[Sidenote: The Main Entrance]
“There is nothing in a hospital small enough to be careless about,”
is a remark frequently heard in hospital corridors. It is important
for the housekeeper to bear in mind that, although oft quoted, this
statement happens to be true. Perhaps no one thing will produce a
more lasting impression on a casual visitor than the manner in which
he is received at the front entrance. Two trained nurses who spent a
couple of days in visiting hospitals in an eastern city related the
following experience: At hospital number one the door was opened by a
very untidy-looking, irrepressible colored boy, who seemed to feel it
his duty to do the gallant thing according to his ideas of gallantry.
After an entirely unnecessary speech, his concluding remarks were that
he would just love to go through the hospital with them, but he “ain’t
got no time,” and he guessed he’d have to ask Dr. —— to go with them.
At hospital number two, no one specially seemed to be in charge of the
door, and, after repeated rings, a resident physician, who, judging
from his hair and general appearance, had been napping, came rushing
through the hall—the door was open—getting into his coat by the time
he reached the door. The climax was reached at hospital number three,
which was a maternity hospital, an adjunct of a large city hospital.
Here the door was opened by a colored woman in the last stages of
pregnancy. At hospital number four a pert maid, none too tidy, was
on duty at the front entrance. Her distinguishing feature seemed to
be that she “didn’t know.” At hospitals five and six, the persons
in charge knew what was expected, and did the proper thing, but the
varied experiences served to show the laxity that exists in that one
particular.
[Sidenote: The Porter]
The careful hospital housekeeper will see to it that the person in
charge of the main entrance knows his business and is reliable and
courteous. He need not know all the business of the institution, but he
should know enough to answer questions properly and when to be silent.
If no special uniform is provided, he should be neatly and quietly
attired. Parcels, telegrams, messages, are constantly being delivered
for the inmates, and he should be responsible for them until they are
delivered to the nurse in charge. Letters should be placed in a locked
box, the key to be held by some reliable person who will see to their
distribution. Mail for the patients should not be given to the inmates
direct, but to the nurse in charge, and some nurse should always be in
charge. Carelessness at this point may result in an important letter
or message not being delivered, or delivered at a time when it is
specially important that the patient’s mind be free from disturbance
or intrusion of any kind. Complaints are frequently made, of large
hospitals especially, that boxes of flowers sent to patients have been
thrown carelessly into a parcel room, and not delivered at all, or
delivered after their beauty and fragrance had gone. If the person at
the door is careless about matters of that kind, he will be just as
likely to be careless about more serious things. A temporary substitute
at the door should always be arranged for when the porter is obliged to
be absent, even for a few minutes.
[Sidenote: The Private Rooms]
In all apartments intended for the use of patients some degree of
uniformity should be observed in the furnishings, though this may
easily be carried to extremes. These rooms vary in size and price,
but the essentials for all are the same. The chief thought should be
to have the furnishings suitable, sensible and restful. Dainty white
enameled furniture for hospital rooms is rapidly replacing that of
darker hue and adds greatly to the attractiveness of the hospital. For
the average room a combination dresser and washstand is preferable to
cumbering the room with two separate pieces of furniture. These have
the essential features of the dresser, in that they provide a mirror
and drawers, and of the washstand by having a towel rack and cupboard.
In any case, small dressers are preferable to large ones. Every
private room should have its own wash bowl and pitcher, soap dish,
mug, receptacle for toilet brush, water bottle and drinking glass. The
bed should be placed so that the nurse can have access to it on three
sides. The woven-wire springs should be warranted not to sag in the
middle.
[Illustration: Combination Dresser and Washstand]
Blankets, on account of the frequent washings, should not be all wool,
nor too heavy. For warmth it is better to depend on light blankets than
on any form of “comforter.”
Rugs may be as bright and handsome as the hospital can purchase. The
cheap wool rugs that are everywhere displayed for sale are a poor
investment. The most satisfactory rugs are those made to order of
tapestry Brussels, or when it can be afforded, the more expensive
grade of Brussels or velvet. For small rooms three widths are usually
sufficient and these made without border are not an expensive rug. For
larger rooms a border is preferable, but in any case such rugs are
economical and serviceable.
Long lace curtains should have no place in a hospital. They are always
getting in the way and being torn, always collecting dust and always an
obstacle to the view and to ventilation. At best they are a nuisance,
an unnecessary expense and serve no useful purpose. Soft, plain white
sash curtains are the only suitable curtains for the hospital window.
Provision should be made for looping them back if the patient desires
it, and most patients have a longing desire to see out of doors.
A comfortable, roomy rocker, with arms and without any “squeaks,” is
indispensable in the private room.
[Sidenote: Hospital Couches]
If large enough, the room should also have a couch. It makes an
agreeable change from the bed during convalescence. The common couches
with elevated head are most unsatisfactory. No patient can lie on an
inclined plane for any length of time in comfort. When it becomes
necessary for a nurse to sleep in the patient’s room when on “special
duty” these couches are an abomination. No nurse could ever get up
feeling really rested, after trying to sleep on such a couch. The best
hospital couch is that styled sometimes “the den couch.” The bed is
flat, a full six feet by two, and the headboard being at right angles,
effectually prevents the pillows from slipping off. Such a couch can
be made as comfortable as a bed, combining both beauty and utility.
They can be made to order by any firm that manufactures couches or
beds. When covered with the best grade of pantasote these couches cost
usually from fifteen dollars upward and when covered with leather from
thirty dollars upward. They are the only kind of hospital couches it
pays to invest in.
[Illustration: HOSPITAL COUCH]
[Illustration: INVALID TABLE]
[Sidenote: Other Accessories]
A straight-back chair, a wardrobe for the patient’s clothing, a movable
screen and a small table or two, complete the essentials in the modern
sick room. The newest hospital tables are of iron and glass and may
be had in different sizes. An invalid’s table that will extend over
the bed is a luxury much appreciated by the patient, especially during
convalescence. Plenty of pillows is another luxury that will add to the
patient’s comfort. A small pillow or two to tuck around the patient,
in places where a little warmth or support is desired, is a sensible
addition to the ordinary furnishing of the sick room. Half a dozen will
be none too many.
The best finish for the walls of the private room is a coat of oil
paint. They can then be subjected to periodical cleaning without being
defaced. The shades should be soft and delicate and restful. A pretty
shade of greenish blue is a delight to most eyes. On the wisdom of
pictures in a sick room, opinion is divided. Some would banish them
as unnecessary, and because they afford a lodging place for dust and
disease germs. Others would introduce them to banish the monotony and
relieve the walls of the bare effect. If used at all, pictures should
be carefully selected, and have plain wooden frames, that will not be
injured by disinfectants. To many patients the illuminated scripture
texts on the walls are a comfort, and few, even of those who in health
have no use for such things, object to them when sick. The custom of
making memorial rooms, picture galleries or museums where the memory
of benefactors is enshrined, is to be condemned. A simple plate on the
wall or on the door is sufficient. More than this is unwise and in bad
taste. The craze for memorials has reached a point that is embarrassing
in many hospitals, and the time must surely come when doctors and
hospital officers will interfere, and protest against having the
patient forever gazing into the countenance of some member of the
family of the benefactor of the institution.
As soon as possible after a patient has left the room, it should
undergo a thorough cleaning. Every article but the stationary
furnishings should be removed. Carelessness about this matter sometimes
proves very embarrassing. Drawers, cupboards, and wardrobes should be
washed with a solution of bichloride of mercury. The windows should be
cleaned and fresh sash curtains put on. The walls should be brushed,
the floor cleaned, the mattress disinfected, the bed clothing washed
and all utensils thoroughly aired. If the last occupant was afflicted
with a communicable disease, the mattress should be subjected to steam
sterilization.
[Sidenote: Fumigation]
Fumigation of the rooms periodically is necessary to ensure the safety
of the coming patients. Formaldehyde for fumigation purposes has
largely superseded sulphur. When the room is ready for fumigation,
the windows should be closed, the drawers of the furniture opened,
all chinks stopped, the keyhole stopped with cotton, and the room
left closed for twenty-four hours. It may then be opened, and, when
thoroughly aired, is again ready for occupancy. The sheet method of
fumigation, using a pint of formaldehyde to every 1,000 cubic feet of
air-space, has been thoroughly tested and proven reliable. The drug is
simply poured on the sheet, which is hung over a line in the room to be
disinfected, which has been prepared as above directed. It should be
remembered that formaldehyde has little or no power of penetration, and
for this reason all possible surfaces of materials to be disinfected
should be exposed.
[Sidenote: The Daily Cleaning]
In the daily cleaning, the work should be so divided throughout the
entire hospital that the regular morning cleaning can be accomplished
in a comparatively short time, leaving special cleaning to be completed
later in the day. In order to accomplish this, it may be necessary to
employ special cleaners by the hour. This does away with the necessity
of providing meals and lodging for a large force of cleaners.
By nine o’clock in the morning the halls and stairs should be in order,
front steps and walks cleaned, wards swept and dusted and the whole
interior presenting a neat appearance. “Dust in a hospital is not only
dust, but danger.” Domestic cleanliness and hospital cleanliness are
quite different terms. The hospital housekeeper owes it to the public
and to the sick whom she serves to keep the wards and rooms in the best
condition for the promotion of health.
On the hardwood floors a soft hair brush will raise less dust than the
ordinary broom. Wet tea leaves should be sprinkled whenever obtainable.
The dust should be taken up frequently. The ward floors, unless
polished, should be washed every day. It is well to change the water
often and not use it too freely. Special attention needs to be given to
corners. After each meal it will be necessary to brush up the crumbs.
[Sidenote: Dusting]
The dusting is even more important than the sweeping, and must be
done with great thoroughness and care. Each patient in the hospital
is helping to make the atmosphere impure by throwing off disease
germs. Dried particles of pus, blood and excreta, lint from blankets
and bedding, scales of epithelium and other matter, more or less
dangerous, are flying about in the air and being deposited on ledges,
skirting boards, window sills, bedstead rails and the various parts of
furniture. To bring in a feather duster or a dry cloth and attempt to
dust, is simply to flap the dust from one place only to have it settle
in another. It results in a more equal distribution of the dust, but it
is not dusting. Dusting is removing dust, and the only way that can be
done effectually is by the use of a damp cloth, to which the particles
will adhere. Furniture that will be injured by that kind of dusting
is out of place in a hospital. Special attention needs to be given to
dusting under radiators and in obscure nooks where dust will accumulate
if not looked into daily.
[Sidenote: Bath Rooms]
The bath rooms, toilet rooms and lavatories also need constant
supervision, and ought to be as carefully cleaned and ventilated as
any part of the hospital. Indeed, special pains are needed if they
are to be free from bad odors. Disinfectants should be used freely
in these places at least once a week, and any evidence of imperfect
drainage promptly reported and attended to. A good disinfectant for
this purpose is the one known as the “American Standard,” made by
dissolving six ounces of chloride of lime in a gallon of water. For
cleaning bath tubs kerosene is recommended. It is a wise precaution to
constantly keep posted over closets and sinks a notice prohibiting the
throwing of matches, hair and insoluble material into them. More than
one plumber’s bill has been caused by a careless maid emptying her bar
of soap from her scrubbing pail into the closet. In fact, so common is
that occurrence that a careful housekeeper has invented a device for
holding the soap, thus preventing such accidents, and also the waste
caused by leaving the soap in the water. This device is a tin box about
eight inches long by four inches wide and four inches deep in front and
six at the back. On the back are two pieces of wire bent over to fasten
the box to the outside of the scrubbing pail. These can be made by any
tinsmith at a very small cost, and will hold a cake of soap and a cake
of sapolio. They will save many times their cost in a year.