Cochroaches and Mayhem: a nurses' life ( First published 19.5.18)

This time last weekend I was swopping stories with old friends following an emotional day at our 30th year reunion for our nursing set. So proud to still have so many of these wonderful ladies in my life, sad at those I have lost touch with and sadder about those we have lost. A strong bond still remains, the impact of being thrown together on a mad journey with no seat belts!

The set of March ’88, how is that possible for so much time to have passed and yet it feels like yesterday? I left home from a quiet Yorkshire village to escape to London at 17 1/2 years old. The longest I had been away from home was on residential for Duke of Edinburgh and French Exchange holidays, so this was a massive step. I was the baby of the group, completely unprepared of what was to come and that the people I would meet and share this experience with would have such an impact on me. This group of strangers, who if I had gone elsewhere I would never have met and yet 30 years on many of us are still in contact proud and astonished at all we went through. These were the simple years, when room rent was taken from our salary every month, takeaways were cheaper than eating in and communal living was our comfort. It’s not til I look at the old photos and realise “Christ I was young!” I felt so grown up and could understand why my parents were so concerned. Big brother was only a train ride away – what could possibly go wrong?! It’s not til now that I look at my oldest boy that I now know how they must have felt, he is two years off where I was – I will never be ready to let him go and yet he is far wiser than I was at that age.

This group of strangers, came from all walks of life, some had travelled, some had had previous jobs or studying, some from different parts of the world and yet here we were thrust together oblivious to the fact that we would all be so important to each other in different ways.

I’d like to say that I chose Bloomsbury College of Nurse Education after scouring data on the quality of the training experience, learning about the reputation of the great UCLH and Middlesex etc etc. The reality is I came and had look around at 3 sites – St Mary’s ( looked a little rough the area!) Kingston ( too much like home!) and Bloomsbury who got my vote basically for three simple reasons:

1. It was a 5minute walk from Tottenham Court Road and Oxford Street

2. The Nurses Home had a very cool sounding name – Rockefeller

3. The tutors I met on my interview were vaguely human

None of my decision making was based on the history of the hospitals. I was oblivious until this reunion tour that we walked in the steps of Lister ( aseptic technique ) who’s plaque sits at the top of the Cruciform stairs. I was unprepared for the variety of experience I would get, but so incredibly excited at leaving home. My poor parents as they dropped me off to my room at “The Rock” cried all the way home apparently and arrived at my brother’s in pieces. besides themselves at the tiny space that was to be my living quarters for the next 3 years, appalled at the state of hygiene after making the mistake of looking in the bathroom and generally wanting to whisk me back to Yorkshire asap – “its not too late to change your mind…” I, from the moment we arrived, was completely excited, keen for them to leave as soon as possible and for most part desperate to get my life started. The reality is when they left, I sobbed too realising that this really was it, there was no going back it had to work. The tutors well accustomed to newbies, having an intake every 2 months, had foreseen this and arranged an immediate gathering of our set, which after formalities and introductions moved us to the local pub, the Jeremy Bentham – now a posh cocktail bar but back then we didn’t know what cocktails were nor could we afford them. I met my first Goth who came from a place that sounded very posh – Jersey. I immediately took to her and she put up with me as I was rather square but she spend the next few years both looking after me and keeping me under her wing. We clicked and a friendship was born that is still strong today. Jersey became a large part of my life, with my parents by chance moving there shortly after I started my nursing – then I was pleased Sarah could show me around but did feel somewhat abandoned. There was definitely no going back now as there was no back to go to I felt. No longer a Goth but still as special a person as she ever was – as nutty as me!

The experience was varied – 4 weeks in college before being launched on the wards. We had an extremely varied training, general nursing meant general nursing, learning every speciality and good basic care throughout. Classroom teaching involved the dreaded A & P ( anatomy and physiology ) but also the basics of making beds, taking temperatures ( with a mercury thermometer ), manual blood pressures and preparing your trolley for dressings. We had fire training in a disused hospital that the instructors would fill with smoke and get you to evacuate beds, patients and everything else. Not an elearning module in sight, this was hands on. We also tried to get hands on experience with live firemen by regularly burning our toast in the toaster but this tactic never really worked – although the fire engines did come in 3’s! The aforementioned techniques and skills ( not the toast burning ) were assessed regularly throughout your training, reiterated and re assessed, ensuring the basics had sunk in and were there to stay. The latter of fire alarms we tried to practice at regular intervals too.

My first module nearly ended my career before it started – I was not prepared for assignments that were a step up from school work and was shocked to fail my first course work, bringing the threat of my training to come to an end. “Should you not reach a satisfactory standard in the test you will be required to discontinue training at this college.” A stab in my heart – panic of such severity but the kick up the proverbial bottom I required to not take it for granted that this would be easy – I never failed another exam again.

At our reunion we shared stores of our experiences but this time sitting in a hotel room rather than the dusky halls of Rockefeller Nurses Home. However, we all agreed that it different feel that different to back in the day and we were very lucky indeed with the level of training we had. One to one mentorship on every ward, continuity of course tutors, with exception of the legendary but bonkers Francis Guilfoyle leaving early on. Placements were varied – all unique, however there was a progressive thread that ran through them, a plan and a progression of experience that we were probably oblivious to at the time but looking back on my “reports” was carefully planned and absolutely meant TRAINING.

Experiences stick in the mind: UCH emergency dept and ward, brought witnessing patients who had been involved in the Triad fights in chinatown one of which arrived in the department with a machete in his head! Burns and plastics showed me the horror of injury and the stark reality of recreational drugs with one girl facing amputation from injecting in her artery rather than vein and another falling asleep on the couch with a spliff resulting in a double amputation. He sobbed as was a guitar player, his career over in one night. A story of one young boy I do share with my children now, as most nursing parents do, in the hope that they make think before they act – probably not. He was only about 16 and had been fooling about on the trains in the station, stood up on top of one of them and hit the overhead cable, his friends when he landed on the ground in a fireball panicked and ran, luckily for the boy someone passing saw the whole thing and he was on the unit quickly. I can still remember the smell and the pain, horror of having to help shower his dressings off, nothing could have prepared me but I learnt quickly the importance of talking to your patient at every step. I learned in my next year of training that he had recovered enough to be discharged home but was having frequent admissions to the psychiatric unit. Institutionalised and feeling safer when in, he would pick at his skin grafts in order to secure admission back to the security of the ward – outside life was terrifying for him now. Funny moments that only a nurse can laugh at – using leaches to help a skin graft take and having to rescue it before the patient swallowed it! No one preparing me for the old man with maggots in his leg ulcers – the cleanest part of him.

The majority of my wards were at The Middlesex, fond memories particularly on the oncology wards where I cut my teeth and learnt many of the skills that are still entrenched today. The terror of psychiatric placements at St Pancras Hospital, where staff seemed to delight in our fear and we witnessed the most vulnerable. This was the milder of placements as some of my colleagues were sent to lock in wards at St Lukes – scary. Still we had our fun too, a patient “J” sticks in my mind, he had lived on the streets ( we didn’t have a homeless problem in Yorkshire so rather a culture shock – “really you live on the streets?!” ), had struggled with drug and alcohol addiction secondary to his sad condition of Tourettes syndrome.

We would sit and talk often and I learned about his life pre illness – he would talk of hope to have his snake and locust tattoo on his face removed, as he felt that was in no way easing his problems!! Set me back a year in that sleepy village of Brompton On Swale and I would have never imagined that I would be sitting there with this incredible man as he tried to control his ticks, which involved a lot of swearing, trying to decide if I was going to giggle or wet myself as he suddenly would stop, face of an assassin and put his hands on my shoulders “bless you my child”, sign of a cross and then walk off. Heart a thumping, confused but very glad to not be injured, he meant no harm. Another chap on the same unit, admitted following travels abroad had resulted in him having some psychosis and being in our unit. The, mean, staff nurses thought it funny to terrify us and as he was being specialed ( one to one nursing ) would send me in to ask him what he wanted for breakfast – “go on – its’ fine.” I quickly ran out after a lesson in expletives that again were not that common in my neck of the woods, but ones that I enjoy bringing out on special occasions! The same chap I remember chased my fellow March ’88er down the corridor one day finding her incredibly attractive ( she was / still is ) shouting “sexy sexy: and scaring her much to the amusement of the wicked staff nurses! Care of the elderly at St Pancras Hospital does not hold fond memories, I seem to remember a few of us reported the charge nurse for abuse of patients and leaching over the student nurses, he was the worst part of old school, been left unsupervised for far too long with the most vulnerable and at risk – not pleasant. I met the first male midwife on my obstetric placement, he had broken down many barriers and was quite inspirational. The only drawback from that placement was that I vowed I was NEVER having kids. We were lucky to work at hospitals that invariably had the most complicated cases but for me – why would you??? Luckily as my memory faded my mindset changed. Surgical placements enabled us to witness pioneering procedures which are now routine. My early oncology placements saw things fungating that I thought never possible to fungate but oh yes they sure did. My female medical placement, early on in my training I think got me intimate with areas my mother never talked about. Male surgical was fun – lots of young men having their legs pulled about! Fond memories of paediatrics too, learning how a child goes under an anaesthetic is usually how they wake up from it was a good life lesson for when my own children had operations but only then could really appreciate what a parent feels when they hand their little one into your care. Fighting for cuddles and feeds on the maternity ward and witnessing my first cardiac arrest on another – the ethical dilemma of being allowed to “practice” CPR on someone after time of death never sat right with me at the time and I withdrew as quickly as I could.

At our reunion, as we entered the old Cruciform building of UCH, now home to medical students and laboratories, memories came flooding back of that first day on the wards. Walking in the entrance to the marbled and tiled staircase was a step back in time – cleaner and a definite absence of cockroaches but still the same in many ways. We wandered around the wards that we first practiced our skills, now full of test tubes and various equipment trying to remember where everything was placed.

We were very fortunate for the timing of our training, the year before we started, the first Aids ward opened at The Middlesex Hospital. Broderip and Charles Bell wards were special places. It was at the grip of the crisis where fear was at its highest and a great many myths needed to be dispelled. We were encouraged to sit on the beds with patients, whereby previously on other wards, particularly sugical, this was severely frowned upon and would almost certainly result in a severe telling off. But here the pace was set by the patient and they taught us lots. These beautiful people, ravaged by a disease that no one really understood but everyone feared – humbling experiences. The first Teenage Cancer Trust was opened also, one of our set started her career there following her time on her training and it was lovely to hear how that specialism has set the pace of her career since. Both units were equally as exciting as they were sad due to many a celebrities visiting the teenagers on the Teenage unit, or friends and colleagues on Broderip and Charles Bell. I’d never seen a real life celebrity before!!

As a newly qualified Staff Nurse not much has changed since that first ward 3 1/2 years earlier – different boyfriend, but still the same conversation – I am at the very least consistent in my anxiety! Not as terrified this time, a bit more confident, under the watchful eye of Sister Shirley who had introduced me to the specialism which I have dedicated my career to ever since – cancer nursing. She was a true inspiration, one of those leaders that I have rarely found since. Calm in a crisis, supportive to show you the way, stepping back when she knew you could do it, never far away and always watching. She had the ability to pull you up in a way that helped you learn, when it was necessary, never blaming always nurturing, sickeningly good at her job. At the time of qualifying all new staff nurses were automatically put on the “Newly qualified Staff Nurse Course” at UCLH. The early days of preceptorship that sadly only few get to have nowadays. It was lost for a while and has been introduced as a new methodology that will revolutionise a newly qualified nurse’s career experience. It’s not rocket science – we always had it – just got lost with the emergence of Project 2000, poor staffing levels and banding down.

So our weekend together was very special, we broke into “The Rock” and found our old rooms, ran down past the clunky metal lift which has now been health and safetied and had a makeover and found the underground corridor

that we would often take to avoid the rain to work, or rush to the shop for emergency chocolate and of course the payphone where many a call was made to my parents back home to reassure them all was well and I wasn’t starving.

Mrs Dunkley no longer sitting in the wooden office guarding all who come in and watching all who go out. Fire alarms often set just to check no sneaky night visitors – damn her she always found us out! The hours we would sit in our rooms, together laughing and crying about our day sometimes all at once. The intense experiences we shared and the horrors we watched, those walls could tell some stories.

We visited the only place that still remains of our dear old Middlesex Hospital, the Fitzrovia Chapel. This place was so special and we heard how after many years of being sealed up, it was loving restored to its former glory. This place had mixed emotions for us all, some ghosts and some dear memories, but most of all held something very unique to

our Middlesex experience – a shared space open all day and night for anyone to sit, contemplate, cry and even shout. We arranged a wedding there for an oncology patient who had weeks to live, he and his wife were so grateful and it was a privilege to be part of it, reception in the now gone boardroom and then their side room on the ward made as special as we could for his last few days of life as husband. Our group also has close connections with the chapel – Kate our special lady, seemingly the “grown up one” of the group but I was told this was far from the truth, she was as vulnerable as the rest of us. Some of her close friends arranged a memorial service there after she died following a car accident. I always looked up to her so grown up and in control – in reality struggling like the rest of us I am sure. I didn’t attend the memorial but being there last weekend it felt like she may have visited too, keeping an eye, making sure we didn’t misbehave too much. As I stood at the alter and turned I could see myself walking out the door, turning down the wood panelled corridor, past the clock, shop and bank, running for the lift and up to the ward, to finish my shift after some much needed contemplation. I can see dirty corridors, smell the faint tang of pseudomonas and the patients smoking in wheelchairs. White belts on blue dresses first years, dark blue as third years, shoes polished, squeaky floors. Every porter knew your name, you knew all of them too. Meals served by each of us from metal food trolleys, the drinks round on a Sunday, stool charts and bed baths . Hangovers on an early shift, out again before a late. Night shifts with enough staff to sit and talk to sleepless patients, toast at 4am.

I was proud to say I was part of March ’88 – yes I trained a long time ago but the friends I made have walked with me through most of my life. Some I have lost contact with but renewed last weekend and there was no awkwardness we just picked up where we had left off – the bond still strong. For me I did my growing up on those wards and with that group of people, they introduced me to many things I had never experienced before holding my hand through things I never imagined. We are spread all over the globe now, many of us still nursing, some are no longer with us but I for one will treasure those who I started my adult life with and am proud of who we all became.

To March ’88 … … … you were awesome, however always remember…it does get cold when you hold it and beware of perineal fall out!!!

I continue to work as an oncology nurse, back to my love of clinical care on a lovely chemotherapy unit. I have also founded an on line support group for nurses and midwives undergoing Fitness to Practice ( NMCWatch.)

More information can be seen at: www.nmcwatch.co.uk.

Part of the work involves campaigning for fairer regulation – if you would like to find out more and support us – have a look at the online petition here

Thanks for reading