Perhaps someone who reads the title of this paper may be inclined to inquire, "Why do you write the baby, as if there were but one baby instead of millions in the world?"
Ah! Every mother knows why; and every loving-hearted young nurse knows why. "My baby," says the young mother, "is the baby of all the world." And "our baby" is the same to the members of the household, if they are of the right sort.
Knowing, as I do, how many mothers of all ages, as well as their daughters, come to the pages of THE GIRL'S OWN PAPER, or apply to its editor, for information on all sorts of domestic subjects, I am most anxious to be of use both to them and their young folk. I feel especial sympathy for those who, until they became mothers, never had anything to do with the practical management of little children. Members of large families pick up their experience quite naturally amongst the little brothers and sisters, and the children of the elder ones furnish in turn a baby school for girl aunts. But where a girl is placed as I was (the latest-born and only survivor of a small family, whose only opportunity of nursing was with a borrowed baby, if there happened to be one in a neighbour's house) she is not likely to be very skilful in the management of a first arrival, at any rate, when she becomes a wife and mother.
Shall I ever forget my own awkwardness under such circumstances; my utter ignorance of the thousand little ways of making a baby comfortable; my yearning love towards the pink-faced girlie, and matronly pride in the possession of this living treasure, which an empire's wealth would not have sufficed to purchase?
Mingled with such thoughts was a lamentable sense of my own insufficiency and inability to discharge fitly the sacred trust which the possession of the helpless babe entailed upon me. And, as I lay in weakness, and saw skilful hands occupied about my little one and knew my deficiencies, even as regarded the care of its tender frame, other solemn thoughts crossed my mind about the living immortal soul of which that was the only covering.
"Lo! Children are an heritage of the Lord," says the inspired Psalmist, and this baby girl was, then, the first instalment which He had given to me. How comforting was the sweet thought that followed; "He who has bestowed will also teach me to treasure His gift and to nurse this child for Him!" I felt then, as I do still after many years, that if there is one human being who, more than another, needs to be instant in prayer, it is surely the mother to whom such a sacred charge is entrusted.
I smile sometimes when I look at the tall girls who call me mother, and who now, in the way of stature, look down on me, yet who run with willing feet in my service, and to save mine a needless step. I smile because I think of the time when I was their willing slave by night and by day, and far more frightened of the first, in her baby years, than all my children put together have ever been of me. But love is a good teacher – especially maternal love – and it is often said that babies bring that into the world with them, or they would never be cared for as they are.
I am not going to write directions suitable for the first few weeks of an infant's life. During that early period it is usually under the care of an experienced or professional nurse. Even in the poorest of homes, when the parents' means are so small the mother cannot afford to pay for the constant attendance of such a person, there is always some kindly neighbour who, without fee or reward, undertakes to wash and dress the baby.
My first advice shall be as to the preparation of the nurse for her work. Take to it in yourself a cleanly person and a good temper, which latter finds its outward reflection in a bright, cheerful countenance. Even the few weeks' old baby shows a marvellous susceptibility to externals, and it would be difficult to say how soon it begins to imitate, or to manifest pleasure at what it sees, if that be pleasant.
On the contrary, who has not noticed the shock which a baby receives from the sound of a harsh voice, or the sight of a sullen, angry face? I have seen a little creature gaze searchingly at its mother's countenance and, if there were no answering smile, the dear eyes have seemed to lose their dancing light, the sorrowful "pet lip," and perhaps a burst of crying has followed. The more intelligent the infant the more sensitive it is to what some would call trifles.
So, dear nurses, go to your care of the baby as to a real labour of love, and let the love shine in your faces, be heard in the ring of your voices, and be manifested by the absence of all impatience or hastiness of temper, even if you should have a very cross baby to deal with. Poor wee things! They cannot tell their troubles, and depend on it, if the baby is "fractious" it has some good reason for it, though you may not be able to find it out. So let your bright face, your endearing words, your cheery song, coax away the puckers from the face of your little charge if all these will do it. But in no case let its cross face be a reflection of your own.
Have nothing about you that can possibly hurt the little one. Rings, brooches, watch-chains, floating ribbons, and ornaments of all kinds are needless and out of place when you are busy with baby. Let your hair be smooth and tidy. Examine your dress to see that no stray pin has been stuck on the belt or waist, and that your sleeves are tucked up and fastened so that you neither get them wet nor have them loose and flapping about in baby's face.
Put on a wide flannel apron, of which every nurse should have two – "one to wash the other" – then you will always have a clean one for present use.
Be calm and patient about your work, neither hurrying nor occupying too much time over the washing and dressing business. Handle the little one very tenderly. Even if your work be one of necessity rather than of inclination, let the infant's helplessness pl with you; for member, a little impatience, a sudden jerk of those delicate limbs, might cause injury to your charge, and to yourself life-long repentance.
Inexperienced nurses are apt to become frightened and flurried if a baby cries, kicks, and screams. But, if the little one is in a passion, there is all the more need for the nurse to be calm, and to oppose patience and firmness to its struggle and clamour. Keep thoroughly master of yourself, dear young nurse, and you will manage baby all the more easily.
Have every requisite ready to your hands before you begin, and let each article of clothing be so placed as to come in its proper turn; so that there may be no rummaging amongst garments, or running about to seek something that ought to be close at your side when wanted. Such neglect tries baby's patience, exposes him to the risk of cold, and you to blame for your want of system and forethought.
Mind that baby, when undressed or in the bath, is not exposed to a draught of cold air. You may guard against this by extemporising a screen in the shape of a clothes'-horse with a sheet or quilt thrown over it.
Here I would say a few words about the clothing of infants. It, as well as the bedding, should combine lightness with warmth. It is of far more importance that it should be plentiful in quantity, and good in quality, so as to secure cleanliness by frequent changes and comfort in the use, than very elaborate in workmanship, or much ornamented.
If much trimming is used, by all means let it be in the shape of soft cambric frills or narrow torchon lace.
Muslin work – especially if a laundress is so ill-advised as to stiffen it in order to make it set well – is a great cause of irritation to an infant's tender neck and arms.
A good nurse will pass her finger round the bands and along the seams of all clothing that is likely to come in contact with the child's skin. If she finds any roughness or sharp points, she rubs them before putting on the garment.
This is not the place to enumerate the articles which compose an infant's wardrobe; but I should like to mention one. The little lawn or cambric shirts worn during the first few weeks are usually made open in the front, from top to bottom. I have always used and recommended a shirt made of one width of the linen, with a single seam at the side, but open on the shoulders, on each of which it fastens with a small linen button and loop. It is slipped over the head so easily; there is no twisting of arms to get them into sleeves; it is quickly fastened, and, when on, it keeps its place and looks pretty, which is more than can be said of the old-fashioned open article, with its useless laps and generally untidy effect.
As a baby should not only be washed, but have a bath every morning, the vessel used should be large enough to hold it comfortably, but rather shallow. The temperature of the water should be about 90 deg., but, as young nurses have not always a thermometer at hand, they should try it with the back of the hand, or, as I have seen some old nurses do, with the tip of the tongue. The whole hand is not a safe test, especially if it be one accustomed to work, s the skin becomes hardened and can bear much greater heat or cold than it would be safe to use for an infant's bath.
I have read some terrible cases of suffering, and even loss of life, which have been caused by the carelessness of young nurses in not ascertaining the water was of a proper temperature before putting in the child.
Soap of a non-irritating quality and a soft sponge must be used. If the infant is quite young, the left hand must be placed below its neck so as to support the head above water. The whole body, including the head, should be well soaped and then gently sponged, care being taken to rinse well all the little folds and creases, so that nothing impure or irritating be retained there. Soft, half-worn towels of nursery diaper are the best to dry with, and this should be tenderly done with due consideration for the delicate skin. The moisture should be absorbed from all bends and creases by gentle pressure – never by rubbing; though the back had limbs will be all the better for a little friction with the hand. Baby likes this when he is first undressed and after washing, and enjoys stretching his round limbs on his nurse's knee whilst she gives them a gentle chafing within reach of the warmth of a fire.
All the creases below the arms, knees, in the dimpled neck, behind the ears, between the thighs and body should be well powdered to prevent the chafing of the skin, and this ought to be done after every change of clothing or sponging, by night or day. A very able and experienced medical man, who has written a valuable work, within a very small compass, on sick and other nursing, advises the use of powdered starch for what we call puffing the baby.
Considering how much we have heard of the introduction of deleterious ingredients into what are called "violet powders," we must recognise the wisdom of this advice. It is of no consequence whether the powder is perfumed or not, but it is of the greatest importance that it should be pure and harmless. The powdering must never be neglected if baby's skin has been damped, so whenever sponging is requisite, the puff is also absolutely necessary.
One occasionally sees the scalp of an infant covered or patched with an unsightly crust. This is usually the result of insufficient or careless washing. At the first sign of it, the spot should be anointed with a bit of pure lard or a little olive oil. This will soften the crust, and it will generally come off during washing; but great care must be taken not to use any degree of violence to remove it. The simple application named and persistent cleanliness are the proper remedies both to take it away and prevent its recurrence.
A quite young baby needs, as I have already said, the supporting hand of the nurse to keep the head above water. An older infant that can sit up strongly and has learned to kick about in and enjoy the water, equally needs the watchful eye of the nurse, and should never be left in the bath for a moment.
A very little water and a very short time have proved sufficient to drown an infant before now, during the momentary absence of the nurse.
In fastening the clothes, use as few pins as possible, and let the pins be well-made safety pins. Wherever strings, buttons, and loops, or a stitch can be used instead, by all means substitute one of these. Always have a needle and thread beside you during the dressing process.
A second bath at night is not necessary, only light sponging o nurse's knee. The head should not be wetted I' evening, and after the morning bath the hair should be gently but thoroughly dried, and brushed with a very soft brush. Warm or tepid water is necessary during the first two or three years of a child's life, perhaps even longer in the cases of delicate children.
It is astonishing how very soon infants may be taught habits of cleanliness and regularly in taking food and rest. These things depend almost wholly on the care and attention bestowed by those who have the charge of them. Remember, dear mothers and young nurses, that it is from you, who are always about it, the little one receives its first and most durable impressions, whether for good or evil, and as regards both mind and body. Can you, then, e too careful with respect to what you do for it; or too prayerful and watchful over yourself in order that from you it may receive nothing but what is good?
After the bath a baby is generally ready for its food, and the meal is pretty certain to be followed by its morning sleep. If the mother nurses her infant herself and a young helper has washed and dressed it, the latter should put away the articles that are done with, empty and dry the bath, and expose night clothes and towels, if possible, to the open air. Never be in a hurry to wrap up clothing or cover up beds. Let them have plenty of fresh air, or at least as much as you can possibly give them. I ought to have said the moment baby is taken out of his cot, the bed should be shaken up and all the bedding spread out and thus exposed. It is an excellent plan to have two sets of sheets in use, one for nights and the other for days; then this airing can be well carried out.
Often, when travelling in Switzerland, I have been struck with the carefulness of the people in airing their beds. As you pass through a village in the early morning, if you look from the windows of the diligence, you will see the beds, which are small, light and much more portable than ours, hanging from every casement. They are turned over and exposed for hours to the fresh air and light, a process which must tend greatly to their purification and to the health of those who use them.
By all means imitate as far as possible this excellent example, and though our cumbrous beds cannot be hung out in like manner, we may give them the benefit of frequent exposure to air and light.
Baby's little bed or mattress, from its small size, has a better chance than any other, so let him have the full advantage of this.
In my next chapter I shall try to give simple instructions on "How to Nurse the Baby."
Showing posts with label nursing. Show all posts
Showing posts with label nursing. Show all posts
Thursday, 9 February 2017
Wednesday, 30 November 2016
24 April 1881 - Answers to Correspondents - Miscellaneous
LITTLE MOLLY – Your name should be engraved or written on your mother's card. If the friends on whom you call be at home, your cards will not be needed. Tell your names to the servant who will announce you, and if your father should send his card, lay it on the hall table as you leave the house.
GREENWOOD – Your desire to devote your restored health to the service of the sick is a very commendable one; but in some cases such creditable desires cannot be carried out; and under the disappointment which you would naturally feel, you must remember that while David's intention to build the Temple was frustrated, his desire to do so was accepted and approved. "It is well that it was in thine heart," was the answer of God. Now in reference to your being a nurse, having been four years suffering from a severe pulmonary affection, we feel sure that you are quite unsuited to such an arduous life. Strong health and nerves are amongst the essential requirements in a nurse. Do not think of it further.
CELANDINE – Feed your puppy with a little sop of bread and milk and water, or porridge and dogs' biscuits. While very young feed him night and day.
CORAL NECKLACE – Gooseberries are not served as a dish for dessert in society. At home, you hold the gooseberry, and having pulled off the little terminal tuft at the end, you squeeze the contents into your mouth. In reference to grapes, which always appear at dinners in society, there is a fully acknowledged difficulty. It is a safe rule to notice what the best bred persons do who are present at table with you; but it is an undoubted fact that they usually make a cup of the left hand, place it close to the mouth, and so receive the stones and skins, and convey them as privately as possibly to the plate, while others swallow the whole in preference. But no one likes to do either; and the best plan is to restrict your indulgences in all such fruits to private dinners.
BESSIE – Your poems have merit and show good feeling likewise; and you write a pretty, well-formed hand; but we cannot always publish even good amateur productions. You are right in supposing that we are neither "bewigged nor bespectacled" nor at all disposed to find fault with your kind letter. We shall always be glad to hear from so good a friend.
CLEMENCE TAYLOR – You suffer from bad circulation, produced either by insufficient clothing and food, or those which are not suitable for your case, or else from too sedentary a life; or, again, you may have a feeble heart. Take exercise; use a flesh brush; eat warming food, such as lentils, beans, peas and so forth; and wear merino under-vests and warm stockings. If not sufficient to improve your state, consult a doctor.
ROBIN – Enclose a note in the parcel containing the wedding gift, only inscribing upon it:- "With all good wishes (or affectionate wishes) for your happiness – From 'Robin,'" giving your real name. Your writing is stiff and large, a more flowing hand would be prettier.
RUTH – Considerably more than a hundred letters come every day. It is necessary to make some selection for replies, although all letters are read. To many questions answers have already appeared in previous numbers. Others will be met b articles soon to appear. Other questions are either trifling ones or could be answered by any person at hand, by an older girl or teacher, or by referring to common school books or dictionaries. Some scores of letters ask opinions about handwriting! If all letters were answered there would be no space left for other matters.
A.C. of E.H.S. GIRL – You give yourself much too long a name for our columns. Exercise a little strength of will and purpose, and resolutely keep your hands still when addressing anyone.
GREENWOOD – Your desire to devote your restored health to the service of the sick is a very commendable one; but in some cases such creditable desires cannot be carried out; and under the disappointment which you would naturally feel, you must remember that while David's intention to build the Temple was frustrated, his desire to do so was accepted and approved. "It is well that it was in thine heart," was the answer of God. Now in reference to your being a nurse, having been four years suffering from a severe pulmonary affection, we feel sure that you are quite unsuited to such an arduous life. Strong health and nerves are amongst the essential requirements in a nurse. Do not think of it further.
CELANDINE – Feed your puppy with a little sop of bread and milk and water, or porridge and dogs' biscuits. While very young feed him night and day.
CORAL NECKLACE – Gooseberries are not served as a dish for dessert in society. At home, you hold the gooseberry, and having pulled off the little terminal tuft at the end, you squeeze the contents into your mouth. In reference to grapes, which always appear at dinners in society, there is a fully acknowledged difficulty. It is a safe rule to notice what the best bred persons do who are present at table with you; but it is an undoubted fact that they usually make a cup of the left hand, place it close to the mouth, and so receive the stones and skins, and convey them as privately as possibly to the plate, while others swallow the whole in preference. But no one likes to do either; and the best plan is to restrict your indulgences in all such fruits to private dinners.
BESSIE – Your poems have merit and show good feeling likewise; and you write a pretty, well-formed hand; but we cannot always publish even good amateur productions. You are right in supposing that we are neither "bewigged nor bespectacled" nor at all disposed to find fault with your kind letter. We shall always be glad to hear from so good a friend.
CLEMENCE TAYLOR – You suffer from bad circulation, produced either by insufficient clothing and food, or those which are not suitable for your case, or else from too sedentary a life; or, again, you may have a feeble heart. Take exercise; use a flesh brush; eat warming food, such as lentils, beans, peas and so forth; and wear merino under-vests and warm stockings. If not sufficient to improve your state, consult a doctor.
ROBIN – Enclose a note in the parcel containing the wedding gift, only inscribing upon it:- "With all good wishes (or affectionate wishes) for your happiness – From 'Robin,'" giving your real name. Your writing is stiff and large, a more flowing hand would be prettier.
RUTH – Considerably more than a hundred letters come every day. It is necessary to make some selection for replies, although all letters are read. To many questions answers have already appeared in previous numbers. Others will be met b articles soon to appear. Other questions are either trifling ones or could be answered by any person at hand, by an older girl or teacher, or by referring to common school books or dictionaries. Some scores of letters ask opinions about handwriting! If all letters were answered there would be no space left for other matters.
A.C. of E.H.S. GIRL – You give yourself much too long a name for our columns. Exercise a little strength of will and purpose, and resolutely keep your hands still when addressing anyone.
Sunday, 27 November 2016
23 April 1881 'How to Wash and Dress the Baby' by Ruth Lamb - Chapter 1 'About Little Nurses'
Before I enter upon the main subject of these chapters I should like to devote a portion of them to a very large class of helpful-handed little people. I mean young nurses. This class includes both boys and girls. Had it not been for this fact, I might perhaps call these youngsters "Little Mothers." But I see, almost daily, such pleasant pictures of small boy-nurses in the exercise of their vocation, that the class must be understood to include them also, if fairly treated.
Perhaps there is no place in which the genus "little nurse" can be studied in all its varieties and to greater advantage than in our public parks. On every fine morning especially, it is to be met with at almost every turn, and of nearly all ages above that of the actual baby in charge.
In the houses of well-to-do people, where there are experienced nurses to assist mothers in the care of their children, or sometimes – alas that it should be so! – to take the entire charge of them during infancy, the elder little people of the family generally have to beg to be allowed to "take baby."
The little lassie of eight or nine who is, perhaps, a baby worshipper, and whose ambition it is to be called a good nurse, is sometimes quite indignant at the amount of supervision to which she is subjected all the while baby is on her knee. She chafes at the continual charges, "Mind you don't hurt him, Miss Annie!" "He'll be off your knee if you're not more careful!" "Put your arm behind his back!" and so on, *ad libitum.
At the same time the vigilant eyes of nurse are so perpetually turned in the direction of her amateur assistant, that any sense of responsibility in that quarter is utterly destroyed, and Miss Annie herself waxes indignant under this persistent and irritating espionage.
True, the elder child's young arms lack the strength and dexterity of nurse's practised ones; but baby, if well, does not object to Annie's rather awkward mode of handling him. He likes to see her young, fresh laughing face close to his, and sister Annie's hair is delightful to pull and to bury his small fists in. He seizes it and tugs with all his might, and so retaliates on his little nurse for having so poked and tickled him into a fit of laughter, in which she joins as heartily. His real nurse's head-gear is much less attractive, her prim cap being carefully and necessarily kept out of baby's clutches, and her hair, tidily tucked beneath it, offers no such temptation to baby's roving fingers as to Miss Annie's soft flowing curls.
But nurse has perhaps just tidied Miss Annie for dinner, and the ruffled hair is an additional grievance. "You should not let baby pull your hair so," she says, in a tone of reproof. "I shall have it all to curl up again before you go downstairs."
It seems a pity to disturb such a delightful game, when baby brother and little sister are so innocently happy. But Annie is tired of such constant looking after, tired of the continual nagging and cautioning, and she would not hurt the chubby darling for all the world. So she sighs in a weary fashion, gives baby a hearty kiss on his dear little distended mouth, evading another grab at her curls as she does so, and resigns herself anew into the hands of nurse, who grumbles a good deal at having to put her right a second time.
Annie's mind is considerably exercised on the subject of nursing and of her assumed helplessness in comparison with the scores of little nurses whom she sees in sole charge of babies. None of the tiny creatures appear to come to any harm in consequence of the trust reposed in mere children by poor mothers who have no choice but to do this, if their household work is to be completed in anything like a reasonable time. She wonders why poor people's children may be trusted to do all sorts of things for and with babies; whereas she is looked after, watched and cautioned at every turn, just as if her little brother was made of egg-shell china, and she had made up her mind to break him with a touch.
Miss Annie looks at her round strong arms, very different from those of some little nurses she sees out of doors; she knows that her limbs are stronger, because she has good health, and is better fed and looked after than they are; she has the will to be useful, and she loves, with all the warmth of her young heart, the helpless darling in the nursery at home.
She feels half-angry, half-humiliated, and says to herself, "I wish I lived in a cottage where there are no nurses to bother and fidget, then mamma would be glad to let me have baby and take him out whenever I liked."
There are plenty of children like our "miss Annie," who grow up comparatively helpless, but who are only so because they are neither taught how to make themselves useful, nor trusted. As a hint both to mothers and children, let me point out a few of the valuable qualities which I have seen developed in little nurses. These have come under my notice as I have watched them in the streets and parks, far beyond the overseeing eye of the mother who was often toiling for their bread at the wash-tub or in the mill.
Carefulness, patience, unselfishness, endurance, good temper, tender love for the little one, and trustworthiness. Perhaps I should notice the last mentioned quality before all the rest. The mother must believe in its existence when she trusts her infant to the care of a nine year old girl or boy. How seldom does the child fail her! How carefully is the baby held, just as a mother holds it! How watchful are those young eyes over the one, two, or three other children who play round the doorstep or near a eat in the park on which the little nurse sits with her sleeping charge.
As to patience, I do not know whether to yield the palm for this virtue to the boy or the girl nurse. Only a few mornings ago I noticed a boy patting, petting, kissing, and comforting a baby whose tearful eyes and pouting lips told of some little trouble. How he persevered in his efforts to pacify the child! He walked up and down, made droll faces and droller noises, until at last he won back a smile to the bonny round face, while his own looked the picture of happiness. The sound of a hearty kiss was the last thing I heard as I turned out of the park.
If you want to know whether these little nurses are interested in their charges, seat yourself near a couple of them and listen to their conversation. You can have a book in your hand, which will put them quite at their ease, though you need not read it.
One will perhaps tell, with anxious face, of some narrow escape that her baby had had through getting cold when he had measles. The other will speak with exultation of a new frock which mother is making for hers. They will compare ages, count and exhibit the wee ivories just peeping, and tenderly rub the little gums to help the next one through. And is not that small nurse a proud individual if her baby, being the same age as the other, or perhaps a little younger, has actually cut a tooth or two more, or has a less bald pate under its woollen hood.
Then what beauty they see in their baby's face! You and I might think it a poor skinny elfish-looking creature, but the little nurse does not. Love gives beauty, and the helpless thing is perfectly lovely in the eyes of its young guardian. You will hear all sorts of admiring epithets showered upon it if you listen.
You know the little nurse's arms ache, and you wonder how she goes on holding it, hour after hour, without a word of complaint. Many a mother would think she had done a great thing had she held her child for half the time.
I write especially in the hope of attracting the thoughtful attention of the girls who will be the mothers of the next generation.
If you, dear girls who read this paper will look around you, you will see many an exhibition of those fine qualities of patience and uncomplaining endurance amongst the little nurses in whom I feel a deep interest. Conscience will, perhaps, tell you that untaught, ignorant, as many of them are, you might yet learn many a lesson from them as you pass along the highways in town or country.
The little nurses are unselfish and brave. Often I Have seen one take off the little woollen shawl, which was doing duty as a bonnet on her own person as well as being her only out-door covering, and wind it round the baby lest the cold wind should reach him.
Fancy, too, the temptations that have to be resisted. Do you not think those two bright lads would like a game at marbles, as well as their neighbours who are unfettered by baby or perambulator? Of course they would, and, depend on it, the faithful nurses, whether girls or boys, fight and bravely win a hard battle when they turn from ball, skipping-rope, hoop, or marbles, and remain the spectators of games in which they long to join, because they will not neglect the helpless infants entrusted to their care.
They have their pleasures as well as trials. In the warm, summer weather, when the grass is dry and the sun shining, the little ones will kick about and sprawl on the ground, enjoying the bustle that is going on around them. But often, when the day we glorious for active play, and the sky is bright and clear, there is a cold wind and the grass is damp. Baby could not be laid down safely, and then the courage and self-denial of the little nurse are called into operation. Then great victories are won of which the world knows nothing.
Little nurses, as a rule, have their reward in the growth, progress, and increasing strength of their babies. What joy and exultation do the first tottering steps cause to their guardians! How proud are they when the wee thing can run alone!
And far beyond even these rewards are the approving smile and word, the whispered blessing, the loving kiss of a good mother, with whose cares and anxieties their children sympathise, and whose toil their young hands have lightened.
There are such animals as crabby, impatient little nurses. I have seen such that could scold and even strike the help.ess and unfortunate babies with which they had to do. But, thank god! There are few instances of this kind and so many of the opposite.
There are mothers, too, who are apt, probably because they do not think about it, to speak lightly or not at all of their children's services. They take their loving labours as a matter of course, and hardly care to cheer and encourage them on the path of duty. So the children gradually become indifferent, and look upon that as an irksome task which should be a pleasure. But it is not with such as these that I am specially dealing in this paper. I wish to picture, as I o often see them manifested, those high and noble qualities which are drawn out in the characters of children by the very fact of trusting them.
We cannot help contrasting the helpful children of the cottage and the streets with those who do nothing, simply because they have so many people to care for them that they are neither called on to think for themselves, nor for others. Watched, waited on, thought for in everything, they grow up helpless, because they have never been exercised in self-reliance; and selfish, because they have not been taught the blessedness of giving, or giving up anything for the sake of others.
There is one sad drawback in the case of little nurses who are trusted too much and too early. They seem almost weighed down with family cares whilst they are but children. Theirs is the growing "old too soon." But in the homes of well-to-do parents, there is little fear of the children being overburdened, whilst it would surely be worth their while to draw out such qualities in their young people as are daily exercised in the houses of their poorer neighbours.
Children who never have to do with babies are often, I was going to say amusingly, awkward in handling an infant. Better, however, say pitiably awkward; because it is a pity that the "future mothers" of our race should have no training in this most important part of woman's work. Boys of this class usually consider it *infra dig to notice babies in public. If they condescend to kiss them they manifest a strong objection to open-mouthed salutes, and touch the little velvet cheek with their lips much as they might approach a red-hot poker. It is a touch-and-go process, which makes mothers and grown-up nurses smile pityingly at the urchin who does not know how delightful is a genuine baby kiss.
Happily, there are lots of little mothers "to the manner born" in every station f life. I fancy I see one of these as I write. From her very infancy she loves her doll as a true mother loves her child, and should an accident befall her wooden or waxen darling, she grieves and moans over it, not as a broken toy, but a wounded baby. Its eruptions – of sawdust – cause her all the anxiety incident to measles. Her tears are real tears, and it is of no use to intimate that the broken arm, over which she is weeping causes Dolly no pain.
A matter-of-fact child laughs contemptuously at the idea of a doll being able to feel, and points to the wooden fragments as proof of her being in the right. She means well, doubtless, but her calm indifference only adds to the grief of the loving-hearted little mite, who presses her injured darling to her breast and loses hours of sleep in weeping.
There is neither rest nor comfort for her until somebody sets to work and restores the limb as far as possible, and then she sleeps; but even then she sobs at intervals as if the trouble could not be forgotten.
As the little mother grows older she wins everybody's admiration by the "handy" way in which she nurses a real baby, and when she has shot up into a slender slip of a lass, as tall as her own mother, she is a greater infant-worshipper than ever. She bestows a perfect wealth of love on the wee things, and the younger they are the better she likes them; because they want the most care and nursing.
If the little mother is missing from her own home circle, her mamma sends a message of inquiry to the nearest friend's house, where she is made free of the nursery, or perhaps to some cottage in the neighbourhood, where a nice clean baby is to be found. Perhaps her attentions are least acceptable to children beyond babyhood. She plagues them a little by wanting to wash and tidy them more frequently than they like, because she is so fond of the work and delights in making them look nice. But she generally coaxes them to submit by offering bribes in the shape of wonderfully got-up dolls, of which she always has a store ready, dressed by her nimble young fingers.
Bless the loving little woman! She is not without a reasonable liking for school work, and loves reading as well as most. But her great charm is her delightful motherliness, even as a child, a quality which is, I fear, insufficiently cultivated at home, and never thought of at all in schools, or supposed to have any place in the so-called "Higher Education of Women."
Yet when I see these sweet feminine qualities in the lassie, I often think to myself that if I were a youth - a good one, mind – I should watch the growing into womanhood of such a "little mother" as I have described. I should value the development of these heaven-bestowed womanly instincts as something more precious than any amount of certificates won for Latin or advanced mathematical knowledge. And though I might have a choice between such a little damsel as I have described and a feminine senior wrangler, I would do my best to win the little mother as the mistress of my future home.
Just another picture of little nurses and I will finish. Some years ago I was in the Peel Park Museum, Salford, and was much edified at the sight of a number of these small people standing before the cases of gaily-plumaged, stuffed birds. They were spelling out the names and repeating them to such of their companions as were above baby age, thus doing their best to improve their minds as well as care for their bodies. I felt rather put out when a policeman conducted them to the door and told them, not unkindly, to "Go play in the park," probably for fear the clatter of their clogs should offend the ears of some well-dressed grown-up folk in the museum The longing, lingering looks they cast behind them quite spoiled my enjoyment, and I felt sorry that in this "People's Museum" well-behaved poor children should have been sent out, because their feet were clogged instead of shod, and necessarily made a clatter on the floors.
I went out almost immediately, and as I drew near the entrance gates I met a picnic party coming into the park – a little girl nurse with a disproportionately large baby in her arms, and quite a train of attendant youngsters, who were evidently going to have "a day out." They were nearly all barefoot, and their clothing was poor and scanty, though the baby was well bundled up in all sorts of odds and ends of garments.
There was a provision basket, containing a bottle of blueish-tinted milk, thick lunches of bread and dripping, a few green apples, and some indescribable scraps of other food. The party did not live in the immediate neighbourhood, as was evident, for the young leader glanced around in some bewilderment and then said to me, "Please will you tell me the way to the swings?"
I directed her to the girls' playground adding, "There were plenty of swings at liberty a few minutes since."
This information gave new vigour to the youngsters. The little nurse thanked me, hitched the baby a little higher on her shoulder, gave her free hand to the toddler next in size, saying, "Come on, Georgie. The lady says there's plenty of swings ready for us."
Away went the bare feet pattering over the hard gravel path, and this humble picnic party was soon lost to my view. With all my heart I wished them a happy day, a safe return, and a good rest for the little nurse in charge when the evening shadows should begin to fall.
Many a time since then, when I have seen over-indulged, helpless girls satiated with too many pleasures, almost wishing they had a want, and not knowing how to spend their time and use their strong limbs, I have thought of that half-clad, barefooted group, and of the almost awful responsibility of the mere child who was charged with the safe conduct of the rest.
When I began this chapter I did not intend to let little nurses occupy so much space, but they came before my mind's eye in such crowds, and I have long felt such a deep motherly interest in them as a class, that I have permitted them to push the baby itself out of sight for a time.
Yet I am truly anxious to interest both mothers and girls in this most important subject – namely, whatever concerns the care of the comfort and well-being of the baby. I am going to write out some simple instructions for its management, which I hope may be of use to young nurses who are willing but unskilful, and who are therefore afraid to offer help in washing, dressing, or nursing the baby.
Perhaps there is no place in which the genus "little nurse" can be studied in all its varieties and to greater advantage than in our public parks. On every fine morning especially, it is to be met with at almost every turn, and of nearly all ages above that of the actual baby in charge.
In the houses of well-to-do people, where there are experienced nurses to assist mothers in the care of their children, or sometimes – alas that it should be so! – to take the entire charge of them during infancy, the elder little people of the family generally have to beg to be allowed to "take baby."
The little lassie of eight or nine who is, perhaps, a baby worshipper, and whose ambition it is to be called a good nurse, is sometimes quite indignant at the amount of supervision to which she is subjected all the while baby is on her knee. She chafes at the continual charges, "Mind you don't hurt him, Miss Annie!" "He'll be off your knee if you're not more careful!" "Put your arm behind his back!" and so on, *ad libitum.
At the same time the vigilant eyes of nurse are so perpetually turned in the direction of her amateur assistant, that any sense of responsibility in that quarter is utterly destroyed, and Miss Annie herself waxes indignant under this persistent and irritating espionage.
True, the elder child's young arms lack the strength and dexterity of nurse's practised ones; but baby, if well, does not object to Annie's rather awkward mode of handling him. He likes to see her young, fresh laughing face close to his, and sister Annie's hair is delightful to pull and to bury his small fists in. He seizes it and tugs with all his might, and so retaliates on his little nurse for having so poked and tickled him into a fit of laughter, in which she joins as heartily. His real nurse's head-gear is much less attractive, her prim cap being carefully and necessarily kept out of baby's clutches, and her hair, tidily tucked beneath it, offers no such temptation to baby's roving fingers as to Miss Annie's soft flowing curls.
But nurse has perhaps just tidied Miss Annie for dinner, and the ruffled hair is an additional grievance. "You should not let baby pull your hair so," she says, in a tone of reproof. "I shall have it all to curl up again before you go downstairs."
It seems a pity to disturb such a delightful game, when baby brother and little sister are so innocently happy. But Annie is tired of such constant looking after, tired of the continual nagging and cautioning, and she would not hurt the chubby darling for all the world. So she sighs in a weary fashion, gives baby a hearty kiss on his dear little distended mouth, evading another grab at her curls as she does so, and resigns herself anew into the hands of nurse, who grumbles a good deal at having to put her right a second time.
Annie's mind is considerably exercised on the subject of nursing and of her assumed helplessness in comparison with the scores of little nurses whom she sees in sole charge of babies. None of the tiny creatures appear to come to any harm in consequence of the trust reposed in mere children by poor mothers who have no choice but to do this, if their household work is to be completed in anything like a reasonable time. She wonders why poor people's children may be trusted to do all sorts of things for and with babies; whereas she is looked after, watched and cautioned at every turn, just as if her little brother was made of egg-shell china, and she had made up her mind to break him with a touch.
Miss Annie looks at her round strong arms, very different from those of some little nurses she sees out of doors; she knows that her limbs are stronger, because she has good health, and is better fed and looked after than they are; she has the will to be useful, and she loves, with all the warmth of her young heart, the helpless darling in the nursery at home.
She feels half-angry, half-humiliated, and says to herself, "I wish I lived in a cottage where there are no nurses to bother and fidget, then mamma would be glad to let me have baby and take him out whenever I liked."
There are plenty of children like our "miss Annie," who grow up comparatively helpless, but who are only so because they are neither taught how to make themselves useful, nor trusted. As a hint both to mothers and children, let me point out a few of the valuable qualities which I have seen developed in little nurses. These have come under my notice as I have watched them in the streets and parks, far beyond the overseeing eye of the mother who was often toiling for their bread at the wash-tub or in the mill.
Carefulness, patience, unselfishness, endurance, good temper, tender love for the little one, and trustworthiness. Perhaps I should notice the last mentioned quality before all the rest. The mother must believe in its existence when she trusts her infant to the care of a nine year old girl or boy. How seldom does the child fail her! How carefully is the baby held, just as a mother holds it! How watchful are those young eyes over the one, two, or three other children who play round the doorstep or near a eat in the park on which the little nurse sits with her sleeping charge.
As to patience, I do not know whether to yield the palm for this virtue to the boy or the girl nurse. Only a few mornings ago I noticed a boy patting, petting, kissing, and comforting a baby whose tearful eyes and pouting lips told of some little trouble. How he persevered in his efforts to pacify the child! He walked up and down, made droll faces and droller noises, until at last he won back a smile to the bonny round face, while his own looked the picture of happiness. The sound of a hearty kiss was the last thing I heard as I turned out of the park.
If you want to know whether these little nurses are interested in their charges, seat yourself near a couple of them and listen to their conversation. You can have a book in your hand, which will put them quite at their ease, though you need not read it.
One will perhaps tell, with anxious face, of some narrow escape that her baby had had through getting cold when he had measles. The other will speak with exultation of a new frock which mother is making for hers. They will compare ages, count and exhibit the wee ivories just peeping, and tenderly rub the little gums to help the next one through. And is not that small nurse a proud individual if her baby, being the same age as the other, or perhaps a little younger, has actually cut a tooth or two more, or has a less bald pate under its woollen hood.
Then what beauty they see in their baby's face! You and I might think it a poor skinny elfish-looking creature, but the little nurse does not. Love gives beauty, and the helpless thing is perfectly lovely in the eyes of its young guardian. You will hear all sorts of admiring epithets showered upon it if you listen.
You know the little nurse's arms ache, and you wonder how she goes on holding it, hour after hour, without a word of complaint. Many a mother would think she had done a great thing had she held her child for half the time.
I write especially in the hope of attracting the thoughtful attention of the girls who will be the mothers of the next generation.
If you, dear girls who read this paper will look around you, you will see many an exhibition of those fine qualities of patience and uncomplaining endurance amongst the little nurses in whom I feel a deep interest. Conscience will, perhaps, tell you that untaught, ignorant, as many of them are, you might yet learn many a lesson from them as you pass along the highways in town or country.
The little nurses are unselfish and brave. Often I Have seen one take off the little woollen shawl, which was doing duty as a bonnet on her own person as well as being her only out-door covering, and wind it round the baby lest the cold wind should reach him.
Fancy, too, the temptations that have to be resisted. Do you not think those two bright lads would like a game at marbles, as well as their neighbours who are unfettered by baby or perambulator? Of course they would, and, depend on it, the faithful nurses, whether girls or boys, fight and bravely win a hard battle when they turn from ball, skipping-rope, hoop, or marbles, and remain the spectators of games in which they long to join, because they will not neglect the helpless infants entrusted to their care.
They have their pleasures as well as trials. In the warm, summer weather, when the grass is dry and the sun shining, the little ones will kick about and sprawl on the ground, enjoying the bustle that is going on around them. But often, when the day we glorious for active play, and the sky is bright and clear, there is a cold wind and the grass is damp. Baby could not be laid down safely, and then the courage and self-denial of the little nurse are called into operation. Then great victories are won of which the world knows nothing.
Little nurses, as a rule, have their reward in the growth, progress, and increasing strength of their babies. What joy and exultation do the first tottering steps cause to their guardians! How proud are they when the wee thing can run alone!
And far beyond even these rewards are the approving smile and word, the whispered blessing, the loving kiss of a good mother, with whose cares and anxieties their children sympathise, and whose toil their young hands have lightened.
There are such animals as crabby, impatient little nurses. I have seen such that could scold and even strike the help.ess and unfortunate babies with which they had to do. But, thank god! There are few instances of this kind and so many of the opposite.
There are mothers, too, who are apt, probably because they do not think about it, to speak lightly or not at all of their children's services. They take their loving labours as a matter of course, and hardly care to cheer and encourage them on the path of duty. So the children gradually become indifferent, and look upon that as an irksome task which should be a pleasure. But it is not with such as these that I am specially dealing in this paper. I wish to picture, as I o often see them manifested, those high and noble qualities which are drawn out in the characters of children by the very fact of trusting them.
We cannot help contrasting the helpful children of the cottage and the streets with those who do nothing, simply because they have so many people to care for them that they are neither called on to think for themselves, nor for others. Watched, waited on, thought for in everything, they grow up helpless, because they have never been exercised in self-reliance; and selfish, because they have not been taught the blessedness of giving, or giving up anything for the sake of others.
There is one sad drawback in the case of little nurses who are trusted too much and too early. They seem almost weighed down with family cares whilst they are but children. Theirs is the growing "old too soon." But in the homes of well-to-do parents, there is little fear of the children being overburdened, whilst it would surely be worth their while to draw out such qualities in their young people as are daily exercised in the houses of their poorer neighbours.
Children who never have to do with babies are often, I was going to say amusingly, awkward in handling an infant. Better, however, say pitiably awkward; because it is a pity that the "future mothers" of our race should have no training in this most important part of woman's work. Boys of this class usually consider it *infra dig to notice babies in public. If they condescend to kiss them they manifest a strong objection to open-mouthed salutes, and touch the little velvet cheek with their lips much as they might approach a red-hot poker. It is a touch-and-go process, which makes mothers and grown-up nurses smile pityingly at the urchin who does not know how delightful is a genuine baby kiss.
Happily, there are lots of little mothers "to the manner born" in every station f life. I fancy I see one of these as I write. From her very infancy she loves her doll as a true mother loves her child, and should an accident befall her wooden or waxen darling, she grieves and moans over it, not as a broken toy, but a wounded baby. Its eruptions – of sawdust – cause her all the anxiety incident to measles. Her tears are real tears, and it is of no use to intimate that the broken arm, over which she is weeping causes Dolly no pain.
A matter-of-fact child laughs contemptuously at the idea of a doll being able to feel, and points to the wooden fragments as proof of her being in the right. She means well, doubtless, but her calm indifference only adds to the grief of the loving-hearted little mite, who presses her injured darling to her breast and loses hours of sleep in weeping.
There is neither rest nor comfort for her until somebody sets to work and restores the limb as far as possible, and then she sleeps; but even then she sobs at intervals as if the trouble could not be forgotten.
As the little mother grows older she wins everybody's admiration by the "handy" way in which she nurses a real baby, and when she has shot up into a slender slip of a lass, as tall as her own mother, she is a greater infant-worshipper than ever. She bestows a perfect wealth of love on the wee things, and the younger they are the better she likes them; because they want the most care and nursing.
If the little mother is missing from her own home circle, her mamma sends a message of inquiry to the nearest friend's house, where she is made free of the nursery, or perhaps to some cottage in the neighbourhood, where a nice clean baby is to be found. Perhaps her attentions are least acceptable to children beyond babyhood. She plagues them a little by wanting to wash and tidy them more frequently than they like, because she is so fond of the work and delights in making them look nice. But she generally coaxes them to submit by offering bribes in the shape of wonderfully got-up dolls, of which she always has a store ready, dressed by her nimble young fingers.
Bless the loving little woman! She is not without a reasonable liking for school work, and loves reading as well as most. But her great charm is her delightful motherliness, even as a child, a quality which is, I fear, insufficiently cultivated at home, and never thought of at all in schools, or supposed to have any place in the so-called "Higher Education of Women."
Yet when I see these sweet feminine qualities in the lassie, I often think to myself that if I were a youth - a good one, mind – I should watch the growing into womanhood of such a "little mother" as I have described. I should value the development of these heaven-bestowed womanly instincts as something more precious than any amount of certificates won for Latin or advanced mathematical knowledge. And though I might have a choice between such a little damsel as I have described and a feminine senior wrangler, I would do my best to win the little mother as the mistress of my future home.
Just another picture of little nurses and I will finish. Some years ago I was in the Peel Park Museum, Salford, and was much edified at the sight of a number of these small people standing before the cases of gaily-plumaged, stuffed birds. They were spelling out the names and repeating them to such of their companions as were above baby age, thus doing their best to improve their minds as well as care for their bodies. I felt rather put out when a policeman conducted them to the door and told them, not unkindly, to "Go play in the park," probably for fear the clatter of their clogs should offend the ears of some well-dressed grown-up folk in the museum The longing, lingering looks they cast behind them quite spoiled my enjoyment, and I felt sorry that in this "People's Museum" well-behaved poor children should have been sent out, because their feet were clogged instead of shod, and necessarily made a clatter on the floors.
I went out almost immediately, and as I drew near the entrance gates I met a picnic party coming into the park – a little girl nurse with a disproportionately large baby in her arms, and quite a train of attendant youngsters, who were evidently going to have "a day out." They were nearly all barefoot, and their clothing was poor and scanty, though the baby was well bundled up in all sorts of odds and ends of garments.
There was a provision basket, containing a bottle of blueish-tinted milk, thick lunches of bread and dripping, a few green apples, and some indescribable scraps of other food. The party did not live in the immediate neighbourhood, as was evident, for the young leader glanced around in some bewilderment and then said to me, "Please will you tell me the way to the swings?"
I directed her to the girls' playground adding, "There were plenty of swings at liberty a few minutes since."
This information gave new vigour to the youngsters. The little nurse thanked me, hitched the baby a little higher on her shoulder, gave her free hand to the toddler next in size, saying, "Come on, Georgie. The lady says there's plenty of swings ready for us."
Away went the bare feet pattering over the hard gravel path, and this humble picnic party was soon lost to my view. With all my heart I wished them a happy day, a safe return, and a good rest for the little nurse in charge when the evening shadows should begin to fall.
Many a time since then, when I have seen over-indulged, helpless girls satiated with too many pleasures, almost wishing they had a want, and not knowing how to spend their time and use their strong limbs, I have thought of that half-clad, barefooted group, and of the almost awful responsibility of the mere child who was charged with the safe conduct of the rest.
When I began this chapter I did not intend to let little nurses occupy so much space, but they came before my mind's eye in such crowds, and I have long felt such a deep motherly interest in them as a class, that I have permitted them to push the baby itself out of sight for a time.
Yet I am truly anxious to interest both mothers and girls in this most important subject – namely, whatever concerns the care of the comfort and well-being of the baby. I am going to write out some simple instructions for its management, which I hope may be of use to young nurses who are willing but unskilful, and who are therefore afraid to offer help in washing, dressing, or nursing the baby.
Sunday, 13 November 2016
16 April 1881 - 'Cookery for Invalids' by Phillis Browne
I remember once hearing of an old gentleman who went to visit at a house where there were three young ladies in the family. While he was there the cook was taken ill, and it was thought advisable for her to have a little gruel. It turned out, however, that there was no one who could make it. The young ladies looked at each other with blank countenances. The housemaid prudently withdrew from the kitchen, and busied herself with brushes and brooms, but the gruel was not to be had, and the sick woman was obliged to put up with a cup of tea in its stead. The feelings of the old gentleman on the occasion are more easily imagined than described. He never forgot the occurrence. As long as he lived those unfortunate girls were associated in his mind with ignorance concerning gruel. When, after a time one of them married, he regarded her husband with feelings of the deepest and most heartfelt pity.
The recovery of a patient very often largely depends upon the food which he takes, and as his power of taking food is affected very considerably by the way in which it is served and cooked, it is well worth while trying to learn how an invalid's food should be prepared.
Cookery for invalids is usually very plain and simple. All rich, highly spiced, and fatty foods are entirely out of the question, and small delicate dishes, light foods, and cooling or nourishing drinks are needed more than anything else. Variety, too, is a great thing in invalid cookery. We all enjoy frequent change of food, and would grow weary of a dish that was set before us day after day. How much more is this likely to be the case with invalids, whose appetite at the best is poor, and who have been rendered fastidious and fanciful through disease. The skill of a cook is shown quite as much in the readiness with which she can provide pleasant little surprises as in the delicacy of the food prepared.
Take, for example, the food which is perhaps more valuable and more frequently prepared for invalids than any other - beef-tea. When first supplied in cases of weakness beef-tea is usually taken with great relish. It seems to give strength and to supply just what is wanted, and a patient will look for it and enjoy it heartily. In a very short time, however, the appetite for it will fail, and the very name of beef-tea appears to excite loathing. In cases of this kind a nurse who is a clever cook will introduce a change of flavour; present the beef-tea under another form, and avoid the name altogether.
A very agreeable variety may be made by using half beef and half mutton or veal in making the tea, or by stewing an inch or two of celery, or even an onion and one or two cloves with the beef. The addition of a little sago also, or crushed tapioca, and a small quantity of cream to the beef-tea will alter its taste, whilst the addition will increase rather than diminish the nourishing wholesome qualities of the tea. When making this, soak a tablespoonful of sago or tapioca in a little cold water for an hour. This will take away the earthy taste. Strain it and put it into a saucepan with a gill of fresh water and boil gently till tender. Add a pint of good beef-tea, hot; simmer this with the sago for a minute or two, then add a quarter of a pint of cream. Stir thoroughly, and serve. If liked, an egg or a couple of eggs may be added to the beef-tea, as well as the cream. The eggs must be broken into a basin, and the specks must be carefully removed. The hot tea, with the cream or without it, should now be poured on gradually, *off the fire, and stirred well that the eggs may be thoroughly broken up and separated. Beef-tea may also be used in savoury custard such as is sometimes made for putting into clear soup. For this, take the yolks of two eggs and the white of one, beat them well, put with them a quarter of a pint of strong beef-tea, and season with a little salt. Butter a small jar or basin, and pour in the custard. Tie some paper, slightly buttered, over the top, and set the basin in a saucepan containing boiling water which will reach half way up the basin, but which must on no account touch the edge of the paper. Set the saucepan by the side of the fire, and simmer very gently till the custard is set. It will take about twenty minutes. If the water is allowed to boil fast round the basin the custard inside will be full of holes, instead of being smooth and even. This custard may be served hot or cold.
Sometimes invalids who have a great distaste for ordinary beef-tea served hot, will enjoy it served cold, or offered as a jelly. Now, the best beef-tea, made from juicy meat, such as the roll of the blade bone, and which has not been allowed to reach the boiling point, will not jelly when cold; but beef-tea made by thoroughly stewing the shin of beef will jelly. Beef-tea jellies because of the gelatine which it contains. Gelatine is the least valuable part of butcher's meat, and it is obtained chiefly from bone and gristle. I do not recommend, therefore, that beef-tea should be made into a jelly because it will be more nourishing, but because it may prove more appetising. I have known invalids enjoy jelly beef-tea who turned away with loathing from liquid beef-tea.
Jelly (I do not mean now beef-tea jelly, but calf's-foot jelly, and isinglass, or gelatine jelly) has fallen very much in the estimation of doctors and nurses of late years. I can remember that when I was a girl calf's-foot jelly was the one article of nourishment that was supplied before all others in cases of weakness. If any member of a family was taken ill the cousins and the aunts, but especially the aunts, used to come round at once with superlative moulds of jelly, as furnishing undoubted proof of sympathy and affection. We children used to regard it as one of the compensations attending indisposition that we were allowed to have an unlimited supply of the same.
Of course calf's-foot jelly is a very different thing to gelatine jelly, but it is possible to estimate even calf's-foot jelly too highly. Jelly is very good when mixed with other substances, which are nourishing, but, taken alone, it serves too often to satisfy the appetite without doing much good. Gelatine jelly made from the gelatine sold in packets is of no use. Hear what Miss Nightingale says about it: "Jelly is an article of diet in great favour with nurses and friends of the sick. Even if it could be eaten solid it would not nourish; but it is simply folly to take one-eighth of an ounce of gelatine, and make it into a certain bulk by dissolving it in water, and then to give it to the sick, as if the mere bulk represented nourishment. It is now known that jelly does not nourish - that it has a tendency to produce diarrhoea; and to trust to it to repair the waste of a diseased constitution is simply to starve the sick under the guise of feeding them. If one hundred spoonfuls of jelly were given in the course of the day, you would have given one spoonful of gelatine, which spoonful has no nutritive power whatsoever."
We must return, however, to our beef-tea, for I want to write a word or two about the best way of making it. I said a little while ago that the roll of the blade-bone of beef was the best part that could be chosen for making beef-tea. I must not forget to add that the butcher should be asked to supply freshly-killed meat, because that will be more full of gravy than well-kept beef. To make good beef-tea, take one pound of meat, trim away all fat and skin, cut the lean into very small pieces; place these in a jar, pour over them one point of cold water, and cover the jar closely; leave the meat to soak for one hour, stirring and pressing it now and then to draw out the juice. At the end of this time put the jar, still closely covered, into a saucepan with boiling water, which will come half way up, but which cannot touch the paper, if paper has been tied over as a cover. Keep the water boiling round the jar for two or even three hours, then pour the tea from the meat, add a little salt, and it is ready for use. Put it in a cool place till wanted and warm a little as required, but do not keep the tea hot till wanted or it will spoil.
Mutton-tea or veal-tea may be made exactly in the same way as beef-tea.
Perhaps girls feel inclined to say, Why should we not put the beef at once into the saucepan, and never mind the trouble of putting it into a jar first? Because by taking this extra trouble we make the beef-tea more digestible. People who are in a weakly condition need to have food that can be very easily digested. If the tea were to reach the boiling point, 212 deg., for even a second, the albumen contained in it would harden, and the tea would not be nearly so wholesome. Therefore we give great care to keep the tea from boiling, and we know that if we thus place it in a jar set in a saucepan of boiling water it never will boil, even if it remains on the fire all day, and so we are safe on that point. All we have to do is to keep putting more water into the saucepan, for fear it should boil away and leave the pan dry, for if this mischance should occur our beef-tea would be burnt.
Perhaps some economical person feels inclined to ask, "Could we not make more beef tea by putting in a quart instead of a pint of water?" Of course, you could put in a gallon of water if you liked, but, after all, it would only be so much more water, and it is the beef-juice that does good, not the water. If I wanted very strong beef-tea for very weak people, I should put less water even than this; and in cases of exhaustion, when the patient could take very little food at a time, no water at all should be put with the meat. The simple gravy of the beef should be drawn out by steaming the meat in the way already described, but without water in the jar, and the juice thus drawn out would be the strongest beef-tea that could be made. The beef-juice or beef-essence, as it is called, is sometimes poured over a slice of crumbs of bread freshly toasted, then seasoned with pepper and salt, and served on a hot dish; and this is an excellent dish for an invalid.
A good many poets have occupied themselves in singing the praises of sparkling wine. I wish some very clever one would take it into his head to sing in praise of good beef-tea. I am sure it deserves far more than wine to have its virtues told. Properly made, of fresh meat (not of somebody's extract), and taken, not instead of food, but in addition to food, I know of no more valuable restorative. It is particularly useful for bringing sleep to people who are overworked and overwrought as so many are nowadays. Let such a one have a cup of beef-tea by the side of his bed, and take it, not the last thing at night, but in the night when he wakes up, and finds Black Care sitting by the side of his pillow, and hears her say, "Now I have you in my power, sleep if you can." Beef-tea will chase away the demon. Let the victim drink it and he will be very different from most people, if he does not lay his head on his pillow, and in less than half an hour fall asleep as quickly as when he was a baby and his head lay on his mother's breast.
In cases of typhoid fever and some other diseases, doctors frequently give orders that raw beef-tea should be administered to the patient. This is made by drawing the juice of the meat out in cold water as already described, then straining it off at once and serving it uncooked. This tea must be made in small quantities, as it will not keep.
In making broth or beef-tea for sick people, great care should be taken to remove every particle of fat from the liquid, for fat will not only be likely to upset the stomach of the invalid, but it will prove most objectionable to him. If there is time for the tea to go cold, the fat will cake on the surface, and can be easily taken off. If, however, the tea is wanted at once, a sheet of clean blotting-paper should be passed lightly over the top of the liquid. The fat, being the lightest, will rise to the surface, and will be taken up first by the paper. The fat will rise more quickly if the jar containing the hot tea is set in a bowl of cold water.
Care, too, must be taken about seasoning the broth or tea. People who like highly-seasoned food in a general way frequently object to it strongly when they are ill. It is wise, therefore, to season beef-tea or broth very slightly, and to place pepper and salt on the tray, and let the invalid season his food for himself, if he is able to do so.
We must not think that we have done everything that is wanted when we have made the tea or broth, seasoned it lightly, and removed the fat. A very great point in catering for sick folks is to make food look inviting. Every article used should of course be perfectly clean and bright, the tray should be covered with a spotless napkin, and if we can put on it a glass containing a few flowers as well as the food, all the better. Also we must remember, not to take over much food up at one time, for this will be likely to set the invalid against it altogether.
Another point is worth remembering. As soon as the patient has eaten as much as he can, take the food quite out of the room, and when it is time for food again bring it in afresh, in a fresh basin with a clean spoon, having made a change in some way. Nothing is more likely to disgust an invalid than to have the food which he had left brought to him again and again, as if we were a naughty child and must finish one portion before any more were given him. We should anticipate and consider the fancies of sick people. We want them to take nourishment and grow strong, and we know that a great deal is accomplished when food is enjoyed; therefore, anything we can do to this end is well worth the trouble.
Chicken broth used to be very highly thought of a few years ago, but it is not worth very much when all is said and done. It is strongest when the whole fowl is cut up, covered with cold water, boiled up, then drawn back and allowed to simmer gently for three hours, and strained for use. A little boiled rice, boiled barley, or chopped parsley can be added with the seasoning. This, however, is a painful way of making broth, because it is giving so much to produce so little. It is better to take the flesh from the bones, stew the latter for broth, then cook the meat separately turning it either into panada or mince. Panada is very nourishing and very good, but the meat must be well pounded after it is cooked, or it will not be made the most of. The meat is cut up and stewed gently with a little good broth, not being allowed to reach the boiling point. It is then pounded to a pulp, pressed patiently through a sieve, seasoned with pepper and salt, and mixed with a spoonful or two of cream, and served. For variety's sake veal may be substituted for the chicken and cooked in the same way. In either case a spoonful of barley may be soaked and boiled, pounded and pressed through the sieve with the meat. It will be a great improvement, but will be difficult to get through the sieve. Chicken mince is made by mincing the meat when raw, heating it gently in milk or good broth for a few minutes without allowing it to boil, then serving it immediately.
Cooling, refreshing and soothing drinks are so much wanted by invalids that I must mention one or two before closing.
Gruel - The world-renowned gruel may be made either with oatmeal or patent "grits." "Grits" are the best. Mix a tablespoonful of grits or oatmeal to a paste with a little cold water; add a point of boiling water, boil the whole, gently stirring well for ten minutes. Sweeten with sugar or treacle, or season with salt and pepper, and serve. The gruel will be much better made with milk instead of water.
Barley Water - Wash two ounces of pearl barley, boil it for five minutes in clear water, then throw the water away. Pour on two quarts of boiling water, and boil gently till the liquid is reduced to half, or for about two hours. Flavour with sugar and lemon juice, strain (or not, as preferred), and serve. If liked, a little lemon rind can be boiled with the barley. Stir the barley water before using. Apple Barley Water - Cut a good large apple wiped, but not peeled, into slices, and boil this with a little lemon-juice till soft. Rub it through a sieve, and add it to a quart of barley-water.
Toast Water - Take a thin slice of bread, and toast it thoroughly on both sides. Put it into a jug, pour a point of boiling water over it, and let it stand till cold. Strain before using.
Lemonade - Roll two lemons on the table to make them soft. Cut the rind off very thinly, and be careful to reject the white pith, as that would make the lemonade bitter. Cut the lemons into slices, and put these, free from pips, into a jug with half the lemon rind and a pint and a half of boiling water. Cover till cold, strain, and serve. A very pleasant drink may be made by substituting oranges for the lemons. A raw fresh egg beaten up with two tablespoonfuls of warm milk and a little sugar is a very nourishing and agreeable drink for invalids. Sometimes wine is used instead of the milk; in this case a little water may be added, or a little soda-water may be taken instead.
When a doctor is attending a case it is always well to consult him before offering any food to an invalid. It is a good plan, however, to think over beforehand two or three dishes which can be obtained and prepared without difficulty, then to suggest these to the medical man. Every good doctor knows that "kitchen physic" will frequently do more good than drugs, and he will rejoice when he sees that this part of the medical treatment is not neglected.
The recovery of a patient very often largely depends upon the food which he takes, and as his power of taking food is affected very considerably by the way in which it is served and cooked, it is well worth while trying to learn how an invalid's food should be prepared.
Cookery for invalids is usually very plain and simple. All rich, highly spiced, and fatty foods are entirely out of the question, and small delicate dishes, light foods, and cooling or nourishing drinks are needed more than anything else. Variety, too, is a great thing in invalid cookery. We all enjoy frequent change of food, and would grow weary of a dish that was set before us day after day. How much more is this likely to be the case with invalids, whose appetite at the best is poor, and who have been rendered fastidious and fanciful through disease. The skill of a cook is shown quite as much in the readiness with which she can provide pleasant little surprises as in the delicacy of the food prepared.
Take, for example, the food which is perhaps more valuable and more frequently prepared for invalids than any other - beef-tea. When first supplied in cases of weakness beef-tea is usually taken with great relish. It seems to give strength and to supply just what is wanted, and a patient will look for it and enjoy it heartily. In a very short time, however, the appetite for it will fail, and the very name of beef-tea appears to excite loathing. In cases of this kind a nurse who is a clever cook will introduce a change of flavour; present the beef-tea under another form, and avoid the name altogether.
A very agreeable variety may be made by using half beef and half mutton or veal in making the tea, or by stewing an inch or two of celery, or even an onion and one or two cloves with the beef. The addition of a little sago also, or crushed tapioca, and a small quantity of cream to the beef-tea will alter its taste, whilst the addition will increase rather than diminish the nourishing wholesome qualities of the tea. When making this, soak a tablespoonful of sago or tapioca in a little cold water for an hour. This will take away the earthy taste. Strain it and put it into a saucepan with a gill of fresh water and boil gently till tender. Add a pint of good beef-tea, hot; simmer this with the sago for a minute or two, then add a quarter of a pint of cream. Stir thoroughly, and serve. If liked, an egg or a couple of eggs may be added to the beef-tea, as well as the cream. The eggs must be broken into a basin, and the specks must be carefully removed. The hot tea, with the cream or without it, should now be poured on gradually, *off the fire, and stirred well that the eggs may be thoroughly broken up and separated. Beef-tea may also be used in savoury custard such as is sometimes made for putting into clear soup. For this, take the yolks of two eggs and the white of one, beat them well, put with them a quarter of a pint of strong beef-tea, and season with a little salt. Butter a small jar or basin, and pour in the custard. Tie some paper, slightly buttered, over the top, and set the basin in a saucepan containing boiling water which will reach half way up the basin, but which must on no account touch the edge of the paper. Set the saucepan by the side of the fire, and simmer very gently till the custard is set. It will take about twenty minutes. If the water is allowed to boil fast round the basin the custard inside will be full of holes, instead of being smooth and even. This custard may be served hot or cold.
Sometimes invalids who have a great distaste for ordinary beef-tea served hot, will enjoy it served cold, or offered as a jelly. Now, the best beef-tea, made from juicy meat, such as the roll of the blade bone, and which has not been allowed to reach the boiling point, will not jelly when cold; but beef-tea made by thoroughly stewing the shin of beef will jelly. Beef-tea jellies because of the gelatine which it contains. Gelatine is the least valuable part of butcher's meat, and it is obtained chiefly from bone and gristle. I do not recommend, therefore, that beef-tea should be made into a jelly because it will be more nourishing, but because it may prove more appetising. I have known invalids enjoy jelly beef-tea who turned away with loathing from liquid beef-tea.
Jelly (I do not mean now beef-tea jelly, but calf's-foot jelly, and isinglass, or gelatine jelly) has fallen very much in the estimation of doctors and nurses of late years. I can remember that when I was a girl calf's-foot jelly was the one article of nourishment that was supplied before all others in cases of weakness. If any member of a family was taken ill the cousins and the aunts, but especially the aunts, used to come round at once with superlative moulds of jelly, as furnishing undoubted proof of sympathy and affection. We children used to regard it as one of the compensations attending indisposition that we were allowed to have an unlimited supply of the same.
Of course calf's-foot jelly is a very different thing to gelatine jelly, but it is possible to estimate even calf's-foot jelly too highly. Jelly is very good when mixed with other substances, which are nourishing, but, taken alone, it serves too often to satisfy the appetite without doing much good. Gelatine jelly made from the gelatine sold in packets is of no use. Hear what Miss Nightingale says about it: "Jelly is an article of diet in great favour with nurses and friends of the sick. Even if it could be eaten solid it would not nourish; but it is simply folly to take one-eighth of an ounce of gelatine, and make it into a certain bulk by dissolving it in water, and then to give it to the sick, as if the mere bulk represented nourishment. It is now known that jelly does not nourish - that it has a tendency to produce diarrhoea; and to trust to it to repair the waste of a diseased constitution is simply to starve the sick under the guise of feeding them. If one hundred spoonfuls of jelly were given in the course of the day, you would have given one spoonful of gelatine, which spoonful has no nutritive power whatsoever."
We must return, however, to our beef-tea, for I want to write a word or two about the best way of making it. I said a little while ago that the roll of the blade-bone of beef was the best part that could be chosen for making beef-tea. I must not forget to add that the butcher should be asked to supply freshly-killed meat, because that will be more full of gravy than well-kept beef. To make good beef-tea, take one pound of meat, trim away all fat and skin, cut the lean into very small pieces; place these in a jar, pour over them one point of cold water, and cover the jar closely; leave the meat to soak for one hour, stirring and pressing it now and then to draw out the juice. At the end of this time put the jar, still closely covered, into a saucepan with boiling water, which will come half way up, but which cannot touch the paper, if paper has been tied over as a cover. Keep the water boiling round the jar for two or even three hours, then pour the tea from the meat, add a little salt, and it is ready for use. Put it in a cool place till wanted and warm a little as required, but do not keep the tea hot till wanted or it will spoil.
Mutton-tea or veal-tea may be made exactly in the same way as beef-tea.
Perhaps girls feel inclined to say, Why should we not put the beef at once into the saucepan, and never mind the trouble of putting it into a jar first? Because by taking this extra trouble we make the beef-tea more digestible. People who are in a weakly condition need to have food that can be very easily digested. If the tea were to reach the boiling point, 212 deg., for even a second, the albumen contained in it would harden, and the tea would not be nearly so wholesome. Therefore we give great care to keep the tea from boiling, and we know that if we thus place it in a jar set in a saucepan of boiling water it never will boil, even if it remains on the fire all day, and so we are safe on that point. All we have to do is to keep putting more water into the saucepan, for fear it should boil away and leave the pan dry, for if this mischance should occur our beef-tea would be burnt.
Perhaps some economical person feels inclined to ask, "Could we not make more beef tea by putting in a quart instead of a pint of water?" Of course, you could put in a gallon of water if you liked, but, after all, it would only be so much more water, and it is the beef-juice that does good, not the water. If I wanted very strong beef-tea for very weak people, I should put less water even than this; and in cases of exhaustion, when the patient could take very little food at a time, no water at all should be put with the meat. The simple gravy of the beef should be drawn out by steaming the meat in the way already described, but without water in the jar, and the juice thus drawn out would be the strongest beef-tea that could be made. The beef-juice or beef-essence, as it is called, is sometimes poured over a slice of crumbs of bread freshly toasted, then seasoned with pepper and salt, and served on a hot dish; and this is an excellent dish for an invalid.
A good many poets have occupied themselves in singing the praises of sparkling wine. I wish some very clever one would take it into his head to sing in praise of good beef-tea. I am sure it deserves far more than wine to have its virtues told. Properly made, of fresh meat (not of somebody's extract), and taken, not instead of food, but in addition to food, I know of no more valuable restorative. It is particularly useful for bringing sleep to people who are overworked and overwrought as so many are nowadays. Let such a one have a cup of beef-tea by the side of his bed, and take it, not the last thing at night, but in the night when he wakes up, and finds Black Care sitting by the side of his pillow, and hears her say, "Now I have you in my power, sleep if you can." Beef-tea will chase away the demon. Let the victim drink it and he will be very different from most people, if he does not lay his head on his pillow, and in less than half an hour fall asleep as quickly as when he was a baby and his head lay on his mother's breast.
In cases of typhoid fever and some other diseases, doctors frequently give orders that raw beef-tea should be administered to the patient. This is made by drawing the juice of the meat out in cold water as already described, then straining it off at once and serving it uncooked. This tea must be made in small quantities, as it will not keep.
In making broth or beef-tea for sick people, great care should be taken to remove every particle of fat from the liquid, for fat will not only be likely to upset the stomach of the invalid, but it will prove most objectionable to him. If there is time for the tea to go cold, the fat will cake on the surface, and can be easily taken off. If, however, the tea is wanted at once, a sheet of clean blotting-paper should be passed lightly over the top of the liquid. The fat, being the lightest, will rise to the surface, and will be taken up first by the paper. The fat will rise more quickly if the jar containing the hot tea is set in a bowl of cold water.
Care, too, must be taken about seasoning the broth or tea. People who like highly-seasoned food in a general way frequently object to it strongly when they are ill. It is wise, therefore, to season beef-tea or broth very slightly, and to place pepper and salt on the tray, and let the invalid season his food for himself, if he is able to do so.
We must not think that we have done everything that is wanted when we have made the tea or broth, seasoned it lightly, and removed the fat. A very great point in catering for sick folks is to make food look inviting. Every article used should of course be perfectly clean and bright, the tray should be covered with a spotless napkin, and if we can put on it a glass containing a few flowers as well as the food, all the better. Also we must remember, not to take over much food up at one time, for this will be likely to set the invalid against it altogether.
Another point is worth remembering. As soon as the patient has eaten as much as he can, take the food quite out of the room, and when it is time for food again bring it in afresh, in a fresh basin with a clean spoon, having made a change in some way. Nothing is more likely to disgust an invalid than to have the food which he had left brought to him again and again, as if we were a naughty child and must finish one portion before any more were given him. We should anticipate and consider the fancies of sick people. We want them to take nourishment and grow strong, and we know that a great deal is accomplished when food is enjoyed; therefore, anything we can do to this end is well worth the trouble.
Chicken broth used to be very highly thought of a few years ago, but it is not worth very much when all is said and done. It is strongest when the whole fowl is cut up, covered with cold water, boiled up, then drawn back and allowed to simmer gently for three hours, and strained for use. A little boiled rice, boiled barley, or chopped parsley can be added with the seasoning. This, however, is a painful way of making broth, because it is giving so much to produce so little. It is better to take the flesh from the bones, stew the latter for broth, then cook the meat separately turning it either into panada or mince. Panada is very nourishing and very good, but the meat must be well pounded after it is cooked, or it will not be made the most of. The meat is cut up and stewed gently with a little good broth, not being allowed to reach the boiling point. It is then pounded to a pulp, pressed patiently through a sieve, seasoned with pepper and salt, and mixed with a spoonful or two of cream, and served. For variety's sake veal may be substituted for the chicken and cooked in the same way. In either case a spoonful of barley may be soaked and boiled, pounded and pressed through the sieve with the meat. It will be a great improvement, but will be difficult to get through the sieve. Chicken mince is made by mincing the meat when raw, heating it gently in milk or good broth for a few minutes without allowing it to boil, then serving it immediately.
Cooling, refreshing and soothing drinks are so much wanted by invalids that I must mention one or two before closing.
Gruel - The world-renowned gruel may be made either with oatmeal or patent "grits." "Grits" are the best. Mix a tablespoonful of grits or oatmeal to a paste with a little cold water; add a point of boiling water, boil the whole, gently stirring well for ten minutes. Sweeten with sugar or treacle, or season with salt and pepper, and serve. The gruel will be much better made with milk instead of water.
Barley Water - Wash two ounces of pearl barley, boil it for five minutes in clear water, then throw the water away. Pour on two quarts of boiling water, and boil gently till the liquid is reduced to half, or for about two hours. Flavour with sugar and lemon juice, strain (or not, as preferred), and serve. If liked, a little lemon rind can be boiled with the barley. Stir the barley water before using. Apple Barley Water - Cut a good large apple wiped, but not peeled, into slices, and boil this with a little lemon-juice till soft. Rub it through a sieve, and add it to a quart of barley-water.
Toast Water - Take a thin slice of bread, and toast it thoroughly on both sides. Put it into a jug, pour a point of boiling water over it, and let it stand till cold. Strain before using.
Lemonade - Roll two lemons on the table to make them soft. Cut the rind off very thinly, and be careful to reject the white pith, as that would make the lemonade bitter. Cut the lemons into slices, and put these, free from pips, into a jug with half the lemon rind and a pint and a half of boiling water. Cover till cold, strain, and serve. A very pleasant drink may be made by substituting oranges for the lemons. A raw fresh egg beaten up with two tablespoonfuls of warm milk and a little sugar is a very nourishing and agreeable drink for invalids. Sometimes wine is used instead of the milk; in this case a little water may be added, or a little soda-water may be taken instead.
When a doctor is attending a case it is always well to consult him before offering any food to an invalid. It is a good plan, however, to think over beforehand two or three dishes which can be obtained and prepared without difficulty, then to suggest these to the medical man. Every good doctor knows that "kitchen physic" will frequently do more good than drugs, and he will rejoice when he sees that this part of the medical treatment is not neglected.
Thursday, 7 July 2016
25 September 1880 - 'Food for Invalids'
Miss S.F.A. Caulfield, one of our most valued contributors, has just published a handbook on "Home Nursing,"* which we recommend our readers to procure for themselves, n order that they may be able, upon any sudden emergency, to undertake with proficiency the important duty of nursing any member of their own household. This is a noble and most humanising occupation for a girl, and is a work which, above all others, is calculated to bring down upon the worker feelings of respect, admiration, and love.
Writing on food for invalids, Miss Caulfield says: - Food must be made to look as attractive as possible, and also cooked so as to please the taste of the invalid. The question of "well-done" and "under-done" meat is a vexed one; but it matters not which may be the prescription of the doctor for ordinary cases if, in any particular one, there be a natural loathing for either mode of dressing. What is eaten with appetite and relish is likely to nourish far more than what is crammed down as a loathsome duty at which the stomach revolts. And as such is the case with some people in reference to slightly cooked meat, on no account should any be presented to them that they will regard with abhorrence and heaving of the stomach. I have known an invalid turn from even a fairly-cooked slice of meat, and say he "was not hungry," but when I stuck a little scrap on a toasting fork, and held it in the fire till scorched, and, while almost too hot to eat, I put a scrap of fresh butter on it, and a sprinkle of pepper, he ate it at once, and asked for more, and thus got a light meal that he not only enjoyed, but that did him good. We do not make light of the rules prescribed by science - very far from it - but we cannot for their sake dare to set aside the laws of kindness and common sense, which have their own time for supremacy, if only the nurse have the judgment to decide on the when.
Much discretion must be observed in allowing the patient to have his own way. Never thwart his trifling fancies if at all permissible to indulge them. He will mind you the more when you must have submission. For instance, let him choose his own position, however awkward it may look; e must know which muscles are mot weary, and how to give them relief, and he wants variety. Lying on the back is often the most distressing of all positions, and should not be insisted upon. Remember how often an infant's crying is stopped by turning on its stomach; it brings relief to internal pain, and new rest to the tired frame; and where there is a cough, or difficulty in breathing, to turn over on the stomach and rest on the elbows, or lie down and lay the face just at the edge of the pillow, will usually put the patient to sleep.
Sick people do not like their soup, tea, or other drinks spilt into the saucer, nor to return to an old piece of jelly or pudding which they have not been able to finish. All that they have tasted should be at once removed, and fresh brought in when required, a rule which holds good as regards lemonade or such-like beverages, which should be poured fresh from the jug into a clean glass. But never leave even the untouched supply in the jug or dish in the sick chamber. Germs grow quickly in organic matter, and in all liquids. Milk and soup, and any description of food, may receive and spread infection. Vessels employed for milk, or any such drinks, the feeding cup included, must be scalded out with boiling water.
It may be desirable for the patient to take warm "slops" and milk puddings. Take care not to nauseate the poor creature with more than really must be taken, in change with other things. I have heard a patient say, "How sickly those tasteless sops are!" Why destroy the little inclination for food which he has by loading him with what he dislikes? The importance of cultivating any little returning fancy for food - while under the influence of confinement to one room, loss of exercise, of sleep, of permission to eat a variety of things, all combined with depression of spirits, bodily pain, and a stomach oppressed with drugs - cannot be too strongly insisted upon. Unless attractive, it will not stimulate the flow of that secretion of the mouth which is absolutely requisite to promote digestion.
In cases where there is a strong tendency to sickness, endangering the loss both of food and medicine, the nurse must have recourse to ice. A small scrap that can be swallowed entire, should be given immediately before the dose, and a similar piece immediately after it. In the same way, when giving cold chicken broth in strong jelly (which a sick person can retain better than any other kind of food), or in giving a spoonful of consommé, administered in dessert, or even teaspoons, at considerable intervals one from another, ice should be given both before and after it Should the nausea be obstinate, a mustard plaster on the pit of the stomach is likely to relieve it; and, in still more serious cases of disposition to vomit, as for instance, when at sea, and where haemorrhage is feared, the use of an indiarubber ice bag will reduce the symptoms when nothing else will. It is a sort of long belt with a brass clasp, divided into three or four pocket inside. The ice should be broken into very small pieces, and when secured by the clasp, the bag should be laid down the spine from the nape of the neck. The result will probably be demonstrated at once. The spinal cord being connected with the brain, the brain powerfully influenced by the stomach, and the latter by the brain, relief is almost immediate, and sleep will probably supervene. But it should be a golden rule never to attempt strong remedies unless simple ones have failed, and no medical man can be obtained to give advice.
While on the subject of food, there is one rule to which I attach much importance. In cases of extreme weakness let no word be uttered by the patient for a full hour after his dinner, nor at least for half an hour after breakfast and tea. It would be expedient for the nurse to retire into the ante-room for that time, leaving the door ajar, and telling him the reason of her so doing. There is more exhaustion produced by conversation than is generally imagined, and in cases of pulmonary disease, bronchitis, and sore throat, this is felt by the sick. But the fact that the brain and stomach, so closely connected as they are, should not be simultaneously set at work is quite sufficient argument, apart from all physical fatigue entailed.
* SICK NURSING AT HOME. By S.F.A. Caulfield. Published at 170, Strand.
Writing on food for invalids, Miss Caulfield says: - Food must be made to look as attractive as possible, and also cooked so as to please the taste of the invalid. The question of "well-done" and "under-done" meat is a vexed one; but it matters not which may be the prescription of the doctor for ordinary cases if, in any particular one, there be a natural loathing for either mode of dressing. What is eaten with appetite and relish is likely to nourish far more than what is crammed down as a loathsome duty at which the stomach revolts. And as such is the case with some people in reference to slightly cooked meat, on no account should any be presented to them that they will regard with abhorrence and heaving of the stomach. I have known an invalid turn from even a fairly-cooked slice of meat, and say he "was not hungry," but when I stuck a little scrap on a toasting fork, and held it in the fire till scorched, and, while almost too hot to eat, I put a scrap of fresh butter on it, and a sprinkle of pepper, he ate it at once, and asked for more, and thus got a light meal that he not only enjoyed, but that did him good. We do not make light of the rules prescribed by science - very far from it - but we cannot for their sake dare to set aside the laws of kindness and common sense, which have their own time for supremacy, if only the nurse have the judgment to decide on the when.
Much discretion must be observed in allowing the patient to have his own way. Never thwart his trifling fancies if at all permissible to indulge them. He will mind you the more when you must have submission. For instance, let him choose his own position, however awkward it may look; e must know which muscles are mot weary, and how to give them relief, and he wants variety. Lying on the back is often the most distressing of all positions, and should not be insisted upon. Remember how often an infant's crying is stopped by turning on its stomach; it brings relief to internal pain, and new rest to the tired frame; and where there is a cough, or difficulty in breathing, to turn over on the stomach and rest on the elbows, or lie down and lay the face just at the edge of the pillow, will usually put the patient to sleep.
Sick people do not like their soup, tea, or other drinks spilt into the saucer, nor to return to an old piece of jelly or pudding which they have not been able to finish. All that they have tasted should be at once removed, and fresh brought in when required, a rule which holds good as regards lemonade or such-like beverages, which should be poured fresh from the jug into a clean glass. But never leave even the untouched supply in the jug or dish in the sick chamber. Germs grow quickly in organic matter, and in all liquids. Milk and soup, and any description of food, may receive and spread infection. Vessels employed for milk, or any such drinks, the feeding cup included, must be scalded out with boiling water.
It may be desirable for the patient to take warm "slops" and milk puddings. Take care not to nauseate the poor creature with more than really must be taken, in change with other things. I have heard a patient say, "How sickly those tasteless sops are!" Why destroy the little inclination for food which he has by loading him with what he dislikes? The importance of cultivating any little returning fancy for food - while under the influence of confinement to one room, loss of exercise, of sleep, of permission to eat a variety of things, all combined with depression of spirits, bodily pain, and a stomach oppressed with drugs - cannot be too strongly insisted upon. Unless attractive, it will not stimulate the flow of that secretion of the mouth which is absolutely requisite to promote digestion.
In cases where there is a strong tendency to sickness, endangering the loss both of food and medicine, the nurse must have recourse to ice. A small scrap that can be swallowed entire, should be given immediately before the dose, and a similar piece immediately after it. In the same way, when giving cold chicken broth in strong jelly (which a sick person can retain better than any other kind of food), or in giving a spoonful of consommé, administered in dessert, or even teaspoons, at considerable intervals one from another, ice should be given both before and after it Should the nausea be obstinate, a mustard plaster on the pit of the stomach is likely to relieve it; and, in still more serious cases of disposition to vomit, as for instance, when at sea, and where haemorrhage is feared, the use of an indiarubber ice bag will reduce the symptoms when nothing else will. It is a sort of long belt with a brass clasp, divided into three or four pocket inside. The ice should be broken into very small pieces, and when secured by the clasp, the bag should be laid down the spine from the nape of the neck. The result will probably be demonstrated at once. The spinal cord being connected with the brain, the brain powerfully influenced by the stomach, and the latter by the brain, relief is almost immediate, and sleep will probably supervene. But it should be a golden rule never to attempt strong remedies unless simple ones have failed, and no medical man can be obtained to give advice.
While on the subject of food, there is one rule to which I attach much importance. In cases of extreme weakness let no word be uttered by the patient for a full hour after his dinner, nor at least for half an hour after breakfast and tea. It would be expedient for the nurse to retire into the ante-room for that time, leaving the door ajar, and telling him the reason of her so doing. There is more exhaustion produced by conversation than is generally imagined, and in cases of pulmonary disease, bronchitis, and sore throat, this is felt by the sick. But the fact that the brain and stomach, so closely connected as they are, should not be simultaneously set at work is quite sufficient argument, apart from all physical fatigue entailed.
* SICK NURSING AT HOME. By S.F.A. Caulfield. Published at 170, Strand.
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.
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.
Tuesday, 24 May 2016
17 July 1880 - 'Nursing as a Profession' by S.F.A. Caulfield
I am given to understand that many of the readers of this paper are anxious to obtain all the information that can be procured on the subject of nursing, with a view to its selection as their vocation in life. The task of writing an article on this question is one of some little difficulty. Although regarding it as a grand profession, and one supplied with a staff most inadequate in numbers for a population such as ours, I decline the responsibility of recommending it, or of dissuading those disposed to join its ranks. According to the rough calculation made, and that probably under the mark, "to nurse the sick of all England properly, twenty-five thousand trained nurses, officered by one thousand fully-trained lady-superintendents, are required." In such hands with the work to be done could be fairly proportioned.
Before supplying any information as to the schools and hospitals in which the requisite training can be obtained, the individual qualifications for a nurse should be carefully considered. These may be classed as mental, moral, and physical; each and all being indispensible in a "probationer."
Under the mental and moral she must possess good temper, self-control, patience, punctuality, cheerfulness, and a willing obedience to those in authority over her. Under the physical, good health, good sight, a delicate touch, quickness of hearing, dexterous fingers, cleanliness, and suitability of age. A chronic cough, a heavy tread, a tendency to faint, or to attacks of hysterics, any description of deformity, or repulsiveness in appearance and expression, would disqualify a candidate for permanent employment as a nurse.
Furthermore, it is only fair to those having so arduous a calling in contemplation, to prepare them for loss of rest, painful scenes, and the necessity for the performance of every office that one human being could perform for another, both to relieve suffering, and to render the surroundings of a sick bed as comfortable and cheerful as possible.
No "fine lady" who calls any charitable service "menial work" should adopt such a vocation. And besides the trial of performing personally repugnant and painful duties, the ill-temper, ingratitude, and fretfulness of her charge must all be anticipated, and accepted patiently, as a part of the sacrifice that a nurse has to make.
Nursing should not be lightly undertaken, nor merely as a means of obtaining a livelihood. A competence, a home, an interest in life, and in some cases a small pension, are to be found by the professional nurse, but certainly not a fortune.
Judging from those whom I have seen or known, they seem to be happy and contented, and even cheerful; yet with a certain amount of gravity, which an intimacy with so much suffering must inevitably produce. But the cheerfulness can be quite as naturally accounted for in the fact that, they are able to assuage that pain, to aid so much in the cures effected, and to comfort the sad and sorrowful. You may now weigh the blessedness of the work against all its trials and self-denials, and then deliberately make your decision.
The profession is divided into three departments - viz., District Nursing, Hospital Nursing, and Private Nursing. Thus the intending nurse has some choice permitted her in the description of work to be done, and the external circumstances with which she would prefer to be surrounded. Beginning with the first-named departments - giving, as I consider, the severest description of work - I cannot do better than quote from Florence Nightingale, when she describes the extra labour incumbent on the "district nurse," over and above the personal attendance / sick. For instance, she goes into a dirty, squalid-looking room, and before she can hope for any change for the better in her patient, she must "recreate the home," and "show it clean for once; sweep and dust away; empty and wash out the dirt; air and disinfect; rub the windows, sweep the fireplace; carry out, shake, and replace the scraps of carpet; lay them down again, fetch fresh water, fill the kettle, wash the patient and the children, and make the bed." Besides this she must "bring such sanitary defects as produce sickness and death to the notice of the public officer whom it concerns."
Having shown the dark side of the picture, I proceed to tell that the district nurse is well cared for when she returns to the home provided for her, and the pleasant companionship of those who have selected the same honourable profession. I need not enter into particulars, as the intending nurse should visit the several institutions where training is to be obtained. Let her see the home for herself, learn its rules, and take a view of the prospect which would open before her, as a probationer in one of the twenty-two institutions that train for themselves, or supply other hospitals.
The "Institution for Nursing Sisters" in Devonshire-square, is the oldest of the kind, and was established in 1840. It provides no less than 20 districts each with a nurse free of charge, but untrained; and trained ones for those who can pay for their services.
With the "Metropolitan and National Association' for providing trained nurses for the poor (free of charge) I have had some acquaintance, for through the kindness of Miss Florence Lees, late Superintendent-General of the institution, I have inspected every part of the central home in Bloomsbury-square. The four branch homes connected with it are all governed by the same regulations. In these houses candidates reside for a month on trial, and if suitable are passed on to the Hospital Training School, as "nurse probationers," to receive a year's training in hospital nursing. They are then returned to the Central Home to be trained in "district nursing," receiving technical class instruction during a period of three months, when, if found satisfactory, they are entered on a register, and placed on the staff of the association. A member so enrolled is expected to continue in the service of the association for three years, three months' notice being given on either side, should a termination of the engagement be desired. Nurse candidates have to pay £5 on admission to the home, to cover the expense of her board, lodging, and washing during the month of trial.
For the year's training in St. Thomas's Hospital Training School the probationers pay £15 on admission, and £15 after six months of residence and training. For this she will have full board, 1s 6d a week for washing, a uniform dress, a separate furnished bed-room, and the use of a common sitting-room. The instruction is paid for out of the "Nightingale Fund," but in case of dismissal, or of voluntary withdrawal the cost will be charged.
When the probationer returns to the home, after the year's training, she will have to pay in advance £14 for three months' training in "district nursing," class instruction, books, full board, and extras; 2s 6d allowance weekly for washing; a separate room (or compartment), and the general sitting-room. Once fully trained, and on the staff of the association, the nurse receives a salary, payable quarterly, of £35 for the first year, £38 for the second, and so on, increasing by £3 yearly until the sixth year, when it will amount to £50 per annum, in addition to their uniform dress, full board, separate bed-room, washing, etc.
From giving a sketch of the terms on which the candidate enters the "Metropolitan Nursing Association," I will give a general idea of those of other institutions. The age at which a candidate is taken varies between twenty-five and forty. At St. Thomas's Hospital she enters as a "Nightingale probationer," at a rising salary, beginning at £10, with partial uniform; and her services are at the disposal of the committee for a period of four years. Here ladies may be trained on a payment of a £30 premium, and after one year will receive a salary rising from £25 to £50, but they are expected to give their service for four years.
At the Royal Free Hospital (Gray's Inn-road) the nursing is done by the "Training School of Protestant Nurses," of Cambridge-place, Paddington, and probationers begin with a salary equivalent to fourteen guineas, rising to £25. Here they give a three months' training at the rate of £1 15s per week, or £30 for one year. In this latter case they are required to give their services for a period of two years extra.
At the Middlesex Hospital lady pupils are receives for not less than six months at one guinea a week. Probationers begin with a salary of £12, rising to £18 after the first year, and then by £2 yearly up to £26.
At the London Hospital "nurse probationers" receive £12 on admission, rising to £21; but they are not promoted to be "sisters." These latter are educated women entering as "sister probationers," whose salary begins at £25 six months after their admission. Both these and the nurses are required to remain three years in the hospital.
At King's College and Charing Cross Hospitals, probationers receive £15 per annum and their uniform. They are bound for three years' service, an engagement renewable for another three years, with a rising salary. Both hospitals are nursed by the community of "St. John's House," Norfolk-street, Strand. Pupil nurses for district work or other institutions are trained for six months at the rate of £24 per annum. Ladies also are trained for not less than three months at a rate of £50 per annum.
At Westminster Hospital probationers begin with £16 per annum. If willing to pay £52 for their training, they are not required to remain there beyond it.
At University College Hospital nurses receive £16 per annum, and everything found for them.
St Mary's Hospital, Paddington, trains gentlewomen and nurses desirous of qualifying for public appointments, or private nursing for one year. If required by the matrons so to do, they remain for fifteen months. They serve then as assistant-nurses, and are paid at the rate of £10 and uniform. Those who pass this year of probation satisfactorily are entered in a register, and recommended for employment.
The Deaconess Institution and Training Hospital will train women of known religious character gratuitously, if they propose to become deaconesses; and will supply them as nurses to public institutions at £12 per annum. (The Green, Tottenham, N.) These have a branch institution at Mildmay Park, and a hospital at Poplar.
The Institution of Nursing Sisters, in Devonshire-square, supply's Guy's Hospital, where the annual salary of sisters amounts to £50 and dresses, and which has a Superannuation Fund for them.
Nurses are also trained at St. Bartholomew's and other institutions in town, including the Children's Hospital (Great Ormond-street), where lady pupils are received of from 21 to 35 years of age, at one guinea a week; and nurses of from 17 to 35 years at 7s 6d a week, for not less than six months. At the London North-Eastern Hospital ladies are received for training at a guinea a week.
In Edinburgh and Dublin, at Liverpool, Manchester, Cambridge, Leeds, Winchester, Leicester, Rhyl, Nottingham, and elsewhere, training is to be obtained.
There are other descriptions of work connected with the profession of nursing, such as, for instance, tending the insane, into which it is not necessary that I should enter in this article. Were I to give my private opinion as to the nature of the work to be performed, in the three departments to which I have referred I should say that "district nursing" was the severest of all; hospital nursing ranking next, in the trying nature of its experiences; and private nursing the least troublesome, allowing, of course, for some exceptional cases.
I have only named a few of the training schools for intending probationers, amongst the twenty-two or more valuable institutions which exist in London or its suburbs. Of the "Bible and Domestic Female Mission" at 13, Hunter-street, of which Mrs. Ranyard was founder, I should have made a particular mention, but that our magazine is especially designed for young people, whereas the nurses connected with this missionary society are required to be nearly of middle age. Still, the young nurse may have this institution in view, as providing a sphere of usefulness for her of a two-fold character in her after life.
Of such a sacred vocation as that of nursing it may indeed be truly said that
"If it is twice blest;
It blesseth him that gives, and him that takes."
Before supplying any information as to the schools and hospitals in which the requisite training can be obtained, the individual qualifications for a nurse should be carefully considered. These may be classed as mental, moral, and physical; each and all being indispensible in a "probationer."
Under the mental and moral she must possess good temper, self-control, patience, punctuality, cheerfulness, and a willing obedience to those in authority over her. Under the physical, good health, good sight, a delicate touch, quickness of hearing, dexterous fingers, cleanliness, and suitability of age. A chronic cough, a heavy tread, a tendency to faint, or to attacks of hysterics, any description of deformity, or repulsiveness in appearance and expression, would disqualify a candidate for permanent employment as a nurse.
Furthermore, it is only fair to those having so arduous a calling in contemplation, to prepare them for loss of rest, painful scenes, and the necessity for the performance of every office that one human being could perform for another, both to relieve suffering, and to render the surroundings of a sick bed as comfortable and cheerful as possible.
No "fine lady" who calls any charitable service "menial work" should adopt such a vocation. And besides the trial of performing personally repugnant and painful duties, the ill-temper, ingratitude, and fretfulness of her charge must all be anticipated, and accepted patiently, as a part of the sacrifice that a nurse has to make.
Nursing should not be lightly undertaken, nor merely as a means of obtaining a livelihood. A competence, a home, an interest in life, and in some cases a small pension, are to be found by the professional nurse, but certainly not a fortune.
Judging from those whom I have seen or known, they seem to be happy and contented, and even cheerful; yet with a certain amount of gravity, which an intimacy with so much suffering must inevitably produce. But the cheerfulness can be quite as naturally accounted for in the fact that, they are able to assuage that pain, to aid so much in the cures effected, and to comfort the sad and sorrowful. You may now weigh the blessedness of the work against all its trials and self-denials, and then deliberately make your decision.
The profession is divided into three departments - viz., District Nursing, Hospital Nursing, and Private Nursing. Thus the intending nurse has some choice permitted her in the description of work to be done, and the external circumstances with which she would prefer to be surrounded. Beginning with the first-named departments - giving, as I consider, the severest description of work - I cannot do better than quote from Florence Nightingale, when she describes the extra labour incumbent on the "district nurse," over and above the personal attendance / sick. For instance, she goes into a dirty, squalid-looking room, and before she can hope for any change for the better in her patient, she must "recreate the home," and "show it clean for once; sweep and dust away; empty and wash out the dirt; air and disinfect; rub the windows, sweep the fireplace; carry out, shake, and replace the scraps of carpet; lay them down again, fetch fresh water, fill the kettle, wash the patient and the children, and make the bed." Besides this she must "bring such sanitary defects as produce sickness and death to the notice of the public officer whom it concerns."
Having shown the dark side of the picture, I proceed to tell that the district nurse is well cared for when she returns to the home provided for her, and the pleasant companionship of those who have selected the same honourable profession. I need not enter into particulars, as the intending nurse should visit the several institutions where training is to be obtained. Let her see the home for herself, learn its rules, and take a view of the prospect which would open before her, as a probationer in one of the twenty-two institutions that train for themselves, or supply other hospitals.
The "Institution for Nursing Sisters" in Devonshire-square, is the oldest of the kind, and was established in 1840. It provides no less than 20 districts each with a nurse free of charge, but untrained; and trained ones for those who can pay for their services.
With the "Metropolitan and National Association' for providing trained nurses for the poor (free of charge) I have had some acquaintance, for through the kindness of Miss Florence Lees, late Superintendent-General of the institution, I have inspected every part of the central home in Bloomsbury-square. The four branch homes connected with it are all governed by the same regulations. In these houses candidates reside for a month on trial, and if suitable are passed on to the Hospital Training School, as "nurse probationers," to receive a year's training in hospital nursing. They are then returned to the Central Home to be trained in "district nursing," receiving technical class instruction during a period of three months, when, if found satisfactory, they are entered on a register, and placed on the staff of the association. A member so enrolled is expected to continue in the service of the association for three years, three months' notice being given on either side, should a termination of the engagement be desired. Nurse candidates have to pay £5 on admission to the home, to cover the expense of her board, lodging, and washing during the month of trial.
For the year's training in St. Thomas's Hospital Training School the probationers pay £15 on admission, and £15 after six months of residence and training. For this she will have full board, 1s 6d a week for washing, a uniform dress, a separate furnished bed-room, and the use of a common sitting-room. The instruction is paid for out of the "Nightingale Fund," but in case of dismissal, or of voluntary withdrawal the cost will be charged.
When the probationer returns to the home, after the year's training, she will have to pay in advance £14 for three months' training in "district nursing," class instruction, books, full board, and extras; 2s 6d allowance weekly for washing; a separate room (or compartment), and the general sitting-room. Once fully trained, and on the staff of the association, the nurse receives a salary, payable quarterly, of £35 for the first year, £38 for the second, and so on, increasing by £3 yearly until the sixth year, when it will amount to £50 per annum, in addition to their uniform dress, full board, separate bed-room, washing, etc.
From giving a sketch of the terms on which the candidate enters the "Metropolitan Nursing Association," I will give a general idea of those of other institutions. The age at which a candidate is taken varies between twenty-five and forty. At St. Thomas's Hospital she enters as a "Nightingale probationer," at a rising salary, beginning at £10, with partial uniform; and her services are at the disposal of the committee for a period of four years. Here ladies may be trained on a payment of a £30 premium, and after one year will receive a salary rising from £25 to £50, but they are expected to give their service for four years.
At the Royal Free Hospital (Gray's Inn-road) the nursing is done by the "Training School of Protestant Nurses," of Cambridge-place, Paddington, and probationers begin with a salary equivalent to fourteen guineas, rising to £25. Here they give a three months' training at the rate of £1 15s per week, or £30 for one year. In this latter case they are required to give their services for a period of two years extra.
At the Middlesex Hospital lady pupils are receives for not less than six months at one guinea a week. Probationers begin with a salary of £12, rising to £18 after the first year, and then by £2 yearly up to £26.
At the London Hospital "nurse probationers" receive £12 on admission, rising to £21; but they are not promoted to be "sisters." These latter are educated women entering as "sister probationers," whose salary begins at £25 six months after their admission. Both these and the nurses are required to remain three years in the hospital.
At King's College and Charing Cross Hospitals, probationers receive £15 per annum and their uniform. They are bound for three years' service, an engagement renewable for another three years, with a rising salary. Both hospitals are nursed by the community of "St. John's House," Norfolk-street, Strand. Pupil nurses for district work or other institutions are trained for six months at the rate of £24 per annum. Ladies also are trained for not less than three months at a rate of £50 per annum.
At Westminster Hospital probationers begin with £16 per annum. If willing to pay £52 for their training, they are not required to remain there beyond it.
At University College Hospital nurses receive £16 per annum, and everything found for them.
St Mary's Hospital, Paddington, trains gentlewomen and nurses desirous of qualifying for public appointments, or private nursing for one year. If required by the matrons so to do, they remain for fifteen months. They serve then as assistant-nurses, and are paid at the rate of £10 and uniform. Those who pass this year of probation satisfactorily are entered in a register, and recommended for employment.
The Deaconess Institution and Training Hospital will train women of known religious character gratuitously, if they propose to become deaconesses; and will supply them as nurses to public institutions at £12 per annum. (The Green, Tottenham, N.) These have a branch institution at Mildmay Park, and a hospital at Poplar.
The Institution of Nursing Sisters, in Devonshire-square, supply's Guy's Hospital, where the annual salary of sisters amounts to £50 and dresses, and which has a Superannuation Fund for them.
Nurses are also trained at St. Bartholomew's and other institutions in town, including the Children's Hospital (Great Ormond-street), where lady pupils are received of from 21 to 35 years of age, at one guinea a week; and nurses of from 17 to 35 years at 7s 6d a week, for not less than six months. At the London North-Eastern Hospital ladies are received for training at a guinea a week.
In Edinburgh and Dublin, at Liverpool, Manchester, Cambridge, Leeds, Winchester, Leicester, Rhyl, Nottingham, and elsewhere, training is to be obtained.
There are other descriptions of work connected with the profession of nursing, such as, for instance, tending the insane, into which it is not necessary that I should enter in this article. Were I to give my private opinion as to the nature of the work to be performed, in the three departments to which I have referred I should say that "district nursing" was the severest of all; hospital nursing ranking next, in the trying nature of its experiences; and private nursing the least troublesome, allowing, of course, for some exceptional cases.
I have only named a few of the training schools for intending probationers, amongst the twenty-two or more valuable institutions which exist in London or its suburbs. Of the "Bible and Domestic Female Mission" at 13, Hunter-street, of which Mrs. Ranyard was founder, I should have made a particular mention, but that our magazine is especially designed for young people, whereas the nurses connected with this missionary society are required to be nearly of middle age. Still, the young nurse may have this institution in view, as providing a sphere of usefulness for her of a two-fold character in her after life.
Of such a sacred vocation as that of nursing it may indeed be truly said that
"If it is twice blest;
It blesseth him that gives, and him that takes."
Saturday, 16 January 2016
17 February 1880 - Useful Hints
TO MAKE YEAST - Yeast for home-made bread may be easily made as follows. Boil 1 lb of good flour, 1/4 lb of brown sugar, and 1/2 oz of salt in two gallons of water for one hour. When almost cold, bottle and cork closely. It will be fit for use in twenty-four hours and one pint will make four quarter loaves.
TEA CAKES - 1/4 lb fresh butter, 1/4 lb sifted sugar, 1/2 lb of flour, one egg and a little milk.
BURNS AND SCALDS - Mix limewater and olive oil in equal parts; if you have it at hand, dissolve as much carbonate of soda as possible in it; soak a piece of lint or rag in the mixture, and cover the injured part entirely with it, that it may be kept from the air. Another plan is to make a thick paste of whitening and spread it over the burn.
RULES TO BE OBSERVED IN A SICK CHAMBER.
The first thing to be remembers is that the doctor's orders are to be implicitly obeyed.
Be careful that the room is kept perfectly clean and well aired.
Endeavour always to have a supply of fresh flowers, or, where their scent is too powerful, branches of bright leaves without perfume may be substituted.
Never introduce disagreeable topics, but seek to entertain the patient by some pleasant news or tale, so as to keep the mind as much as possible from dwelling on suffering and disease.
Never ask a sick person what he will have to eat, but carefully procure such food as is suitable. Should the patient particularly desire anything, hasten to satisfy the wish unless it would be hurtful. Serve the food in small portions in an appetising manner. A small dish well cooked and served awakens an appetite, whilst a large and carelessly dressed repast produces nausea and disgust.
Be very patient and of an even and cheery temper when attending on a suffering invalid. Remember that illness often renders us unreasonable and capricious. Listen with kindness and sympathy to the complaints and murmurings of the poor sufferer.
TEA CAKES - 1/4 lb fresh butter, 1/4 lb sifted sugar, 1/2 lb of flour, one egg and a little milk.
BURNS AND SCALDS - Mix limewater and olive oil in equal parts; if you have it at hand, dissolve as much carbonate of soda as possible in it; soak a piece of lint or rag in the mixture, and cover the injured part entirely with it, that it may be kept from the air. Another plan is to make a thick paste of whitening and spread it over the burn.
RULES TO BE OBSERVED IN A SICK CHAMBER.
The first thing to be remembers is that the doctor's orders are to be implicitly obeyed.
Be careful that the room is kept perfectly clean and well aired.
Endeavour always to have a supply of fresh flowers, or, where their scent is too powerful, branches of bright leaves without perfume may be substituted.
Never introduce disagreeable topics, but seek to entertain the patient by some pleasant news or tale, so as to keep the mind as much as possible from dwelling on suffering and disease.
Never ask a sick person what he will have to eat, but carefully procure such food as is suitable. Should the patient particularly desire anything, hasten to satisfy the wish unless it would be hurtful. Serve the food in small portions in an appetising manner. A small dish well cooked and served awakens an appetite, whilst a large and carelessly dressed repast produces nausea and disgust.
Be very patient and of an even and cheery temper when attending on a suffering invalid. Remember that illness often renders us unreasonable and capricious. Listen with kindness and sympathy to the complaints and murmurings of the poor sufferer.
Monday, 26 May 2014
8 March 1884 - 'A Few Hints on Nursing for Our Girls' by A Hospital Nurse - Part 1
The fact that almost every woman has at some time to act as a sick-nurse is generally acknowledged, but only very little provision is made for training our girls to be intelligent and efficient aids to the doctor, when their turn comes to take the management of a sick room. I wish on this occasion as a nurse of some experience to address the readers of THE GIRL’S OWN PAPER as young nurses, and to give a few simple hints which may be useful either in attending sick friends, or on meeting with some of those cases of accident to which we are liable every day of our lives; cases in which a little knowledge and presence of mind may avert a great deal of trouble, sometimes may save even life itself.
To begin with, I have a piece of encouragement to give you as inexperienced nurses, if you are suddenly called upon to act. Remember that loving care, unselfishness, and obedience will make up for a great deal. If you can get your patient to like your attendance, and not to object to receive your assistance when necessary, you may, by obeying your doctor in every point, carry through a case very creditably without regular training. Still, study and experience are not to be undervalued; for one thing, even if you have had but a little, it is a comfort to yourself to know that you have at least a fair idea how things ought to be done from having done them before, or having seen others do them. I know from personal experience that even when the patient and friends are satisfied, and the doctor complimentary, there is yet a keen sense of incompetence, or at least of uncertainty; a feeling that if so-and-so had been done otherwise it would have been better; a haunting fear of something absolutely necessary for the well-being of the patient being left undone. This is all very foolish. When we go into hospital for training, we learn that what we have to do is carry out orders; not to originate, or to fancy that things have been forgotten.
However, we must come now to practical matters. Suppose you have a member of your family laid up at home with a bad knee and the doctor orders a blister, would you know how to apply it? First be sure you know the exact place where it is to go on. Some doctors mark it on the patient’s body, and it is a very good plan. The place should be washed clean, of course, leaving the mark. When you get the blister-plaster, if there is a little bit of stuff like silver paper over the flies (the brown part), take it off before applying, unless the patient’s skin is exceedingly tender. Warm the blister slightly, holding the back to the fire. The doctor will tell you about how long it is to stay on and the signs by which you will know when it is to be taken off. The ointment for dressing the blister should be spread upon a piece of lint or old linen cut to the right size before the plaster is removed. Have a pair of sharp scissors ready or, failing them, a needle will do. Then take the blister off as gently as you can without dragging. The best way to do this is to take it with both hands and draw it towards the middle from the edges. Have a piece of cotton-wool or old linen to catch the “serum” as the fluid that runs out is called, and if the blister has risen much it may be well to put a saucer underneath to save the sheets. In hospitals there are trays for such purposes. Snip or prick the blister at its lowest part, and the fluid will run out. If possible, do not let any flow over the healthy skin, as it is apt to scald. You may help it out with a little gentle pressure. There will be some dead loose skin. Opinions differ as to whether it should be cut off at first or not. It will come away in time. It is always removed if the blister is to be kept “open”; but the doctor will explain this to you. By keeping it open I do not mean leaving it uncovered; this is never done. I mean keeping up the irritation by means of some smarting ointment.
A blister should be dressed at least every morning and evening until the place heals up. In some parts of the body the dressing will keep its place if laid on, but it is generally well either to bandage it loosely or to fasten it down with two or three strips of strapping or diachylon plaster. If you use this for any purpose, heat it first by holding the back – the linen side – to the fire, or by putting it round a vessel of hot water. Otherwise unless the skin is very hot it will not stick.
Sometimes a poultice has to go on when the blister comes off. In this case if you have to attend to all yourself, you must open the blister first, and cover the place with a piece of lint or old linen, while you make the poultice, which would be quite cold if you made it first, besides, it does not take long to prepare, and ointment is often very tedious to spread.
If you are set to make a poultice and are not in good practice, do not be afraid of having it too hot. It is much more likely to be too cool with all your pains. Do not be afraid, either, of having it too big if for a surgical case. In poulticing the breast cut a hole for the nipple.
First spread out your linen or whatever you are going to spread upon so as not to waste time after the poultice is mixed, then scald out the vessel in which you are going to make it. Throw away that water and pour in some more, as much as you think will do, from a kettle hissing and boiling furiously, put your meal in by degrees, stirring it in quickly until you have a thick smooth paste with no dry meal at the edges of the bowl. Always stir in the same direction, not backwards and forwards. Turn out on your linen and spread it evenly, about a quarter of an inch in thickness; cut the edges straight, leaving a good margin of linen to turn in like a hem. The linen should be double. I have often seen poultices spread on lint, but it is great extravagance, for large ones, at any rate. Tow does very well for the purpose, but is requires some practice to lay it properly, and a badly-made tow poultice is very uncomfortable. Dipping the knife or spatula into boiling water makes it easier to spread the meal.
When taking off a poultice or any dressing, if it sticks never drag it; moisten it slightly with warm water and it will come away. If a poultice is likely to remain a good while unchanged, and is over an open sore, a very little oil spread upon it will keep it from sticking. Some people recommend oil with all linseed poultices. I do not. It is hard to put little enough, and it is rather dirty. A properly made poultice ought not to stick, but in a case where one might not like to disturb a patient during the night I should use oil, as if left on many hours a poultice is apt to get dry.
A mustard poultice is an old-fashioned remedy for cold on the chest. The approved way to make it was to use cold water, and spread it on brown paper with a little bit of muslin over the front to protect the skin. This could not be kept on long. Perhaps ten minutes or a quarter of an hour is as long as one could bear it from the time it is first felt. Nowadays I generally see linseed meal mixed with the mustard, or mustard leaves are used. They are very good and clean and easily applied. When you take off a mustard leaf lay a folded pocket-handkerchief or a piece of old soft linen over the place.
The nicest way of making a bread poultice that I know is to grate up stale bread in a colander, pour a little boiling water upon it, and stir it up with a knife. It takes much less water than you would think, as it should be a pretty stiff paste, and if sloppy it is no good and will fall to pieces before coming off. With a little oil spread over it, it is a very soothing application but this does not make a very hot poultice. If heat is required, and you use bread, first scald out your vessel, put in a little boiling water and then some coarsely crumbled bread, stir it, and leave by the fire or in the oven to soak for five minutes or so.
Most extraordinary mistakes have been made about blisters and poultices, though they seem simple things. It is not fair, however, to expect people to know what they have never been taught.
Not long ago I left a blister on a patient, and asked his wife, a middle-aged woman, if she knew what to do when the time came to take it off. She told me that she had never seen a person blistered but once, and then she fainted. The first blister I put on, many years ago, did not rise. If it had risen I should certainly not have known how to treat it, though probably some one in the house could have told me. It is, however, very stupid and very wrong of people nursing the sick not to ask for directions in a case of this kind if they are not quite sure that they know what to do. In some arts we learn a good deal by one of our own mistakes, but a nurse’s mistakes mean suffering to her patient, and this being the case she ought never to be ashamed to confess ignorance and ask for instructions.
A clever person not long ago who was too lazy or too proud to ask for directions in a simple matter, set about making a linseed poultice by blending up the meal with cold water – I suppose with a vague idea of making starch. If it ever reached the spreading stage it must have been a nice sticky mess. Many years ago a doctor in the North of Ireland, prescribing for one of his out-patients, gave the wife a blister, a bottle of medicine, and some other things that were required, with, as he thought, full directions how to use them. Calling a few days afterwards to see how the man was getting on, he found that the woman had put all he had given her into a saucepan and boiled it, giving the mess afterwards to the patient as a dose. The doctor said that the man would most certainly have been poisoned, only that the flies of which the blister was composed made him very sick, and he brought the whole thing up, so that after all no great harm was done.
Fomentations or stupes are often ordered to relieve pain. There is a particular kind of material called spongio-piline used in hospital for the purpose, but a stupe can be made quite well by wringing out coarse flannel in boiling water. If not wrung every day, a fomentation is about the most miserably uncomfortable thing that can be imagined, and is almost certain to give the patient cold. A good way to prepare one is get a strong towel and lay iyt over a wash-hand basin; then lay your flannel in the towel, and pour boiling water upon it until it is well soaked. By twisting the ends of the towel in opposite directions, you will not scald your hands, and you will be able to wring the flannel dry. Two people can prepare a fomentation much more easily than one. To relieve acute pain opium is sprinkled on the flannel before applying, and turpentine is sometimes ordered as a counter-irritant. If the stupe is to be plain hot water, bring the flannel to the bedside in the towel so as to keep it as hot as possible, shake it up just before applying, and it will keep warm much longer. Fold a dry towel and lay it over the fomentation when you put it on. In hospitals a piece of waterproof material is generally used for this purpose. Sometimes these stupes have to be changed very frequently, but the doctor will tell you this. If you have many to prepare it will be worthwhile to make a regular “wringer”, by running a stick or lath into a hem at each end of the towel. By twisting these sticks in opposite directions, you can wring with little or no fatigue. The wrists soon get tired doing it the other way.
When a doctor asks you any question about yourself or anyone else, be quite sure you understand what he means. If you do not, tell him so. I remember once hearing a girl unintentionally quite deceiving a physician about a shivering fit she thought she had had; it was probably just a little chilliness, but she made herself out so very much worse than she really was, that he thought she must have had a severe rigor, as it is called, and sent her to the fever hospital, where, I believe, they rather laughed at her and sent her away in a day or two as having nothing the matter.
Another thing: When you get a prescription made up at a dispensary, be sure you understand how the medicine is to be given. Doctors have ways of their own of writing directions, meant for the dispenser, not for you. A girl once brought me a piece of paper that had been given her with a bottle; from having been some time in the hospital as a nurse I could explain it to her, but before I went I could have made nothing of it. In most of the London hospitals I believe they have printed labels for all the bottles, “Take two tablespoonfuls three times a day” and so on. It is a good plan and ought to be universally adopted. If you do not understand the directions, however, and ask the dispenser, he will always tell you when and how the physic is to be taken.
There are a few simple things to be noticed in giving medicines that you may as well understand. It may perhaps be an unnecessary caution to tell you if you are directed to give, say, a tablespoonful of anything, only to measure it in the spoon and bring it to the patient in a cup or glass. I have known a spoon put to the sick person’s lips with the dose. A moment’s thought will convince you that is a most slovenly and uncomfortable proceeding. Always wash your cup and spoon immediately after giving medicine. If you have to give castor oil, first rinse your vessel and spoon in cold water; then put your milk, or brandy-and-water, or whatever you are going to give it on, into the glass, measure the oil in a spoon, and pour it as carefully as possible into the middle of the glass, not letting a drop touch the sides. It is well to pour out castor oil near the patient, as carrying it across a room is apt to shake it up . When it is desirable to make the oil act quickly it should be stirred up in hot water. This must be a most abominable dose; but, given as I have described, castor oil need not be hard to take at all. However, some children, and grown people too, are very obstinate, and if this medicine is ordered will point-blank refuse to take it. For them we had a plan in hospitals of shaking the oil up with about twice the quantity of peppermint-water in a soda-water bottle. Any bottle, of course, would do, provided it was clean and big enough. It takes a good deal of shaking until it comes into a sort of creamy stuff. It seems to me that this would be far nastier than the oil in its usual form; but I am bound to say that I have seen a boy who would roar for half an hour if you suggested castor oil in his hearing, but would take this mixture without the slightest fuss. A nurse, who has had large experience, told me that she never knew a child object to it.
Sometimes when a pill is ordered for a patient one is rather put aback by the statement that he or she never did and never could swallow such a thing. I have sometimes been able to persuade one of these incompetent people to try a very simple plan, which I never knew to fail even with a small pill, which is more difficult to swallow than a big one. Put it back as far as possible on the tongue, and take a drink of water; it is almost sure to go down. In case of a child, however, or a patient who is determined that he cannot take a pill on any terms, the best way i s to scrape it up and mix it with a little sugar in a teaspoon. Then, of course, there is no further difficulty.
To begin with, I have a piece of encouragement to give you as inexperienced nurses, if you are suddenly called upon to act. Remember that loving care, unselfishness, and obedience will make up for a great deal. If you can get your patient to like your attendance, and not to object to receive your assistance when necessary, you may, by obeying your doctor in every point, carry through a case very creditably without regular training. Still, study and experience are not to be undervalued; for one thing, even if you have had but a little, it is a comfort to yourself to know that you have at least a fair idea how things ought to be done from having done them before, or having seen others do them. I know from personal experience that even when the patient and friends are satisfied, and the doctor complimentary, there is yet a keen sense of incompetence, or at least of uncertainty; a feeling that if so-and-so had been done otherwise it would have been better; a haunting fear of something absolutely necessary for the well-being of the patient being left undone. This is all very foolish. When we go into hospital for training, we learn that what we have to do is carry out orders; not to originate, or to fancy that things have been forgotten.
However, we must come now to practical matters. Suppose you have a member of your family laid up at home with a bad knee and the doctor orders a blister, would you know how to apply it? First be sure you know the exact place where it is to go on. Some doctors mark it on the patient’s body, and it is a very good plan. The place should be washed clean, of course, leaving the mark. When you get the blister-plaster, if there is a little bit of stuff like silver paper over the flies (the brown part), take it off before applying, unless the patient’s skin is exceedingly tender. Warm the blister slightly, holding the back to the fire. The doctor will tell you about how long it is to stay on and the signs by which you will know when it is to be taken off. The ointment for dressing the blister should be spread upon a piece of lint or old linen cut to the right size before the plaster is removed. Have a pair of sharp scissors ready or, failing them, a needle will do. Then take the blister off as gently as you can without dragging. The best way to do this is to take it with both hands and draw it towards the middle from the edges. Have a piece of cotton-wool or old linen to catch the “serum” as the fluid that runs out is called, and if the blister has risen much it may be well to put a saucer underneath to save the sheets. In hospitals there are trays for such purposes. Snip or prick the blister at its lowest part, and the fluid will run out. If possible, do not let any flow over the healthy skin, as it is apt to scald. You may help it out with a little gentle pressure. There will be some dead loose skin. Opinions differ as to whether it should be cut off at first or not. It will come away in time. It is always removed if the blister is to be kept “open”; but the doctor will explain this to you. By keeping it open I do not mean leaving it uncovered; this is never done. I mean keeping up the irritation by means of some smarting ointment.
A blister should be dressed at least every morning and evening until the place heals up. In some parts of the body the dressing will keep its place if laid on, but it is generally well either to bandage it loosely or to fasten it down with two or three strips of strapping or diachylon plaster. If you use this for any purpose, heat it first by holding the back – the linen side – to the fire, or by putting it round a vessel of hot water. Otherwise unless the skin is very hot it will not stick.
Sometimes a poultice has to go on when the blister comes off. In this case if you have to attend to all yourself, you must open the blister first, and cover the place with a piece of lint or old linen, while you make the poultice, which would be quite cold if you made it first, besides, it does not take long to prepare, and ointment is often very tedious to spread.
If you are set to make a poultice and are not in good practice, do not be afraid of having it too hot. It is much more likely to be too cool with all your pains. Do not be afraid, either, of having it too big if for a surgical case. In poulticing the breast cut a hole for the nipple.
First spread out your linen or whatever you are going to spread upon so as not to waste time after the poultice is mixed, then scald out the vessel in which you are going to make it. Throw away that water and pour in some more, as much as you think will do, from a kettle hissing and boiling furiously, put your meal in by degrees, stirring it in quickly until you have a thick smooth paste with no dry meal at the edges of the bowl. Always stir in the same direction, not backwards and forwards. Turn out on your linen and spread it evenly, about a quarter of an inch in thickness; cut the edges straight, leaving a good margin of linen to turn in like a hem. The linen should be double. I have often seen poultices spread on lint, but it is great extravagance, for large ones, at any rate. Tow does very well for the purpose, but is requires some practice to lay it properly, and a badly-made tow poultice is very uncomfortable. Dipping the knife or spatula into boiling water makes it easier to spread the meal.
When taking off a poultice or any dressing, if it sticks never drag it; moisten it slightly with warm water and it will come away. If a poultice is likely to remain a good while unchanged, and is over an open sore, a very little oil spread upon it will keep it from sticking. Some people recommend oil with all linseed poultices. I do not. It is hard to put little enough, and it is rather dirty. A properly made poultice ought not to stick, but in a case where one might not like to disturb a patient during the night I should use oil, as if left on many hours a poultice is apt to get dry.
A mustard poultice is an old-fashioned remedy for cold on the chest. The approved way to make it was to use cold water, and spread it on brown paper with a little bit of muslin over the front to protect the skin. This could not be kept on long. Perhaps ten minutes or a quarter of an hour is as long as one could bear it from the time it is first felt. Nowadays I generally see linseed meal mixed with the mustard, or mustard leaves are used. They are very good and clean and easily applied. When you take off a mustard leaf lay a folded pocket-handkerchief or a piece of old soft linen over the place.
The nicest way of making a bread poultice that I know is to grate up stale bread in a colander, pour a little boiling water upon it, and stir it up with a knife. It takes much less water than you would think, as it should be a pretty stiff paste, and if sloppy it is no good and will fall to pieces before coming off. With a little oil spread over it, it is a very soothing application but this does not make a very hot poultice. If heat is required, and you use bread, first scald out your vessel, put in a little boiling water and then some coarsely crumbled bread, stir it, and leave by the fire or in the oven to soak for five minutes or so.
Most extraordinary mistakes have been made about blisters and poultices, though they seem simple things. It is not fair, however, to expect people to know what they have never been taught.
Not long ago I left a blister on a patient, and asked his wife, a middle-aged woman, if she knew what to do when the time came to take it off. She told me that she had never seen a person blistered but once, and then she fainted. The first blister I put on, many years ago, did not rise. If it had risen I should certainly not have known how to treat it, though probably some one in the house could have told me. It is, however, very stupid and very wrong of people nursing the sick not to ask for directions in a case of this kind if they are not quite sure that they know what to do. In some arts we learn a good deal by one of our own mistakes, but a nurse’s mistakes mean suffering to her patient, and this being the case she ought never to be ashamed to confess ignorance and ask for instructions.
A clever person not long ago who was too lazy or too proud to ask for directions in a simple matter, set about making a linseed poultice by blending up the meal with cold water – I suppose with a vague idea of making starch. If it ever reached the spreading stage it must have been a nice sticky mess. Many years ago a doctor in the North of Ireland, prescribing for one of his out-patients, gave the wife a blister, a bottle of medicine, and some other things that were required, with, as he thought, full directions how to use them. Calling a few days afterwards to see how the man was getting on, he found that the woman had put all he had given her into a saucepan and boiled it, giving the mess afterwards to the patient as a dose. The doctor said that the man would most certainly have been poisoned, only that the flies of which the blister was composed made him very sick, and he brought the whole thing up, so that after all no great harm was done.
Fomentations or stupes are often ordered to relieve pain. There is a particular kind of material called spongio-piline used in hospital for the purpose, but a stupe can be made quite well by wringing out coarse flannel in boiling water. If not wrung every day, a fomentation is about the most miserably uncomfortable thing that can be imagined, and is almost certain to give the patient cold. A good way to prepare one is get a strong towel and lay iyt over a wash-hand basin; then lay your flannel in the towel, and pour boiling water upon it until it is well soaked. By twisting the ends of the towel in opposite directions, you will not scald your hands, and you will be able to wring the flannel dry. Two people can prepare a fomentation much more easily than one. To relieve acute pain opium is sprinkled on the flannel before applying, and turpentine is sometimes ordered as a counter-irritant. If the stupe is to be plain hot water, bring the flannel to the bedside in the towel so as to keep it as hot as possible, shake it up just before applying, and it will keep warm much longer. Fold a dry towel and lay it over the fomentation when you put it on. In hospitals a piece of waterproof material is generally used for this purpose. Sometimes these stupes have to be changed very frequently, but the doctor will tell you this. If you have many to prepare it will be worthwhile to make a regular “wringer”, by running a stick or lath into a hem at each end of the towel. By twisting these sticks in opposite directions, you can wring with little or no fatigue. The wrists soon get tired doing it the other way.
When a doctor asks you any question about yourself or anyone else, be quite sure you understand what he means. If you do not, tell him so. I remember once hearing a girl unintentionally quite deceiving a physician about a shivering fit she thought she had had; it was probably just a little chilliness, but she made herself out so very much worse than she really was, that he thought she must have had a severe rigor, as it is called, and sent her to the fever hospital, where, I believe, they rather laughed at her and sent her away in a day or two as having nothing the matter.
Another thing: When you get a prescription made up at a dispensary, be sure you understand how the medicine is to be given. Doctors have ways of their own of writing directions, meant for the dispenser, not for you. A girl once brought me a piece of paper that had been given her with a bottle; from having been some time in the hospital as a nurse I could explain it to her, but before I went I could have made nothing of it. In most of the London hospitals I believe they have printed labels for all the bottles, “Take two tablespoonfuls three times a day” and so on. It is a good plan and ought to be universally adopted. If you do not understand the directions, however, and ask the dispenser, he will always tell you when and how the physic is to be taken.
There are a few simple things to be noticed in giving medicines that you may as well understand. It may perhaps be an unnecessary caution to tell you if you are directed to give, say, a tablespoonful of anything, only to measure it in the spoon and bring it to the patient in a cup or glass. I have known a spoon put to the sick person’s lips with the dose. A moment’s thought will convince you that is a most slovenly and uncomfortable proceeding. Always wash your cup and spoon immediately after giving medicine. If you have to give castor oil, first rinse your vessel and spoon in cold water; then put your milk, or brandy-and-water, or whatever you are going to give it on, into the glass, measure the oil in a spoon, and pour it as carefully as possible into the middle of the glass, not letting a drop touch the sides. It is well to pour out castor oil near the patient, as carrying it across a room is apt to shake it up . When it is desirable to make the oil act quickly it should be stirred up in hot water. This must be a most abominable dose; but, given as I have described, castor oil need not be hard to take at all. However, some children, and grown people too, are very obstinate, and if this medicine is ordered will point-blank refuse to take it. For them we had a plan in hospitals of shaking the oil up with about twice the quantity of peppermint-water in a soda-water bottle. Any bottle, of course, would do, provided it was clean and big enough. It takes a good deal of shaking until it comes into a sort of creamy stuff. It seems to me that this would be far nastier than the oil in its usual form; but I am bound to say that I have seen a boy who would roar for half an hour if you suggested castor oil in his hearing, but would take this mixture without the slightest fuss. A nurse, who has had large experience, told me that she never knew a child object to it.
Sometimes when a pill is ordered for a patient one is rather put aback by the statement that he or she never did and never could swallow such a thing. I have sometimes been able to persuade one of these incompetent people to try a very simple plan, which I never knew to fail even with a small pill, which is more difficult to swallow than a big one. Put it back as far as possible on the tongue, and take a drink of water; it is almost sure to go down. In case of a child, however, or a patient who is determined that he cannot take a pill on any terms, the best way i s to scrape it up and mix it with a little sugar in a teaspoon. Then, of course, there is no further difficulty.
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