Maintaining order in the room does not mean that patients should be made uncomfortable. All patients, especially old people, want certain possessions within reach, and their wishes should be considered in spite of the fact that the æsthetic
effect is generally far from good. For instance, a perfectly smooth bed is undesirable if in order to make it smooth the patient must be tucked in so tightly that he is uncomfortable. And it would be a mistake to remove an old man's newspapers before he has read them, even if he persists in strewing them all over the floor.
The Attendant.
—One person and one person only should carry the entire responsibility for the patient. She should plan for him as well as care for him, should see the doctor and take the doctor's orders. Confusion and innumerable mistakes result when several members of the family attempt to do the talking and directing.
The attendant should wear washable dresses with sleeves that can be rolled up, washable aprons, and shoes with rubber heels. All her clothing should be comfortable. She should be neat in appearance, scrupulously clean in person, and should keep her finger nails short and smooth. Jewelry, especially rings and chains that rattle, and finery of any sort are all out of place in a sick-room.
The attendant must learn that her own sleep, her diet, and her out-of-door exercise are essential to the patient's well-being hardly less than to her own. An amateur nurse often considers that going without food and sleep is a proof of her devotion.
In a passion of self-sacrifice she neglects herself utterly for the first few days, and as a consequence is quite useless at a later period when her services may be most needed. An exhausted, sleepy nurse, trained or untrained, is wholly unfit to be trusted with medicines and doctor's orders, to note changes in the patient's condition, or to give him kindly attention. Efficiency and fatigue have never pulled together since the world began, and no one can do good work when suffering from lack of sleep and rest.
The person, then, who genuinely wishes to give her patient the best possible care should not make a martyr of herself. She should go out of doors daily; both fresh air and occasional absence from the patient are essential to her physical and mental well-being. Moreover, she will be showing her patient the greatest kindness in the long run if during her recreation time she thinks of him as little as possible. Indeed, she need not consider herself inhuman if she has a thoroughly good time.
On the other hand, a person who is responsible for the care of a patient must be made to realize that she and she only is ultimately responsible during the entire 24 hours of every day. Being responsible for a patient does not mean that she should be with him every minute, or do everything herself: it does mean that she should plan so effectively
that everything necessary is done, either by herself or by another competent person. When she goes away for even half an hour, she should appoint someone else to be responsible in her place and to her when she comes back. She must consequently make very clear just what she wants done. If there is medicine, nourishment, or treatment to be given, she can easily make a list, with the time for each, and ask that each item be crossed off the list as soon as the work has been done. She should not forget to ask for the list when she returns.