Good bed-making is imperative in sickness, and nothing is a better test of a nurse’s capacity than the way she keeps her patient’s bed. Some nurses are eternally fidgeting till they work the unhappy invalid into a frenzy. Others, again, in their dread of disturbing him, let the patient toss everything to the wildest confusion, trusting to one grand and general clearing up to set matters right. A good nurse keeps things straight almost unconsciously, taking advantage of any chance the patient gives to smooth out the crumpled sheet, or tossed bed-clothes, with a strong even pull, or to replace a heated, crushed pillow with a fresh cool one (though careful that, if cool, it is not chilly). Remember when smoothing a sickbed never to jerk or twitch the clothes, and be always sure your attempts do not endanger anything that may be lying on the bed, and whose downfall would most certainly disturb and flurry the invalid. A wide bed in a measure is a substitute for having 2 beds, as considerable relief may be obtained by using alternate sides of the bed; moreover, you can cool one side when the patient is on the opposite side, by turning back the clothes so as to let the air reach the lower sheet. Bed linen should always, if possible, be exposed to the open air, in the sun and wind, before using, as this freshens it most effectually, whilst a drop or two of good lavender or rose water sprinkled on sheet and pillow-case add greatly to the pleasantness. The best way of making a bed so as to give the least possible disturbance to the sick person, and prevent bed sores, is laid down in these rules:—(1) Keep the sheet below the patient perfectly smooth; (2) wash the parts where the bone is prominent daily with soap and warm water, dry them well, rub them over with a little spirits of wine or whisky to harden the skin; (3) change the patient’s position frequently; (4) never let him lie on a blanket; a freshly-made bed, a good sponge over with vinegar and water, would often, after a restless, sleepless night, have the good effect of making the patient fall into a sound sleep. It is best to make a good lather with the soap, and not to use much water. Zinc-powder and boracic acid powder are often used to powder the back after the washing.
A very common torment of invalids is the weight of the bed clothes. They are heavy, but not warm. For the rich, blankets and eiderdown quilts are easily obtained; but for the poor, paper is far better than many more costly coverlids. It is by no means necessary to spend money on a paper blanket, though these are excellent; a few sheets of brown paper, or even newspapers, pasted together to the size of the bed, add greatly to the warmth and practically nothing to the weight. If it is not the beat possible covering, it is very good, and absolutely costless.
It is often necessary to change the sheets without disturbing the patient. This can be done either from side to side or from head to foot. The former method consists in loosely rolling up the soiled sheet sideways, from the side of the bed where there is most unoccupied space, until the roll can be pressed against the patient’s side. The clean sheet, previously loosely rolled up from side to side, is then unrolled over the uncovered part of the bed, until the clean roll lies by the side of the soiled one. The patient is now lifted over on to the clean sheet, the soiled sheet is taken away, and the spreading of the clean sheet is completed. The second plan is to roll up a clean sheet loosely from end to end. Beginning at the head of the bed, the soiled sheet is rolled down from underneath the bolster, and the clean sheet unrolled after it, and arranged in its place. The shoulders of the patient should then be raised a little, and the soiled sheet rolled down from under them, while the clean sheet is unrolled to follow it. The hips, and lastly the legs and feet, are to be gently raised one after another in a similar manner, the soiled sheet taken away at the foot of the bed, and the unrolling of the clean sheet completed.
With paralysed and other helpless patients, frequent washing or sponging is more necessary, and the draw-sheet becomes useful. This consists of a small sheet folded lengthwise 2 or 3 times, so that when placed beneath the patient it may reach from the middle of the back to the knees. One end of the folded sheet should be the part first used, the rest being loosely rolled up to within a few inches of the patient’s side. As the sheet becomes soiled, the unused portion is unrolled sufficiently for the soiled part to be drawn from under the sick person, and a clean part substituted. The soiled portion is rolled up as it is withdrawn, and secured by a safety-pin. A piece of waterproof sheeting or a strip of thin oil-cloth passed beneath the draw-sheet still further protects the bed.
Bedding and pillows should not be too soft, otherwise the patient is continually sinking into hollows, and becoming hot and restless in consequence. When a patient needs to be propped up, the greatest mistakes are made. Pillows are jammed and wedged in at the patient’s back till he is completely built in. A cheap and simple pillow which doctors strongly recommend as a support in such cases is made of chaff, or chopped straw, and stuffed hard. It is covered with any cheap material, and is shaped like a writing desk—that is to say, it is made to slope. It should be a little longer than an ordinary pillow, and should be 8-12 in. deep behind and 3-4 in. in front. Ordinary pillows (1 or 2) placed upon this as a basement make a capital back-rest for persons suffering, say, from bronchitis. Such a rest has many advantages: it does not give way, hence the patient no longer finds himself from time to time in a deep hole; it allows the arms and shoulders free movement; it is also cooler, and permits more frequent change of posture. In propping a patient up it should always be remembered that the back needs support as well as the head and shoulders.
A very great comfort to sick people, especially to those who have to be left much alone, is to be furnished with some simple arrangement by which they can raise themselves into the sitting posture and so maintain themselves with slight effort. This can be attained by fixing a length of strong webbing to the foot of the bed, and placing knots upon it at intervals, so as to enable it to be more readily and firmly grasped. A netted bed-rest, 3 yd. in length, is a very simple and useful contrivance; its main use is the same as that of the knotted webbing, but by allowing it to pass round the back of the invalid, and spreading it out, it makes an exceedingly pleasant bed-rest, fashioned on the principle of the hammock. A swing bed-rest has several advantages. It is very cool, and allows a free play of air on all sides of the patient, which is a very important advantage. It permits, moreover, considerable movement, and does away with the fatiguing restraint of keeping the body in one position. If the ventilation through the network be too great, or the weather be cold, a pillow can be placed against the patient’s back, within the rest. Instead of the rest being netted, it may be made of strong towelling, which will bear rougher usage. Its strength and serviceability will be increased by stitching here and there bands of webbing; and at each of its narrower ends strong broad tapes must be fastened, by which it can be secured to the foot of the bed. Such netted bed-rests can be had (5s. 6d. each) at the Depot for Ladies’ Work, 16, King Street, Manchester.
Bedridden patients, and those who are paralysed or otherwise reduced to a condition of great weakness, often complain that they are continually slipping down in the bed. Often a box or footstool is slipped in at the foot of the bed, that the patient’s feet may be pressed firmly against it to prevent slipping. But this cannot be long continued where the legs are weak, for the muscles become exhausted, the knees give way, and then the slipping goes on just as badly as ever. This can be prevented, if a little round pillow, 3-4 in. only in diameter, be fixed so that the patient, though lying down, as it were sits upon it. Such a pillow, to answer its purpose, must be tied in its position very securely, and this may be done by a piece of webbing attached to each end, and tied either to the head or sides of the bedstead.
Following is a way to make pillows with paper stuffing. Use any sort of paper, and tear all into small square or oblong pieces. Then roll each piece between the finger and thumb into a tiny spiral, exactly as if beginning to make round spills. It is very little trouble to do. It is a most suitable occupation for blindman’s holiday, or for people with weak eyesight; and the pillows, as may be supposed, are far more elastic than if made of the same paper, flat. Of course, it is most suitable for an under pillow, if one has a choice; but so long as there are so many unfortunate invalids without any pillows at all, the plan is worthy of remembrance.
A table to stand on the bed is very convenient for trays, &c. It can be bought ready made, and is not at all expensive, or a very little ingenuity is needed to make one. About 2 ft. long, hollowed out on one side, and 1 ft. broad, is a good size. The legs may be 6-7 in. high.
The bed can be refreshed and aired by raising and lowering the clothes so as to produce a fanning motion. To turn a pillow without fatiguing the patient, put the hollowed palm of one hand at the back of his head while with the other you quickly reverse the pillow and replace it. To lay a bed with a waterproof sheet for temporary use, first make the bed with a blanket beneath the under sheet, and then spread the waterproof, a blanket and another sheet, without tucking in. When done with, it is only necessary to draw out the waterproof with its blanket and sheet, leaving the patient on a fresh sheet. No amount of care will keep crumbs out of a sickbed; they catch in every fold and frill and pass up the sleeves, and demand a search after every meal in which bread figures. To avoid rucks in the under sheets, stretch it tight on the mattress and fasten it down with safety pins.