Tabitha (25 page)

Of course, Tabitha knew what to do. She and Darby changed
the patient’s linens, rearranged his pillow, and disposed of the soiled sheets
in less than two minutes.

“Ye’ve done this b’fore, I wager.” Darby waved an accusing
finger under Tabitha’s nose.

“I wager.” Tabitha’s response was dry.

“S’ you’re not a green VAD?” She considered Tabitha with a
glimmer of respect.

Tabitha lifted one shoulder. “Never said I was.”

“Ha!” Darby grinned and they moved to the next bed. The ward
had twelve patients down each side of the room. Tabitha and Darby, working more
and more as a well-oiled team, changed the linens of the entire ward in less
than an hour.

As they finished, Tabitha noticed the Sister checking their
work. The nurse nodded in approval. “Well done, Darby, Hale.”

“That’s high praise, I’d say,” Darby whispered.

“What is her name?” Tabitha asked.

“Sister McDonald. C’mon, then. Let’s get the bin to the laundry.
I’ll show you the way.”

Tabitha worked hard that day and took pains to catalog the
differences between the manner in which her hospital in Denver did things and
how Sister McDonald ran her ward. Tabitha observed a process closely before
attempting a duty. The other VADs on the ward, two of them, said nothing to
her, but they watched Tabitha with growing approval, as she mastered one duty
after another.

Shortly after the VADs had served lunch to the patients, a
grizzled older doctor whisked into the ward. “Where is Sister McDonald?” he
demanded. “I have post-surgery wounds to examine.”

Tabitha could see how frazzled the doctor was.
I can’t
imagine how overworked this poor man must be
, she thought.

“She is at her lunch, Dr. Furler,” Darby answered. “I am
certain she did not expect you. You are usually here an hour from now.”

He cursed under his breath and growled, “I have an
amputation in an hour and cannot be late. One of you will have to assist me in
my examinations here.”

The other two VADs skittered to the end of the ward and
busied themselves there. That left Darby and Tabitha staring at each other—and
Darby shot Tabitha a plea for help.

Tabitha shrugged. “I would be happy to assist, doctor,” she
offered.

The doctor grunted and moved to his first patient. “Hurry
up, then.”

“Darby, where are the wound care trays?” Tabitha hissed.

Darby jumped to show Tabitha where the supplies were kept.
Tabitha, armed with the appropriate dressings and instruments, moved alongside
the doctor and wordlessly anticipated and supplied what he needed as he removed
dressings and examined or treated wounds.

In America, the status of a doctor was far above that of a
nurse and, Tabitha saw, it was no different here. She was silent as she worked
with the doctor, but she was trained to foresee a physician’s needs. If Dr.
Furler scowled at what she presented to him, she had a second option already in
hand.

They reached the last of the five patients he had come to
examine. Private Pierce, perhaps age eighteen, had lost his leg below the knee.
Tabitha smiled at the boy, hoping to reassure him.

The doctor began to gently work the sticky bandage free from
the boy’s stump. Just as he pulled it away, blood spurted from the wound. Great
pulsing jets of it shot across the end of the bed and onto the floor.

The doctor swore and clamped the soiled bandage onto the
wound. “Hemorrhage!” he snarled.

“Here, doctor.” Tabitha slapped a sterile cloth on the bed
and dropped a scalpel and a clamp followed by a thick pad of bandages onto the
clean surface. She wrapped her hands about the soiled bandage and took over the
task of keeping pressure on it. As soon as the doctor released the pressure for
her to maintain, he grabbed the clamp and pad. Moments later, he had sliced
open the stitches on one side of the stump’s flap, located the bleeding vessel
and clamped it.

Blood was everywhere—staining the floor, spattered on the
bed, covering Tabitha’s gloved hands. Tabitha called to Darby, “We need sutures
and needles. Several sizes. And clean gloves. Right away!”

Darby jumped to gather what was needed and delivered them to
her. Tabitha stripped off her soiled gloves. Darby awkwardly helped her don
fresh ones. While Darby regloved the doctor, Tabitha sorted through the needles
and sutures and presented her estimate of the best size to him.

“Very good, nurse,” he muttered. Within moments he had tied
off the ruptured blood vessel and removed the clamp.

“I do not like the looks of this stump,” he muttered aloud.

Tabitha leaned closer, sniffing and noting the puffiness.
“Something in the wound is suppurating.”

“Yes,” Dr. Furler agreed. “I need to open the flap all the
way and look for the source of infection. Can you prepare for that?”

“Yes, doctor,” Tabitha answered. She rattled off a short
list of instruments to Darby who now stood by to fetch anything they needed.
The other VADs hovered nearby, watching with interest.

Tabitha spoke to their patient. “Private Pierce, the doctor
must open your stump to clean it. It may pain you, but you must keep entirely
still. We do not want to cause more bleeding. Can you do that?”

She gestured with her chin at one of the VADs. “Bollard,
please stand by Private Pierce’s head to calm him. The girl moved to obey
Tabitha.

The doctor clipped the remaining stitches around the stump’s
flap and laid it open. Before Tabitha could stop herself, she pointed. “There.”

“Indeed,” Dr. Furler muttered. “The tissue here has
necrotized. Scalpel.”

Tabitha had the sharp instrument at the ready. As the doctor
cut through and removed the dead tissue, Tabitha offered sterile water for him
to rinse the wound.

He frowned. “How does this look, nurse? I am afraid my sight
is not all it used to be.”

Tabitha leaned in again. “Is that a tiny bone fragment, doctor?”

He looked where she pointed and took a pair of tweezers from
her hand to probe it. “Yes, it is. You have good eyes,” he mumbled.

Fifteen minutes later, the doctor had finished redressing
the stump and Tabitha was gathering the bloodied instruments and soiled
bandages.

“Darby,” she said, “Let’s change Private Pierce’s bed again,
shall we?”

That was when she noticed Sister McDonald. The nursing
sister, hands clasped behind her back, was observing and nodding. “You did
well, Hale.”

“Yes, she did. What is she doing in a VAD uniform?” the
doctor complained with a scowl. “Obviously she is a skilled nurse.”

“Yes, doctor. We are aware. However, this is only Nurse
Hale’s first day with us.”

He rounded on Tabitha and she stepped back, a bit startled.

“Do you have surgical experience?”

“I-I am trained in all aspects of nursing, doctor, but have
not worked surgery since school. However, I took a specialty course in
traumatic wound care, and I worked the emergency services ward at my last
hospital.”

“And where was that?” he demanded.

“Denver, Colorado, doctor.” The other VADs were ogling
Tabitha with wide eyes now. Darby stared at her with something close to awe.

“American. Right! I heard we had an American volunteer. A
unique situation.” He turned to Sister McDonald. “Well, she is wasted as a VAD,
do you not think?”

“We have plans for her, Doctor. We hope to utilize her
better as soon as she has settled in.”

Tabitha, startled again, wondered,
What does that mean?

The doctor harrumphed and checked his watch. “Late. I’ll be
back this evening to see this patient.”

Sister McDonald looked at Tabitha, a ghost of a smile
playing on her lips. “A fine first day, Nurse Hale. Carry on.”

“Wot? She called you
Nurse Hale
,” Darby whispered.

Tabitha laughed. “I guess she did.”

When their twelve-hour shift ended, Tabitha was exhausted
but elated.
Thank you, Lord! Thank you for helping me, for strengthening me
today.

She fell into bed after dinner and slept until six the
following morning, when Darby shook her awake.

“I say,
Nurse Hale
, you sleep like th’ dead. Get up
now or we’ll be late.”

Tabitha groaned but rolled out of her cot. Her first sight
of the day was Darby’s grinning face and the curious eyes of her fellow dorm
mates.

“Don’t think we’ve been prop’ly introduced,” Darby smiled,
holding out her hand. “Ellen Darby, VAD.”

“Tabitha Hale, quite out of my league, I fear,” Tabitha
returned with a yawn.

“Cor, and I doubt that.” Darby grabbed Tabitha’s arm. “Come
on, now. You mustn’t be late,
Nurse Hale
.”

The other girls in the dorm giggled, but they were
good-natured giggles.

Thank you, Lord!
Tabitha prayed.
It is going to be
all right
.

~~**~~

All but two of the VADs in Tabitha’s dormitory had Sunday
off, and Tabitha finally had the time and energy to write letters—one home to
Palmer House, one to Claire, and one to Mason Carpenter. She took her time on
the letter to Carpenter, knowing that its contents would astonish him, but she
could not stop smiling as she wrote it.

My dear Mr. Carpenter,

I pray that, by God’s grace, you are well and fruitful in
your walk with him!

I have something to tell you, dear friend. Your letters
speaking of the overflow of wounded in British hospitals spoke deeply to my
heart.

After much prayer, the Lord led me to volunteer with the
American Red Cross to nurse the wounded. Unfortunately, at this time, they have
a presence in the war zone only on their hospital ship, the
SS Red Cross
.
They did, however, suggest that I volunteer with Queen Alexandra’s Imperial
Military Nursing Service, via the British Red Cross, to serve in a Voluntary
Aid Detachment.

This I did and was accepted. I arrived in England a week
back and was posted to Colchester Military Hospital in Essex. The
administration does not yet know quite what to do with me as I have been
trained as a nurse and most VADs have not; however, I am content to serve where
the Lord places me.

For the past week I have worked in a ward of amputees. I
cannot tell you how these young men touch my heart. I often sit by their
bedsides to talk with them or write letters for them. Only two days past, I was
honored to pray with a young soldier to receive Jesus as his Savior and Lord.
Although he is racked with what is called “phantom pain,” I see the peace of
Christ now resting on his brow, and he smiles with a joy that makes every
difficulty bearable.

My dear Mr. Carpenter, please do write to me at the
address below? I hope and pray that Colchester is not too far from Catterick
and that, someday soon, I will have earned a two- or three-day pass and can
come to visit you.

Yours always,

Tabitha

The Monday after Tabitha had worked on the ward for two
weeks, Sister McDonald called her into the little closet the ward used as an
office.

“Nurse Hale, you will please report to Matron.”

“Yes, Sister.” But Tabitha felt frozen and could not move.

“Nurse Hale, you are adapting to our ways. Obviously you are
a fine nurse.” Sister McDonald’s eyes crinkled in a friendly fashion. “Go on, now.
Matron Stiles wishes to speak to you.”

When Tabitha appeared before Matron Stiles, Tabitha was
amazed to see Sister Alistair with her. The nurse nodded at Tabitha. “Good
morning, Miss Hale.”

“Good morning, Sister.”

Matron Stiles did not beat about the bush.

“Nurse Hale, we have a proposition for you, one that will
utilize your skills and experience even though we cannot muster you into the
QAIMNS. Would you be interested?”

“Yes, I believe so, Matron. Um, what do you have in mind?”

“We would like to appoint you head of Colchester’s nursing
VADs.”

“I beg your pardon?”

“Nurse Hale, we wish you to manage our VADs. Oh, not all of
them; I am speaking of those who are medical aides. We wish you to manage their
training, discipline, keep them in order, that sort of thing.”

“Me?” But Tabitha felt herself growing a little excited.

“Yes. We nursing sisters quite flinch when new VADs arrive.
Some are minimally prepared; most are not. A few are entirely unsuitable.” The
matron leaned toward Tabitha, her smile growing. “I think you would agree that
the VAD ranks are quite a mashup. However, we are so short on nursing sisters,
that we must find ways to improvise, to stretch and better manage our
resources.

“Mind you, what we are proposing is novel. Some would—and I
dare say,
will
—call our idea unorthodox or revolutionary. Nevertheless,
Matron-in-Chief wishes us to proceed. My nurses cannot leave their posts to
train these volunteers, but you can.”

Sister Alistair spoke for the first time. “Sister McDonald
has reported on your performance and your willingness to work hard to her
exacting standards. We have also received a good report from Dr. Furler who, it
seems, is outraged that we are underutilizing you.”

“Quite so, Sister.” Matron Stiles bent her gaze on Tabitha.
“We would like you to take charge of the hospital’s VADs and bring them up to
our standards. In a limited capacity, of course. What do you say?”

Suddenly Tabitha grinned. “I say
yes
, Matron. It
would be my pleasure to serve in this way.”

“Excellent. We shall reassign you to different lodging and—”

“Um, no, thank you, Matron. I should like to remain where I
am, if that is acceptable.”

The two older nurses studied her. “Very well,” the matron
conceded. “If you think it wise.”

“Do I understand correctly that I will remain a VAD?”
Tabitha asked.

“Yes,” Matron Stiles admitted. “That is true.”

“Then I should prefer to lead by example, wherever
possible,” Tabitha explained. “My presence in the dormitory will help.”

Sister Alistair queried the matron. “American egalitarianism?”

Matron Stiles said nothing, but she finally nodded. “Very
well. We shall see how you get on.”

Word of Tabitha’s appointment spread through the hospital
ranks. Her fellow VADs did not know how to react. They stepped back from
Tabitha and waited to see what would happen.

Tabitha, relieved of her nursing duties, began visiting
every ward in the hospital to evaluate the working VADs. She studied the
expectations of the nursing sisters, made notes of areas of incomplete (or
utterly lacking) VAD training and, with Matron Stiles’ permission, instituted
mandatory hour-long classes each evening directly after the day shift ended and
each morning as the VADs came off night shift.

The timing of the classes was hugely unpopular with the
VADs, but they had no choice in the matter. Each shift had nearly one hundred
VADs: The sullen volunteers gathered in the basement classroom Tabitha had
appropriated, and the enormity of the task before Tabitha became clearer.

Tabitha studied her students and saw the widest array of
backgrounds and aptitude she could imagine. She discovered that not all the
VADs assigned to the hospital were young girls either. Some were middle-aged
spinsters or widows, some older than she.

Tabitha huffed.
Lord, this will be like chasing chickens
around my father’s barnyard!

“Our goals,” Tabitha began, “are to become exemplary
volunteers and to disprove the notion that VADs cannot assume and adequately
perform many daily nursing duties. If you have a desire to make nursing your
permanent vocation, I can help you. I can help you
if
you work hard.”

She noted the women whose interest she had aroused. “If you
set your mind to learn and you acquit yourself satisfactorily, I will note your
progress in your record. When opportunities for advancement arise, your
training will be your friend.”

Tabitha focused an entire week’s classes on a single,
specific set of nursing duties or skills. “Each week, once you perform well on
the week’s tasks, you may be excused from the remainder of the classes for that
week,” she informed the surly volunteers. “However, if you are sloppy, slow, or
incorrigible, you will train extra hours until you are proficient. And you will
become proficient. Those who do not become proficient will receive a poor
report. Two such reports and you will be removed as a nursing aide.”

The VADs looked at each other. A few straightened.

At the end of the first week’s classes, Tabitha took each
shift and broke it into two cohorts. She appointed the two most competent VADs
from the shift to be cohort proctors. One of the appointed proctors was Ellen
Darby.

“I will address you,” Tabitha announced, pointing to the
group on her left, “as Colchester Green. You,” she pointed to the cohort on her
right, “Will be Colchester Blue. Night shift cohorts are Colchester Red and
Gold.”

Curious and excited rumblings ran through her class.

Then Tabitha called the proctors to her side and gave the
two women narrow armbands the color of their cohort’s name to wear above their Red
Cross armbands. Tabitha herself wore a wide red armband designating her as Head
VAD.

Tabitha addressed the two proctors. “Please wear your
armbands whenever you are in uniform. Wear the symbols of your leadership
proudly and acquit your cohort well, but understand that only the best VADs may
wear these armbands—they are not permanent appointments.”

Tabitha observed as the other VADs began to comprehend the
armbands’ honor and significance.

“You can see how large our cohorts are,” Tabitha added,
keeping her voice casual. “If others of you demonstrate your competence to my
satisfaction and show an eager willingness to improve the performance of your
entire group, I may be inclined to break the two cohorts into four and appoint
additional proctors.”

The two proctors considered each other, and speculative eyes
followed Tabitha.

The following Monday, as the classes focused on a new set of
skills, Tabitha noted a shift in morale. The VADs began to willingly assist
their fellows, and a sliver of competition grew between the cohorts—a
competition that spurred overall class progress.

Very good,
Tabitha breathed.

Tabitha’s days were long. She arose early to instruct the
outgoing night shift and stayed late to teach the day shift. From the start of
the first class she established high standards, and she allowed no VAD to fall
below her expectations.

Tabitha coached the VADs in proper etiquette when
interacting with doctors and nursing sisters: She drilled the women on the
correct manner in which to answer a physician’s or nurse’s questions, how to
respond to their instructions, how to ask clarifying questions, and how to
properly report on a patient’s condition.

She evaluated every VAD’s posture and deportment. She
demanded that each woman stand tall with hands at her sides or clasped in front
of her.

“No nurse or aide stands, sits, walks, or works in a sloppy,
lackadaisical manner. Every movement is to have purpose; every task is to be
done well. Our very presence, wherever we go, should inspire confidence in our
abilities and professionalism.”

Tabitha reprimanded any VAD who slouched or slumped. She
corrected posture so often in the first weeks that merely her entrance into
classroom or ward produced a general “snapping to attention.”

She instructed the VADs in basic sanitation rules and
expectations. The volunteers learned the importance of personal and nursing
hygiene. They practiced cleaning and sterilizing instruments using boiling
water, chemicals, and the autoclave. She emphasized sanitary processes to prevent
necrotic and bacterial gangrene, other bacterial infections, or infectious
disease.

“A hospital is the perfect breeding ground for contagion,”
Tabitha insisted to her students. “Our cleanliness—the care we take in washing
our hands, wearing clean garments, and using only sterile fields and
instruments—can prevent infection or disease. Think of our patients! They are
vulnerable and we are their guardians. We must not be sloppy or inattentive to
our duty.”

Then Tabitha moved on to the differing care for their
patients’ many and varied injuries: Shell-shock, amputations, gas inhalation,
brain trauma, burns, bullet wounds, and internal injuries.

The gas inhalation cases that came to them from the field
hospitals of the Western Front were beyond horrible to treat. The patients
often developed pneumonia or emphysema and, despite the hospital’s best
efforts, died horrible, suffocating deaths. The pitifully few men who survived
suffered scarred lungs and a lifetime of illness and disability.

Tabitha reminded her students that the majority of gas cases
died immediately when the heavy chlorine gasses sank to the bottom of the
soldiers’ trenches. Worse, those soldiers who survived but had inhaled lethal
doses died only days later.

Tabitha taught the VADs how to write letters for the
soldiers. She taught them to suggest salutations and letter closures, how to
identify themselves as the letter writer, how to best describe the soldier’s
wounds and treatment to his family, and how to include cheerful tidbits. She
also taught them how to write to a deceased patient’s family. She demonstrated
how kind, well-chosen words could provide comfort.

Tabitha stressed proper conversation while treating
patients; she instructed the VADs in appropriate responses to inappropriate comments
or behaviors and, above all, how to maintain a professional attitude at all
times.

The most difficult task to train was how to bathe patients
who were bedbound.

“Nursing sisters and orderlies will not always be available to
perform this task. Given the shortage of nurses and the overflow of the wounded
returning from the war zone, this situation is likely to worsen. We must,
therefore, be prepared to take up this routine duty.

“If you have never seen a man’s unclothed body before, this
task will, initially, seem difficult,” Tabitha told them, not mincing words.
“We will practice in groups of two until you can perform this task well and
without qualms.”

She began scheduling the groups of two when she could be
present to instruct, and made sure that the first students scheduled were not
squeamish on the idea. She began in Sister McDonald’s amputee ward with Darby
and the other proctor, Hensley.

“When you have become proficient at this task,” Tabitha
informed the two women, “you will assist me in training the others of your
cohorts.”

Sister McDonald looked on as Tabitha demonstrated how to
position the screens around a patient’s bed and perform the bath.