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Comparing the 80s with today: St Bartholomew's and the Royal London Hospitals

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Former senior nurses at St Bartholomew’s and the Royal London Hospitals look back at their experiences of nursing in the 1980s, while a current ward and senior sister at Barts and the London NHS Trust reflect on their roles today

Thirty years ago nurses returning home at the end of a long shift had the choice of three terrestrial channels to watch on television. Video recorders were beginning to make an appearance in a few homes but satellite, cable and digital TV were still a long way off.

In 1979 nobody ever started a phone call by saying ‘I’m on the train,’ and Blackberries only grew on bushes. However, as the decade wore on, yuppies appeared and were joined by ‘nimbies’ and ‘dinkies’ – all struggling to solve the Rubik’s Cube. Fashion-wise, Lycra was a widely used fabric and, as the decade progressed, power shoulders and hair just got bigger and bigger.

In the wider world, 1979 was still the Cold War era with much of eastern Europe living under communism, while people in the UK were about to start living under Margaret Thatcher, who famously declared: ‘There is no such thing as society.’

Politically, the 80s was a time when many traditional roles and structures where demolished as the cult of the individual took hold. Individual choice became the watchword and manifested itself in anti-trade union legislation, the sale of council houses and budget-tightening across many public services – the NHS being no exception.

‘In the eighties, pressure on beds was beginning to increase’

That’s the big picture. But what was it really like to be a working nurse in the late seventies and eighties? Rosemary Campbell trained as a nurse at St Bartholomew’s Hospital in the seventies and then completed a year’s work at the hospital to secure her nursing ‘badge.’ Then after a spell in another hospital, she returned to Barts in 1979 to work as a night sister, as well as spending time first on a male ward and then a women’s surgical ward before being promoted to ward sister.

She says: ‘The 80s was a good time to be a ward sister. I was responsible for managing the patients and the nurses and a big part of my job was preparing patients for theatre and then receiving them back onto the ward and handling their care until discharge.

‘In those days we didn’t have recovery wards or high dependency units so all the patients came straight back to us for care after theatre, even though they had undergone very complex surgery. I had to be sure that I had enough experienced nurses to deal with all the patients.

‘The 80s was a time when pressure on beds was beginning to increase but we would still get to keep patients on the ward for longer than now. Bed managers hadn’t been invented! I think nurses also had a little more time to spare than they do these days.

‘Often people weren’t exactly well when they were with us after surgery, but they were recovering and there was the opportunity to talk to them and get to know them and hear about their worries. This post-operative period could feel like a special time.

‘I regretted that as the years went by, post-operative time on the ward was cut. We would send patients off into the care of others in the community and the wider NHS and although I know teamwork is very important and often works extremely well – indeed, discharge planning was becoming an important part of the job in those years – I was still a little apprehensive about letting them go.’

In terms of teamwork, on the ward Rosemary felt that her opinions were listened to by doctors and that teamwork within the ward was always considered important.

‘Despite technological benefits over the last 30 years, you can’t replace a nurse’s observations‘

She points to the clinical skills of nurses at a time when there was less technology as evidence of the skilled nature of the job. ‘We did have some mechanical aids but a lot of things which are commonplace now such as Hickman lines and central intravenous drips were just being trialled during the early 80s.

‘However, I don’t think anything can replace a nurse’s own observations and I think that staff in 2008 would agree with this even though they have many technological benefits.’

Barbara Thompson, who worked in several senior roles at The Royal London Hospital in the late seventies, recognises many of the challenges faced by Rosemary in dealing with a busy workload.

Barbara’s role included taking overall charge of three or four medical wards – in a role similar to today’s modern matrons. Along with senior colleagues she had to ensure that there were always enough qualified staff to care for patients and to administer medicines so rosters were strictly followed.

She says: ‘In a typical day I might have to help with patient care, support nurses who were either new to the job or whose patients needed extra attention and I had to ensure that the wards ran smoothly.

‘The London was always a busy hospital and I don’t doubt that it still is very busy on the wards. Pressure on beds was beginning to build from the seventies onwards, but I think that on a typical ward there would have been some patients who were less acutely ill than others and we could get to know them.’

For both Barbara and Rosemary, mealtimes were an important part of ward life. Sisters ordered meals from a selection and then dished them up to patients, helped by available nursing staff. In Rosemary’s case she remembers setting up tables at the end of the ward so that mobile patients could eat together, while Barbara recalls that the more able patients were keen to help out, dispensing tea to fellow patients and enjoying a chat and a walk around the ward.

‘Advances in technology today mean we can talk to patients while taking a blood pressure reading’

Fast forward to 2008 and Alison Thompson, the current ward sister on the 25-bed Percival Potts Ward at Barts, still sees similarities in her work and ward life to the older sisters – although mealtimes are handled differently and the throughput on the ward is higher.

These days, patients will arrive on Alison’s gynae-oncology and breast surgery ward at 7.30am in the morning and can expect to have their operation the same day. Many of them will be discharged the next day while others requiring complex procedures will stay for one or two weeks.

Alison says: ‘We have very busy theatre lists every day from Monday to Friday and a high turnover of patients. While it is true that we don’t always get to know the ones who are only with us for a day, we do spend time with the ladies who are here for longer.

‘And advances in technology which have given us blood pressure machines for example, mean that we can talk to patients while we are taking a reading.’

Alison has been a ward sister for four years. When on duty, as well as running the ward she also has her own group of patients to look after so still gets to do hand-on work as well as tackling the paperwork which has become more of a feature of hospital life since the 80s.

Alison says: ‘We have to show that we are delivering good care and getting results – and that means paperwork. I think that is one of the differences between now and the 80s. I do understand the need for this although like most people I became a nurse so that I could be with people and care for them.’

‘Our nurse-led project has cut the number of people who have to go to ICU’

For Darlene Romero, currently senior sister on Millward Ward at The Royal London, the hands-on approach to nursing also remains the key to the profession despite the welcome increase in technological advances.

Darlene has been at the trust since 2000, having arrived in the UK from her native Phillippines the year before as a fully trained nurse.

Sister Romero is in charge of Millward ward, a 25-bed ward for respiratory patients including people with COPD, asthma, lung cancer and chest infections.

One of her key projects on the ward is the nurse-led work for patients with COPD who can be treated with non-invasive ventilation. This is aimed at cutting the number of patients who need to be treated with invasive ventilation in ICU.

Sister Romero says: ‘It is a nurse-led project with team members taking on the decision-making about which patients are suitable for the treatment and for the management of the patients while they are in the hospital.

'We have cut the number of people who have to go to ICU, which frees up beds there for other people and the patients themselves find the non-invasive techniques easier to deal with and the same goes for their friends and relatives.’

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