Grateful thanks to Sylva for submitting his vivid and fascinating recollections of nursing life.
In front of me is my first pay note with a commencement date March 3rd 1959 and a take home amount of £2:18:11 (old money) for one weeks work as a male Cadet mental nurse.
I became a student in July of the same year on my 18th birthday, (not in Wakefield.) and completed my three years training in 1962.
Following on from army service, my father started his Mental nurse training and was already a Charge nurse, my mother untrained (became Enrolled by default.) and my brother a Staff nurse at the time I started my own training. The majority of all grades of staff were employed from the surrounding villages.
The recent article (Lindsay Pantry) in the Wakefield Express has prompted me to put ‘pen to paper’ some memory notes without any specific story line, or categorisation.
If I am to make notations of social history in a specific area, for example Coal Mines, Fishing Industry, Acute General Hospitals etc then it is imperative to give some indication regarding the way of life and level of technology outside the subject matter, because invariably the two develop in tandem in a generational time scale.
In the 1950’s life was relatively simple with lots of bicycles and fewer cars. Mining industry was flourishing, not everyone had a television but most had a valve radio. Washing machines, fridges, gas and electric ovens were ‘thin on the ground’, no fitted carpets and an electric vac or home telephone would be considered luxury.
No such commodity as the two way light dimmer, no modern bathroom appliances and yet it was quite common to have an outside toilet with normal chain pull flush. Open coal fires were commonly found in most households and the sight of the coal man was a very welcome visitor. There was a seemingly decent public transport bus service (bus conductor) with the private sector fulfilling the need of the workers at the factories and mines.
As young children and teenagers, we devised our own outdoor play pursuits and sometimes this bordered on being mischievous. Clothing in families were usually handed down and altered by hand where applicable, and holes in socks were darned by your mother as was the making of clippie mats.
Whether it was private, or council owned property everyone tended to their gardens with neat bordered lawns at the front and vegetable plots at the rear. Children from council housing mixed equally well with private housing children as did their parents. We did not have school uniform, yet all children went to school neat and tidy with polished footwear.
If you walked about with hands in your trouser pockets, my mother would simply sew them together until you stopped the habit. Swearing and really bad language—-I never knew what it was like to hear this uttered.
From an illness point of view there was of course your local village doctor whose surgery was an open house with no appointment system, you simply walked into the waiting room and asked someone who was the last person in, consequently you then knew when it was your turn to see the doctor. At that time, the local cinema had two projectors which were illuminated inside the casing not by a powerful lamp bulb, but by two carbon rods.
My interview for RMN training.
Following a psychology test involving written and verbal questions (stop watch timing) I have a further interview with a tutor and Chief Male Nurse, subsequently I am told that I can initially start as a cadet nurse working in the Medical/ records office until I reach 18years of age when I will formerly commence RMN training.
Uniform—-Good quality made to measure navy blue suit with waistcoat and two pairs of trousers plus a trilby hat which had to be carried in one hand when moving a deceased body from a ward to the mortuary.
Wages, these were paid every Thursday in cash, with a facility to nominate a colleague to collect on your behalf.
Day Shift pattern was an alternative week of mornings then a week of afternoons.
Hours of duty were (6am to 2pm and 2pm to 10pm with night duty 10pm to 6am)
One day off per week set in rotational fashion, Monday one week, then Tuesday the following week and so on.
Holidays were something you did not request, they were given you.
At my early age the hospital viewed from the outside was very elegant indeed with its litter free grounds, immaculate cricket/sports area, and an abundance of flower beds provided by the hospital gardens, which would have equalled today’s Garden Centres,(A limited supply of allotments were provided and offered to any staff member group).
Wherever you viewed ‘looked lived in’ with freshly painted woodwork and neat curtains where applicable, for there were in many areas, wooden shutters which replaced curtains as a safety measure.
Male and Female patients were physically segregated and separately managed with a Chief Male Nurse responsible for the male side of the hospital and a Matron for the female side. Often the male and female nursing staff came from the same family.
For all intents and purposes the area covered by the hospital and its ‘workings’ were akin to being a small self contained village, for indeed there was a church/chapel and its own choir (hospital staff.).
All the artisan workforce were permanently employed as staff members, so you had plumbers/boiler men/electricians/joiners/painters and decorators/ fire officer/seamstresses/ gardeners/shoe repairer/porters/ hospital laundry.
The admin side of hospital life was governed by a ‘Hospital Secretary’ with the overall responsibility taken by the Medical Superintendent and Hospital Management Committee.
Residential quarters were supplied to single nursing staff, married nursing staff (houses) Medical staff, Head gardener, Hospital Secretary, Chief boiler house/engineer/Fire Officer (small emergency fire tender on permanent standby with trained rotational duty volunteers from the male nursing staff).
The staff canteen was a single storey stone building that actually segregated nursing staff from all other staff in respective dining rooms. In the nursing dining room there were tables set with table cloths and cutlery for resident staff and a waitress service.
Staff Social Club, this was a flourishing area for developing community spirit and gossip.
Nurse Training School:
This depended on periods of block training in the classroom, visits to other mental hospitals and ward based learning in different category wards. The tutors always gave the students an insight in to the previous generations of life in a hospital asylum, with its associated available treatments in comparison with the 1959 era, for example pre frontal leucotomy, or Deep Insulin Therapy to name two, whilst nursing staff were called Attendants. As nursing students we were told that all aspects of mental health treatments in each new generation always looked back with disdain at the previous one, and thought the present was more ideal and humane.
I always remembered this ruling, and it is perfectly true, so sometimes when articles are written and illustrated with macabre methods of mental health treatments 200 years previous, then the article should also portray general life as is was on a day to day basis.
My first placement on a ward was a little frightening to say the least, even though my father had tried to prepare me for the unexpected.
It was known as a locked ward (some wards were unlocked and others locked) and I remember the Charge Nurse who was physically built like an outhouse (not uncommon) taking me into his office and giving me a talk on basic points:
Never ever leave a key in a lock and always keep it secured to a chain.
Never lend a key to a patient (some patients will tell you the other shift do so.)
Always when unlocking a door to leave the ward turn to face the room.
Never show fear.
Never run to a fight, take stock of the situation and wait for assistance, because some patients were deemed clever enough to stage the fight to cause a distraction whilst the key is wrenched from your person.
Fire regulations and precautions were literally ‘drummed in to you’.
Suicidal Caution Card (SCC) The Charge Nurse went to great lengths to explain the fact that even though every duty shift had one designated member of staff with special responsibilities for a named suicidal patient it was every member of staff’s business to be equally vigilant. The SSC card had to be signed at the beginning and end of each shift at ‘handover’.
Self defence training did not exist but there were certain members of staff who would demonstrate safe restraint techniques.
The Charge Nurse then said that he was giving me a ‘minder’ until at such times I gained confidence, he then proceeded to take a pack of five Woodbines out of a locked cupboard and shouted out the name Boris, and at that another very physically proportioned person appeared in the door way (not staff.) and the patient was given the Woodbines and told to look after this boy, (me). I cannot pretend that I was not frightened because I was, but I was to become eternally grateful for this particular Charge Nurse’s introduction and the ‘Minder’ who never left my side when on duty and even though his English was poor, his signs and gestures spoke volumes.
It has to be remembered that a locked ward contained some very unpredictable personalities prone to outbursts of violent behaviour and who would be a danger to the public if ever escaped. Also this collection of Paranoia persons in one locked environment required some special qualities of staff members who always had to be seen as dominant group leaders.
In reality the nursing care philosophy given in nurse training, whilst been good in theory and for exams, was no match whatsoever for the hands on experience gained from real life situations on the wards.
The fact that I started my training in the deep end was a brilliant confidence booster for the remainder of my training and ‘stood me in good stead’ on many occasions.
Other wards in the hospital were a mixture of patient categories and numbers except for the admission/treatment unit which had a specific function.
When I was allocated this unit for a period of training you had to learn some extra observational skills and after care nursing of patients undergoing Electroconvulsive Therapy (straight and modified).
It was in this unit that I first saw a fixed steel bath in the centre of a single bathroom with water jets on either side, the Charge Nurse told me that the bath was originally used for violent or agitated patients as method of physical control. The patient (male or female) would be placed in the bath, forcibly if necessary, and a wooden lid with neck opening placed over the patient/bath and held down by nursing staff, at which point the jets would open to release COLD water.
In general, some of the long stay wards, housed patients who had almost grown up from boy to man and this had become their home. It was unfortunate in many ways that given adequate support and accommodation some patients would indeed have benefited from living in the community. The lack of single room accommodation was also a drawback to give identity and personal living space to some patients who would have valued the opportunity to live normal. This was indeed recognised by all senior nursing staff but the implementing of such a scheme would have enormous repercussions on cost as at that time they had just built a brand new nurse’s home and refurbished another after many years of debate. The nearest I can remember that closely resembled community care, was when a patient was discharged and allowed a room on a ward to ‘live in’ and being full time employed on the gardening team.
Parole was given in two stages, one was not to leave the hospital grounds, and the second group were allowed to visit the local village. I do not recall any problems at all except for their habit of picking up ‘tab ends’ but perhaps it is worth mentioning that the local organist for the Catholic Church was in fact a long stay patient.
The hospital housed app 2000 patients at any one time, and to cater for their individual needs required a dedicated army of all staff grades and departments to do so.
Some wards contained upwards of 70 patients, and were normally housed with the ground floor for the dayroom, ward kitchen, Charge Nurse’s office, store rooms etc and the upper floor being the dormitory area.
Within different hospital departments (including wards) male and female patients were ‘employed’ as proficient and semi proficient labour force for a monetary payment (I am unclear regarding how this actually worked).
As I have already indicated, the hospital deemed itself to be almost self sufficient which included the following supporting services:
Shop and tea bar.
Cobblers for leather shoe repairs.
Hospital kitchen (patient meals were very substantial)
The dayrooms and dormitories which had an almost universal colour scheme of creams, greens and browns, were generally kept very clean, with the industrial heavy duty linoleum flooring buffed to a soft sheen.
From a recreational viewpoint there were some definite positives, such as snooker tables, organised dances, cinema, cricket & football, walking parties over nearby rural areas.
Visiting hours were restricted to Sat and Sun afternoons which were held in a very large dining room with a centre separation corridor to divide female and male patients and their visitors.
There were two long tables for a charge nurse and a ward sister to receive visitors who had to show the staff a visitor’s card which was duly recorded in a visitors’ ledger. A junior member of nursing staff would then go to the respective ward and escort the patient (each had a biscuit tin) back to the visiting room where visitors would fill the tin with sweets and cakes.
Other members of nursing staff would remain in the visitor’s area to quell any fights, which did happen fairly frequently.
Sickness among patients was a normal process, and a ‘sick ward’ was used to accommodate none life threatening illnesses. However deaths did occur and these were treated with dignity, for example when a person died and a doctor certified death, two male student nurses would be despatched to the mortuary to collect a polished wood large wheeled hand trolley called a bier to which was added a coffin, this was then wheeled through the hospital grounds where the empty coffin would be taken to the ward for the deceased to be placed in the box. On the return journey a large black cloth sheet was draped over the coffin, and each staff member would be carrying a trilby hat by their side.
Whilst I enjoyed my mental nurse training some fifty years ago, it was refreshing to realise that even then, thoughts of improving future quality of care was mooted, even by the most senior nursing staff and it would be true to say I never once witnessed patient cruelty by any member of staff. Incidentally one unusual feature of staff promotion, was that to become a charge nurse you had to wait in line for a staff death or retirement, so for example when my father died, the next most senior staff nurse was promoted to Charge Nurse without any competitive interviewing.
From a positive aspect, the beginning of a new era of pharmacological drugs were seen to be a major force in the treatment of mental illness and together with the publication of the1959Mental Act hopes for a better future were high.
On the down side, it must be said that for the vast majority of patients there was a very distinct lack of privacy and individual choice.
1/ all dormitories were very sparse with row upon row of black tubular steel beds, white counterpanes and one pillow, NO bed side lockers were provided so when patients undressed, their clothes were folded in a bundle and placed on the floor underneath the bed. Chamber pots had just been removed. There was once an incident where a male patient did ‘hang himself’ and died whilst still in bed (admission ward) and a full investigation followed with two members of nursing staff severely reprimanded. The tubular head frames were quite high and he used his own tie to form a noose attached round his neck and the free end tied to a bed head rail then his own body became a dead weight which resulted in asphyxiation.
2/ clean shirt day was a system where all patients were asked to remove their shirts and they were handed out a clean replacement to the nearest fit.
3/The ten head shower room was a communal area, with the availability of perhaps one single bath.
4/ Wet shaving 60-70 patients was sometimes a nightmare, In the dayroom long trestle type tables were set up with each member of staff given a bowl of warm to hot water, one razor with one blade, and a towel. A small table on the left side was set up with a trustee patient acting as ‘latherer’ and a similar table was set up on the right side with towel and roll of toilet tissue manned by another trustee. The patients lined up in front of the ‘latherer’ who very quickly commenced lathering while the staff commenced shaving and the patient went to the small right table to repair any small bleeding skin cuts.
Restraint issues: Side rooms, padded rooms, restraining harnesses, padded helmets should not be really seen as draconian treatment measures, for in the absence of large numbers of staff to physically contain a prolonged violent outburst or an issue of self harm, the use of other physical measures were deemed necessary to prevent harm to the patient in an era when selective medication was not available.