It is absolutely necessary that all the bedding used in illness shall be thoroughly aired, but, of course, it should never be done in the sick-room. Unhappily, it is by no means rare to find the fire screened from a patient by clothes-horse or chairs, covered with damp things, the vapour from which ought to be sufficient warning of the folly of such a practice. A good rule in this connection is that everything, down to cups and saucers, shall be removed from the sick-room as soon as soiled, and only returned to it in a condition for immediate use.
Re-making the patient’s bed is our next consideration. If well enough to go into another room, he should either be carried there, or laid on a sofa and wheeled in. As soon as he is out of the way, the window of the sick-room should be thrown open to its widest, and the bed-clothes taken off one by one, well shaken, and left so exposed that the air can circulate freely around them. The mattresses should share the same treatment, and if possible, be left for a few minutes before being replaced. The patient will indeed be peculiar who does not enjoy the refreshment of a bed thus aired.
But in helpless illness, the changing of bedding is a more complicated matter, and needs practice to make perfect. There are two ways of changing the under-sheet The first may be used when the patient is not quite helpless, and the nurse has to work alone. The soiled sheet is freed at the top, and after the removal of pillows and bolster, is rolled up to the patient’s head; the clean sheet, after being well tucked in at the top, is loosely rolled in such a way as to lie close against the soiled one; they must now be worked down together, rolling the soiled, and unrolling the clean, the patient raising himself on elbows and feet just enough for the nurse to pass the sheets under him. In this way it is possible to get the under-sheet smooth and tight; but it is not an easy thing, and an assistant should be had if possible. If help is to be had, and in all cases where the patient is quite powerless, it is better to adopt the second plan. Remove the pillows and bolster, so that the patient lies quite flat in bed; turn him over on his side with his back to you. Loosen the sheet lengthways, and proceed with the rolling and unrolling as before, till the rolls come close up to the patient’s back. Depress the mattress under him, whilst the assistant draws the sheet through, and in so doing, slowly turns the patient on his back. He will now be lying on the clean sheet, and the difficulty is over. The trained nurse will be able to do this without removing the upper clothing, and in no case should all the coverings be taken away. Draw-sheets may be removed in the same way, but being small, are easier to manage. Some people tack or pin the clean to the dirty, and draw through whilst an assistant keeps the patient raised. Changing the upper clothes is not such a serious undertaking, though seldom properly managed by amateurs. The counterpane and blanket may be taken quite off the bed, and given to an assistant to shake, outside the room; but the sheet must never be removed without an immediate substitute. A good plan is to loosen the soiled sheet all round, tuck the clean one well in at the foot, and draw the free end upwards, under the dirty sheet, which is gradually drawn away or rolled up. As a general rule, the patient’s bed should be made and his night-shirt changed at least once a day, and cases where this is not feasible ought not to come within the scope of home-nursing.
If a pair of clean sheets a day cannot be managed, one may be made to do, by letting yesterday’s clean upper sheet be to-day’s lower one; but draw-sheets must be changed as soon as soiled, irrespective of number. Where mackintosh is used, it should also be frequently changed, washed over, and thoroughly dried, in the open air if possible.
The patient’s bed, it will be seen from the directions for making it, must never stand so that one side is against the wall, nor must it be in a direct current of air; but it is well if it can be so arranged as to face the fire and at the same time allow the patient to amuse himself by looking out of window. In badly finished houses, there is often considerable draught from cracks in door or window frame, and from this the patient must be carefully guarded by the judicious use of screens.
We now turn to consider how the sick-room may be kept in that state of perfect cleanliness essential alike to the patient’s comfort and recovery; and of all neglected points, this is perhaps the one most frequently forgotten or ignored; not one in a hundred of home-nurses having a conception of her duty in this respect. Difficult it undoubtedly is; but where the patient can be removed to another room for an hour or two once a week, it is quite possible for even inexperience to be successful.
We will suppose the weekly removal has taken place, and the nurse has to make hay while the sun shines. She first strips the bed, sending the clothes into another room to be aired; and throwing the window open to its widest, she directs her attention to the grate. The best way of removing the ashes is to carefully collect all the large pieces of coal and cinder, and then very gently draw the ashes away into a piece of stiff paper, which folded over them, will prevent any dust rising in their transit. After cleaning grate and fire-irons and making up the fire, the nurse turns her attention to the carpet, which, after being well strewn with damp tea-leaves, should be briskly swept with a hand-broom. If the furniture is simple, it may be washed over with a wet cloth and dried, all cushions or stuffed furniture being beaten out of the room. The window, often overlooked, should be nicely cleaned; and then the bed being re-made, the patient may be brought back into a room thoroughly well cleaned and aired. It is not necessary that a nurse should herself perform all menial work; indeed, it is much better she should not; but she ought to see that the above directions are faithfully carried out. For the rest of the week, the carpet should be wiped over with a damp (not wet) cloth, tied to the end of a long broom, and the furniture well and quickly dusted. It is not enough to merely wipe over furniture and let the dust loose; the duster should be folded over bit by bit as it becomes soiled, and once or twice during the process of dusting, shaken out of a window in another room or in the staircase. A room thus treated will keep in perfect order for some time; but should the illness be long, an effort must be made to take the carpet up about every six weeks or two months, that it may be beaten and thoroughly aired. If carpets are made in the sensible fashion of squares, secured by brass nails with broad heads, there will be little difficulty in managing this; but it will not hurt the carpet to let it remain loose.
In cases where the weekly removal is impossible, the floor must be wiped over carefully every day with a damp cloth, and tea-leaves used now and then, the patient being protected from the dust by screens; but this plan is only for use as a last resource in extreme cases. Under such circumstances, it is not a bad plan to have a small portion of the furniture, say a chair or table and an ornament or two, removed each day and thoroughly cleaned, out of the room; otherwise, it is almost impossible to keep things in proper order, in spite of daily dusting.