DN150: One Hundred & Fifty Years of District Nursing

district nursing 150 - queens nursing institute

irene sankey

Irene Sankey MBE

 

Irene Sankey grew up in Birmingham and began her nurse training in 1932 at the Royal Sussex County Hospital, Brighton. In 1938 she decided to undertake midwifery training and was accepted to the Abel Collins Maternity Hospital in Nottingham. The six month course, for which she paid £100 plus expenses, involved one month ‘on the district’ for which she was equipped with ‘a coat, mackintosh and storm cap.’ After a temporary spell at St Chad’s Hospital in Birmingham she worked as a private nurse before returning to Brighton in 1939. In 1941 she decided to do her Queen’s Nurse training.

She wrote, “It was a six month training for which I did not have to pay. I was accepted by the Brighton District Nursing Association which paid me £60 per annum (i.e. £5 per month for six months, provided I signed a contract to work a further year). The year’s experience was a great help in consolidating the six month’s training.

“We lived in. Uniform, bicycle and the nursing bag with all its equipment were provided. We work black shoes and stockings, navy gloves, navy or white scarves in winter, a navy coat and storm cap. Because of the war we also carried a gas mask in its cardboard box, and a tin hat. We had to provide small towels for our nursing bag and once we were trained, we had to buy a set of surgical instruments, scissors, and thermometers.

“The ubiquitous rules and regulations all over again: in by 10pm…rooms to be kept tidy…beds to be made before breakfast…nursing bags always kept in the District room…and on…and on…and on. We were all grown women, most had held responsible posts, but we accepted what seemed to us ‘petty’ rules, knowing that sooner or later one or another would be contravened…”

She continued, “Looking back over the various courses of training I have undertaken, Queen’s takes pride of place. It was by far the most useful, valuable, worthwhile and stood me in good stead in later years. It taught me much I could never learn from a textbook: to be resourceful, to be versatile, to improvise, to be resilient, to listen… It taught me that patients were people, not ‘cases’.

“All the houses and homes were different. They may have had the same physical features, but there the similarity ended. Some were clean, many were dirty, a number very begrimed, and certain others were indescribably filthy! There were the real poor and the improvident. The homes of the poor were usually clean and scrubbed, and in the 1940s few families had a vacuum cleaner and fewer still had washing machines; not many had hot water in their taps and hardly any had a bathroom. So it was not easy to be clean and wholesome…I had met and learned to deal with fleas during my month in Derby, but I did not meet bugs until I started my district training. If a house was bug-infested, you knew the moment you opened the door because there was a distinctive, peculiar and obnoxious smell. We gritted our teeth and hoped for the best. I always carried a large, strong paper bag into which I put my folded coat and hoped to find a clear space for it. We avoided chairs and sofas with upholstered seats (often horsehair) and never hung our coats on a hook next to other coats.

“The imprudent, in my view, spent their money recklessly, but there was little I could do about it. Money went on cigarettes, beer and gambling, and the children went without shoes, slept on urine-soaked mattresses with an old coat for a blanket. Yet there were residential localities which were not all poverty-stricken back-streets and Matron, wise woman that she was, never kept one nurse on a difficult area of squalor for long: usually no more than three months. Just as in hospital we had to be proficient and knowledgeable on different wards, so on the district we had exposure and encounter with all types of homes and families.”

“One aspect of my training I disliked intensely was collecting money. The NHS was eight years away…so patients who could afford it were asked to pay. At the first visit a new patient could be assessed – a sort of ‘means test’, but this was shelved if they could afford to pay the maximum (2 s 6d) or if they belonged to a provident scheme. I found it embarrassing and distasteful, asking them about their income and expenditure. This information, together with other details necessary in our Case Book, was taken to the Superintendent who decided how much they should contribute, the amount varying from as little as threepence to as much as two and six per week or per visit, depending on individual circumstances. The ‘necessitous poor’ was nursed free of charge. Monday was pay-day. We went out with our tiny receipt books and most of us had a small tin for the money…

“We each had a geographical area to cover, which meant that we met many of the doctors, not like today (2001) when a nurse is attached to one group practice. A new patient was always called upon first, followed by the very poorly and then those who needed two visits a day. During the first visit the room was put in ‘nursing order’. This entailed a great deal of tact to move furniture around. For instance, in hospital there was always a locker and we had the use of a dressing trolley. In the home we had to improvise: a small table was ideal, placed next to the bed – we had to find a flat surface! We were taught to protect the furniture, whatever its condition from heat or lotions used for dressings. We nursed our patients. Every aspect of ‘general nursing care’ was carried out. In addition to washing or bathing, we washed their hair (sometimes a beard!), cut their nails, cleaned their dentures or made sure they brushed their own teeth. We made their beds and left them cleansed and comfortable…”

“Synonymous with the district nurse is the black Gladstone bag strapped to the carrier of her bicycle. It was made of leather, had a white fitted lining with loops to hold small bottles and jars, and an outside pocket. Our nursing bag was sacrosanct. Never did a piece of equipment receive such loving care! We took soap, towel and nailbrush from the outside pocket, opened the bag, then washed or scrubbed our hands before removing anything from it.

Contents of the Nursing Bag

1 lotion thermometer
1 pair surgical scissors
2 pairs dressing forceps
1 pair sinus forceps
1 probe
1 metal spatula
1 catheter size 8
Funnel, tubing
Rectal tube size 14
Ear syringe
1 syphon douche and nozzle
Rubber gloves
Small kidney dish
Small enable bowl
1 instrumental towel
Dettol
Surgical spirit
Soda bicarbonate
Vaseline
Zinc and Caster Oil cream
Copper sulphate
Powder dredger
Small tin of sterile dressings

“Once a week the nursing bag was emptied of all its contents. The bottles and jars were replenished, the lining changed, the outside of the bag buffed with black Cheery Blossom Boot Polish until it shone.

“The ballet came to Brighton for a week before it went to London. Three of us decided we would take the risk and hoped that we should not be missed at supper. We met at the theatre about a quarter to seven – still carrying our black bags; there had not been time to take them back to the Nurses’ Home. Once we were seated, we put the bags under the seat, between our feet. One of us had borrowed a key, so that solved one problem. We never knew how the Superintendent had heard about our escapade, but one by one we were summoned to the office for the ‘telling off’ of a lifetime! It was bad enough missing supper, but to have put our nursing bags under our seats ‘in a theatre’ was unforgivable!

“The six months training seemed to pass quickly and in no time at all, the examination was upon us – a written paper followed by the ‘practical’. This involved a full round of visits escorted and every movement watched by a Queen’s Examiner.”

Irene passed with flying colours and later in her career looked up her record card which said ‘Has potential. Should do well. Suitable for administration.’ She continues, “In September 1941 I added QN to my qualifications and became No 15866 on the Queen’s Roll, was given a Queen’s badge, worn on a cord around the neck, and a Queen’s badge for my storm cap.”

In 1942 Irene began training as Health Visitor and worked in Aston, Birmingham. She writes, “During my second day, I knocked on a door. Eventually a small boy’s head appeared round the door.

“Mum, it’s the woman from the Council ‘ouse,” I heard.
“Tell her I’m busy.”
“She’s busy.”
The door was slammed. We had no legal right of entry.
I was dispirited. That evening, when I returned home, I looked out the storm-cap I had worn for my Queen’s training. The next day, I showed up at the house again. I knocked. The same small head appeared round the door.
“Mum, it’s the nurse.”
“Tell her to come in.”

Moving back to Sussex, to Haywards Heath, Irene worked as district nurse, midwife and health visitor on a salary of £210 a year. One day the Honorary Treasurer of the association said to her, “This is difficult, but I may as well come straight to the point… I’m afraid that there isn’t enough money in the kitty to pay your salary.”
“Oh…” was all I could say.
“If you run short of money, I’ll happily lend you some.”
“Thank you. I’m fine, as long as I can pay Mrs Cook’s rent.”
“We should have enough in a week or two – we’ve a jumble sale coming up and there’s a special appeal going out.”

A member of the district nursing association committee gave her his old car, an Austin 7. It was “like a little box; the starter button was on the floor and when I looked down, I could see the road through a hole in the floorboards – the size of a saucer! The door handle came off in my hand but I managed to have that repaired. That tiny car turned out to be a boon and a blessing, however. It humped along rutted lanes to remote cottages and farmhouses. It kept me dry, but during the winter months it was bitterly cold as there was no heating. I often took a hot water bottle and a rug on my knees. It became a well known sight in Haywards Heath. No-one ever locked their cars in those days and I frequently returned to find a note on the seat, or a bunch of flowers, a half-dozen eggs, a cabbage, a bag of potatoes, a box of chocolates… The note would be signed, but the gifts never bore any names…”

“The district nurse, the midwife and the health visitor were one and the same – three in one, so to speak. As the midwife I would say ‘goodbye’ to a new mother on the fourteenth day and as the health visitor, greet her ‘good morning’ on the fifteenth. The patients appreciated the continuity of care. At the same time, as the district nurse, I could be visiting another member of the family. Babies were born at home, usually with just the midwife in attendance. We called the doctor only in emergencies and this usually meant a forceps delivery.”

After two years in Haywards Heath, Irene’s next post was as an Assistant Superintendent in Rochdale in Lancashire before becoming Superintendent at East London Nursing Society at Limehouse in the East End, in November 1946. In this area, “Cable Street was notorious: the police went about in twos at night, but the District Nurses, more often than not alone, were never harmed.” Over thirty nurses lived together in the home, rationing of food was still in force and the Superintendent’s job included overseeing the kitchen as well as every other aspect of administration. Her career then took her to Devon as Assistant Superintendent and then back to London to work for the Queen’s Institute itself. She became a Queen’s Visitor and in 1957 joined the World Health Organisation in Singapore to train the first health visitors and district nurses there.

She was awarded the MBE in 1976 and published her memoirs in 2001 as ‘Thank you, Miss Hunter.’

Irene Sankey died peacefully in her sleep on Christmas Day 2010 aged 100.


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