In the first of a new series looking at the differences between nursing in the UK and the US, Sara Morgan talks about tricky hospital corners.
When I first moved to the UK and began practicing as a nurse here, I knew that adjustments would have to be made.
First, I had to relearn my mother tongue because, as George Bernard Shaw noted, “England and America are two countries separated by a common language”. Every drug had a different name on this side of the Atlantic, abbreviations were changed (why is nitroglycerin GTN in the UK and NTG in the US?) and my spelling, which had always been stellar, was suddenly terrible. Recognize these: pediatrics, esophagus and hemaglobin?
While my left brain was struggling with getting my words and pronunciation right, my left brain was coming to grips with all of the different numbers I was encountering. I was surprised that the UK still weighed people in stones as I was quite sure that both pounds and kilograms were readily available. Most lab values had radically changed as well. A normal blood glucose in the US is between 80 and 120 mg/dL. Change the units, though, and all of a sudden, normal becomes 4 to 7 mmol/L here in the UK.
But my biggest hurdle in adjusting to work here came from a surprising source: hospital corners.
You are probably reading this thinking ”What’s the problem? Hospital corners are easy to do and if you weren’t taught how to do them at home, weren’t you taught during your very first hospital placement in nursing school?”And that’s where you would have identified a key difference between American and British healthcare: the fitted sheet.
In my American hospital, we had fitted sheets to go on mattresses and flat sheets to be tucked over patients with their blankets. When I realized that my new English hospital didn’t have any fitted sheets, I suggested that purchasing some might save a lot of time for nurses when they make beds. Additionally, since fitted sheets don’t slide loose, nurses aren’t constantly trying to pull out wrinkles that have formed underneath patients who do a lot of tossing and turning. The explanation I received was this: all sheets were pressed after laundering and fitted sheets would not pass through the rollers of the press. Since I had no suggestions for how to get around this requirement, I was left wondering why sheets needed to be pressed in the first place. I admit that Americans are known for being casual in both dress and attitudes, but in this case, our “casual” and therefore unpressed hospital sheets seemed to be a benefit to both nurses and patients.
Fitted sheets were not unique to my hospital, either. Back in nursing school, in between learning to measure blood pressures and how to put on sterile gloves, we were shown how to make hospital corners. Once. And the professor even prefaced the lesson by saying “We will be showing you how to make hospital corners today, but only for historical reasons. You’ll never have to do them in practice.” We all watched attentively, laughed at how old-fashioned it seemed (right up there with wearing nursing caps) and then promptly forgot all about it.
“We will be showing you how to make hospital corners today, but only for historical reasons. You’ll never have to do them in practice.”
This lesson came back to haunt me. I was fine asking my fellow English nurses to show me how to use an unfamiliar type of ECG machine, or having to look up drug names in the BNF, but my pride was at stake when it came to bed making. I simply couldn’t ask anyone how to make hospital corners. It was too basic a skill, almost as bad as asking someone to show me how to feel a pulse. So I slyly watched the other nurses around me, and tried to pick up their techniques. If I was helping someone to make a bed, I made sure I was ready with the blankets and top sheet, while the other person tightly tucked in the corners. But for all of my observing, copying and practice, I still can’t make a proper hospital corner. The edges are loose, the creases saggy and the sheet pulls free at the slightest hint of tension.
So, to any of my British patients who have woken in bed to find bunches of fabric gathered under their shoulders, or the bottom of their sheet wrapped around an ankle, I offer my apologies. This American can convert her weight into stone and spell colour with an extra ‘u’, but she simply cannot master the art of the hospital corner.
About Sara Morgan
Sara Morgan trained and practiced as a nurse in the United States before coming to work in the UK. She has worked as both a nurse practitioner and as a lead nurse on the Productive Ward initiative.