From washer-up to waitress - a step closer to nursing?

Whilst I was still at school, I got my first job  in a hotel in London Road, St.Albans. It was run by a couple called Paddy (Irish, sharp as glass) and Elsa (Swedish, peculiar as hell), and catered mostly for travelling sales and business men. It was a no frills establishment; a bar, a restaurant and a trouser press in every room. Elsa and Paddy managed the hotel in equal parts; Elsa, oversaw the kitchen and Paddy, ran the bar. Their only son, Mark, had the run of both but did nothing in either.  

The job came about through my father, who had done various jobs for Paddy over the years and knew him quite well. I don’t remember being interviewed for it, I think it was more a case of ‘can she wash up?’, ‘yes’, ‘fine the jobs hers.’  So I worked as a dish washer in the hotel kitchen, standing in the corner of the kitchen, mistress of two large stainless steel sinks, one for washing, one for rinsing and a metal draining board for stacking and drying. It was a hot and greasy job which required little skill but it was a job and I was paid 70p an hour for doing it. 

The chef was a hairy, heavy-faced italian, the father of a boy in my class at junior school. He was irreverent , loud and lazy (the chef, not the boy in my class). He might have been talented but he was rarely allowed to cook anything more than boiled water into which was dropped whatever boil-in-the-bag meal the customer had (unknowlingly) ordered. ‘Duck a la orange’ and ‘Chicken Chasseur’ were particularly popular. The menu offered what was, in the early 1980’s, fairly standard hotel fayre; a mixture of English and French dishes with boiled side vegetables or mixed salad. Elsa also liked to bring a little bit of Sweden into the restaurant on occasions. A particular favourite of hers was to drop half a hard-boiled egg in the (powdered) tomato soup before serving. Sometimes, the waitress would flick the egg out again if Elsa wasn’t looking but mostly it would sink out of sight only to pop up and surprise the unsuspecting customer as they dipped their spoon in for their first mouthful.  

I worked 2-3 nights per week usually finishing by about 10.00pm with the occasional late night if a ‘works’ party came in. The senior waitress was called Edna, an older woman, who kept everyone else in order. The youngest were a year to two older than me, two sisters called Carla and Paula. When Carla left to attend University I was promoted into her place and given a small pay rise. I was also given ‘The Grange Hotel’ waitressing uniform to wear, a dark blue skirt and a light blue nylon shirt (nice). I enjoyed the customer contact and it was certainly better than washing up although it wasn’t as easy as it looked. In my first week of being ‘out front’ I pushed a laden sweets trolley over the carpeted floor in the restaurant and it caught on a ridge and tipped over. There was a landslide of creamy desserts including the Black Forest Gateaux and the English Trifle, both of which ended up on the floor. Fortunately, the restaurant had yet to open and Elsa just swept in, scooped the trifle back into the glass bowl, added a flurry of whipped cream on top plus a couple of cherries from the bar and popped the whole thing back on the top shelf of the dessert trolley. Not sure that the means justified the end but still, it was an impressively, nordically cool, disaster aversion.

Apart from giving me a healthy wariness about what really happens in restaurant kitchens, waitressing taught me that I enjoyed and had a capacity for working with people. The long hours and repetitive work also taught me that I didn’t want to work in the hotel trade, either as a waitress or anything else. A year or so later I switched from waitress to domestic in my first hospital job, just roads away from where I lived. 

 

Next week, seeing it from the floor up - in a hospital at last.

The Secret World of Cell Barnes Hospital

My first experience of being in a hospital setting was as a Friday afternoon volunteer at Cell Barnes Hospital, a hospital for long term patients with severe learning and physical disabilities. Cell Barnes Hospital was built by Hertfordshire County Council on a plot of land formerly owned by the Earl of Verulam and sitting on the southern outskirts of St.Albans. It was officially opened in 1933 as a certified institution for the reception of Mental Defectives as defined by the Mental Deficiency Act 1913. The act categorised mental deficiencies into a hierarchy of conditions starting from the bottom with Idiot and moving up to Imbecile then to the Feeble-Minded and then finally to the Morally Defective at the top; in each case the condition had to be present from birth or an early age to meet the definition in full.

The 600 bedded hospital took its first five patients in March 1933 and quickly became established with a full population. During the war it provided additional beds for St.Bartholomew’s Hospital, London along with its nearby neighbour, Hill End Hospital. Shortly after the war, in 1948, the newly formed National Health Service acquired Cell Barnes along with Harperbury Hospital (also for Mental Defectives) and grouped them together to be managed by the Cell Barnes and Harperbury Group (No 8) Hospital Management Committee, which was responsible to the North West Metropolitan Regional Hospital Board. The hospital continued to house patients in need of long term care, catering for over 700 at its peak, until its controlled demise in the year 2000.

At the time I was there, around 1980, Cell Barnes was still a thriving hospital comprised of multiple buildings including the large main house which housed the hospital dentist, the original two storey dormitory wards and many additional buildings including the social club, the Ena Daniels School and the hospital kitchens. Although the original hospital farm had been discontinued in 1965 (most hospital farms were closed down around the same time in keeping with the then government policy) the site remained green, open and spacious and those patients who could move around the grounds freely were encouraged to do so.

I went to Cell Barnes as a volunteer because I didn’t like cross country running not because I had a deep yearning to work in healthcare. As a pupil at the nearby Beaumont Secondary School in St.Albans, Friday afternoons were given over to three mile runs which took us gasping and purple faced across the muddy fields and tracks of the neighbouring Oakland’s College campus. However, the school was also keen to build links with the local community so a group of pupils were asked if they would like to forego the Friday afternoon mud run and make weekly visits to the patients in Cell Barnes instead. The hands of those of us without an athletic bone in our bodies shot up quickly and low and behold we found ourselves on the volunteer books at Cell Barnes.

Our first duty was to accompany a group of patients on an all day trip to the adventure park and fair ground at Billing Aquadrome, Northamptonshire. On the day in question, the school minibus took us to the hospital early in the morning so that we could travel to the Aquadrome with the patients and staff. On arrival we could see a hire coach waiting to depart with the patients already on board, each sat by the window next to an empty seat. The group leader asked to get on and sit ourselves next to a patient, who would then be our ‘charge’ for the day. It was with some trepidation (and no preparation), that we climbed on board and made our way down the coach, filling the empty seats as we went.

I sat down next to a man who looked to be in his thirties (28 it turned out). He had a thinning hair combed over the top of his head and was wearing a dark blue mac and a suit and shirt underneath. His face was wrinkled and his almond-shaped eyes thinned when he smiled. His shoulders were sprinkled with dandruff, made worse by his frequent habit of pulling a comb from his suit pocket and combing over any stray (real or imaginary) strands of hair. His name was Malcolm Drabbling (pseudonym), he had Down’s Syndrome and he could talk for England. He talked all the way to Northampton and all of the way back again. He had many teeth missing (so much for the hospital dentist) and his speech wasn’t easy to understand but once you were tuned into him it got easier and he certainly didn’t let it stop him talking.  Later I found out that he had dentures but didn’t like wearing them, preferring instead to ‘gum’ his food making meal times fairly hit and miss (as his messy clothes testified).

Despite intermittent rain, the day trip was good. We broke into small groups went on rides, played in the park and ate our packed lunches. Malcolm was like a child and an adult at the same time. He laughed frequently and easily but was very serious with his things; the comb went back into the pocket every time, the mac was folded on his arm when he was warm, the wrappers from lunch were placed carefully in the bin. It was a good day but a tiring one, and by the end of it everyone was more than ready for home.

After the trip, we continued to visit Cell Barnes on a weekly basis. Each Friday, when I arrived, Malcolm would run towards me, mac flapping open, arms flailing widely at his sides, mouthing hello. The dandruff laden hugs were bearable to see him so happy. Visiting time passed easily; we went in groups to the canteen or workshops or walked in the grounds. One day Malcolm showed me his most treasured possession, a sports hold all in which was a boxed Mr Kipling sponge, a present he said, from his parents. One of the nurses told me they hadn’t visited or been in touch for a several years, the sponge cake appeared to be all he had to remember them by and he treated it accordingly, with absolute reverence.  

Like many patients at Cell Barnes, Malcolm had little contact with the outside world and a limited understanding of it. He was cared for, fed and safe albeit as one of many. He and the other patients, many of whom were highly dependent, were well away from the public consciousness. When Cell Barnes closed, the more able patients like Malcolm were transferred to small community homes and both they and the communities they went to live in had to adapt to a whole new way of living. The secret world of the hospital for ‘Mental Defectives’ became very public and for some that was a difficult adaptation to make, staff, patients and public alike.  

For me the visits to Cell Barnes were an intriguing insight into a whole new world, the world of hospitals smells, sights and sounds although it was the job that the nurses did that really caught my eye. I was 17 and hooked, I just didn’t know it yet. 

It is to my lasting regret that I stopped visiting Malcolm a year later when I left school, but I have him (and my lack of athleticism) to thank for starting me on a journey which has continued to this day. Thanks Malcolm.

Setting out my stall

It's true. The last thirty years of healthcare in the UK have seen such changes, at such speed, as to make healthcare today almost unrecognisable from that of the late '70s. Gone are the well scrubbed Nightingale wards, the frilly caps and the deference to doctor. Gone are the convalescent patients pushing the tea trolley round, the weekend cleaning rota and the orange rubber enema tubing. But whilst many lament their passing (well, perhaps not the enema tubing), it is wrong to look back with rose tinted glasses, especially when most of us who were (almost) there now have the kind of middle-aged long vision that requires a level of clarity and detail that only clear glass (preferably with some magnification) can give. The trouble with rose tinted glass is that it has a habit of obscuring the finer detail of the picture, as indeed does the passage of time. That being the case, now, in this my 30th year of being a qualified nurse, seems a good time to tell my version of events, before time, memory and eyesight fail to do them justice.

So why bother? Because, I believe this period of time will come to be seen as a hugely  important one in the development of UK nursing history. The pace of change, the economic pressure, the public's expectations, the (constant) political interference, the nursing shortages and the relentless advance of medical science are all contributing to a pressure cooker environment in healthcare and I am not alone in fearing the periodic blasts of steam we have seen escaping in recent years (witness Francis, Berwick, Keogh) are only scorching portents of things to come.

Whatever happens in the next few decades, it will be important to understand why, to make sense of it and to learn from it. What I want to do is glance over the shoulder of the profession to an earlier time when the pace was altogether different. In other words, get some perspective on where the profession was in-order to understand where it is now. Perhaps through the re-telling of my story (and the stories of others) I can do something toward defining the healthcare landscape which moulded my generation of nurses and those that came afterwards. After all, we are the ones who have seen nursing rudely shunted into the 21st century and it is we (in education, research and practice) who have to take responsibility for safely navigating the profession through what in my opinion is the most difficult time it has ever experienced.

I'm sure somebody famous has already said that the answers to the future lie in the past, so my first recollection, to be posted in a few days, starts way back in the day, just as the last patient pushed tea trolley rattles off into the rose tinted sunset.