If the nurse can direct or tactfully lead the patient’s attention away from himself and his illness, she has found a big reinforcement to his treatment. This question is so vital in the care of patients that it will be discussed at greater length later on.
One Thought Can Be Replaced by Another
If we control attention we control thought, and with the suggestible patient this principle depends upon the one just now considered. Hope and courage-breeding thoughts can replace despairing and fearful ones, but it will be only when attention is directed through interest or by will to new material. There is no blank in waking consciousness. The last thought or feeling or perception, through association of ideas, brings up a related one, and so on indefinitely. We may start with a pebble on the road and go on logically, smoothly, until in five minutes we are thinking of the coronation of King George, with no sense of anything at all unusual in the succession. It may be a very roundabout process, from “pebble” through “rough way,” “ways that hurt,” “dangerous ways,” “brigands,” “uncertainties of life.” “Uncertain lies the head that wears a crown,” “King George and his crown,” “coronation.” But this constant stream of thought can be broken into at any point by a spoken word, a passing vehicle, which diverts the mind’s trend. So the nurse can take advantage of the mind’s very suggestibility, and substitute for the unhappy and sickness breeding by turning attention to anything else of a happier color, and may divert the entire stream of thought in that direction. She who knows these simple laws of the mind, and who at all knows people, is a therapeutic agent of unlimited value.
Habit is a Conserver of Effort
It is always easier to follow a beaten path than to break one’s way through untrodden forests. It is easier to walk after we “learn how,” and learning how is simply doing it over and over until the legs and feet have acquired habits of motion and accommodation to distances and to what is underfoot. It is easy to do anything after we have done it again and again, so that it has become second-nature, and “second-nature” is habit. The wise man early forms certain habits of personal care, of eating, sleeping, exercising; of study, of meeting the usual occurrences of life. The first day he spent at anything new was a hard one. Nothing was done naturally. Active attention had to be keenly held to each detail. He had to learn where things belonged, how to do this and that for the first time, how to work with his associates.
Do you remember the first hospital bed you ever made, the first bed-bath you gave, the first massage? You had to be taught bit by bit, detail by detail. You did not look upon the finished whole, but gave almost painful attention to each step that led to the made bed, the completed bath, or the given massage. Your fingers were probably all thumbs unless you had experience in such things before you came to the hospital. Your mind was tired from the strain of trying to remember each suggestion of your instructor. The second time, or certainly the third or fourth time, it went better. After a week of daily experience you gave the bath or massage or made the bed with much less effort. A month later the work was practically automatic and accomplished in a fraction of the time you spent on it that first day. Now you can do it quickly and well with little conscious thought; and at the same time carry on a brisk conversation with your patient or think out your work for the day. Your mind is free for other thoughts while you perform the task easily and perfectly. Your method of doing the work has finally become a habit which saves the effort of conscious attention. The details of your routine work are directed by the subconscious. The habit will be energy and time saving in proportion to the accuracy of your first conscious efforts spent on the new undertaking. Thus, useful habit is the result of active effort.
We can acquire habits of thinking and habits of feeling as well as habits of doing.
But the other habits, the bad ones, are not acquired with effort. We fall into them. Hazy thinking is easier than clear thinking. Suppose you are by nature rather oversanguine or overdespondent, and you make no genuine attempt to evolve that nature into poise. Directing will to do what desire opposes is too difficult, and you go the way of least resistance. So easily are the bad habits formed; but only with tremendous effort of will and persistence in refusing their insistent demands can they be broken or replaced by helpful ones.
But habits can be learned; and bad habits can be broken when an overpowering emotion is aroused against them, possesses the mind, and controls the will; or when reason weighs them in the balance and judgment finds them wanting, and volition directs the mind to displace them by others.
The nurse meets in her patients numberless habits which retard recovery of body and make for an unwholesome mental attitude. Some patients have the complaint habit, some the irritation habit, some the self-protection habit, some the habit of impatience, some of reckless expression of despair, some of loss of control, some of incessant self-attention. The nurse who can arouse an incentive to habits of cheer expression when the least cause of cheer appears, who can by reason, or if that is not possible, by suggestion; by holding out incentives, or by making some privilege depend upon control—this nurse can help her patient to displace habits of an illness-accepting mind by habits of a health-accepting one. Above all, let her beware of opening the way to habits of invalidism. Some people acquire the “hospital habit” because it is easier to give way to ill-feeling, however slight, and to be cared for with comfort, than to encourage themselves to build up endurance by giving little attention to minor ailments.