With woman, with my sister

Midwifing my sister: a deeply profound experience

(Originally published in The Practising Midwife (2006); 9(4):18-9.

In 1993, as a nearly-qualified student midwife, I cared for a friend having her first baby; it was a harrowing experience.  I felt vulnerable as a junior in the NHS hierarchy.  My friend was relying on me to protect her from harm but I felt powerless to do that.  She and I felt traumatised from the birth.  I vowed not to provide midwifery care for a friend or family member again until I could have more influence over the decision-making process.

So when, in 2002, my sister Anne asked me to be her midwife I was rather wary.  At the time, I had been working overseas for several years.  I had only recently returned to midwifery practice in the UK and begun to rebuild my confidence.  Anne lived outside my normal area of practice and I felt uneasy about acting as a midwife in an unfamiliar area.  Initially we planned for me to be a birth partner rather than a midwife.  I encouraged her to book with her local midwives but to use me as a sounding board if she wished.  However, as we talked through her birth plan and the various scenarios that might happen within NHS maternity care, Anne became sure that she wanted me to be her midwife, not just her doula.  She wanted to know the person at her birth that would be helping her to make decisions.  She wanted me as a midwife to protect her and her baby from routine medicalisation.  This was especially important as Anne was having her first baby at 40 and she felt that she might be treated as high-risk by virtue of her age alone.  She felt well prepared for the birth, both physically and mentally, and wanted minimal intervention.

Anne (left), Me (Centre), Esther (Right) - around 1970

Anne felt she would be unable to birth comfortably in her local hospital which had tiny labour rooms and seemed busy and impersonal.  However, her husband felt uncomfortable with the idea of a homebirth.  As a compromise, she decided to have her baby in the unit where I worked, staying with our parents (who live locally) as the birth approached.  I explained to Anne that I could not guarantee being present at the birth, as I was working full-time and also studying for an MSc.  I reserved the right to ask a colleague to take over Anne’s care if at any time I felt awkward or unable to be objective in my professional decision making.  I talked with my supervisor who agreed to support me and signed a vicarious liability form to enable me to work outside of my contracted hours if needed. 

Anne in recent years

As it happened, Anne timed her birth perfectly!  She went into labour at forty one weeks and spent a few hours at a local pottery and later at home, using yoga positions and breathing techniques.  She phoned me just before I went to work for a night shift to tell me that her contractions were getting stronger, although she was coping fine.  I warned my colleagues at work that my sister might be arriving in labour and they were very supportive, making plans to free me up should the need arise.  Anne kept in touch by phone, and finally came into the hospital with her husband at around 0230, contracting strongly every 2 minutes! 

As she walked through the door I could see she was in well-established labour and was coping really well.  She seemed very relaxed and I think the ‘adrenaline rush’ which sometimes accompanies women into hospital and puts their labour “off the boil” did not occur because she knew she was coming to someone who loved her and whom she trusted.

I ran the birth pool as Anne had thought she would like to use water for labour and/or birth.  However, in the event she seemed to get into a rhythm on dry land and did not want or need to get in the water.  She was almost completely silent in labour.  She did not need me to have physical contact, just to be there.  I supplied tissues, bowls and water when she threw up (which she did throughout her labour) and helped her find other comfortable positions when her knees gave way.  She spent most of the time standing leaning over the bed, squatting next to it, or kneeling on the floor.  She used no pain relief, other than a TENS machine.  I sat at the side of the room, quietly reading whilst writing notes which I hoped would not only provide a midwifery record of the birth, but also some sense of the occasion.  I reviewed my note-taking with the midwife in charge every couple of hours to help me maintain a sense of objectivity. 

I had decided to have a second midwife in the room with me for the birth, to give me confidence and to ensure transparency.  However, I learned that not all midwives are comfortable with normal birth in upright positions and labour rooms without monitors!  I noticed that Anne’s rhythm was disturbed when other people entered the room.  I worked hard to maintain a relaxed atmosphere and to protect Anne from unnecessary interventions from others, whilst making sure that I had the back-up I needed.  When the delivery was imminent I called for a second midwife with some reluctance.  To my delight a like-minded colleague entered the room, having just arrived for an early shift.  She did not disrupt the calm, expectant ambience that we had created and was just “there for me” which I really appreciated, not taking over but being appropriately friendly and kind. 

Anne birthed baby Freya beautifully at 0717 in a kneeling position, with little input from me.  As Freya was born Anne said (more to herself than anyone) “I can’t believe it, it was just how I wanted it to be”.  It was the end of my shift so I hand-picked a lovely midwife to take over from me.  We then had some very special family time, making phone calls, Freya nuzzling skin-to-skin and all of us having some good old NHS tea and toast.  The following night my colleagues arranged for me to work on the postnatal ward so that I could continue to care for Anne and Freya.  Anne then went back to my parent’s house for a fortnight of mothering before returning home, breastfeeding beautifully and delighted with her birth experience.  Freya is now three and brings us all a great deal of joy.

Anne has recently given birth to her second baby, Max, at home.  Four months after Freya’s birth, I also helped my sister, Esther,  to have her first baby at home.  Again, it was a wonderful experience for all of us and I have become fascinated with the concept of midwifing friends and family.  Having strangers in attendance at a birth is only a very recent phenomenon.  Less than a hundred years ago, women were almost always midwifed by family members or someone well-known to them; in many parts of the world this is still the norm.    In today’s culture of medicalised birth owned by “the system” rather than by the family, many of my colleagues and friends expressed surprise that I was “allowed” to care for my family members in a professional capacity or that I should want to.  Some found the idea disgusting; others wondered if it is even legal.

Midwifing Anne was a profoundly moving experience.  It felt so natural and right to be looking after her in labour.  It did not feel weird, scary or awkward – I felt very relaxed and had a strong sense that everything would work out fine.  I had faith in Anne’s ability to birth her baby without intervention and I felt immensely proud of her for what she achieved. It has deepened our relationship and I have a very special bond with Freya.    I am not able to birth my own children (though I have an adopted daughter) and being with my sister as she had her baby was strangely comforting. If I had been lucky enough to birth a baby, I like to think that I should have been as strong and brave as my sister was. 

If your sister or friend wants YOU to be her midwife:

• Encourage her to write a birth plan and talk it through with you
• Enlist the support of your supervisor and your colleagues
• Be prepared for some negative comments
• Have a back-up plan for a long or difficult labour
• Be careful about who comes in the room!
• Enjoy it!

My lovely sis with her kids a few years ago

Episode 5 - The Denture Disaster

After my 'booze cruise and bruise' on the children's ward came the placement I had been dreading - eight weeks of geriatric nursing at St. Francis Hospital in Dulwich (http://www.kcl.ac.uk/depsta/iss/archives/collect/1sa40-0.html). Previously a workhouse the hospital struggled to disassociate itself from its history and had a poor reputation amongst the general public, many of whom believed that if  you were admitted there you would never come out, except in a box.  The fact that it specialised in care of the elderly and mental health (at a time when long stays were common for psychiatric patients) did little to shake this belief.   Senior student nurses relished sharing horror stories from the geriatric wards.  I steeled myself for endless hours of heavy lifting, commodes, double incontinence and crusty toenails. 

However, from the moment I arrived on the ward I loved it. Though the work was indeed heavy and tiring, I loved being with older people and often felt sad to leave at the end of a shift.  Both of my grandmothers (separately and at different times) had lived with us throughout my childhood and I found that I knew how to relate to older patients, balancing caring for their needs without removing their independence.  There was a steady ward routine which varied little from day to day, presenting less of a challenge for my dyslexia, and I found immense satisfaction in providing good nursing care and making people comfortable.  Patients often arrived from nursing homes in a terrible state - care homes then were less well regulated than they are today. Sometimes they came from their own homes where they had been just managing on their own until succumbing to an illness and losing the plot completely.  Many times we received confused, agitated and aggressive patients, covered in faeces and lying in wet sheets with bed sores, matted hair and grimy nails - as well as the illness or infection that had brought them into hospital.  The transformation was often remarkable once patients had a few days of antibiotics, good nutrition, attention to their personal hygiene and compassionate care and companionship.  The hospital hairdresser and the barber visited the wards regularly - I also became adept at the shampoo and set having watched my mother do this for my grandmother countless times.  Sister frequently whipped round the ward with her razor, militantly getting rid of the old ladies' whiskers!  A new hair-do and the knowledge that they no longer had to cope alone restored some dignity and humanity to our patients and the person that they had been (and still were inside) began to shine through. 

Many patients wore dentures (false teeth) which were kept in dedicated pots on their bedside table.  Cleaning dentures was a gruesome and time-consuming business but an essential part of the morning routine when helping patients to wash and dress. In the small hours one night shift, needing an activity to keep me awake, I decided to collect all the dentures from patients' lockers and wash them, lightening the load a little for staff on the early shift.  Before I had thought this through carefully I  tipped all of the dentures from all of the pots into the sink and set about scrubbing them. It slowly dawned on me with a terrible sinking feeling that I had no idea whose dentures were whose, and which ones fitted together.  It took the best part of a week, and much trial and error, to reunite every denture with its pair, and every pair with its owner! Thankfully sister was kind to me and appreciated that I had the best intentions, even if my actions were somewhat misguided at times.

The ward sister was young and dynamic and ran the ward with military precision, insisting on high standards of care and hard work from her staff. She had a tough job as many of the qualified staff were agency nurses. Some were critical of the sister, saying she had progressed quickly up the hospital hierarchy only because of the unpopularity of geriatric nursing but I learned much from her and from my placement on the ward. I learned, as would learn time and again, not to pay attention to others' opinions of staff or placement area before making my own judgements.

Although many patients responded to treatment, death was also fairly common on the ward and most patients had 'do not resuscitate' orders in their notes. The cardiac arrest team had to come from Dulwich Hospital, separated by a foot tunnel under the railway, so such calls were not often made!  I remember a patient named Aggie who died gently one day whilst talking to the patient in the opposite bed.  When her neighbour realised she was having a one-way conversation she called me over in a piercing voice saying 'Nurse!  I think she's DEAD!' I summoned the ward sister who quietly drew the curtains round the bed and decided not to call for assistance.  Some may have disagreed with her decision, but it was a death with dignity and her family appreciated that no one jumped up and down on her chest at the end of her life.

During the placement I was also studying for my end of year exam which involved learning by heart Virginia Henderson's 'Nine Activities of Daily Living' with the aid of a mnemonic that I can't remember now - only that it was something to do with an elephant! Wikipedia has refreshed my memory of those activities: maintaining a safe environment, communication, breathing, eating and drinking, elimination, washing and dressing, controlling temperature, mobilisation, working and playing, expressing sexuality, sleeping, death and dying.  We based patients' care plans on these activities though working out how old ladies in the geriatric ward could express their sexuality was always a difficult one!

These activities also provided a structure for answers to exam questions. Despite the denture episode I passed the placement with flying colours and passed my exam, progressing into the second year and receiving a maroon belt to match my frilly hat.  That summer I moved out of the Nurses' Home at St. Francis hospital into an attic room at no. 88 Herne Hill, a huge old house shared with 6 phsyiotherapy students and began one of the happiest times of my life.  Those stories will have to wait for the next episode...

Curried Sweet Potato and Red Lentil Soup (Adapted from Hugh Fearley-Whittingstall’s Veg Book to be Slimming World Friendly!)

Spray a large heavy saucepan with frylight.  Chop 2 onions, 3 cloves garlic, a large knob of peeled and grated fresh root ginger and 1 fresh red chilli.  Sweat these down in the pan on a medium heat, adding a few tablespoons of water as the mixture dries out.  Add in 1 tbsp ground coriander and 2 tsp curry powder.  Cook for another 2-3 mins, adding a small amount of water if too dry.

Meanwhile, peel 3 large or 5 smaller sweet potatoes and cut into cubes of about 1 inch.  Add the sweet potatoes to the onion mixture and 1 teacupful of Red Lentils.  Stir for a few minutes to coat in the spices, then add about 1 litre of water and 2 tbsp Marigold Veg stock powder (or stock cubes – or use fresh stock if you have any).  Grind in some black pepper, bring to the boil then simmer on a low heat for approx 30 mins until the potatoes and the lentils are soft.  Add salt to taste after cooking (apparently if you add salt to beans or lentils before cooking they become tough!)

(The original version uses olive oil to sweat the onions, and a can of coconut milk at the end with some lime juice).

Blend the soup once it’s cooked, and serve with a generous dollop of low fat yogurt and lots of chopped fresh coriander or watercress.

Walk the dog Mulligatawny Soup

A recipe for a low-fat tasty soup that cooks itself whilst you walk the dog.

Chop an onion and 1 clove of garlic and grate a 'thumb' of ginger. Sweat in a pan with some fry-light (spray oil) adding a few drops of water if it gets too dry.  Add the following spices (or just use curry powder if you're feeling lazy): 1/2 tsp cinnamon, 1/2 tsp turmeric, 1 tsp ground coriander, 1/2 tsp group cumin, 1/2 tsp chilli powder, pinch ground cloves. 1 bay leaf or curry leaf.  Cook for a couple of minutes, adding a little more water if sticking to the bottom.  Add 1 cup red lentils, 3 chopped carrots (no need to peel), 3 chopped potatoes, 1 chopped apple, 1 tin chopped tomatoes, 1 pint water and 1 veg stock cube (or Marigold stock powder).  Bring to the boil, put in the oven at 160c and walk the dog for an hour.  If you're planning a longer walk, cook it at a lower heat!

Blend it if you like (or leave it if you prefer chunky) and serve with a dollop of low fat yogurt and chopped fresh coriander.

Episode 4: Frilly Frolics

First year student nurses at Kings in 1984 all had white belts but were divided into 'paper caps' and 'frillies'. The very newest students wore paper caps (see photo above!) but if, after 6 months, they passed an exam they were issued with a linen frilly (similar to a maid's mob cap) and could lord it over their juniors, having moved one very small rung up the ladder of NHS hierarchy.  In posession of a frilly one could proceed to placements on paediatric and geriatric wards and so I found myself working on a children's ward at Kings over Christmas 1984.  It was a high-risk ward specialising in babies having surgery for liver disease, a scary place for a junior student nurse.  One-to-one mentorship and supernumerary status for students were as yet unheard of.  By the end of our first week  we were caring for patients alone with only cursory supervision - and then often from senior students rather than qualified staff!  I particularly hated working in the milk kitchen. Babies with liver disease had special vile-smelling milk (I think it was called Pregestimil) - and student nurses made it up in batches after a terrifying lesson on the dangers of hidden bacteria and the need for scrupulous hygeine.  I became adept at changing the milton tanks daily and making up gallons of formula but lived in fear that I might make a mistake and kill all the babies in one fell swoop with a rogue germ.

Over the Christmas period we did a week of night shifts - my first ever experience of working at night.  Many children had gone home for Christmas and no routine surgery was planned so the ward was quiet.  We had little to do expect fold drawsheets and deep-clean the ward.  The staff room had been stocked with party food (sausage rolls, crisps and mince pies - all the wrong stuff for an overweight student nurse) and there were copious bottles of wine, presents from grateful families that had been locked in sister's office during the year to be shared at Christmas.  Before our midnight dinner-break the staff nurse gave us a 1.5 litre bottle of wine and sent us off with instructions not to come back until it was finished!  Looking back I shudder to think of the blood alcohol levels amongst NHS staff over the festive season with drinking on duty at Christmas not only accepted but positively encouraged. I had never been a big drinker and poured my wine down the toilet so that I could show the staff nurse the empty bottle, keen to be seen to be playing the game and fitting in. 

Junior student nurses generally had responsibility for the 10 bedded lower-risk bay at the end of the ward, many of whom were long-stay patients with more common conditions such as broken bones.  Previous experience with my young cousins and a brief period as a nanny came in useful when dealing with recalcitrant pre-schoolers on traction and fussy eaters after surgery.  Parents were not encouraged to stay in hospital with their children so student nurses took over the parenting role.  There were serveral sick babies in side wards and we had responsbility for feeding them every three hours.  In between times they were just left to lie in their cots - this seems so cruel now, but it was how things were 'back in the day'.  I cuddled the babies and spent time with them whenever I could but risked the wrath of the staff nurses if caught doing so!

A few weeks into my placement I developed chicken pox, never having had the disease in childhood.  I became extremely unwell and had 5 weeks away from my placement, recuperating back at home in Kent.  I returned to the ward for one final week during which the ward sister completed my practical assessment.  To my intense shame I failed.  She made sure I knew that I was a huge disappointment to the ward, to my set and to the profession and that I would have to repeat the placement at the end of my course.  She shared with me her firm opinion that I did not have what it took to be a nurse and would not be surprised if I didn't make it.  My protestations about having been absent for the majority of my placement fell on deaf ears - her mind was made up.  I left the placement with my confidence in tatters and dreaded the thought of returning to the ward for most of the next 3 years. Happily, my fears were unfounded and I passed the placement second time around, enjoying many of the challenges put before me.  The same sister was so impressed with my improvement that she recommended I pursue a career as a paediatric nurse (more about this in a future installement!)

Although the experience of failure was dreadful, I have been able to draw on those memories time and again when working as a midwifery lecturer, assuring students that I do indeed know what it is to fail a placement and to have one's confidence blown apart.  However, it also taught me not to quit and to face my fears, trusting that right and good will prevail in the end!

Episode 3: Waking the dead

After gynaecology came my first placement at Dulwich Hospital on Barry, a Male Medical ward on the second floor.  It specialised in skin and respiratory diseases and was run by an excellent 'old fashioned' sister of whom everyone was terrified.  She was a great teacher though, and wonderful with the patients - does anyone remember her name?  I saw the agonies of eczema and psoriasis in young men who returned time and again for daily dressings and ultra-violet light treatment.  I became adept at the application of Texas catheters and bathing dirty old men without getting groped!  I also had my first experience of laying out the dead, juddering with shock as the deceased elderly patient let out a groan from his lungs as we turned him over.  It was a privilege to perform the age-old rituals of death, offering a last wash and a shave and preparing a body before the porters were called to escort it to the mortuary.  However busy the ward, this task was never rushed and curtains were drawn around all the other beds as the body was removed to avoid distress.

We had not yet had our lectures about death and dying but thankfully I had mentors to guide and support me as I learned  the ropes.  However, one of my fellow students learned the hard way.  The ward sister left her alone with a dead patient to 'make him comfortable' whilst she phoned the old man's relatives and attended to other duties. Some time later the sister returned, escorting in the family of the deceased to pay their last respects.  Imagine everyone's horror to find Grandad, not lying in the bed wearing a shroud and covered in a sheet, but sitting up in his arm chair, fully dressed with his glasses on, reading the paper.  The student had thought this semblance of normality would be reassuring for the relatives!

Episode 2

Being a student nurse in the 1980s wasn't easy.  Others' memoirs from earlier times (such as Jennifer Worth's 'Call the Midwife') chronicle nursing as a way of life rather than a job with little pay, no time off, rigid hierarchies, rationing of 'late passes' and strict rules - an almost monastic existence.  However there was also a solid support structure with matrons, sister tutors, home sisters and communal meals.  Kings College Hospital in the 1980s thought itself progressive and, though traditional uniforms and hierarchies were still very much in evidence on on the wards, student nurses were free to come and go as they pleased with swipe cards to enter the Nurses' Home out of hours.  The staff canteen served food at meal times but there was no expectation of communal eating - and thus little sense of community. It could be a lonely place at times for a girl like me from a sheltered background with little experience of city life.

I had never really been one for parties.  A life-long struggle with my weight gave me little confidence in such situations and I felt more at home cooking a meal for friends or in small groups of those known to me than out at the student Union Bar (can anyone remember its name?) or trawling London's nightclubs.  Whilst loving the career I had chosen I battled homesickness for a while and often went home to Kent on days off, or to my aunt's house in London where there were 4 young cousins to play with. I was also exhausted for much of the time.  We worked long hours with huge amounts of responsibilty placed upon us and were the lowest of the low in the pecking order.  I underwent a host of medical investigations into my exhaustion for which no cause was found.  I now know that I am dyslexic and that adjusting to new situations can cause extreme tiredness for those with dyslexia (learning new routines and procedures requires and huge amount of effort and a drain on working memory).  The benefit of hindsight!

Two members of our 'set' came from Guernesy (Julie Brouard and Tracy - can anyone remember her surname?) and were Salvation Army members.  They had chosen Kings for its proximity to the William Booth Salvation Army College and Citadel at Denmark Hill. They swapped their nursing uniforms for 'The Army's' navy and maroon outfits on their days off.  For me, joining a local church and becoming involved with the Hospital's Christian Union (CU) made a huge difference.  These provided the sense of community that I found lacking elsewhere and introduced me to other student nurses, physios, medical and dental students who would become lifelong friends.  On Sundays off we often congregated for lunch at 'Auntie Bren's' - a single lady in the church who opened her home to students and other singles - and went for walks in Dulwich Park to work off our extra calories!  The church also provided me with an outlet for musical expression and I became a regular member of the Herne Hill Baptist Church worship band, playing piano and flute and singing my heart out.  Some time later, after we had moved out to private accomodation, my flatmate and I joined one of the church's homegroups - and enjoyed evenings in the home of a retired local surgeon who was a member of the House of Lords!  The CU weekends away to youth centres and campsites cemented the group and my place in it as resident caterer and musician and my homesickness soon resolved as I developed a sense of belonging. My faith also helped to make sense of some of the sadness I saw on a daily basis at work.

Meanwhile, life on the wards continued.  Eight weeks of introductory school - where we learned the basics of nursing care and had increasing contact with clinical areas - was soon finished and I started my first 8 week placement on Ferguson, a Gynaecology ward.  The sisters at Kings wore bottle green uniforms with starched collars and cuffs and Ferguson's glamourous sister (can anyone remember her name?) complemented the green dress with her silver bob and scarlet lipstick!  There were three sorts of patients - women having regular gynae operations such as hysterectomies and repairs of their prolapses, those with gynaecological cancers undergoing radiotherapy in a closed room, and young girls coming in and out for terminations of pregnancy in a six-bedded side ward.  The student nurses were mostly allocated to the main ward and we were judged on how quickly we picked up the medical abbreviations in common use during the nursing handover such as  'The women in bed 12a [never bed 13 for superstition's sake] has had a TAH, BSO and HI' (Total Abdominal Hysterectomy, Bilateral Salpingoophrectomy and Hormone Implants!)

Every patient having gynae surgery was admitted the night before their operation and had a pubic shave and 2 glycerine suppositories as soon as they walked through the door.  Late shifts were very busy, admitting several new patients and undertaking their pre-operative care whilst simultaneously putting the longer stay patients to bed where required, doing any evening dressings and providing for their toilet and hygeine needs.  Working on Ferguson I soon became proficient at giving intramuscular injections.  Every patient had pre-op medication of 'Om and Scop' - Omnopon and Scopolamine - given intramuscularly into the upper outer quandrant of the buttock! I also learned the basics of nursing from working with fellow students.  One evening I learned how to show love and compassion to my patients by watching another student - not much more senior to me - dress a lonely elderly woman's pressure sore then provide a bedpan, give her a wash and change her into a clean nightee, smooth her pillows and tuck her in  with a hug and a kiss.  The student's name was Emma - thank you Emma, wherever you are.

On one such busy late shift we had 7 or 8 new admissions for surgery the following day.  The staff nurse was frazzled - not enough staff and too many patients - and dispensed the newest student nurse (me) to give 2 suppositories to a new patient in preparation for her surgery the following day.  The present NMC rules for administration of medicine had not been invented yet. I had seen suppositories being administered before, but mostly under the sheet and I had not looked too closely at the precise location for penetration.  I was also gloriously naive about my own anatomy, never having examined it at close quarters.  Armed with the suppositories, a  plastic glove and some KY jelly I squared my shoulders and walked towards the patient with an air of confidence that belied my inner anxieties.  It couldn't be too difficult could it?  'Well Mrs. Jones, I have two suppositories for you here that the doctor has ordered.  Please remove your underwear and lie down in the bed on your side'.  Mrs. Jones duly did as asked, though she appeared surprised at such a request - the hierarchy of hospitals in the 80s was such that patients did not question the doctor's orders.  Donning my glove, with a squeeze of jelly and a swift removal of the sheet, I lifted the patient's buttock and popped the suppository in the nearest hole.  'There Mrs. Jones, all done'.

The shift finished at 9.15 pm and I returned for the early shift at 7.15 the following morning.  The staff nurse approached me with an angry face and questioned why I had not administered the suppository last night as she had requested.  My protestations fell on deaf ears and the surgeon was most disgruntled that his patient had not undergone the necessary bowel preparation.  Meanwhile, whilst I was making the beds Mrs. Jones drew me to one side.  She told me she was a nurse and she did not think the suppositories had been meant for her - and that I had put them up the wrong hole.

To be continued!

Starting my memoirs!

As well as thoroughly enjoying the recent BBC series 'Call the Midwife' and having read all of Jennifer Worth's books I have recently been reading other auto-biographical tales from nurses and midwives.  This genre  appears to be fast gaining popularity in the UK and, as midwifery history is one of my favourite subjects, I am somewhat of an addict to such books. Some stories ring true to my own experiences whilst others are very different but they have all caused me to reflect on my career and determine to chronicle the highlights before I am too old to remember them.  Maybe one day they will form a book of their own!

I had wanted to be a nurse as far back as I can remember.  There is a family tradition of caring - nurses, midwives, doctors and occupational therapists span three generations. We had grandparents living with us for most of my childhood and caring for them was part and parcel of life.  Though a Grammar School girl, my strengths pointed to a practical career and so I found myself arriving at the gates of Kings College Hospital London in May 1984 and placing Floppy, my large cuddly teddy, on my bed in the Nurses' Home.

I tentatively explored my new 'home'.  Long corridors of single rooms with 4 shared toilets and baths for one floor.  The open drain from one bathroom ran into the next, so you could watch your neighbour's bath water (and a few half-drowned cockroaches) drain away whilst you lay soaking.  There were no communal areas except a small kitchen with several pints of milk or tins of beans all labelled 'Don't Steal'!  However, there was a Nurses' Sitting Room with a grand piano some distance away above the main door of the hospital and I loved my stolen moments of solitude with Handel and Brahms.  I had studied music at A level and missed the hours spent on the piano each day.

Not yet knowing my fellow students I retired early to bed, to be woken at 5am with the fire alarm.  A sleepless home-sick student had burnt the toast.  Pulling on a old cardigan and a pair of worn espadrilles I followed the crowd down the stairs. A dressing gown and slippers had been on the kit list but I had not anticipated such an immediate need for these!  At the assembly point I tried to blend into the wallpaper as the other 53 new student nurses modelled the entire range of Marks and Spencer's  nightwear.  A few minutes later, as 4 fire engines arrived and handsome firemen flooded the stairwells, a line of nervous young men in suits filed past.  I found out later these were the boyfriends of the pupil nurses who had started their training a few weeks before us - and had already learnt to circumnavigate the rules concerning overnight visitors!

We had been allocated bedrooms in alphabetical order - so Nurses Cooke (me), Challoner, Drewett, Evans, Forshaw and Franklin soon became acquainted.  During our eight weeks of introductory school we were allowed on to the wards at Kings to practice our new-found skills, firstly bed making then, in the second week, bed bathing.  Kate and I arrived on the male surgical ward and were assigned to a middle-aged man who had undergone abdominal surgery 10 days ago.  He was well enough to wash himself but had nobly volunteered to have a full bed bath by the student nurses.  We collected our equipment - a bowl of warm water, towels and flannels.  Carefully copying the method we had learned in the classrooom we worked our way down from his face to his arms, body and legs, soaking, soaping, rinsing and drying.  The time arrived to approach his nether regions. Kate soaped the flannel and handed it to me.  I rinsed the flannel and handed it back to Kate.  The patient watched us with amusement.  Finally Kate picked up the sheet and, looking straight ahead at the wall, gave 'it' a firm scrub.  The patient nearly exploded with alarm and we hurriedly escaped through the curtains with our dignities intact!

Next time.... giving my first suppository to the wrong patient and putting it up the wrong hole.  To be continued!