[Sidenote: The Linen Room]
The linen room is one of the very important parts of the institution.
Demands will be made on it almost every hour, and, if the hospital is
to do proper work, it must be equal to the demands. As well expect a
carpenter to construct a building without tools as expect nurses to do
conscientious work without a sufficient supply of bed and body linen
to keep their patients in proper condition. Lack of knowledge on the
part of the managers as to the amount of supplies necessary, rather
than a lack of money, is accountable for the shortage of linen in
many hospitals. An important part of the housekeeper’s duties is to
know what supplies are on hand, and keep the board informed as to the
needs. Time, and tact, and perseverance in educating them as to what
is absolutely necessary for proper work, will do much to correct such
defects in hospital management. It is difficult for the laity, who are
perhaps accustomed to having bedding changed in their homes but once a
week, and then sometimes allowing for but one clean sheet for each bed,
to appreciate that a constant changing of beds goes on in a hospital,
both day and night, and that economy is out of the question. A hospital
can really afford to be extravagant in the matter of linen. That is
one point, and perhaps the only one, in which lavish expenditure will
really redound to the good of the hospital. Better cut down expense in
a dozen other ways than to give rise to the criticism that the hospital
has not sufficient linen to keep its patients and its beds in proper
condition. Cleanliness may be next to godliness in most circumstances,
but no hospital can afford to let cleanliness take second rank with
any other virtue. In fact, if want of cleanliness in the care of the
beds or patients be noted, very grave doubts as to the godliness of
the management will surely arise, be the professions in that direction
never so loud.
[Sidenote: Bed Linen]
The amount of linen required per bed will depend somewhat on the
character of the work done in the hospital. Where only acute cases
are handled, and emergency work is done, the supply must needs be
greater, as the average number of patients entirely confined to bed
will be greater. Six pairs of sheets and pillow covers for each bed is
a fair amount to begin with. That number of sheets is often needed for
one patient in a day, but taking the average patient in the average
ward, that amount will usually be sufficient, even to provide for the
extra demand in special cases. A half-dozen draw sheets for each bed
in the ward are also necessary. Six face towels and four bath towels
per bed is a fair estimate. Two spreads for each bed and two pairs of
blankets will be sufficient for the ordinary ward, but a few extra
blankets should be provided for each ward, for the use of patients who
require extra heat. This estimate is based on the supposition that
linen sent to the laundry Monday morning will be returned at the latest
by Wednesday morning following. Every well equipped hospital has its
supply of gowns for the use of any patient who needs them or cares to
use them. They are best made to order of firm bleached muslin, without
trimming of any kind. For ease in management they should be open all
the way and should fasten in the back. Tape fastenings will be found
most satisfactory, as buttons are constantly torn off in the mangle.
[Sidenote: The Room]
The linen room should be really a room—not a closet. Special cupboards
or closets for each ward or department will be needed, but the general
linen room has special needs that do not apply to the ward closets.
Plenty of light is a necessity. A work-table, a sewing machine, and a
gas stove on which an iron may be heated, should be in it, besides the
shelves and cupboards needed for the hospital linen supply. To this
room new linen should be sent to be marked.
[Sidenote: Marking Linen]
It will be found that a uniform system of marking linen will save time
in sorting. Sheets may be marked on the wrong side at the corner of the
top end, pillow covers an inch above the hem close to the seam, towels
in the corner of one end just above the hem, table-napkins and tray
cloths diagonally across the corner. Blankets and spreads may be marked
by a tape sewn diagonally across the corner.
[Sidenote: Linen Accounting]
The person in charge of the linen room will be expected to keep the
linen in repair and to account for every piece that passes through her
hands. It is very important to have a systematic method of accounting
for linen that will enable the housekeeper to know the amount on hand,
and to discover if linen is lost. It matters not whether the washing
is done on the hospital premises or sent to a commercial laundry, some
system of accounting is necessary unless the housekeeper is willing
for a constant depletion of blankets, sheets, towels, etc., to go
on without her knowledge. Where a public laundry is patronized the
importance of this matter is evident. When hundreds of towels and
sheets are sent in at once, it is not unusual for linen to be taken
from the large quantity to supply missing articles in the list of
other customers who had sent smaller amounts, from which, if articles
were missing, it would be quickly discovered. The housekeeper of a
certain institution relates the following incident bearing on this
point: The linen of the institution was sent to a public laundry,
and for some time she had been missing towels, though the laundry
always claimed to return the proper number. Finally the manager of the
institution happened into a barber shop and accidentally discovered
there a pile of the institution towels. Inquiry revealed the fact that
the barber kept strict account of his towels and the laundry had to
return the number sent or pay for them. The barber cared nothing whose
mark was on the towels if he got as many as he sent. A laundry employee
had been in the habit of substituting linen from large institutions to
make up the required number from smaller lots, and thus the problem of
the missing linen for that institution was solved. The inexperienced
housekeeper may perhaps settle down into the belief that of course the
linen sent to the hospital laundry is safe since it does not leave the
premises. If all servants and everybody about the establishment were
tried and true and trustworthy, through and through, it might be safe,
but in these days of possible degeneracy and certain uncertainty in the
servant class, it is wise to trust implicitly but few, and to keep an
eye on those.
[Sidenote: Discarded Linen]
Another point that needs some emphasis is that the housekeeper or her
assistant—not the nurses or the servants—must decide when linen is to
be discarded. Well-worn or torn linen should not be sent to the wards.
A special drawer, marked “Discarded Linen,” should be in the general
linen room, and into this the one who sorts linen can lay aside what in
her judgment is unfit for wear or beyond mending. But the housekeeper
should reserve for herself the privilege of deciding when an article
is to be used as old linen. Unless this rule is rigidly enforced, a
reckless extravagance will be the result. Good towels will be used as
dusters or as scouring cloths. Sheets that might have been utilized
in some other way will be torn up and used as cleaning cloths, and a
constant depletion of the supply will go on without the housekeeper’s
knowledge. Many a housekeeper who has assumed charge of a hospital
that had been previously managed without a system of linen accounting
has found it one of the most difficult of her tasks to check the
tendency to appropriate the hospital towels, sheets and pillow covers
for cleaning purposes. Constant vigilance in that direction for months
was needed to impress the household that the haphazard, loose way of
handling linen was a thing of the past.
[Sidenote: Emergency Supply]
Every careful hospital housekeeper has found the necessity of a special
closet, for the storing of extra linen of all kinds for times of
special emergency. It is poor management to have the full supply in
circulation at one time. Attention to this emergency closet will save
embarrassment many times. What could be more embarrassing than to have
a patient injured in an accident, brought in grimy and dirty, and not
have a clean gown to put on him? And yet that very thing has happened
when the hospital housekeeper has failed to anticipate the emergency.
Sheets that are worn thin in the center may be doubled and stitched
together for draw sheets, and in that way will last for months. The
ends of bath towels can be hemmed for wash cloths. Squares of linen
from partly worn tray-cloths and napkins may often be fringed for
doilies for ward medicine trays. The training in economy in supplies,
and in methods of utilizing material that would otherwise be wasted, is
an important part of the nurse’s training that will benefit her through
life.
[Sidenote: Removing Stains]
The nurses, too, in their use of hospital linen, are responsible in no
small measure for its appearance. Blood-stains and various other stains
can be readily washed out when the stain is fresh. Every nurse should
be taught that it is her duty to remove such stains as far as possible
by a preliminary soaking and washing before being sent to mingle with
other clothing in the laundry. A little salt in the water will hasten
the process. If such matters were thoroughly impressed on each nurse,
as a part of her duty in her hospital training, there would be fewer
complaints of nurses in private practice needing an extra maid to wait
on them. Stains from certain oily dressings are exceedingly difficult
to remove. In fact, in the general washing it is practically impossible
to thoroughly efface such stains. A little care in managing, and, as
far as possible, keeping one set of sheets for cases requiring such
dressing, will prevent the whole ward supply from being stained. The
oldest linen should be specially set apart for such cases.
[Sidenote: New Linen]
Where a regular maid is in charge of the linen room, she can usually,
in addition to the general care of the linen, make up new material.
The cutting of new goods is a matter for the housekeeper’s personal
supervision. Each new lot of linen that is laid on the shelves for
general use should be added to her inventory. Under the heading of
“Discarded Linen” in her linen account book, she can mark each piece
she lays aside as old linen, and by reckoning up each month the new
linen that is added, and the discarded linen, can readily keep account
of the amount in general use. In buying linen for a hospital it is
questionable economy ever to buy cheap material. Towels and spreads
should always be without fringe.
[Sidenote: Shelf Management]
In placing linen on the shelves of a general linen room some method
will be found advantageous. If the rule is to lay towels and pillow
covers on the shelves in piles of twenty, sheets and spreads and gowns
in piles of a dozen, it is but the work of a few minutes to take an
inventory of the contents of the linen room. If, in buying linen,
the housekeeper has taken pains to secure glass towels with some
distinctive pattern or coloring, it will be easy to keep the kitchen,
diet kitchen and ward glass towels in separate piles. Red and white
check toweling for the kitchen, blue and white check for the diet
kitchen, and plain white toweling with a single stripe on the edge, for
the ward glass towels, is a distinction easy to secure in any place.
Face towels for patients can be secured with red border and for nurses
and officers with blue.
[Sidenote: Laundry Bags]
Each nurse should be instructed to bring with her two laundry bags—one
to be kept in her room to receive soiled linen, the other to be sent
to the sorting room, to remain till the clean clothes are returned
in it. A list of the articles contained should be pinned to each bag
to facilitate the sorting of the clean clothes and for reference.
It is needless to state that all nurse’s clothing should be marked
with her full name. Initials may be sufficient marking in a home, but
are useless in a hospital. If it can be brought about (and it can by
insisting on it), it will be found that a uniform system of marking
nurses’ clothing will be a great saving of time in sorting. To have
a pile of thirty or forty nightdresses to sort and put in bags, and
find no two marked in the same place, making it necessary to unfold
every garment and look it over on all sides to find the mark, is an
unnecessary trial and waste of time for whoever has the sorting to
do. If each garment were marked on the under side of the front, which
is usually folded on top, to sort them would be an easy matter. To
return clothing without being washed, when the nurse has not marked it
properly, is the only way to teach nurses, who are habitually careless
in their marking.
Printed laundry lists should be furnished for the sorting room,
duplicate lists of each lot of clothes sent to the laundry being made.
One list goes to the head laundress, the other is retained in the
sorting room for reference.
HOUSEKEEPER’S LINEN ACCOUNT BOOK
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Date | Supplies Purchased | Supplies Received | Value | Remarks
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