Living and Nursing in America The way it is and was

Dedicated to our daughters Jane and Penny Grandchildren

Reuben, Jason, Ruth-Ellen, Corey, Seth and Victoria

Acknowledgments

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First and foremost I have to thank Ian Huckin of Enstone in Oxfordshire, England. He has over the past 4 years been invaluable to me and a real friend. He has willingly edited all of my books, with gentle and constructive criticism. He recognises and does not try to change my way of writing, even though I realise it is a little unorthodox. Plus dealing with the complication of English versus American spelling, and what is correct grammar. If it wasn’t for Ian’s help and encouragement, I would still be working on my first book instead of my third.

To our daughters, Jane and Penny, and our grandchildren, for giving me the reason to start these books in the first place.

To Aynhoe Writers Club; over the 4 years I was in England, they have given me the encouragement and confidence to get my books finished.

To Reverend Gill Barker; Rector at Aynhoe St Michaels Church, for the support she has given me during a very difficult year.

To America, and my patients over the years, who gave me the varied and unexpected experiences which, hopefully, will make this book interesting? It may even help to bring about changes to the American Health Care system, which are long overdue. It has been an interesting journey to say the least.

To Hilary and Brian Mullins, our life long friends, who have been there for us, through both the good and bad times – and as they say we have had more than our share of bad times! Their love support and encouragement has been unrelenting. No one could have better friends. If someone was to write a book ‘What it takes to make a good friend’ they could be the models for it.

And last but no means least: To Mike Griffis; my husband of almost 50 years. His love, support and encouragement have been unending. He has willingly moved house and home for the betterment of my work. He has given up jobs he loved, so that I could continue with my career. He was a househusband long before such a thing was heard of. He has taken responsibility for more than 50% of the household chores, and the raising of our girls. He is the best thing in my life, and I bless the day we met - 2nd January 1962.

Table of Contents

Preface

This book describes the life of a British Nurse who came to the United States as a result of her marriage to an enlisted man in the U.S. Air force who was stationed in England. Dawn, a nurse, received an education based on principles espoused by Florence Nightingale in 1860 when she established the Nightingale School for Nurses at St. Thomas Hospital in London. The primacy of a concern for the welfare of the patient coupled with tenacity for holding the line when that welfare was compromised and the necessity of possessing a broad range of clinical competence were the hallmarks of the training of Nurses. Dawn’s personal attributes absorbed these principles readily.

The story Dawn tells can be read and interpreted in many ways. It will become quickly obvious to the reader that she and her family moved over a large part of the United States primarily because of transfers inherent in the military life of her husband and later in search of work. They lived and continue to live on the edge of a financial cliff most of the time and Dawn initially had to work to keep the family on a steady footing, later Mike supported her by moving to wherever was in the best interest of her career. In addition to the vivid descriptions of the towns and states in which they lived there are important observations about the challenges she faced, given her background, within the institutions of the health care system in which she worked. She was put in situations which were directly contrary to the principles she was taught and believed. She met these head on at substantial risk to herself and to her great credit addressed them with tenacity and courage. Dawn had an overall living experience that many Americans have not had and are unlikely to have as our population gravitates to the cities and their suburbs of this country.

If one just skims this book the lessons and impressions will be largely dependent on the breadth of physical and intellectual experience the reader has with the United States. I vividly remember a trip our family took in the late 1940’s when my father piled my mother and three kids into a Dodge Sport Coupe and headed west from Detroit, Michigan to Colorado, Wyoming and Montana to see the sights. We came back through Montana and North Dakota to Minnesota to visit my Grandmother. The vastness of the country is awe inspiring but as little kids we wondered when the wheat, corn and grass would end.

It would be easy to have a totally negative view of the nursing and medical establishment, but that would not be justified because Dawn describes a subset of a greater whole. Her observations are real, however, and contain within them the kernel of elements regarding the health care

system in the United States which must be addressed as the country tries to reengineer the way health care is delivered and financed.

I chose to approach the book differently. At first I thought I would skim it since I had been asked to write this preface. Even though I have had extensive experience with the U.S. health care system and with Government and am quite familiar with the system in the U.K. and those on the European Continent and Russia this approach did not work. I chose to slow down and read it for the images the words and observations brought to my mind. This worked. Some who read this will take umbrage with her professional observations, others will be satisfied. She describes the travel and living situations vividly and many readers will relate to these because they are not unique to just the United States. I found them to be interesting and delightful.

I knew and worked with Dawn during a part of her professional life where her substantial skills as a Nurse Practitioner and advocate could be released in the setting of an academically affiliated teaching hospital Her efforts contributed to the way in which care was delivered and her tenacity helped to sponsor programs and services on behalf of patients that latter were adopted nationally. In addition she took on the problem of equitable treatment of the women pilots that ferried aircraft to and from the battle zones in WW II. Indeed, when she left the hospital she was truly irreplaceable. Florence Nightingale would be proud of her. I can strongly recommend this book to both the U.K. and U.S. audience.

Howard H. Green M.D.

Former Chief of Staff at VAMC White River Junction

Vermont

Foreword

This follows on from two books written and self published in 2007. Although it is a stand alone book, the others do have some relevance as to why this was written.

The first - ‘Aynhoe Village Life’ - covered the village of Aynhoe itself, and the people that lived there. It is on the eastern edge of the Cotswolds in England, where I came from and grew up. It covers village life from 1880’s to 1956. These are primarily stories as told by grandparents, family and villagers, and instilled in me the importance of the family unit. Aynhoe now spelled Aynho officially, because shortly after the war the post office changed the spelling without discussing it with the villagers, I resist it as much as I can!

The second - ‘Nursing at the Horton’ - describes nurses training as it was taught during those years, shortly after the National Health Service came into being in England. It gave me the grounding of how I believe nursing - and care to and for the patient - should be. The primary teaching, above all else, was ‘The Patient comes first, second and last. Everything else has to fit in between’. Nurses were highly respected as professionals. It was a job one was proud to be a part of. I learned very rapidly that this was not, and I doubt even, considered in American patient care. I also cover meeting and marrying an American Serviceman, and having two daughters before we left England.

It is normal for people to have preconceived ideas as to what another place, and the people, may be like. I was no different. I was not sure how I would deal with a country full of Americans, if they behaved like the American tourists in England did at that time; loud, braggers and acting superior. Most of the GI’s I met were much the same. I found, after arriving in America, that the people were just like we were in England. Quiet, hard working, cared about their home and families, and did not flash bundles of money around. I believed that medicine would be much like England’s, but maybe a little better, because it was a richer country, and wasn’t still trying to get over the effects of the war. Boy! How wrong I was!

This book charts both the nursing and the medical care I experienced in the many States that we lived in. You will find many of the stories shocking. Indeed early on there is far more shocking than heart warming. Sadly, I doubt that in some areas, there has been very little change with the passing of the years. I sincerely hope I am wrong on that count. The difference between different parts of the country is eye opening.

The book also covers what it was like for a young English woman, her American husband and two daughters, coming to a strange land, and

learning to live and adjust to a totally foreign way of life. I have now lived in America for over 40 years. There are some places I love - not only for the beauty, but also for the way of life - while there are others I hope I will never have to return to. We have lived primarily around Vermont in northern New England for almost 30 years. I love the way of life, the people, and the beauty, but I no longer like the long cold winters. The novelty of those has worn off!

The return to England for our future retirement turned out to be sadly for only four years, as the family needed us back in Vermont. We found very positive changes taking place in the healthcare field – so hopefully.................

Chapter 1

America

13th  April – May 4th 1965

The plane inside, was nothing like I had ever seen on the movies, which was all I had to go by. But then the rust on the outside didn’t look too good either! This one, on the inside, was just a grey metal shell, with all the nuts and bolts exposed. There was no carpeting on the floor, and the seats were dark green, with very little space between the rows. There were four seats on each side. I don’t believe there were any down the middle. Mike said; it looks like this, because it is really a cargo plane that has been fitted with seats, so it can carry passengers. The plane had in fact been used in the Berlin airlift. Now, in 1965, it looked like it should have been retired. It was flying under the name of; ‘Trans Global World Airways’, out of Canada, and was a turbo prop. Apparently it was designed to hold 99 passengers, but they had crammed in seats for 129. Military people have no baggage limit, which would add to the planes future problems.

They had put the temporary kitchen, for the crew to use, at the rear of the plane along with the toilets. The space was so limited, that it required the stewardesses to stand in the toilets, to work in the kitchen. So there was constant shuffling when the toilets were needed by the passengers.

The pilot told us that the flight was expected to last 9 hours, and that we would be landing at Maguire Air Force Base. That we would go over Shannon, then across the Atlantic. I can describe the take off only as; ‘it lumbered down the runway’.

The sun was with us until just past Shannon, then we hit the storm, and that lasted until we got to the Maine coastline. The pilot tried to get above the storm, but he couldn’t. There was not enough power with what he was carrying. Next he said he would try to go around the storm, by aiming for Goose Bay in Labrador, and then go down the coast. That didn’t work either! The air pockets we suffered, and the shaking of the plane from the storm, were frightening. People were being sick, and children were crying. The attendants had to remain in their seats, with their belts on, for most of the flight. In between the worst of the storm, they tried to serve our meal. Luckily for them, it was just grilled cheese sandwiches, an apple each, and coffee to drink. Even that took them over 3 hours to serve. During the coffee round, one stewardess ended up in a passengers lap. How she didn’t spill it I’ll never know! It turned out that that was all the food they had on board. Added to this, the heating and cooling system on the plane was erratic,  to

say the least. It was literally freezing. The nuts and bolts in the plane shell froze up, and were covered with thick ice. Then the heating cut in, we were all sweltering, the ice melted and dripped on us. Then it went back to freezing again.

During all of this, our eldest daughter, Jane, decided she needed to go to the toilet. The disposable nappies had just come out, and I had put her in one, explaining to her she could use it instead of going to the toilet. Jane would have no part of it. So down this rocking plane we went. She took one look at the toilet and screamed: I’m not using that. It looked like a one-hole outhouse toilet seat, all made of wood. I told her; it’s this or the nappy. She decided on the toilet. The space in there was so small; I had the back of my heels against the wall, and my toes hard against the front of the toilet. The ceiling was slanted, so my head was over and above this one unhappy child. I had finally got her nappy off, and just got her sat over the hole, when we hit another air pocket. Jane came up, and I managed to dodge her head. By this time she was screaming bloody murder! Let me say this; she did not ask to go back there again! And because of the storm, the flight took 13, instead of the specified 9 hours. The attendants, when they were able to walk up the aisles, were heard to say; Do you think this bucket is going to make it?

For the pilots that know Maguire, there is one runway, that if you come in and land a bit early, there is a bump that can cause difficulty for the pilot, to keep the plane safe. Guess what! That’s right! We hit the bump, and we went down the entire length of the runway, rocking from side to side as if we were on a see-saw!

This flight was the first of two, contracted to bring Air Force personnel to the States. There was an Air Force General on our flight Apparently, because of complaints he lodged on arriving in the States, the second one was cancelled, and given to a commercial passenger carrier. Weren’t they lucky!

We thought that all we had to do was clear customs, and then get to Philadelphia for our next flight to Texas. Even though the plane was late, we had plenty of time - we thought.

At Maguire we had to go through processing. They had a room with attendants, for the small children to go to rest and be fed. The rest of us had to stay in this large room, to fill out the same type of paperwork that we had already completed to get married, and to get a visa to come into the states. We had to list all the places we had lived from birth, get finger printed, then again swear that we were not there to overthrow the government, and did not plan to participate in illicit earnings. Now, can you imagine anyone that had those plans owning up to it at that or any other time? Eventually we were released, and we gathered up our luggage and children. Mike told me

to take the girls and the hand luggage, and try and find a taxi or a limousine. There was only one limousine there. I told him where we needed to go and he said he could take us there. We were all loaded up and he didn’t move. After half an hour of waiting; and our time to the next flight getting closer and closer; I asked him when we would be leaving. He said; when he was full. I explained to him about the time for our flight, and he responded; That’s your problem, Lady, not mine. All I thought was: ‘Welcome to America - land of rudeness’! We made it to the airport with no time to spare. The people at the ticket counter said we would have to run to make the plane, and they hoped to get our baggage on board. The run was about a quarter of a mile, each of us carrying a child and hand luggage. There were porters leaning against the wall all along the way, and not one offered to help. I mentioned it to Mike once we were settled on board. He said: If we had just had a briefcase, and looked like we might tip, well then they would have offered!

Our flight was with American Airlines. It was called a ‘Businessman’s Night Flight’, with several stops before reaching Fort Worth, and due to arrive there at 2:30 am. We took off and went to full flying height, then immediately dropped down again. Mike said Oh No! Now what? figuring what we had just survived, now what was going to happen? At least on the inside this plane looked like they did in the movies. We landed in Baltimore. After we took off, our next stop was Nashville. So there was quite a bit of time before we landed again. One of the stewardesses came to us and said; You all look exhausted. Where have you come from? We explained to her about the length of time, and that all we had eaten in over 16 hours was a grilled cheese sandwich and an apple. Also that the flight was so rough, the girls hadn’t slept since we left Upper Heyford. There wasn’t supposed to be any food on this flight, so we did not expect to get anything to eat. They took the girls from us, made them each beds on the rows of seats across from us, and gave them a hot milk drink. They rested quietly, but only slept for about 10 minutes. For us they brought extra pillows and blankets, and somehow made us sandwiches and hot chocolate to drink. I have a suspicion we were eating their lunches. We weren’t able to sleep, but it was nice to rest comfortably.

When we left England, it was just above freezing, so of course we were dressed accordingly. Mike had to wear his blues uniform, and was carrying his heavy uniform winter coat. When we got off the plane in Fort Worth at 2:30 am, it was 80 degrees, and the full blast of it hit us off the concrete, as we walked to the terminal. Mike was stripping clothes off of himself as fast as he could, and off the girls. The only thing I could take off easily was my top coat. By this time we had been traveling over twenty-four

hours, in less than desirable conditions, and we looked like the wreck of the Hesperus! As soon as we got inside the building, Mike saw his parents walking towards us. At 2:30 in the morning his father was immaculately dressed in a business suit, and his mother looked like she had just walked out of a ban box, (immaculately dressed.) Her hair and make-up was perfect, and she was wearing a medium blue suit, white blouse and high heels. I figured I might as well give up right there and then! Other than welcoming us all, they didn’t say much to me, mainly because they couldn’t understand a word I said! The girls were too shy and tired to offer much. I do remember Mike telling them how slow they talked. Mother said it wasn’t them that had changed; it was him, and he was talking way too fast.

By the time we got to their home, Mike’s brothers, Mark and Steve (They were actually closer to our girls’ ages than ours) and Papa - Mike’s grandfather, Heidt Tyson - were all waiting for us. The girls took to Papa right away, and they just looked at his brothers. After the girls had had some breakfast, we put them to bed. Mike and I planned to stay up as long as possible, so we could adjust to the time change quicker. We finally gave up in the early evening.

The plan had been to stay with the family for four weeks. After three weeks, it was apparent that four people descending on them for that long, was too much to ask, and we needed to get settled at the new base.

Mike had been able to see some of his old friends, and we had met most of the extended family, including his other grandfather - Tom Griffis

- in Hamilton. We had purchased a used car, a Buick Special, with Dad co-signing because we had no US credit. It is necessary for everyone to have a car in the US, because of the distances one has to travel, even to the shops. With all that accomplished, we headed for Clinton Sherman Air Force Base, in South Western Oklahoma. On the map it does not look far, but even with the daytime speed limit of 70 mph, it was going to take us a good eight hours. Between Fort Worth and the base, the countryside is very flat, and you can see for miles. It seems as if you are never going to get anywhere. Once we were out of the city, there was hardly any traffic, and you could go for miles and not even see a building. Then, in the distance, you’d see a town appear on the horizon. It would seem an indeterminable time before you reached it. Luckily the girls slept a good part of the way, and we had enough things for them to play with when they were awake.

Chapter 2

Oklahoma

May 1965 to January 1967

Initially we found a Motel close to the base, to stay in for a week. Mike took his pay record to finance, to get his pay, quarters allowance and travel pay. Luckily it was a considerable amount. Though we had no way of knowing it at the time, it was the last pay we would receive until November, because they lost his pay records. There was a trailer park just off base, which had a trailer for rent. It was only slightly bigger than the one we lived in when we were first married. We stayed there for a couple of weeks. There was also a partially furnished 10 by 65 foot trailer for sale. We were able to get a loan at the local bank, allowing us to purchase it. We knew that some of the furniture coming to us from England, wouldn’t fit in it, and we would have to sell those items. It had 3 bedrooms, a bathroom, a living room, and a kitchen in the front of the trailer facing the road. It had a fair sized garden to one side, which was fenced off, so it was a good place for the girls to play.

The trees around the site were on the other side of the dirt road which went around the park. Those were only mesquite trees, which at best only grew as tall as a small apple tree. They definitely gave little to no shade. Around our fence someone had planted morning glories; they are a vine with trumpet-like flowers. All they seemed good for was as a breeding ground for the mosquitoes, which were eating the girls alive. We decided that, although they were quite pretty, they weren’t worth having. I managed to pull them up quite easily, and had only a handful left to do. When I grabbed the next set of vines, I felt something bite my right index finger. I dropped it, and saw a black spider crawling away. I killed it and it turned out to be a black widow. They are quite poisonous.

At the dispensary, they decided to not give me the anti-venom, because there was a question that I might have an allergy to part of its derivative. Three days later, as my hand was still quite swollen, and I was a bit delirious, they gave me a dose of adrenaline. It worked, but boy does it make your heart race!

South Western Oklahoma is flat, with soil redder than I had ever seen before. If it gets onto wet clothes, it permanently stains them. It is also right in the middle of the tornado belt. The tornado season is May to end July. We arrived there the first week in May!

The first six weeks we were there, we spent most evenings, and a good part of the nights, in the tornado shelter in the park. It worked well, even though it used to be the old septic tank for the park. The sirens would go off to warn us to take shelter, and then they would sound the all clear when the danger had passed. I was not afraid of the storms, figuring we were safe in the shelter. But every time the siren sounded, I had a knot in my stomach, that wouldn’t let up until the all clear was sounded. I could not understand why, until a Scottish girl that lived there, asked me how I was dealing with the storms and the siren. I told her my reaction. She told me, that I was probably too young to have a conscious memory of it, but the reason for reacting the way that I did to the siren, was because it was the same sound as was used for the bombing raids and for the all clear in WW2.

About four weeks into this nightly habit of sirens and storms, Mike and I were trying to lay new carpet in the living room, and the siren went off again. We decided to keep an eye on the situation, but to carry on with what we were doing. All went well without incident, we thought! At around 5 am Mike had a fit of coughing, so he went to the kitchen to get a drink of water. He ran back to the bedroom, saying the car is gone. I said: Did you lock it? He confirmed that he did. As I went through the living room, I looked out of the window. There was enough light to see the car about fifty yards down the road. When we got to it, the strange thing was, it was on the other side of a sign post, there were no tracks in the dirt roads - as you’d expect to see if it had rolled there - the car was still locked, and the emergency brake was on. Later that day, someone told Mike, that there had been a lot of little twisters in the area throughout the night. So the car was probably picked up by one of them, and then put down where we found it. The car was always parked about 15 feet from the front of the trailer. It never ran quite the same after that experience.

During the first six weeks of being there, we had one more occurrence that was scary to me. A group of families from the park decided to go for a picnic, and do some fishing at a local lake. The children were all paddling in the water, just off of a very nice wide sandy beach. The fishing lines, about six of them, were way out from where the children were. I noticed something large going towards one of the lines, I pointed it out to one of the men. He thought it was a turtle and started to reel it in. When it got to about 50 feet from the shore, he yelled out: Cotton Mouth, get the kids! Everyone darted into the water, dragged the kids out and took them way back up the shore. It continued to come up onto the shore. It was a huge snake, also known as a water moccasin, and very poisonous.

On 15th June the temperature hit 115°F (46°C) in the shade. The only problem was; we had no shade! I had read as a child, that in America

it got so hot that eggs could be cooked on the paths. I had already learned that going barefoot could cause severe burns on the soles of your feet. The girls had to be watched closely, to prevent that from happening to them. I decided to see if I could cook an egg on the path in front of our trailer. It was concrete slabs, so I thought that should work fine. I broke the egg onto the path, and it immediately sizzled and spattered, as if I had broken it into a too hot pan. It cooked rapidly.

I had been led to believe, for a good portion of my life, that America was very civilized. My experiences so far did not paint that picture for me at all.

Oklahoma is part of the mid-west. It is also in the Bible belt, where religion plays a very prominent part in the lives of the people that live there. The largest religion is either the Southern Baptist or the Church of Christ, otherwise known as the Carmelites. Next would probably be Methodist. There were very few Catholics or Episcopalians (same as Church of England), and only a smattering of any of the other religions. To say there is a church on every corner is not far from the truth - usually a Southern Baptist on one, and across from it a Church of Christ. Mike says that America was founded primarily for ‘a freedom of Religion’; he says it should be for ‘a freedom from Religion’! All the church members are expected to tithe 10% of their income to the church, and if they slip behind in their amount that they are supposed to be paying, the preacher will go to the house for it. This happened to one sergeant. The story goes: He was out watering his lawn. His wife had been in Germany for six weeks, caring for her sick parents, so she hadn’t been making her donations. The preacher stopped by to tell her husband how much he owed the church. He turned the hose on the preacher, and told him that was all he was getting now, and in the future. He was unaware his wife had been talked into tithing, and stopped it.

A small town close to the base was called Cordell. There was a small family-run department store there, which sold just about everything but food. Every time we went in someone would approach us, and instead of asking if they could help us, they would say; What church do you belong to? I would respond; Episcopalian, and Mike would say; Methodist. The reaction we would get was: Oh! I suppose that is alright. They would then turn and walk away from us, to let us fend for ourselves. We were in Oklahoma for just over two years, and this pattern never changed. We had to use the store, because there was very little choice in the area. Before we left, we made plans to visit the store one last time, and we were prepared for them. Of course the usual happened, but this time I said Church of England and Mike said I don’t, I’m an atheist.