Birdie

Starting my first job as a qualified nurse in the small hospice/nursing home was both exciting and daunting. I knew there was more responsibility for me now but since I had decided to work in one of my comfort zones, I wasn't too nervous on my first day. The home was in a large but cozy Victorian building, with a large entrance hall, sturdy staircase and many original features. To the left was a spacious, open-plan dining room and lounge, with the kitchen leading from the dining room. There were a few bedrooms and a bathroom on the ground floor, as well as the office, and more bedrooms and bathrooms upstairs to accommodate the fourteen residents. It must have been an incredible house when it was first built and I loved the character of the place. The manager, Sandra, was welcoming and she appreciated that I was fresh out of training. For a while she made sure I always worked with another qualified nurse but, eventually, I would be the only one on shift, managing a team of care assistants! The care and nursing staff were completely lovely and I will always feel lucky that they were the people who gave me my first year of experience as a qualified nurse. I am yet to find a team in a nursing home who are more genuinely devoted to the care of their patients or who know how to support each other like they did. None of them made me feel silly for not knowing things and despite sometimes working fourteen hours without a break from the place, the shifts were enjoyable and the atmosphere was warm and friendly. I truly believe that an open and inviting environment is better cultivated - for both staff and patients  - in small places of work, be it a care home, clinic or GP surgery. I am not one for the modern conglomerate way of working, where patients become numbers and money is the key motivator.

One thing that surprised me on my first day was that after we had got the patients out of bed, washed them, dressed them and given them breakfast, we all sat down to eat breakfast together in the dining room. This meant that we were right next to the residents in the lounge and we could attend to them immediately whenever they needed us, at the same time as giving us a break together. The meals spent round the table were so valuable for building relationships and meant we actually had some fun at work! This routine was repeated after the residents had finished their lunch and were settling in their armchairs for an afternoon nap, and again late in the evening after they had all gone to bed. I'd never worked anywhere so social; spending down time with these colleagues certainly made the long days pass easily.

One of the first residents I met was Birdie. She was in her nineties and was a petite, softly-built lady with pure white hair, round blue eyes and about four teeth. I immediately loved her and she remained my favourite all the time I worked there. She had advanced dementia so had no idea who any of us were but was physically very well and, apart from getting confused with the buttons on her blouse, could take care of herself. She rarely spoke and when she did her words were limited but she was perfectly mobile and often wandered about the place. I was told that she once decided to sneak out of the building, while some visitors were walking through the front door, and take a stroll into town. The staff were so worried but the police found her safe and sound, having a lovely time on the seafront! Needless to say, we had to be sure of her whereabouts at all times. Even though Birdie rarely spoke, she would look into your eyes and say, 'I love you'. I know she had dementia but I truly believe that she knew what she was saying and that this was her way of expressing her gratitude for the care we gave her. She had the most gentle nature, until we tried to get her in the bath that is. At that point she would scream bloody murder, fight and refuse at all costs to get in. We had to move so fast to get her clean and out again before the neighbours could complain about the noise. As soon as she was dry, she was her sweet self again, until the next bath. 

Another favourite pastime of hers was rummaging through the other residents' handbags looking for sweets. If she found any she would scurry into her room and hide her treasures. Of course the other ladies would be furious if they caught her and she would have to reluctantly give them back. Another hilarious moment with Birdie was playing Bingo, or any other board game that involved counters. Rather than use them to cover her numbers or move around the board, she made up her own game of putting the counter on her tongue, popping it in and out of her mouth. She would do this so fast it was a real job for us to retrieve it. She found this so funny and we'd usually end up laughing so hard that the other residents' game would be over until we had rescued her from the risk of choking. Sometimes, when she was in a quieter mood, she would rummage around her own handbag and show me the photos she had in there. She used to show me her husband, who I later discovered had worked for the Royal Mail all his life, and, even though he had died years before, they still sent Birdie a hamper each Christmas. She also had a son and her eyes would come to life as she pointed him out and told me his name. According to the other staff she also had grandchildren. It still makes me so sad that in all the time I worked at the home, Birdie never had even one visitor.

Another entertaining resident was 67 year old Ernie. He was a terminal patient who was suffering with a brain tumour. He was a real cuddly bear of a man and his condition did nothing to squash his jolly demeanour. In contrast to darling Birdie, he had a very supportive family who visited regularly and could often be heard raucously chatting and laughing with him in his room. One afternoon I went in to see to Ernie and he was surrounded by relatives. He introduced his wife, son and daughter-in-law one by one and then turned to another man on his right and proudly announced, "This is my other son. I like to call him Fuckface." I had no idea how to respond! The room fell silent for a split second and then the family erupted in cackles of laughter. His wife shook her head with tears rolling down her cheeks and told me that she had made a fortune from Ernie's swear box!  Their visits did him the world of good.

There were two other men in the home suffering from brain tumours who were too young to be in palliative care - Tom and Jay. Both men were bed-bound and had days when they felt awful but they always surprised me with their determination to enjoy life. Tom was 56 and had two girls in their early twenties. He had made his room as personal as possible and had a pretty snazzy TV at the end of his bed. His partner and daughters visited daily and often watched his favourite TV shows with him. He had a mini fridge next to his bed full of his favourite chocolate and it really made an impact on me that he still found things in life to look forward to. It made me think of Ida who was always so happy with the funny little meal I used to make her each day. This was such an important lesson for me. To this day, no matter what is going on, I remember that there are things that may only be tiny, but that still make this world a great place to be.

Jay was always laughing and joking and he smoked like a chimney. In those days he was allowed to smoke in his room, as long as a relative or member of staff were with him. This surprised me, especially since I'd been told about a previous patient who had secretly lit a cigarette in her room next to her oxygen tank. It had exploded and set the room on fire! Miraculously, nobody had been hurt but there was a lot of damage to the room. Jay had a wife and 7 year old daughter and he most definitely wanted to enjoy what was left of his life with them. I found his situation unbearably sad. His wife was gentle and caring but had such resolve, especially when their daughter was with them. They shared genuinely joyful times together through Jay's last days. Regrettably, he wasn't with us long and passed away while he was still 40, just two years older than I am now. 

There were two residents who had suffered terrible strokes. Lucie, a rosy-cheeked lady in her late seventies, who always had a groovy little top-knot on her head. Despite losing her mobility and speech, she had such warm and sparkling eyes and, much like Tom and Jay, still seemed to find pleasure in life. She had two daughters who were very attentive and between them visited each day. Even though Lucie could no longer really communicate, she could understand what was being said and she could still laugh. Her eyes conveyed so much joy at the sight of her daughters or in simple everyday things like being made comfortable in her bed or armchair. She enjoyed food and hugs and people still taking the time to talk to her even though she couldn't answer. 

Chen was a lady in her sixties and had lost all mobility and speech. She appeared to be asleep day and night and was always nursed in bed. She had an incredibly devoted husband who spent each and every day by her side from morning until night. He spoke to her, fed her, kissed her forehead and spent hours massaging her legs and arms to maintain good circulation. Chen would sometimes moan in pain and he would be right beside her trying to ascertain where she was hurting. She knew he was there and he used to almost burst with joy when she smiled at him. It was her only way of communicating happiness and it made his hours of care worth it. 

Working in this home made me more aware than ever of how vital good care is. The staff could not have done more for the residents' quality of life, and the visits from their relatives made a real difference. A person may not be able to function or express themselves like they once did but when they are loved and shown true kindness - from either care staff or family - they are given a reason to live. For me, this was real nursing.