Notes on Nursing | Page 6

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 this 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.

How very seldom you see a nurse who acknowledges by her practice
that nothing at all ought to be aired in the patient's room, that nothing at
all ought to be cooked at the patient's fire! Indeed the arrangements
often make this rule impossible to observe.
If the nurse be a very careful one, she will, when the patient leaves his
bed, but not his room, open the sheets wide, and throw the bed-clothes
back, in order to air his bed. And she will spread the wet towels or
flannels carefully out upon a horse, in order to dry them. Now either
these bed-clothes and towels are not dried and aired, or they dry and air
themselves into the patient's air. And whether the damp and effluvia do
him most harm in his air or in his bed, I leave to you to determine, for I
cannot.
[Sidenote: Effluvia from excreta.]
Even in health people cannot repeatedly breathe air in which they live
with impunity, on account of its becoming charged with unwholesome
matter from the lungs and skin. In disease where everything given off
from the body is highly noxious and dangerous, not only must there be
plenty of ventilation to carry off the effluvia, but everything which the
patient passes must be instantly removed away, as being more noxious
than even the emanations from the sick.
Of the fatal effects of the effluvia from the excreta it would seem
unnecessary to speak, were they not so constantly neglected.
Concealing the utensils behind the vallance to the bed seems all the
precaution which is thought necessary for safety in private nursing. Did
you but think for one moment of the atmosphere under that bed, the
saturation of the under side of the mattress with the warm evaporations,
you would be startled and frightened too!
[Sidenote: Chamber utensils without lids.]
The use of any chamber utensil _without a lid_[5] should be utterly
abolished, whether among sick or well. You can easily convince
yourself of the necessity of this absolute rule, by taking one with a lid,
and examining the under side of that lid. It will be found always
covered, whenever the utensil is not empty, by condensed offensive
moisture. Where does that go, when there is no lid?
Earthenware, or if there is any wood, highly polished and varnished
wood, are the only materials fit for patients' utensils. The very lid of the
old abominable close-stool is enough to breed a pestilence. It becomes

saturated with offensive matter, which scouring is only wanted to bring
out. I prefer an earthenware lid as being always cleaner. But there are
various good new-fashioned arrangements.
[Sidenote: Abolish slop-pails.]
A slop pail should never be brought into a sick room. It should be a rule
invariable, rather more important in the private house than elsewhere,
that the utensil should be carried directly to the water-closet, emptied
there, rinsed there, and brought back. There should always be water and
a cock in every water-closet for rinsing. But even if there is not, you
must carry water there to rinse with. I have actually seen, in the private
sick room, the utensils emptied into the foot-pan, and put back unrinsed
under the bed. I can hardly say which is most abominable, whether to
do this or to rinse the utensil in the