[Sidenote: Cleanliness of carpets and furniture.]
It cannot be necessary to tell a nurse that she should be clean, or that
she should keep her patient clean,--seeing that the greater part of
nursing consists in preserving cleanliness. No ventilation can freshen a
room or ward where the most scrupulous cleanliness is not observed.
Unless the wind be blowing through the windows at the rate of twenty
miles an hour, dusty carpets, dirty wainscots, musty curtains and
furniture, will infallibly produce a close smell. I have lived in a
large and expensively furnished London house, where the only constant
inmate in two very lofty rooms, with opposite windows, was myself, and
yet, owing to the above-mentioned dirty circumstances, no opening of
windows could ever keep those rooms free from closeness; but the carpet
and curtains having been turned out of the rooms altogether, they became
instantly as fresh as could be wished. It is pure nonsense to say that
in London a room cannot be kept clean. Many of our hospitals show the
exact reverse.
[Sidenote: Dust never removed now.]
But no particle of dust is ever or can ever be removed or really got rid
of by the present system of dusting. Dusting in these days means nothing
but flapping the dust from one part of a room on to another with doors
and windows closed. What you do it for I cannot think. You had much
better leave the dust alone, if you are not going to take it away
altogether. For from the time a room begins to be a room up to the time
when it ceases to be one, no one atom of dust ever actually leaves its
precincts. Tidying a room means nothing now but removing a thing from
one place, which it has kept clean for itself, on to another and a
dirtier one.[1] Flapping by way of cleaning is only admissible in the
case of pictures, or anything made of paper. The only way I know to
_remove_ dust, the plague of all lovers of fresh air, is to wipe
everything with a damp cloth. And all furniture ought to be so made as
that it may be wiped with a damp cloth without injury to itself, and so
polished as that it may be damped without injury to others. To dust, as
it is now practised, truly means to distribute dust more equally over a
room.
[Sidenote: Floors.]
As to floors, the only really clean floor I know is the Berlin
_lackered_ floor, which is wet rubbed and dry rubbed every morning to
remove the dust. The French _parquet_ is always more or less dusty,
although infinitely superior in point of cleanliness and healthiness to
our absorbent floor.
For a sick room, a carpet is perhaps the worst expedient which could by
any possibility have been invented. If you must have a carpet, the only
safety is to take it up two or three times a year, instead of once. A
dirty carpet literally infects the room. And if you consider the
enormous quantity of organic matter from the feet of people coming in,
which must saturate it, this is by no means surprising.
[Sidenote: Papered, plastered, oil-painted walls.]
As for walls, the worst is the papered wall; the next worst is plaster.
But the plaster can be redeemed by frequent lime-washing; the paper
requires frequent renewing. A glazed paper gets rid of a good deal of
the danger. But the ordinary bed-room paper is all that it ought _not_
to be.[2]
The close connection between ventilation and cleanliness is shown in
this. An ordinary light paper will last clean much longer if there is an
Arnott's ventilator in the chimney than it otherwise would.
The best wall now extant is oil paint. From this you can wash the animal
exuviæ.[3]
These are what make a room musty.
[Sidenote: Best kind of wall for a sick-room.]
The best wall for a sick-room or ward that could be made is pure white
non-absorbent cement or glass, or glazed tiles, if they were made
sightly enough.
Air can be soiled just like water. If you blow into water you will soil
it with the animal matter from your breath. So it is with air. Air is
always soiled in a room where walls and carpets are saturated with
animal exhalations.
Want of cleanliness, then, in rooms _and_ wards, which you have to guard
against, may arise in three ways.
[Sidenote: Dirty air from without.]
1. Dirty air coming in from without, soiled by sewer emanations, the
evaporation from dirty streets, smoke, bits of unburnt fuel, bits of
straw, bits of horse dung.
[Sidenote: Best kind of wall for a house.]
If people would but cover the outside walls of their houses with plain
or encaustic tiles, what an incalculable improvement would there be in
light, cleanliness, dryness, warmth, and consequently economy. The play
of a fire-engine would then effectually wash the outside of a house.
This kind of _walling_ would stand next to paving in improving the
health of towns.
[Sidenote: Dirty air from within.]
2. Dirty air coming from within, from dust, which you often displace,
but never remove. And this recalls what ought to be a _sine qua non_.
Have as few ledges in your room or ward as possible. And under no
pretence have any ledge whatever out-of sight. Dust accumulates there,
and will never be wiped off. This is a certain way to soil the air.
Besides this, the animal exhalations from your inmates saturate your
furniture. And if you never clean your furniture properly, how can your
rooms or wards be anything but musty? Ventilate as you please, the rooms
will never be sweet. Besides this, there is a constant _degradation_, as
it is called, taking place from everything except polished or glazed
articles--_E.g._ in colouring certain green papers arsenic is used. Now
in the very dust even, which is lying about in rooms hung with this kind
of green paper, arsenic has been distinctly detected. You see your dust
is anything but harmless; yet you will let such dust lie about your
ledges for months, your rooms for ever.
Again, the fire fills the room with coal-dust.
[Sidenote: Dirty air from the carpet.]
3. Dirty air coming from the carpet. Above all, take care of the
carpets, that the animal dirt left there by the feet of visitors does
not stay there. Floors, unless the grain is filled up and polished, are
just as bad. The smell from the floor of a school-room or ward, when any
moisture brings out the organic matter by which it is saturated, might
alone be enough to warn us of the mischief that is going on.
[Sidenote: Remedies.]
The outer air, then, can only be kept clean by sanitary improvements,
and by consuming smoke. The expense in soap, which this single
improvement would save, is quite incalculable.
The inside air can only be kept clean by excessive care in the ways
mentioned above--to rid the walls, carpets, furniture, ledges, &c., of
the organic matter and dust--dust consisting greatly of this organic
matter--with which they become saturated, and which is what really makes
the room musty.
Without cleanliness, you cannot have all the effect of ventilation;
without ventilation, you can have no thorough cleanliness.
Very few people, be they of what class they may, have any idea of the
exquisite cleanliness required in the sick-room. For much of what I have
said applies less to the hospital than to the private sick-room. The
smoky chimney, the dusty furniture, the utensils emptied but once a day,
often keep the air of the sick constantly dirty in the best private
houses.
The well have a curious habit of forgetting that what is to them but a
trifling inconvenience, to be patiently "put up" with, is to the sick a
source of suffering, delaying recovery, if not actually hastening death.
The well are scarcely ever more than eight hours, at most, in the same
room. Some change they can always make, if only for a few minutes. Even
during the supposed eight hours, they can change their posture or their
position in the room. But the sick man who never leaves his bed, who
cannot change by any movement of his own his air, or his light, or his
warmth; who cannot obtain quiet, or get out of the smoke, or the smell,
or the dust; he is really poisoned or depressed by what is to you the
merest trifle.
"What can't be cured must be endured," is the very worst and most
dangerous maxim for a nurse which ever was made. Patience and
resignation in her are but other words for carelessness or indifference
--contemptible, if in regard to herself; culpable, if in regard to her
sick.