Stephanie Silver’s aim when she wrote The Monologues of a Tired Nurse was to give audiences “a brutally honest account of how it feels to work within the NHS in a understaffed, underpaid and emotionally draining time”. As a nurse herself, it’s a feeling she knows all too well, and though her characters are fictional, it’s clear throughout that the play is coming from a very personal place.
Brutal is an accurate word to sum up the show, which sees newly qualified nurse Emily grow gradually more and more dishevelled and distressed (not to mention covered in various unmentionable body fluids) as she realises actually being a nurse is considerably tougher than she expected. Her mentor, the older, wiser and much more experienced Sally, tries to toughen her up, not because she enjoys being mean, but because when you’re working in acute medicine, there’s no time to stop, worry, think (or eat, sleep, breathe…) – you just have to get on with it and hope for the best.
The play, directed by Simon Nader, makes a political statement about the increasingly limited resources available to the NHS, placing ever more pressure on the already stretched staff and putting patients’ lives at risk as a result. Stephanie Silver’s Sally has grown used to working under this pressure, but that doesn’t mean she’s okay with it – her monologues reveal a bitterness and world-weary honesty; if she could go back, she tells us frankly, she’d choose a different career. She’s done her fair share of crying over the years, but these days she just smokes and drinks, puts the tough days behind her and moves on, because she has no choice – if she breaks down, the patients will still be there needing help, and if she’s not there to offer it, then who will?
Makenna Guyler’s Emily, on the other hand, is young and idealistic, and hers is a personal rather than political viewpoint. She went into nursing for a very specific reason, inspired by a traumatic family history and lingering sense of guilt, but her fear of cracking under the pressure means she repeatedly does just that. Despite her brave attempts to claim that getting a thank you from a patient makes the long hours and emotional turmoil all worthwhile, her bright smile begins to crack more and more frequently. The harsh fact of the matter is that at the end of the day, wanting to help – however desperately – may not be enough.
Despite, or perhaps because of, these difficult truths, it’s impossible to leave the theatre without a new respect and admiration for anyone in the nursing profession. Put aside any misguided beliefs that nurses are just there to hold hands and empty bedpans; they have to make life or death decisions every single day, and that responsibility alone – even with limitless resources at their disposal – would be enough to break a lot of people.
The growing crisis in the NHS is well documented, and we’ve heard a lot in recent months about the struggles of junior doctors to keep up with ever-increasing workloads – but nurses never seem to make the headlines, despite being an equally essential part of the health service so many of us take for granted. The Monologues of a Tired Nurse aims to remedy this, and does so with unflinching honesty. It’s not pretty… but it certainly packs a punch.
Who better to write a play about what it’s like to work for the NHS than someone who does it every day? Stephanie Silver was inspired by her own professional experiences to write Monologues of a TiredNurse, which has its final run this week at the Lion and Unicorn as part of the Camden Fringe.
“I’m a nurse and have been for the last eight years,” says Stephanie. “I was working on a cardiothoracic intensive care for a while; it can be a tough environment. I was going through some personal problems and having some episodes of feeling very down about my job. I sat down and wrote some monologues to get some feelings off my chest and Tired Nurse kind of happened.
“It’s a brutally honest account of how it feels to work within the NHS in a understaffed, underpaid and emotionally draining time. The stories are fictionalised, but based on real life encounters of how it feels to be a nurse or any another healthcare professional working in today’s health service on an emotional and personal level.”
The show’s been in development since 2015, since Stephanie performed it at one of the first ever Actor Awareness scratch nights. “It’s changed a lot since then,” she says. “Even after performing it at Edinburgh 2016, we changed it up for the London run at Baron’s Court in 2017. I want it to be as visceral and engaging as possible to really grab the audience’s attention, and the director Simon Nader has always been fantastic in bringing the vision of the piece alive.
“Nurses definitely relate to the play. Anyone who works in the public services in any capacity, whether they are a teacher, policeman, fireman or army officer, can relate to the level of pain and stress in the play and the feelings of never being good enough, especially in the current climate with all the cuts and pressures to work faster and be more efficient but with twice the work load. An army veteran told us in Edinburgh it was some of the most honest accounts of working on the frontline he had seen – that meant a lot.
“I’d like people to see the human, the person behind the professional. I’m sure most people do but the papers and government spin so much crap that it is infuriating. Health care professionals aren’t cogs or robots, they’re people trying their best. And if you want a great health service providing the best care then please look at who you vote for and how you treat the people you meet at point of service. Make a conscious effort to invest in our healthcare in more ways than just saying, ‘I pay my taxes, so I am owed this’.”
After doing some acting as a child, Stephanie trained as a nurse before returning to theatre as an adult. “When I was ten I was in Goodnight Mister Tom, a TV film, and then at 18 I did a summer course at The Poor School, but after that thought I couldn’t afford drama school so I should do a sensible job, and kinda just stayed until I turned 28! Then I thought fuck it, time to probably do some acting before it’s too late. I also had a brain haemorrhage, which soon makes you realise that if you keep leaving things you might be dead before you actually get to do them!
“Juggling the two jobs is doable. Must actors have many jobs, it can feel like two very different worlds! Mainly it’s hard work, long hours and no sleep. I hardly see my friends but I’ve been trying to work on balance. I don’t waste time, I write everyday, and I do one thing everyday for my acting, whether it’s write an email or read a bit of a play or watch something to inspire me. I also do emails on the tube, on the toilet – anywhere really. You can sleep when you’re dead, right?! My mum always says that!”
As well as writing and performing in Tired Nurse, Stephanie’s also set up Glass Half Full Theatre, a company dedicated to creating daring, provocative work. “I really love writing and find it rather depressing waiting around as an actor so decided to produce my own writing,” she explains. “I’m not very well connected as I come from a zero theatrical background, so I got involved with Actor Awareness and met a lot of like-minded people looking to create work. At one of their first scratch nights, I performed Tired Nurse. I asked a mate along and then we decided due to the amazing response to take it to Edinburgh. That was financially not a great idea but it was one of the best experiences.
“I also got heavily involved with Actor Awareness and realised that there a lot of actors just not working – a lot – and what a brilliant thing if I can produce work. So I created Glass Half Full, dedicated to creating thought-provoking contemporary plays with a strong social, political, ethical, domestic backbone; plays with messages aimed at a young demographic, about the world we live in today and the kinds of world we could live in. So hopefully we are making thought-provoking challenging plays. Fingers crossed!”
Glass Half Full have lots of exciting plans for the year ahead: “This is our last run of Tired Nurse as we’ve been doing it for the last year. The immediate aim is to look to produce our show Walk of Shame for EdFringe 2018. I also produce new writing nights every so often. Hoping to do one of those in September so keep an eye out on Twitter, the event is called A Series of Short Plays – we did the first event in May, and it was a great night so we aim to be back with that but with a twist!
“We also have a play called Our Big Love Story, a story of racism after the July 2005 bombings which we are getting on its feet for production in 2018. That’s enough to get on with for now…”
It’s been a long old week. A couple of work trips and several late nights meant that by the time Friday rolled around, I was feeling pretty shattered and wanted nothing more than to go home and collapse into bed.
Why am I telling you this? Because fortunately, I have an office job where being tired might mean I’m a bit less productive than usual, but isn’t a matter of life or death. Now imagine being that tired and having to carry out complex medical procedures, or administer drugs that could, in the wrong dosage, prove lethal. And then imagine it’s your very first day as a junior doctor, you don’t know where anything is and suddenly you’re responsible for real patients in real pain, who expect you to know exactly what to do to help them.
In Resuscitate Theatre’s Rounds, six junior doctors are about to learn that just wanting to help people – which seems the most fundamental requirement for a medical professional – may not be enough. The show touches on several of the issues facing the people we rely on to keep us healthy… and it’s terrifying. Long shifts, abuse – racist and sexist – from patients, indifferent management and the fear of knowing one wrong move could cost someone their life are all piled on top of the usual problems faced by 20-somethings just out of uni, like romance, fitting in with colleagues and finding a work/life balance (and someone to feed the cat).
Directed by Anna Marshall, an internationally diverse cast (Christina Carty, Alex Hinson, Nicolas Pimpare, Penelope Rodie, Iain Gibbons and Adam Deane) bring to life the six young doctors, each of them coping in their own way – and some better than others – with the pressures and insecurities of their job. At just an hour in length, the show gives some of the characters a little more air-time than others, with one in particular ultimately taking centre stage in a conclusion that’s simultaneously shocking and somehow inevitable. This is both a blessing and a curse: on the one hand, it means we don’t really get to know the characters that well; on the other, by spreading the focus quite thinly the show is able to demonstrate the vast number of problems that need to be addressed.
The set, designed by Naomi Kuyck-Cohen, is deceptively simple, made up of six medical screens which form a vital part of the show’s choreography. The movement sequences within Rounds tell us just as much as any of the dialogue scenes; choreographed by Lexi Clare and directed by Davide Vox, they effectively convey the frantic nature of an average day through the repetition of routine tasks like checking x-rays or scrubbing up for surgery, while curtains are whisked aside again and again as the doctors treat a seemingly endless stream of patients.
The characters on stage are fictional, but based on real stories (in fact the show was devised with input from junior doctors) and it’s sobering to realise that they represent the doctors treating us and our loved ones every day, in increasingly difficult circumstances. When the show was first performed at last year’s Illuminate Festival, the junior doctors’ dispute with the government was making headlines. Though it may no longer be the top story, that doesn’t mean the problem’s gone away, and if anything, shows like Rounds are more important than ever, to keep the problems faced by junior doctors – and the NHS in general – in the spotlight. And on a more personal level, it may make the rest of us think twice before complaining about a bad day at work.
Rounds is at the Blue Elephant Theatre until 25th March.
Heather Ralph is a London-based theatre producer from Northern Ireland. Currently she’s working with a number of companies on new and returning shows, but took a little time out of her busy schedule to chat about life as a producer, and tell me a bit about what we have to look forward to over the coming weeks.
“What does being a producer involve? I sum it up to friends as a constant chain of emails!Which isn’t actually that far from the truth,” she explains. “It entails a lot of organising of things – mostly my inbox! – and talking to venues. Once a project is off the ground, I usually head up the marketing campaign as well, which requires even more emails and a lot of time spent on HootSuite, Twitter, Facebook, you name it! I really like to try and connect theatre companies with each other, so am always on the lookout for other companies to cross promote with. This is so much easier when the shows are part of a wider festival, like the VAULT festival for instance.
“Before you get to this stage of a project, however, a lot of time goes into research. This is usually for funding and opportunities to develop new work. The tricky part of this is narrowing down what is most suitable for which project.If you just apply blindly for everything with every project, I personally would have no time for all those emails I have to send!
“To sum up it’s a lot of time spent at a computer, so I try and go into the rehearsal room as often as possible, even just to work on my laptop at the back. With all my current projects I’ve come on board at different stages. Shows like Rounds and purged, I’ve been on board since the start. With Rounds in particular it’s been great to be in the rehearsal room in the first few weeks, seeing how the actors come up with their ideas, and when we’ve had junior consultants come in tohelp us develop movement sequences by showing us how they perform things like a cranial nerve exam!
“My goal is to continue to work with people I like who produce work I love, while trying to survive the London rent prices at the same time! That would be my advice to anyone else: when you find people you like working with, stick together and make work; a great team can achieve anything. One of my favourite companies to work with is Haste Theatre, they make great work and are so driven – if you haven’t heard about them you should really check them out. As a company they’re very self sufficient and produce a lot of their own stuff – I’ll usually come on board and give them a helping hand with press and advise them with ACE forms and venue splits every now and again.”
So what’s on the horizon? “Dr. Zeiffal, Dr. Zeigal and The Hippo That Can Never Be Caught! is an award-winning kids’ show from Mouths of Lions with fantastic falling over, a lot of hippo chasing and loads of little hippo enthusiasts laughing at Dr. Zeiffal. It may be billed as a kids show, but we welcome old and young Hippo Catchers. I first came across this show as an audience member; it was just my boyfriend and me amongst a lot of little Hippo Catchers – this is how I refer to children now – but we loved it!
“Then there’s Blood & Bone, a colourful, kooky and downright dirty puppetry show from Cicada Studios. If you want an hour to forget your woes and have some real belly laughs, I’d advise catching Dr. Zeiffal, Dr. Zeigal and The Hippo That Can Never Be Caught! and Blood & Bone – thoughI will of course warn you that Blood & Bone is not a children’s puppet show. It’s for adults and gets very dirty very quickly. Those who are opposed to puppet nudity and puppet sex should probably not attend…”
That’s not all:“Oyster Boy is a multi-award-winning dark comedy about the struggles of a boy born with an oyster shaped head from Haste Theatre, and purged isan intimate, physical, visceral play by Catharsis about the impossibility of communicating to others the issues around mental health deterioration. Last but not least, Resuscitate Theatre are bringing back Rounds, a powerful and urgent tale of the first line of defence for the NHS.
“Rounds and purged are less zany shows, but equally as engaging. Both are based on true stories, dealing with mental health and issues that affect all of us daily, either directly or indirectly. Mental health awareness is a really important subject to me; both shows are a brave attempt to educate and move our audiences while offering some clarification into other people’s lives and their decisions we may not understand, which I think is an important thing for theatre performances to offer. Both shows focus on human relationships, and their physical style allows for a great sense of urgency to be portrayed.”
Heather’s particularly excited about the return of Rounds. “Genuinely I love this show. I shouldn’t say this but everyone knows it’s my favourite project I’ve worked on to date. And I’m even more excited it’s at Blue Elephant Theatre. Please check this venue out – it’s doing great things with new work and the team behind it are all superstars. I came across it last year when I worked with Les Femmes Ridicule on their show In The Gut and since then I’m never out of BET! I’m pretty sure Niamh (the Artistic Director) will eventually block my email address…
“What’s happening with the NHS is terrifying. Rounds focuses on the humans behind the junior doctors, and I think it demonstrates an important life lesson on our own vulnerabilities and how the government responds to them. Exeunt Magazinegave us a great quote for Rounds, but the sentiment stands true in anything: ‘Rounds is a lesson is vulnerability; without vulnerability we will never learn and we can never recover.’ The NHS and all its staff are very vulnerable right now, it’s how we go forward from here that will matter. The scary thing is the path so far doesn’t look that great.”
Juggling such diverse projects is a challenge – but an enjoyable one: “Kids’ shows is actually a new thing for me this year, and it’s been quite fun figuring out all the different rules that come with how to produce a kids show!” reveals Heather. “Mouths of Lions are no strangers to kids’ shows, so we’ve all really knuckled under as a team to make the most of the VAULT festival. But yes, it’s so much fun, it means my day is never boring. The challenge is to stay on top of everything and remember who you talked to about what show!”
Two of Heather’s shows can be seen at this year’s VAULT festival, which opens this week. “I’ve never done the VAULT festival before and I am so excited! There are so many great shows happening, but I have my eye on a few that I really want to get to: Cat Loud’s Wayward,Shrapnel Theatre’s Litterati, Cornwall vs China (shameless plug: you can grab a combo ticket for Cornwall vs China and Blood & Bone for just £18…), Redbellyblack Theatre Company’s A Year from Now. And one more high recommendation from me: Bric a Brac’s Ash, directed by Anna Marshall, who’s the director of Rounds.
“Why check out the VAULT festival? Because this is a month of great fringe theatre at affordable prices happening right here in London. No trains to Edinburgh or Brighton needed, just grab a tube to Waterloo and enjoy yourself!”
Check out the links below for more details and to book for Heather’s upcoming shows:
Rounds, which opens this week at the Illuminate Festival in Wimbledon, follows six junior doctors as they try to balance their demanding jobs with a life outside work. It’s a hugely topical subject, and while they’ve avoided taking a political stance, Resuscitate Theatre are hoping the show will open audience’s eyes to the pressures – both personal and professional – faced by junior doctors every day.
“I don’t think there could be a more relevant time to be doing a show like this. I’m proud of the work we’ve done and hope that the production is able to convey to audiences what it’s like to be coping with life, death and the pressures of an overstretched NHS on a daily basis,” explains Penny Rodie, who plays Dr. Lucy Wright.
“Lucy’s a hard working overachiever who often feels that her best isn’t good enough. She found things tough at medical school so is determined to prove that she’s a capable and confident doctor. Her single-mindedness means she struggles to form the close relationships she’d hoped to have with her fellow doctors, and this leads her to make some questionable choices.”
Davide Vox plays Dr. Giobbe Poretti: “Giobbe is a young Italian doctor that moved to the UK one year before the events of Rounds, in order to pursue his career in medicine. During the show we see him facing the difficulties of being a foreign doctor in an English hospital, being alone and far away from his friends and family, and struggling to create new relationships with the other doctors that revolve around him.
“We’ve taken the decision to face the issue by purely presenting junior doctors’ everyday lives, rather than push a preconception on the strikes and political situation. This gave us the chance to focus on their human relationships and feelings. When does anyone ever think about their doctor’s everyday life?”
The show’s been in development for a few months, incorporating material gained from interviews with junior doctors and the actors’ own personal research. Davide interviewed Italian doctors living and practising in the UK, and says he discovered things he would never have known:
“Lack of time for family and friends (an Italian junior doctor gets an average of 2 or 3 minutes every two weeks to speak with their relatives on Skype, as they’re constantly pushed to work not only inside the hospitals but also on their own to try and solve the natural language gap), pressure to constantly work on ameliorating their English, and racism are still big problems for all Italian doctors. Of course I was also able to relate and bring in part of my personal experience as an immigrant.
“The biggest surprise was probably that, despite the fact that they are praised and extremely respected for their professionalism, Italian doctors, like all doctors coming from non-English speaking countries, are periodically tested on their language knowledge, no matter how long they’ve been living in the country. Apparently the English test is quite challenging, even for British doctors, and one small failure can cost you a full year of mandatory break. Foreign doctors are absolutely not supported and it just doubles the pressure they’re put under.”
Penny took a different approach: “I focussed my research on mental health problems amongst doctors and NHS workers in general, as this is something that has affected Lucy’s life and continues to do so. I learnt about the stigma that still surrounds mental health issues, symptoms and triggers, and looked at how this might affect what happens in the workplace.
“I looked at a few distressing case studies where doctors’ mental health deteriorated, and found that the procedures of the General Medical Council in these circumstances can often just pile more pressure on rather than providing the support required. I came away with a sense that these were caring people whose profession failed them.
“I hope audiences have empathy for Lucy’s situation and come away with an appreciation of just how tough it can be to get through each day, no matter how passionately she might want to help people.”
Davide hopes the show will move people. “I’d like them to go away feeling related to the characters we’re bringing on stage, understanding all the turmoil, hopes and dreams of these human beings. I hope they’ll also be able to get what it means to be an immigrant and how difficult it is to be far away from home, from your family and friends, no matter where you actually come from. How the choice of leaving for another place is never easy and it always come with a lot of sacrifices.”
Rounds is at New Wimbledon Studio on 18th and 19th May.