no HCAs or other untrained people on the nursing staff, just student nurses. I know that there are some degree trained nurses today who seem to think we would not be able to cope with today’s training (nice old girls but a bit dim and we don’t understand what it is like to be under pressure!!)

Our first 11 weeks were spent in the Preliminary Training School. We worked the same hours as in the hospital (48 hours a week excluding meals). The whole time was taken with lectures, demonstrations and practising the new skills we had been shown. At a rough calculation this is 528 hours, no free periods, any private study had to be done in our “free”  time!

Of course there have been many advances made in medicine over the last half century so we would have different things to learn, but some of the advances would make some of our lectures and demonstrations superfluous now thus freeing up time for the new methods and theory. We learned very complicated methods of bandaging, urine testing was done using chemicals in test tubes over bunsen burners (not little sticks to dip in). We learned how to make and pack dressings and how to sterilise them, they did not come in convenient packs. Many of the medicines and injections had to be calculated and measured. They did not come in handy ampoules. 

We did invalid cookery and general nutritional needs. The meals were delivered to the wards in heated trolleys and served by the Sister and handed round by the nurses, who fed those unable to feed themselves, and reported back if the patient was not eating, so I never heard of anyone suffering from malnutrition.

As well as the obvious subjects (anatomy, physiology, hygiene, first aid etc.) we also had lectures on the history of nursing, legal aspects, ethics and it was impressed on us too how limited our knowledge was at this stage.

I don’t know whether we were especially fortunate, but our training was carefully planned and supervised. I worked out that over the three years we spent 1100 hours in the school and 5556 hours on the wards, which probably compares quite well with a three year degree course!

After we had gained our SRN we had to do 1 year as a staff nurse to get the coveted hospital badge and certificate, only then were we considered fully trained!

When we went on the wards we were given only the tasks for which we had been trained, and were usually paired with a nurse further along in her training.

The NHS was still relatively new and the patients remembered the time when they either had to pay for treatment or be means tested for voluntary hospitals, so most of them were very grateful for the treatment they received. They had no problem knowing which were SRNs, students, domestics, radigraphers etc. as we all had distinctly different uniforms.

Every ward had a permanent Sister, Staff nurse and domestics. Each Consultant had his own firm of registrars, housemen and student dressers and they usually had beds on 2-3 wards. I don’t remember any problems in getting a doctor when we needed one.

Our ward training was divided between the QE, a modern hospital which specialised in heart surgery and neuro surgery as well as the general wards, the General Hospital, an older long established hospital was in the centre of the city and dealt with a huge number of emergencies. We also spent three months each at  The Children’s Hospital and the Women’s Hospital, so we had a very good alround experience, by the time we had completed our training.

We had study blocks in our second and third years, where we had lectures from the same consultants who lectured the medical students.

The time spent on the wards not only increased our abilities to perform the tasks set, but also gradually increased our confidence. Of course some ward sisters were better teachers than others (just as some lecturers are better able to impart their knowledge!!) and some managed their wards better than others.

We had (what I think) were advantages, in that we had to live in the nurses home, so we had no domestic worries to distract us. We were all single, so no family worries! We were well fed, our uniforms were provided and laundered. Of course at the time we thought we were too closely guarded by Home Sister and the wardens and a Matron who considered herself in loco parentis, but I see now that it gave us security, and we always had the fun of out-witting them. 🙂

Because we lived in such a closed community there was a great loyalty for your “set” and friendships were forged which have lasted to this day. Whenever I meet or write to my friends we are all agreed that we were lucky to train when we did and would not want to be starting now.

If the “blogs” I read are an accurate description of hospital life today,  the hospitals are run by bureaucrats, matrons are distant from the nurses, patients are  increasingly demanding, visitors wander around at will and the domestic staff are provided by outside agencies who have profit as the guideline. I think the rot set in when the government in the 1980s decided that “market forces” should rule and patients became “consumer units”.

Yes, we were the lucky generation to train when we did. It was hard work, long hours and low pay, but, we were generally respected, had a lot of fun made lots of friends and most of the patients were lovely.