History’s ward round

Author Kate Eastham looks back on nursing history, including her own, and says there are lessons to be learnt in how we support the nurses of today

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The world of nursing has changed completely since I was a first-year student nurse on the wards of Preston Royal Infirmary in 1977. My generation now reminisce about living in the nurses’ home, the hard physical work, the bedpan round, the strict discipline imposed by ward sisters, and, of course, the uniform. I have fond memories of starch – starched caps, collars and, if you were lucky, a snowy white starched apron.

We are all part of nursing history and many of us would feel lost amidst the advanced technology of a 21st century hospital ward. Except for one very important thing: the patients. As they lie there anxious or afraid in their beds, they may well be subject to an increasingly complex range of medical procedures than the patients we once knew, but their need for care remains.

We had the security of living in the nurses’ residence and a small but decent living wage

And there stand the nurses beside them – observing, interpreting, treating, just as they always have done. When I watch a modern-day nurse I realise that many of my generation, however lost we might feel amidst the technology, would still find some way of caring for a patient. After all, that was the focus of our training. The patients were at the centre of everything, our starting point. The whole service of nursing was directed by their needs.

The wards were well staffed back then and we students went straight from preliminary training school to become junior members of the team. The work was physically demanding – stripping and making beds to exact specification, bathing, daily dressings, enemas, bedpan rounds, and we bodily lifted patients in and out of bed regardless of their weight or height. Despite my love of the starched uniform, it certainly wasn’t ideal for lifting patients from bed to chair or sliding someone in and out of the bath!

Yet we all seemed to love it – those, that is, who survived the first few months of training. We had the camaraderie and the security of living in the nurses’ residence and we received a small but decent living wage for our efforts. It appals me now to consider how nurses are not even given bursaries to train. What does it say about the value placed on this essential profession? And don’t we have staff leaving the service in droves?

When Florence Nightingale was recruiting nurses for the Crimean War, she was overwhelmed with volunteers, all wanting to make a difference. We nurses have an incredible history. Who wouldn’t feel proud of Florence and her band of nurses setting to work straight away, as soon as they arrived, to clean the filth from Scutari hospital to make way for wounded soldiers?

Who wouldn’t feel proud of Mary Seacole with her medical bag slung across her body, walking towards the Crimean frontline to treat the wounded where they lay? Treating all as she found them, even enemy soldiers.

Florence Nightingale almost died from a fever in the Crimea and suffered chronic illness for the rest of her life because of it. But that didn’t stop her, on her return home, from writing and influencing healthcare and nurse training. The early nurse probationers earned a living wage and received board and lodgings plus uniform during their 12 months of training. Selected for “moral character”, with emphasis on qualities such as sobriety and trustworthiness, they were expected to become competent in the application of leeches, poultices and bandages, among other things. However, probationers could be dismissed on the spot, with drunkenness recorded as the most common reason. Although given that the 19th century nurses were supplied with a daily allowance of beer this seems more than a little unfair.

As a student nurse myself, walking through Preston Royal Infirmary in the early morning or on night duty, wrapped in my navy blue woollen cloak with red lining, or as I sat by the bed of a poorly patient, I always had a sense of these Victorian nurses. It was easy to imagine the swish of a long skirt on the polished floor or the quiet conversation of a nurse and her patient from another time.

I always wondered about them, but like many other areas of history, it’s not easy to find accounts of individual women. However, one story reported by the press in 1888 made a lasting impression on me. Nurse Finn was working at an infectious diseases hospital when a two-year old was admitted with diphtheria. A tracheotomy was performed, to aid the child’s breathing, but the tube became blocked and the “poor little sufferer” was found gasping for breath. Nurse Finn applied her lips to the tube and sucked to remove the obstruction, saving the child’s life – an action that almost certainly risked her own health.

Maybe, in a world before suction machines, this was common practice in all hospitals, but she was hailed as a brave nurse all the same. Her story gives some idea of the determination and ingenuity required from our nursing forebears who worked without the basic equipment that we now take for granted, never mind the lack of antibiotics, intravenous drips, sterile procedures, safe anaesthesia or sophisticated surgical techniques.

Nursing was one of the first professions for women and an early element of the women’s movement. It gave women the opportunity to lead independent, useful and interesting lives, and was seen as an honourable and skilled calling. What does this history mean for nurses right now? Is it relevant to an NHS subject to pressures unimaginable in the 1970s?

There are important truths that can be distilled from the history of nursing. These truths might be described as the essence of nursing, some extraordinary combination of character, vocation and training. This essence involves the need to bear witness, having a keen eye to the patient’s welfare, stepping forward and taking action or being an advocate. Key skills required include observation, communication, calmness and, above all, compassion.

This essence was there with our Victorian forebears and is still alive in our current generation of nurses. I’ve seen it myself. In March 2017, for example, after the Westminster Bridge attack, the media reported how nurses and doctors rushed out of St Thomas’ Hospital, towards danger, so that they could treat the injured. And this commitment can be seen every single day, in any hospital or community setting. Even off duty, nurses will use their knowledge and experience for the benefit of others.

Clearly, the spirit of Florence Nightingale and Mary Seacole is alive and kicking in our nurses of today. Therefore, don’t they deserve more support than ever before as they contend with specialist roles, blurring of boundaries, increasing workloads and re-validation? Isn’t it time we once more paid our student nurses a living wage as they strive to acquire the skills to fulfil this crucial role?

Our nurses provide an essential service and most of us will require their attention at some time in our lives. Let’s hope the dedication required for nursing will gain greater public recognition and nurses will receive the support they need for the training and development they deserve – and that we, as patients of the future, will benefit from.

The Liverpool Nightingales by Kate Eastham is published by Penguin (£6.99)

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