More "Downstairs" than "Upstairs"

Image via WikipediaAfter my first couple of years or so in "Mans Service" as it was called back in the so-called swinging 60's, I could have been forgiven for being of the opinion that I had in fact joined a cleaning company rather than a  Fighting Machine that was capable of policing troubles the world over. In fairness, I had "travelled", perhaps not to all corners of the globe, but I had seen North Wales, Talacre Beach, Rhyl Seafront, Hollywell on a cold day and Colwyn Bay. Add to this the move to that well known epicentre of excitement-Tidworth.

The Tidworth move I do not regret for one moment. It was, for me, the start of a life long learning curve that stays with me even until today. The hunger for learning has not left me. Sadly, there was the small matter of what I was learning. Largely it was cleaning. This next chapter of Life In The Fast lane, sorry, "Once Upon A Time" will reveal secrets of even more cleaning!!

Cleaning consisted of High Cleaning, Low Cleaning, Cupboard Cleaning, Cardboard Box Cleaning, Needle Tray Cleaning, Scissor Tray Cleaning, Patient Trolley Cleaning, Surgeons Boots Cleaning and.........laundry. Well, someone had to wash and iron the cotton reusable facemasks and theatre caps, so why not get the trainee techs to do it. (I must be fair and say that the Theatre Sisters did their fair share of this last part of cleaning as well as with the needle and scissor trays)

The High (and low) cleaning was oh so much fun! After every list all theatre furniture, including anaesthetic machines, operating tables and suction apparatus etc., was removed to the foyer area, while buckets full of steaming hot soap and water was spread across all floor areas of the theatre, anaesthetic room, scrub up area, laying up room (instrument prep room) and sluice area. It was at this point that it became clear that whoever had designed the suite of rooms had done so with a sense of humour and cunning. Then the builders had been brought on board and persuaded to lay the floors so that they tilted away from the drains, by which route we were challenged to persuade the water to leave. Hands up whoever it was said "I bet the floors were set to drain the water in the opposite direction". Spot on, hole in one so to speak. Still, being almost as devious as the designers etc., we persuaded the water away and into the drains.

Added to the above daily ritual, there was the weekly "Blitzing" to look forward to. same emptying routines, but then out came "The Stirrup Pump". The aim became not only to clean the floor, but the walls as well. A good "stirrup pump aimer" could point the hose bit at the walls while person number two pumped feverishly, with such deliberate aim that the corner was cleaned efficiently without wetting the ceiling. As you might imagine, wetting the ceiling turned the rooms into something approaching a tropical rain forest with it taking hours to stop dripping. Not only were the walls and floors sprayed, but anything that moved was likely to be soaked, i.e, any person foolish enough to enter the room during this procedure was immediately soaked. Not too bad when the water was warm, but as it cooled after hitting you, it was bordering on the cold side to say the least. I always found myself on the pumping end of the procedure. Possibly my aim was found to be suspect.

Cupboard cleaning was an every weekend  experience. Tidworth Theatres were blessed with a number of cupboards I never saw equalled, let alone exceeded, throughout the whole of my 23 years and 231 days in Her Majestys Armed Forces, regardless of where I worked. The biggest, and possibly least favourite were the Surgical Instrument cupboards. In the days to which I refer, there were only ever a small number of pre-packed and sterilised instrument sets. There were just a General (basic) set of instruments that were used as a starter kit for cases where an incision was required and added to this was a Tracheostomy Set, Hysterectomy Set and Tonsil Set. All other instruments required for any and all other use, were "sterilised" in the Laying Up room using steam heated water. It was occasionally possible however to construct a set in advance of a pre-planned list or individual case.

In the cupboards were perhaps around 1000 or more instruments, ranging from tiny "Bulldog Clamps" used in fine vascular surgery, to large Aorta Clamps, Amputation Shields and Saws. I know it sounds a little odd, but all techs would have their favourite instrument, based upon it's design. Mine was the Myoma Screw-a beautifully designed and perfectly manufactured "screw" shaped instrument with a handle, used to.....perhaps I should leave it there!!
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Next time I'll be talking about work carried out by the Theatre Technicians outside of the Operating Theatre. Vesatility being the name of the game.

Once Upon A Time......"Time Waits For No Man"

In the world of learning, there is no time available in which to dawdle, drag your feet, or whatever phrase you choose. In a pressured environment there is always a pressure put upon trainors to ensure the new guys are up to speed as early as possible, while at the same time respecting that to rush headlong into the training programme may lead to things being missed. This could well lead to failure in an individual in a field or local emergency, such as a Major Incident being declared locally.

I will say one thing about every aspect of military, clinical and management training I undertook-willingly or otherwise, it was thorough, complete and always but always validated. What happened after that was down to the individual as to how they performed or responded in whatever situation they found theirselves. I have, in the 43 years since I qualified as an Operating Theatre Technician and the 46 years since I qualified as an Army Trained Nurse, found myself in situations, both emergency and non critical that I should have been capable of managing following the training I received. I have also found myself in emergency and non-critical types of situation,  that were not covered in my training. How did I cope? Simply by standing back for a moment-appraising the situation-assessing the job that has to be done-deciding how to deliver what is required and in what order. This has to be done in moments, not minutes and days in an emergency. My training in my roles as a nurse and in theatres taught me this. Not what I should do, but how to "manage" what I must do and quickly. Many of you reading this will know exactly what I mean. This will cover colleagues working as doctors, nurses, physio's, lab techs, pharmacy techs et al.

Returning to my training as an Operating Theatre Technician, which was supervised by senior Techs, Surgeons, Anaesthetists and Sisters, I certainly remember being put through my paces in all areas of the operating theatre. No stone was unturned in ensuring that I received the full works in terms of tips, short cuts, risk assessing and managing what to do first and subsequently, during an emergency situation and pre-empting what others would be doing in such circumstances. The skill in knowing what you and others would be doing was most useful when being called out after normal working hours for emergency surgery.

Tidworth was strategically placed between Andover, Hampshire, and Salisbury, Wiltshire. (I hope I am right geographically-never my strongest subject!) The main road between the two, and passing worryingly close to Tidworth Military Hospital was the A303. The hospital had a busy and well managed casualty department, that was "on take" for blue lights (or blues and two's as they are known now.) The A303 was infamous for the amount of accidents occuring. Many of them were due to the fact that "drinking and driving" was not as well publicised as now, and speed. To be honest, the local roads were just as good at supplying casualties as the A303 at times. Another contributing fact was that seat belts were not in place in my early years in Tidworth. Anyway-back to what I was saying about knowing what to do and what others would be doing. When called out to theatre to attend to casualties, information was sent to you from Reception, giving some details of the situation, this gave you the opportunity to "put your thinking head on" prior to arrival. This invarioubly gave you a good start on arrival. Often the surgeon would be scrubbed up and ready to go just as you finished assembling the "starter kit" of surgical instruments required for the early part of the surgical procedure. If your role on that occasion was to work with the anaesthatist, you had, again, a starter kit of drugs, intubation equipment and so on, so that the patient could reach the operating table swiftly.

All in all, My training was invaluable at the time and subsequently. Don't believe though that it was all blood and gore and excitement. Most of the time was spent carrying out what I found to be boring daily routines that included washing and ironing Theatre Caps and Masks!!!!! In the next part I'll talk about the less than glamorous side of the job.