Trying as are many, indeed we may truly say most of the duties of the
sick-room, nothing renders them so much so as the fact that the disease
under which the patient is suffering is of an infectious, or of a
contagious nature.
There is a great deal to be said on the head of avoidance of infection
or contagion, while nursing a sufferer through disease of either one
nature or the other. In this as in all other matters connected with
sick-nursing, heroic, would-be-martyr-like conduct is absurd and
blamable, for prudence goes for a great deal, and indiscretion brings
trouble and suffering on others as well as yourself. 'I don't mind
_what_ risk I run; I am too anxious to think about myself!' always
seems to us a feeble and (to use a strong northern word) a very
feckless sort of remark, only made, in nine cases out of ten, to exact
the tribute of a surprised or admiring look. On the contrary, the aim
and end of every sick-nurse should be to do as much good and be as much
comfort as possible _with the least possible risk_. To achieve this,
the smallest and most apparently trivial precautions are worth taking,
in order to prevent the friends and relatives about you having the
additional trouble and anxiety of nursing you as a second invalid, just
when 'number one' is recovering.
'I am so anxious I can't eat! I haven't touched a morsel to-day!' are
by no means uncommon remarks to hear from the lips of some one who is
nursing, or assisting to nurse a case of infectious disease. Yet this
abstinence is just the very worst thing you can possibly do under such
circumstances, and the most calculated to render yourself an easy prey
to that unseen influence pervading the air, and like the seeds of some
poisonous plant, ready to take root if soil be found favourable to its
growth. Feebleness, over-weariness, exhaustion, want of sufficient
nourishment--all these things aid in preparing this suitable soil,
and woo the disease germs that are floating about in the air to take
root and bring forth bitter fruit. A vigorous cheerful person, capable
of strong self-control, often seems able to defy the closest contact
with disease; and even if some _malaise_ (often closely allied to the
disease of the patient) knocks over the willing nurse for a time, the
elastic constitution of body and mind seems to throw off the poison,
and no serious illness results. Nothing is more common than the
occurrence of these spurious attacks of illness, allied to that from
which the person nursed is suffering, and the following case is an
example.
A lady nursing a friend in small-pox, after lengthened attendance in
the sick-room, was attacked by faintness, shivering, a sensation of
nausea, and violent headache. Both the nurse and her friends concluded
that a seizure of the loathsome disease from which the patient was
suffering was inevitable. However, the following day several large
blotches appeared on various parts of the body; all unpleasant symptoms
gradually disappeared; and in a day or two--without the original
sufferer having had any idea that her nurse was kept away by anything
more serious than need of rest--she was able to return to her duties,
and never suffered any further deterioration of health. In the same
way we have known those who were nursing cases of fever to be suddenly
attacked by sore throat, headache, and vertigo, these symptoms passing
off after twenty-four or forty-eight hours, and no further evil
resulting. A vigorous constitution, care while nurse-tending as to diet
and exercise, joined to a mind calm and equable, and ready to face all
possibilities without flurry, feverish excitement, or fear, will in
many cases enable the sick-nurse to throw off the seeds of disease. But
a malignant influence which floats in the atmosphere of the sick-room,
pervading the breath of the sick person, and hanging like a bad odour
about the bed-clothes, carpets, and even the wall-paper of the room,
is necessarily a difficult enemy to evade--and such is infection. And
any one who has a timorous dread of it is far better away from the
sick-room.
This is, we think, a matter that cannot be too strongly insisted upon.
To watch for symptoms is often to develop them; and constant dwelling
upon the condition of any one organ of the body, and apprehension as
to disease in that organ, will often produce at all events functional
derangement if no greater evil. By this we do not mean that neglect
of one's self is ever justifiable, but only that fearful and timorous
apprehension is deleterious.
So strongly has this fact impressed itself upon us with regard to
infection, that we even think it would be well to strain a point,
and encourage a person to absent herself from the sick-room, rather
than run the risk of having a nurse of this temperament near a
patient suffering from disease of a catching nature. In sickness the
perceptions are often rendered painfully acute, and the mind naturally
much concentrated on itself, is therefore ready to take offence
or be troubled by trifles. We have seen a patient shrink from the
ministrations of a person whom he _felt_ to be in a state of fear.
Just in the same way, if the duties of the sick-room are (as they
often must be) unpleasant, a _look_ of aversion or disgust is enough
to wound the sufferer beyond the power of caress or words to heal! A
woman who turns sick, or is obliged to put a handkerchief to her nose
at a foul smell--who shudders at the sight of blood, ought never to
be in a sick-room. The same may be said of one who is always feeling
her own pulse, or (as we once saw) looking at her own tongue in the
glass (by no means a graceful proceeding), to see if symptoms are
'declaring themselves.' All or much of this sort of nervousness may be
affectation; but at the same time we must not judge unkindly of those
who from natural temperament dread infection, and are therefore likely
to fall a prey to it.
And now, taking it for granted that we have a tolerably sensible woman
to deal with, and that she is called upon to nurse a case of fever,
small-pox, diphtheria, or any such-like unpleasant ailment, what
precautions are best calculated to reduce the risk of infection to a
minimum?--a risk which we cannot do away with, but are certainly called
upon to guard against to the utmost in our power. Attention to diet, so
as to ward off great exhaustion _at any time_, and taking at least half
an hour's exercise in the open air, are excellent rules to observe.
Never go into the sick-room _fasting_. And here we must strongly urge
upon every sick-nurse the value of coffee as a restorative. In times
of cholera epidemics among our soldiers, the first precaution the
authorities invariably take is to order a cup of strong coffee to be
served out to each man the first thing in the morning. The effects of
this plan are known to be admirable.
Take a brisk walk shortly after your breakfast; order a cup of hot
strong coffee to be ready when you come in, and take it _before going
into the patient's room_. Nothing helps to throw off the weariness of
a night's watching like this turn in the fresh air (even if taken of
necessity under an umbrella), and the coffee braces the nerves and
invigorates the system.
To speak of the avoidance of alcoholic stimulants is to enter upon
delicate ground; though we are of opinion that in _serious_ cases the
nurse should seldom touch anything stronger than coffee throughout the
whole time. This abstaining gives a power of recovering with great
promptitude from the effects of long-continued watching and heavy
duties in the sick-room. Depend upon it that the recurring glass of
sherry, the oft-repeated 'nip' of brandy-and-water, do a world of harm
both in the sick-room and out of it.
That wine and brandy are valuable restoratives in weakness, cannot
be denied; and it is certain that there are many constitutions which
_need_ a moderate amount of stimulant; but that stimulants are taken
to a perfectly needless and most pernicious extent, even by those who
by no means come under the term 'drunkard,' and that among these are
numbered women as well as men, is a stubborn and unhappy fact. One of
the many evils resulting from this over-use of stimulants is this: when
severe illness and prostration call for wine or brandy, the system is
so used to their action that but little benefit accrues; at all events,
little when compared to that prompt answer the constitution gives to
even small doses, when that constitution has either made very sparing
use, or no use at all, of such whips and spurs to the energies of life.
The proper ventilation of a sick-room is a most important means of
lessening the danger of infection; and this more particularly in such
diseases as fever, small-pox, or diphtheria--that is, diseases coming
distinctly under the head infectious. In those which are contagious,
ventilation is of course also important, but not equally so. And this
leads us on to speak of the difference between infection and contagion.
Infection is subtly diffused through the atmosphere, the patient's
breath, the clothes, hangings, walls, &c. Contagion consists in the
disease being propagated by the emanations of the sick person. It is
therefore obvious that the latter (contagion) is more easily guarded
against by a prudent person than the former (infection). The plentiful
use of disinfectants seems to be one of the best preventives against
contagion; but of course all such details are generally regulated by
the medical man in attendance, and no better advice can be given to the
amateur sick-nurse than to follow his directions _implicitly_.
We will, before leaving this subject, quote one passage from Dr
Aitken's excellent work, _The Science and Practice of Medicine_. In
volume one, page 222, he says: 'Ill-health of any kind therefore
favours the action of epidemic influences.' Thus then, we see how one
of our highest medical authorities bears out the truth of what we have
said--namely that for the sick-nurse to neglect her own health--to go
without sufficient and regular food--in a word, to lower by any means
whatever the standard of her own physical condition, is to intensify
the risk of infection or contagion for herself, and trouble and anxiety
for those belonging to her.
We have no belief in the disinfecting of clothes that have been worn
during attendance on cases of an infectious nature. It is far better to
wear an old dress, wrapper, shawl, &c., and when the illness is over
_have them burned_. The same thing applies to clothing worn by the
patient.
We remember one most lamentable case where (as was supposed) everything
was disinfected, washed, and exposed to the air; yet the gift of a
night-dress to a poor woman resulted in virulent small-pox, and the
sufferer, a young married woman, was cruelly disfigured in spite of the
best care and nursing an hospital could give.
It comes then to this: infection cannot be evaded; but risk may be
reduced to a minimum by an observance of the precautions we have noted,
by the exercise of plain common-sense, and by the _reality_--not
romance--of devotion to the work undertaken by the sick-nurse.