The Apprentice

What’s happening?

Much bruhaha about nursing and nurses is flying around in the Twittersphere at the moment:

• Some believe that a degree in nursing is the only safe way forward because ‘ordinary’ nurses may not know “how to access/interpret/implement research”. I didn’t make that bit up – someone actually put that in a Tweet to me. Perhaps they haven’t realised it yet, but nurses managed to nurse – and quite well actually – before the concept of a degree in nursing was even born
• Organisations are exploring ways to fill nurse vacancies, and unfortunately it seems to be with the ‘cheaper alternatives’ such as nurse associates
• The sensible folk are exploring alternative (to the degree) routes into a nursing career

I suspect that when it all comes out in the wash, what we will have is a raft of clinicians who have a variety of knowledge, skills and education, all of whom will be happily delivering care at a level they are content with. Perhaps more importanly, they will be delivering the care and compassion that our patients want.

All our yesterdays

Given that nursing is changing, some may say into a role that is not actually nursing, it is perhaps timely to remind ourselves why being a student of the ‘apprentice’ style training (circa 1930-1983), wasn’t so bad. According to tales from those that have gone before us, it was damned hard work, the hours were long, the days off were few, the ward Sisters/Charge Nurses, but mostly Matrons, were tartars whose sole job it was to make your life a misery, you couldn’t get married if you were still training and if as a staff nurse you married, you were immediately put on a 3-month stint of nights, equipment breakages were paid for out of your meagre salary and.. well, the list goes on. But there were good times too:

1. Working split shifts for 6 and a half days in a row, trying to attend lectures in between shifts/sleep, and having only one full day off a month never did me any harm.
2. Being part of the rostered workforce while on placement made you feel part of a team (despite as a first year student, being so low down the pecking order that you had to clean the sluice all day, every day for the first 6 weeks, after which you were promoted to bottle/bedpan rounds, and it was only half-way through your second year you actually realised that those people in beds who stared at you whilst you walked down the ward were patients).
3. You trained at one hospital – ‘your’ hospital. Over your three years of training, you came to know its hospital’s  culture, staff and foibles. You were fiercely proud of it. And you probably still are, even it is now a block of flats for people with Shoreditch Beards and trendy shoes….
4. …which K-Skips weren’t
5. When you passed your SRN (State Registered Nurse) exam you recieved a length of Petersham and a silver buckle (the former from the hospital, the latter from your proud parents/grandparents/dog) to signify that you were indeed a staff nurse and thus capable of running a ward. It also meant that it was compulsory for you to take your coffee/tea break in the ward office with Sister and the other staff nurses. All at the same time. Whether you wanted to or not. No more stuffing doughnuts in the staff canteen.
6. After 6-12 months, were given a hospital badge and in some cases, promoted to Senior Staff Nurse. By this time, Sister will have grudgingly admited that “You may make a half-way decent nurse after all”
7. Such trifles (3-6) always broke the ice at conferences – ‘I trained there too, what set were you in, do you remember Sister Snapdragon?’, and allowed parents/grandparents the opportunity to boast about you to whoever stood still enough to listen.
8. The fact that it was compulsory to live in the nurses home ensured that our moral welfare was never in danger, that the home sister would come marching into our rooms each morning [or evening in the night nurses wing] to make sure we weren’t late for work, and that being allowed an 11pm ‘late-pass’ was a privilege often rescinded because of some minor misdemeanour such as breaking a thermometer)
9. The uniforms were fabulous despite having to spend 2 hours trying to change your half-moon shaped piece of linen into something resembling the Taj Mahal.
10. …K-Skips.
11. You learnt about the process of turning raw sewerage into fresh water (the visit to the treatment plant being the highlight of year 1) and the journey of a cheese sandwich from teeth to… well, the other end, and can still recite the physiological processes involved.
12. You learnt to make a bed; importantly, the type of ‘hospital corner’ used took on a Masonic significance as often they indicated the hospital you trained in. And you still make you own bed using those corners (unless you use fitted sheets of course – clearly not designed by a nurse)
13. You learnt how to cook bland meals for those with ‘gastric ulcers’ and how to boil 40 eggs for the breakfasts at 4.30am because after that you had to start getting patients up, and do the drugs round, and clean the sluice before Sister came on duty. Some learnt the art of buttering mounds of bread and covering with sheets of damp kitchen paper in an attempt to keep them fresh. These lucky few have gone on to have second careers in cricket teas after retirement from nursing.
14. You learnt that while it appeared that Sister was fulfilling every wish of the consultants, actually what she was doing was skilfully managing them while letting them think they were in charge. And when she discussed clinical matters, she held her own because she knew her patients and their conditions inside out, and so was respected, whether she had a degree or not.

However, what is shiningly obvious is that on the whole, we loved it. And perhaps we don’t want it to change because it was fun. You got to  know your patients well. You were part of a caring team and when it all went well, it was great, but when it went a bit wrong, you had the support required. And really, so what if you were shouted out by the night sister because your cap had fallen off during a resuscitation and ‘you don’t look very professional’? You just moaned about her over a snatched coffee and swapped the Cadbury’s for some Exlax… (not really)

+Actually, the sewerage plant I visited has been converted into trendy flats…