Sickroom

“ Without cleanliness, you cannot have all the effect of ventilation; without ventilation, you can have no thorough cleanliness.
Very few people, be they of what class they may, have any idea of the exquisite cleanliness required in the sick-room. For much of what I have said applies less to the hospital than to the private sick-room. The smoky chimney, the dusty furniture, the utensils emptied but once a day, often keep the air of the sick constantly dirty in the best private houses. ”

“ The hospital had formerly been a large hotel, and was divided into many rooms, all crowded with sick. The wounded men who were not gangrened were carefully kept apart from those who were. Some of these were frightfully disfigured in the face or head, and presented a ghastly appearance. In rooms filled with fever-patients old men and mere boys lay helpless, struggling with various forms and stages of disease, hoarsely raving, babbling sweetly of home, vainly calling remembered names, or lying in the fatal stupor which precedes death. ”

“ The hospital nurse showed us through the wards and the examination room, where we found the grim rack for the torture of the examination, brutal to the patient, but convenient for the surgeon to do as much villainy as possible in a given length of time. No diseases are so rife or dreadful in their consequences but that their compulsory treatment, when it involves the indecent exposure of woman or man, is worse in its effects than the disease itself. ”

“ For instance, if one of the fever-patients was taking veratrum, I must see it dropped and given, and note the pulse. If one was just struggling through dysentery, I must attend to his nourishment, and generally fed him myself. Down-stairs was one large room, and three of good size, but smaller. The large one was also a ward. My business-room opposite was also the linen-room of the hospital. Shelves ran from floor to ceiling, a counter in front of them. In one corner stood my desk, and beside it a large country rocking-chair; in another a rough lounge for the convenience of visiting patients. ”

“ The air of the apartment cannot be too pure; therefore, let the evacuations from the bowels be instantly removed, either to a distant part of the house, or to an out-house, or to the cellar, as it might be necessary to keep them for the medical man’s inspection.
Let there be a frequent change of linen, as in sickness it is even more necessary than in health, more especially if the complaint be fever. In an attack of fever clean sheets ought, every other day, to be put on the bed; clean body-linen every day. A frequent change of linen in sickness is most refreshing. ”

“ A vigorous constitution, care while nurse-tending as to diet and exercise, joined to a mind calm and equable, and ready to face all possibilities without flurry, feverish excitement, or fear, will in many cases enable the sick-nurse to throw off the seeds of disease. But a malignant influence which floats in the atmosphere of the sick-room, pervading the breath of the sick person, and hanging like a bad odour about the bed-clothes, carpets, and even the wall-paper of the room, is necessarily a difficult enemy to evade—and such is infection. ”

“ Each patient in the hospital is helping to make the atmosphere impure by throwing off disease germs. Dried particles of pus, blood and excreta, lint from blankets and bedding, scales of epithelium and other matter, more or less dangerous, are flying about in the air and being deposited on ledges, skirting boards, window sills, bedstead rails and the various parts of furniture. To bring in a feather duster or a dry cloth and attempt to dust, is simply to flap the dust from one place only to have it settle in another. ”

“ Cautions in visiting Sick Rooms.—Do not venture into a sick room if you are in a violent perspiration; for the moment your body becomes cold, it is in a state likely to absorb the infection; nor visit a sick person, (if the complaint be of a contagious nature,) with an empty stomach, nor swallow your saliva. In attending a sick person, place yourself where the air passes from the door or window, to the bed of the invalid, not between the invalid and the fire, as the heat of the fire will draw the infectious vapor in that direction, and you would run much danger from breathing in it. ”

“ The patient must be kept in bed during the entire attack. He must not be allowed to even sit up in bed until the physician gives him permission. This is a very important essential in the treatment of this disease, and the nurse must be held responsible for the conduct of the patient in this respect. Because of the character of the poison, there is a tendency to paralysis of the heart, and frequently children have been allowed to sit up too soon only to fall back dead in bed. ”

“ It is very desirable that the windows in a sick room should be such as that the patient shall, if he can move about, be able to open and shut them easily himself. In fact the sick room is very seldom kept aired if this is not the case—so very few people have any perception of what is a healthy atmosphere for the sick. The sick man often says, "This room where I spend 22 hours out of the 24 is fresher than the other where I only spend 2. ”

“ There are not separate beds for each patient, but as the sick are brought in they are laid together side by side, in the same bed, whatever the disease, so that he who suffers from fever is placed beside another who suffers from palsy. There are four in a bed, and in times of pressure even more. Sometimes one arrives{73} who develops the plague, when the whole of the patients in the hospital catch the infection and all die together. ”

“ And now a cab drawn at a foot’s pace towards the great door of the hospital—to so many the jaws of death. A little crowd here even, to see the patient carried in by the two stout porters. A little crowd here, when it might be a case of fever or something else—infectious, contagious. But no; this is no fever case, but one for our skilled surgeons; for the poor lad is bleeding, bound up, and fainting. ”

“ The causes of disease, in the mean time, have been less earnestly studied in the eagerness of the search for remedies. Speak softly! Women have been borne out from an old-world hospital, two in one coffin, that the horrors of their prison-house might not be known, while the very men who were discussing the treatment of the disease were stupidly conveying the infection from bed to bed, as rat-killers carry their poisons from one household to another. ”

“ If it were not for the unconceivable untidiness and want of observation which exists in the human race, such cautions as not to leave about the room the clothes the sick person has last worn, hanging up or huddled on a chair in a corner, would seem superfluous. But I have actually seen a girl stricken down by a sudden fever, lying at death’s door, on her little white bed, whilst the wreath she wore at the ball where she took the fatal chill, still hung on her toilette glass, and her poor little satin shoes were scattered about the room. ”

“ The sick-room, particularly, should be so arranged that the impure air may escape, and pure air be constantly admitted into the room. It is no unusual practice in some communities, when a child or an adult is sick of an acute disease, to prevent the ingress of pure air, simply from the apprehension of the attendants, that the patient will contract a cold. Again, the prevalent custom of several individuals sitting in the sick-room, particularly when they remain there for several hours, tends to vitiate the air, and, consequently, to increase the suffering and danger of the sick person. ”

“ Our hospital simply could not run without the help of the patients themselves. They fetch and carry and bathe and scrub and hold legs and arms for dressings, and joke and jolly each other along till it would break your heart, for they themselves are sick men. For our up-patients here have been mighty sick or they{140} would have been sent on to England, unless they are some of the few that are going back to the Convalescent Camp and from there back into the lines. So often, too, we see a man reach way over from his bed to give his neighbor a puff at his cigarette. ”

“ He should wash his hands with antiseptic soap after handling the patient. Exercise regularly in the open air. Nurses should wear washable dresses, which are frequently changed and a washable cap should cover their hair. When in the sick-room do not approach the patient near enough to catch his breath. Do not touch with your lips any food, dish, or utensil which has been in the sick-room. Do not eat or drink in the sick-room. Wear no clothing that the patient wore before being taken sick. ”

“ I must also have some rooms in which to isolate infectious cases, especially the dysentery ones. The patients with sleeping sickness, again, I cannot keep for any length of time in hospital, as they endanger the health of the whole station, and later on I shall build a hut for them in a quiet spot on the other side of the river. There is plenty of work to do beside the mere medical treatment.
*****
With the hospital building finished, the doctor's wife can develop her activity to the full. In the fowlhouse there was only room for Joseph and myself. ”

“ There is too much visiting in the sick room, too many people share the care of the patient, the nurse mingles too freely with other members of the family, and there is not enough care to keep the soiled bedding, garments and refuse of the sick room absolutely separated from that of the rest of the house. ”

“ This arrangement brought the three hospital buildings in a line, while the bakery, dead house and pest-house were in a line to the rear. A line of guards paced their beats around the whole.
I supposed when I was sent to the hospital that I had fever of some kind, but in two days the soreness of my throat and the pustules on my face and hands told the story too plainly, that the inoculation of a few days before was doing its work. I was down with a mild form of small-pox, varioloid, the doctors called it, but a Tennessee soldier pronounced it a case of the “Very O Lord.” ”

“ Yet, although we "nose" the murderers, in the musty unaired unsunned room, the scarlet fever which is behind the door, or the fever and hospital gangrene which are stalking among the crowded beds of a hospital ward, we say, "It's all right."
Without chill.
With a proper supply of windows, and a proper supply of fuel in open fire places, fresh air is comparatively easy to secure when your patient or patients are in bed. Never be afraid of open windows then. People don't catch cold in bed. ”

“ Every sick Man, as soon as he arrives at an Hospital, should be washed with warm Water, or if there is a warm Bath, or bathing Tub, to be put into it; and afterwards be supplied with a clean Shirt [156] well-aired before he be put to Bed; and his own dirty Linen should be immediately carried to the Wash-House: And every Morning each Nurse ought to carry a Bucket full of warm Water, and a Piece of Soap and a Towel, round to each of her Patients, and make them wash their Hands and Face, and their Feet, when dirty. ”

“ Over a whisky-and-soda I gave him the "slip," and he looked at my arm and said, "Yes, scabies," and I was put into the isolation ward and treated for this disease. How more people did not die in that hospital beats me. I personally never got any sleep, and left in a fortnight nearly dead. Lights were out at 10 p.m. This sounds good, but there were about eight of us in the ward. I had to have my foot treated every three hours. The man in the next bed to mine was treated for something every two hours; and nearly all the other beds were treated three or four times during the night. ”

“ The cleaning of rooms after a communicable disease will be considered later.
A sick room must be kept tidy as well as clean. The effect of order is quieting, but it should be maintained whether the effect upon the patient is apparent or not. Food and medicine should not be kept in the sick-room, and all used dishes, tumblers, soiled linen, etc., should be removed at once. Unnecessary articles should not be found in the room at any time; every necessary article should be kept in its place, and its place should be a good one. ”

“ Let ventilation, sunshine, and absolute cleanliness rule in the sick-room. Never raise a dust, but wipe the carpet with a damp cloth, and pick up bits as needed. Never let lamp or sun light shine directly in the eyes, and, when the patient shows desire to sleep, darken the room a little. Never whisper, nor wear rustling dresses, nor become irritated at exactions, but keep a cheerful countenance, which helps often far more than drugs. ”

“ As nothing contributes more to the restoration of health, than pure air, it should be a primary object, to keep a sick-room well ventilated. At least twice in the twenty-four hours, the patient should be well covered, and fresh air freely admitted from out of doors. After this, if need be, the room should be restored to a proper temperature, by the aid of a fire. Bedding and clothing should also be well aired, and frequently changed; as the exhalations from the body, in sickness, are peculiarly deleterious. Frequent ablutions, of the whole body, if possible, are very useful ”

“ To announce baldly in the sick-room that the patient is tired and the visitor must go, will only elicit aggrieved protests from both. In illness lasting only a day or two all visitors should be discouraged; during colds, because they are communicable; during general fatigue, headaches, digestive upsets, and painful menstruation, because rest and quiet are highly desirable. Visitors at such times too frequently give injudicious sympathy, and may actually delay the recovery of patients who enjoy playing the rôle of interesting invalid. ”