Linen Accounting
The person in charge of the linen room will be expected to keep the linen in repair and to account for every piece that passes through her hands. It is very important to have a systematic method of accounting for linen that will enable the housekeeper to know the amount on hand, and to discover if linen is lost. It matters not whether the washing is done on the hospital premises or sent to a commercial laundry, some system of accounting is necessary unless the housekeeper is willing for a constant depletion of blankets, sheets, towels, etc., to go on without her knowledge. Where a public laundry is patronized the importance of this matter is evident. When hundreds of towels and sheets are sent in at once, it is not unusual for linen to be taken from the large quantity to supply missing articles in the list of other customers who had sent smaller amounts, from which, if articles were missing, it would be quickly discovered. The housekeeper of a certain institution relates the following incident bearing on this point: The linen of the institution was sent to a public laundry, and for some time she had been missing towels, though the laundry always claimed to return the proper number. Finally the manager of the institution happened into a barber shop and accidentally discovered there a pile of the institution towels. Inquiry revealed the fact that the barber kept strict account of his towels and the laundry had to return the number sent or pay for them. The barber cared nothing whose mark was on the towels if he got as many as he sent. A laundry employee had been in the habit of substituting linen from large institutions to make up the required number from smaller lots, and thus the problem of the missing linen for that institution was solved. The inexperienced housekeeper may perhaps settle down into the belief that of course the linen sent to the hospital laundry is safe since it does not leave the premises. If all servants and everybody about the establishment were tried and true and trustworthy, through and through, it might be safe, but in these days of possible degeneracy and certain uncertainty in the servant class, it is wise to trust implicitly but few, and to keep an eye on those.
Discarded Linen
Another point that needs some emphasis is that the housekeeper or her assistant—not the nurses or the servants—must decide when linen is to be discarded. Well-worn or torn linen should not be sent to the wards. A special drawer, marked “Discarded Linen,” should be in the general linen room, and into this the one who sorts linen can lay aside what in her judgment is unfit for wear or beyond mending. But the housekeeper should reserve for herself the privilege of deciding when an article is to be used as old linen. Unless this rule is rigidly enforced, a reckless extravagance will be the result. Good towels will be used as dusters or as scouring cloths. Sheets that might have been utilized in some other way will be torn up and used as cleaning cloths, and a constant depletion of the supply will go on without the housekeeper’s knowledge. Many a housekeeper who has assumed charge of a hospital that had been previously managed without a system of linen accounting has found it one of the most difficult of her tasks to check the tendency to appropriate the hospital towels, sheets and pillow covers for cleaning purposes. Constant vigilance in that direction for months was needed to impress the household that the haphazard, loose way of handling linen was a thing of the past.
Emergency Supply
Every careful hospital housekeeper has found the necessity of a special closet, for the storing of extra linen of all kinds for times of special emergency. It is poor management to have the full supply in circulation at one time. Attention to this emergency closet will save embarrassment many times. What could be more embarrassing than to have a patient injured in an accident, brought in grimy and dirty, and not have a clean gown to put on him? And yet that very thing has happened when the hospital housekeeper has failed to anticipate the emergency.
Sheets that are worn thin in the center may be doubled and stitched together for draw sheets, and in that way will last for months. The ends of bath towels can be hemmed for wash cloths. Squares of linen from partly worn tray-cloths and napkins may often be fringed for doilies for ward medicine trays. The training in economy in supplies, and in methods of utilizing material that would otherwise be wasted, is an important part of the nurse’s training that will benefit her through life.
Removing Stains
The nurses, too, in their use of hospital linen, are responsible in no small measure for its appearance. Blood-stains and various other stains can be readily washed out when the stain is fresh. Every nurse should be taught that it is her duty to remove such stains as far as possible by a preliminary soaking and washing before being sent to mingle with other clothing in the laundry. A little salt in the water will hasten the process. If such matters were thoroughly impressed on each nurse, as a part of her duty in her hospital training, there would be fewer complaints of nurses in private practice needing an extra maid to wait on them. Stains from certain oily dressings are exceedingly difficult to remove. In fact, in the general washing it is practically impossible to thoroughly efface such stains. A little care in managing, and, as far as possible, keeping one set of sheets for cases requiring such dressing, will prevent the whole ward supply from being stained. The oldest linen should be specially set apart for such cases.
New Linen