Final Year Read online

  Barlow blushed hotly, and twisted her fingers in front of her apron. “Yes Sister. No Sister,” she mumbled. “I’m sorry, Sister.”

  My heart sank, Sister was obviously mad about something in spite of her cuffs being on. She wouldn’t have turned on Barlow otherwise. I hoped it was nothing I’d done -

  “Now, Nurse Gardner,” she turned her icy gaze on to me. “I want to speak to you in my office. Nurse Barlow can carry on alone for a moment.”

  She rustled down the ward, and I followed her, my knees shaking. It must be pretty bad if she couldn’t tell me about it in the ward. The office was only used for really hefty reprimands.

  “Sit down, Nurse.” Sister settled herself behind the small desk in her cubby hole of an office. “Last night, I told you that the wife of the patient in Bed One was in the side ward, did I not?”

  “Yes Sister,” I was puzzled.

  “You must surely realize, Nurse, that a patient’s relative only stays overnight if that patient is very ill. Yet, I came on duty this morning to find that this poor girl had been alone all night in that side ward, without so much as a visit from you. She was in a state of terror when I spoke to her. She thought that her husband was so ill that no one had had the time to come and see her and tell her how he was. She was too frightened to come out to find a nurse to ask about him, so there she remained all night. What have you to say about this?”

  She was right, of course. I should have gone in to see Mrs Bright more than once, but quite honestly, I had forgotten all about her. “I did go once, Sister,” I said shamefacedly. “But she was asleep - “

  “Possibly she was, Nurse. The poor thing was exhausted. But one visit was not enough. You have as much of a duty towards your patients’ relatives as you have towards them, you know. Your theoretical work is excellent, Nurse - I have never found a single chart that was not satisfactory after you have been on duty, and you have never omitted a single part of any patient’s treatment. But you need more than that if you are to be a good nurse. A little more thought for the patient’s feelings - a little compassion - is worth infinitely more than any amount of correct charting.”

  I sat dumbly looking at my hands clasped on my apron. I had been told about this sort of thing before. There was the time I had not noticed a patient in tears, the time a child had refused flatly to let me give him injection because I “never told stories. I like the one who makes me laugh, even if she does hurt me a little bit.”

  Sister got to her feet. “I will say no more about this episode, Nurse. But remember - I don’t want to think I have left my patients in the care of a heartless chart expert. Patients are people, and they must be treated as such. And they are frightened people, at that.”

  I stood up too, smoothing my apron in front of me. “Yes, Sister. I’m sorry I forgot Mrs Bright, but - “

  “No excuse, Nurse.” She pulled her cape firmly round her angular shoulders. “Just remember what I have said. There is more to being a good nurse than having the necessary knowledge. Good night. I hope you have a quiet one,” and she smiled, softening her usually grim face to a fleeting prettiness. “Night duty is hell, isn’t it?” and she was gone.

  I followed her out into the corridor, and stood for a moment looking after her. Then I turned, and looked down the big ward.

  Some of the bed lights were out, the patients already lying tucked beneath the bedclothes. But most of the white covered beds still lay in a pool of light, the men in them propped up against their pillows as they drank the last drops of their cocoa. Barlow was standing beside Bed Seven, her hands tucked into her apron bib, talking softly to the young man who looked up at her, his eyes bright with pleasure. A man in a dressing gown was walking slowly down the ward, making a list of the men who wanted to join in the sweepstake on next Saturday’s big race. Altogether, the ward looked warm, and friendly, and peaceful. Safe. And it was all I wanted. A ward of my own, where I would be the Sister, wearing the gold medal on my apron bib -

  “And I can’t have that without knowledge. Compassion is important, I know, but I must have the theory right - “ I said aloud.

  “Of course you must. Who says otherwise?”

  I turned sharply, to look up into the vivid blue eyes of Peter Chester. His burnished head leaned towards me in a way that made my throat contract, and his thin mouth smiled gently at my obvious confusion.

  “Who says otherwise?” he repeated.

  “Sister.” I was finding it difficult to control my voice. How could any man be so disturbing? “She - she - well, I forgot to look after Mrs Bright properly - the wife of the man who was in Bed One yesterday. She was in the side ward, and I only visited her once. So, Sister obviously thinks I’m a heartless monster, because she told me I lacked compassion.” I bit my lip. “I suppose she’s right,” I said, trying to be honest. “But - “

  “Nonsense,” Peter was bracing. “My dear girl, you were much too busy looking after your patients to worry about healthy relatives. Tell Sister from me that she’s talking through her frilly cap.”

  I was dubious. “I don’t know, Mr Chester. After all, I did spend a long time talking to you. I should have found time for Mrs Bright. The poor girl was terrified, Sister said.”

  “My friends call me Peter.” He took my elbow in a firm grip, and walked me towards the desk in the ward. “Look, Avril - may I call you Avril?”

  I nodded dumbly, wondering idiotically how he had managed to find out my Christian name, and thinking how wonderful it sounded when he said it in his deep warm voice.

  “Well, Avril, the time you spent talking to me was of value. You learned something about the diseases you are nursing, and knowledge saves lives when compassion only weeps over death. If I was ill, I’d much rather be nursed by someone like you, than by a nit like that girl on female surg. tonight.”

  “Oh, you mean Joanna Jennings.” I pulled the report book to the front of the desk. “Poor Joanna. She doesn’t know a bone from a muscle, but she’s the kindest girl there is, and so gentle. When we worked together on Kids, the little ones loved her. She told them stories - “

  Peter perched on the edge of the desk, watching Barlow settle the last of the men before she put the lights out.

  “Then she ought to be a Nanny, not a hospital nurse. Girls like that are no doubt delightful creatures. But they can be a positive menace if they’re faced with a ward emergency that needs real knowledge if it isn’t to turn into a catastrophe.” He leaned over and looked at me searchingly.

  “Don’t fall for all this sentimental nonsense, Avril. A hospital is a battlefield, and disease is one hell of an enemy. No one ever won a war with sympathy. And doctors and nurses have careers to think about just like lawyers or actresses. Don’t try to copy the Joannas of this world, my dear. You’re fine - just fine, as you are.” He touched my face fleetingly, leaving the spot his fingers had touched burning as though it had been set on fire.

  I looked down at the desk, blushing scarlet.

  “Thank you - Peter,” I said, stumbling a little over his name. “You’re awfully good for me. Sometimes I think that perhaps I’m too interested in theory - too ambitious - “

  “Not a bit of it. Nursing needs girls like you, not girls like Joanna Jennings. The only comfort is she’ll probably fail her exams, and hospitals will be spared the services of a sympathetic compassionate - ninny.”

  He became brisk, and pulled a book from the pocket of his white coat. “Now, you’ve got an exam in the morning, haven’t you? What do you want to revise?”

  I plunged into our question and answer session with alacrity. The ward was quiet, and I knew Barlow would cope. I pushed the memory of Day Sister’s sharp blue gaze into the back of my mind, together with the shame I had felt when she told me about Mrs Bright, and tried to concentrate on working with Peter, for the next morning’s important exam.

  But even as I tried to concentrate, tried to focus all my attention on to the book Peter was showing me, I found my attention slipping. I
was acutely aware of his body so close to mine. I could feel my heart beating thickly under my apron, and I wondered foolishly if my perfume was bothering him, or whether he had noticed my make-up.

  Suddenly, Barlow appeared from the shadows to stand beside the desk.

  “Nurse Gardner,” her voice was frightened. “Mr Jeffries - the appendix from this morning. He’s breathing oddly. Will you come and see him, please?”

  I pushed my chair back, and hurried over to Bed One, pulling my torch from my pocket as I went. Mr Jeffries was lying back on his pillows, his head thrown back, gulping air as though his very life depended on getting it. Almost without thinking, I pulled the pillows from under his head. “Barlow,” I said urgently. “Bed blocks, quickly. And call Night Sister and tell her to warn theatre. This man’s bleeding. Quickly.”

  As I pulled back the bedclothes to tighten the many-tailed bandage that held the dressing in place over the wound, Peter took Mr Jeffries’ pulse. Then he disappeared towards the phone. I pulled the bandage as firmly as I could - anything that would slow the bleeding would help -

  I was frightened. I knew how rare it was for an artery to slip its tie after a simple appendicectomy, but I knew it could happen, as it obviously had here. I checked his pulse again, and then Barlow and I tipped the foot of the bed up on to the big wooden blocks Barlow had dragged from the locker.

  Peter was back. “Porter’s on his way. I’m going to scrub. Get him to theatre as fast as you can,” and he ran away down the ward, almost sliding through the door in his hurry.

  Mr Jeffries was desperately pale, almost green from the lack of blood in his cheeks. The trolley trundled softly to the bedside and the porters and I lifted him on to it, as gently as we could. With a quick word to Barlow, telling her to stay in the ward, I grabbed a mask from the jar by the washbasin at the door, and hurried alongside the trolley out to the lift, holding the wrist of the man moving restlessly on it, feeling the thready rapid pulse fluttering under my fingers. He was still dopy from his anaesthetic, which was just as well, I told myself grimly. I only hoped he would live to wake up from his next anaesthetic.

  We took him straight into theatre, bypassing the anaesthetic room. Chick raised an admonitory eyebrow at me over the needle she was threading, because I hadn’t stopped to put on a theatre cap and gown.

  “I did damn well to get a mask on, Ducky,” I murmured, as I rapidly arranged Mr Jeffries on the table, tucking his hands under the binder that lay across it. The anaesthetist was already holding a mask over the man’s face - no time for Pentothal - as I undid the bandage I had fastened so firmly in the ward.

  Under the dressing, the abdomen was taut and swollen, the sutures bulging and straining against the pressure of free blood in the peritoneal cavity.

  Peter came up to the table, his gloves dripping from their immersion in a bowl of saline. He hardly seemed to see me as I stepped back, and he took my place beside the now anaesthetized patient.

  I went to the door of the theatre, very aware of my uncovered head, and lack of a gown. As I looked back, I saw Peter cut the stitches, and watched the terrifying red pool that spread over the green towels Chick had hastily clipped into place. I heard the sucker gurgling as it tried to clear the blood that was filling the abdomen, obscuring the bleeding point - the point Peter would have to find very quickly if the man was to live.

  The darkened quiet of the ward came as a shock after the brightly lit tension of the theatre. Barlow’s scared face peered at me from the desk where she was sitting, obviously sick with fear in case something else should happen while she was alone in the ward.

  “Will he be all right, Nurse?” she asked anxiously.

  “I don’t know yet,” I said soberly. “I hope so. But he must have bled a lot. Get his bed ready quickly, will you? Blocks, a drip stand, electric blanket - you know, don’t you? I must see about getting some blood for him.”

  As I hurried to the phone, Night Sister came bustling into the ward.

  “Ah, Nurse Gardner,” she said, panting a little from her run up the stairs. “Has the man gone to theatre yet?”

  I nodded. “I took him myself. They’ve started.”

  “Good girl. Nurse McLean was already set up for an emergency laparotomy from Gynae., thank the Lord. Quick as she is, she couldn’t have had the theatre ready for this in under ten minutes otherwise.” She nodded her grey head happily. “You got him to the table within ten minutes of noticing his condition, Nurse. You’re a good girl. Was the poor man very upset?”

  “I hadn’t time to notice, Sister.” I was nettled. Was everyone hell bent on reminding me about being careful of the patients’ feelings? “It was more important to get him to the theatre fast, than to worry about that. And he was still woozy from his anaesthetic and post-op. morphine anyway.”

  Sister peered at me above her glasses. “Well, well, my dear. I wasn’t criticizing, you know - just asking. You’ve done very well. No need to get cross, is there?”

  I was contrite. “I’m sorry, Sister. I’m a bit tense, I suppose. I’m just going to see about some blood for Mr Jeffries. He’ll be sure to need it.”

  “Away with you, then. You young things have a stronger sense of urgency than an old woman like me. I’ll do the round with little Barlow. I do hope the boy with the head injuries has made up his quarrel with his wife. I must ask Barlow. She’s on good terms with the poor young man.” She waddled away down the ward, putting her hand on Barlow’s shoulder in a motherly way as the younger girl came to meet her.

  As I phoned the technician on night call for the Path. Lab., I smiled a little, thinking about old Ma’s kind-hearted inquisitiveness about the patients’ private lives. She had been Night Sister at the Royal for longer than any of us could remember, and she had mothered more patients and nurses over the years than anyone could possibly count. Dear old Ma. No use in an emergency, but nice to have around for all that.

  I ordered a bottle of blood to sent straight to the theatre, grateful for the routine policy of cross matching blood for all surgical cases. It was a one in a thousand chance that a straightforward appendix would ever need a transfusion, but Mr Jeffries was the one in a thousand.

  It was more than an hour later when I heard the lift gates rattle open, and saw the theatre trolley appear at the door of the ward. Chick was at the head of it, a bottle of blood held high in her hand, as the transfusion went on running, her gown splashed ominously with a broad red stain, her mask dangling under her chin.

  As we lifted Mr Jeffries into bed, Chick hung the bottle on the drip stand that stood ready.

  “Appendicular artery had slipped its tie,” she murmured. “It was a near thing. But I think he’ll do. Another ten minutes and I’m not so sure.” She pulled her mask off, and swung it gently from her little finger. “You did well, Avril. Chester told the anaesthetist you were a treasure.”

  I kept my head bent over Mr Jeffries as I took his blood pressure.

  “Did he?” I mumbled, as I took the stethoscope from my ears and entered the reading on the chart I had prepared.

  Chick looked at me quizzically. “You’re a bloody marvel as far as he’s concerned. He was just asking my runner to ring the lab. for some blood, when the lab. boy appeared at the door with it and said you’d asked for it. You think of everything, sweetie. Our blond beast will be trying to cut poor old Dickon out, I’m thinking.” She shook her head sharply. “I must go. I left my poor junior mopping up the gore to get ready for an emergency from Gynae. I haven’t a hope in hell of swotting for the morning.” She grinned at me lopsidedly.

  “Tell you what, hon. Make me a crib. List the quarantines of the specific fevers on a bit of rice paper for me, and I’ll eat it after I’ve copied out the gen. The Pawn will think I’m a miracle, too, then, and she won’t ever be able to prove I’ve cheated.”

  “Get going, screwball,” I laughed and pushed her ample rump towards the door. “I’ve got work to do, too. I’ll try to go over the fevers with you at breakfast.�
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  “If I’m still alive by then,” she whispered back at me over her shoulder. “Hope this lad does O.K. See you.”

  I went back to Mr Jeffries. His face was a little less pale now. The green tinge had disappeared, and he was breathing naturally. I checked his pulse again, and made sure the drip was running freely. “Yes,” I thought with relief. “He’ll make it.”

  I sent Barlow to her meal, and asked her to bring back a sandwich for me. She was palpably relieved. The last thing she wanted was to be left holding the fort while I went to the dining room.

  I did a round of the ward, settling and reassuring the men who had wakened because of the bustle round Bed One. I gave the head injuries patient a bottle, a glass of water to the boy in Bed Seven - who was clearly disappointed that I wasn’t Barlow - and a couple of codeine to the man who had had his varicose veins tied. Then I returned to Mr Jeffries, and settled myself in a chair beside him, a textbook on medicine on my lap. I listened to his breathing with one ear while I learned dosages of digitalis, and tried not to wonder whether Peter would come back.

  The screen behind me opened with a soft sound, and I turned hopefully to see who had come. Dickon was standing looking at me.

  “Only me, Avril,” he whispered. “What’s up? Had a panic?”

  I nodded. “Post appendix, slipped an artery tie. It was a bit of a rush.”

  He smiled. “And I’m sure you coped beautifully. Look, I won’t hang around. I just want to write up some notes. Charts on the desk?”

  “Help yourself, Dickon.” I started to take Mr Jeffries’ blood pressure again. I heard the screen move, but as I closed the sphyg., and turned to chart the improved reading, Dickon was still standing there in the shadows.

  “Have coffee with me, Avril, in the morning? I’m off till one.”

  Almost without thinking, I shook my head. “Not tomorrow, Dickon - I mean this morning. I’ll be too tired after the exam to do anything but fall into bed. Do you mind?”