Hospital housekeeping

by Charlotte A. Aikens

Ward Lockers

Aseptic ward tables of iron and glass are now being used in some hospitals, but it is doubtful if their use will ever be general. They answer some of the purposes of a ward table, but not all. Even very poor patients prefer to have their own combs and toilet articles, their own handkerchiefs and stationery, their own books and flowers. If some place is not provided for these numerous small things, which the average patients find it necessary to have close by, they will inevitably resort to stowing their “things” under the mattress—a custom not to be tolerated by the neat housekeeper. Good housekeeping requires that in a hospital, as elsewhere, a place be provided for everything and everything be kept in its place. Until the proper aseptic ward table is invented and offered at a reasonable price, the small wooden locker, well coated inside and out with enamel paint, will continue to be used. These lockers can be made to order for a very moderate price, usually from three to five dollars each. They should be about 20 inches in width, 30 inches from the floor, 14 inches deep, and mounted on castors. The drawer should be about 4 inches deep and there should be a shelf in the lower part. A daily inspection of bedside lockers is necessary, or apple cores, fruit peelings, remnants of food, and refuse of various kinds will accumulate. All cupboards and linen rooms should have daily attention, and should be in such perfect order that the doors may be thrown open at any time for inspection without embarrassing the nurse in charge.

Care of Patient’s Clothing

The outer garments of the patient and those not needed during illness should be taken charge of by the nurse on the entrance of the patient, and the list recorded in a book provided for the purpose in every ward. Each article should be labelled, and placed in the locker in the general clothes room, and the number of the locker noted with the list of clothing in the record book. An accurate and uniform system of clothes records throughout the hospital should be insisted on. Unless this is done confusion when the nurses’ places are changed will be inevitable. Carelessness in this duty on the part of a nurse has resulted in no small discomfiture to the hospital officers. Clothing has been mislaid and not found for weeks after the patient has left the hospital, and the whole institution has been branded with negligence by the patient and his friends. All the kindness received, and the most skillful professional treatment, will often be lost sight of, if, through the carelessness of a nurse, the hospital is unable to render to the patient the clothing entrusted for safe-keeping. Money or valuables should never be kept either in private room or hospital ward, but sent to the office to be deposited in the safe.

Ward Medicine and Records

Though many well-regulated hospitals have a medicine cabinet in every ward, the custom does not generally prevail, nor is it desirable that it should. The less a patient knows, sees or thinks of medicine, except the dose intended for him at the time, the better. The custom of hanging clinical records over the foot or at the head of the bed is another custom that might better be abandoned, even though it be very convenient for the nurse. Patients are only too prone to meditate upon and discuss their symptoms, in spite of all efforts to induce them to trust themselves entirely to doctors and nurses, and cease questioning and worry. Some sympathizing friend or convalescent patient may be depended upon to keep them informed when an unpleasant symptom is recorded. This will occur in spite of all rules and vigilance. It is not easy under any circumstances to keep ward patients from discussing their ailments and symptoms. Especially is this true in women’s wards. In men’s wards the newspapers are read, the political situation is discussed, city improvements and occurrences are talked about, all sorts of subjects occupy the time of those who are able to talk, but a different state of things entirely prevails in the women’s wards. What they get to eat, how they feel, and the nurses and doctors furnish the general topics there. To have a clinical record to gossip about might divert attention from the nurses and doctors, but even these long-suffering individuals would willingly sacrifice themselves as a topic of conversation rather than have the patients read the records and constantly discuss their symptoms.

Adjuncts to the Hospital Ward

The tendency in modern hospitals is in favor of smaller wards, as affording better facilities for proper classification and separation of patients. A nurses’ utility room adjoining every large ward or located conveniently near two or three small wards, where medicines, clinical records, supply charts and blanks, order books and the memorandum books necessary for ward work are kept, is a much appreciated convenience in some hospitals. Opening off this room is the ward diet kitchen, where the refrigerator and food supplies for the ward are kept, and the facilities for quick preparation of special diets for individual patients.

Quiet Room

A much needed adjunct to a hospital ward is an isolation or “quiet” room, to which a patient whose presence is offensive to the other occupants of the ward may be removed. Whenever possible, a dying patient should be separated from the other patients in the ward. Gruesome tales that are disgraceful have been told of patients passing out of life in full view of the other occupants of the ward, without even the measure of privacy a screen affords. It is a melancholy comfort to relatives and friends to be with the patient in his last hours, and this cannot be permitted in a ward without confusion and discomfort to other patients. When planning a ward for the care of the sick or the poor, the object, of course, is the saving of lives, but people will die in hospitals in spite of the best skill and care, and the poor man is surely entitled to a quiet place to die in. There is much in hospital life to blunt the sensibilities of those who live in such institutions constantly. Familiarity with suffering and death robs them of mystery and awe, but it should never be allowed to detract from the reverent care of the dying and dead. “Put yourself in his place,” is a good rule to observe in dealing with even the most unworthy of Adam’s sons.