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  • Writer's pictureMargaret Adkins Writing

Book Review: These Are The Hands: A Personal Reflection (Part Two)

Updated: Mar 28, 2021

Poetry Review: a personal reflection | Margaret Adkins Writing
Poems from the Heart of the NHS

Poems, Hands & Companionship of Colleagues.

Margaret Adkins

As a contributor to These Are The Hands I feel that I am among colleagues, despite never having worked with any of the other contributors. It is five years since I retired from nursing to become an undergraduate in Creative Writing & English Literature at the University of Worcester. For me, this anthology triggers a raft of memories involving the close companionship of colleagues throughout my career.

The other contributors feel so familiar through their poems that I can envisage being at work together. I imagine grabbing five minutes to listen to Daniel Racey, the GP Trainee in The Clearing whose senses are so ‘keen’ he feels that he ‘could have been a deer / on the edge of a clearing; or to chat with the Domestic Assistant in Ashleigh Condon's poem, who has become a patient In This Room, and is reflecting on the time she mopped the same floor after a woman had died.

I see myself on nights, ‘weaving in and out of the sleep of strangers’ with Amanda Walsh, the Nurse in 4am; or sympathising with Neil Alexander Douglas, the GP who is, ‘greeted by the muscled thud / of a growling torso in When I Came To Visit You At Home; or reaching out to Eilidh Urquhart, the Junior Doctor in Comrades, whose ‘stethoscope hangs limp’.

Image Credit: Wix

I am raging beside Khadija Rouf, a Consultant Clinical Psychologist in Care because, ‘We must create a new landscape where the clock ticks. / We must package efficiently, pull tight and be Fit / for Purpose with targets translated through the prism / of spread sheets and calculations.’

The other contributors feel so familiar through their poems that I can envisage being at work together.

Even though I haven’t discussed my experience in, Your Quarrel, I know the other contributors understand the exchange of words in this poem between my Practice Manager and me, a GP Practice Nurse. It first appeared in my debut pamphlet, Mingled Space published by V. Press (2019).

It features the Practice Manager who was rankled by the time I took to finish a morning list of patients and finishing late. Despite the fact that, ‘the bucket of water thick with shed skin and pus and infected / blood just stood between us’ he refused to acknowledge the fact that a patient may need longer than their appointment slot. He refused to accept that at the end of that particular morning, where several patients had required longer, the tight ten-minute appointment system with no room for manoeuvre was at fault rather than my time management.

The tone of Your Quarrel jars with the narrative that applauded the NHS and labeled NHS staff as heroes at the height of the first wave of the Covid-19 pandemic. It brims with my weariness of bureaucracy. It is hard to read this poem aloud in the present climate. Nevertheless, I have included it in my website: a link can be found at the end of this review.

Image Credit: Shutterstock

Micromanagement inevitably creates tension and lowers morale among employees. Camaraderie buoys colleagues, but once a workforce becomes exhausted, the desire to move on can gather momentum for some. Shortly after ‘Your Quarrel’ in 2012, I handed in my notice and moved to a different role.

Two of my poems feature in These Are The Hands. They bookend my career and are situated in different political eras.

Unlike the jaded tone and conversational form of Your Quarrel, my other contribution First Last Offices is a tender narrative poem of six quatrains. It describes an event that happened in 1979 when the NHS was just 31 years old and I was a bright-eyed, first-year student nurse.

I wonder how I managed to muster the confidence to cope, when I arrived on the cardiac medical ward, a nervous nineteen-year-old, to find the third-year student who should have been the nurse-in-charge that night, absent through sickness. A healthcare assistant who knew the ward well was on duty and the night sister patrolling the hospital, sent another first-year student from my group to work with me. She and I bonded as we washed the body of an old man after his death at the start of the shift and then muddled through the nursing regime for the rest of the night.

There was no hint from her that we had any choice but to cope.

I remember discussing the scenario with a tutor when we were next back in the nursing school for a block of theoretical teaching. There was no hint from her that we had any choice but to cope. It is extraordinary to remember a time when a preliminary training of six weeks was deemed sufficient to release first-year student nurses onto the wards and expect them to deal with that level of responsibility with minimal supervision for the duration of a night shift.

NurseTraining, Queen Elizabeth Hospital, Birmingham
Margaret : four months before the night of 'First Last Offices'

My nurse training in the early 1980s sounds prehistoric beside the degree-based training of today. However, although expectations of first-year student nurses were high and unyielding, I still describe those years as a time of nurture and true respect.

I am not looking through rose tinted spectacles; I am remembering the State's obligation to care for employees. Respect came in the form of pay and conditions. Student nurses were part of the workforce and were therefore paid a salary. While we learnt, we earned sufficient to be economically independent and unbridled by loans, especially if we resided in subsidised nursing accommodation. Not only that, we could afford holidays, shopping sprees and nights out without scrimping.

In addition, we were rewarded with a good pension scheme; a generous quota of bank holidays (ten per annum, in addition to the twenty-five days annual leave allowance) and far more generous renumeration for working unsocial hours than is received today. Because student nurses trained predominantly on the wards, staffing levels were better than adequate and breaks on duty were the norm, even in exceptionally busy times.

Many have alluded to the old model of ward-based nurse training as exploitative.

Many have alluded to the old model of ward-based nurse training as exploitative. I never felt exploited, undervalued or taken for granted. I am grateful for how those three years shaped me and above all, I cherished the support and companionship of students working on mass across NHS settings.

I still describe those years as a time of nurture and respect.

These Are The Hands documents moments, experiences, memories: snapshots of working lives, past and present. Connections and companionship can be detected within shared knowledge. The truths however, reveal far more than the hands that support one another and deliver care. Some hint at the fragility of our NHS, dependent on changing priorities of governments for funding. Priorities that depend of course, on all our hands as we vote across the United Kingdom.


Links to Readings:

Margaret Adkins Writing:

These Are The Hands | Live Event | Louise Winters & Matt Matheson:


These Are The Hands: Poems from the Heart of the NHS £9.99 available online from Fair Acre Press

The Poetry Pharmacy and from all good bookshops.


Links to Margaret Adkins:

Twitter: @M4dkins

Margaret Adkins started writing when her nursing and midwifery career came to an end in 2015 after thirty-six years. She become a full-time student at the University of Worcester. She gained a BA (Hons) in Creative Writing & English Literature and an MRes in Theatre & Performance. Winner of the inaugural University of Worcester V. Press Prize, her debut poetry pamphlet Mingled Space is published by V. Press (2019).


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