Making Good on Private Duty | Page 6

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in a lofty manner, rather trying when you take such pains with them.
You may conclude that it is not necessary to keep them accurately in
such a case, but this same doctor may ask you some day how long ago
it was that the patient's temperature took such a sudden rise, or how
many days it is since she first had solid food, and if you have
accurately kept and carefully preserved your records, you can tell
without a moment's hesitation. It is better, more business-like, and
every way to be commended, that the nurse should keep, and be
exceedingly particular about these records. If the doctor will write his
orders on the fresh daily record at his morning visit, it is a great help to
the nurse, but very often he is in a hurry and you must write them
yourself. If you have to do this, take your record and write as he tells
you, when he tells you. If the orders are at all intricate it is your only
way of being absolutely sure you have everything correct. It is a
protection to you also, if the family are inclined to criticise.
A nice little point for you to remember is always to leave the doctor
alone with the patient for a few moments, if it is at all possible, at each
visit, Wait until he has asked all the questions he wishes, or until you
have told him all that is necessary to tell before the patient, and then on
some errand, real or imaginary, leave the room. Of course, if the patient
is desperately ill, you cannot do this, nor will it then be necessary.
It is a good plan to wait for the doctor at the head of the stairs, or at the
foot, if you are likely to be over-heard, and tell him there all you could
not say before the patient as to her condition, etc. He likewise may have
something to say,--some final instruction to give, some caution he

would not wish the patient to know of. This is also the time to speak
about yourself if you are sick or tired, or unhappy in your position.
Perhaps neither of you have anything to say, and a friendly nod and a
"patient is doing nicely, nurse," will send you back to the sick- room
feeling that your work is appreciated, which always goes a long way
toward making the hard places easy. Your patients may be very curious
as to what you have to say to the doctor, but you can readily and truly
tell them that there are many things you have to say to him, that would
be hard for you to say before them, and hard for them to hear too, and
these are things you arrange outside.
Always be sure to have on a convenient table, if your doctor be of a
homoeopathic school, a little covered tray, and on it two glasses, clean,
and turned upside down to keep them from dust, teaspoons and covers
for the glasses, also a small pitcher of fresh water. Many doctors of the
old school also use some medicines in water, so it is best to have
glasses always at hand.
Do not sit down when the doctor is making his professional call, unless
he or the patient requests it. He will probably sit at the side of the bed,
your place is at or near the foot. If the doctor knows the patient well, as
a friend, and is inclined to stay a long time, chatting, you can go quietly
to another part of the room, and take up your work or reading, but be
sure the doctor has finished asking you questions before you go.
Use sparingly technical terms. If your patient's feet are oedematous, tell
the doctor they are much swollen; if he ask if they are oedematous tell
him "yes," but do not volunteer to name the peculiar kind of swelling.
If the abdomen is tympanitic, tell him it seems much distended; and if
he questions much further, answer the questions fully and intelligently.
If your patient has the symptoms of phlebitis, tell him of the rise of
temperature, the swelling of the leg, the tenderness along the course of
the vein, and he will know that you know and appreciate the gravity of
the disease; but be sure you do not attempt to give the symptoms a
name, that is not your place.
I would have you be very careful as to what instruments you carry;
have them of the best. Let your thermometer be of the very best make.

There is nothing more trying in a small way than to have your
thermometer doubted, and if you know it is the best the market