I
THE NURSE AND HER PATIENT
You may think it unnecessary for me to tell you any more about "the patient." You will say, perhaps: "Have I had all this training, and must I yet be told how to treat a patient?" I answer that you have been taught how to watch the progress of disease, how to follow intelligently the doctor's orders, also certain manual arts, your proficiency in which is unquestionably most necessary, but there is much more comprehended in the meaning of the term "a good nurse" than this. How often do we hear stories of nurses who were good—but—who were skillful—but— and after the but comes a long list of such faults as do not show so much in hospital life, where the routine and the many rules and the constant supervision make them less likely to become prominent. "She bangs the doors." "She breaks the fine china." "She wears heavy shoes," or "She talks too much," or "She is pretty and spends too much time over her front hair"—but why go on? You have all heard such tales—ad nauseam, and if you are wise, you will set up a sign-post against every one of these snares into which your sister nurses have fallen, and on this you will print in large, clear letters: "Danger! Walking on this place forbidden." So much by way of apology for treating you once more to a lecture on "the patient."
The relation between nurse and patient should, from the first, be a more than amicable one. You have come to bestow the priceless blessing of unwearied, skillful care upon one who should thankfully receive it, and believe me, if you do not go to your patient with a feeling of thankfulness to God for allowing you to assume such a sacred trust as the care of a human life, you are in no condition to undertake the work. Your nursing should be, in a way, an exponent of your own spiritual state; looking at it in its highest aspect, an outward and visible sign of an inward and spiritual grace.
In the first place, then, you must be in entire sympathy with the sick one—and here do not mistake me—by sympathy I do not mean sentimentalism. The two emotions are as far asunder as the poles. Sympathy, then, you must have, and if you do not intuitively feel it, let me tell you what to do to rouse your dormant feelings. Try earnestly to put yourself in the patient's place. Has she had an operation of some kind, and you have all night been trying to keep her quiet on her back, and she has been begging you to let her turn "never so little?" When you go to lie down, and have, perhaps, a backache, and feel tired, instead of settling yourself in the most comfortable position you can, lie straight and square on your back and say to yourself, "Now I can't turn over," and imagine you have by your side a nurse who will not let you turn. You will find out in the course of an hour that your patient has had a good excuse for all her complaints, and the next night you will know just where to slip your hand in the hollow of the back or under the shoulders to give a little ease. The patient will profit by such exercise on the part of the nurse, and your sympathies will be quickened. Never forget that the patient is sick, and you are not. You can, you must be firm in what you know is for your patient's best good, but you must never be dictatorial or argumentative. It is hard, I know, to bear with all the foolish, unreasonable whims of sick people, but if you are true nurses you will do it. There are, however, several consoling thoughts which have always helped me, and which I will tell you. In the first place, always remember, as I said before, that the sick one is sick, and on that ground you can overlook much. In the second place, remember that it will not last long. A few days or weeks will surely bring a change. She cannot, in the nature of disease, remain for long in the very trying stage, unless indeed she have some kind of mania, and of course if that is the case, you need pay no attention to her whims. If she says white is black, let it go. It does not make it so to have her say so, but if you argue the point, and bring all your wisdom to bear upon your demonstration, you may bring her pulse and temperature up to a point that will do her a real injury.
Tact, as you know, is worth everything to you, and by it you will win your way to all hearts. Try then to feel as the patient does, and you will know by instinct how to treat her, and will, perhaps, be often rewarded for some little deed by the pleased surprise with which she will say, "How did you know I wanted it done?" You need not tell her how you knew, but you may be sure she will appreciate you all the more for your prescient thoughtfulness. Her pillows may be flat and hot, her hair uncomfortable, her under sheet wrinkled or untucked from the bottom; all these and a dozen more little things can be arranged so easily, and they conduce so much to the sick one's comfort when done, that you must ever have them in your mind.
Be most careful also as to your patient's belongings, her top drawer, her various boxes, and her linen closet. You must keep all these things just as she did. You may think it a very foolish thing for her to have three piles of handkerchiefs, each of a different age, or degree of fineness, but if that is her way, she will be better satisfied if she knows you will not lay a fine handkerchief over a more common one. So keep them as carefully divided as if they were the two parts of a Seidlitz powder.
Hang her clothes up carefully whenever she goes back to bed, be it once or oftener during the day. Separate them and hang them up; don't pick all up together and put them over a chair. Put her shoes away, lay the stockings on a shelf or put them inside the shoes. Fold her pretty shawl or kimono and lay it in a drawer. Let her see that you know a good thing, and know how to take care of it.
Put away fine china or glass and bric-a-brac, if she is very ill, and you need space for necessary glasses or other articles. It will be a pleasant way of beguiling the tedium of some long day in her convalescence to bring forth and arrange them in their accustomed places. Be careful of books, table-covers, and all the articles of luxury and beauty you will find in many of our city houses. Remember that these things belong to some one else, though you are for the present custodian, and think how provoked you would feel if some stranger should come to your home, and, even if she did nurse you back to health, she left many nicked plates, broken vases and handleless cups behind her. I think you would not want her to nurse you again.
I saw recently in an English magazine devoted to nursing, a very clever article on "Talk." The writer, a nurse, thought subjects were scarce. She says: "We must not talk to the patient about her own complaint, that would make her morbid; or about the doctor, for that would be gossip; or the hospital, for hospitals are full of horrors; or the other nurses, for that might lead to talking scandal; or about other patients, for that would be betrayal of confidence. Now what are you to talk about when a patient is well enough to talk, and your talking to her will not hurt her (but on this point be very sure before you air your eloquence)? It is indeed quite a question, and the nurse must often use all her ingenuity to keep the patient to the right subjects, for even patients, though they hold it so reprehensible in a nurse to talk gossip, do not disdain to serve up their neighbors occasionally to the nurse, with some very highly seasoned scandal sauce, and here the honor of the nurse must come into play; let her forget it if possible, as woe will betide the poor girl if in her next place she unwittingly lets out any of the secrets she has heard in these long talks. Try then to steer clear of the neighbors. If your patient be a cultivated person, and you yourself know anything about books, you have a never-failing topic. All the latest books, the famous books, the most entertaining books, and if you can read aloud and the patient likes to hear you, read to her, and it will do both good—only be sure not to tire her by reading too much at one time. Talk of interesting places you have visited and she will do the same, of pictures you have seen, and last, but not least, you can talk about clothes. Generally the first serious piece of business a convalescent concerns herself about is the purchase and making of some new clothes. She wants something new and fresh, and if you can give her any new ideas on the subject or tell her of any pretty materials you have seen in the shop windows, you will prove as entertaining as if you talked on any of the forbidden topics, and many times more useful."
I would like, in closing this chapter, to say a word as to reading the daily papers. If your patient is a woman, she will want to know just about what you, yourself, would be interested in, and this is very easy; but if your patient is a man, it is harder to know what he will want; politics, the money market, etc., which most women skip over. If then your patient is a man, commence on the first page and read slowly the headings of the news items, when one strikes him, as desirable to hear, he will tell you to read it; when you get through the news you may turn to the editorial page and do the same there. Unless you know your patient very well do not attempt to enlighten him as to the stock market quotations, for it is, I suppose, well nigh impossible for an ordinary woman to read them so that a man will understand her. He will probably laugh over your well meant endeavor, and ask you to "kindly let him look at the paper," when he will in a moment find out what you have been trying to say.