Episode 2

Being a student nurse in the 1980s wasn't easy.  Others' memoirs from earlier times (such as Jennifer Worth's 'Call the Midwife') chronicle nursing as a way of life rather than a job with little pay, no time off, rigid hierarchies, rationing of 'late passes' and strict rules - an almost monastic existence.  However there was also a solid support structure with matrons, sister tutors, home sisters and communal meals.  Kings College Hospital in the 1980s thought itself progressive and, though traditional uniforms and hierarchies were still very much in evidence on on the wards, student nurses were free to come and go as they pleased with swipe cards to enter the Nurses' Home out of hours.  The staff canteen served food at meal times but there was no expectation of communal eating - and thus little sense of community. It could be a lonely place at times for a girl like me from a sheltered background with little experience of city life.

I had never really been one for parties.  A life-long struggle with my weight gave me little confidence in such situations and I felt more at home cooking a meal for friends or in small groups of those known to me than out at the student Union Bar (can anyone remember its name?) or trawling London's nightclubs.  Whilst loving the career I had chosen I battled homesickness for a while and often went home to Kent on days off, or to my aunt's house in London where there were 4 young cousins to play with. I was also exhausted for much of the time.  We worked long hours with huge amounts of responsibilty placed upon us and were the lowest of the low in the pecking order.  I underwent a host of medical investigations into my exhaustion for which no cause was found.  I now know that I am dyslexic and that adjusting to new situations can cause extreme tiredness for those with dyslexia (learning new routines and procedures requires and huge amount of effort and a drain on working memory).  The benefit of hindsight!

Two members of our 'set' came from Guernesy (Julie Brouard and Tracy - can anyone remember her surname?) and were Salvation Army members.  They had chosen Kings for its proximity to the William Booth Salvation Army College and Citadel at Denmark Hill. They swapped their nursing uniforms for 'The Army's' navy and maroon outfits on their days off.  For me, joining a local church and becoming involved with the Hospital's Christian Union (CU) made a huge difference.  These provided the sense of community that I found lacking elsewhere and introduced me to other student nurses, physios, medical and dental students who would become lifelong friends.  On Sundays off we often congregated for lunch at 'Auntie Bren's' - a single lady in the church who opened her home to students and other singles - and went for walks in Dulwich Park to work off our extra calories!  The church also provided me with an outlet for musical expression and I became a regular member of the Herne Hill Baptist Church worship band, playing piano and flute and singing my heart out.  Some time later, after we had moved out to private accomodation, my flatmate and I joined one of the church's homegroups - and enjoyed evenings in the home of a retired local surgeon who was a member of the House of Lords!  The CU weekends away to youth centres and campsites cemented the group and my place in it as resident caterer and musician and my homesickness soon resolved as I developed a sense of belonging. My faith also helped to make sense of some of the sadness I saw on a daily basis at work.

Meanwhile, life on the wards continued.  Eight weeks of introductory school - where we learned the basics of nursing care and had increasing contact with clinical areas - was soon finished and I started my first 8 week placement on Ferguson, a Gynaecology ward.  The sisters at Kings wore bottle green uniforms with starched collars and cuffs and Ferguson's glamourous sister (can anyone remember her name?) complemented the green dress with her silver bob and scarlet lipstick!  There were three sorts of patients - women having regular gynae operations such as hysterectomies and repairs of their prolapses, those with gynaecological cancers undergoing radiotherapy in a closed room, and young girls coming in and out for terminations of pregnancy in a six-bedded side ward.  The student nurses were mostly allocated to the main ward and we were judged on how quickly we picked up the medical abbreviations in common use during the nursing handover such as  'The women in bed 12a [never bed 13 for superstition's sake] has had a TAH, BSO and HI' (Total Abdominal Hysterectomy, Bilateral Salpingoophrectomy and Hormone Implants!)

Every patient having gynae surgery was admitted the night before their operation and had a pubic shave and 2 glycerine suppositories as soon as they walked through the door.  Late shifts were very busy, admitting several new patients and undertaking their pre-operative care whilst simultaneously putting the longer stay patients to bed where required, doing any evening dressings and providing for their toilet and hygeine needs.  Working on Ferguson I soon became proficient at giving intramuscular injections.  Every patient had pre-op medication of 'Om and Scop' - Omnopon and Scopolamine - given intramuscularly into the upper outer quandrant of the buttock! I also learned the basics of nursing from working with fellow students.  One evening I learned how to show love and compassion to my patients by watching another student - not much more senior to me - dress a lonely elderly woman's pressure sore then provide a bedpan, give her a wash and change her into a clean nightee, smooth her pillows and tuck her in  with a hug and a kiss.  The student's name was Emma - thank you Emma, wherever you are.

On one such busy late shift we had 7 or 8 new admissions for surgery the following day.  The staff nurse was frazzled - not enough staff and too many patients - and dispensed the newest student nurse (me) to give 2 suppositories to a new patient in preparation for her surgery the following day.  The present NMC rules for administration of medicine had not been invented yet. I had seen suppositories being administered before, but mostly under the sheet and I had not looked too closely at the precise location for penetration.  I was also gloriously naive about my own anatomy, never having examined it at close quarters.  Armed with the suppositories, a  plastic glove and some KY jelly I squared my shoulders and walked towards the patient with an air of confidence that belied my inner anxieties.  It couldn't be too difficult could it?  'Well Mrs. Jones, I have two suppositories for you here that the doctor has ordered.  Please remove your underwear and lie down in the bed on your side'.  Mrs. Jones duly did as asked, though she appeared surprised at such a request - the hierarchy of hospitals in the 80s was such that patients did not question the doctor's orders.  Donning my glove, with a squeeze of jelly and a swift removal of the sheet, I lifted the patient's buttock and popped the suppository in the nearest hole.  'There Mrs. Jones, all done'.

The shift finished at 9.15 pm and I returned for the early shift at 7.15 the following morning.  The staff nurse approached me with an angry face and questioned why I had not administered the suppository last night as she had requested.  My protestations fell on deaf ears and the surgeon was most disgruntled that his patient had not undergone the necessary bowel preparation.  Meanwhile, whilst I was making the beds Mrs. Jones drew me to one side.  She told me she was a nurse and she did not think the suppositories had been meant for her - and that I had put them up the wrong hole.

To be continued!

Starting my memoirs!

As well as thoroughly enjoying the recent BBC series 'Call the Midwife' and having read all of Jennifer Worth's books I have recently been reading other auto-biographical tales from nurses and midwives.  This genre  appears to be fast gaining popularity in the UK and, as midwifery history is one of my favourite subjects, I am somewhat of an addict to such books. Some stories ring true to my own experiences whilst others are very different but they have all caused me to reflect on my career and determine to chronicle the highlights before I am too old to remember them.  Maybe one day they will form a book of their own!

I had wanted to be a nurse as far back as I can remember.  There is a family tradition of caring - nurses, midwives, doctors and occupational therapists span three generations. We had grandparents living with us for most of my childhood and caring for them was part and parcel of life.  Though a Grammar School girl, my strengths pointed to a practical career and so I found myself arriving at the gates of Kings College Hospital London in May 1984 and placing Floppy, my large cuddly teddy, on my bed in the Nurses' Home.

I tentatively explored my new 'home'.  Long corridors of single rooms with 4 shared toilets and baths for one floor.  The open drain from one bathroom ran into the next, so you could watch your neighbour's bath water (and a few half-drowned cockroaches) drain away whilst you lay soaking.  There were no communal areas except a small kitchen with several pints of milk or tins of beans all labelled 'Don't Steal'!  However, there was a Nurses' Sitting Room with a grand piano some distance away above the main door of the hospital and I loved my stolen moments of solitude with Handel and Brahms.  I had studied music at A level and missed the hours spent on the piano each day.

Not yet knowing my fellow students I retired early to bed, to be woken at 5am with the fire alarm.  A sleepless home-sick student had burnt the toast.  Pulling on a old cardigan and a pair of worn espadrilles I followed the crowd down the stairs. A dressing gown and slippers had been on the kit list but I had not anticipated such an immediate need for these!  At the assembly point I tried to blend into the wallpaper as the other 53 new student nurses modelled the entire range of Marks and Spencer's  nightwear.  A few minutes later, as 4 fire engines arrived and handsome firemen flooded the stairwells, a line of nervous young men in suits filed past.  I found out later these were the boyfriends of the pupil nurses who had started their training a few weeks before us - and had already learnt to circumnavigate the rules concerning overnight visitors!

We had been allocated bedrooms in alphabetical order - so Nurses Cooke (me), Challoner, Drewett, Evans, Forshaw and Franklin soon became acquainted.  During our eight weeks of introductory school we were allowed on to the wards at Kings to practice our new-found skills, firstly bed making then, in the second week, bed bathing.  Kate and I arrived on the male surgical ward and were assigned to a middle-aged man who had undergone abdominal surgery 10 days ago.  He was well enough to wash himself but had nobly volunteered to have a full bed bath by the student nurses.  We collected our equipment - a bowl of warm water, towels and flannels.  Carefully copying the method we had learned in the classrooom we worked our way down from his face to his arms, body and legs, soaking, soaping, rinsing and drying.  The time arrived to approach his nether regions. Kate soaped the flannel and handed it to me.  I rinsed the flannel and handed it back to Kate.  The patient watched us with amusement.  Finally Kate picked up the sheet and, looking straight ahead at the wall, gave 'it' a firm scrub.  The patient nearly exploded with alarm and we hurriedly escaped through the curtains with our dignities intact!

Next time.... giving my first suppository to the wrong patient and putting it up the wrong hole.  To be continued!

Granny's Marmalade

Granny lived most of her adult life in Dundee and was famous for her Dundee Marmalade. She was making marmalade on the day that she died - the fruit and the sugar were all weighed out and the jars were ready.  The following day my Mum finished the marmalade in her honour and family members all received a jar at the funeral.  I have a copy of Granny's recipe in her handwriting and I use her old preserving pan.  Seville Oranges have a fairly short season so I adapted this recipe and substituted clementines for Christmas which worked just as well.

GRANNY DUNCAN'S DUNDEE MARMALADE
Preparation Time: 35m  Cooking Time 35 m (These were Granny's times, I think it takes longer!)

3lb seville oranges
3 lemons
3 sweet oranges
6 pints of water
6lb preserving sugar (but granulated sugar is fine)

Wash the fruit, put in a large preserving pan with the water and cover with a lid.  Bring to the boil and cook over a low heat for 1 1/2 hours or until the fruit presses easily.

Weigh the sugar and put it in a low oven to warm, together with your jars (minus lids - the heat will melt the rubber seal).  Boil the lids then leave them to cool separately.  Make sure they are completely dry or the marmalade will go mouldy.

Lift out the fruit and leave to cool.  Reserve the liquid.  Scrape out the fruit from their rinds and separate any pips, putting the fruit (chopped if necessary) into the liquid and the pips into a muslin bag.  Add the muslin bag to the liquid and boil rapidly for 15 minutes.  Meanwhile, finely shred the orange and lemon rinds with a sharp knife (you can do this in a food processor but it won't look so pretty).  Remove the bag, leave it to cool and then squeeze it into the marmalade.

Add the rinds and the warmed sugar and slowly bring back to boiling point (sugar should always be dissolved slowly or it will crystallise).  Boil the marmalade until setting point is reached - about 30-35 minutes. 

What is setting point?  Officially it's 104c with a sugar thermometer.  However, my experience is that thermometers are not always accurate and the pan you use makes a difference.  I use my Mum's easy method - ie the marmalade should turn more syrupy - dip a wooden spoon in the marmalade and hold it high above the pan.  If it runs straight off like water it's not ready yet.  If it forms a slow, sticky drip it's there.  Alternatively see http://www.bakingmad.com/tips/marmalade-making/setting-point

Put into heated, sterlised jars and cover whilst warm.  Pretty labels and lid covers optional!

Granny's Girdle comes into its own

My grandmother was a wonderful woman.  A midwife, a Dundee doctor's wife (and his dispenser), a powerhouse of energy and a model housewife who could clean something to within an inch of its life and remove any stain from anything.  She (Sadie) was one of 10 siblings and had sisters called Beldie, Katie, Maisie, Ovie and Flora.  Most of them lived well into their 90s (and Ovie is still going strong at 90+).  Katie was 102 when she finally popped out to the Chemist and popped her clogs. 

I an proud to have a few of my Granny's things  but two I treasure above the others - her preserving pan and her Girdle.  North of the border this is not a complicated item of underwear but the perfect receptacle for a batch of pancakes. The Girdle comes out on lazy Saturday mornings or days when we find ourselves with a little more time and the chance of a leisurely breakfast.

If you cook up a batch of these, spare a thought for Mrs. Sadie Duncan and the inspiration and love she brought to our lives.

Gluten and Diary Free Breakfast Scotch Pancakes (Drop Scones)

Heat and lightly grease Granny's girdle or a large non-stick frying pan.  Place a large plate and a clean tea towel in a very low oven to keep the pancakes warm as you make them. 

Place the following ingredients in a large bowl or jug:

175g gluten-free self-raising flour (Doves Farm and Asdas are both good)
1 tsp gluten-free baking powder
45g caster sugar
1 egg
200 mls soya milk (or a mixture of soya milk, plain soya yogurt and water)
20g melted sunflower (or other dairy free) margarine

Whisk until there are no lumps but don't over-mix.

Place large tablespoons of pancake mixture onto the girdle, about 4 at a time or however many you have room for.  Turn when the tops are all bubbly and no longer wet (usually about a minute).  Remove to the plate when both sides and golden and keep warm in the clean tea towel.

Serve spread lightly with sunflower margerine and maple syrup (or melt some golden syrup in the microwave so it pours).

Great with a plate of fresh fruit, soya yogurts and fresh coffee :)  Good with bacon and egg too.

For ordinary pancakes just use regular SR flour, dairy milk and butter.

You can make a really big one like Hannah, if you wish!

An old fashioned pudding - my way

Once again today we enjoyed the company of our friend and neighbour, Mr Webley, for Sunday lunch.  Roast lamb, roast potoatoes, beans, baby carrots - and instead of redcurrant jelly we had Blackberry and Apple jelly which was delicious with the lamb (sorry to my veggie friends...)!

It was a drizzly day, perfect for an old fashioned pudding.  I have a bag of apples in the shed from my friend Kerry's garden and the store cupboard provided the rest:

Gluten and Dairy Free Apple Sponge Pudding

'Butter' a pudding dish with sunflower margarine and place a generous layer of apples (peeled and chopped) in the base.  Dot over a few teaspoons of jam or jelly - I used the end of a jar of Damson jam but anything would do.  Or, a generous tablespoon of Demerara sugar with a sprinkling of cinnamon would be good.  Not cinnamon and jam together though, I don't think that would work.

For the sponge, mix together with an electric mixer:

4 oz sunflower (or any diary free) margarine
4 oz caster sugar
2 large free range eggs
4 oz Dove's Farm gluten free self-raising flour
1/2 tsp vanilla extract
1 tsp gluten-free baking powder

Spread the sponge mix over the apples and jam, and bake at 180c for approx 30-40 mins until the top is golden and the cake mix is cooked through.  Serve warm with Alpro Soya Custard or soya cream. 

Yummy!

I do like a challenge.... and I don't like cooking separately

After a spell in hospital last year and six months on high doses of steroids I was feeling lousy and very fat.  Determined to find a sustainable way to lose some weight and regain a sense of health and well-being I gave up gluten and dairy, following advice from several friends who had done so and never looked back.  Ten months on it has been the best decision I have made in a long time (along with giving up full-time work and getting a dog!)  I am 3 stone lighter, much fitter and not really missing much of what I used to eat (when I get the urge for a cheese sandwich some egg mayo on a gluten-free oatcake seems to do the trick!)

I'm not fanatical about it.  I don't think I am truly allergic to those substances - though probably intolerant.  However, if someone gives me a cup of tea with ordinary milk I drink it  - and I eat the bread in communion services!  Generally though, I avoid gluten and dairy where I can.

Tonight my daughter asked for Spaghetti Carbonara - one of her favourite dishes.  Yes, we did have a sachet of Dolmio Carbonara Sauce in the cupboard - but I wanted to keep that for a work-day when I send her round to the neighbour's with her supper in hand.  I don't like cooking two separate meals and I try to eat together as a family where we can.  So I created a version that we could both eat happily and share it with you to tickle your tastebuds if that's your thing:

Cut 4 slices bacon into strips and fry until crispy.  Set aside.

Cook 2 servings of gluten-free spaghetti (I used Morrisons).  Add a handful of frozen peas a few minutes before the end of cooking time (my concession to 5 a day).

Meanwhile, put 2 fresh egg yolks in a large bowl with 1/2 tsp Dijon mustard.  The mustard flavour goes some way to replacing the cheesiness of parmesan.  Add 75mls soya cream (Alpro soy is the best) and about 2 tbsp soya milk.  Try to use unsweetened cream and milk - the cream I used today was sweeter than I would have liked and I will try it with Alpro next time).  Whisk this all together with some seasoning.  Go easy on the salt as the bacon is salty - but lots of pepper is good!

Grate some parmesan cheese for anyone who is eating dairy.  Chop some chives.

When the pasta is cooked, drain and immediately stir into the sauce, leaving for a few minutes for the hot pasta to 'cook' the sauce.  Add in the bacon and chives and put the cheese on the table for anyone who wants it.

Nice :)

Spicy Dairy-Free Mussels with sherry and soya cream

I love mussels but never cook them at home because no one else in the house is that keen.  In fact, before tonight I have never cooked mussels but have eaten them many times in restaurants and seen them cooked on TV and in my sister's kitchen on numerous occasions.

Lingering at the Morrison's fish counter this morning I wanted squid but there was none - then I spied the bag of mussels.  I didn't know what I would do with them but I knew I wanted them!

Tonight, with the rest of the family on a sporting sojourn at the far end of the county I browsed the BBC website for Mussel recipe ideas, then adapted them to create my own.  I have to say they were the BEST mussels I have ever eaten, so share the recipe for you to try for youself.

Heat 1tbsp olive oil in a large pan with a lid.

Finely chop 1/2 large onion, 1 stick celery, 1 clove garlic and 1/2 red chilli and gently saute in the pan until soft.

Meanwhile, clean the mussels (not a difficult job).  Pull off any 'beards' and throw away any mussels that are still open and don't shut when tapped.  Rinse the mussels under cold running water.

Turn the pan up high and add the mussels.  Throw in 1/2 wine glass of dry sherry and put the lid on the pan immediately.  Steam for about 4 minutes until all the mussels are open, shaking the pan periodically.  Add 2 tbsp soya cream, salt, pepper and a handful of chopped coriander and serve in a big bowl with a spoon (for the juice) and a separate bowl for the shells.  Don't eat any mussels that remain closed.

I didn't have anything else with this - no chips, no bread etc - it didn't need it - just used the spoon to consume the yummy 'soup' at the end!