Notes on Nursing | Page 5

feverish at night, with burning hands and feet,
they are almost sure to be chilly and shivering in the morning. But
nurses are very fond of heating the foot-warmer at night, and of
neglecting it in the morning, when they are busy. I should reverse the
matter.
All these things require common sense and care. Yet perhaps in no one
single thing is so little common sense shewn, in all ranks, as in
nursing.[5]
[Sidenote: Cold air not ventilation, nor fresh air a method of chill.]
The extraordinary confusion between cold and ventilation, in the minds
of even well educated people, illustrates this. To make a room cold is
by no means necessarily to ventilate it. Nor is it at all necessary, in
order to ventilate a room, to chill it. Yet, if a nurse finds a room close,
she will let out the fire, thereby making it closer, or she will open the
door into a cold room, without a fire, or an open window in it, by way
of improving the ventilation. The safest atmosphere of all for a patient
is a good fire and an open window, excepting in extremes of
temperature. (Yet no nurse can ever be made to understand this.) To
ventilate a small room without draughts of course requires more care
than to ventilate a large one.
[Sidenote: Night air.]
Another extraordinary fallacy is the dread of night air. What air can we
breathe at night but night air? The choice is between pure night air from
without and foul night air from within. Most people prefer the latter.

An unaccountable choice. What will they say if it is proved to be true
that fully one-half of all the disease we suffer from is occasioned by
people sleeping with their windows shut? An open window most nights
in the year can never hurt any one. This is not to say that light is not
necessary for recovery. In great cities, night air is often the best and
purest air to be had in the twenty-four hours. I could better understand
in towns shutting the windows during the day than during the night, for
the sake of the sick. The absence of smoke, the quiet, all tend to
making night the best time for airing the patients. One of our highest
medical authorities on Consumption and Climate has told me that the
air in London is never so good as after ten o'clock at night.
[Sidenote: Air from the outside. Open your windows, shut your doors.]
Always air your room, then, from the outside air, if possible. Windows
are made to open; doors are made to shut--a truth which seems
extremely difficult of apprehension. I have seen a careful nurse airing
her patient's room through the door, near to which were two gaslights,
(each of which consumes as much air as eleven men), a kitchen, a
corridor, the composition of the atmosphere in which consisted of gas,
paint, foul air, never changed, full of effluvia, including a current of
sewer air from an ill-placed sink, ascending in a continual stream by a
well-staircase, and discharging themselves constantly into the patient's
room. The window of the said room, if opened, was all that was
desirable to air it. Every room must be aired from without--every
passage from without. But the fewer passages there are in a hospital the
better.
[Sidenote: Smoke.]
If we are to preserve the air within as pure as the air without, it is
needless to say that the chimney must not smoke. Almost all smoky
chimneys can be cured--from the bottom, not from the top. Often it is
only necessary to have an inlet for air to supply the fire, which is
feeding itself, for want of this, from its own chimney. On the other
hand, almost all chimneys can be made to smoke by a careless nurse,
who lets the fire get low and then overwhelms it with coal; not, as we
verily believe, in order to spare herself trouble, (for very rare is

unkindness to the sick), but from not thinking what she is about.
[Sidenote: Airing damp things in a patient's room.]
In laying down the principle that the first object of the nurse must be to
keep the air breathed by her patient as pure as the air without, it must
not be forgotten that everything in the room which can give off effluvia,
besides the patient, evaporates itself into his air. And it follows that
there ought to be nothing in the room, excepting him, which can give
off effluvia or moisture. Out of all damp towels, &c., which become
dry in the room, the damp, of course, goes into the patient's air. Yet this
"of course" seems as little thought of, as if it were an obsolete fiction.