Meet Barbara: 71-year-old nurse and role model
Since 2013 Barbara Craven has been a member of the clinical navigation team based at Clay Cross Hospital. She is 71 years-old (72 in May 2023) with no intention of retiring from a 30-hour-per-week role she enjoys and flourishes in.
Barbara is a highly experienced nurse and for many years was a tissue viability clinical nurse specialist working in Chesterfield Royal Hospital and in the community, before her retire-and-return move into the clinical navigation team with Derbyshire Community Health Services.
She was 61 years-old when she applied for and was appointed to the clinical navigation role, requiring a new skill set of largely desk/computer-based aptitudes in using her extensive clinical knowledge to support a wide range of colleagues and patients in their care pathways.
Any suggestion that her role in clinical navigation is better suited to her because it is less physical than hands-on ward or community nursing was absolutely dispelled by Barbara. It was a role which came up through a chance encounter with a former colleague in Morrison’s carpark, who mentioned the vacancy to her. Barbara had been “climbing the walls” after 10 months of retirement and decided to apply. It could equally have been in a ward or community setting.
And while the opportunity in clinical navigation was not a pre-planned career move it was a perfect fit for Barbara. “It’s like being a human sat nav is how I describe it to patients, helping them on the best discharge pathway. I can use all my past experiences, communication skills, listening and empathy too.”
Throughout her nurse training and nursing career Barbara has stayed with her roots in Derbyshire. She trained at Chesterfield Royal, was a bank community nurse when her children were small, then district nursing sister and community practice teacher. She loved district nursing, undertook her nurse prescribing qualifications and discovered a passion for wound and palliative care.
“District nursing is where I found my autonomy working with a particular GP, who was the first one to ask me what I thought about a particular patient’s condition! That was such a revelation, to be asked my opinion! My confidence built from then on.”
Her continued zest for work and for the companionship of being in the workplace is explained by Barbara: “Family and friends are very important to me and colleagues are my extended family. I can’t sit still for long enough to sew or knit; I like to be doing things. I enjoy cleaning, ironing, and cooking - I really should have had a cleaning business!”
Barbara has maintained her dedication to nursing for more than half a century while also raising a family - she is now a grandmother to four, aged between 14 and nine. She’s had no sickness absence since 1982, excepting bereavement leave. Her energy and her generosity in sharing her knowledge have been remarked on by colleagues and former colleagues.
“I still feel I have a contribution to make, even though others say I am mad to be still around!! I’m always happy to lend a helping hand within my competencies and I enjoyed having students, being able to share my knowledge and help others to maximise their potential.”
And she added: “I enjoy work, it’s the people I work with. I think that sometimes it’s just as well I’ve ‘been there, done that’ so I can be a good mentor to some of the younger nurses.” Of her brief foray into retirement when she left her tissue viability role, she said: “I was sick of morning television and there’s a limit to the number of times you can go into town for a cup of coffee!”
While we were talking to Barbara about her decision to carry on working into her 70s, we took the opportunity to ask her about what had changed in nursing since she first started her career. This is what she told us:
In 1967, when Barbara started as a nurse cadet, the NHS was less than 20 years old, and the culture was very different from the experiences nurse recruits would recognise today.
Her mum wanted her to be a secretary but, she said: “My dad was a miner at Williamthorpe colliery and had a bad pit accident, the roof fell on him. I felt useless when he was discharged home, that made me decide on nursing as a career.”
At 16, with the equivalent of CGSEs, Barbara entered a hierarchical nursing culture with strict hospital etiquette on everything from how you greeted your seniors to which table you were allowed to sit at to eat your meals. Daily inspections each morning checked the recruits had the right lace-up shoes, American Tan tights and their hair tied-up, not touching collars.
As a cadet nurse Barbara was paid £270 a year and her duties included making teas, fetching x-rays and bloods, and generally helping the nurses. When on the private patients’ unit, she also had to clean the brass plates. Nurse cadets who felt unwell on duty were never sent home but told to lie down in a side room until they were well enough to go back on shift.
“It was not etiquette to remain seated when spoken to by a more senior person, so if anybody senior to yourself walked in, you had to stand up. It took me ages to stop doing this! It was good manners to let senior people pass first and you had to hold the doors open for them as well.”
“If you were ever asked to do something, you wouldn’t dare say ‘it isn’t my job’. And if you weren’t sure about anything you wouldn’t go to a sister. You had to ask someone just above you, so a Year 1 would ask a Year 2, but you were often afraid of the nurses in the year above you.”
As well as a strong focus on discipline imposed on nurses and cadets, they were also required to exhibit loyalty and obedience to those in authority and to give ungrudging service and to accept correction “in the right spirit” as an opportunity to improve. Medical staff were all men and addressed as Sir or Mr and everyone else by their proper surnames, never ever first names.
This deference extended to patients’ visitors – so long as they arrived during the stipulated visiting hours which were strictly enforced. Cadets were told to attend to visitors promptly and pleasantly and offer a chair if they were kept waiting.
It was not a system everyone could hack. Of 13 student nurses in Barbara’s group only four finished their training and Barbara was the only one who stayed in the profession, the others leaving for different reasons – including to work in a supermarket and one who was homesick for Malaysia.
At 18 Barbara became a student SRN – or state registered nurse - and was officially counted as part of the workforce numbers. But life didn’t get much easier! The duty rotas were all last minute, making it difficult to plan anything and students were expected to pick things up quickly. It was a case of being shown how to do things once and then get on with it.
Training was through the (old) Chesterfield Royal’s school of nursing with all tuition taking place on site and assessed by the Chesterfield Hospital Management Committee Examining Board.
There were no specialist nurses and very little input from other professionals, so students were expected to develop a broad knowledge.
“Matron did a daily ward round, spoke to all the patients and checked the beds and hospital corners. Everything had to be neat and tidy, even the patients sat to attention!! We had to know all the patients on our ward, their names, diagnoses, and any investigations – we might be asked for this at any time of day or night.”
These were also times before pressure-relieving mattresses on the wards. “There was a two-hourly “back trolley” round – which meant all the patients’ bottoms were inspected, washed, creamed, and rubbed hard for circulation. Even if you were in for having your tonsils out you still had to have your bottom inspected.”
Student nurses wore yellow dresses which were laundered in the hospital and over time the yellow faded and the material became thinner and transparent in certain lights. This made the newspaper headlines in 1967, that Chesterfield nurses were wearing see-through dresses.
Obstetrics training was at Scarsdale in those days, but it was not a placement in which students felt very welcomed. “The staff never knew why they had to have student nurses because we weren’t much use to them. I can remember a staff nurse saying to me: we wouldn’t have nurses like you in my day, because I’m 4ft 11” and I wasn’t tall enough. I used to get the job of helping patients onto the bidet in the morning and I became quite professional with that.”
There was a lot of cleaning involved in a student nurse’s workload; everything from damp dusting with disinfectant to instruction in how to clean baths and lavatory bowls, mouthwash mugs, sputum mugs and bed pans (no single use equipment). They had to learn trolley and tray settings for every procedure, making up colostomy dressings and kaolin poultices were all part of the job. Barbara remembers a measles and flu epidemic in 1969 when volunteers were drafted in to help the hospital cope. Head lice and scabies were regular problems amongst patients.
“I do remember vividly on a night duty I had a baby stopped breathing on me whilst I was feeding it. The vicar and parents were called, and the baby was Christened. The baby did survive!! But I was certainly leaving nursing then, I just wanted to go home and was distraught. But I had good supportive colleagues who were on night duty with me, and they made me feed another baby. Like they say if you fall off a horse get straight back on.”
Barbara has lived through many transitions, seeing nursing move from a largely task-based role to being much more focused on individualised care. The closure of long-stay hospitals and focus on community-based care have been other big changes in the way care is delivered. Operations which used to require several days in hospital are now done as day cases or in some cases are obsolete procedures due to advances in medication.
“Life expectancy has increased, there are more demands on health services and patients living with increased comorbidities. People have greater demands and expectations and are not always grateful. You find a lot more older people looking after older people – a patient who is 100 will have children in their 80s, you can’t expect them to be travelling all over. The NHS has to make challenging decision about where the money is spent.”
On being adaptable to new ways of working, which Barbara has had to do many times over the years, she said: “It’s just learning along the way and not to be frightened of it. I mean, I don’t know a lot of things but as long as I know what I need to know, that’s all I need to know!”