People's History of the NHS


Portrait of Empress Zauditu Ishuah aka Jennifer Simpson

I was born in the UK, in the ‘50s, I am born of the Windrush Generation, my mother and father came to the UK in the late 1950’s.

My mother worked in the National Health Service; she started as an SEN (State Enrolled Nurse) and worked her way up to become a senior staff nurse. I suppose she heavily influenced my life.

I started my training quite late, I had a child, and my child is disabled. She was born with spastic tetraplegia and partial sightedness. It was a challenge but despite the challenges that I faced I did well at school. I left with A-level and O-levels and went on to do my training at the University of Central England. I obtained a Bachelor of Science degree with an RGN. I was actually one of the students who received prizes for completing a 2.1 degree despite having very severe mitigating circumstances - with a disabled child, y’know, it’s quite difficult being a single parent, black, female and struggling to do a degree was quite something.

I was employed by Sandwell and West Birmingham hospitals in December 1993. I was quite overwhelmed with getting the post because I had quite a few issues which made me think I wasn’t able to get a job. I went straight into theatres where I did the rotation for 18 months, but during that course of time I was so interested and motivated by what I was learning that it triggered me to want to know more. So I was so interested in operations actually taking place in surgery than being a scrub nurse! Y’know I’d be sent to go and get something and I’d be looking at the operation rather than wanting to get the bit of equipment that I’d be sent to run for.

Anyway, there was the opportunity for theatre nurses to train further to become first assistants to the surgeon. So I saw this bit of paper on the wall once and I thought ‘that looks interesting’ so I applied and sure enough, sometime later, I was actually accepted on the course. One of the criteria required was that you had to attend a meeting after work to even be considered to enrol on the course. So I went to the meeting and I was the only one at the meeting (laughs)! But I was accepted onto the course. It meant travelling up to ---- it was a highly condensed course that would equip the practitioner to carry out a myriad of tasks which was encompassed from nursing speciality to doctor’s land ideally so it was sort of blurring the boundaries.

So this course came about as a direct response to the junior doctors in the early 2000/ 2001 when we were talking about the reduction of junior doctors hours at that time. So what the government wanted to do was equip nurses to take on some of those skills and responsibilities.
Having been able to take the course certainly provided me with some of those skills and equipped me to actually come back - I’d got all these skills that nurses had never had before so I was able to pioneer the role and I became the first 1st assistant in City Hospital (Birmingham). Which meant, being a scrub nurse, had to find a scrub nurse to replace me during those times when I was chosen to assist a particular surgeon during his surgical procedures.

He hadn’t got a junior doctor at that time, again the role was very new, so here I was; black, female, single parent, disabled child, now pioneering this role!

It started off with me having to shadow the consultant and his team. The training itself was based on that particular hierarchy where you’ve got a consultant, registrar, surgical health officer, house officer, Jenny - me, yeah?

So as I came into the team all these different hierarchies or specialities would embrace me and teach me certain things. I was exposed to the theatre lists, I was expected to scrub up and assist with surgical procedures. I was taught how to suture using skin --, sub particular, suturing, minor surgical procedures, peg insertions, given the ability to organise and order x-rays, CT scans, MRI’s and ultimately after all of this and prescribe.

So here I was now, all these skills; singing, dancing (!) I went back to the theatres and I’m no longer operating as a scrub nurse but more on the surgeon’s team where I would be scrubbed up rather than giving them the equipment. The equipment was now being handed to me! I would be retracting tissues, assisting with various parts of the procedure itself and then left to close.

So can you imagine the first few days of Jenny closing the wound? I remember we did a mastectomy, huge breast removed because of cancer, and after the mastectomy the surgeon said I stitch up and the wound was approximately 15 inches long and by the time I’d finished I’d got quite a crowd! It was quite a surreal movement, very encouraging and very motivating to be part of this new movement that seemed to be taking place.

It then carried on with me developing the role even more; seeking authorisation to request bloods, ECG’s, chest x-rays, being sent on courses which was usually only accessed by the medical profession. To learn how to request ECG’s how to request scans etc according to Trust policy. They also identified the role for me in the training of other staff junior doctors and it culminated in me developing protocol for the role. I divided the role up into four particular areas: ward work which involves patients that were coming in, they needed to be prepared for surgeries they needed to be pre-assessed, organising bloods etc. Consent, I was able to do all of that. There was the theatre work where I was assisting the surgeon and also teaching and training junior doctors and carrying out surgical procedures. Post-op(eration) work, going to see the patient post-operative on the ward and so on and also research and development.

As time progressed, and because it was a particularly new role, I began to become more and more involved in gaps that seemed to present themselves within service provision. So I would be involved in pre-admission of the patient. Introducing new concepts such as post-recovery, carrying out peg insertions, I was even taught how to do colonoscopy, sigmoidoscopies, I ended up having minor operating lists where the surgeons would refer patients with sebaceous cysts and other lumps and bumps and I had a list created where I was the main surgeon. Started off once or twice a week, I was also taught how to do hernia repairs, and again, they had a list set up specifically for one of the surgeon’s overseeing me for that

So, that’s my story! - Nurses, particularly black nurses, don’t get the opportunity to rise into more managerial places so for me to have pushed and have blurred the boundaries between the medical profession was quite something. So I’d walk down the corridors and I’d get a lot of nods from my fellow brothers and sisters because there was one of us doing something pioneering.

As a direct result of that role it went from 1st assistant to surgical care practitioner role which was the name that was given at a national level. I was called upon to give talks at the Royal College of Nursing, the Royal College of Surgeons and also the Surgical Care Practitioners forums. So I’d been up and down the country giving lectures trying to formulate this new post and now we have had thirty such new posts developed in (Birmingham) City and Sandwell so I’m proud to say: I’m black, I’m female, I may be single mother, I may have had difficulties as I’ve gone through life but I have pioneered a role and I’m extremely proud of that. Thank you.

All photographs copyright of Inès Elsa Dalal © 2019 Commissioned by Sandwell and West Birmingham NHS Trust, 2018. No photographs or text may be referenced or published elsewhere, without prior permission.

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One thought on “Portrait of Empress Zauditu Ishuah aka Jennifer Simpson

  1. Well done Empress Zauditu Ishuah aka Jennifer Simpson this is an amazing story. You have paved the way, shown what an be achieved against the odds and been a role model to boot. I salute you

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