Shroud for a Nightingale

Profession (Miss Beale, in defiance of an unfortunate comparison, always thought of it with a capital P) was climbing so painfully into the twentieth century, kicking away the stones of outworn attitudes and methods- Miss Beale was frequently required to make speeches and certain pet phrases tended to stick in her mind-it really was a pity to house young students in this Victorian pile. It would do no harm to incorporate a strong comment about the need for a new school in her report Nightingale House was rejected even before she set foot in it.

But there was nothing to criticize in her welcome. As she reached the top step, the heavy door swung open letting out a gust of warm air and a smell of fresh coffee. A uniformed maid stood deferentially aside and behind her down the wide oak staircase, gleaming against the dark paneling like a Renaissance portrait in gray and gold, came the figure of Matron Mary Taylor, hand out-stretched. Miss Beale assumed her bright professional smile, compounded of happy expectation and general reassurance, and stepped forward to meet her. The ill-fated inspection of the John Carpendar Training School had begun.

III

Fifteen minutes later, four people made their way down the main staircase to the demonstration room on the ground floor where they were to watch the first teaching session of the day. Coffee had been served in Matron’s sitting room in one of the turret blocks where Miss Beale had been introduced to the principal tutor, Miss Hilda Rolfe, and to a senior consultant surgeon, Mr. Stephen Courtney-Briggs. She knew both by reputation. Miss Rolfe’s presence was necessary and expected, but Miss Beale was a little surprised that Mr. Courtney-Briggs was prepared to devote so much of his morning to the inspection. He had been introduced as Vice-Chairman of the Hospital Nurse Education Committee and she would normally have expected to meet him with other members of the committee for the summing-up discussion at the end of the day. It was unusual for a senior surgeon to sit in at a teaching session and it was gratifying that he took such a personal interest in the school.

There was room for three to walk abreast in the wide wood-paneled corridors and Miss Beale found herself escorted by the tan figures of Matron and Mr. Courtney-Briggs rather, she felt, like a diminutive delinquent. Mr. Courtney-Briggs, stoutly impressive in the formal striped trousers of a consultant, walked on her left He smelt of after-shave lotion. Miss Beale could discern it even above the pervading smell of disinfectant, coffee and furniture cream. She thought it surprising but not disagreeable. The Matron, tallest of the three, walked in serene silence. Her formal dress of gray gabardine was buttoned high to the neck with a thin band of white linen around the throat and cuffs. Her corn-gold hair, almost indistinguishable in color from her skin, was combed back from the high forehead and bound tight by an immense triangle of muslin, its apex reaching nearly to the small of her back. The cap reminded Miss Beale of those worn during the last war by Sisters of the Army Nursing Service. She had seldom seen it since. But its simplicity suited Miss Taylor. That face, with its high cheekbones and large, slightly protuberant eyes-they reminded Miss Beale irreverently of pale veined gooseberries- could have looked grotesque under the fripperies of a more orthodox head-dress. Behind the three of them Miss Beale could sense the disturbing presence of Sister Rolf e, uncomfortably close on their heels.

Mr. Courtney-Briggs was talking:

“This influenza epidemic has been a thorough nuisance. We’ve had to defer taking the next set off the wards and we thought at one time that this set would have to go back. It was a close thing.”

“It would be,” thought Miss Beale. Whenever there was a crisis in the hospital the first people to be sacrificed were the student nurses. Their training program could always be interrupted. It was a sore point with her, but now was hardly the time to protest She made a vaguely acquiescent noise. They started down the last staircase. Mr. Courtney-Briggs continued his monologue:

“Some of the training staff have gone down with it too. The demonstration this morning is being taken by our clinical instructor. Mavis Gearing. We’ve had to recall her to the school. Normally, of course, she would be doing nothing but ward teaching. It’s a comparatively new idea that there should be a trained instructor to teach the girls on the wards, using the patients as clinical material. Ward sisters just haven’t the time these days. Of course the whole idea of the block system of training is relatively new. When I was a medical student the probationers, as we called them then, were taught entirely on the wards with occasional lectures in their own free time from the medical staff. There was little formal teaching and certainly no taking them off the wards each year for a period in the nurse training school. The whole concept of nurse training has altered.”

Miss Beale was the last person to require an explanation of the function and duties of a clinical instructor or the development of nurse training methods. She wondered whether Mr. Courtney-Briggs had forgotten who she was. This elementary instruction was more suitable for new members of a Hospital Management Committee, who were generally as ignorant of nurse training as they were of anything else to do with hospitals. She had the feeling that the surgeon had something on his mind. Or was this merely the aimless chatter, unrelated to its hearer, of an egotist who could not tolerate even a moment without the comforting resonance of his own voice? If so, the sooner he got back to his out-patient session or ward round and let the inspection proceed without the benefit of his presence, the better for all concerned.

The little procession passed across the tessellated hall to a room at the front of the building. Miss Rolfe slipped forward to open the door and stood aside as the others entered. Mr. Courtney-Briggs ushered Miss Beale in before him. Immediately she was at home. Despite the anomalies of the room itself-the two great windows with their spatter of colored panes, the immense fireplace of carved marble with its draped figures supporting the chimney- piece, the high molded ceiling desecrated with the three tubes of fluorescent light-it was happily evocative of her own student days, an utterly acceptable and familiar world. Here was all the paraphernalia of her profession; the rows of glass-fronted cabinets, with their instruments placed in shining precision; the wall charts showing in lurid diagram the circulation of the blood and the improbable processes of digestion; the wall-mounted blackboard smeared with the dust of past lecture notes imperfectly erased; the demonstration trolleys with their linen-covered trays; the two demonstration beds, one containing a life-sized doll propped among the pillows; the inevitable skeleton hanging from its gibbet in forlorn decrepitude. Pervading all was the astringent and potent smell of disinfectant Miss Beale breathed it in like an addict Whatever faults she might later find with the room itself, the adequacy of the teaching equipment the lighting or the furniture, she never felt other than at home in this intimidating atmosphere.

She bestowed on students and teacher her brief smile of reassurance and encouragement and perched herself on one of the four chairs placed ready at the side of the room. Matron Taylor and Miss Rolfe seated themselves on each side of her as quietly and unobtrusively as possible in the face of Mr. Courtney-Briggs’s determination to be fussily gallant over pulling out the ladies’ chairs. The arrival of the little party, however tactfully arranged, seemed temporarily to have disconcerted the nurse tutor. An inspection was hardly a natural teaching situation, but it was always interesting to see how long it took a tutor to re-establish rapport with her class. A first-class teacher, as Miss Beale knew from personal experience, could hold a class’s interest even through a heavy bombing raid let alone the visit of a General Nursing Council Inspector; but she did not feel that Mavis Gearing was likely to prove one of that rare and dedicated band. The girl-or woman rather-lacked authority. She had a propitiatory air; she looked as though she might easily simper. And she was a great deal too heavily made up for a woman who should have her mind on less ephemeral arts. But she was, after all, merely the clinical instructor, not a qualified nurse tutor. She was taking the session at short notice and under difficulties. Miss Beale made a mental resolution not to judge her too harshly.

The class, she saw, were to practice feeding a patient by intra-gastric tube. The student who was to act as patient was already in one of the demonstration beds, her check dress protected by a mackintosh bib, her head supported by the back rest and a bank of pillows. She was a plain girl with a strong, obstinate and oddly mature face, her dull hair drawn back unbecomingly from a high nobbly forehead. She lay there immobile under the harsh strip lighting, looking a little ridiculous but strangely dignified as if concentrating on some private world and dissociating herself from the whole procedure by an effort of will. Suddenly it occurred to Miss Beale that the girl might be frightened. The thought was ridiculous but it persisted. She found herself suddenly unwilling to watch that resolute face. Irritated by her own unreasonable sensitivity, she turned her attention to the nurse tutor.

Sister Gearing cast an apprehensive and interrogative glance at the Matron, received a confirmatory nod and resumed her lesson.

“Nurse Pearce is acting the part of our patient this morning. We have just been going through her history. She