A Treatise on Anatomy, Physiology, and Hygiene Part 64

1002. Does the nurse require knowledge and practice in her employment, as well as the physician? Who is the natural nurse of the sick? 1003.

What, then, is inc.u.mbent on every girl? 1004. Should there be schools to educate nurses, as well as physicians and surgeons?

1005. BATHING. The nurse, before commencing to bathe the patient, should provide herself with water, two towels, a sponge, a piece of soft flannel, and a sheet. The temperature of the room should also be observed.

1006. When the patient is feeble, use _tepid_ or warm water. Cold water should only be used when the system has vigor enough to produce reaction upon the skin. This is shown by the increased redness of the skin, and a feeling of warmth and comfort, after a proper amount of friction. Before using the sponge to bathe, a sheet, or fold of cloth, should be spread smoothly over the bed, and under the patient, to prevent the bed-linen on which the patient lies from becoming damp or wet.

1007. Apply the wet sponge to one part of the body at a time; as the arm, for instance. By doing so, the liability of contracting chills is diminished. Take a dry, soft towel, wipe the bathed part, and follow this by vigorous rubbing with a crash towel, or, what is better, a mitten made of this material; then use briskly a piece of soft flannel, to remove all moisture that may exist on the skin, and particularly between the fingers and the flections of the joints. In this manner bathe the entire body.

1008. The sick should be thoroughly bathed, at least twice in twenty-four hours. Particular attention should be given to the parts between the fingers and toes, and about the flections of the joints, as the acc.u.mulation of the excretions is most abundant on these parts.

In bathing, these portions of the system are very generally neglected.

The best time for bathing, is when the patient feels most vigorous, and freest from exhaustion. The practice of daubing the face and hands with a towel dipped in hot rum, camphor, and vinegar, does not remove the impurities, but causes the skin soon to feel dry, hard, and uncomfortable.

1005. What should a nurse provide herself with, before bathing a patient? 1006. When should cold water be used? 1007. How should the bathing then be performed, so that the patient may not contract a cold? 1008. How often should a sick person be bathed? What is said of daubing the face and hands merely with a wet cloth?

1009. FOOD. It is the duty of every woman to know how to make the simple preparations adapted to a low diet, in the most wholesome and the most palatable way. Water-gruel,[24] which is the simplest of all preparations, is frequently so ill-made as to cause the patient to loathe it. Always prepare the food for the sick, in the neatest and most careful manner.

[24] Directions for making the simple preparations for the sick are found in almost every cook-book.

1010. When the physician enjoins abstinence from food, the nurse should strictly obey the injunction. She should be as particular to know the physician's directions about diet, as in knowing how and when to give the prescribed medicines, and obey them as implicitly.

1011. When a patient is convalescent, the desire for food is generally strong, and it often requires firmness and patience, together with great care, on the part of the nurse, that the food is prepared suitably, and given at proper times The physician should direct how frequently it should be taken.

1012. PURE AIR. It is the duty of the nurse to see that not only the room is well ventilated in the morning, but that fresh air is constantly admitted during the day. Great care must be taken, however, that the patient does not feel the current.

1013. Bed-linen, as well as that of the body, should be aired every day, and oftener changed in sickness than in health. All clothing, when changed, should be well dried, and warmed by a fire previous to its being put on the patient or the bed.

1009. Should every woman know how to make the simple preparations adapted to a low diet? 1010. Should the nurse strictly obey the injunctions of the physician relative to food? 1011. What period of a person's illness requires the most care in regard to the food? 1012.

Give another duty of the nurse. 1013. What directions respecting the bed-linen of the patient? What is necessary when there is a change of clothing?

1014. TEMPERATURE. The warmth of the chamber should be carefully watched by the nurse. The feelings of the patient or nurse are not to be relied on as an index of the temperature of the room. There should be a well-adjusted thermometer in every sick-room. This should be frequently consulted by the nurse.

1015. The temperature of the sick-chamber should be _moderate_. If it is so cold as to cause a chill, the disease will be aggravated. If, on the other hand, it is too warm, the patient is enfeebled and rendered more susceptible to cold on leaving the sick-chamber. The Latin maxim, "_In medio tutissimus ibis_," (in medium there is most safety,) should be regarded in the rooms of the sick.

1016. QUIET. The room of the patient should be kept free from noise.

The community should be guided by this rule, that no more persons remain in the room of the sick, than the welfare of the patient demands. It is the duty of the physician to direct when visitors can be admitted or excluded from the sick-room, and the nurse should see that these directions are enforced.

1017. The movements of the attendants should be gentle and noiseless.

Shutting doors violently, creaking hinges, and all unnecessary noise, should be avoided. Most persons refrain from loud talking in the sick chamber, but are not equally careful to abstain from _whispering_, which is often more trying than a common tone.

1018. It is the duty of the nurse to ascertain the habits of the patient as respects the period for eating and sleep, when in health, that she may prepare the food and arrange the sick-room in accordance with the practice of the patient. If the person who is sick is ignorant of the necessity of the removal of the waste products from the system the nurse should invite attention to these functions at such periods as are in accordance with the previous habits of the patient.

1014. Why should there be a well-adjusted thermometer in every sick-chamber? 1015. What is said of the temperature of the sick-chamber?

1016. Why should the sick-room be kept quiet? 1017. What is said of noise in the sick-chamber? Of whispering? 1018. Should the habits of the patient be regarded in reference to the period for eating and sleep?

1019. The deportment and remarks of the nurse to the patient should be tranquil and encouraging. The illness of a friend, or persons who have recently died, should not be alluded to in the sick-room. No doubts or fears of the patient's recovery, either by a look or by a word, should be communicated by the nurse in the chamber of the sick. When such information is necessary to be communicated, it is the duty of the physician to impart it to the sick person.

1020. The nurse should not confine herself to the sick-room more than six hours at a time. She should eat her food regularly, sleep at regular periods, and take exercise daily in the open air. To do this, let her quietly leave the room when the patient is sleeping. A watcher, or temporary nurse, may supply her place. There is but little danger of contracting disease, if the nurse attends to the simple laws of health, and remains not more than six hours at a time in the sick-room.

DIRECTIONS FOR WATCHERS.

1021. These necessary a.s.sistants, like the nurse, should have knowledge and practice. They should ever be cheerful, kind, firm, and attentive in the presence of the patient.

1022. A simple, nutritious supper should be eaten before entering the sick-room; and it is well, during the night, to take some plain food.

1019. What should be the deportment of the nurse toward the patient?

Should doubts and fears of the patient's recovery be communicated in the sick-room? When necessary to impart such intelligence, on whom does it depend? 1020. How long should a nurse remain in the sick-chamber at a time? 1021. What qualifications are necessary in a watcher? 1022. What directions in regard to the food of the watcher?

1023. When watching in cold weather, a person should be warmly dressed, and furnished with an extra garment, as a cloak or shawl, because the system becomes exhausted toward morning, and less heat is generated in the body.

1024. Light-colored clothing should be worn by those who have care of the sick, in preference to dark-colored apparel; particularly if the disease is of a contagious character. Experiments have shown, that black and other dark colors will absorb more readily the subtile effluvia that emanate from sick persons, than white or light colors.

1025. Whatever may be wanted during the night, should be brought into the sick-chamber, or the adjoining room, before the family retires for sleep, in order that the slumbers of the patient be not disturbed by haste, or searching for needed articles.

1026. The same general directions should be observed by watchers, as are given to the nurse; nor should the watcher deem it necessary to make herself acceptable to the patient by exhausting conversation.

1027. It can hardly be expected that the farmer, who has been laboring hard in the field, or the mechanic, who has toiled during the day, is qualified to render all those little attentions that a sick person requires. Hence, would it not be more benevolent and economical to employ and _pay_ watchers, who are qualified by knowledge and _training_, to perform this duty in a faithful manner, while the kindness and sympathy of friends may be _practically_ manifested by a.s.sisting to defray the expenses of these qualified and useful a.s.sistants?

1023. When watching in cold weather, what precaution is necessary?

1024. What is said relative to the color of the clothing worn in the sick-room? 1025. What suggestions to watchers relative to the arrangement of the sick-chamber? 1026. What should watchers observe?

1027. What is said of employing those persons to watch who labor hard during the day?