2411. While the case is doubtful, a dessert-spoonful of spirit of nitre diluted in water, given at bedtime, will throw the child into a gentle perspiration, and will bring out the rash in either case. In measles, this appears first on the face; in scarlatina, on the chest; and in both cases a doctor should be called in. In scarlatina, tartar-emetic powder or ipecacuanha may be administered in the mean time.
2412. In all cases, cleanliness, fresh air, clean utensils, and frequent washing of the person, both of nurse and children, are even more necessary in the nursery than in either drawing-room or sick-room, inasmuch as the delicate organs of childhood are more susceptible of injury from smells and vapours than adults.
2413. It may not be out of place if we conclude this brief notice of the duties of a nursemaid, by an extract from Florence Nightingale's admirable "Notes on Nursing." Referring to children, she says:—
2414. "They are much more susceptible than grown people to all noxious influences. They are affected by the same things, but much more quickly and seriously; by want of fresh air, of proper warmth; want of cleanliness in house, clothes, bedding, or body; by improper food, want of punctuality, by dulness, by want of light, by too much or too little covering in bed or when up." And all this in health; and then she quotes a passage from a lecture on sudden deaths in infancy, to show the importance of careful nursing of children:—"In the great majority of instances, when death suddenly befalls the infant or young child, it is an accident; it is not a necessary, inevitable result of any disease. That which is known to injure children most seriously is foul air; keeping the rooms where they sleep closely shut up is destruction to them; and, if the child's breathing be disordered by disease, a few hours only of such foul air may endanger its life, even where no inconvenience is felt by grown-up persons in the room."
2415. Persons moving in the beat society will see, after perusing Miss Nightingale's book, that this "foul air," "want of light," "too much or too little clothing," and improper food, is not confined to Crown Street or St. Giles's; that Belgravia and the squares have their north room, where the rays of the sun never reach. "A wooden bedstead, two or three mattresses piled up to above the height of the table, a vallance attached to the frame,—nothing but a miracle could ever thoroughly dry or air such a bed and bedding,"—is the ordinary bed of a private house, than which nothing can be more unwholesome. "Don't treat your children like sick," she sums up; "don't dose them with tea. Let them eat meat and drink milk, or half a glass of light beer. Give them fresh, light, sunny, and open rooms, cool bedrooms, plenty of outdoor exercise, facing even the cold, and wind, and weather, in sufficiently warm clothes, and with sufficient exercise, plenty of amusements and play; more liberty, and less schooling, and cramming, and training; more attention to food and less to physic."
DUTIES OF THE SICK-NURSE.
2416. All women are likely, at some period of their lives, to be called on to perform the duties of a sick-nurse, and should prepare themselves as much as possible, by observation and reading, for the occasion when they may be required to perform the office. The main requirements are good temper, compassion for suffering, sympathy with sufferers, which most women worthy of the name possess, neat-handedness, quiet manners, love of order, and cleanliness. With these qualifications there will be very little to be wished for; the desire to relieve suffering will inspire a thousand little attentions, and surmount the disgusts which some of the offices attending the sick-room are apt to create. Where serious illness visits a household, and protracted nursing is likely to become necessary, a professional nurse will probably be engaged, who has been trained to its duties; but in some families, and those not a few let us hope, the ladies of the family would oppose such an arrangement as a failure of duty on their part. There is, besides, even when a professional nurse is ultimately called in, a period of doubt and hesitation, while disease has not yet developed itself, when the patient must be attended to; and, in these cases, some of the female servants of the establishment must give their attendance in the sick-room. There are, also, slight attacks of cold, influenza, and accidents in a thousand forms, to which all are subject, where domestic nursing becomes a necessity; where disease, though unattended with danger, is nevertheless accompanied by the nervous irritation incident to illness, and when all the attention of the domestic nurse becomes necessary.
2417. In the first stage of sickness, while doubt and a little perplexity hang over the household as to the nature of the sickness, there are some things about which no doubt can exist: the patient's room must be kept in a perfectly pure state, and arrangements made for proper attendance; for the first canon of nursing, according to Florence Nightingale, its apostle, is to "keep the air the patient breathes as pure as the external air, without chilling him." This can be done without any preparation which might alarm the patient; with proper windows, open fireplaces, and a supply of fuel, the room may be as fresh as it is outside, and kept at a temperature suitable for the patient's state.
2418. Windows, however, must be opened from above, and not from below, and draughts avoided; cool air admitted beneath the patient's head chills the lower strata and the floor. The careful nurse will keep the door shut when the window is open; she will also take care that the patient is not placed between the door and the open window, nor between the open fireplace and the window. If confined to bed, she will see that the bed is placed in a thoroughly ventilated part of the room, but out of the current of air which is produced by the momentary opening of doors, as well as out of the line of draught between the window and the open chimney, and that the temperature of the room is kept about 64°. Where it is necessary to admit air by the door, the windows should be closed; but there are few circumstances in which good air can be obtained through the chamber-door; through it, on the contrary, the gases generated in the lower parts of the house are likely to be drawn into the invalid chamber.
2419. These precautions taken, and plain nourishing diet, such as the patient desires, furnished, probably little more can be done, unless more serious symptoms present themselves; in which case medical advice will be sought.