III
THE NURSE HERSELF
It is just as necessary for the nurse to be careful of herself as of the patient, though her care must be manifested in a far different way. Always remember that to do really good work you must have really good tools. No man owning, and intelligently working a valuable machine, would keep it going at its highest speed all the time. He takes care of it, keeps it clean, renews defective parts, oils it; and then he expects it to run for so many hours, and to run well,—to do its work thoroughly. But with all his keeping it in order he does not make it work night and day for weeks or months. Such folly is never heard of in an engineer; but with us human beings, who own and manage a far more wonderful machine than any steam engine, we hear of it often, and always, always the tale winds up with the inevitable catastrophe. The business man develops paresis, the clergyman loses his voice or his eyes, the nurse contracts some disease that incapacitates her for work, in every case mother Nature makes the careless or ignorant owner of the wonderful machine pay the penalty of the misuse. It does not matter to Nature what the reason is for our breaking the great laws; we can kill ourselves with philanthropic work just as surely as with over indulgence. One trouble is, that it does not always kill. A paralytic may live for years, so does a man with paresis. When the wonderful God-given machine works badly, or stops entirely, we look on, and sometimes wonder why it is that those who are so helpful, such fine examples of courage, of skill, of virtue, so hardly to be spared, are the ones to be taken away. Do we wonder, we who are nurses? Do we not know what did it? Ah! yes—we know, we know, that such and such a nurse was tired out when she went to still another case— and when we heard she herself was ill we were not slow to say, "Foolish girl! Did she suppose she was made of wrought iron and sole leather?" But will we take heed, and not do likewise, or will we wonder, with the unthinking ones, why it is that the good, useful people are always taken away? Do not deceive yourselves; they are not "taken away," they take themselves away, for God will not reverse His wise laws because we (no matter how good we are) act in defiance of them.
Please remember I am only speaking now to the good nurses—the enthusiastic ones,—poor nurses, lazy nurses have no temptation to overwork themselves. They may die of indigestion, but they will not die of exhaustion.
It seems to you so natural for others to be sick. You have seen the sick by scores in the hospital, and have waited on them, felt sorry for them, sympathized with them; but have you thought that it was within the bounds of possibility that you could ever come into such a pitiable condition? You go from house to house in your private nursing, always you find the sick, and it seems natural, quite the proper thing. You care for them, they get well, or die—and on you go to the next—but reflect on what made them sick, and though you know you are made of like flesh and blood, do not conduct yourself as if you were not. "Oh, yes" (how often have I heard it said), "I know she worked too hard, but I am so strong, you never heard me complain; I can nurse a fever case for two weeks and never go out of doors for air or exercise." Is it not foolish? Is it not wrong for any sensible woman to talk thus?
Now listen to some few practical hints as to how to keep yourselves in good working order. In the first place, then, never go to a case unless you are feeling well. It is far wiser, as far as you are concerned, and better also for the sick one, for you to say so frankly, if you are not well. Tell the one who comes for you, that you could not do justice to the case, as indeed you could not. Sick people are as sensitive as babies to the subtle influence exerted by the one who is so constantly over them. If you are in full health and strength, your rubbing will be quieting and effectual, your very presence, if you are careful and gentle, will be soothing. On the contrary, if you yourself are suffering and are using the nervous force you ought to be giving your patient in hiding your own malady, your presence will not be so eagerly welcomed; your patient will not know what is the matter, but she feels rather a relief when you are absent. Going to a case feeling perfectly well, the next thing is to keep well.
Be careful about your eating. Your meals will of necessity be often irregular, that is unavoidable, but eat only wholesome things. Do not eat candy; and at dinner, which you will probably have in the evening after the family are through, avoid patties, and rich puddings, ice cream, and such like. You will always find plenty of plain food and fruit in the most luxurious homes; eat these and let the rest alone. If you want to keep your stomach and whole digestive apparatus in good order, you must care for it, and not overtax it. If you have a pretty good stomach it will bear a good deal of abuse, but in the end it will grumble, and a dyspeptic nurse is not an attractive object. As to your night suppers, which you should always have, should your case require constant watching, I would recommend plenty of coffee, tea, or cold milk, if you can drink it, bread and butter, cold meat and fruit. Never eat candied fruits, cake, or pies at night. Have eggs if you care for them, and pickles if you like. Remember, the plainest food, the most easily digested, the most nourishing is what you must have. Believe me, you will be rewarded for the temperate use you make of all the dainties you see, by a clear complexion, and good color, which will make you "good to look at," especially good for a sick person to look at.
As to the nurse's night toilette, it is quite a problem sometimes as to just what is best to wear. When the patient is not ill enough for the uniform to be retained for night duty, the nurse should be comfortable enough so that she can sleep; yet dressed enough for any emergency. I think a house gown of pretty material much neater than the kimono. Be sure this fits about the shoulders, and never have loose flowing sleeves. A white frill in the neck looks very trim, and is always becoming. The corset and all tight clothes should be removed, stockings and underwear kept on. The hair should be arranged simply, but not allowed to hang in a loose braid, unless you are very sure you will not see any but the patient, and even then it may be unwise, as a braid of hair has an exasperating way of slipping from its proper place (hanging down the back) and dipping into whatever you are stooping over. Dressed thus, with night shoes to protect the feet, one can lie down on a lounge and sleep very comfortably, being freed from tight clothes, and yet being entirely presentable, no matter what happens. To undress regularly and put on the diaphanous low-necked short sleeved night dress of the present mode, and go to bed, when you are sure you will have to get up one or a dozen times during the night is not good judgment, I think. You get out of a warm bed, and if you only put on your shoes and stockings, your patient must wait while you do it. If anything serious occurs suddenly, you either run the risk of taking cold from being insufficiently clad while doing what must be done, or your patient must wait while you dress—both bad.
Never get into bed with your patient. This seems to most people a quite unnecessary caution, but it is the commonest experience of the successful nurse, that a woman, feeble and nervous, should ask and almost insist that she shall lie down by her, or get into bed with her. I always wonder that a sick woman can not realize that she is not a pleasant bed-fellow, but she seldom does. Of course you are not to tell her that she is not fit to sleep with, but you can say that she needs and ought to have the whole bed to herself, and you will sit by her and hold her hand, or if she insists on it, you can lie down, with your house gown on, on the outside of the bed, being careful to give her plenty of space, and when she is asleep, get up quietly and lie down on your lounge, which should be placed so that you can see her every movement.
Never let the patient think for a moment that you fear her disease; if she has diphtheria, do not tell her or the family that you have a delicate throat or that it is sore, and do not examine it by the help of a hand-glass where any one can see you. Do not go to such cases if you really fear them, but if you go, and have reason to feel that you have contracted the disease, tell the doctor as soon as you can, and if he thinks you ill, he will send you home. Never tell a patient you have a weak back or any weakness. Tell the doctor and he will see to it that you have rest or medicine, but do not let the patient know it. Never go about a sick room with a long face; it is enough for the sick one to have to be sick; the family sympathies are all enlisted for her. You are there to be a help and a comfort, not an added anxiety. Of course these remarks do not apply to any of you who are tired from a long, exhausting case. The family in such instances are ready and willing enough to let you rest. Keep your cheery manner: all higher considerations aside, it is money in your pocket to look cheerful. I have known one or two good, faithful, conscientious nurses who were dismissed from case after case, merely because they looked "so doleful." It may seem curious to place a commercial value on a smile, but in reality it amounts almost to that.