If the nurse’s height will allow of two mattresses, it is a good plan to alternate them so that the under one of yesterday shall be the upper one of to-day. Those who have not tried this simple way of securing a change, will hardly believe the comfort it affords to a helpless patient.
On the same principle, it is a great alleviation to the monotony of long illness if the room will allow of two beds, one for day, the other for night; and this arrangement permits the thorough airing of bed and bedding, which it is otherwise so difficult to secure.
Bed-hangings are happily following the lead of the ancient four-poster, and will soon be only remembered as things of the past; and in illness, even the valance, still in use, had better be banished. Pillows should be firm and not too soft; and bolsters should have covers of their own, and not be rolled round in the under-sheet, according to a common and very shiftless process. I have known the sheet to be tucked round the bolster in such a careless way that by the patient’s merely getting into bed it has been pulled out of place, and has continued a fruitful source of irritation for the rest of the day.
How to keep the under-sheet smooth and free alike from crumbs and wrinkles is one of the professed nurse’s arts, and is just one of those apparently small matters, neglected as such by inexperience, which make home-nursing the unsatisfactory thing it often is. Yet those who have gone through a tedious illness can hardly fail to remember the discomfort of what a tiny patient used to call ‘rucks.’ To him, poor little man, rucks made stopping in bed a misery; and his incessant demands to have them removed, suggested to even his inexperienced nurse the idea that there might be a right and a wrong way to such a commonplace thing as bed-making. The right and only proper way of arranging a bed for illness is to give special, minute attention to the placing of under-blanket and sheet. If the former can be dispensed with, especially in summer-time, it will be well; but very few patients will agree to this, and it is hardly of sufficient importance to argue about, except in special cases, when the doctor will probably give his veto.
In an ordinary way, be careful to choose a thin blanket, without holes of course, but one that has been pretty well worn, and that, therefore, will not greatly add to the heat of the patient’s body. Then—more important still—the blanket must be considerably larger than the bed, in length as well as width. The mattress being arranged as evenly as possible, the under-blanket should be laid upon it, and well tucked in at top and bottom, as well as sides, till there is not a crease or wrinkle of any sort. The under-sheet must now be put on in the same way, and the nearer it resembles a drum in tightness the better. A few minutes spent in extra care at this point will save the patient hours of discomfort later on.
Should there, unfortunately, be no covered bolster, the sheet, after being securely tucked in at the bottom, must be drawn tightly upwards, and the bolster rolled round in the free end and then placed well up against the bed-head. The difficulty is to get the sheet tightly stretched without pulling the bolster away from its proper place. The number of pillows must be regulated by the nature of the patient’s malady and partly by his previous habits. In ordinary cases, one large pillow is enough, and it is a good plan to place it lengthways, one end resting against the bed-head, and the other on the mattress, thus avoiding the hollow between the patient’s shoulders and the bed, which is a fruitful source of uneasiness and restlessness. In convalescence and in many forms of illness, pillows play an important part, and we shall have more to say about them later on.
We now return to the bed, furnished as far as the under-sheet and pillow. Should the patient be quite helpless, it will be necessary to place next, the contrivance known as a draw-sheet, which should consist of old linen or calico that has been washed to extreme softness. It should be folded lengthways till just long enough to reach from below the patient’s shoulders to his knees. This, with an under-piece of mackintosh, is carefully put in place and tucked in with the same care and tightness as the under-sheet.
In regard to the upper bed-clothes, they too require care in tucking in, especially at the bottom; and if so long as to need folding back, the folding must on no account be done at the top. I have seen patients with chest complaints literally labouring under the weight of clothes placed in exactly the wrong place. In illness, as a rule the feet need extra covering, and the breathing organs no more weight of clothes than is absolutely necessary. The upper-sheet being light, may be allowed to turn over for neatness, but blanket and counterpane must only come up to the patient’s neck. This folding back is such a common error, that it needs special notice, and in ordinary life, as well as in illness, should never be tolerated. The number of upper-clothes to be put on the patient’s bed will vary with circumstances; but, as a rule, in a room with a fire, one blanket and a counterpane will be enough. The great point is to secure warmth without weight, and for this purpose, the ordinary cotton counterpane is about as bad as possible. An excellent substitute is the kind of blanket known as the ‘Austrian,’ which is cheerful in appearance as well as light and warm. In cases of exhaustion, nothing is better than a chintz-covered down, which can be shifted or removed without disturbing the patient.
A good many amateur nurses err on the side of over-heating a patient, and do not understand its connection with restless tossing and broken sleep. Should these symptoms occur at night, especially if accompanied with a flushed face and moist skin, it is well to gradually reduce the number of coverings, carefully noticing the effect of so doing.
On the ground of their greater warmth, cotton sheets and pillow-cases are preferable to linen; but some people have a decided fancy for the latter, and it may safely be used, provided the sheets are warmed just before being put on the bed. Simple airing is not enough; I have known the chill of linen set a patient off into a shivering fit, although the nurse has been particularly strong in the airing line.