In the second of her two Christmas messages to the BGS, “Matron Brooke” (a.k.a. Bridget Leach from the Heart of England Foundation Trust) gives us her own inimitable take on the festive season.
Hello My Dears
The Festive Season is once more upon us and, as has become traditional, I am sitting at my bureau penning my Christmas message to my colleagues and dear friends hard at work in our beloved NHS. I always write in a fountain pen of course, finding the biro leads to a more scruffy hand.
What a year; every time one sees a paper our NHS is in trouble for yet more misdemeanours. I have informed the staff here at Greenfields that they should no longer buy the red tops and stick to the broadsheets, but there are a couple of residents who will insist on The Daily Mail (I believe they were both ‘in trade’) and one who will read nothing other than The Daily Mirror. How one is expected to be aware of what is going on in the world, when met with front page headlines concerning someone with the ridiculous name of Posh and erstwhile ‘celebrities’ having jungle holidays, I will never know.
Anyway, that aside, we must find a solution for this daily lambasting of our service. I must say I find the lack of respect for those who work within the NHS most disconcerting. I’m not saying there are not issues to be addressed – believe you me I have very strong views on this and myself and Sir Hugo Fothering-Smythe (our esteemed chief surgeon) have spent many a lunchtime discussing this.
However, let us move onto more pleasant matters.
Christmas in hospital brings back many happy memories. Carols being sung around the wards were not an optional activity: all student nurses and medical students not on duty were expected to be there and, at St Mungo’s, were led by Dr Henry D’Amontage (a rather enthusiastic geriatrician with, as I recall, a very fine baritone voice) who saw it as his mission to ensure several carols were sung on every ward.
The wards would compete with each other to become the best decorated, and many of the patients would be recruited for paper chain making and window painting. The medical students who decided ‘festive’ anatomical paintings on the female surgical ward windows were a good idea soon changed their minds when Sir Hugo made them wash it all off, when they could have been attending the mess party!
The Consultants would of course visit their wards on Christmas Day, and carve the turkey for Christmas lunch. I would often find myself in awe of Sir Hugo’s exceptional carving skills whereas the physicians, though enthusiastic, lacked the finesse of a surgeon and the carving would be rather haphazard.
The Sister’s office and Staff rooms would be teeming with Christmas fayre for any staff working or visiting the ward to enjoy. However, if I found anyone lurking in there if a call bell was ringing or a bed was unmade, they would be reprimanded most severely and anything other than a very small sherry during the shift was a foolish move.
Patients had to be encouraged not to over indulge, and we would occasionally find it necessary to confiscate certain items brought in by families for them to enjoy so as to avoid unpalatable purgatives being required on Boxing Day.
The highlight of my Christmas tended to be the Grand Walk around, undertaken by Sir Hugo, the hospital almoner, Lady Cynthia Bloomsbury (chairwoman of the League of Friends) and of course myself. We were very much of the opinion that staff should be able to see that the senior staff were around on festive days, just as they were. The walk round would begin with a glass of mulled wine and a mince pie in my sitting room at 9:30 – fortifying us for the task ahead. My fresh hat would have been starched to within an inch of its life and my uniform crisply ironed: I expected a similar appearance in ALL of my staff. Sir Hugo would be dressed as ever in a beautifully cut suit and would sport a red waistcoat and green pocket handkerchief in deference to the season.
As we arrived on each ward, the staff would line up to receive our Christmas wishes before scuttling off to continue their duties. The Ward Sister (no ward sister of mine ever took Christmas Day off) would then accompany us on a tour of the ward where we would exchange a kindly word with the patients and Lady Cynthia would dispense gifts kindly bought by The League of Friends. The female patients would of course receive some cotton handkerchiefs and the male patients socks: all the patients were very grateful and touched by the gifts, even the men on the vascular ward who would often, after we had left of course, share jokes of what to do with the socks making many a young student nurse blush…
Don’t misunderstand me though my dears, whilst a lover of Christmas and the bringing of a little cheer to our patients I would never tolerate inappropriate behaviour.
Kissing a junior doctor under some mistletoe hastily pulled from his pocket would result in a trip to my office, a dressing down and general discussion about morals and a likely telephone call to your parents – I never understood why the parents I did telephone found the whole situation rather amusing, though in these cases I could see why the young student nurse behaved in the way she did if she had them as an example.
Arriving on duty with even a hint of a hangover would earn you sluice duties for the whole morning, guaranteed to clear even the foggiest of heads.
It must be said however I have chosen to ignore some of the pranks that often occur at this time of year. Ivy Aspirin is nearly always admitted on Christmas Eve with a regime of two hourly soap and water enemas prescribed throughout the following day – the junior nurses face during morning report is quite a sight to behold; I kept a student nurse who came to ask me for a long stand for an hour once – such things are harmless and all add to the excitement of the day.
‘Bed pressures’ were not the issue they are today. Many of our patients would be allowed home for Christmas – some of them just for the day. I once had to be really very stern with a family who bought back their father who had recently undergone bilateral below knee amputation drunk as a Lord. We would often admit patients who maybe didn’t need much treatment other than a good bath and a couple of decent meals.
It is unfortunate that despite all the advances in medicine that our humanity and understanding of the need for laughter (some still say it is the best medicine) has been mislaid and I think that is unfortunately particularly true at this time of year.
Our patients may feel particularly low when in hospital over what has become not just a religious festival, but a time for families to come together. As such they may find a little tinsel in a nurse’s hair or perhaps a festive sock peeking out from a pair of trousers (no trousers on female nurse though please, absolutely no need and a dress can look so much neater!) rather cheery. However, I am in absolute agreement that festive earrings and musical broaches are most unprofessional and really rather irritating – I would never allow even a stud earring on my nurses at St Mungo’s!
It would seem however that such things are now frowned upon; tinsel is viewed as a dirtier and likely more contaminated item than a 3rd year medical student. A festive sock is viewed as rather unprofessional. Decorations are meant to be ‘minimalistic’ in the extreme. Tinsel is all but banned and decorations other than a rather unimaginative fibre optic tree are frowned upon. Some of our patients would be hard pressed to know it is actually Christmas day at all.
At this festive time we should endeavour to raise both patient and staff morale by adopting a slightly more relaxed demeanour whilst maintaining a professional and efficient attitude.
Looking forward to 2016, I hope the general public will re-embrace our beloved NHS, acknowledge that all is not lost, and remember that the press don’t like a success story.
Carry on the good work you do. Doctors please wear a suit and tie and nurses please re-consider starch, I remain certain the lack of a robust and appropriate dress code has caused some of the problems we have.
With very best wishes,
Matron Brooke
British Geriatrics Society 