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Interview with Edna Chestnut Lockfaw, May 17, 2004 | UNCW Archives and Special Collections Online Database

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Interview with Edna Chestnut Lockfaw, May 17, 2004
May 17, 2004
Mrs. Lockfaw is a 1941 graduate of James Walker School of Nursing. Mrs. Lockfaw discusses her student training, nursing career, the operating room setting, and various transitions within the hospital setting. She became an operating nurse and retired after 21 years. Her interview contains details of James Walker Hospital's daily routine of patient care.
Phys. Desc:

Interviewee:  Lockfaw, Edna Chestnut Interviewer:  Mims, LuAnn Date of Interview:  5/17/2004 Series:  Southeast North Carolina (SENC) Length:  55 minutes


Mims: Today is May 14, 2004. I'm LuAnn Mims for the Randall Library Special Collections, Health Services project of Southeastern North Carolina. We are talking today with Mrs. Edna Chestnut Lockfaw, a 1941 graduate of James Walker School of Nursing. At the present, Mrs. Lockfaw does not wish to appear on videotape, but we are making an audio recording.

Mims: We were talking off camera a little bit and talking about where you came from, what your family was doing. Can you restate that for me?

Lockfaw: I came from a farm family in Duplin County, which is about 50 miles from here and it was in the Depression and people didn't have a lot of money and going to college was out of reach so it just left going into nursing or going to a department store to work or something like that. I don’t actually remember who recommended or why I decided to come to James Walker, but I did and applied and did get in and came in training in February 1938.

Mims: 1938, this is a time of the Great Depression.

Lockfaw: Well, it was after I think the early 30’s was the Depression.

Mims: Well we were still trying to pull out of it by this time with Roosevelt.

Lockfaw: Oh yes and we had the CCC camps and things like that.

Mims: So there was a little bit more opportunity for a young lady to go into, but it was pretty much limited to certain things.

Lockfaw: Right.

Mims: Do you have any recollection of like a family member being in medicine or a friend?

Lockfaw: Absolutely not. It was just kind of out of the clear. We had always been…everybody had been healthy; nobody had been to the hospital. I had not had any experience with nurses or doctors, but as I say I just don’t recall what prompted me to do that.

Mims: Do you remember anything hearing about Walker before you went there?

Lockfaw: Yes…you mean the hospital?

Mims: Yes, uh-huh.

Lockfaw: I knew there was a James Walker Hospital in Wilmington and there was also a Bulluck’s Hospital. It seems to me I did have a relative that had to come down to Bulluck’s one time, but I had not heard anything special. I had a cousin, Mary Hewitt, who lived in Wilmington who was a practical nurse and she was a practical nurse, she wasn’t a registered nurse. But it might be talking to her that influenced me. In thinking back, maybe that’s what it was.

Mims: Do you remember anything about the application process to get into the school?

Lockfaw: No, they just sent you an application and you fill it in and there were requirements. You had to have a doctor’s certificate and one from the dentist and a personal recommendation for your character, I guess. We just sent it back in and then they let you know you were admitted, I guess. It’s kind of fuzzy.

Mims: I can imagine. When you came down to Wilmington, did you drive or take the train?

Lockfaw: This cousin, she lived at Rocky Point, and I believe that… my father probably drove me to her house and she brought me over to James Walker the day I entered the school. I did not come for an interview or anything before being admitted as a student nurse. Looking back that sounds strange and you know it might not be true.

Mims: No, I haven’t heard anybody else say there was an interview process. They went on the recommendations of these people…

Lockfaw: I don’t remember.

Mims: I’m surprised there wasn’t kind of like clinical evaluation test to find out if you were a good match or not, but nobody remembers any type of pre-testing.

Lockfaw: Not pre-testing, but I do believe we had a physical after we got there sometime in the next maybe month or so.

Mims: It’s just that all these ladies showed up and nobody really knew that much about nursing.

Lockfaw: We didn't. It was a new thing and I don’t remember all the details and rules and regulations like that. We had to pay a fee, but I don’t remember what it was and I don’t remember what it covered, but we did have to pay for our books. For the first six months, I guess you’ve been told, we were pre-clinical students and just wore the blue striped dress and apron and black shoes and hose. Then at the end of six months we got the bib, starched bib to go with our uniform and we’d gotten our cape. Of course we had to pay for the cape.

Then at the end of that year we got our plain cap. I guess you’ve been told about the little band we get to go on it?

Mims: It varied for the different years you were there.

Lockfaw: Right, well the first year we had just a plain one and then when you were a junior, we had a narrow black velvet band around your cap and as a senior, you got a wider band. That was the only distinction between the classes.

Mims: Well this must have been really an important stepping-stone because so many people have mentioned it. Can you remember what you felt like receiving your cap?

Lockfaw: It was just exciting to get your cap. Then you had arrived if you got your cap. You could stay; you were not on probation any longer. And then you went into, and I’m sure classes must have started right away and our classes were held in the basement of the nursing home was a classroom down there. We were taught by the doctors on the staff and we were taught -- the hospital had two employees, a Mrs. Viola Coffman and Miss Ruth Pannill and they taught a class.

It was professionalism and Miss Pannill was just the epitome of being professional and she just wanted us to stand up and be professional. And we were, we were just taught that way. In fact, upper classmen were respected. We would hold the door for them. The only time we could go ahead of them was in the cafeteria line (laughter). Nobody got ahead of anybody in the cafeteria line when we went to eat. But if you were going through, you let upper classmen in first.

If you were on duty and at the desk and a supervisor or doctor came up, you stood up …showing respect for them. You were always having that in the back of your mind. It was rudimentary stuff that nurses do. I can’t remember …

Mims: Like the beginning kind of class they taught?

Lockfaw: Right, I can’t remember, it had a name, arts and something, anyhow they were employees of the hospital and they lived there and they did teach the nurses. And the dietician taught us nutrition. She lived in the place and that was Miss Boyd. As I said, Margaret Banck was the laboratory technician and she lived in the nursing home and she taught chemistry to our class.

Mims: You guys were getting like a holistic point of view before you even stepped into the hospital or this was just ongoing?

Lockfaw: No, this was when we were admitted as students, we were assigned a room in the nursing home. It was posted on the bulletin board where we would be at such and such, our duties, you know. We didn't have three months in everything, but we usually had a month of 7 to 3, 3 to 11 and 11 to 7 and sometimes we had that each shift in each specialty like Ward B was pediatrics or Marion Sprunt was obstetrics and operating room, of course you didn't work 3 to 11, you were on call there.

But in the operating room, that was really interesting. We did a lot of stuff up there besides operating. They didn't have recovery rooms.

Mims: Where would people go?

Lockfaw: Back to their room and a nurse monitored them until they woke up and of course the doctor was on call and we never had any problems. When we worked in the operating room, we had other things to do too such as wash the gloves. They didn't have disposable gloves.

Mims: Really?

Lockfaw: No, they had rubber gloves and they were washed and hung up to dry and then we checked them for holes and if they were okay, we powdered them, sized them and wrapped them up and sterilized them and they were used again.

Mims: How long would a glove hold up under that kind…

Lockfaw: A long time … unless it had a hole in them, they did last a long time. Another thing we did was make the plaster paris for casts. We would get these rolls of crinoline or whatever it was, but we’d put on gloves and we had plaster of Paris, a powder, and we just had to rub in that stuff and roll it up. Then when it was ready to be used, all they had to do was stick it in water and put the cast on. Now that was a student nurse duty in the operating room besides the surgery. Also they made the glucose.

Mims: The pharmacy didn't do that?

Lockfaw: No, it was done in the operating room. We had a special person was assigned and of course, they had a recipe and it was in flasks and it had to be filtered many, many times and then it was autoclaved and sterilized and ready to go.

Mims: That’s incredible because now I think everything comes out of the pharmacy.

Lockfaw: And everything is disposable. Oh, they sterilized everything, rectal tubes, catheters, syringes.

Mims: You guys weren’t responsible for putting the trays together for the various surgeries were you? Like putting the instruments and whatever else the doctor might need?

Lockfaw: Yes indeed, yes we had to do that. We had different sets for different things. A tray with all the instruments that would be used in a special operation for maybe a hysterectomy, tonsillectomy or gallbladder or then orthopedics would be another whole different thing, but we had trays with instruments that would be used in that operation. At the end, I don’t remember if we did it at the end of the case. I know later at Hanover, they had a workroom and somebody was hired to wash the instruments and put them on the trays. But back then, we had to do it and put them on the trays, wrap them up and autoclave them.

Mims: How did you learn how to do all this?

Lockfaw: Osmosis, I guess. Well you were never in there by yourself. You always had somebody telling you what to do next.

Mims: Because surgery goes fairly quick and, you know, you have to have everything done….

Lockfaw: Oh after the patient is on the table, yes. It goes fairly fast.

Mims: So this prep work is very important.

Lockfaw: And it does take awhile to put the patient to sleep. You know you get the patient on the table and he’s not right ready, then he’s got to be put to sleep and his abdomen prepared or the site that’s going to have the surgery and drapes, sterile drapes, takes a little while to get ready, but the actual surgery doesn’t take that long.

Mims: Do you remember who the supervising nurse was in that situation?

Lockfaw: You mean when I was…

Mims: A student nurse.

Lockfaw: A student nurse in the operating room, who the supervisor was, no, I don’t know that we had a special supervisor. I think maybe the supervisors were assigned to the operating room because I do know we had a night supervisor named Alma Boyd who worked the whole hospital, or half, we had one or two on duty and she would, in case they had to have an operation at night, I remember that she would be the one to call us.

All I remember is an old anesthetist we had, but I cannot remember if we had a supervisor. I don’t believe we had a special supervisor.

Mims: Well, you just brought up something else that I know has changed a lot and that is the idea of the call, being on call. I talked to Dr. Williams the other day and we were discussing a doctor on call meant they were at the hospital when their duty was on because there were no beepers, no cell phones. So if you guys were on that rotation, how would they get word to you?

Lockfaw: Well now, as a student nurse, we were right there in the nurses’ home so we were… but later on the telephone. There was somebody on duty from 11:00 to 7:00 and if they had an operation they called the person that’s on call to come on out.

Mims: But as a student…

Lockfaw: As a student, we were living right there in the nurses’ home and very available.

Mims: But still you had obligations for like day classes or something?

Lockfaw: Aw, that’s just tough (laughter). If you were working and a class came up, you got relieved to go to class, but you had to go back to work when the class was over and that’s it. Back then if you worked 7:00 to 3:00 and had a class 6:00 to 8:00, well you worked 7 to 3 and that night you went to your class 6:00 to 8:00. And if you worked 3:00 to 11:00 and had classes 10:00 to 12:00, you went to class and then you worked 3:00 to 11:00 and if you were on 11:00 to 7:00, you got up out of bed and went to class when it came time.

Mims: How did you do it?

Lockfaw: (Laughter) Everybody did it, that’s the way it’s done so.

Mims: A lot of discipline goes into that.

Lockfaw: Well, I guess we were just told that’s the way it is. We hadn’t been there before, we didn't know.

Mims: I know that you guys were kept tabs on once you were in the nurses’ residence like your social activities.

Lockfaw: Oh we had a housemother who lived there and we were required to sign in and sign out, there was a book at the front. We would sign out and say we were going to the movie, going to church, gone wherever and then we signed in and the curfew was 10:00 p.m. Of course you could have permission to stay out later if it was a special occasion.

And another thing when we first went in, student nurses were required to furnish their hypodermic syringe, a little 2 cc syringe, a thermometer, you had to have a watch with a second hand and a pair of scissors. And every morning the people who were working 7:00 to 3:00 met, we had a big assembly room down in the basement of the nursing home and I think there was a piano down there and we met every morning before you got… What we did was get up, dressed, got ready to go to work, went to inspection, supervisors at the door to make sure you had all these things. Oh she also looked to see if your shoes were shined. Then we went to breakfast and then we went to work.

Mims: And at that time your work schedule as a student, was it variable or was….

Lockfaw: They instigated the 8-hour shift, worked 7:00 to 3:00. At least our class did. I think maybe we had a prayer or it seems like maybe we sang a song or something down there before we went, but…. oh, oh, we were also allowed $5.00 a month allowance; however if we broke a syringe that belonged to the hospital, it was reimbursed out of our allowance. They must have been very cheap (laughter). I don’t think you can buy anything for $5.00 now, but that’s the way it was.

Also we got a two weeks vacation, we got our sick leave. If we had to have an operation or medicine or be in the hospital for any reason, it was absorbed by the hospital. But if we missed any days, it was made up at the end before we graduated. If you were sick three days, you had to stay three days; you had to have three more days.

Mims: It didn't leave you much time for extracurricular activities.

Lockfaw: Well, in the summertime, we had all that time off.

Mims: Would you go home in the summer or would you stay here?

Lockfaw: Well, we had to stay here. We had two weeks vacation, but we didn't have cars so we couldn't go home for a night. I don’t think anybody in my class, I don’t think anybody that was in the school the same time I was… owned a car. I don’t believe they would have let us have it.

Mims: Do you remember going into town to do anything?

Lockfaw: Oh yes, but you know it was 10th and Red Cross. I wasn’t but 10 blocks from downtown. We could walk down there anytime. There was a bus service and we could ride the bus. I don’t remember the details since it was so long ago, but there used to be a trolley and it stopped right there on… I believe it’s 10th Street in front of the hospital because it seems to me that one time the first affair we went to at Lumina, we rode on the trolley. We just walked there and got on the trolley, rode the trolley to the beach and back up.

My memories are very vague except that we did go on the trolley. Then they were discontinued so I didn't get to ride the trolley anymore. But they had a city bus and the city bus stopped there and you could go all over town on the city bus. Well, I guess somebody’s told you about the layout of the hospital.

Mims: Well, I’m getting more and more of an idea and I do have a visual reference, but like when you walked into it, I keep seeing like these screened porches. Was that on the front of the hospital? Like what did the entrance look like?

Lockfaw: Well, it was like a lobby, the main entrance. No, but I’m talking about the wards.

Mims: Yes, let’s talk about the wards then because it’s such a different concept from what we have now.

Lockfaw: Well, now in the old hospital, they had, well I guess you’ve been told about the Marion Sprunt Annex where they had obstetrics. Above the delivery bit, they had the women’s ward and the children’s ward. The women’s ward was Ward C and the children’s ward was Ward B. And they had a system that they could pull curtains between the patients. I believe they’ve got walls now instead of curtains.

But that was in Ward B and Ward C for the women and the children and then there was a Ward D which was the men’s ward and they also had curtains pulled between them. They had a bedside table in there and usually a chair. Now that was in the old. Now then the new annex that was built was called the Annex. We had Upper Hall A which was private rooms and Lower Hall A, which was wards, but they had little walls between them.

Mims: A semi-private kind ….

Lockfaw: A semi-, the curtain was on the front. See they had walls between the beds and then a curtain that pulled in the front and they had a bed and chair and a bedside table. In the old hospital, it was called Upper Hall B and Lower Hall B and then the new annex, was called Upper Hall A and Lower Hall A.

Mims: Well, where was the nurses’ station in these wards? Was it in the ward or was it down the hall?

Lockfaw: It was usually at the end of it. It was not right in the middle of it. Now like in Ward D was a big room and the desk was over there. It wasn’t that big. I don’t remember…seems like we could have about 20 patients on there.

Mims: Where was like the administration office, was that in the front part?

Lockfaw: Yes, as we went in there was like this lobby and then to the left were business offices in the old James Walker. I remember that… a Mr. Fisher I think was director then.

Mims: I heard that there were these porches and I can’t tell if they were on the front or if they were over on the women’s side.

Lockfaw: Nobody showed you an annual?

Mims: It was in the old…yes, I have seen an annual but we haven’t…I mean I’m getting to the point where I need more specific information. [Break] We’re looking at a picture of the front of the hospital and this was a front porch?

Lockfaw: Yes, front porch and there was a front porch on the second floor. The third floor was the operating room.

Mims: These arched windows?

Lockfaw: Uh-huh, that was the operating room in the old hospital.

Mims: Dr. Williams talks about that they would put the operating rooms on the highest floor because of the air-conditioning not working and that there were least favorable contaminants up so high.

Lockfaw: I didn't realize that, but anyhow, and this is the porch on the original hospital. It was a screened porch, but they just had chairs to sit. But see this is where the maternity people were so they didn't go all the way down here, but they must have had a porch too but I just don’t recall that.

Mims: Were the wards able to access these, the porches?

Lockfaw: The who?

Mims: Whoever was on this floor right here, would they be able…

Lockfaw: Yes.

Mims: Okay.

Lockfaw: At the end of the hall, there was a door to go out.

Mims: Just trying to figure out, I know that people talk about not having air-conditioning in this hospital and that it would become really, really hot, but they would just open up the windows.

Lockfaw: Oh yeah, they did that.

Mims: So that’s different because of course now a hospital is kept really, really cool.

Lockfaw: Too cool.

Mims: Too cool especially the surgical suite. I’ve been a patient before and I know it’s very cold.

Lockfaw: I cannot fish it out. [Looking through annual]

Mims: So this over to this side was the Marion Sprunt Annex?

Lockfaw: Right, uh-hum.

Mims: Now was this connected at all to the main hospital?

Lockfaw: Uh-hum.

Mims: It was like a corridor?

Lockfaw: Uh-hum.

Mims: There was also an annex I believe called the Bear Annex.

Lockfaw: That’s behind the whole…

Mims: Okay, Bear was behind it and was that connected to the main hospital? It was separated.

Lockfaw: Uh-hum.

Mims: And the same with the colored ward?

Lockfaw: That’s right, there was a driveway between the colored ward and the main hospital in the back. But in front of the colored ward, we called it the dispensary.

Mims: Okay, what is that?

Lockfaw: Instead of an emergency room.

Mims: Oh.

Lockfaw: But that’s what we called it, but it was the emergency room. That’s where all the emergencies came in. It was the emergency room. And then behind, upstairs from that, was the colored ward. It must have been behind it too and upstairs. It must have been more that just that because I don’t remember the layout of the whole thing.

Mims: Whenever you had to go through all your rotations, you had to rotate through these various areas.

Lockfaw: Right and we usually had a 7:00 to 3:00, 3:00 to 11:00 and 11:00 to 7:00.

Mims: Right.

Lockfaw: But not always three months in each one.

Mims: Right, do you remember what are you liked the least? What area you didn't like at all.

Lockfaw: I liked the contagious ward the least.

Mims: I don’t blame you there.

Lockfaw: The Bear building.

Mims: And what do you think was your favorite?

Lockfaw: Well, surgical patients, the operating room and then surgical patients after their surgery maybe.

Mims: Was this the entrance of the new part? Because see it doesn’t have that balcony on that section there.

Lockfaw: I just don’t believe that was the entrance to the … with the street right there. It might have been but I just don’t remember it.

Mims: Well, it changed too. I mean they did some changes on it because see here’s like the front there and see that looks different than the other picture.

Lockfaw: That’s the old one. You can tell by 1920.

Mims: Yeah, yeah. I know that a lot of people didn't care for the surgical area because they sometimes felt you know under the gun kind of situation.

Lockfaw: There’s the new building. I can’t conceive just how it was in connection with the other one.

Mims: I don’t either. I’ve got an aerial though that I’m going to start piecing together.

Lockfaw: I think that I must need an aerial to…

Mims: I was thinking that there was one in this, but I’m not sure. But you know what I’m saying about surgery? It goes really fast and you have to be really prepared and so some people didn't like it whereas like sometimes the doctors maybe were a little bit more brief.

Lockfaw: Oh well they want everything perfect for their case, which you can’t blame them for that and they didn't have the very best personnel and equipment and everything else at their disposal. And we were good at it.

Mims: Do you remember any of the physicians you worked with?

Lockfaw: Yeah, Dr. Hooper and his father, Dr. Coddington and his father, Dr. Dickey, Dr. Powell, George Johnson, Dr. Wynell, yeah I remember them. But getting back to the care the patients got, has anybody told you about the a.m. care and the p.m. care the nurses had to have?

Mims: No.

Lockfaw: Well, every morning that patient got his face and hands washed and his teeth brushed and his back washed and rubbed. And every night before he went to bed, it was repeated and if they wanted a complete bath, they got that too. But that was because they had to stay in the bed, back care was important because they did have to stay in the bed so much because it was 10 days with cataracts. They had to stay flat on their backs with sandbags to the head.

A hernia patient had to lay there for about two to three weeks before he could get up. Appendix about at least three to five days and maternity patients after the baby was born had to stay in the bed 10 days. So often when they got up, they fainted, had to go back to bed (laughter). But that care was important because the patient was in the bed so much.

Mims: And how would you change the sheets?

Lockfaw: Oh, you learned that. You’d just roll them over to the edge of the bed and change this much and then roll them back to the clean side and take the dirty off and fix it.

Mims: So a lot of backbreaking type work.

Lockfaw: Right, it was kind of hard. But it was not hard especially if the patient was able to cooperate. But if the patient wasn’t, then you got another nurse you know to stand there and hold the patient in position so you could do it. But it was not hard to do.

Mims: Well, you also talked about postop care was done on the floor.

Lockfaw: Yeah, they went back to the room they were going to occupy.

Mims: Would that require one on one attention?

Lockfaw: Yeah, as long as they were under anesthesia asleep, you did stay with them and monitor them.

Mims: So would you be assigned to that particular patient?

Lockfaw: Yeah, you were probably assigned to him before he went to surgery. Then they called down and said he was on pre-op medication and you had to do that and see that he went to surgery and then when he came back…of course I don’t remember now what happened to your other patients while you were looking after that one. (Laughter) Arrangements were made, but I don’t remember any casualties or incidents with patients waking up.

Mims: That’s what I was getting to.

Lockfaw: Arrangements were made, but I don’t remember any casualties or incidents with patients waking up.

Mims: I had another nurse, Lil Newton, talking about the drop ether patients and their recovery. Do you remember any of those?

Lockfaw: I remember the drop ether.

Mims: And supposedly the patient woke up sick.

Lockfaw: Nine times out of ten, uh-hmm.

Mims: Really sick.

Lockfaw: Vomiting all over.

Mims: So that’s changed a lot.

Lockfaw: Oh improvements in anesthesia along with medications, right.

Mims: Now when you were doing your training, did you learn about IV care?

Lockfaw: Student nurses were not allowed to do IV’s, but we had interns back then. When I was a student nurse we had interns who were learning stuff and they got to do all the IV’s.

Mims: So whenever you were working later on, how did you learn to do IV’s?

Lockfaw: I never had a lesson in it. I think it’s something you just pick up. Evidently they do now, but see I graduated in ’41 and got married and had children and didn't work again until 1946, which was after the war. So I missed out on a whole lot of stuff.

Mims: Because World War II definitely brought about some changes.

Lockfaw: Many, many changes.

Mims: And one of them being ambulation after surgery.

Lockfaw: Right, because I was just so surprised. I said, gosh now they won’t let you stay in the hospital, won’t let you stay in the bed. But they learned that from the war that it was better for them to go ahead and get up. Oh I didn't get around to our duties in the diet kitchen.

Mims: Okay.

Lockfaw: Well, if we were assigned…we had to have a month in the diet kitchen and learn about diets. We had to go to work at 5:00 in the morning and there was a mountain of oranges that, of course we had an electric squeezer, but we had to squeeze all the orange juice. I guess they had canned back then, I don’t remember, but yeah, they got fresh orange juice.

Mims: (Laughter) The things nurses had to do.

Lockfaw: Right, that’s what we did. I remember that was the first thing. You go over there and you had to squeeze that mountain of oranges or however many, a lot of them. Then if it hadn’t been done, the diet kitchen was a split shift. You worked some in the morning and then you had to go back later in the day and work. And sometimes you set the trays up in the afternoon. If not, you did it the next morning. The trays with the salt and pepper, sugar and stuff.

We had big racks to put the trays on. Now I don’t remember now how the meals got served, but they were set up ready to serve on the elevator to the patients.

Mims: Would the nurses or student nurses serve the lunches or did they have like a nursing aid that…

Lockfaw: No… well, I guess the nurse did because that rack arrived on the floor with all the patients’ food and the student nurse took it to them back then.

Mims: Not today.

Lockfaw: Not today, oh not today. They come up from the kitchen. They have their own business.

Mims: Do you remember anything about working in the nursery, about working with the babies?

Lockfaw: Well yeah, we had to have some time in there. Just this little room full of babies and we bathed them and changed them and took them to the mothers for nursing.

Mims: I had someone talking about the milk station.

Lockfaw: Oh yes, the milk lab. I didn't like that. That’s where they made the formulas and sent them up.

Mims: It’s sort of like making the glucose in surgery.

Lockfaw: Now you give them a can or whatever.

Mims: You guys, I don’t know, I’m getting more and more depth of what you guys were involved with. It was more than just total nursing, it was total immersion into the hospital.

Lockfaw: Well, that’s right. It was kind a jack-of-all-trades in the hospital, taking care of the patients, taking care of the hospital and keeping things going.

Mims: Do you recall any of the really old physicians that may have been working at the time? A prominent name that always comes up is Dr. Fales.

Lockfaw: Oh he just died recently. Yes, indeed I remember Dr. Fales. And that’s Mr. Sprunt and Ellie Farther. I don’t remember him, I really don’t. Murchison, you ever heard of David Murchison?

Mims: I have, his name has come up several times.

Lockfaw: Well there he is.

Mims: I was wondering if any of them ever had time to share changes that they had experienced? Like you’ve seen so many changes, somebody who was older at that time, did they ever share any of their transitions with the nurses about how they used to do things a certain way and now you’re doing them different?

Lockfaw: No, I really don’t. I remember that all the doctors were very friendly and helpful and would answer questions, but I don’t know if they ever volunteered any information on how it used to be.

Mims: How would you know when a doctor came on your floor? Was there any way that they alerted the student nurses that a doctor was present?

Lockfaw: No, you just saw him coming. Back then everybody knew everybody. I think now, I don’t know any of the doctors now much.

Mims: Okay, so you took a couple of years off during the war and stayed at home and had your family.

Lockfaw: Right.

Mims: And so you went back to work in 1946.

Lockfaw: Right and what I did then was private duty.

Mims: Okay, tell me about that.

Lockfaw: Because if you’re doing general duty and you can’t go, it’s very hard on the people who do you know. If somebody don’t show up, it makes it hard for the people who did. But if you’re doing private duty, that means you have one patients. You could get somebody to come for you, you know if something happens and you can’t.

Mims: Well this whole idea of private duty nurse, it was assigned to a patient in a ward?

Lockfaw: No, private duty was absolutely the desire of the patient to have her own special nurse and we had a registry and a registrar and your name was on there and when you were ready to go to work, you called her and said, “I’m available.” And we worked on rotation. So when somebody wanted a nurse, they called her and she called you and she’d call and say go to Mr. Smith wherever at such and such hour. However, I worked only 7:00 to 3:00 because of my children.

Mims: Where would you usually go?

Lockfaw: To the hospital. I did do some nursing in the home. We nursed in the homes also. And this was a long time ago and I did have one or two cases at Babies Hospital. And I have had one or two at Cape Fear. Mostly, this was as you say now from ’46 to ’60, I don’t remember when Cape Fear opened. Mostly though it was in the hospital. Nine times out of ten you nursed the patient just three or four days after surgery. You were there after surgery to be with them.

Mims: And this is more of a relief for the family?

Lockfaw: Uh-hmm.

Mims: Would you work in a relationship with the nurses on duty there or would they just bypass that room because there was a nurse there?

Lockfaw: They bypassed that room as far as caring for the patient, but the nurse reported to them. They were fully aware of what was going on with the patient.

Mims: So then if any additional tests or procedures came up...

Lockfaw: Right, they were in charge of the patient also you know, but we were in charge of their immediate care.

Mims: Did you like doing private duty?

Lockfaw: Yes. It was kind of boring sometimes if it was just one patient. But then in 1960 I believe, I decided that my children were grown and I’d try some general duty and the only opening they had was in the operating room.

Mims: Well what a coincidence, you kind of liked that.

Lockfaw: Right. So then I proceeded to do general duty in the operating room.

Mims: Now what would that entail?

Lockfaw: That entailed being a scrub nurse, which means to scrub your hands and put on your sterile stuff and assist the doctor in this procedure or be the circulating nurse who walks around and gets you what you need.

Mims: Hmmm, I never have understood the difference between those two.

Lockfaw: Really?

Mims: Yeah, cause you talk about…

Lockfaw: Scrub nurse and circulating nurse. Well the doctor, see before surgery, outside the operating room there’s these sinks and you scrubbed your hands up to your elbows. You had a little brush and soap and scrub and rinse and scrub and rinse for 10 minutes, your first scrub of the day is 10 minutes. Then you walk in there like this and somebody hands you a towel and you dry your hands off and you still stand like this and then they hold the gown up and you go in the gown and they tie it in the back for you and then they go get your gloves and open them up and you put your hands in, then you’re a scrub nurse. Then you can walk up there to that sterile field where they’re going to make an incision and touch.

Mims: Would you actually touch the patient or would you touch the tools?

Lockfaw: Oh whatever you’re asked to do. Sometimes you’re asked to hold a retractor, sometimes you’re asked to do this that or the other, but you mainly give the doctor the instruments.

Mims: Now there’s always that joke about you know you have to (slap the instrument in doctor’s hand). Is that true?

Lockfaw: Well, now see he’s standing here operating and he wants some Kelly and he’s looking at what he’s doing so if he feels it with his hands, he’s got it.

Mims: So that’s an important part of it cause if they drop it….

Lockfaw: You get another one (laughter).

Mims: It’s not sterile anymore.

Lockfaw: Oh you have what you call a mayo stand with all these instruments laid out on it so they’re really easy to get to. The doctor is standing there, the doctor’s here and the scrub nurse is here. He has assistants on that side and maybe there’s an intern there and you just hand him stuff, as he wants it.

Mims: That’s very intense to sit there and have to do that.

Lockfaw: Clamp, clamp, clamp, suction, suction and sponge.

Mims: Did you work for any particular doctor or just whoever?

Lockfaw: Just an operating room nurse, whatever came up.

Mims: Well, in that time period between your training as a student nurse in surgery and your actual general duty nursing in surgery, how much change did you see there?

Lockfaw: A lot. Well not as far as surgery and what the scrub nurse or circulating nurse would do, but it was just different kinds of surgeries and the new equipment and stuff like that.

Mims: Were you still using the old rubber gloves?

Lockfaw: Oh by then they had disposable. Even had some for people who were allergic to rubber.

Mims: How about the gowning, was it still the cotton kind of gowns?

Lockfaw: Oh they still had them and some doctors wanted them, but they had disposable paper ones. They had packs they bought.

Mims: And then as far as like technology changing. Were there different kinds of tools available or were they about the same?

Lockfaw: They might have had some new ones, but they still had all the old ones.

Mims: Because we have a doctor surgical kit from a Civil War doctor at Randall Library. I bet you’d be interested to see what they came with.

Lockfaw: Has it been on display in the hospital?

Mims: Not at New Hanover Hospital, it’s only been at….but it was Dr. Thomas Fanning Woods surgical case. But we’re constantly looking through it saying you know it looks more like dental kinds of tools, but I’m sure you could probably recognize more than what we do. I know that anesthesia changed.

Lockfaw: I think that’s probably the biggest change.

Mims: So the patients were prepped a little bit differently maybe.

Lockfaw: Well, always they got a preop medication when I was a nurse. They got a painkiller like morphine or Demerol and some atropine, which… I forgot what it does (laughter). Anyhow there was a preop. Then they go to the operating room. They used to start an IV with pentathol, but I believe Lil said they hardly use pentathol now, some IV to kind of take the edge off. And then they intubate, nine times out of ten put an intubation tube in.

Mims: Now that’s all done…

Lockfaw: By the anesthetist.

Mims: Anesthetist.

Lockfaw: Or anesthesiologist.

Mims: So you didn't have to be a part of any of their…

Lockfaw: I didn't have anything to do with anesthesia unless they wanted something I could bring them.

Mims: Well, tell me about circulating. Now what was that?

Lockfaw: Okay, after this nurse and the doctor get in their sterile garb and they’ve started the procedure, they might want something out of that cabinet over there and they can’t go get it because they’d be contaminating themselves so the circulating nurse does that. And if you need more sutures, she furnishes that. As they use the sponges, they’re thrown off into a bucket over there and then she has to keep count of the sponges.

Mims: The circulating nurse?

Lockfaw: Yeah and anything you need and then when the surgery is over, she’s ready with the dressing to put on and stuff like that.

Mims: Yeah as far as like after the surgeon is done and the patient is done, what is the duty of the nurse in there?

Lockfaw: After the operation is over and they put the dressing on the patient, it’s still on the table. Then when the anesthetist says the patient can be moved, then they roll in the stretcher and the patient is moved to the stretcher and taken to recovery.

Mims: Does the scrub nurse have to go with the patient?

Lockfaw: No, the anesthetist goes with the patient. The circulating nurse usually goes unless there’s a nurse assistant there sometimes. Sometimes they have a nurse assistant.

Mims: So how much time in between surgeries would you have?

Lockfaw: Just enough time to clean up the room and set up the next case and the quicker the better. But it usually takes 20 minutes, something like that. See what they do is roll out all the dirty stuff, instruments to the work room and then the nurse assistant comes in and takes all the linen out and scrubs down the floor and empties the trash.

Then it’s ready for the circulating nurse to go in and open up the next case which is, they have stainless steel tables there see and then they’ll have this pack of linen, open it up and then they’ve got their instruments all sterile. All they have to do is open it. Then the scrub nurse comes in and arranges it to her comfort.

Mims: When you were a student nurse observing, you know participating in that, about how many surgical cases were done a day? Do you remember?

Lockfaw: Sometimes three, four, five.

Mims: And then when you returned to work, about how many cases were done?

Lockfaw: Twenty, thirty, forty (laughter).

Mims: What’s the difference?

Lockfaw: I don’t know if it’s that we became such a big hospital or covered more territory or more people. More people I guess. The population grew so I guess illnesses grew.

Mims: Or more intervention that surgery can help with?

Lockfaw: Oh, I don’t know but everything got to be more. Bigger and more.

Mims: How long did you work in this capacity?

Lockfaw: Oh then in 1981 I retired and then in 1982 I was all rested up and ready (laughter) to do something so I went back to see if they wanted me part-time. So I got a job doing part-time in ambulatory surgery.

Mims: Oh, right there at the hospital?

Lockfaw: Right there at the hospital?

Mims: That new…

Lockfaw: Where it is right now.

Mims: In the back, back there. That was kind of a new concept during this period of time. Can you give me any idea of the development in the ambulatory surgery?

Lockfaw: Well it started off really little. It started off, I think the first time it was on the 7th floor, then they moved it to the 9th floor and then it had its own place down there. No, I don’t remember all the details about it except that it was ambulatory surgery and people could come in that morning and have the operation and go home that evening.

Mims: Do you remember what particular surgeries started in ambulatory?

Lockfaw: Those that didn't have to stay overnight, something that could…see they were having so many surgeries, big surgeries I think, that had to be hospitalized or maybe major surgeries, they didn't have time to do these little ones, you know. So I think that had something to do with it too.

Mims: Well, I’m just wondering you know there’s like biopsy type surgeries that are not as invasive.

Lockfaw: Right.

Mims: So the care afterwards would be minimized maybe.

Lockfaw: Well, now they do a lot of stuff in ambulatory like arthroscopies, they let you go home.

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