On the day you qualified, after you’d passed the exams, collected your badge and certificate, did you feel that you were a nurse?
In theory the answer should be in the affirmative, but in truth it’s not always that simple. It can take an event or recognition, or simply enough time, to confirm in your own mind that you really are now a nurse.
I qualified as an RMN in the late 1970s at St Augustine’s Hospital, Chartham, Kent - now closed since 1993. In those days newly qualified mental health nurses didn’t feel they were nurses until they had completed an additional qualification in general nursing. The incentive to do this was the staff nurse salary, which was maintained while training.
After working and enjoying two months at the hospital, an interview was organised for me at the Medway Hospital in Kent, and within two weeks I started a five-day induction. Historically the hospital and the area always had an association with the Royal Navy, and this was reflected by the barracks and dock situated within the borough.
The first ward I was assigned was a general male medical unit at St Bartholomew’s, one of the oldest existing hospitals in England and predating its more famous namesake in London by 50 years. The unit was situated in an area called “Chatham Within” in the borough.
“It was clear that they didn’t understand what was happening as they had never had an RMN posted to the ward before”
After introducing myself to the ward staff it was clear that they didn’t understand what was happening as they had never had an RMN posted to the ward before. Indeed, the staff nurse even gave me the keys for the medicine trolley when she went for a coffee break.
Everything was so different to anything that I had come across before. The ward was cleaned by a dedicated housekeeper, and the beds were arranged in two orderly rows of 12 housing general patients with ailments within a diabetic, cardiac, urinary and respiratory category.
Every morning I and an auxiliary would start work on one row, assisting patients to wash and recording clinical observations. Invairably, the staff working on the other row would at some point request assistance, usually with lifting. This annoyed me as they nearly always didn’t follow basic common sense, their response was generally just to repeat the phrase ‘“we are a team”.
“There seemed to be a different attitude”
In a psychiatric ward a medicine round might take 10 to 15 minutes but in my first general nursing ward it could take up to an hour. There seemed to be a different attitude or concept between the two types of nursing.
That said, I loved the work and tried to learn as much as I could about the various conditions. But I was hampered by my lack of anatomy and physiology knowledge and later in my training, when I realised its importance, I borrowed a book on the subject and read it again and again to help me in exams.
As much as I felt a part of the team I got the impression that the ward staff did not think I was taking the training and work seriously, for example at the daily handover I would take notes on any piece of paper, even a serviette, while others carried notebooks.
One morning, early in my training, that changed.
The staff nurse asked me to help with the drug round. My first patient was being started on treatment for an infection that had interfered with his diabetes.
“This is 250mg Amoxil for this gentleman,” said the nurse handing me the pot containing the tablet.
“Isn’t he allergic to Penicillin?” I asked.
“I think you are right, Patrick. Don’t give it, I’ll go and check and if need be I’ll contact the prescribing doctor.”
“The tone of my voice must have been effective since the staff nurse told me to call the emergency number”
A mistake had taken place and the doctor thanked the both of us for the observation before correcting the records. The staff nurse moved on with the round while I set about making the first patient more comfortable until I noticed that a patient in the opposite row appeared to be struggling with his breathing. I pulled the curtain and called out to the staff nurse. The tone of my voice must have been effective since the staff nurse told me to call the emergency number 222 for the cardiac team and at the same time the doctor rushed out of the office and gave a precordial thump to the patient’s chest.
Within minutes the cardiac team arrived. I just continued dispensing medications on the ward round even though I had never witnessed a cardiac arrest before.
After 55 minutes we finished the drug round and I moved on to doing the numerous routine duties that are part of general nursing, including making up a new bed as the cardiac patient who had been resuscitated and transferred to another ward.
While the afternoonhandover was taking place I did what I did best - spent time talking to some of the patients.
After the handover the sister called me to the office, sat me down and said how pleased she was to hear about what had occurred during the morning. She gave me a small notebook which she had bought for me yesterday as she had noticed me writing notes on any piece of paper.
With the notebook safely tucked away I walked up the hill to my lodgings at Gillingham on the day I knew I was a nurse.
Patrick Whyte, RGN/RMN