On the gynaecology ward, where I worked as a Saturday morning domestic, the bed covers were pale pink, the bed wheels all faced the same direction (toward the middle of the ward) and the open end of each pillow case faced away from the door (yes, really).
The main ward was designed to the Nightingale layout with a separate and smaller ward area at one end for the convalescing patients. At this time, the early 1980’s, patients usually stayed in hospital to convalesce after their operation or period of illness. This resulted in a mixture of acutely ill and recovering patients on the ward, making for a very different ward dynamic to the one that exists in hospitals today. Staff had more time to get to know their patients and the patients had time to get a head start on the recovery process before going home to pick up work, domestic duties and family life again, as is often the case today. The mix of ill and recovering patients resulted in a different atmosphere to the ward as well; the convalescing patients would be able to chat to each-other, move around independently and even help with tea and coffee rounds if they wanted. The recovering patients often cheered up the sicker patients on the ward, giving them hope for their own recovery. For the nurses, the chance to work with the ‘convalescents’ was also a welcome break from the more stressful and demanding work with the acutely ill patients.
As well as the mix of patient dependency, the number of patients having operations was fewer. The main operating days were weekdays with only emergency cases being handled on Saturdays and Sundays; this meant that weekends were quieter for everyone, with less acute activity on the ward and a generally more relaxed atmosphere all round. Later on, when I became a student nurse, weekends were to be looked forward to as a time to emotionally re-charge, a time to prepare both ourselves and the ward for the busy week ahead. Nowadays operating lists are no respecters of weekends, and Sundays can be as busy as Wednesdays whilst convalescence supposedly takes place after discharge, when life at home for the patient quickly resumes its normal pattern and demands. The rapid throughput of patients, if poorly managed, can impact negatively on their psychological and physical recovery with the potential for rapid re-admission for un-resolved issues such as wound healing and infection. Many patients in today’s National Health Service (NHS) would find it hard to imagine a time when post-operative patients stayed in hospital for several days or even longer after surgery or could go to a convalescence home near the sea to recover from their operation if they wished, as indeed some of ours did.
Peggy and I made a good team. She was funny and kind and despite our age difference we had a good laugh together. We also worked hard to keep the ward looking spick and span. I often think back to those times; goodness knows what the care on the ward was like but it was certainly very clean. Years later, as a ward sister myself in the mid-1990's, I watched the responsibility for ward cleaning being handed over to cleaning contractors and saw first-hand the loss of pride in cleaning that came with moving domestics out of the ward team. I'll never forget asking our ward domestic to clear the huge balls of dust behind the clinical waste bin in the sluice only to be told "But that is rolling dust Sister, we can't do anything about that" (!). On John D’Marinas, we were answerable to the ward sister and although she might not have known what to do with a cardiac defibrillator she certainly knew the importance of keeping the ward spotlessly clean.
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