The Hive (4 page)

When Heston too had gone, and one or two of the other men had departed for their ward rounds, Jamieson and Sisson, a physician senior in appointment to James, joined Elizabeth and French, and the talk turned to hospital matters.

Elizabeth listened carefully, watching the three men as they talked at each other through her, offering no comments of her own.

‘You have great scope here, Miss Manton,’ Jamieson was saying. ‘With all due respects to your predecessor, this place is long overdue for a shake-up.’

Sisson, a big man in a shabby brown suit, scowled. ‘Not too much of a shake-up, I hope, Miss Manton. I’m a great one for letting workable methods go on working. No need to make changes just for the sake of it, hey?’

‘It isn’t always possible to realise methods work less well than they might until you change them,’ French said, his eyes on Jamieson. ‘New ideas are worth trying for their own sake, wouldn’t you think, Sisson?’

‘I would not! There’s enough work to be done with what we know. No need to go digging for a lot of stuff it’s unlikely you can do anything with.’

‘Research can uncover a good deal one
can
do something with,’ French said mildly.

‘Depends on the research,’ Jamieson said sharply.

‘And what else is needed,’ Sisson grunted. ‘Remember that. Treat the ill you can treat, and with what you’ve got left, you can have a go at the others—the ones who might be ill, but don’t know it. Wouldn’t you agree there, Miss Manton?’

‘Of course we must always treat the frankly ill,’ Elizabeth said carefully. ‘But I hope that a hospital will always find the energy to work towards preventing future illness. If that is what you mean.’

‘Something like that,’ French said. ‘Something like that. My own feeling is that if one can find some of the causes of illness, one may not at this moment be able to treat the existing illness—recognised by the sufferer or not—but perhaps have a later basis of preventive work.’

‘That again, French?’ Jamieson sounded scornful. ‘If you’ll forgive me, I can’t see that a research project involving psychoneurotics, or whatever it is you’ve got in mind, can ever be deemed a piece of preventive medicine.’

‘At this stage, I can’t pretend that I do either,’ French said easily. ‘But it might. That’s my point. Make your research, and then apply it. It’s a question of one’s approach.’

Sisson grunted. ‘Expensive and bed cluttering research is all very well if you’ve got the beds and the money. We haven’t. Miss Manton’ll bear me out on that, I’m sure, once she’s had a chance to look about the place a bit.’

James smiled at her then. ‘We’re boring Miss Manton. It’s
hardly fair to bombard her with our private argument on her very first day. She will think we are trying to enlist her aid on one side or the other—and since she has no knowledge of the argument or its protagonists, we mustn’t alarm her with our discussion!’

Elizabeth smiled. ‘I must confess I am rather in the dark about your discussion—but I had realised it wasn’t an entirely abstract one.’

French threw back his head, and laughed very loudly.

‘Miss Manton, you must forgive us. I had forgotten that we were talking with an intelligent woman. As Jamieson said, no disrespect to your predecessor, but she—well, she was not a woman to appreciate the importance of personalities in apparently abstract discussion. But we mustn’t overload you with all this on your first day. You will have plenty of time to hear all about it. Plenty of time.’

‘A week, to be precise,’ Sisson sounded surly. ‘The committee meeting will be next Monday afternoon.’

‘Which committee is this?’ Elizabeth asked.

‘Oh, general medical and nursing purposes. It deals with all the day-to-day things,’ French said easily.

‘And a few others,’ Sisson said. ‘Bed allocations.’

‘Yes, a few others,’ French was smooth. ‘You’ll discover how it works, Miss Manton, next Monday. As Matron, you’re an ex-officio member.’

‘I shall look forward to it.’ Elizabeth began to move towards the door, and they followed her: ‘And I must now return to my office, if you’ll forgive me. I have a good deal to do before I meet my sisters after lunch. It has been most pleasant meeting you all. I am sure we will work very happily together. And may I assure you of all the help it is in my power to offer you? If there are any nursing matters you wish to discuss, please don’t hesitate to see me at any time——’

And she shook their hands and with those men she passed as she went, leaving behind considerable satisfaction. In the consultants’ eyes, the new matron had definite possibilities.

They were ruffled. Elizabeth could feel their annoyance as she leaned back in her chair listening to Gladys McLeod, the
Home Sister, murmuring about the need for a new bathroom in the P.T.S. annexe. Gladys was the last to give her report, and her red face and stumbling phrases as she talked reflected the feelings of the other sisters.

Elizabeth had thought very carefully about this reporting session, and to Miss Baker’s surprise, had had her office filled with chairs ready for it.

When the sisters had arrived, and begun to form their usual queue outside the office door, Miss Baker had told them that ‘Matron would like you all to go straight in, please Sisters—yes, that’s right, Sister East, all of you together. No, I can’t say why, Sister. She just asked me to bring you all right in.’

They had settled themselves awkwardly on their chairs, unwilling to talk while Miss Baker bustled about and when Elizabeth had come in last of all to take her place at her desk, had stood up together, their starched aprons rustling as they moved. Only Dolly, her head down over her report book, had remained seated, ostensibly too absorbed to notice Miss Manton.

Elizabeth had made no sign she noticed this lapse from protocol, and said charmingly, ‘Please—don’t stand up. There is no need for you ever to do so. I don’t particularly value these—forms of respect. I prefer to earn them for myself.’

They had sat down again, looking at her covertly, noticing the make-up, the way her hair was arranged, the well-cut dark green uniform so much more attractive than Miss Biggs’ voluminous navy blue had been, and moved a little uncomfortably in their chairs.

Miss Manton had leaned forward, her arms folded on her desk, and said carefully, ‘I hope you will forgive me for asking you all to come in and report en masse like this. I have a reason for it. Apart from wanting to know about your individual wards and departments,. I want to know all of you, too, and I thought you might prefer to sit in here comfortably while you all give me your reports, and then we can go on to discuss one or two other things.’

So they had, one by one telling her of their bed states, their admissions and discharges, ill patients and operative cases, all
very conscious of each others’ presence, and disliking the whole business. Even Daphne, who had a very small report to offer, merely statistics about the number of operations performed, was disturbed, feeling, as they all did, that Miss Manton had no right to make them display themselves in this way.

At last, McLeod shut her report book, and put it on the desk. They sat in silence, looking at Miss Manton as she put the Home report book on the pile beside her, and then turned and smile at them all.

‘Thank you for being so brief. I know you all want to get back to your wards, and I don’t want to waste your valuable time. But there are one or two things I must say, and I think it is worth using time on them.’ She paused, and then looked down at her hands on the desk.

‘I realise quite well that you all expect me to make a good many changes in the Royal. New matrons are always likely to do that, are they not?’ She looked up and caught Mary Cotton’s eye, and Mary blushed because she always blushed when people looked at her directly, and smiled back.

‘Well, I can assure you of this. I will make
no
changes in ward or departmental routines unless I absolutely must, and then only after I have been here long enough to have a really thorough understanding of the way things are.’

Josephine moved, and then relaxed, and Ruth looked across at her and raised her eyebrows so that Josephine grimaced back in relief.

Elizabeth missed nothing of this exchange, and went on smoothly, ‘However, there are some things about which I am concerned, and want to do something positive immediately.’

The tension, which had relaxed momentarily, began to build up again.

‘It is in the area of staff relationships I want to do these positive things. In my experience, when staff relationships are really good, when people work together not because they merely happen to be colleagues, but because they have given intelligent thought to the need for harmony, and the importance of inter-dependence, then a good many excellent things happen.’

She began to tick off her fingers.

‘First, senior staff are happier. That is very valuable in itself. Secondly, junior staff—and I mean students—are happier, study better, and make a better showing in examination results—which are important if the Royal is to remain a training school. As you know, the Ministry is quick to downgrade a hospital if they feel it is not a suitable training school—and they are much affected at the Ministry by examination results. Thirdly, patients are happier, get better more quickly, bed occupation shortens, turnover increases, and waiting lists shorten.’

‘All this happens when relationships are good?’ Dolly East’s voice cut across rather harshly, and Elizabeth looked at her and nodded.

‘Yes, Sister, in my experience they do.’

‘In your last hospital was it like that?’

‘It was. Most certainly.’

‘I see,’ Dolly said no more, sitting very straight and looking across at the younger woman with a wooden expression on her face.

‘And another thing that happens is this. Because student staff are happy, because morale goes up, recruitment improves. The power of talk, you know. Happy girls encourage others to join them.’

Sylvia Swinton, the sister from Male Surgical, stirred and said, ‘I don’t quite see—I mean, we
are
happy here. At least
I
am. I thought most of us were. We wouldn’t be here if we weren’t.’

‘Oh, I’m sure you are happy—and as you say, if you were positively unhappy, I realise you would leave. No, I mean something rather more. I mean that I would like us here to make a concrete effort to raise hospital standards by means of improving our relationships with ourselves and our nurses.’

Josephine wrinkled her face in puzzlement.

‘I’m sorry, Matron. I just don’t see what you mean. Do you mean we mustn’t tell a nurse off if she does wrong? Because it’d make her unhappy? If you let them get away with things, well, you get nothing done properly——’

‘Oh, I’m not for a moment suggesting we treat the students like babies! If they misbehave, or are negligent, of course,
they must be dealt with! Look, let me tell you in detail what we did at my last hospital, and then perhaps you will all see what I would like to do here.’

‘Your last hospital—that was Colston, wasn’t it?’ Dolly said.

‘Yes, Sister. A mental hospital. We had a three hundred bedded unit in which physical illness was treated, however. You need not fear I am trying to make the Royal into a mental hospital community—but I would like to offer you the results of experience I gained there.’

Elizabeth sat very straight as she said this, looking directly across at Dolly, holding her glance until it was Dolly who was forced to look away. She had been aware of the sneer in Dolly’s question as Dolly had intended her to be, could feel the cold resentment behind every word the older woman spoke.

‘I must say——’ Mary Cotton began breathlessly, and then reddened.

Elizabeth looked at her encouragingly, eyebrows up. ‘Yes, Sister Cotton?’

Mary, gratified that the new Matron remembered her name, started again.

‘Well, I just wanted to say, I’m all for anything that makes the nurses happier. I mean, look at my pupil midwives. I do my best, you know, I do my best, but I lost three of them only last month. I know midder isn’t easy, but all the same, I shouldn’t have lost three girls, trained and all as they are. It’s so sad when they don’t get their midder, and anyway, we need them so badly—I know being staff nurses they get fed up with all the junior work they have to do—the sluicing and all that—but even so, they ought to be happy. The babies are so sweet, aren’t they? And there’s so much they can do for the poor little mums—well, I just think anything there is that can help make them happy, I’m all for it——’

She stopped, and laughed. ‘Oh, I do run on, don’t I? You must forgive me—the others know me, don’t you? Chatterbox Cotton, that’s me——’

‘My dear Sister, there is no need to apologise for talking! In a way, it’s talk I want to encourage. Half the battle is being able to articulate one’s ideas and feelings.’

‘Well, I must say, Matron, if you want us to get the nurses
talking all the time, I can’t see us getting anything done on the wards.’ Josephine’s worries were beginning to mount again. ‘It’s all I can do to get through the work as it is, without having them waste good time chattering——’

‘Look, we are rather at cross purposes here. Let me tell you exactly what I have in mind, and we can go on to discuss it later.’ Josephine subsided at the rebuke, and Elizabeth went on smoothly.

‘I want us to employ a particular technique known as group—discussion.’ For a moment the word therapy had trembled on her lips, but she rejected it, relising in time that the word could carry implications that the sisters were in need of psychiatric treatment.

‘Each fortnight, we meet somewhere pleasant in our free time, and over coffee—or perhaps sherry, to make the whole thing more sociable and relaxed—we talk about our feelings and attitude towards our work. We do this in a positive way, by appointing for each session a chairwoman, and selecting a subject. Then, in talking about the selected subject, we learn to talk of ourselves, about our reactions to each other, what makes us upset and why, what causes us to have hostile feelings, and why, and so on. You will find that though this may be difficult at first, in time you will be more and more able to verbalise your personal feelings, and you will come to a new understanding of yourselves, your relationships with each other, your juniors, your seniors and your patients. I hope, once this has become established with us, you will be able to start similar discussion groups among your staff, so that the benefits of the technique spread right through the hospital——’