Chapter 7 - Finding Her Stride

The Final Years of Nurses' Training

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“The shows are up, let’s be quick!” Trish nudged Jean and pointed with her chin toward the notice board ahead. Jean and Trish had become good friends, and on the rare occasions they had the same day off they spent the day together. Once a month, the local theatres donated 20 tickets for one of their performances to the students at Alder Hey Hospital. The girls had already gone to see Harry Belafonte perform by signing up for the donated tickets, so each month they eagerly scanned the new offerings. On a bulletin board just inside the dining hall, sign-up sheets appeared once a month with a brief description of the show on offer, and 20 lines below for students to sign up for the tickets. The performance dates had to line up with their evenings off, so it wasn’t always possible to take advantage of the free tickets, it was always exciting to see what was there, nonetheless. On the occasions where the dates aligned, Trish, Jean, and a few of the other girls they had become friendly with rushed to sign their names below their preferred show.

When it worked out, the girls who had tickets to the same show pooled their money together for the evening. Usually, they had just enough to catch the bus into the city, and a shared meal at a Chinese restaurant. There was very little money left over from their meagre student salary after the deduction for their room and board, and they had purchased the few personal items they needed. The staff at the Chinese restaurant had no issue with the girls ordering one large bowl of fried rice, and as many forks as there were girls. It became their “usual” restaurant whenever they had a night out. Nights out were something exciting to anticipate, they broke up the routines of studying and shift work.

There were other distractions to the routine, such as seasonal holidays, or the occasional sporting event. One such event was a field hockey match between the doctors and the nurses from the hospital. In the days leading up to the match, there was a lot of good-natured banter from players on both teams. Trish loved the competitive mood, and she was delighted to take part. The doctors had the advantage of size and strength; they used brute force to get the ball in the net. The nurses were smaller and tried to use their speed and finesse to outplay the doctors. It created a lopsided and amusing match up, and there were shrieks of laughter from both players on the field, and the staff and community members who were watching the rowdy match up. Hospital staff who weren’t on shift that afternoon cheered from the sidelines. People who lived in the houses along the street beside the field watched from their upstairs windows. In the end, the doctors won the match, but they left the field with just as many bruises as the nurses, and spirits were high all around.

The victorious team from the field hockey match!

On the wards, Trish became more confident in her skills and enjoyed the work. As second-year students, Trish and her classmates added a stiff green belt to their uniforms. Besides providing a bit more support to the rolls of extra fabric in her oversized uniform dresses, the belt let other staff know Trish was in her second year. It signaled what she should know and be capable of doing. Third-year students wore a green band on their caps for the same reason.

As she progressed through the training, Trish spent less time cleaning, and more of her time was focused on complex tasks. Sometimes she had to make decisions on her own, even in unusual cases. On one night shift in Casualty, a Chief Inspector from the local “nick”, or police station, came in. He was in great pain and covered in sweat. Alder Hey was a children's hospital, and the Chief Inspector was decidedly not a child.

“I’ve a bad case of indigestion, Nurse. Have you anything for it?”

Despite having no training in the care of adult patients, Trish knew better than to take his self-diagnosis as fact. The Night Sister was nowhere around, so Trish took his temperature, pulse and respirations, or TPR, and did a modified physical assessment. She knew his symptoms could be more serious than indigestion and told him so. His TPR seemed fine, and there was nothing physically that she could find wrong. She sent an aide to the kitchen to fetch some bicarb. The Chief Inspector went off with his dose of bicarb, and Trish spent the rest of the night wondering if she had done the right thing. The following evening, a young constable brought a large bunch of flowers and a basket of fruit into Casualty, a token of gratitude from the Chief Inspector. Trish was relieved to know it had turned out well; it had been weighing on her mind.

By the third year, Trish was pleased to note she liked most of the wards she was assigned to. The kids were great wherever she worked, and she enjoyed interacting with them and caring for them. The exception was the Operating Theatre. Seeing children prepped for surgery troubled Trish. It reduced them to just a body needing repair, rather than active, talkative, kids, full of life. When her class studied the theory components related to the operating theatre in second year, she was already dreading the rotation. Besides learning about the practices and procedures for working “on the theatre” students memorized the names of the basic surgical instruments used in the theatre, what they were for, and the order they needed to be set on the tray to form a “general set”. In the final evaluation, the tools were mixed up on a table and each student had to name each tool and lay them out in the correct order for a general set. It required memory and focus, but it was possible. Trish knew she would completely forget how to lay out a general set the moment the evaluation was over. Fortunately, in the third-year training, just before her rotation in the theatre, students had another opportunity to review the basic procedures for working in the theatre. They also reviewed the general set, as well as some additional surgical instruments they may encounter in their upcoming rotation. Despite her strong wish to avoid it, her rotation in the operating theatres began as scheduled, and to her dismay, it lasted longer than was usual. It carried on for several more weeks than her other rotations, and she didn’t like it one bit.

Despite disliking her time in theatre, Trish found inspiration on two occasions during her rotation when she assisted Miss Isabella Forshall, one of the few female pediatric surgeons of the time. During the war, Miss Forshall was one of the few pediatric surgeons left in Liverpool as most male colleagues had been drafted into the war. She worked tirelessly to serve young patients and advocated for improved post-surgical care. By the time Trish began her studies nearly a decade later, Miss Forshall had gained international recognition for her contributions to pediatric surgery. Seeing a woman excel in a male-dominated field and be acknowledged for it was deeply inspiring.

Trish assisted Miss Forshall and Sister Burns, the Senior Sister in the operating theatres, in two procedures: a cleft lip repair and a cleft palate repair. During both procedures, Miss Forshall sat on a high stool and used a large overhead magnifier as she skillfully created nearly invisible sutures on the small faces in front of her. She produced near-flawless results, like those Trish saw documented in before-and-after photos in Miss Forshall’s office, results would change that child’s experiences in life. Watching her work in each case felt very special, like Trish was observing a true master. From the perspective of a student, the other quality that Trish felt made Miss Forshall special was her kindness to student nurses. She explained what she was doing and why at every step of the procedure.

Other surgeons, though certainly just as skilled, were not kind to students, with some seeming to go out of their way to be unkind. One surgeon, Miss Forshall’s registrar, who clearly had adopted none of his superior’s kind ways, looked Trish square in the eyes as he squirted the remains of a syringe of “plastic skin” down the top of her dress as she held a baby’s head still for him. The liquid skin adhesive was icy cold on her skin, and she couldn’t move away, as she was holding the baby in position. She silently cursed her oversized dress, with its square neck that hid little as it gaped open, leaving her vulnerable to such pranks. She imagined he was smiling behind his mask as he did it.

The next time she encountered him, she was the one with the smile. She noticed he had rather hairy arms, so when she had a syringe of plastic skin in her hand, she gave a quick squirt of it onto his hairy arm. Trish smiled as she did so, thinking about the time he would have to get the adhesive out of the hair. She apologized almost immediately, but didn’t regret doing it. It was all part of the shenanigans that made working “on the theatre” more bearable, especially as her rotation there was more weeks than usual.

Finally, her time on the theatre was done, and Trish had just two more rotations before her third-year training was complete. Her next rotation was the Orthopaedics ward, on the girls’ side, where patients who had orthopaedic surgeries recovered. The young patients had to adjust to restrictions and treatments like traction, casts, and physiotherapy while their bones healed, but Trish was relieved that they were conscious, talkative, and nothing like the sedated bodies that had been so uncomfortable to see in the operating theatres.

Her last rotation was on the Neo-Natal Surgical Unit. Trish very much enjoyed working there. She felt no hesitation when working with the tiny babies, many of them premature or born with complications requiring surgery within 24 hours of birth. They had conditions such as diaphragmatic hernias, oesophageal atresia, spina bifida, or hydrocephalus. Trish found the work to be interesting and varied.

As the end of the three-year long nurses’ training loomed, when Trish and the other soon-to-be graduates weren’t worrying about final exams, and the State Examination, they were thinking about their first jobs as staff nurses. Before the end of her rotation on the Neo-Natal Surgical Unit, Trish was delighted to be offered a staff nurse position, pending her successful completion of the State Examination. She happily accepted the position as she enjoyed her rotation on the unit, and it seemed the Ward Sister had appreciated her efforts. Now the only thing standing between her and the staff nurse position were the school exams, and the State Examination.

The final exams in the Alder Hey nurses’ training were designed to help graduates with revisions by giving them an idea of what might appear on the State Examination. As was her practice, Trish prepared well for the school exams. Nonetheless, she was anxious to learn her results so she could begin revisions for the more intimidating State Examination.

When she woke the morning after the school exams, her marks were the furthest thing from her mind. A rash covered her from head to toe. Home Sister told her to report to Sick Bay, a ward, staffed like any other, where resident nurses and doctors received care when they fell ill. Trish went to Sick Bay as directed. The doctor assessed her, and other than the rash, found nothing wrong with her. Nonetheless, he kept her in Sick Bay, as an undiagnosed rash could not be left free to roam in a Children’s Hospital.

The following day she felt the flush of fever, and rather quickly went from feeling well, save a nasty rash, to being quite ill. The doctor said that she perhaps had German Measles. Even a fan blowing over a bucket of ice to cool her provided no relief. Through the day, the doctor's early diagnosis of German Measles was ruled out; there were no patients with that diagnosis in the hospital. Her joints became swollen and painful until she couldn’t tolerate the weight of even a bedsheet on her body. The new working diagnosis was that she might have Rheumatic Fever. She slipped in and out of awareness over the following days until finally the fever broke. Once the fever subsided, her condition improved quickly.

On her last day in Sick Bay, Trish noticed Sister Burns enter the ward, then walk directly toward the bed she was occupying. Trish’s rotation on the theatres had ended ages ago, and she hadn’t seen Sister Burns since. What on earth could the Senior Sister from the Operating Theatre want with her here? She didn’t have to wait long to find out as, without fuss, Sister Burns asked Trish if she would accept a staff nurse position in the operating theatres after she qualified. Trish couldn't contain her surprise. She realized Sister Burns may have kept her in the theatre for more weeks than usual because she saw something in her. Trish hadn’t thought she was excelling, she was simply gritting her teeth and getting through it. It had been her least favourite rotation. She felt honour to be asked, but relieved she could politely refuse the offer, as she had already accepted the NNSU staff nurse position.

After a week in Sick Bay, Trish was feeling better, and the doctor recommended she return home for three weeks to rest and recover completely. It wasn’t how she had imagined her time as a student at Alder Hey would end, but she was very much looking forward to getting back to work in NNSU. She would continue working as a third-year student, until she passed the State Examination, and applied for registration with the National Nurses’ Registration Board. Only then would she be a “Registered Sick Children's Nurse”, and she just couldn’t wait. But first, she would return to her parents’ home on Crofton Crescent and convalesce for three weeks, as the doctor suggested.

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Author’s note:

We often see our parents through the lens of their roles in our lives— caregivers, disciplinarians, cheerleaders. Perhaps they are our role models or mentors, but who were they before they became these things to us?"

To better understand who my parents were before they were, well, my parents, I set about interviewing them about their lives before marriage and kids. I started with my mom.

Trish Lewis was 18 years old and desperate to escape a mind-numbing administrative job at a factory in Liverpool in the 1950’s. She made the impulsive decision to join a friend to interview for nurse’s aide training at Alder Hey Children’s Hospital. That decision changed the trajectory of her life and launched her into an interesting and rewarding career as a nurse.

Trish is my mom, and this is her story, as told to me in a series of interviews in 2024. The story is pieced together from Mom’s memory, photos, and documents. As we all know, memory is fallible. In the telling of this story, some names have been changed, either because they could not be recalled, or to protect the privacy of the person. The Journey is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.

If you are enjoying this story, you may also enjoy reading my memoir, “Resilience in the Rubble: A True Tale of Aid and Survival in Kashmir”. The book shares my experience as a first-time medical aid worker in Azad Kashmir, Pakistan, after an earthquake devastated the region in 2005. It also tells the story of Nadeem Malik, a local teenager who lived through the earthquake, and his struggle to provide for his family in the aftermath.

The Journey is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.