Matters Miscellaneous
The ease with which the routine work of the ward goes on will depend largely on proper facilities and a proper system. There should be a regular order for the work of the day—a time for bed making, a time for sweeping and dusting and washing the ward floors, a time for the daily cleaning of the bath rooms and toilet rooms and refrigerators and cupboards. Interruptions may be expected, but unless a routine order of work is established the cleaning will be executed in haphazard style. Neither nurses nor maids can be depended on to use their judgment in such matters. If left to plan their work, they will probably be found sweeping their wards when the doctors are ready to begin their dressings, and the time for other things will depend on their ideas of the importance of the various duties. The habit of doing things quickly and thoroughly should be formed by every one who has any responsibility of the routine work of a hospital, where everything should move with clock-work precision. So much time can be wasted by lack of system, or in talking or dawdling. The untidy habit of leaving glasses or utensils dirty till a sufficient quantity has accumulated to make it a necessity to wash them, should never be tolerated.
It ought not to be necessary to mention the necessity of plenty of tools and the right kind of tools for ward work—plenty of basins, and syringes, and dressing pans, and instruments, and drinking-cups, and medicine glasses, and the thousand and one little things that go to make up the complete furnishings of the hospital ward. But, as a matter of fact, many nurses go through their course of training hampered by a lack of facilities for proper work. One set of instruments for dressing is provided, where several are needed at the same time; insufficient linen to keep the beds and their occupants clean is the rule, and so on indefinitely.
Destruction of Appliances
On the other hand, head nurses and hospital housekeepers lament over the carelessness of nurses and the constant destruction of hospital appliances. Just what course to pursue with the girl who every few days puts a rubber catheter or rectal tube or nozzle on to boil, and lets it burn up; who pours boiling drinks into glass tumblers, and thereby keeps up a constant breakage; who leaves hypodermic needles without wires, and finds them useless when needed again; who breaks medicine glasses and fails to report the accident, till the head nurse finds her measuring medicine with a spoon; who puts the thermometer into the mouths of delirious patients or children, and goes away and forgets it; who lets the sterilizer boil dry; who puts glass syringes and appliances in unsafe places, and returns to find them broken—just what course to pursue to correct these destructive tendencies is an ever-recurring problem to the hospital housekeeper. Nurses who are most careful and conscientious in carrying out the doctor’s orders, and in their duties to the patients, frequently lack that fine sense of honor regarding their duty to the hospital and the care of materials. A deposit for breakage is now demanded in some hospitals when a nurse enters for training. If this is not done the nurse should be made to replace articles destroyed and to pay for repairs that are rendered necessary by her carelessness.
Proper economy in the use of hospital goods is an important lesson for nurses to learn early in their career, and one which will demand frequent emphasis throughout their course. Gas stoves are left burning when not in use, and help to swell the gas bill. Milk is left out of the ice-box, and quickly becomes unfit for use. Materials of various kinds that could be utilized are thrown away. The destruction or waste of one article seems a very trivial affair, but in the aggregate such trivial affairs amount to hundreds of dollars in the course of a year. The cost of rubber sheets alone is an important item in ward expenses. The best will soon crack if folded when not in use. If loops of tape are fastened to the corners and the sheets hung against a closet wall when not in use, they will be found to last twice as long.
Screens
Plenty of screens in a hospital ward is a necessity to proper nursing. The poor appreciate privacy and refinement and delicacy as much as many of their wealthier neighbors, and they have a right to such privacy as a screen affords. The timid, frightened little woman who has just been admitted, and who shrinks from the gaze of everybody, ought to be screened off till the first awful feeling of strangeness wears away. The patient who is critically ill needs also to be screened. The general work of the ward requires the constant use of screens. One screen for every two beds is not too many for the necessities of the average ward. One of the most practical and altogether desirable ward screens is made of a wooden frame, white enameled, covered on both sides with white oilcloth. A set of clothes-bars, from four and a half to five feet high, makes a very satisfactory frame, that is large and yet light enough for one nurse to handle.
A fair equipment for a ward of twenty beds would be: