Saturday, 2 July 2016

18 September 1880 - 'On Nursing the Sick' by Medicus

 For the following short paper, and the hints therein given, I am convinced that neither preface r apology is required. There are some things that every girl ought to learn to do, and learn to do well, and nursing the sick and ailing is certainly one of these. This is a kind of knowledge which is bound to come in useful some day, when mayhap a beloved brother or sister or parent is laid low on a bed of sickness. Love alone cannot raise the sufferer up nor ease a single ache, but nursing, carefully and correctly carried out, and guided by affection, can work wonders. Medicine is nothing without it, for good nursing will often pull a patient through even where physic has failed.

I will suppose now that you have a brother who has been stricken down with some disease, and that you have constituted yourself his nurse. The doctor has told you that the illness will not be a short one, but that with careful nursing and the medicines he will prescribe your brother will almost assuredly get well again. You perceive that the physician says almost assuredly. He dare not say more. The keys of life and death are in the hands not of him, but of a far higher power. You are naturally anxious, therefore, and determined to strive to do your best. Well, then, you are to remember in the first place to put great store upon every word that falls from the doctor's lips, and faithfully and punctually carry out all hi instructions.

The room itself in which your brother lies will demand attention. If you have the choice of many rooms, choose a large one, a cheerful one, and one that can be easily and thoroughly ventilated. I do not like a sick-room to look too like an hospital, but at the same time it should be furnished as a sick-room; all unnecessary furniture should therefore be sent away, and more especially all heavy hangings and curtains, because they harbour dust and infection, and take up the valuable room that is needed for air. Away, then, with lumbering chests of drawers, boxes, and wardrobes. One good-sized table will be useful, a little one also by the bedside, covered with a neat white cloth, on which medicine bottles may stand, and always a bottle of the coldest, purest water you can procure. The toilet articles should be few and useful, including, of course, a comb and brushes, with a hand looking-glass and a nice soft piece of sponge. The washstand should move on castors, so that it can be drawn noiselessly towards the bed; and how refreshing gentle washing to a fevered face is, or laving the hands and arms with cold water, only those who have been really ill can tell. The towels should be plentiful, and always soft and white, and neatly folded when not in use. Two, or at most three, chairs will be quite sufficient, and there should be a sofa in the room, one big enough to make up a temporary couch, with rugs and pillows, on which your patient can recline while the bed is being made. There must be no curtains to the bed, k ought to be just moderately and comfortably soft. The sheets ought to be cotton, and pray mark this: let the blankets be light and warm, the counterpane also a light one, and no more weight of any kind put on the bed than is absolutely necessary. Attention must be paid to the pillows, too; they ought to be elastic, and so arranged as to support the shoulders as well as the head. Air and water cushions may or may not be required in your brother's case. The doctor will tell you. A pocket arranged neatly on the wall will be handy for holding the patient's handkerchief, and a bottle of perfume or vinegarette. If you have a graduated medicine glass you will find it handy to measure the medicine with, and if soups have to be taken a feeder will obviate the necessity of raising him up too often.

And now here are a few of the things which you are on no account to leave in the sick room - unwashed cups, glasses, or dishes of any kind, the water the patient has washed in, the medicines no longer in use, or dirty linen, while a saucepan or cooking utensil and a slop pail should never enter the room.

The temperature of the room is very important, and a thermometer exceedingly cheap. A medium warmth is best, say about 60 degrees, or a little over if the sick one feels chilly at that. The air should not be allowed to get too dry, and a kettle of water on the fire, throwing out steam to moisten the atmosphere, may sometimes be necessary, but of this the physician will be the best judge.

My young readers must never forget that two things of the very highest importance in a sick-room are FRESH AIR and LIGHT. There is nothing more poisonous to a patient, nothing so surely curtails his chance of getting well and retards his recovery than breathing and re-breathing the same air. See, then, that the window and door are both thrown wide open for some time every day, so as to thoroughly change the atmosphere in the room. While this is being done you will be careful, of course, to cover your patient up to prevent the risk of his catching a chill, but this risk, let me tell you, is very small indeed while he is lying still in bed. Sick people are more apt to get cold by getting up momentarily from a warm bed without taking the precaution to wrap well up. Independent of this thorough every-day ventilating of the whole apartment, I sincerely advise you to have the window always a little open both at the bottom and the top, unless the weather is very damp or foggy. As to light, it ought to be in abundance, unless countermanded by the doctor, as it would be in certain brain and eye ailments. Nothing is more unervating for a sick person than to be kept in a semi-darkened room, and o other hand plenty of sunlight, and perhaps a cheerful view from the window, greatly tend to recovery.

You cannot be too careful in keeping the room tidy and clean; attend to it first thing in the morning, see to carpet, furniture, bed and bedding, and take away all spoons, glasses, cups, etc., to be washed. Do not do this fussily, but steadily and quietly.

Your patient himself will require many little personal attentions. His face and hands need sponging every morning and evening. This may be done either with cold or tepid water, whichever is more grateful to his feelings, and a little toilet vinegar may be added with advantage. The bed must be kept exceedingly neat, and smooth, and clean, and the body linen ought to be changed every three or four days. Have everything at hand before you begin to assist him to change, the doors and windows shut  for the time, and the linen nicely aired, and warmed before the fire.

Your brother's gentle nurse must also pay some attention to her own dress and general deportment. She ought to be neat and clean in the extreme, and to mind what she wears. Rustling dresses, for example, are very trying to the nerves of a sick person, while creaking shoes are intolerable. Something that will wash had best be worn, something light and cheerful, like the room and all the sufferer's surroundings. On no account wear a black dress.

Your brother, whom I still suppose your patient, may be so ill as to be delirious or wandering in his talk; if so, he is never to be left alone, but carefully watched and, if need be, kindly but firmly controlled in his actions. If he be merely wandering in speech, appear to take an interest in what he says, but do not attempt to argue with him, or even to set him right. A clean white handkerchief dipped in cold water, in which a little vinegar has been mixed and placed on the brow, and changed whenever it gets hot, will often calm an excited patient, and sometimes induce gentle slumber. If your brother falls asleep, keep the room as still as possible, and at all times endeavour to prevent sudden noises, such as the slamming of doors or the rattling of kitchen utensils.

When people are ill they are naturally alarmed about themselves, and more especially will they be so if they observe that those around them take a gloomy view of their case. A nurse's watchword should therefore be HOPE. There is no better medicine, believe me. Never, therefore, give way to grief, nor show signs of it in your patient's presence. Always have a cheerful face. And do not allow those who may happen to visit your brother to talk about or dwell too much upon his state and condition. Lead them rather to speak about subjects of outdoor life, and in such a way as if you firmly believed, and everyone else did, that the patient would soon be up and around again in his old way. But do not talk yourself, nor allow your brother to talk to the verge of fatiguing him. You will naturally try to keep the room as quiet as possible by wearing light shoes, oiling creaking doors, and preventing clattering noises, but whatever you do avoid hurry and fidget and over-officiousness. This only tends to keep the sufferer in mind of his illness; so does *whispering in a sick room.

Do not bend much over the patient nor eat anything which may taint the breath. Remember that every mouthful of fresh air is of value to him. Give the medicine and the food at the proper time by your watch, and note down any change you may observe whether  for the better or the worse, with the exact time of day at which it occurred. This ought to be shown to the doctor, and may be of very great service to him. Take care that the mouth and nostrils are not covered up during sleep, else the sufferer may be poisoned in the carbonic acid gas he has breathed. Keep the temperature of the room as uniform as possible both by night and day.

Be careful to say no word to discourage your patient, talk to him quietly but cheerfully, trying to lead his mind away from the state of his feelings. I need hardly say to you be always kind. A sick person is so sensitive, and very often fretful and peevish in the extreme, sometimes not seeming even grateful for all that is done for him. But if you would really be a good nurse and true, you must learn to put up with this.

I may in a future paper give some special rules for cooking  for the invalid and the sick. Here I may simply remark that in the first stages of sickness but little food can be taken, and no persuasive force should be used to make the patient eat, for now the stomach is weak in the extreme. Drinks cooling and exhilarating will be of more consequence for the first few days. But when the long dark days of pain and sickness are past, when the glad period of convalescence has at length arrived, and the doctor has pronounced your brother out of danger and no longer needs to see him every day, when a brighter, clearer look comes into your patient's eye, and an easier smile plays around his lips, then, although you may move about with an easier mind, your duties of nurse must in no way be relaxed. Indeed, now the physician may be said to have almost given up the reins to you; you must, therefore, still continue to be gentle, firm, and kind to your brother. He needs quiet and rest more than anything else. His food must be given him on the principles of little and often. It should not be highly flavoured nor stimulating, but of small compass and nourishing, and most daintily served up. Let the cloth on the tray be of spotless white, the spoons and forks and knives as clean as clean can be, and the crystal polished and sparkling.

Avoid exciting your patient in any way; rather do all you can to soothe him. Still, let the room be bright and cheerful, and bring flowers to it; nothing is more pleasing to the eye of an invalid than beautiful flowers. Sometimes, too, a pretty pictorial representation of a scene from the New Testament, such as Jesus healing the sick, or "the Good Shepherd," will wisely supply beneficial food for thought when the poor patient is too weary to talk or to listen to others. And, oh, how many of our poor sick have been led in this way to the green pastures and still waters, to Jesus, the Saviour of the world! Read to your brother out of his favourite authors; this is eminently soothing to the nerves. Play to him if he cares for music. And now, with one more word of good advice, I conclude. Do not pester your patient with questions as to what he should like to eat or drink. Consult yourself as to this, and the little dainties you bring will then come in as welcome and glad surprises. I repeat my caution to you not to seem over officious, for it is curiously true that nothing is properly relished by a sick or nervous patient that seems forced upon him, not even love itself.

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