Extract from:
David May © Day in the life of a ward in the 1980s
Relationships with Family
Ward 14, like other wards in the hospital, and indeed, the hospital as a whole, is in many respects an environment closed to the outside world, with its own rules, procedures and practices. Of course, as we have shown, it is accessed on a regular basis by other hospital personnel who may have responsibilities for, or an interest in, the children but always operating within a framework laid down by the ward sister. This applies too to the children’s families. The ward has a flexible visiting policy and is generally open to families, a practice that is encouraged by Sister. Family members, parents mainly, will occasionally be found on the ward during the daytime, and at weekends especially. Never more than one or two at any one time, they can be seen in the ward, or more often in the corridor away from the hustle and bustle of the main work areas – the dormitories or dining area – sitting with their child, occasionally perhaps changing them or performing similar work, but mostly just attempting to communicate and maintain contact. Sister works hard to maintain a good relationship with families and takes a personal interest in their situation and needs. She sits on the parents’ committee and in that capacity provides an important link between the hospital and the families.
Staff-Patient Interactions.
Below are some extracts from our fieldnotes which illustrate the way that nurses and other hospital staff engaged with the children on the ward. Some children received a great deal of attention – they were the nurses’ ‘pets’, whilst others received much less.
Edith, the enrolled nurse, was on duty this morning. Darren (one of the ‘big end’ boys), as is his usual practice when she is on the ward, follows her around, calling her ‘mum’. Edith told Darren that she was not his ‘mum’. He replied ‘yes’ but continued calling her ‘mum’. Edith told me that she had looked after Darren since he was “a wee baby. At tea-break Darren wandered into the staff room. He was not given a row. Instead Sheila took him on her knee and he was given a cup of tea (or milk) while Sheila talked to him. Darren pointed to the pot with water in it and said ‘tea’. Sheila said ‘coffee’, but Darren replied ‘tea’, at which all three nurses in the room said in unison ‘coffee’, but Darren insisted on ‘tea’. This interchange was repeated several times until the nurses gave up.
Darren seemed to get a great deal of attention today. He was frequently held or spoken to. In the morning I saw him eating crisps, which he could only have been given by the staff. At lunchtime he was given two plates of custard and ice-cream and he usually is given extra juice. Sheila mentioned she was on holiday next week and so would be taking Darren out – and also Alister, “because I haven’t had him for a while.” In conversation later with Sister about Darren I suggested that he was a little “spoilt”. She replied ”He’s not spoilt, he’s loved”.
In Ward 14 today, Darren was with the nurses when they were having their early morning cup of tea. He came round into the kitchen with Edith before any of the other nurses had come through. She wiped his nose and took him to the table. Other nurses made the tea and Darren was put on a chair at the table. Edith gave him a small plastic mug with milk in it. Several times Darren called Edith ‘Mum’. Several of the nurses talked to Darren or looked at him while they had their tea. He put his head down on the back of the chair and the nurses commented that Darren was ‘in the huff’ and “he hasn’t been right since he had that cold.” Darren climbed up on to Edith’s knee. She held him like a baby and said “You’re just a wee baby.” Darren sat quite happily there. When Sheila returned to the ward – she and another nurse had gone across to another part of the hospital to deliver a message, taking Darren with them – she came into the Extension and began talking to Arthur. Another nurse who had come on to the ward for a few hours relief work, sat beside her with Maureen on her knee. She did not talk to Maureen, but Sheila would occasionally address a comment to her. Brian was sitting in the corner beside them but was not spoken to. Most of the other children were sitting around the room in their chairs. The T.V was on – and remained on all morning – but the children, although they were for the most part facing towards it, were 15 feet or more away and seemed to take little notice of it Mrs L, the Bed-Maker/Nursing Assistant, came into the extension and began talking to Peter. She asked him if he was alright, to which he replied “No”. She then took him on her knee and continued to talk to him, keeping up a constant conversation for several minutes about his father and what happens when he comes to see him and take him out. Mrs L remarked to me that Paul was getting very thin, largely the result of the staff not being allowed to feed him, as Sister was very keen to encourage him to feed himself. But ‘sometimes he does, and sometimes he doesn’t.” Paul’s mum, however, had suggested that the problem really was that “Paul was lazy.” The physiotherapist came into the extension and began to position some of the patients. Maureen picked up a small wedge and carried it across the room to her. Mrs L commented on this saying “Maureen likes to be helpful – sometimes too helpful”. Mrs L also spoke to Malcolm saying ” Oh Malcolm you’ve been awful good today. You never said a word”.
I was at the “babies” side this morning. The nurses talked very little – neither to the patients nor amongst themselves. They carried on with feeding and changing quickly and efficiently. Once the children were all dressed they were carried or wheeled one after the other into the school room.
Most of the children from the ‘babies’ dormitory were taken out on to the veranda today. Two student nurses went to sit with them. One began talking to Paul, taking hold of his knees and moving them about quickly. She said ‘Ride your bicycle’ and ‘Climb the hill’. She then took him on to her knee and shouted over to Robbie to ask what he was doing. This was the sum of the interaction between nurses and children that morning up to the nurses’ tea break.
A couple of student nurses from another ward came ‘visiting’. They were talking and playing with the children and giving them juice.
At about 11.30 am the hairdresser came to cut the hair of several children. First was Marion. The hairdresser started as if she was going to do it carefully, and then she said “It’s quicker and kinder to do it like this”, and she began to hack away at Marion’s hair. The next child was Noel. She said ‘Oh, it’s a boy now. Well, it doesn’t really matter if it’s a boy or a girl”, and she began to chop away at his hair. After Noel, she cut Geoffrey’s hair, with the help of two nurses who held his arms down as he has a tendency to hit out. All the haircuts were very badly done. One of the students later commented to me that the hairdresser should spend more time on the haircut and less time telling (sensational) stories of hair-cutting in mental handicap wards.
After lunch the children were again put out on the veranda – all of them this time. Three children sat in wheel-chairs and two in buggies. These were all placed so that they were facing out on to the hospital grounds rather than inwards to the ward. Four children were lying on mats and Amy was lying supported by a wedge. Geoffrey was lying in the beanbag, and Roy was sitting in the round seat/basket supported by cushions. Ruth was sitting in a little moulded chair supported by cushions. One of the student nurses remarked to me that she liked Geoffrey, although she wasn’t sure why. “There’s just something about him. I think it’s because he fights against you all the time.”
© David May 2015