Surgical Ward Sister - 50's Style Part 1
[Names withheld at the author’s request.]
I became a Ward Sister in RIE in 1954. At that time you didn’t apply for the job – it was offered to you! I was then interviewed by the Chief Surgeon and eventually my appointment was confirmed.
The previous incumbent had already left so I was on my own. However, there were plenty of people to turn to for advice. An early memory was that there was a ward cat! I was modern; I couldn’t have a cat in a surgical ward, so one of the doctors kindly took it home.
The hours were long but in retrospect we usually seemed to be adequately staffed. The day staff covered the ward from 7.30 am to 8.30 pm. This was achieved by some staff working from 7.30 to 5 pm [or 6 pm] and some working `split shifts’ – 7.30 am to 1 pm and back at 5 pm until 8.30 pm. We had a day off once a week; a staff nurse or senior student acted as deputy so we could go off duty leaving the patients in safe hands. The night staff came on at 8.30 pm and worked until 8 am. They were given a report of the patients’ progress and had to know all their names, diagnoses and treatments.
In those days the ward sister was `hands on’ and closely involved in patient care. After breakfast was served, Sister went round the patients to talk to them and hear how they had slept; how they were feeling. She checked that everything was in order – e.g. the wound dressing was secure; temperature charts; fluid balance charts; I.V. infusions etc. After the morning routine care was complete, the dressing round was done. This was quite a ritual. A list was made and a student nurse delegated to prepare the patients and observe the procedure. The appropriate sterile instruments had to be ready. [In 1954 these were boiled up in a kidney dish on the ward kitchen stove!] The patient was made comfortable afterwards and we moved on to the next one.
At that time it was customary for patients to be confined to bed after surgery. This could be for 7 days, 10 days or even longer. Very often there was a patient with a fractured femur on traction in each corner of the ward, therefore care of pressure areas was of vital importance. These patients had to be moved and pressure areas massaged at regular intervals. The occurrence of a pressure sore was one of the ward sister’s biggest nightmares. On operating days Sister was involved in supervising patients being prepared for theatre and receiving them on their return. The `three man lift’ was employed as we lifted them into bed.
On `waiting days’ emergency admissions [including accident patients] were received for 24 hours. When all the beds were full we ordered extra beds which arrived from the tunnel. These were made up ready for the next emergency admission. It was the usual thing to have beds down the centre of the ward. We were expected to cope although sometimes it was hard going! We were free to ask for an extra nurse if the situation became too hectic.
In those days nurses were expected to do some cleaning duties. Tidying and cleaning lockers was a nursing duty and some `damp dusting’ of the ward was done. Cleaning and disinfecting sputum mugs was done after the doctors had inspected them on their rounds. I can also remember polishing the ward floor with a `bumper’ on Sunday afternoons. We also did the ward mending of the linen! The ward maid was an important part of the ward team. She kept the ward in pristine condition and expected the staff to maintain her standards of cleanliness. Perhaps the juniors were a little in awe of her?
Meals were served by Sister so were tailored to the needs of individual patients. A member of staff would feed helpless patients as nutrition was an essential part of their care.
Teaching student nurses was an important part of the ward sister’s job. The students had to know the patients’ diagnoses and work out their care. It was important for them to observe changes in the patient’s condition and develop good powers of observation and clinical judgement. Records were kept and reports written on specific issues by day and night staff, but a lot of information was passed on verbally. In later years the Kardex system was introduced and more com
prehensive written reports were available for reference.
One of the advantages of the job was that sisters had their own sitting room on their ward. We could give doctors their coffee in comfort and we could also entertain our friends when we were off duty. Our bedrooms were above Wards 17&18. They were attic rooms but we were all surgical sisters and lived together happily with our older and more venerable colleagues,
Altogether it was a happy lifestyle; we felt really in charge of our little kingdom. A daily visit from an Assistant Lady Superintendent helped to sort out problems and keep us on our toes.
I hope present day nurses get as much satisfaction from the job as we did!
Editor's Footnote:
I was allocated to this ward as a 3rd year student approaching finals. Up until that point I had hated surgical placements and dressings in particular, which I had always experienced with great fear of severe rebuke from the presiding sister. However, this ward sister was different; what I learned about wound management from her saw me through diverse critical care scenarios, 22 years of military nursing and equipped me to teach Eritrean Registered Nurses wound management, often applied to such horrors as landmine trauma, gas gangrene, and advanced cancer.