the nurse who moved to Leeds

The situation

Reshma trained in Kottayam and spent eight years on medical and cardiac wards in Kerala, the last three as a senior staff nurse. She is calm in an emergency and good with frightened families. When she moved to Leeds with her husband and their daughter, she expected the clinical work to be the hard part.

It was not. The clinical work was familiar. What wore her down was talk. Handovers moved at a speed she had not met before. Patients called her "love" and asked if she wanted "a brew". A colleague said she would be "back in while two" and Reshma waited, puzzled, for a number that never came. Phone calls to GP surgeries and pharmacies left her checking her notes three times.

At her Trial Class she put it simply: "At home I was the nurse people came to with questions. Here I am the one asking 'sorry?' all day. I feel like I've become quieter than I am."

What was getting in the way (observed in sessions)

The coach began with three short role-plays: giving a handover, taking a call from a patient's son, and raising a concern with a senior colleague. Several patterns showed up.

Handover overload. Receiving a handover, she tried to write down every word, fell behind, and did not ask questions because the outgoing nurse was clearly in a hurry.
Giving handover in story order. Her own handovers began with admission history and reached the current concern last, so listeners lost the thread.
Accent and slang. Not her accent, which was clear, but other people's. Dropped words, "owt" and "nowt", "while" meaning "until", "mardy" for a grumpy patient.
Phone anxiety. On calls she spoke quickly, apologised often, and did not confirm what had been agreed.
Softening a safety concern until it vanished. With a senior colleague, she wrapped a real worry in so many polite phrases that the concern itself was hard to hear.
Few friendships. Breaks were spent with her phone, because the canteen chat moved too fast to join.

None of this was about her vocabulary, which was strong, or her nursing, which was excellent. It was about pace, order, local English and confidence to speak up.

The coaching approach, session by session

Session 1: the map

A conversation about her shifts: which moments drained her most, and which went well.
One primary aim agreed: be understood first time, and understand others without pretending.
Mission: for one week, write down every phrase she heard on the ward that puzzled her.

Sessions 2 and 3: handovers, both directions

Receiving. Instead of writing every word, she drew a simple grid for each patient with four boxes: what is going on, what has changed, what is due, what to watch. She practised filling it from fast recorded handovers the coach read aloud.
Asking during a fast handover. A short line that keeps things moving:

"Sorry, just checking: bed 6 is due bloods at two, and the family are coming at four?"

Giving. Reordering her own handover so the most important thing comes first, then the background.

"Bed 12, Mr Hartley. Main concern is his breathing, which got worse this afternoon. Sats were steady this morning and dropped after lunch. The doctor's reviewed him. Please keep an eye on his obs every hour."

Sessions 4 and 5: Yorkshire English

The coach worked through her list of puzzling phrases: "Are you alright?" as a greeting, not a question about her health; "a brew" for a cup of tea; "nowt" and "owt" for nothing and anything; "while" meaning "until"; "mardy" for grumpy or sulky; "chuffed" for pleased.
Listening practice with recordings of regional voices, focusing on catching the key words rather than every word.
Asking without shame. The reframe that helped most: patients enjoy explaining local words. It becomes a conversation, not a failure.

"I haven't heard that one before. What does 'mardy' mean? I'm still learning Yorkshire."

Sessions 6 and 7: families and phone calls

Patients' families. Worried relatives often ask the same question several ways. She practised a calm opening, short answers, and a clear line about what she could and could not share.

"I can see you're worried, and I'd want to know too. I can tell you he's comfortable and the team is reviewing him this afternoon. For the results, the doctor will speak to you directly."

Calls to GP surgeries and pharmacies. Purpose in the first sentence, patient details chunked slowly, and a read-back before hanging up.

"Hello, this is Reshma, a staff nurse on Ward 14 at the hospital. I'm calling about a discharge for one of your patients. Can I give you the details?"

Pace on the phone. Recording herself on practice calls and slowing down, especially on names, dates of birth and doses.

Sessions 8 and 9: speaking up about a safety concern

This was the hardest work. In role-play, the coach played a busy senior colleague. Reshma's first attempt began with three apologies, and the concern came at the end as a question.
A three-part shape. What I am seeing. Why it worries me. What I am asking for.

"I'm worried about Mrs Ali in bed 3. Her blood pressure has dropped twice in the last hour and she's more confused than at handover. I'd like someone to review her now, please."

Holding the point when brushed off. Repeating the concern calmly, without new apologies:

"I understand you're busy. I'm still worried about her, and I'd feel better if she was reviewed in the next few minutes."

The coach was clear that ward and hospital procedures for escalation belong to her employer and training. The coaching was only about the words and the steadiness in her voice.

Session 10 and onward: making friends

Break-room small talk. Three openers from her own life: her daughter's new school, learning to like Yorkshire puddings, finding a Kerala shop in the city.
Saying yes to small invitations and having one question ready to keep a chat going.

What changed, in her words (composite reflection)

The reflection below is written in the style of what nurses in this situation commonly tell their coaches. It is not a quote from one person.

"The grid changed handovers for me. I stopped trying to catch every word and started catching the right ones.
"I used to pretend I understood the patients. Now I ask, and they love telling me what things mean. One of the older ladies teaches me a new word every morning.
"Speaking up was the hardest. I still feel my heart go fast. But I say the three parts and I don't apologise first. I don't sound rude. I sound like a nurse.
"And I go to the canteen now. Not every day, but most days."

What the reflection does not claim: anything about her career, her registration, her pay or her employer's view of her. Those depend on many things beyond conversation. What coaching can change is whether an experienced nurse sounds, on a new ward, like the nurse she already is.

Lessons anyone can use

Catch the right words, not every word. A simple grid beats frantic notes.
Lead with the most important thing. In a handover or on the phone, the main concern comes first.
Ask about local words. It starts conversations and nobody thinks less of you.
Chunk and read back on the phone. Names, numbers and doses, slowly, then confirm.
Raise a concern in three parts. What I see, why it worries me, what I am asking for.
Small talk is part of settling in. Prepare three openers from your real life.

Published by The Full Stop, the journal of Brightside English. Composite case study; no real learner, employer or family is represented. Reviewed by a Brightside senior coach. Corrections: see our editorial standard.