18. Should auld acquaintance be forgot

Hundreds and hundreds of staff must have sung this Robert Burns song at numerous staff parties during the time that Joyce Green existed and many staff who were working at this time (i.e. night staff) must also have quietly mouthed or hummed this song on New Year's Eve as each year finally ended and gave way to the next one.

There has, after all, always been something deeply symbolic about rounding off the old year and welcoming the new one, hasn't there ?

But at the same time it's also worth remembering that at various times and in various places throughout medieval Christian Europe the start of the new year has been on a date OTHER THAN 1st January. The start of the year has - or so it seems - also been celebrated on 25th December, 1st March, 25th March and on Easter Day.

In fact it was not until 1582 that reform of the Gregorian calendar was responsible for restoring January 1 as New Year's Day.

At this point most Roman Catholic countries adopted the Gregorian calendar almost immediately but apparently it was only gradually adopted by Protestant countries and Great Britain, for example, did not adopt the reformed calendar until 1752. Until then it seems the British Empire and their American colonies still celebrated the new year in March.

Thus the date for celebrating the arrival of the New Year hasn't been at all constant. However perhaps one thing that HAS been constant through out time has been the annual wish to put certain things behind us as each year ends and to then to move forward as positively as possible into the new year ?

So maybe it worth ending the year by reminding ourselves of some of the words in one of the verses of that famous song by Robbie Burn's ?

"And here's a hand, my trusty fere !
And gie's a hand o' thine !
We'll take a cup o' kindness yet,
For auld lang syne".

Good luck for 2007.

17. Christmas day in the Workhouse

In fact it was West Hill Hospital that started life as a Work House wasn't it, not Joyce Green ?

So although some in-patients at Joyce Green might have known hard times during Christmas periods, perhaps it is reasonable to assume that on the whole most patients were well looked after in the wards at Christmas ?

At Joyce Green (and perhaps it happened in other hospitals too) a scratch choir of nurses in full uniform with their flowing capes turned inside out to reveal the bright red linings used to muster at in the hall outside outside Matron's office at around 8.30pm and then two groups would set out in different directions to sing a couple of Christmas carols on each of the wards with each nurse carrying a candle-bearing lantern and a song sheet.

The nurses on-duty in each of the wards would - once the carollers were marshalled at the main door of their particular ward - turn off the main ward lights and having flung open the wards doors would allow the group to process slowly around each ward fulfilling the annual tradition and declaring the age old Christmas story in song.

The patient-care workload had usually been carefully managed in the run-up to Christmas so that no dressings were done on Christmas morning itself (unless warranted). Patients wouldn't have their hair-washed that particular morning and any other similar tasks which COULD be postponed until the following day were put on hold so that the patients could be spoiled over more leisurely breakfasts than was usually the case.

In fact, as in millions of homes across the country, the predominant activity of Christmas day was eating and was based around preparing the patients and the ward for lunch (and then later on, the evening meal).

For those patients who wanted to go there was the opportunity to go (... or to be taken ...) to either the Anglican chapel or the Roman Catholic church in the grounds for the appropriate Morning Service or Mess. Then in the afternoon - and again in the evening - family members and friends were allowed to come onto the wards during the designated visiting hours. But the highlight of the day - first for the patients and then a little later for the nursing staff - was the Christmas lunch with pride of place being given to the huge turkeys that were sent from the main hospital kitchen.

It was customary for one of the Consultant staff on each ward to turn up and to carve the bird - after having first visited each patient and exchanged Christmas greetings with them - and although this could be easily interpreted as yet another example of the prevailing paternalistic pattern of medical staff behaviour, nonetheless both the ward nursing staff and the patients seemed to relish their participation.

Perhaps it made everyone feel that they were not forgotten at a time when everyone else was at home with their families. Certainly the word of thanks from the Consultant Physician or Surgeon to the nurses who were assembled together for their own lunch three quarters of an hour or so later (often in an empty side ward), before the the Consultant left to go home, was usually both anticipated and appreciated.

Wherever possible nurses on the morning shift were allowed to go off duty early and some of the afternoon/eve shift staff were also allowed to come on duty a little later too. This was possible because once the patient's visitors were installed a useful interval existed during which time the nurses were not required to be very active on the battle front (unless of course a patient required something).

Of course emergency admissions arrived even on Christmas Day and sadly some patients "saw in" Christmas Eve/Christmas Day but didn't "see it out" and in both sets of circumstances upset relatives had to be assisted and counselled.

Thus once again I can look back and re-feel the sense of almost tangible relief felt by many of the patients, relatives and members of staff at the end of the big day that the day had (usually) "gone well", with fewer emegencies and unexpected happenings than were potentially possible.

16. Preparing the wards for Christmas

By this time in the run-up to Christmas a Christmas tree and holly branches would have been delivered by the gardening staff to each of the wards that was going to remain open.

These were of course "the real McCoy" ... 8-9 feet high and each of them had a time honoured resting place in their ward. Most of the medical wards where still of the long, open Florence Nightingale type and so trees in these wards were often positioned at the bottom end of each ward in front of windows (looking out on to the backs to the ward blocks) and sitting between two doors ... one leading into the the toilet cubicle area and the other leading into an area housing bathrooms and wash basins. Care obviously had to be taken that there were no over-hanging branches to impede the passage of wheelchairs or zimmer frames being used by patients going in or out of either of these rooms.

Thus as you entered most of these long, open wards there in front of you at the end of the two rows of hospital beds, stood a beautifully decorated tree with a collection of gift-wrapped parcels around its base beaming out its unspoken message of familiarity and comfort.

In contrast, the surgical wards of the 60's had been re-furbished in advance of the medical wards and so surgical patients were housed - in the main - in two, four or sometimes six-bedded bays. Thus when it came to installing the Christmas tree, mounting 'the crib scene' and putting up streamers and decorations, variations on Christmassy themes and colour schemes could be produced by those extraordinary nurses who had a flair for interior design.

The Christmas tree was often installed in the main entrances of surgical wards or in the "nurse's station" but I shall never forget the enthusiastic installation one year of the crib in Ward 2B.

There was always stiff competition between the wards to achieve the best results when it came to preparing the wards for Christmas and I remember that one of of our senior Staff Nurses, a tall, young bespectacled Staff Nurse called Teresa, had arranged to borrow four adult size tailor's dummies from a local shop and in "our ward" we set out to create a life-size nativity scene in an empty but prominiently situated bay.

The usual offering, a small, table-top wooden stable and its nativity figures were banished from sight and three or four of us set out to reconstruct the an almost life-like Bethlehem stable scene in the midst of our surgical ward.

Mary was helped into a sitting position in front of a artistically draped orange-box manger, Joseph placed in a protective upright position at her side and two shepherds were eased into positions of adoration in front of the crib. All of them were then dressed (draped) in yards of dress material which had been begged, borrowed or stolen from Dartford haberdashery shops or Dartford market and then dressing gown cords and pins were used to finish off their costume arrangements.

Then to add yet more 'authenticity' to this "lowly cattle shed" an immense quantity of fine wood-wool was spread out around the feet of the performers. (By wood wool, I mean that very fine, curly, packing substance that used to be used by porcelain china manufacturers for packing delicate china into boxes ready for transit to shops).

The guiding star then had to be wired up onto one of the cubicle walls to give the effect of the star hovering over Christ's birthplace and "voila" the job was done.

No prize was ever awarded for the best-decorated ward but that year when nurses, walking- patients, relatives and hospital staff visited each other's wards to inspect the results, ours was designated, by common consent, the best dressed ward in the hospital.

And "the icing on the cake" as far as this tableau was concerned ?

Well just imagine yourself there - in front of that stable on Ward 2B - on Christmas Eve. It's dark and cold outside on the salt marshes. Inside though the main ward lights are off and the majority of patients are now sleeping with just dim night-lights 'on' high up on the ceilings. It's warm and quiet .... and there - as never before - anyone wanting to could hestitate for a few moments in front of a life sized, ward manger scene.

A borrowed baby Jesus lies in the crib, his parents and the shepherds standing quietly by and above their heads the natal star hovers motionless, illuminated by the light of solitary, well postioned (but carefully dimmed) overhead bed light !

Drink it in - as I did all those years ago. That scene will certainly remain stamped on my memory for a long time ... and will, I suspect, also have been encoded within the memories of a lot of other people too.

15. Getting even closer to Christmas at JGH

In days now long gone ... as we approached the 4 day marker point leading up to Christmas Eve, the planned admissions of surgical patients (non-urgent cases) used to be carefully tailored to ensure that only patients requiring minor surgery were admitted.

This was so that the maximum number of patients could be discharged on Christmas Eve and so that certain wards could (hopefully) be closed down .... either that or a certain percentage of the surgical beds could be temporarily closed down and held in reserve for emergency admission purposes during the holiday period.

The situation in the medical wards was obviously different and these were very often bulging at the seams way before Christmas arrived, with only those managing to achieve near-miraculous recoveries having any hope of "going home for Christmas".

But to return to the state of play within the surgical wards, I can remember certain quiet conversations that could be heard during ( ... or often after ... ) "Ward Rounds" when the medical staff and the senior nurses would try and work out who was going to be fit enough to go home before Christmas, who could be moved elsewhere and (sadly) who was not likely to survive until or beyond the Christmas period.

As I have mentioned above, the goal in this pre-Christmas period was to try to calculate how many surgical beds were expected to remain 'open' over Christmas (or might be needed) and how many others could be closed. Based upon these calculations if was then usually possible to plan strategies for moving patients onto the wards that were were going to be staying open.

Then usually on 23rd or 24th December the portering staff would make themselves available to transfer patients (either on foot, in wheelchairs or in their beds) out on to the connecting surgical corridors and along to one or more of the male wards and female wards that were going to remain open.

I remember nurses and porters, trimmed with garlands and tinsel, and patients too entering into the spirit of the Christmas exodus from their "own" wards and can recall - even now - the laughter and some of the frivolity as these two groups (the patients and the staff) as they moved out of familiar territory on their journeys to find room in another "inn".

Yes ... there were lots of jokes and lots of legs-being-pulled as these short journeys were made but if one listened carefully (particularly to what was NOT being said too) one could often sense the feelings of sadness amongst people who were not going to be going home for Christmas and who would instead have to spend the festive period on a strange ward - perhaps next to someone who they didn't know OR more tragically the awareness by some patients - who were not being moved - that perhaps their remaining days could be counted fairly quickly on one hand.

Soon the wards that WERE to remain open would need decorating with Christmas streamers and decorations ... but perhaps I can talk about this particular activity in my next entry ?

In the meantime perhaps some readers can identify with how happy those people were who WERE expecting to go home and how pleased too certain staff would be feeling too at the thought that they were going to be off-duty on or other of the Christmas 'special days' because of the fact that the surgical work-load was expected to be reduced.

Yet a certain sense of camaderie and determination to "make the most " Christmas could still be sensed amongst those patients whose health meant that they had to stay put during Christmas and also amongst the staff that expected to be working over Xmas Eve, Xmas Day and Boxing Day, who I suspect felt (deep down inside themselves) a measure of pride that they were going to be able to "serve" their fellow men and women during this special time.

14. "Douce nuit, sainte nuit"

Tucked in amongst some of the many traditional English carols - at a Festival of Christmas Music that I attended yesterday evening - were some songs from other European countries.

They included "Rui, Rui, Chiu" (a Spanish carol), "Il est ne le divine enfant" (which was French) and "Nouve Grassenc"(a beautiful Provençal carol). Even though I didn't understand all the words that had been helpfully included on the carol sheet, nevertheless I was still able to enjoy the "sense" of what was being expressed.

Later on I found myself thinking about the many non-English speaking patients that must have passed through Joyce Green Hospital and all the bewilderment and confusion that they must have felt as they tried to grapple with the mixture of strange English words that colleagues must have tried to use to explain things to them or to ask them questions.

I certainly remember working as a Staff Nurse on the Accident Ward at West Hill Hospital when a French family were forced to gather around the bed of an unconscious 27 year old man who had been rendered unconscious in a road traffic accident on The Brent.

He had been married the day before the accident and he and his French wife had been on their way to London by car - for the main part of their honeymoon - when, after stopping for some cigarettes, he drove off on the 'wrong' side of the road. His young French-speaking wife was understandably distraught and then his French-speaking parents arrived later that night and - yes, you've guessed - none of the staff on duty spoke French ... and I remember feeling awful for them as they hovered over this unconscious husband/son, trying desperately hard to understand something of what was being said to them.

I'm sure that you too have probably felt the anguish of certain patients and/or their relatives as they have struggled to make sense of a language that is not their own and "felt" for them as they struggled. Yet as I listened to those 'foreign' carols in that 13th Century church yesterday I was slightly reassured to realise that the care and concern that we try to show to other people can still transcend human language barriers, albeit imperfectly.

And so, during the same carol service, as we stumbled over the German words of "Silent Night" in their "Stille Nacht" form I found myself being grateful on behalf of the many "overseas" patients who must have passed through the Joyce Green's doors, for the love and concern that so many staff must have endeavoured to show to "foreign" patients such as these.

Thus although our care of many of these patients was far from perfect I was nonetheless proud to feel that we had probably done our best in some difficult situations during the past.

A question posed on 9/Dec/2006

Q. Who was Joyce Green ? Her name appears to be used in the local area quite a lot, but I cannot find any history of who she was ? Anonymous.

A. In her excellent book (details of which can be found an earlier blog posting), Francine Payne - a local historian/writer - suggests that four local farms, including one referred to as Joces or Joyces Farm, can be identified on a 1778 map in a book entitled "Hasted's History of Kent". The land was owned apparently by a certain Richard Joce.

When the hospital was constructed it also occupied a piece of land belonging to one of the neighbouring farms called Marsh Street Farm and thus, because the name "Marsh Street Hospital didn't seem to have quite such an interesting sound to it the hospital came to be called "Joyce Green Hospital", after the-green-belonging-to-Mr-Joce .... on which the hospital was (partly) built.

13. Planning for Christmas

Cast your mind backwards - not so much to the week leading up to Christmas each year - but to the week(s) BEFORE the pre-Xmas week at Joyce Green Hospital. The "pre" pre-Christmas week, if we can call it that ?

The hectic busyness and frenzied activities concerned with the the "proper" pre-Xmas period hadn't yet begun (because certain things were only allowed to happen could from around 20th Dec), but if you think about it carefully there where nonetheless certain happenings and traditions which one began to see happening and also to "feel" in the atmosphere even at this "pre pre" stage, preceding Christmas.

Stop and think for a minute (if you have got the time !) about some of the things that HAD to be done or were usually going on during this 10 day period that we are considering at the moment.

Remember ward "Bran Tubs" for staff ? Each member of ward staff would draw out a slip of paper from a pot bearing the name of another member of the staff and would then become responsible for buying a suitable present ("no more than x or y pounds in value") for that person and would then become responsible for depositing it in a festive wrapper in a decorated tub in time for Christmas ?

Although this type of event could be good fun, even leading to explosions of laughter when the great day for opening the tub gifts arrived, this sort of event did sometimes cause sleepness nights for various junior nurses, especially if they found themselves having to carefully chose a gift for someone much more senior to them, whose tastes they knew nothing about or with whom they might not have been getting on with particularly well !

Also at this point in the calendar, too, Ward Sisters were very often expected to plan ahead and, having decided which patients were to still likely to be "in" on Christmas Day itself, would arrange for one or two of the nurses to go out on shopping expeditions to buy small gift items which would then have to be wrapped up ready to go under the ward Christmas tree once the ward had been installed during the 'proper' Pre-Christmas period.

Do you remember where the money used to come for these extra creature comforts ? Sometimes monies were found from hospital endowment funds or patient amenity funds (courtesy perhaps of the W.R.V.S.) but very often - especially when it came to paying for items of food and drink which would be laid out in ward side-rooms for 'Christmas hospitality' purposes - this money was raised via raffles. Thus one feature of this "pre-pre Christmas" period that I distinctly remember was the task of having to sell raffle tickets, associated with huge baskets of fruit, boxes of chocolates and bottles of the hard stuff, to ward visitors and relatives during visiting periods.

Also during this "run-up period" practises of various sorts would begin (or continue perhaps, in the case of preparations already under way). Scratch choirs were frequently cobbled together and caused to rehearse by the incumbent hospital chaplains and priests, in order to shaw up the musical renderings which were going to be offered shortly as integral parts of the forthcoming religious celebrations within the hospital.

But I also have fond memories of some very "mixed" staff groups who came together to produce the successful annual hospital pantomines in the main hall of West Hill Hospital.

The previously unrecognised talents of midwives, ambulance personnel, medical secretaries, X-ray personnel, catering staff and myriads of others could quite literally be observed being fashioned into shape through regular practises before the "real" pre-Christmas period. Precious evenings were set aside and these dedicated members of staff, who were usually already busy-enough were put through their paces until the Christmas rush approached and no further time could be spared. Then with "Nowell" looming all these minor activities, including pantomime practises, were temporarily down-scaled until the great day had come and gone.

Perhaps you have special memories of things that began to happen (or needed to be done) in these annual "pre" rush-hour periods at Joyce Green ? Yes, ward Christmas trees had to be ordered, numbers for ward meals "guess-imated", tickets purchased for hospital dances from Admin ... but I wonder right now - as you look backwards - what special memories YOU retain in your heart ?

Have a good run-up to the forthcoming pre-Christmas period, won't you ?