Popular Science Monthly/Volume 9/June 1876/Hints for the Sick-Room
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Hints for the Sick-Room
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WHEN a woman thinks of making deliberate choice of the profession of a sick-nurse, she can, of course, take into careful consideration if her character and temperament are or are not suited for so arduous and trying an avocation. If she is a person of excitable nature, and possessed of but little self-control, she can be wisely counseled to give up the idea of a life for which she is so thoroughly unfit; but no peculiarities of character or temperament can exempt a woman from being called upon by the plain voice of duty, at one time or other of her life, to take her stand by the bedside of one dear to her, and soothe as best she may many a weary hour of restlessness and pain.
Very few, indeed, are the women who escape this rule—most have to take upon themselves the burden of attendance in a sick-room—and perhaps there are few subjects upon which the generality of women are so well-intentioned, and yet so ignorant. With the very best and kindest meaning in the world, attention bestowed upon a suffering person may be productive of more discomfort than comfort to the patient, and endless annoyance to the physician, just because the zealous, but alas! untrained and undisciplined volunteer does everything the wrong way.
Again, from a mistaken and unreal idea of true delicacy and refinement, many women shrink from ever seeing or learning anything about suffering or sorrow; and so, when the inevitable fate brings the sights and sounds of pain, the dreadful realities of death, cruelly home to them, they are paralyzed by terror, and useless, nay, worse than useless to those most dear to them. Even as I write, sad instances rise before my mind of a lack of moral courage, an utter possibility of self-command, that has led the mother to flee from the bedside of her dying child, the wife to turn away from the failing sight that yearns to gaze upon her face while life yet lingers! The contemplation of pain could not be borne, because the mind was weakened and enervated by a selfish habit of yielding to the dislike of bravely facing anything disagreeable. Let all true women train themselves to possess self-control, calmness, and patient courage; let them strive to acquire a certain amount of knowledge of the cares and duties of the sick-room: let them not shrink from hearing-the details of this or that form of suffering and disease, and gladly and readily offer help (when they rightly and safely can) outside the bounds of their own immediate home circle. Let them rejoice in any fitting opportunity that may come in their way of perfecting themselves in this, the highest and holiest of woman's duties, so that when their own time of trial comes they may not fail!
Taking it for granted that there are many who will gladly take a few plain and practical hints on this subject, I shall condense the result of a somewhat long and wide experience into a short space.
And, first: It is in things which of themselves appear trifling, and even insignificant, that the comfort of a sick-room is made or marred. For instance, an energetic and amiably-intentioned person places a cold pillow beneath the shoulders of a patient suffering from pneumonia, that is, inflammation of the lungs; a fit of coughing, perhaps a restless night, is the result. Five minutes' warming of the pillow at the fire would have prevented all this mischief, and even conduced to sleep.
Dress, again, is a matter of great importance in a sick-room, and here I must enter a protest against that very common practice of the amateur sick-nurse making a "guy" of herself. I really have seen such startling and unpleasant costumes donned "for the occasion," as seemed to me enough to cause delirium in the patient, if long contemplated—shawls, and dressing-gowns, and wraps, of such an obsolete and awful character, that the shadow of the watcher, cast upon the wall by the dim light of the night-lamp, must form a horrible "old granny," and be by no means a pleasing reflection to meet a sick man's eyes, as he wakes weak and confused from an opiate-won sleep!
The best dress for a sick-room is plain black—for the simple reason that no stain shows upon it—an old silk is the most economical, but silk rustles, and is therefore objectionable. Black lustre is very serviceable—not made long enough to trail, upset chairs, and get under the doctor's feet; and not having hanging sleeves, but fitting close and neat at the wrist, so as to be finished off by nice white linen cuffs. (I have seen a hanging sleeve catch on some projecting point of chair or table, and convert a glass of egg-flip into a "douche" externally applied, swamping the patient in a yellow sea, besides sending her into hysterics.) A habit of moving quietly about the room, and yet not treading "on tiptoe" and making every board in the floor creak its loudest, is also very advisable; and nothing can be better by way of foot-gear than those soft, warm felt boots now so common; they both keep the nurse's feet from becoming cold, and make the least possible sound in moving about. Of course the manner of speaking in a sick-room is all-important. Oh, the horror of that dreadful "pig's whisper," which penetrates to the inmost recesses of the room, and wakes the sleeping patient as surely as the banging of a door!
I call to mind a case of fever—a very bad case, in which sleep was the one desideratum—almost the only hope. The sufferer had fallen into a doze—the terrible throbbing of the arteries in the bared throat seemed a little less rapid—the fire that was burning life away raged a little less fiercely—but, some idiot peeped in through a half-closed door, and with horrible contortions of the visage, intended to express extreme caution, whispered in blood-chilling tones, "How—is—he—getting—on—now?"
In an instant the patient had raised himself in bed, the poor hot hands were thrown out to ward off he knew not what—the filmy eyes stared wildly round—the parched tongue faltered: "What is it? Where is it?" And for hours the weary head tossed from side to side, and meaningless words fell on the ears of those who watched and waited, and almost feared to hope. And yet it was meant in kindness!
In some of the most severe diseases, such as cholera and diphtheria, the patient is often intensely conscious of all that is passing around him. The wish to know everything that is said and done is extreme, and nothing excites a patient so much as anything like whispering and mystery. The natural voice, only so much lowered as to be perfectly distinct, is, then, the proper tone for a sick-room. If silence is needed, let it be complete, and no whispering permitted either in the room, or, worse still, outside the door.
And now I must say a few words on a disagreeable but yet most important subject. In any case where operative surgery is necessary, it cannot be too strongly insisted upon that no one shall remain present whose calmness and self-control are not a certainty. I remember well a delicate and difficult operation having to be performed—not a painful one, but where success mainly depended on the perfect stillness of the patient. Scarcely had the first slight incision been made, when the room resounded with the moans and cries, not of the sufferer, but the friend who had kindly come to support her through the ordeal! With many a sob, and choke, and gurgle, the friend was assisted from the room, and then all went well enough; but great delay, and much increase of nervousness on the part of the patient, naturally resulted.
One of the many very eminent surgeons of whom America can boast once told me that on the occasion of performing a most formidable operation, in which promptitude was a vital necessity, he saw, at a moment when seconds were precious, a friend, who had insisted on remaining present, suddenly turn deadly pale, and fall fainting on the floor, in uncomfortably close proximity to the chloroformed patient. Dr. B—— stooped down, and quietly rolled the insensible individual into a corner of the room, where he enjoyed undisturbed repose until such time as some one had time to "bring him to."
Thus it may be seen that any one who is in the least nervous, and cannot be certain of his own powers of self-command, acts with truer kindness in remaining absent from such scenes, than by becoming an added source of anxiety, where there is so much already of the gravest character. If, however, a woman has the moral courage to face such trials calmly, and without flurry—if she can do simply what she is told, and nothing more—if she can hold her tongue—wholly dismiss herself from her own mind, concentrating all her attention on the patient, she may be of untold help and comfort. On the other hand, a sick-nurse who asks the doctor endless questions—who presumes in her ignorance to criticise his treatment—who is spasmodic in her sympathy, and ejaculatory in her lamentations, is pestilent in a sick-room, and should, if possible, be got rid of at any cost.
But as well as the nervous and excitable nurse, there is another species of the genus against whom I would warn any one who in the least values his own comfort, and that is, the person who insists upon "helping you" to nurse some very severe case, and never ceases assuring you that she "keeps up splendidly at the time, but afterward—;" and then comes an ominous shake of the head, which is a ghastly intimation of what a time you will have of it with her, when what she is pleased to call the "reaction" sets in. Nothing can be more aggravating than to contemplate such an individual, and look forward to the "breaking-down" which she assures you is inevitable, and which you feel assured will come just when you and everybody else are tired out with nursing the real sufferer, and when you want to go to bed, and sleep your sleep out. The very idea of having to put hot-water bottles to her feet, and mustard-poultices to her side, and cooling lotions to her aching brow, and watch her acting the martyr (the while you are wishing her at Jericho, or some other equally hard-to-get-back-from place), is not a pleasant anticipation, as you sit opposite to her through a long night of watching, and she tells you, with a melancholy yet vainglorious countenance, how she shall "pay for this afterward." But she treats with scorn your suggestion that she should go to bed—indeed, she would be bitterly disappointed if she might not immolate herself—and you. This sort of thing is what I call "selfish unselfishness," a kind of self-sacrifice that is always acting as its own bill-poster.
But there is one kind of nervousness which I do not think meets with sufficient consideration, and that is the unconquerable fear which you will find some people have of any disease that is infectious. Now, I think this sort of fear is far more constitutional than mental, and it appears to me most uncharitable to speak of those who are thus nervous by temperament as "so frightened," etc. Depend upon it, if any one has a great dread of infection, he is far better away from the chance of it. If I heard a person express a great and overpowering dread of small-pox, cholera, fever, or diphtheria, I should do all in my power to prevent that person going near any case of the kind, because I should be morally certain of the result. As a rule, I believe that those who are perfectly fearless are comparatively safe; and there is no truer test of perfect freedom from nervous dread than the fact of being able to sleep at once, quietly and naturally, and without the mind being obliged to dwell upon the work of the day. The best cholera-nurse I ever saw used to tell me that she often sat down in the corner of a room, on the floor, and "slept right off" for half an hour at a time, either day or night, just as such opportunity for rest presented itself. But of course there are exceptions to all rules; and one of the most devoted and the most fearless in attendance on the sick, during a terrible epidemic, died just when the worst of the battle seemed over.
But to return to some of those "trifles," the knowledge of which is so needful to those who would try to fulfill well the duties of an amateur sick-nurse.
When active personal care of a sick person is undertaken, the finger-nails should be kept very short. I have seen a long nail tear open a blister, and expose a raw surface, causing great pain. For the same reason, all removable rings should be taken off; and any ornaments that hang loose and make a jingling noise are best dispensed with, as they irritate and annoy a sensitive patient.
It seems to me that this very unpretending paper will be hardly complete without a few words as to the diet that is best for any one acting as sick-nurse in a long and trying case.
One great point is, to let no silly notions of sentiment prevent you making a practice of taking substantial and regular meals; and, when you have to sit up all night, be sure and have food at hand, and never go more than three hours without eating. Now, I am going to say what I know many will highly disapprove of, and it is this: when you are nursing a long and anxious case, and you want to be able to "stay" to the end, avoid all stimulants. There is nothing you can do such hard work upon, there is nothing that will support you in long-continued watching and fatigue, like good, well-made coffee. Stimulants only give a temporary excitement, that passes itself off as strength. They injure that clearness of thought, that perfect quietude and recollectedness which are so essential to the good sick-nurse; and they tend more than anything else to that miserable "breaking-down afterward" of which I have already spoken.—Chambers's Journal.