Sunday marked International Nurses’ Day, chosen in honour of Florence Nightingale’s birthday. Modern nursing has changed dramatically since the 1800s – but some things remain the same.
Six nurses from the Suffolk branch of the Royal College of Nursing spoke to reporter about their experience of nursing through six different decades.
Jenny Janes began her training as a nurse in 1961, aged 18. Now 70 and retired, she has seen the profession change a great deal over the years.
Bernadette Smith, 60, trained as a nurse from 1974 to 1978, starting aged 22. She is now a community school nurse and will be retiring in July.
Nurse Sandra Gover started her training in 1981.
Tracey Risebrow, 42, is an Education Standards lead at Ipswich. She began her training aged 18 and was part of the first cohort of Project 2000 in 1989 – the new theory-based nursing training.
Debbie Simmonds, 54, is a diabetes research nurse. She came to nursing later in life, starting in 2000, aged 42.
Lisa Mickleburgh has just started out on her nursing career, studying for a nursing degree at UCS. For would-be nurses now, training involves a lot more theory and less practical experience – but they all have a lot to learn from each other.
Jenny said: “When I trained, we were paid a salary during our training.
“From the 80s up to now, it was a diploma-level training and you got a bursary and now it’s just moved to an all-graduate profession and you have to get a degree in nursing to qualify as a nurse.
“I got £12 a month, but I had to live in the nurses’ home and all my board and lodging was paid – so £12 was what was left every month and back in 1961 it was a lot of money.
“In the three years that I did, what I had to know about the different treatments and conditions and diseases, is nothing like what they have to know now, because medical science has gone on so much.”
Bernadette started out on a salary of just £48 a month. She said: “We had to live in and my accommodation was provided, but food we had to provide for ourselves. When we first started we were kept together for the first six weeks.
“We were all in the same building and the front door was locked at night and we had a matron – she was a retired nanny who’d worked for the royal family – and she lived there in a little one-bedroom flat and made sure that there were no male visitors – or female visitors to the one male nurse. It was quite strict for the first six weeks, while you were in what they called ‘preliminary training school’ or PTS. Then after that you got your uniforms and then you were just let loose on the wards.
“We could actually be in charge after second year. We could be running a ward at the end of your second year – sometimes on nights, we would be in charge.”
Sandra had a similar experience.
She said: “Nursing within practice was quite task-orientated and not as patient-centred as today.
“As a student nurse we would often be tasked with taking the entire wards observations. There were lots of positives however, with more time to talk to patients as there were many times when the wards would not be full to capacity.”
Tracey started training at the end of 1989. She said: “We got a grant of £4,000 a year – I’d just come straight from sixth form, I thought I was so rich.”
Debbie was seconded from her position as a healthcare assistant to start her nurse training.
She said: “I suppose Project 2000 would be the significant difference – the move from the more practical training that Bernadette, Jenny and Sandra had, to the more theoretical training that the rest of us had.”
Lisa is part of the new degree-educated nurses and she feels the change is a positive step for future nurses.
She said: “Our patients are much sicker, they are in for much longer with more complications and we do need that extra bit of clinical expertise and that comes from a degree education. But there’s a lot to be said for the diploma students – they’re just as good as nurses.
“We’re a lot more protected, but I think a lot of that’s come with the whole blame culture that’s evolved, so they protect students more, so we’re not allowed to run the wards. But it’s a bit of a shame in a way, because I think that’s how you really develop your leadership skills.”
Although their training may have changed, all the women got into nursing with the same basic ideals.
Tracey said: “One thing that hasn’t changed is the reason people go into nursing – there’s been all this bad press lately that people don’t care – you don’t go into nursing if you don’t care about patients.”
Lisa added: “99% of people who apply for nursing do it because they want to care and it’s usually because they’ve experienced either bad care or good care and want to contribute towards it.”
New targets introduced into the NHS have changed the way nurses work – and not always for the better, it is claimed.
Debbie said: “I love nursing, I love being nurse and I am still proud of being a nurse, although sometimes that is challenging. I think the system is broken and nurses themselves don’t feel cared for. There’s no compassion with regards to nursing and their employment and that really is an issue.”
Lisa said: “Targets shift your priorities from what they should be and really nurses should just be left to nurse.”
Jenny added: “Years ago, you’d write ‘Good day, slept well. Good day, slept well. Good day, slept well.’ And it was taken as given that the patient had had fluids, had eaten as appropriate, had their bed changed, had had a wash, had been to the loo. But now you’ve got to have something separate for all of it so that you know it’s been done.”
Despite the challenges, all the women are very positive about their profession.
Bernadette said: “We’re as caring and enthusiastic about it now, as when we started, despite targets.”
Tracey said: “I think one thing that’s really good to point out is that although we all start off with the same three-year training – we all end up in different places. Bernadette ended up as a school nurse, I’ve ended up working in education. Debbie’s now working as a research nurse and Jenny was doing district nursing.
“So we all started from the same point, but there are hundreds of ways you can go from that nurse training. Nursing is a career with lots of opportunities.”
Debbie added: “And the economy is never going to make any difference – because you’re always going to need nurses.”
Jenny Janes started training in 1961. She said: “We had to live in the nurses’ home, even though I only lived half a mile away.
“We weren’t allowed to get married. Anyone who married, or worse, became pregnant, had to leave.
“During the first year you were the sluice nurse, generally responsible for what came out of patients. In the second year you were the kitchen nurse, generally responsible for what went into patients.
“In the third year you were elevated to the lofty heights of helping with dressings and doing the medicine round (always in twos and no controlled drugs or IVs), and being in charge if sister or staff nurse went to lunch.
“Uniform was provided and laundered, with clean starched apron daily, a collar and frilly cap.
“Tips I remember to this day: Nothing on the floor but the nurses’ feet. “Never stand when you can sit, never sit when you can lie.”
Tracey Risebrow started training in 1989.
She said: “I started my nurse training straight from sixth form, having just turned 19.
“I was expecting to start in January 1990, but was told Suffolk College was piloting the new Project 2000 course and I could start early.
“Our lectures were mostly held in the Education Centre at Ipswich Hospital, rather than the college.
“Instead of a wage, we were the first group to be given a bursary of £4,000 a year.
“The course was much more academically based than I expected and it was a surprise to find we did not get near a patient for many weeks.
“I remember there being academic exams frequently, but not so much in the way of practical exams. As a result I did feel I was lacking in some of my practical skills when I qualified.
“It was hard being a pilot group where everything was so completely different.
“Having said that, it was worth it at the end when I had my shiny new belt buckle and red belt and was able to call myself a staff nurse.”
Bernadette Smith started training in 1974.
She recalled: “I travelled by plane from my home in Cork on September 2, 1974 to take up a place as PTS nurse at Barnet General Hospital.
“We spent six weeks there as we completed our induction.
“Then, after a week’s leave, we were presented with our uniform: caps, studs, starched aprons and red and navy capes and let loose on the wards.
“Most of the staff on the wards and other areas were friendly and helpful.
“There were some inspirational leaders, some dour consultants and some wonderful patients. It was during this time I became the future Royal College of Nursing (RCN) activist – I stood up for another student who was allocated a bedroom with no window and refused to work on a night shift until a cockroach problem was dealt with.
“At the end of my second year I got married and had special permission to seek a transfer to Leicester Royal Infirmary.
“I qualified and had a reception provided by the Charles Frear School of Nursing.
“This was one of my proudest moments.”
Sandra Gover started training in 1981. She said: January 1981 was the start of my nursing journey.
“The first six weeks of our training began with an introductory block called PTS. We lived within the school of nursing and had to share a room.
“We would commence the day at 8.30am in the clinical skills room where we would practise making beds with hospital corners, giving injections to oranges, giving mouth care etc, before our lectures started. We would wear our uniform at all times and our tutors would often hold an inspection to ensure we were wearing our uniform correctly.
“After PTS finished, we moved into hospital accommodation. As student nurses, we would often be tasked with taking the entire ward’s observations. Following successful completion of medicine management, we could hold the keys and do the drug round as well as be in charge, which mainly happened on nights.
“My decision to train to become a nurse was the best decision of my life and I regard it as an honour to be a part of this profession.”
Debbie Simmonds started training in 2000. She said: “I started my nurse training in September 2000, the year of the NHS Plan, introduced by the Labour Government.
“The course structure was three semesters per year. The first 18 months of the course I remember having two days in practice and two days in college with a study day per week, converting to three days in practice and two theoretical days in the final year.
“The class was a real mixture of young and mature students, of which I was, at 42, a very mature student. It had been 26 years since I had written an essay and I can distinctly remember the difficulty I had in writing my first assignment. Every semester held two concurrent modules, each requiring an assignment and portfolio of practice for assessment. We also had a ‘home ward’ which we attended in our first year and returned to in our final year.”
Lisa Mickleburgh is currently training. She said: “I’m starting out my career at a time of great change. Academically, there seems to be much more demanded from nurse training. Every nurse from now on will be degree educated. For some, this is an issue of debate.
“However personally, I think it’s a positive thing. Nurses are often seen and treated as second-class citizens, particularly by doctors. I think degree education will put us on a much more level footing with them in the future.
“I’ve had to make a few sacrifices to do my training (mostly financial and social), but it is a sacrifice worth making, to be able to do something I love, and one day, be able to proudly call myself a nurse.”
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