Putney Hospital, being on the edge of Barnes Common, which was a huge geographical area, meant we got all sorts drifting in, night and day. Tramps, children, couples, basically anyone who had come to grief in the open air or on the road, some way or another, were brought in. The ambulance men (and they were mainly men then) were aware that I was a ‘new girl’ and sometimes took advantage of it, especially when I was left on duty in casualty all alone. Another bitter cold night in the middle of winter during my first year it turned out that I was the only nurse in casualty left on duty. It was sometimes like that, as we were often not that busy at night. Putney Hospital had been set up originally to serve the local community, so it was not a really hectic place serving central London, like Barts (St Bartholomew’s) could be. It was part of Westminster Hospital, so we did send patients there when necessary, such as when a case was more serious or needed more complex equipment or nursing.
However, this evening Night Sister was at dinner and the house doctor had gone to sleep in the downstairs ‘on call’ bedrooms allocated to night staff. He could be called and woken up in an emergency, and Sister floated round the hospital at night, but I was supposed to cope the best I could with most situations, on my own, otherwise. When an ambulance turned up at the entrance the rule was that I had to go out to it and see who was being brought in. Usually the ambulance men would say, ‘Got a heart attack here, nurse,’ or ‘It’s a car crash,’ or whatever. I think this night they saw me coming. It was freezing and I’d thrown on my cape, but was shivering terribly in the wind. The rule was I wasn’t supposed to accept any patient without seeing them first in the ambulance. The ambulance men, George and Charlie, whom I’d seen before on nights, indicated that because it was so bitter cold they hadn’t got the time or inclination to let me clamber aboard and check out their patient. I was also rapidly turning into a human icicle, so I went back into casualty as the two men carried in this fella on their stretcher all wrapped in a red blanket. ‘Found him on Hammersmith Bridge,’ explained George. ‘Think it’s a heart attack, probably.’ And with that they were gone.
So I was stood there, next to this man, wrapped in a red ambulance blanket. He looked frozen, poor old chap. He had grey whiskers and bushy grey eyebrows, and was in a brown raincoat and suit. I folded back the sides of the blanket and thought, ‘Sweet Jesus, he looks really terrible,’ so then I felt for his pulse. Nothing. I felt again, and then put my head on his chest, listening for his breathing. Not a sausage. Oh my God! He was dead! Oh Lord, what should I do? Sweet Jesus, I was really for it now! I looked around the casualty department and absolutely no one was around; it was like a ghost town, as it was now four in the morning. Thing was, the rule was I was not authorised to take in a dead body; it was absolutely against regulations. This had been drummed into us as trainees over and over and over again. Had I been listening? Well, obviously not.
I was supposed to go out to the ambulance and assess the patient, then if they were deceased they were termed Brought-in-Dead (BID) and I was supposed to decline them, so they went straight to the morgue, or even to another hospital altogether. We had been told many times that it was too much paperwork, as a BID involved the police, the mortuary, the coroner, tracking down relatives and so on. If they were found dead in the street or died in the ambulance they were never brought in. That was the rule. It was a huge job and we were not supposed to touch it with a barge pole. So there I was with a dead body on a trolley to dispose of – a poor old BID – and I hadn’t the foggiest where to start sorting out such a mess. I could feel the panic rising: Who could I turn to? Where would I start? I pulled the blanket down further and saw his grey, frozen face with icy whiskery eyebrows. Dead all right. As a doornail. Jesus, what was I to do? In those days there was no resuscitation equipment, like defibrillators or anything like. I stood there, panting quietly – what on earth should I do next? I couldn’t go and get Night Sister and say casually, ‘Oh, by the way, Sister, I have a dead body in Casualty.’ She’d absolutely kill me. So thinking quickly now, I wrapped him up again in his nice red blanket, so that he looked like a giant Christmas cracker on his trolley, and then pushed him into a corner, trying to hide him to buy some more thinking time. Suddenly I heard Night’s Sister’s clipped tones behind me: ‘Any developments, nurse?’ I jumped out of my skin. ‘Sorry? … Er, no, Sister, everything’s fine … This man … I don’t think he’s very well … actually, Sister …’ But it was no good, Sister was already peering past me curiously at the red-wrapped bundle that I was desperately trying to hide behind me all the while.
I couldn’t stop her as she advanced towards the stretcher. ‘What on earth is this doing here? That’s an ambulance blanket – why didn’t you give it back when they brought him in?’ And with that she pulled the blanket down: ‘Jesus Christ, he’s dead,’ she said. ‘He’s not,’ I said, covering wildly, ‘surely not. The ambulance men just brought him in. I was just … I didn’t realise …’ ‘Brought him in?’ She was shouting now, and I could see her eyes beginning to pop out in their characteristic way. ‘Nurse, you know that you are supposed to go out to the ambulance to assess the patient. Rigor mortis has set in – this means this man died two or three hours ago! He was brought in dead – B-I-D. You know better than this, Nurse Powell, or you really should do by now.’ At her angry words my usual waterworks started flowing. I was soon crying helplessly. It was a nightmare; I was in trouble, all over again. I’d be back in Ireland in a wink, with my mother ‘told-you-so-ing’ me to my father over my head. ‘For goodness’ sake stop snivelling, nurse.’ Night Sister was incandescent and she went on and on and on about procedures and rules. Then she went on and on about needing to uphold standards and follow correct regulations and what would happen if we didn’t (the end of the world, obviously). Suddenly she marched off and got Percy the porter and instructed him in clipped, frosty tones to take the poor dead man down to the mortuary. She didn’t even look at the body, poor thing, or try to work out who he was. What a way to end his life – I felt truly sorry for him. Then Sister was back, facing me, eyeballs popping: ‘I’ll see you in my office, Powell, ten o’clock sharp, tomorrow morning, no nonsense.’ And with that, she turned on her heel and was off. Standing there, wiping my eyes, I realised that the ambulance men, as nice as they were, had pulled a fast one on me. I was a gullible greenhorn, a real eejit, and it showed.
So I was there next morning, exhausted and trembling, and it wasn’t just Sister, but Matron, too, I had to face. I had to have a clean apron on, and stand, with my scrubbed hands behind my back, like a very naughty schoolgirl. Matron wiped the floor with me. ‘You know there are rules, nurse? And rules are meant to be followed … blah-di-blah-di-blah …’ I wanted to disappear between the floorboards. However, to be fair to her, she did stop and say, towards the end, as I was blowing my nose loudly, that she would have a word with Night Sister as I shouldn’t have been left entirely on my own while I was training. So she was actually quite fair to me in the end, and I had to learn yet another painful lesson in the importance of sticking to the damned rules … My mother would have been so proud.
There was a more tragic death one night, however, which made me very sad and again made me realise how important it was to be thorough and observant as a nurse. A young lad of about fifteen was brought in after having a fall on the Common; it wasn’t clear how, but he was probably larking about with some friends and had fallen out of a tree and broken his ankle badly. He was taken to the men’s medical ward, but mysteriously got worse, as he developed a very high temperature. His ankle was set, but still he worsened, and we discovered he was dying from tetanus (lockjaw), which was incurable at the time. However, it was only when he was examined during the post-mortem that it was found that he had a deep graze on the back of his head. This has gone horribly septic and had done for him. It was appalling to us all that this injury had been missed. More importantly, it felt terrible that such a young life was snuffed out so quickly from something that should have been dealt with at the time, and which, today, would be so easily treatable with antibiotics.