THE National Health Service was born 60 years ago this week into a dutiful, deferential age. Three years after the end of the Second World War there were still shortages and people had to make do and mend, in the health service as everywhere else.
The NHS was a formal world where first names were virtually unknown and cleanliness was next to godliness – a world of matrons, starched aprons and strict routine. In part two of her series Rosalind Griffiths talks to some who worked in the service in its early days in Shetland.
TIMES were tough before the advent of the NHS, according to 87-year-old Agnes Hobbin.
There was no back-up from social services – doctors and nurses had to be paid for, and illness in the family, especially of the breadwinner, was a constant fear.
Nurse Hobbin, as she later became, grew up on a south mainland croft, the youngest of 10 surviving children.
She recalls the time one of her brothers was sent home from school ill, with either suspected scarlet fever or scarlatina, and her 13-year-old sister had to get exemption from school to look after him.
The disease in the household left the young Agnes with a kidney infection which, in the days before antibiotics, was treated with a starvation diet. There were no antibiotics to treat or her burst eardrums either – the remedy was hydrogen peroxide to clear them.
Nurse Hobbin started her career as a nursing auxiliary at the old Gilbert Bain on the day the Second World War broke out. She was called up to the civil reserve and spent the last two years of the war in a military hospital in Tingwall.
It was “tremendous nursing” in pre-NHS and pre-antibiotic days, she said. “You had to be really good nurses, you couldn’t depend on people getting better by giving them a pill.”
By 1947 she was married and had her first child in the new maternity annexe at Midgarth, where the fee for a week’s stay was around £2 per week. When her next child came along everything was free.
Later she did midwifery, district nurse and health visitor training, working throughout the isles.
NURSING was the life of Georgina (Gina) Henderson, who was a “triple duty nurse” covering general nursing, midwifery and health visitor’s duties for 30 years in the south mainland. She always wanted to be a nurse and remembers bandaging her cat when she was a child.
Nurse Henderson, as she became after her marriage to local man Andrew Henderson, looked after people from Sumburgh Head to Maywick from cradle to grave.
Now aged 90, Nurse Henderson, originally from Fraserburgh, trained in Glasgow and Edinburgh and was sent to Shetland “for one year” in 1950.
Nurse Henderson had to learn to drive to come here and would travel by mini van on comparatively bad roads, equipped with the black leather bag which held all kinds of dressings and potions, there being no chemists’ shops in those days.
It was a happy time, she recalls, with neighbour helping neighbour – something that happens less now that people are more prosperous – and she knew everybody, dealing as she did with anything from accidents to infectious diseases (in which case the house would be shunned by neighbours).
She cannot remember how many babies she has delivered – not everyone went to the new Midgarth annexe – or how many lives she has saved. “It was ay the nurse they called, they didn’t bother the doctor much.”
She had to do heavy lifting of patients too, if there was no-one to help her.
Nurse Henderson was awarded the MBE – a treasured silver medallion on a red ribbon – for services to nursing in 1981: “I never found out who nominated me.” It was a fitting reward for someone who loved her work: “If I had my life to live again I’d do exactly the same.”
NOELLE Gordon, 80, went to Edinburgh to train in 1946, two years before the advent of the NHS, and returned to Shetland as a state registered nurse in 1950, working at the same time as surgeon Daniel Lamont.
The strict discipline is something she remembers from those days, together with the nurses’ wearing of veils and the formal modes of address – no first names were permitted for staff or patients.
Sister Shearer (who went back as staff nurse Gordon after marrying and having a family), worked at the Isolation Hospital (the old Lerwick Combination Hospital, partly on the site of the present Gilbert Bain), which dealt with infectious and acute medical cases, and remembers an outbreak of polio in June 1950. An iron lung was brought to Shetland, organised by then Medical Officer of Health Dr Sandy Black. The contraption was like a metal coffin in which the patient lay with their head sticking out, and pressure inside was adjusted by means of dials to aid their breathing.
Tendon transplants and electric shocks to stimulate the muscles were the treatment for the disease, which left the patient wearing splints or calipers. Polio was virtually eradicated by mass inoculation later in the 1950s.
TB cases were cared for at the sanitorium, now Montfield, and she recalls patients being taken onto the verandahs to benefit from the fresh air, according to the medical thinking at the time.
Starched aprons were the order of the day for the nurses. “We were fastidious about our uniforms, it was a bigger thing than it is now, and we had frequent changes of apron as required.”
For barrier nursing of patients with infectious diseases, gowns, plastic aprons and masks would be donned over the uniform.
However, in spite of the hygiene, she remembers an aspidistra plant in the Isolation Hospital, a sure sign of the times.
EVA Yates started her nursing training in 1952 (on 1st April, she recalls) at the Western General Hospital in Edinburgh at the age of 16.
The training was to last three years and three months, and three Shetland girls were in the class of 32, a number which slowly dwindled.
The student nurses were on the ward one day a week and they took weekly tests. Nurse Yates gained her SRN qualification in 1955. “We were very proud of our hospital and our badge.”
From the first week, the students were taught how to clean. It was instilled into them that the patients were the most important people in the hospital, and that gossip was forbidden. The strict training gave Scottish nurses a good reputation, she said. “We could circumnavigate the world with our training.”
Back in Lerwick, where later became a sister, she worked at the Lerwick Combination Hospital (known as the Isolation Hospital) which had two big wards and single rooms for barrier nursing. Later she worked at Brevik Hospital.
The strict regime persisted with the doctors and matron firmly in charge and greatly respected. “We knew our place.”
Polio, rheumatic fever and chest infections were common illnesses at the time. Patients with pneumonia and pleurisy can often nowadays stay at home “with a good dose of antibiotics”, but in the 1950s the treatment was isolation with a red flannel and a poultice on the chest to keep them warm.
If patients were transferred to Aberdeen they went on the thrice-weekly boat accompanied by a nurse. She went on three occasions, sitting up beside the patient all night, wearing her uniform. “It was a great responsibility but you didn’t realise that at the time.”
Very occasionally, patients would be taken to Aberdeen by plane – seats would be taken out to make room for a stretcher.
THE biggest change retired theatre and outpatients sister Marie Williamson has noticed in her years of nursing and afterwards is the length of patients’ stay.
In the past, she said, anyone having hernia or varicose vein operations would be in hospital at least 10 days, until the stitches came out – now patients can be home the next day, meaning nurses do not have a chance to get to know them.
Techonology has played a part in this too, said Sister Williamson, who trained in Edinburgh and worked in Shetland from 1964 until her retirement in 1972. Patients having tests would have to spend a night in hospital then – now they can have a quick diagnosis and go straight home. Another improvement is that nurses no longer have so much heavy lifting, thanks to the advent of hoists.
Theatre lists in the sixties and seventies could be arduous, with nurses working all day and being on call at night. “If I went to the North Star cinema I had to phone and say where I was.”
As a student in Edinburgh, Sister Williamson, 67, was expected to help the ward maid with the weekly “high cleaning”, which included washing radiators. The matron could drop in at any time and check the standard of housekeeping – the wheels of the beds had to be aligned with the floor boards, and at 4pm daily the white counterpanes on the beds had to be folded (in a line) over the end of the beds. “It was good discipline. If you could be careful about the minor things you would be careful about big things.”
Nurses were taught everything had to be centred around the patient. Sister Williamson said: “The time I felt most truly a nurse was in my first year when I gave bed baths and so on. As you go up you take steps away from the patients. Nurses in those days had a bond with the patients – they were scared of matron and so were you.”
SHETLAND’S first maternity annexe opened at Midgarth in 1947, shortly before the start of the NHS.
It consisted of two Nissen huts (with frosted glass windows) and a wooden hut, all linked internally by steps, and could accommodate 12 patients. Sister Edna Duncan, who later became Poplar, was in charge from 1957, continuing to be in charge when the maternity department moved to the annexe adjacent to the Gilbert Bain Hospital in 1962.
Five patients would be in the upper Nissen hut with seven in the lower hut. There was a labour room and a “first stage” room, which could double as a labour room (C-section patients would go to the old Gilbert Bain). Patients who had just had babies were not allowed to walk and were carried up and down stairs.
All domestic service was done in the wooden hut, and in a corridor connecting the Nissen huts were the kitchen, dining room, sluice and office.
Sister Poplar recalls: “It was very basic and in winter with the gales and snow the draught was dreadful. We would pin up grey army blankets against the windows to keep out the draught. Everyone just accepted it because there was nothing else.”
Heating was provided by radiators heated by a boiler – and it was the job of ambulance drivers to fire it up with smokeless fuel.
Washing of the towelling nappies was another job, this time done by nursing auxiliaries. “They washed them by hand and hung them out on the washing line. It was primitive but we were happy and the patients were happy. It was a wonderful place to work.”
Babies born there would lie in canvas hammocks suspended from a wooden frame and the only incubator was a “Queen Charlotte” model, which had spaces for hot water bottles on each side of the baby and at their feet.
The “new” annexe, now demolished, was something of a culture shock having only 11 beds. But a new dome-shaped incubator delighted the nurses: “We thought we were living in clover.”
In spite of modern medical improvements, Sister Poplar prefers the traditional system of keeping babies in a nursery rather than beside the mother – it allowed the mother to rest.
Very few patients in her time – she became nursing officer in 1974 – went to Aberdeen. But once she had to go to Aberdeen to collect a baby that was in hospital there. “If we had a day off we would do it then. We never thought of going when we were on duty.”
THE happiest days of my life. That is how Jean Couper, 74, remembers her nursing days.
Nurse Couper started at the old Gilbert Bain when she left school, doing her training in the time of Matron Margaret Mair and becoming an enrolled nurse. She also worked at the former Brevik Hospital.
After marrying and having a family she went back to nursing, this time at the new Gilbert Bain Hospital. She then spent the next 35 years working in most departments of the hospital – on ward 1, ward 2, and the operating theatre, which she particularly enjoyed, getting so into an operation once that the surgeon had to ask her to stand back.
She recalls making up dressing packs of cotton wool balls and swabs, which would then be put in the steriliser, and making up beds which would be checked by the matron: “Everything had to be perfect or the matron would tear it up.”
Nurses would get very close to patients sometimes, she said, and patients were always very grateful. Above all, there was tremendous pride in working for the NHS.
That pride extended to the uniform. The folded and starched caps were secured with kirby grips, and aprons were starched too. The enrolled nurses’ dress was green (staff nurses’ dresses were red and sisters’ dresses were blue) which was very different from the more unisex informal dress code now, with no headdress, tunics and trousers. “I’ve never had a pair of trousers on in my life.”
MERRAN Henderson worked for the NHS in Shetland between 1960 and 1995, becoming chief nursing officer in 1974, ending as the director of contracts and standards and gaining an OBE.
She was a staff nurse in the old Gilbert Bain, and when the new hospital was opened she became a sister. “I was a staff nurse in the morning and a sister in the afternoon.”
There were about 32 patients, she recalls, and everyone was amazed to have so much space and more modern equipment, although the X-ray department was tiny by comparison with today’s.
In the old Gilbert Bain, she recalls, rubber catheters were still used and had to be boiled to be sterilised. All dirty instruments had to be scrubbed to make sure they were properly clean, then put in boiling water them put into a steriliser. Hands were scrubbed with soap and water and dried on a clean towel to ensure no hospital-acquired infections: “We personally took it as a disgrace if there was an infection of even one patient. Everyone was conscious the place had to be cleaned and if anything was spilled it was cleaned immediately.”