Thus used, an attendant will soon learn that it is not the easiest way to care for a patient, that its use involves increased watchfulness and care, and greater discretion, and that it is strictly a form of medical treatment. It is a harsh remedy at its best, and needs to be used with kindness, intelligence, and judgment, and it is to be applied but for one purpose, namely, that the patient may be benefited.
The Use of the Covered Bed.—Like restraint it is never to be used except by the orders of a physician, nor is its use to be repeated without special orders; it is always to be considered a method of treatment and something the attendant has no interest in, except to know how best to use it when ordered to do so.
When in a covered bed the patient should be frequently visited; he should be taken up at least once in three hours, unless asleep; the bed and the patient should be kept perfectly clean. If used in the daytime an attendant should sit beside the patient for some hours and try to keep him quietly in bed, and the same should be done in the evening when the patient is put to bed. An attendant should be able to report how much the patient sleeps, how much quiet and rest is obtained, the effect of the treatment, and compare the condition of the patient when in the bed with what it is when not used.
The Use of Seclusion.—Seclusion is shutting a patient alone in a room in the daytime. If allowed to be done without orders from the physician it should be immediately reported. If ordered to be continued the patient should be seen at least once in fifteen minutes, while many need to be seen once in five minutes, and an attendant should never be far from the door. The patient should be frequently taken to the closet. The effect and result of seclusion should be observed and reported.
Many physicians never use any form of restraint, while others make considerable use of it as a means of treatment. An attendant should be able to successfully care for any case, so as to meet the wishes and directions of the physician, and only as he is able to do this can he give the patient the highest standard of attention, care, and nursing.
CHAPTER VII.
THE CARE OF THE HOMICIDAL, SUICIDAL, AND THOSE INCLINED TO ACTS OF VIOLENCE.
Patients with Delusions of Suspicion demand special care, and are properly classed with those inclined to commit acts of violence, because they are frequently fully under the control of delusions, which make them dangerous and difficult to manage.