The First Year

by Lucilla Andrews

  I said a little breathlessly, ‘Yes, Sister.’

  She looked at her watch. ‘You have fifteen minutes to get suppers and drinks round ‒ and here is Kate! Look sharp, Nurse Standing!’

  Kate pushed the electric food-trolley into the ward, and we certainly looked sharp. I had thought the speed at which we worked in Francis Adams could not be improved upon. I discovered I was wrong. The rate at which Kate and I served those suppers made my pace in Francis seem like slow-motion. Kate was a tower of strength and far better-humoured than Elsie. The women were helpful and considerate. ‘You new, dear?’ they asked, as I handed round plate after plate. ‘There now. It must make ever such a nice change for you to come up here after working in the busy wards with all the sick people. Mary’s ever such a restful ward, what with no one being what you could call properly ill.’

  I had no breath to spare for conversation; so I grinned at each in turn to show I agreed that I was having a pleasantly restful evening, and rushed on with my plates. Every few minutes Sister Mary’s head popped like a masked Jack-in-the-box round the nursery door. ‘Not done yet, Nurse Standing? Get on, child! You haven’t all evening to dawdle round with those hot milks! My babies are getting impatient.’

  When I had delivered the last cup of hot milk Kate told me to leave the clearing up to her. ‘Sister’ll create if you aren’t along in the nursery soon ‒ and don’t forget your mask!’

  ‘Thanks, Kate, for everything,’ I said gratefully. I took a mask from the ward jar, tied it round my face, and knocked at the door of the large nursery. Sister bellowed from within. ‘Come in, child. Don’t bother to knock. My babies aren’t fussy about such formalities.’

  I went in and closed the nursery door behind me. Then I had to stand quite still, momentarily transfixed by the sight of all those babies ‒ and the noise. There were only thirty babies in that nursery, but they looked to be more like three hundred, and every baby was lying on his or her back, flaying the air with furious little white woollen-clad limbs, and demanding food at the top of his or her infantile but extremely powerful lungs.

  Sister Mary roared above the uproar. ‘Don’t stand and stare, child! Get on! Here.’ She offered me a baby. ‘Take this little fellow to Mrs Hilden, No. Twenty-three.’ But before she let go of the baby she inquired briskly. ‘I suppose you’ve held a young baby before?’

  ‘Yes, Sister. One of my cousins had twins last year. She lives near us at home, and I’ve seen quite a lot of her babies.’

  ‘That’s a mercy,’ she said frankly ‘This boy is quite an old man; it’s his tenth day.’ She touched his head gently. ‘But I am relieved that your experience of babies is not solely based on your training with Janet. Take him to his mother.’

  Master Hilden felt soft and he smelt sweet. I held him against my right shoulder; his ear was close to my mouth. ‘You’re much nicer to hold than Janet, duckie,’ I murmured, as I took him to his mother, ‘and I must say I like a lad to have three chins.’

  Having delivered him to Mrs Hilden, I returned to Sister. She said she would finish changing the babies, and wanted me to take the others round. ‘Begin with that line of cots on the left. Their cots are marked, and they have their name-tapes tied round their right wrists, so you cannot make a mistake. Go into the ward, call out the names, and the mothers will direct you.’

  I did as she said, and the mothers told me where to go. ‘Who you got there, dear? Young Sims? Mrs Sims ‒ she’s No. Twelve.’

  ‘Baby Black? Over to Fifteen, Nurse.’

  ‘Gillings? That’s mine, Nurse, dear. That’s my Mabel!’

  ‘You got my Charlie this time, love. I can see by the colour of his hair above the shawl. Bring him over to Mum. Hallo, lovey! And how’s my boy to-night?’

  Sister Mary came in, a baby tucked under each arm. ‘Here you are, ladies. They’re all yours.’ She walked round the ward, supervising the mothers, babies, and myself. When all the infants were distributed she told me to go back to the nursery. ‘Make the cots up with fresh sheets as you were taught by Sister P.T.S. The linen is waiting on the radiators.’ After a few minutes she came into the nursery to see how I was managing. ‘Hand me that pile of clean sheets, child, and I’ll do this side.’ As she stripped the small cots she asked after Francis. ‘I understand your ward is quite busy to-night? It was good of Sister to spare you under those circumstances. Of course, Sister Francis,’ she went on as she tucked under the clean sheets at double the speed I was tucking, ‘was once one of my staff midwives. She appreciates the fact that I never ask for help unless driven to do so. I had to have help this evening. All my pupil-midwives are held up in the Labour Wards this evening. We expect six new babies to-night.’

  ‘Six? To-night, Sister?’

  ‘Get on, child,’ she replied mechanically, but her eyes smiled at me. ‘Yes. Six. Possibly seven. We’ve had one woman in as an emergency, and there is some question of her carrying twins, but we are not certain yet. My pupils are all very thrilled, and so is the mother; so we can but hope they will be twins. Now’ ‒ she straightened her back and rubbed it as if it ached ‒ ‘take all that soiled linen to the laundry chute, then wash your hands, and start re-collecting the babies. I’ll show you how to tuck them down for the night.’ She looked at the nursery clock. ‘I may get called away. If I do when all the babies are in go back to the ward and settle the mothers. They like to have a little sleep before the ten-o’clock feed.’

  She was tucking down the last baby when a pupil-midwife came into the nursery. ‘Sister, please? Nurse Ellis says could you come?’

  The nursery was wonderfully quiet when she had gone. Most of the babies were already asleep; the few awake made soft, contented little chewing noises; no one cried. There was an air of peace in the nursery, and it smelt of baby-powder and clean linen and the faint, sweet scent of clean babies. I walked round all the cots to see if they were all all right, and wondered if any corner of Martin’s to-night was as pleasant as this silent nursery. I stopped by one cot, leant down, and touched the sleeping baby’s petal-soft cheek with one finger. The baby did not stir; he slept on with one hand that had escaped his shawl pressed against his cheek like a fat little starfish. The baby had flaming red hair, and I recognized him as Charlie. As I looked at him I thought of the expression on his mother’s face when she had taken him from me; and then I remembered how all those other women had looked ‒ they had looked as if someone had switched on a light inside them.

  I knew I ought to get back to the ward and the routine, but I stayed where I was a couple of minutes. Then the door opened slowly, and Kate peered cautiously round. ‘You in there, Nurse? I don’t want to push you, dear; but you did ought to be getting on with the final drinks. Sister Mary won’t half create if you don’t carry on with your routine.’

  I stifled a sigh. ‘Thanks, Kate. I’m coming.’ I took a last look round the nursery, then followed her departing head reluctantly. Someone was always only too ready to create to me if I didn’t get on with my routine. But perhaps that was not such a bad thing. Routine has to be done ‒ and in doing it you do not have time to think. I had been so busy in Mary that not only had I been unable to think ‒ I had not even had time to make a mistake.

  The thought made me smile. I was still smiling when I joined Kate in the kitchen, and she asked what the joke was. ‘Or are you just happy in your work, Nurse?’

  I set a tray with cups. ‘Expect that’s it, Kate.’

  She opened a fresh quart-bottle of milk. ‘From Francis, aren’t you, dear?’ I nodded and she smiled. ‘I mind about you, dear! You must be Nurse Standing.’

  ‘Kate,’ I protested, ‘don’t believe a word of it.’

  Her smile widened. ‘Elsie told me of you, dear. “Talk about clumsy,” says Elsie, “I tell you, Kate, you’ve not seen the like! That Nurse Standing, she’ll break a pile of plates as soon as look at ’em! And our Staff Nurse ‒ she tells her off all day! But it don’t worry young Nurse Standing”.’ Kate shook her head over th
e milk saucepan. ‘I mind that Staff Nurse Bennings when she was a pupil-midwife up here. A proper little madam, she was! But it’s easy to see she don’t put you out, dear. You just take things as they come. And that’s the way to get on in a hospital. Just do your work and don’t take too much notice of them as tells you off. It don’t do to fret and wear a long face. Because what I says is, why worry? It may never happen.’

  I said, ‘You’re right there, Kate,’ and set another tray. I wondered casually what her reaction would be if I told her that what was secretly worrying me was the thought that something I wanted was never going to happen.

  The Rugger Club Ball was held two weeks after that evening in Mary. I moved to Casualty during the first of those two weeks and promptly became so engrossed in that department that the ball, Bill’s invitation, Francis Adams, and even Bennings slipped from memory. The only person I could not have forgotten was Jake Waring, even had I wanted to forget him. He was constantly in Casualty, as he had personally to see every surgical patient admitted to the hospital; his opposite number, Dr Spence, the Senior Medical Officer, saw all the medical admissions, and the two men, of necessity, haunted Casualty Hall.

  Sister Casualty was on holiday during my first few days; the Senior Staff Nurse, Nurse Davis, ran the department in her absence. As Casualty at Martin’s was so large, two staff nurses worked there on day-duty and not only one, as in the wards. Nurse Davis was a tall young woman, who looked amiable and wore a sister’s belt. None of my set had yet worked in Cas., and Nurse Davis was an unknown quantity; so the girls advised me to walk warily with nurses wearing sisters’ belts. ‘And call her Sister, Rose,’ added Angela; ‘it’ll pay. Can’t go wrong if you use a little tact.’

  With this advice in mind, I said, ‘Good morning, Sister,’ when I first reported to Nurse Davis for duty.

  ‘Goodness me, Nurse!’ Nurse Davis blinked through her spectacles. ‘You must not call me that. Sister Casualty is the only sister in this department. I am Nurse Davis, and this’ ‒ she nodded at her colleague ‒ ‘is Nurse Blake.’

  I sighed inwardly and apologized aloud.

  Nurse Davis remarked pleasantly that I must be Nurse Standing. Then she noticed my white belt. ‘Oh, no!’ She exchanged glances with Nurse Blake. ‘You aren’t as junior as all that! You are surely not the P.T.S. set?’

  ‘P.T.S. but one, Nurse. I’ve come from Francis Adams.’

  She said that Sister Casualty had mentioned before going on holiday that a new pro. was coming from Francis Adams.

  ‘But I understood from Sister that it would be a second-year.’

  ‘Perhaps Matron is short of second-years now Nurse Erith is warded,’ I suggested, then wished I had kept quiet, remembering how much Bennings had disliked any suggestions from juniors. And Bennings did not even wear a sister’s belt.

  Nurse Davis only smiled. She had a charming smile. ‘It may well be that. And I believe the second-year exams come up again shortly. I suppose Matron did not want to move anyone else from a ward at this juncture. Well!’ She looked again at Nurse Blake, then back to me. ‘I hope you will be able to manage the work here, Nurse Standing. We do not have much time to spare for teaching, which is why Sister Casualty prefers not to have very junior nurses in her department. So you will just have to do your best to pick up the work as quickly as you can, and we will all do our best to help you. But I am afraid Sister Casualty is not going to be very happy about the situation. Still’ ‒ she gave me another of her attractive smiles ‒ ‘I expect you will manage quite nicely.’

  ‘I hope so, Nurse. Thank you.’ And most sincerely did I hope I would be able to manage, too; but I also felt very gloomy at the prospect of my immediate future.

  As the day progressed I grew even gloomier. It was Monday; Casualty Hall was full most of the day. The crowd terrified me, but Nurse Astor, the Casualty Senior, who was in her third year and had been detailed to show me my work for this one day, surveyed the packed Hall coolly. ‘Slack for a Monday,’ she murmured. ‘I wonder why. It isn’t Bank Holiday or anything, is it?’

  I said I did not believe there were any Bank Holidays in November.

  ‘Most extraordinary.’ She gazed round and appeared really hurt that London could muster no more than a couple of thousand patients for our Casualty on a Monday morning. ‘Perhaps,’ she brightened, ‘we’ll get busy as the day goes on. I hope so. I do so dislike being slack.’

  I said I disliked being slack too, then saved my breath, as I needed it to keep up with the swift canter at which she was showing me round the place.

  Casualty had thirty dressing-rooms. Nurse Astor ran through them verbally. ‘They are all divided into main groups: male; female; children. Then split into the different firms: medical; surgical; gynaecological; orthopaedic; and so on. Then subdivided again: acute medical; chronic medical; straight acute surgical; dirty surgical; old wounds; etc., etc. You haven’t a hope,’ she added reassuringly, ‘of taking all this in to-day; but don’t let that upset you. No one remembers what’s what and who goes where at first; but you get it straight in time. In any case, delegating the patients doesn’t ever concern you. Sister Cas. or one of the S.N.s is always on duty in the hall to direct the patients as they come in. The only problems about the rooms you may meet at your present stage are Doctors’ Letters, and they are a law unto themselves. So, whatever you do, Standing, don’t make a mistake over a Doctor’s Letter, or all hell is let loose.’

  I had no notion of what she meant, but promised to be very careful with Doctors’ Letters. Did I have to deliver the medical staff’s mail or something, I wondered.

  ‘Until six o’clock,’ she went on, ‘all Doctors’ Letters are seen by the S.S.O., the S.M.O., or their registrars. No one else. Got that?’ I nodded dumbly. ‘Remember ‒ never a C.O.’

  I had to stop her. I was now utterly lost in all these letters. ‘What are ‒ or rather is ‒ a C.O., Nurse?’

  She smiled. ‘Sorry. I forgot how junior you are. As you were. The C.O.s are what the housemen are called when they work down here. Casualty Officers. But the S.C.O. ‒ the Senior Casualty Officer ‒ isn’t a houseman at all. He’s a senior registrar, and up in the senior-resident bracket. Now, the C.O.s see the people who wander in here from the streets ‒ and most of our patients do that. In this part of London people use Martin’s as their G.P. They’ve done it for centuries and no newfangled Health Service machinery is going to make them change their habit. They don’t call in a family doctor if the old man or the kids feel queer; they just potter into Cas., sit down on one of the benches, and leave it to us. It’s rather a nice habit, we think, and it makes Cas. a very homely spot. They know us; we know them.’ She looked round the Hall thoughtfully. ‘This place may be the size of Waterloo Station, but you’ll be surprised at how matey it can be. You’ll find you’ll see the same faces over and over again, and very soon most of the patients will know you by name. And after a couple of months in Cas., whenever you set foot outside Martin’s, you’ll run into old patients who will shake you warmly by the hand and ask after the “old ’orspital.” But don’t forget ‒ the exceptions to all this are the Doctors’ Letters. So when ever a patient flaps an envelope at you and says, ‘I got a letter from me doctor, Nurse, take the patient and letter straight to Sister.’

  I asked how the patients evaded Sister in the first place.

  ‘They get muddled ‒ not surprisingly ‒ because most G.P.s will address their envelopes to “The Out-Patients Department, St Martin s Hospital.” It applies to some hospitals; not this one. Our Out-Patients only take clinics, and we get all the new patients here in Cas. Every single patient coming into Martin’s with anything from a cut finger to a bad road accident comes through Cas. Which can make it confusing when you are new, as we can be madly hectic. But the scheme really works pretty well, and Sister Cas. is a magnificent organizer.’ She led the way into a dressing-room. ‘We’ll check the stock in here.’

  I watched what she did. ‘Has Sister Cas. been here
a very long time?’

  ‘She’s been Sister here just over three years.’ She shut the drawer and opened another. ‘Pass me that basket over there.’ She refilled the second drawer with clean rolls of cotton wool. ‘That’s done. Let’s do the bottles.’ She crossed quickly to a china shelf on which stood a long row of lotion bottles, and held each up to the light to see how much fluid it contained. ‘Sister Cas. staffed here for four years under old Sister Cas., then took over when the old girl retired.’ She handed me two bottles. ‘Ether and flavine. We’ll take them to the stock-room and refill ’em. I should have remembered to bring the stock ether and flavine with me, as those two we always need, but I haven’t stocked and tested for quite a spell, and I forgot that point.’ She straightened the bottles on the shelf and returned to her former subject. ‘Sister Cas. is pretty young to be the sister of such an important department, but Matron’s keen on young sisters. When they are as nice as Sister Cas. I’m with Matron every time. Sometimes I’m not so keen.’ She glanced over her shoulder. ‘Worked in Agatha?’

  ‘Only Francis.’