Call Me Sister (2 page)

A year ago I’d qualified as a midwife in Belfast. The Royal Maternity Hospital’s work was so specialised a normal delivery was a surprise. The training had been hard work, with plenty drama. I’d thought I’d have a break from it so the last thing I expected in a medical ward was this.

I said, ‘I’m sure everything’s fine, but I’ll come back in a minute and have a wee look. It’s maybe worth checking.’

*  *  *

I needed to see Mrs Mackay’s notes and was so sure Sister Gall had gone, it was a surprise finding her in the office mulling over them with the doctor. Frowning, she looked up. ‘Shouldn’t you be dressing that bedsore?’

So much for patient care and identity! I wondered if nursing for as long as she had had made her forget she was there because of patients. Maybe over a period of time in the same hospital surroundings you could be so taken over by inventories you could become lost to patients’ needs. I hoped I’d never lose sight of the fact that they had names, and the one with the bedsore was Miss Caird.

She was an old lady who lived in an isolated house in an Inverness-shire glen. Noticing a lack of lights in the home, a neighbour had checked on her. When she found her in bed, dehydrated, emaciated and with a foul-smelling bedsore, she immediately sought medical help. Miss Caird was confused, but nobody was sure if that was due to her present state or because she might already have dementia.

‘She’s never been one for company and she’s seemed to be getting even worse. Lately it’s got so she wouldn’t allow anyone near the place,’ explained the neighbour who’d found Miss Caird. Glancing round the ward, she added, ‘And she’d never have been here if she’d been conscious. She’ll no like it here at all at all.’

Even if she was screened off and the other patients spoke quietly, how could she? This must be a planet away from her own world, where the elements prevailed. Now, under our care and a ceiling of peeling plaster, she lay quiet and undemanding. Only a faint gleam in the faded blue of her eyes when anyone spoke to her showed she had an awareness of sorts.

Her infected sore demanded the sort of attention which made it all too easy to forget the sufferer. I understood why a trained member of staff with a stomach less queasy than a student’s should have to deal with this, but not why Sister Gall always made herself exempt. Still, she was supposed to be off duty at the moment and I
was
meant to be in charge.

I knew the dressing needed to be done, but it would take time, our most limited commodity. Reckoning our pregnant patient was a priority, I persevered with my audience. ‘I’m not sure Mrs Mackay’s contractions are Braxton Hicks. They’re usually painless, but I think she’s feeling these ones.’

Sister Gall and the doctor looked puzzled, so I continued. ‘We wouldn’t want to risk a delivery here, especially with a diabetic.’

Sister Gall shuffled some papers in exasperation. ‘Instead of frittering away your time, I suggest you go and do that dressing as I told you to do ten minutes ago. Mrs Mackay was fine when we saw her, wasn’t she, Doctor?’

The doctor, looking worried, nodded. ‘Of course, I’m not up so much on midwifery. Unless we wanted to specialise in it, our training didn’t cover it in great detail. Maybe if Nurse Macpherson’s a trained midwife, we should be listening to her.’

‘What?’ Sister Gall was shocked. ‘Mrs Mackay’s here to have her diabetes stabilised, not to have a baby, and Nurse Macpherson’s here as a staff nurse in a medical ward. Good gracious! I’ve never heard the like. Anyway, the diabetic consultant’s coming in this morning. He’ll know best.’

‘Will he be coming soon?’ I wondered aloud.

‘Soon enough. Now just get on with the other work. There’s a whole ward to run.’

‘Yes, Sister.’

Miss Caird lay so still that for a moment I thought she might be dead, but her eyelids fluttered when I touched her cheek. ‘I’m coming to see you soon,’ I whispered. ‘I’ve just a wee worry on at the moment.’

I got back to Mrs Mackay. She was now looking so uncomfortable that I began to really fret.

‘Is your tummy tightening regularly?’ I asked, noting the unfinished tea and half-eaten toast.

‘Everything’s fine, isn’t it?’

‘Oh, just dandy. But just to be sure, let’s have a look at you.’

A quick examination was enough. And enough was enough. Holding out her dressing gown and slippers, I said, ‘Come on, Mrs Mackay, you climb into these whilst I get a wheelchair. We’re going on a trip and it’s from here to Maternity.’

I was in such a hurry to get Mrs Mackay wheelchaired over to Maternity, I nearly ran over Sister Gall. She must have heard the sound of the racing wheels because she shot out of the office. She looked furious.

‘Can’t stop,’ I said, knowing that if I did, things could become undignified. I’d just have to deal with her when I came back. Right now, that wasn’t a priority. Certain that our patient was in labour, I knew that, once delivered, her baby would need special care and probably in an incubator. When I got back, and reasoning that this might strike a chord, I’d say to Sister Gall, ‘And as far as I’m aware, that’s not part of our ward’s inventory.’

Between silently practising the lines and assuring Mrs Mackay that we hadn’t quite reached the sound barrier break point, we arrived at the Maternity Unit. It had been a long sprint and by the time I handed over my charge, I was quite out of breath. Struggling to get it back before returning to Medical, I rehearsed my putdown lines but could have saved myself the bother. My senior had stomped off, saying she’d had enough for one morning. We’d see her in the afternoon.

So, now and having the time, I attended to Miss Caird. As I dressed a dreadful sore that demanded every skill I could muster, I packed the foul-smelling space where there had once been flesh. I looked for some sign of healing; it’d be a gauge on her health. There was none. Any point of contact now seemed to bruise her skin whilst, under its translucence, her veins mapped out their blue, tortuous routes.

A simple arrangement of flowers stood in a vase nearby. Nurse Black must have put them there, as well as provided the tartan ribbon tying back Miss Caird’s lank grey hair. I feared it was too late for her to notice those small kindnesses. With her weak pulse and shallow breathing, she seemed to be drifting downwards and ever faster from us.

I wished I knew more about her. There were no clues from the few possessions stored in the old-fashioned metal locker parked beside her bed. Her neighbour had brought them in and she was her only, but occasional, visitor. She knew little other than what she’d previously told us.

‘Private and proud,’ she’d reiterated, shaking her head. ‘Private and proud.’

Aware that even if Miss Caird seemed far away, she might still hear things going on around her, I settled for a one-way conversation. ‘One of our patients has gone over to Maternity. I think she was a bit surprised. You see, her baby isn’t due for a while. We’ve just to hope everything will be fine.’

Although there was no response, I sensed she was listening, so I carried on. ‘They’re awful busy over there so I don’t suppose they’ll have time to let us know how she’s getting on. But when I go off duty I’ll nip along to Maternity, find out, and then I’ll come back and tell you.’

It didn’t take that long.

Sister Gall made her official return, looking as if she’d been caught in the rain. She was drying her spectacles whilst her cap had little blotches on it, making it look a little less starchy. It was even a little askew. Replacing her spectacles but avoiding eye contact, she sounded subdued as she said, ‘I went over to check on Mrs Mackay before coming on duty. You were right. She was in labour.’ She sighed gustily. ‘She’s had her baby and it’s a girl.’

‘And how are they?’

‘She’s OK. Worried about the baby, of course. I went to see it. It looks too big to be in an incubator.’ Referring to the baby as an ‘it’ seemed to give Sister Gall slight satisfaction. She was beginning to pick up speed. ‘Makes you wonder if they know what they’re doing over there.’

I thought I might say diabetic mothers’ babies were often big and would soon lose the extra fluid they carried and return to a more normal weight. Considering Sister Gall’s recent learning curve, I decided that although she hadn’t done midwifery training herself, she’d probably had enough for one day and she’d appreciate a return to familiar ground.

‘I’m sure they’ll both be fine, but actually I’m more worried about Miss Caird. She’s really going downhill.’

Like a circus horse smelling sawdust, Sister Gall perked up. She sat up straight and lifted her chin. ‘Right. You go back, keep an eye on her and I’ll tell the doctor. We can’t have her suffering.’ Already she was on the phone.

I was right to be anxious. Our patient had become flushed, restless and was muttering in a different language. It could be Gaelic. I couldn’t understand it but Mhairi probably would. While waiting for the doctor, I decided to ask her.

She looked surprised but pleased. ‘
Gu deibhinin
(certainly), it’s my native tongue!’ she said, drying her hands and coming with me. ‘It’s when I speak from the heart.’

I could see that. After listening closely to Miss Caird and murmuring back some Gaelic words, she translated. ‘She says she’s going to die.’ With an awkward hand, she soothed Miss Caird’s brow. ‘I’ve told her to be brave and she’s in good hands, but look, Staff, she’s frightened.’ She pointed to tears streaming down Miss Caird’s with ered cheeks.

I felt awful. I should have realised she was in all probability a native Gaelic speaker. No wonder communication was poor. Now it seemed time was moving too fast for me to make up for a lost opportunity. She probably never understood a word I was saying. Settling for the next best thing, I whispered to my interpreter, ‘Mhairi, could you tell her about Mrs Mackay and her having a baby and we’re sure everything’s going to be all right.’

The ward maid bent down and relayed the message. It sounded like a lullaby. The only sign that Miss Caird might have heard was her faint muttering. Now the other patients, never loud at the best of times, fell silent. It was as if they were all holding their breath and listening.

Then, Sister Gall’s stubby fingers pulled back the surrounding screens, their rail-fastenings rattle, breaking the silence. One look at our patient and after a brief exchange of glances with the doctor, she took over.

‘Right, Miss Caird, It’s a bit busy round here and you need plenty rest and something to help your pain, so we’re going to move you into the wee room opposite my office. It’ll be easier to keep an eye on you there.’ Grasping the rail at the head of the bed, she said, ‘Right, Doctor, you take the other end, and, Staff,’ she gave me a nod, ‘you can get on with the rest of the work.’

With the screening curtains swept back and Miss Caird moved out, the ward’s other patients moved into a chattier mode. Later that day, a stroke victim would fill the space left by Miss Caird. She’d be surrounded by an anxious family who were either thronging every corner or jamming the hospital telephone line demanding a progress report. Sister Gall found them a pain and a lot more difficult than the care of Miss Caird. But soon that wouldn’t be needed either and the room opposite the office was emptied. One day, as quietly as she had come, Miss Caird drifted away.

It’s a sad fact but all nurses have to learn to cope with death. This would be Nurse Black’s first one. I supposed that I’d be the one helping her handle it, but Sister Gall shook her head. She said, ‘I’ll take her and show her what to do, but it’s a traumatic enough experience without her having to see that awful sore. Will you make sure it’s covered before we start? She’s a good wee nurse and we don’t want to lose her.’

Was it my imagination or was there a slight softening in Sister Gall’s steely approach? Her consideration was as unexpected as was the tone of the dressings request. Afterwards, Nurse Black’s reaction to the experience was unexpected as well.

She was in the sluice putting fresh water into a vase of flowers. Concentrating on drying the base, she mused, ‘Don’t you worry, I’m fine, Staffie. And you know, I was dreading dressing a dead body and I certainly didn’t expected Old Gallstone to be anything but practical, business-like and totally uncaring.’ She sniffed hard then continued. ‘And of course Miss Caird was a very private person. But Sister Gall dealt with her as if she was still alive and gave her the respect and dignity I’m sure she’d have wanted. Honestly, she made the whole business seem easy but right.
And
she let me use rosemary,’ the young student finished with a note of triumph. ‘After I told her it was a herb for remembrance she let me weave a sprig of it through Miss Caird’s fingers. It made them look almost alive. I felt it was a good way of saying goodbye. What d’you think, Staff?’

Linking her arm in mine and handing her a tissue, I said, ‘I can’t think of a better way of marking your care. It shows that someone we thought unknown who kept herself to herself will never be forgotten. And I’ll never forget you for your tribute.’

‘So, you’ll be off skiing, I suppose?’

Sister Gall was doing her best. We were in the office and after giving her the handover report I had a day off. Since Mrs Mackay’s transfer to Maternity, the ward sister had softened a bit, at least enough to consider her staff might have a life outwith food calorie and cutlery counts. She had even begun to trust me to run the ward when she was off duty.

Toning down the criticism she’d so easily given before must have been difficult. It would be a shame for me to lose this goodwill, but it was sure to go if I were to tell her I’d applied for a district nursing job in Ross-shire. I’d be spending my day off having an interview in the county’s headquarters which were in Dingwall, twenty miles north of Inverness.

My sister Elizabeth and I had two maiden aunts who used to live there. When we were on our summer holiday staying with our granny in Nairn, the highlight was to visit them. I don’t know why we never went by train. It would have been possible, and quicker. Maybe Granny’s Calvinistic spirit rejected the idea of ease, leading her to declare with exasperation, ‘You’re both such poor travellers. I hope you can make it at least as far as Inverness without actually being actually sick. When we change buses there, you’ll get a break. That sometimes helps.’