Renal nursing memories.
This paper summarises Sydney Hospital's history and early
memories of renal nursing. Sydney hospital was originally a tent in
1788. Renal care developed through the 1960s until the devolution of
renal services to other metropolitan hospitals in the 1980s. Renal
nurses have played a major role throughout.
history, kidney, renal, dialysis
|Article Type:||Personal account|
Nephrology (Personal narratives)
|Publication:||Name: Renal Society of Australasia Journal Publisher: Renal Society of Australasia Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2009 Renal Society of Australasia ISSN: 1832-3804|
|Issue:||Date: July, 2009 Source Volume: 5 Source Issue: 2|
|Topic:||Temporal Scope: 1980s (Decade) AD Event Code: 200 Management dynamics|
|Product:||Product Code: 8043100 Nurses NAICS Code: 621399 Offices of All Other Miscellaneous Health Practitioners|
|Geographic:||Geographic Scope: Australia Geographic Code: 8AUST Australia|
In the height of summer cockroaches ruled supreme and the ward
In February 1981, as an eager 18 year old, I began my student nurse training at Sydney Hospital. This beautiful building is the oldest and the first hospital in Australia and at that time it was busy and always full, thanks to its proximity to the heart of Sydney. The hospital dated back to 1788, where a tent hospital catering to the ills and ails of convicts was first established close to what is now The Rocks.
In 1811 it was moved to its current site in Macquarie Street, where building supplies, including copper for the lovely domed roof, were shipped out from England. For many years the construction was known as the 'rum hospital', as the building contracting was exchanged for a monopoly on rum. The original edifice was so large that years later the Northern wing was taken over to become the Houses of Parliament, and the Southern wing was turned into the Mint. All buildings to this day retain many elements of their original architecture.
In 1868 then Premier Henry Parkes requested nursing assistance from Florence Nightingale, who promptly sent Lucy Osburn out to the new colony, to establish Australia's first school of nursing on the premises. The first six nurses she trained later became matrons at various other hospitals, and the Lucy Osburn School of Nursing proudly trained thousands of nurses over the next 115 years. The building was officially named Sydney Hospital in 1881.
Back to my story. From 1981, after finishing preliminary training school (PTS) my first introduction to real nursing was on the orthopaedic ward. Good grief, what had I let myself in for? Whilst orthopaedics provided the perfect setting for the full scope of "basic nursing practices" it was extremely tiring and heavy work, long before back-safe considerations. After two months it was with some trepidation that I anticipated my second rotation, the renal ward. I was informed by nurses far more experienced than myself that I would either love it or hate it , but due to all the measuring of wee and weights, probably the latter!
Ward 17 was the renal ward, and it appeared huge and foreboding. Situated right at the back of the hospital the external verandah overlooked the Domain, and if you leaned right over you could see part of the harbour from the balcony. It was set up in the traditional "Nightingale wing" format, housing about 14 male beds on the south end, and 12 or so females on the north end, all beds in rows down the sides and facing each other, with curtain/railing provisions for privacy. To say that the buildings retained an original element of charm was an understatement: the lace fretwork may have been decorative, if in need of a lick of paint, but the floors sloped and the only air conditioning was from the drafty, wooden doors and windows. They never shut properly. In the height of summer cockroaches ruled supreme and the ward sweltered. The patients always fought over the limited smoking space on the verandah, when they were well enough to smoke out of bed, small miracle there were no disasters, the oxygen cylinders were housed there too!
Down the female end of the ward there was a room out the back where haemodialysis was performed. This I discovered quite by accident on one of my first shifts after 'losing' a patient . I popped my head around the corner and recall being confronted with strange vat-like contraptions to be informed "he's on dialysis, we'll bring him back before lunch".
From my very first day on Ward 17 I was relieved to discover a nursing system that made some kind of bizarre sense to me -the most fascinating people (patients and staff), fluid balance charts (more input than output) and the curiosity of dialysis, apparently such a new and innovative intervention.
Peritoneal dialysis was performed on there as well as haemodialysis and of course student nurses could only watch. I recall one roasting hot day, where the registered nurse (RN) scrubbed, donned mask, sterile gloves and gown and very carefully attached many lines to dialysate containers which were hung up quite high and connected to the cycler machine. Finally the main line was attached to the patient, who languished under a pile of sterile drapes. The whole connection process took close to an hour. I am not sure how long the dialysis took but he was certainly still connected by the end of my shift at 11 pm (no 2400 hour clocks in those days).
Another prominent memory, probably due to the frequency with which it occurred, was the overflowing of the sluice in the pan room. Most of these patients were anuric for heavens sake so how could so many bed pans need scrubbing? The enormous, ancient sluice sink, used mainly for soaking bed-pans took ages to fill. It was customary to turn on hot water taps to fill the sink and of course this took so long that it was usually only remembered as the water was seen seeping onto the carpet from the pan room, half an hour later. Thankfully peritoneal dialysis effluent was poured down an old ceramic drain, so the carpet stains were usually only from water!
The Charge Nurse was an enthusiastically and friendly as even then she tried to recruit nurses for future renal roles. I remember the entire staff there being supportive and encouraging with their teaching programs. But especially I liked the patients. I liked how we got to know them, treat them and finally send them home and perhaps not see them for a while; but the nature of renal illness dictated that they returned to us before too long, and then at least there was a familiarity which could be family like.
Unfortunately, by 1983 Sydney Hospital began its decline as a major teaching hospital. Many of its unique medical and surgical units were distributed to other hospitals. The renal unit was transferred to the Royal North Shore Hospital, and from those initial pioneering times the kidney transplant tally from both institutions was over 880 by the turn of the new century.
To this day my admiration for what renal patients endure has never waned, and from those humble Ward 17 beginnings it has always been a privilege getting to know the many wonderful, friendly and grumpy, stoical and irritable, brave and ultimately long suffering people who become renal patients.
Submitted January 2009 Accepted May 2009
Bradshaw, W 2009 Historical Reflections: Renal nursing memories Renal Soc Aust J 5(2) 72-73
Wendi Bradshaw is Clinical Nurse Specialist, Casey Haemodialysis Unit, Melbourne, Victoria
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