- 24 March 2021
- 22 min read
What I’ve Learned From My 41 Year Nursing Career
- Richard Gill
- Mat Martin
- Matt Farrah
- Louise Fountaine
- Pam Drysdale
- Laura Bosworth
- Jimmy Choo
- Victoria Parry
If you’ve ever wondered what being a Nurse in the UK for the last 40 years might have been like, here’s your answer. Cath Bardwell started as an SEN in 1979 and has just retired. Here’s her story.
Topics Covered In This Article
Introduction 1979 - 2020
My name is Cath Bardwell.
I started Nursing in 1979 and trained to become a State Enrolled Nurse.
Years later, I went on to become a Registered Nurse.
I was also fortunate to take time out to explore other things in the interim.
I feel that all my life experiences mattered in equal measures and culminated in making me a better Nurse.
In 2020 after serving as a Community Matron for six years, I became ill with Covid-19 and was incredibly lucky to recover after five weeks and returned to work.
However, Covid-19 had taken its toll and left me extremely fatigued and I decided to retire from Nursing at the age of sixty-one whereas I had always thought that I would work until at least sixty-six.
When my daughter returned to work following Maternity Leave, I then concentrated on caring for my lovely Grandson three days a week.
My story spans forty-one years. I had left school with a handful of qualifications at sixteen, yet I achieved a Master’s in Medical Science with Distinction at the age of 53, showing that it is never too late to learn.
I believe that Nursing is the most rewarding job in the world.
The World Was A Different Place When I Started My State Enrolled Nurse (SEN) Training In 1979
I used the word ‘training’ here as the Nurse training back then was quite regimented in some ways. In two years, I worked on wards and units specialising in: Male Medical Female surgical orthopaedics A&E Children Gynae Rehabilitation for older people Theatres Mental Health.
What Did Nursing Uniforms Look Like In The 1980s?
Female students wore a uniform of black leather laced up brogues, American Tan tights, blue checked knee-length dresses with white belts, white paper hats with stripes indicating which year student cohort you belonged to, a fob watch, scissors and the much-needed wooden spatula with a guide to show how many drops a minute were required to instil IV fluids at mls /hour.
We also were issued with navy woollen cloaks with hoods and red linings to wear to walk back to the Nurses’ home after shifts.
Once qualified the dresses were green for Enrolled Nurses with bronze buckles, (mine was embellished with The Yorkshire Rose), blue for Registered Nurses with silver buckles and navy for Sisters and Charge Nurses.
Sisters also has frills on their caps and frilly cuffs.
Much more comfortable but not as stylish!
Nurse Training: Nightingale Wards And Funny Memories
The wards were mostly Nightingale Wards with beds lining each side and length of the ward.
At night we would sit in the middle of the ward to observe patients between our rounds.
One memory was of seeing a dark figure move from one end of the ward to another and the Auxiliary Nurse saying “Oh! it’s just Mick from the Crypt” and another was when on a male orthopaedic ward at night on a warm summer evening a pigeon had flown in through the open window of the sluice and all the men shouting at me to “Catch the pigeon!”
I remember with fondness being chased by an ‘ostrich’ on Christmas Day on the children’s ward with the children howling with laughter as I climbed over furniture to avoid being caught.
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The training itself was carried out both by lessons in The School of Nursing housed in the hospital grounds and by placements on the wards.
The lessons were theoretical e.g., Anatomy and Physiology, and practical e.g., How to apply bandages and dressings.
Whilst working in A&E, a man attended in his gardening clothes, he had cut his thumb and I had to clean his wound and I applied dressings and bandages.
I also had to administer injections intramuscularly into his backside and I soon saw why he was reluctant to lower his trousers as he had no pants on!
On my next placement in ‘school’ it turned out that the man’s wife was the tutor who had taught the bandaging lesson and she praised me for dressing her husband’s hand well (neither of us mentioned him ‘going commando!’).
Nurse Training: Challenging Times On A&E
Training was not always fun as depicted above.
There were incredibly sad moments when I Nursed patients who were extremely ill and dying, children who suffered the trauma of being separated from their parents as well as suffering from illness.
Nowadays of course, parents can stay with their children.
There were tense moments also e.g., when I was out with the ambulance crew in their new fully equipped land rover, drawing up Diamorphine while the vehicle travelled at over 100mph in preparation for attending a road accident on a country road.
Back in A&E we had to continue to treat the young men who had crashed into a stone wall.
Their injuries were horrific and as I helped with the acute care of these men, a Nurse told me “ If you can do this, you can do anything!”.
There were of course incredibly sad times when a patient passed away and the rituals performed were carried out with great dignity.
1st Job As A SEN: Rehabilitation Unit for Older People 1981-1983
I loved working with older people but found the work back breaking!
We had to physically lift many patients from lying down to sitting to eat their food and lift patients from bed to chair and vice versa.
Each ward had a ‘bath book’ that had to be completed daily to record when each patient had had a bath.
There were also ‘toilet times’ when each patient was escorted to the toilet.
It was not the way that we treat people today thank goodness as all care should be individualised.
This role gave me a grounding in excellent basic Nursing care and a love of older people, their stories, and the joy in enabling some people to be discharged home to continue to live their lives independently.
Notes! The practice of lifting patients was later abolished and improved training in Moving and Handling was brought in.
Now the emphasis is to ensure that people are cared for in their own homes and consequently the numbers of care agencies has expanded.
Working On A Renal Transplant And Acute Dialysis Unit
This role was completely different to my previous role.
I was given the job to bring my basic Nursing skills to the unit as they had been deemed excellent.
The training for this role was demanding and the role dynamic.
I learned to perform haemodialysis, peritoneal dialysis and care for patients undergoing renal transplants pre- and post-operatively.
I attended a post- basic course in Renal Nursing and whilst on this course, I had the opportunity to care for people who were learning how to dialyse at home.
I was part of a team and there was always help available as dialysing acute patients was complex.
We had to monitor the patient’s clotting times and add heparin to the blood accordingly to stop it clotting, we administered IV normal saline if a patient’s blood pressure dropped, this was all done instantaneously so it was a very responsible job.
The whole team wore white uniforms and white clogs on the unit so that any debris or blood could be detected, and we had a changing room on the unit so that we were able to change straight away.
We were expected to don our coloured uniforms before going anywhere else in the hospital.
Whilst working with patients awaiting and later receiving transplants, it was a privilege to work one to one with people.
I no longer saw the people whom I cared for as ‘my patients’ yet people who needed my help.
This role was one of the most satisfying times of my life and career as a Nurse. I remember one patient who was a similar age to myself and on night duty I became quite nauseous and had to sit down in her room, whilst apologising to her, she remarked “Cath, I think you are pregnant!”and she was really excited for me.
It turned out that she was right and when next on duty she asked me if I was pregnant and was delighted for me.
What I found remarkable about this lovely young woman was that due to her having transplant drugs for the rest of her life to stop rejection of the kidney, she herself would never be able to have her own baby.
I will never forget her.
Note! On the unit we worked shifts and this involved night duty.
As I was not a fan of working all night and sleeping in the day, I volunteered to work the holidays and this included Christmas Day.
This ensured that I did not have to work nights as often.
We worked ten nights in a row and had a week off.
The Flexibility of Nursing: Bank Nursing On Surgical Units And Working In A Hospice 1991 - 1995
After leaving the Transplant Unit I spent a few years having and nurturing my two lovely daughters.
There came a time however when duty called (and the bank balance was in the red) and I returned to Nursing on an as-and-when contract covering the Surgical Wards of my local hospital.
This was a fantastic experience as I moved from one surgical speciality to another.
I was mostly covering for staff sickness and holidays and worked most weekends whilst my husband looked after our two girls.
I also worked some afternoons.
My most memorable time was when a patient’s operation had not been successful, and she had not recovered from the anaesthetic.
I remember escorting her back to the ward and the porter noticing the tears streaming down my cheeks.
I felt so deeply sorry for this elderly lady who had no family, and I obtained permission to sit and hold her hand until she passed away and later helped to perform the last offices.
I later went to work for a local hospice.
This was very sad for me personally as my mother had passed away in this hospice a year previously.
It was also very cathartic as I worked through the many thoughts embroiled in my mind about death and dying.
It was a privilege to be able to help people to live out their last weeks and days to the full and to die with dignity and peace.
The hospice had a great creche and in summer you could hear the children playing outside on the lawn.
Those happy sounds resonated through the rooms.
Note! What was remarkable about both the above roles was that I gained both employments via informal interviews.
(I did have great references I might add.)
Studying To Become A Registered Nurse - 2005
After I had suffered the trauma of my mother passing away, I took a break from Nursing and spent ten years doing other things.
I spent time studying and gained a 2:1 in English Studies where I particularly enjoyed creative writing (and was partly mentored by the lovely Barry Hines who wrote ‘A Kestrel for a knave’ known as ‘KES’ in the film world).
I dabbled in a PGCE teaching Secondary English.
I home-taught my daughter for three years and worked for the National Trust for a short time until I finally decided to return to Nursing.
This time I would become a Registered Nurse.
Instead, I undertook a two year post graduate course in Health Care Studies with Professional Registration in Nursing and gained a Distinction.
Huge Changes Had Taken Place In Nursing When I Returned In 2005
On returning to Nursing after ten years, the changes were immense.
‘Project 2000’ had been launched in 1989 and was in place in the mid 1990s. This had moved Nurse training based within hospitals to studying at a college.
There were less placements on wards than previously and students were now supernumerary, whereas when I trained in 1979 we received a salary and students were counted within the staff numbers.
Project 2000 provided bursaries to students and I was lucky to receive a bursary in 2005.
There was a greater move to recruit male students and mature students. Enrolled Nurses were given the chance to attend conversion courses and the training to become an enrolled Nurse ceased.
I am delighted to hear that the bursary system has now been reintroduced where students can receive £5,000 per annum.
There are also several routes into Nursing including a Nursing degree or a Nursing apprenticeship within the workplace requiring level 3 qualifications or Nursing associates can top up to become an RN in 2 years.
During the time that I took a break from Nursing there were many changes taking place and on return to Nursing some of the changes were that there was a greater emphasis on Health Promotion, Prevention of Ill Health, Self-Care and Empowerment.
Reflection was a large part of practice as was Research and Evidenced Based Practice.
In hospitals Modern Matrons replaced Nursing Officers.
Moving and handling had changed 100% for the better. I had hurt my back twice years ago and welcomed the new techniques: enabling patients to move up the bed themselves if possible, use of slide sheets and hoists and other aids.
There was a greater emphasis on training.
Infection Control had upped its game since MRSA.
All patients on admission were now swabbed, no flowers allowed in the wards and the domestics damp dusted everywhere especially underneath the beds. Alcohol gel and liquid soap dispensers were in every bay on the wards.
I Became A Registered Nurse At The Age Of 49 In 2007
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Do you have any questions for Cath?
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My first role was on a Urology Ward.
As I had received a distinction at University, I was allowed to choose the field of work within the hospital that I was most interested in.
I did want to work in the community as I had enjoyed this on the course, yet it was not allowed unless you worked your ‘preceptorship’ within the hospital.
I had worked in Urology years ago when bank Nursing in another hospital, so the work was familiar but this time I had to learn quickly to teach students, delegate to Healthcare Assistants, carry out a ward round with the doctors, increase my skills which included
• bladder washouts
• removal of drains and IV catheters
• maintaining pumps
• instilling insulin, heparin, analgesia and other medications
• administer IV antibiotics
• administer drugs
• prepare patients for theatre and Nurse the patients post op
• Nurse palliative patients and patients who were towards end of life
There were many other duties and skills required.
I can honestly say that in a 12 hour shift I was lucky to have a 20-30 minute lunch break!
It was exhausting.
I always remember another Staff Nurse telling me in no uncertain terms that this work would be too hard for ‘someone of your age’ but I was to prove her wrong as she complemented me on the day that I was leaving on being really good at my job!
Moving From The Wards To The Community Was A Breath Of Fresh Air
For me it was fantastic no longer having to work night duty.
However, after working three long shifts a week on the wards it took some time to get used to working five days a week again.
2008 I started work as a Community Nurse and in 2011 Joined a consortium of Community Matrons as a Case Manager.
The role of Community Nurse was a challenging one.
We all learned from each other, mainly by observing once and then having a go a few times under supervision.
Then you had another skill under your belt!
Examples of this are male catheterisation, changing a supra-pubic catheter yet there were other procedures that required more extensive training for example administering IV antibiotics in the home.
I Nursed patients who required dressings following an operation, requiring Diabetes monitoring and insulin administering, bowel care, catheter care, incontinence management, leg bandaging, venepuncture, amongst many other interventions.
I also performed reviews for people with Long Term Conditions.
Caring for patients who were palliative and those at end of life was a part of my role that I will never forget.
To support people and their families in their own homes to help fulfil their wishes to be comfortable and die at home in dignity was such a humbling experience.
Working autonomously most of the time, in people’s homes was such a privilege.
Yet I also worked as part of a team with links to many other services.
This revolutionised record keeping.
Studying For A Masters In Medical Science - Developing Nursing Skills
For three years I worked full time on Community whilst also studying for my Master’s in Medical Science in my spare time.
I gained my second Distinction.
I felt as though my vocation in Nursing was now a career and I gained confidence through being able to attain my academic qualifications alongside my Nursing skills and knowledge.
I became very curious about underlying health conditions and was given the opportunity to cover for the Case Manager’s maternity leave.
Later I was deployed to work as a Case Manager within a consortium of Community Matrons.
I worked full-time and was released to attend Uni to study to become a Non-Medical Prescriber.
Training To Become A Non-Medical Prescriber
To become a Non-Medical Prescriber, I attended University one day a week for six months in 2010 and I was mentored by a GP.
The course was examined by different methods including a OSCE where I was to practice my assessment and prescribing skills with an actor pretending to be a patient and this was filmed.
I had to pass a maths calculation test by 100% and learned about Pharmacokinetics, Pharmacodynamics amongst others.
I was to develop a formulary over the next ten years and became able to prescribe many medications including antibiotics, diuretics, analgesia, anti-hypertensives, anti-diabetes medications including insulin amongst many others.
This ensured that my work as a Community Matron enabled me to provide the patients in my care with timely treatment and I was able to follow patients up.
I Became A Community Matron And Knew This Was What I Was Meant For - 2014
This is the longest that I had ever stayed in a role yet was enveloped by it as I felt as though I was playing a vital part in people’s journeys.
I built up a caseload of patients who were suffering from complex, multiple long-term conditions.
I would help them to manage their conditions, adjusting medications when appropriate, looking for changes in their conditions and acting accordingly which often meant liaising with specialist Nurses.
This included realising when patients were nearing end of life.
As the role progressed, I had to take on more patients and prioritise my work every day to ensure those patients who were unstable or struggling were seen first.
I opportunistically assessed patients for memory problems and commenced pathways for memory assessments.
I often had to refer patients to Safeguarding, sometimes when patients were self-neglecting and other times when there was abuse from another person: physically, mentally of financially.
On a few occasions I was asked by the GPs to visit some patients who were expressing suicidal ideation and I helped those patients to look for the root of their problems, seek solutions and signpost accordingly.
GPs would often involve me in patients who were deemed as ‘high service users’ and/ or at risk of hospital admission as I was given the time to help patients to sort out their numerous problems and again this often involved referring to other professionals.
Conclusion - Retirement
Being a mature Nurse has its advantages - you bring a plethora of life experiences.
For instance, you can relate to your patients well.
The role of Community Matron certainly suited me at this stage of my career as many patients were mostly over 60 and could relate to me, and vice versa. However, I must add that there are many younger Community Matrons who are highly successful in this role.
Whilst I was completely engrossed in this role, I completely forgot that I was getting on a bit!
The role was incredibly challenging and stressful as I worked autonomously. Most patient visits were complex and at times potentially distressing.
Of course, the flipside was that the role was extremely rewarding, and it was a joy to be able to form relationships with patients and their families and carers and to do all I could to help improve their quality of life and wellbeing.
There were many moments where patients and their relatives would share stories and photographs of their life’s events.
It was wonderful to be able to learn about their past through those snapshots of their lives.
It was an emotional journey working as a Community Matron within a community.
I will miss all the wonderful people throughout my career whom I was fortunate to help to care for, and their families and carers.
Final Note! Considerations If You Wish To Become A Community Matron
If you wish to earn the full rate of pay gain employment with an NHS Trust as some GPs tend to pay less.
Since I gained employment with a master’s degree and a Non-Medical Prescribing qualification, the pre-requisites required to become a Community Matron have changed.
To become a Community Matron you need to be working towards Masters level, to have a Non-Medical Prescribing qualification and in addition to either have or to plan to undertake Advanced Assessment Skills on an APACS course.
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Do you have any questions for Cath?
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