The little girl suffered from brittle bone disease and any childhood bump resulted in broken limbs.

"Not a summer went by when I wasn't on crutches," she said.

"Stepping off a kerb awkwardly meant I could end up with a cracked ankle."

Now she's back in the same casualty department - as a student nurse.

"It's the unpredictability of the work," said the former Knutsford High School pupil. "It's you and the rest of the world and you just get on with it."

In the past Sarah, now 24, did voluntary work at Bexton Court and worked during the summer at a Knutsford nursery.

From an early age she knew she wanted to work in a caring profession, but didn't know which sector.

Instead after A-levels she got a degree in health sciences where most of her fellow students were nurses.

"After mixing with them and finding out more about their job I knew that was what I wanted to do," she said.

In September after a rigorous two-year course in the classroom and on the wards at Macclesfield, Sarah will finally qualify.

Studying involves writing assignments and attending school at Leighton Hospital in Crewe.

But Sarah admitted that most lessons are learned on the job.

"There is only so much that you can get from reading books," she said.

"The rest comes from dealing with the patients and their families."

Experience on the wards has taught Sarah that there are no strict rules when coping with dying patients and their relatives.

Instead she uses intuition to gauge the best course of action.

"Some doctors say that it is in the patients' best interest not to know they are dying but it isn't always so easy," she said.

"Instead I read their body language and listen to what they are saying - then I decide."

Relatives often treat nurses as another member of the family and confide in them.

But Sarah tries not to get too emotionally involved. She has cried on the ward only once after a woman patient died as she held her hand.

"She told me that if she saw my face on the other side she'd be happy," she said.

"I just burst into tears."

Making death as dignified as possible is one of the many satisfactions Sarah gets from her job.

But the emotional strain can be hard to deal with.

"You don't finish your shift," she said. "You take it home with you."

Often Sarah and her flatmates at the Macclesfield nursing home 'talk shop' after work. Pay is one of the topics frequently discussed. The recently announced 12 per cent pay increase for newly-qualified nurses was a pleasant surprise for Sarah who expected much less.

After qualifying she can now expect to earn £14,000 a year.

For now, though, she has to survive on £260 a month after paying her rent.

"Everyone has an overdraft and we have to buy books and pay for uniforms if we want more than two," she said.

But Sarah and her colleagues don't seem to have time to do anything apart from work.

After an eight-hour shift on the ward and overtime on top, Sarah goes home to read her theory books.

This increased emphasis on studying is part of the nurse training known as Project 2000.

The scheme has been criticised for not providing enough practical experience but Sarah believes it teaches students to be more responsible.

"With old-style nursing you were just told how to do an injection but we are also shown why it is done that way as well," she said.

"It makes you understand the reasons behind practical nursing."

Applicants have a choice of nursing from mental health to children's care.

But all new students are expected to complete a 18-month common foundation programme, spending time in every department.

It was during these placements that Sarah decided that the accident and emergency department - the one where she'd spent so much time as a child - was the ward for her.

"As soon as those doors open you don't know what to expect," said Sarah, formerly of Mobberley.

"When I was first there, there was a stabbing but at other times it was really quiet."

After qualifying Sarah hopes to climb the nursing career ladder.

But she doesn't want promotions that will sacrifice her contact with patients.

"The problem is that the higher up you go, the more management there is in the job," she said.

Instead she hopes the Government's idea of nursing consultants, with more powers to diagnose, will eventually be adopted.

"I like the sound of the role," she said. "It would be a senior position but would still maintain patient contact."

For now Sarah has hard work ahead of her to ensure she qualifies in six months.

"Anyone thinking of coming into nursing must realise that it is very difficult," she said.

"We're not angels. We're just doing a job."

Converted for the new archive on 13 March 2001. Some images and formatting may have been lost in the conversion.