Miss Nightingale's Nurses

by Kate Eastham

Next he walked over to the mirror propped behind the washbowl and felt the daily shock of his appearance. A wild man with bright blue, blood-shot eyes stared back at him from the mirror with an expression of defiance. He could not believe that this was the same young man that had graced many a ladies’ drawing room. His hair was growing back now after it had been shaved off during his bout of fever at Scutari, but still looked stubbly. His beard and whiskers, however, defied all attempts to be trimmed back with scissors and continued to flourish.

  With a sigh he turned from his reflection, pulled on his shirt and then tied the bright red sash that served as a cholera belt firmly around his waist. He knew that some thought a piece of cloth tied around the body couldn’t possibly ward off cholera, that it was just useless superstition, but he had known one very respected doctor in Scutari who swore by it, and so from his first week in the Crimea he had followed suit and tied the sash around his waist every morning and so far it had worked. Out here, where cholera was rife in the army camps, a doctor needed to use every means that he could to survive.

  Once the sash was secure he sat down on his bed and pushed each foot in turn into the sturdy leather boots that he had bought especially for this trip. They had been stiff and shiny for some weeks when he first arrived in the Crimea but now bore the scars of daily toil.

  He was not surprised to note the dried blood on the toes of both boots from yesterday’s botched job. Steadfastly ignoring these new stains he strode towards the door. ‘Let battle commence,’ he muttered to himself as he exited the room.

  10

  ‘Let us never consider ourselves as finished nurses … We must be learning all our lives.’

  Florence Nightingale

  Rose woke with a start, confused about where she was and what she was doing. Rubbing her eyes and then focussing on her surroundings she became aware of the bed and the shape of her patient under the thin blanket. She was a nurse, working in a military hospital – she could smell it now.

  Feeling heavy in her limbs and still exhausted, she stood up and leant over the girl to assess her condition. Her colour was good, nice and pink, and when Rose tipped her head and held her pale cheek close to the girl’s face she could feel gentle breath on her skin. Looking down the girl’s body she saw the slow rise and fall of her chest in what appeared to be a natural sleep. She was alive and seemed to be well, at least for now.

  Then she looked across to the other bed.

  The hospital nurse had not fared so well.

  Rose went straight to the bed and stood for a few moments with her head bowed, saying a short prayer for the woman who had arrived in Balaklava only a few weeks ago. She hadn’t known this nurse but remembered she had come up with a group from Scutari. She had seen her on the ward but these hospital nurses who came out to war as paid help already had some experience back home and usually set themselves apart from the volunteers. In fact Rose, when she thought about it, was the only ‘lady volunteer’ at the hospital at the moment. They’d had chaplains’ wives previously, at least two, but they had died of fever alongside their husbands. All were buried in graves not far from the walls of the hospital.

  She had heard a rumour that all fever cases were now going into a pit to be covered with lime, but she chose not to think about this. There was so much death from cholera, typhus and Crimean fever that she was forced to accept that this might be the only solution, but she shuddered when she thought of the bodies wrapped in blankets that now had to go out of the back of the hospital and into one big hole in the ground. It didn’t seem right that they weren’t able to give a proper Christian burial. They didn’t even have a chaplain at the moment.

  As she stood there, Rose said another prayer for the woman and then gently pulled the sheet up to cover her face. Taking a deep breath she walked back to the bed of the new nurse. She sat back down for a few moments but was almost immediately disturbed by the sound of Sister Roberts’s sturdy boot heels clicking on the floor as she came into the room.

  Rose jumped up from the chair.

  ‘Good morning, nurse, you’ve made an early start,’ said Sister, probably aware that Rose had spent the night in a chair. ‘Ah, I see,’ she said, looking over at the shrouded bed. ‘I feared she might succumb during the night. Such a shame … I’d got to know her and I really liked her. I’ll perform last offices; it’s the least I can do.’

  Sister Roberts stood quietly for a few moments and both nurses listened to the steady breathing of the girl in the other bed. Then Sister straightened her apron and lifted her chin.

  ‘Right, Nurse Blackwood,’ she said, noting her tired face, ‘get yourself some breakfast and then go along to the wards and see how they’re doing. Then as soon as you’re done, get yourself back to the nurses’ quarters for some sleep.’ Pausing for a moment she added, ‘I saw Dr Lampeter heading out on his horse earlier so he won’t be back for a while but we need the place shipshape before he does his round.’

  ‘Yes, Sister,’ replied Rose automatically as she had learnt to do. It was, in fact, no hardship to take orders from Mary Roberts because despite her stern expression and tightly pulled-back hair she was an able and compassionate woman who would pitch in and work hard.

  The situation with the nurse in charge, Miss Smith, was very different. She stayed mainly in the small room that served as her lodgings and her office. It contained, by all accounts, a small bed and a desk piled high with papers. Once a day she would emerge, stamping and shouting at the nearest nurse, orderly or doctor, and then retreat. It amazed Rose that even the battle-hardened soldiers on the wards who had fought the Cossacks were in awe of Miss Smith.

  As Rose approached the ward she became aware of shouting and banging, and then out through the open door ran the biggest rat she had ever seen. Instinctively she drew her skirt tight around her legs as the creature scampered past her. She closed her eyes and was sure she felt the brush of its scaly tail. An orderly was chasing, and she glimpsed his red, sweating face as he ran at the rat with a wooden club. Rose let her body shudder, then, composing herself, entered the ward with a cheerful expression. Opening the door, she never failed to be surprised by the scene – Dragoons, Hussars, Lancers, Riflemen, Guards and common soldiers all mixed up together and closely packed. Some on beds, some on the floor; all bearded and many bloodied and bandaged. Some were still wearing ragged remains of muddied uniforms; some were barely covered, their broken and smashed military hats and helmets cast forlornly beside the beds. And she never got used to the smell; it hit her afresh every single day.

  The quietness of the ward sometimes worried her. There could be a murmur of conversation and staff calling to each other but many of the men lay so diminished that speech was difficult. Those who were strong enough were immediately sent back up to the trenches, so inevitably this group of patients were always in an extremely sorry state.

  Seeing young Arnold now in the bed by the door, she did her best to smile at him and was sure that his eyes smiled back. Rendered speechless by the bullet penetrating his cheek, and having suffered wounds to both arms, Arnold was a pitiful sight indeed. The wound to his cheek was packed with lint, his head bandaged and both arms immobilized with splints. Communication was difficult but they had devised a system of nods and hand squeezes and Rose always volunteered to feed Arnold when he was able to eat. This was a difficult task as he was liable to choke and liquid leaked out through the hole in his face. She knew that his facial wounds would be reviewed by Dr Lampeter today, so would make sure she was working close by.

  The next bed was empty and Rose assumed that the occupant, who had developed an infection following an amputation of the forearm, had died during the night. The orderlies did their best to remove the bodies before the day started in an attempt to keep up morale among the remaining men. The stripped bed now held a stained mattress in testament to the struggles of the many wounded who had occupied it. No doubt it would be filled again very soon. They had tried to make some attempt recently to keep the patients wi
th fever separate from the others because Sister Roberts had observed that the fever cases tended to spread quite readily in close proximity. However, this was impossible at times of heavy casualty.

  The nurses and orderlies had got on well with their morning duties, helping men at their toilet and giving out some breakfast. Yet the ward never looked any brighter or cleaner or different. Since they had employed some of the army wives to tackle the laundry there was at least a supply of clean sheets and bandages. These laundresses had constructed washing lines at the back of the hospital which now hung heavy with all the bedding and supplies, but it was almost impossible to keep up with the piles of linen.

  Rose preferred to work with the wounded rather than the fever patients, for whom not much could be done except sponging them down and waiting. The dressings were regarded as the responsibility of the doctors but she felt confident enough to attend to those that did not need to be reviewed or would not be expected to require the application of a knife to debride. She took up a basket of clean bandages and looked around for the most needy patient. There were always a number of men moaning in pain and with a very short supply of laudanum there was often no relief for this, but if a change or repositioning of a bandage could help, Rose would give it a try.

  The old soldier two beds down from Arnold looked a likely candidate. The bandage supporting his head wound had slipped down overnight and was now obscuring his left eye. Rose had done the dressing a few times for Stanley, and she knew that the bandage was a crucial support for a large flap of skin that covered a mess of bone on his scalp. She couldn’t imagine the daily pain that this man had to endure, and had become an expert at fixing the bandage in a way that could help him.

  She approached the bed, spoke softly to him and touched his hand gently. He opened his good eye and smiled through the pain.

  ‘Hello, Stanley, is it all right if I try and fix that dressing for you?’ she asked gently.

  ‘You can have a go, miss,’ he replied.

  They both knew that removing the old dressing would be very painful but then this would settle and be more manageable throughout the day. She felt the man steel himself as she began to unwind the outer layers. Rose recoiled only when she spotted the lice that had worked their way into the dressing.

  Then his whole body tensed as she got to the part that was stuck, fabric to skin. Rose had found that using a little bit of water at this time and leaving it to soak could help so she did this now, holding the man’s hand for comfort while it was absorbed. She then warned him before the next move, and as always he told her to go quick, get it off, and to ignore his cry of pain. She did this now, praying that the flap of skin didn’t come away with the gauze pad. She knew which way to peel the dressing so that the skin moved back into place.

  Her experience with this particular wound served them well and the procedure was a success. Her patient visibly relaxed and she knew that re-bandaging would be an easy task now. Rose had been ably instructed by Sister Roberts and it was always satisfying to see the improvement in this poor man’s situation. The wound, however, wasn’t looking good. Each day the amount of discharge increased and the flap of skin became drier and darker in colour. She would report the deterioration to Dr Mason, rather than Dr Lampeter. She didn’t know what was wrong with the man but he always looked distracted, even deranged at times. The patients reported that he did a good job but she just couldn’t work him out.

  As she looked up from her bandaging she noted that the man in the bed opposite had been watching her perform this duty very closely indeed. He too seemed to be relieved that it had gone well and his comrade would now be more comfortable.

  Rose didn’t have time to move on to her next dressing because the doctors arrived, chatting away as usual, standing one each side of the first bed. Rose knew that she needed to get over there, to be with Arnold. Dr Lampeter was looking across Arnold’s bed, directly at Dr Mason, making little effort to engage with the patient. ‘I think we need to remove this patient’s dressing and the packing and suture up the wound if it’s clean enough.’

  Rose saw the look of horror on Arnold’s face and slipped in beside Dr Mason. She looked straight at Dr Lampeter, who immediately looked away, and said, ‘I’ll remove this dressing, doctor, while you see the next patient, then you can come back and suture.’

  ‘I think I need to do that, nurse,’ said Lampeter, taken aback by her direct approach.

  ‘I’ve been packing the wound and know exactly what to do,’ said Rose, already starting to unravel the bandage.

  Lampeter nodded and muttered something about making sure she did a proper job, and then moved away from the bed with a smiling Mason in tow.

  Rose took care with unwinding the bandage, talking quietly to Arnold through every step. As always he managed very well, but Rose saw the tears rolling down his good cheek. She used the large forceps from the dressings basket to remove the sodden packing. She thought that the wound had cleaned up – certainly the amount of suppuration was reduced and there was no foul smell. This might be all right.

  As soon as she was ready she called down the ward: ‘The patient is ready now, doctor,’ standing her ground by the bed. She had no intention of leaving her patient’s side.

  Lampeter came over directly; he was very interested in this wound.

  ‘Ah yes, looking much better. I think we could proceed to sutures today. What do you think, Mason?’

  Mason, still smiling at Rose, nodded his assent as Lampeter called over to the orderlies to come and hold the patient down.

  ‘No!’ shouted Rose almost involuntarily, standing by her patient’s bed with her fists clenched at her sides. She could not have borne the sight of Arnold being held down while the painful procedure was inflicted and all the men on the ward able to see. ‘Arnold can manage this if I stay with him, especially if you give him some drops of laudanum first.’

  Lampeter was clearly thrown by her interjection but could see that she wasn’t a woman to be argued with. ‘This is very irregular, nurse, very irregular,’ he muttered as he stomped off to get the laudanum. Mason was now laughing and clearly enjoying the spectacle of the fearsome Dr Lampeter being told what to do.

  Rose knew she was right to try this new approach, and only hoped that it would work. While Lampeter was away she told Arnold exactly what the procedure would involve and roughly how many sutures he would have to endure. The black silk they used was thick and the needle had been blunted by much use, but she didn’t tell him this. Hopefully, with the laudanum inside him he would manage. Rose also took the precaution of slipping him a nip of brandy from the small flask that she always carried in her apron pocket.

  Lampeter came back and Rose administered the drops of laudanum into Arnold’s mouth. She then asked the doctors to go and see other patients while it took effect. Again, Lampeter seemed appalled at this suggestion, shaking his head and muttering, but seeing her face he had no choice but to go off down the ward with the smiling Dr Mason.

  When they returned to Arnold’s bed, Rose was happy to let them proceed. Lampeter produced the needle and thread and, as Rose held the boy’s hand and spoke to him quietly, instructing him to take deep breaths as the needle pierced the skin each time, the suturing commenced. Arnold squeezed her slim hand very hard each time the needle penetrated his flesh but he never moved his head. Rose watched carefully as the stitches went in and bright red blood began to run down Arnold’s cheek. Lampeter paused when required to deftly swab the blood from the boy’s chin.

  Despite herself, Rose was forced to admire the sureness of Lampeter’s hand and the speed of his work. As the last suture went in Rose smiled to herself and gave Arnold’s hand a squeeze in return. When Mason congratulated Lampeter on some fine stitching, she thought that Lampeter looked a bit too self-satisfied and this annoyed her. As they all stood back from the bed they felt or even heard a sigh of relief from the soldiers around the ward.

  Certainly Arnold was not a pretty sight with the flesh take
n up and puckered at one side of his face, but at least he might live to see home again.

  ‘Thank you, Dr Lampeter,’ said Rose on behalf of her patient. He mumbled something in response then walked away. Please yourself, she thought, then quickly turned to find Mason staring at her in a most peculiar fashion. Feeling a little uncomfortable, Rose cleared her throat and said, ‘I need to speak to you, Dr Mason, about the patient Stanley Jackson, the man with the head wound.’

  Dr Mason was still looking at her in a strange way and his eyes didn’t seem to be connecting with what she was trying to say.

  ‘Who, which one?’ he said, looking wildly around the ward.

  ‘That patient,’ said Rose, calmly pointing to the man two beds down from Arnold.

  ‘Yes, yes, of course. I have seen the wound. How is he doing?’

  Rose indicated that they should move out of earshot of the patients and they walked through the door of the ward to stand just outside. ‘Things aren’t looking too good,’ she said with genuine concern in her voice, and she described the wound. Mason listened intently to what she was saying, standing as close as he could to Rose as she spoke.

  ‘Mmm,’ he said when she’d finished. ‘Is he delirious?’

  ‘No, not as yet.’

  ‘But if, as you say, the wound is worsening then it’s just a question of time before our Mr Jackson deteriorates … such a shame, he’s a nice chap.’

  ‘Yes, he is,’ said Rose quietly. ‘I will speak to him about last things, see if he wants any letters writing home.’

  ‘Yes, good idea,’ said Mason. ‘And do keep me informed.’

  Sister Roberts appeared next to Rose and smiled at Dr Mason. ‘Can I interrupt for one moment please,’ she said. ‘Rose, you look exhausted. If you’re finished here, go and check your patient in the nurses’ sick bay, then get some rest.’

  ‘Yes, Sister,’ said Rose. She had no strength left to argue.

  ‘I will keep an eye on Mr Jackson for you,’ said Dr Mason, watching her as she walked away.