When a patient asks for the bedpan it should be brought if possible without a moment's delay, not only because no other form of neglect makes a patient realize her helplessness more acutely, but also because the desire to use it often passes quickly and delay may encourage the habit of constipation. If the patient does not ask for the bedpan, the attendant should offer it at suitable times. Bedpans should be warmed before use. An easy way to warm one is to let hot water run over it; the outside should afterward be dried.
To place the bedpan, first flex the patient's knees and push the night gown up; place one hand under the patient's hips, raise them slightly, and with the other hand slip the pan into place. If the patient is entirely helpless two persons are needed to lift her. Place a pad or folded cloth between the patient's back and the pan;
then lower the patient gently. Before removing the pan, bring toilet paper, water and two pieces of soft old muslin or gauze. A patient, if able, prefers to use the toilet paper without assistance; her hands should afterward be thoroughly washed. If she is unable, the attendant must do everything needed. After the patient has been cleaned as thoroughly as possible with paper raise her hips with one hand and then remove the pan; it is important to raise her first because the skin often adheres and may be injured if the pan is suddenly pulled away; carelessness in managing the bedpan has caused more than one bed sore. Then remove the pan with one hand and cover at once. Turn the patient, if helpless, on her side, wash the parts with one piece of old muslin, thoroughly dry them with the other, and either burn or thoroughly wash both pieces afterward.
Empty the bedpan and clean it at once; ordinarily one can clean it without wetting or soiling the hands. Use cold water first, removing all adhering solid particles with a tightly rolled piece of toilet paper. Do not use a brush for this purpose. After using cold water, rinse the pan thoroughly in hot water, and at least once a day wash it well in hot soapsuds. Directions for disinfecting the pan will be given later, but remember that a properly kept pan needs no deodorant
solution. Glass urinals should be provided for men, and kept clean in the same way. Contents of both bedpan and urinal should always be carefully inspected; neither should be emptied in the dark.
DAILY ROUTINE IN THE SICK-ROOM
Obviously the routine of a patient's day must vary according to her condition, her preferences, and the amount of time the attendant has to give her. The temperature, pulse, and respiration must be taken and all medicine, nourishment, and treatment given at the exact times ordered, but the attendant should learn whether or not the doctor wishes her to wake the patient for food or treatment. Good management in the sick-room depends upon foresight and planning, and therefore it is well to keep in mind the following suggestions:
Vitality is lowest in the early morning, hence baths and treatments, especially if they are fatiguing or painful, should if possible be left until after breakfast. Patients often wake early and wait, weak and miserable, for the day to begin. A hot drink at this time may give relief and enable the patient to sleep again. Even though breakfast time is near, nourishment should be given as soon as the patient wakes. She may not admit that
she is hungry, but her nourishment should not be delayed until the family breakfast is ready, or still worse, finished.
Before breakfast the bedpan should be offered, the patient's face and hands should be washed, her teeth brushed, her hair tidied, the bed straightened, and the room put in order. These services should require a few minutes only. The room if properly arranged at bed time needs only a little attention now unless untidy work has gone on during the night; disorder in a sick-room is as unnecessary in the early morning as at any other time.