THE SICK-ROOM.
However skilfully designed the arrangements of a house may appear to be,
however sumptuously decorated and furnished its rooms, it is impossible
to know whether a great law of common sense and practical usefulness has
guided such arrangements, until there has been an illness in the house.
Then will it be discovered--too late alas!--whether doors and windows
open conveniently, whether fireplaces give out proper warmth, how the
apparatus for ventilation works, and whether the staircases, landings,
cupboards, and a thousand unconsidered items of the architect's labours
have been planned in the best possible way, or in the stupidest. For the
comfort and convenience of the patient at such times, it is by no means
necessary that much money should have been spent on the construction of
the house that chances to shelter him in his hour of suffering, nor
that its furnitures or decorations should be of a costly character.
Fortunately such things need not aim at anything higher than cleanliness
and convenience, and we only require to exert our own recollections in
support of this assertion. As far as my individual experience goes, I
have seen an old woman, who had been bed-ridden for years, more
comfortably housed and tended beneath a cottage roof, and her room kept
more exquisitely clean and sweet than that of many wealthy patients in
splendid houses. Of course everything depends on the capacity for
organisation and arrangement in the person who has charge of the
invalid, but the nurse's task may be made much easier by having to
perform it in a bed-room and under conditions which are in accordance
with the exigencies of such a time.
Many smart and pretty-looking bed-rooms are discovered by their sick
owner to be very different abodes to what they seemed to him in health.
Awkwardly-placed doors and windows produce unsuspected draughts; the too
close proximity of an ill-arranged staircase or housemaid's closet
becomes a serious trouble, and a low pitched ceiling prevents proper
ventilation. It is more difficult than one imagines to find in a badly
proportioned room a single convenient place for the patient's bed. It
must be either close to the door, or touching the fireplace, or under a
window or in some situation where it distinctly ought _not_ to be. I
have known such faults--faults which occasioned discomfort every moment,
and had to be remedied by a thousand make-shift contrivances, occur in
splendid rooms in magnificent houses; and I have known poor little
modern dwellings in a colony to be perfectly free from them. When I am
told, "such or such a room or house is a very comfortable one _to be ill
in_" then I know that the construction and arrangement of that abode,
however simple it may appear, must needs be up to a very high mark
indeed. Of course a great deal can be done to modify existing evils, by
a judicious arrangement of screens and curtains, by taking out useless
furniture, by substituting a comfortable low bed, easy to get at, for a
cumbrous couch where the unhappy patient's nose seems as if it was
intended to rub against the ceiling, and various other improvements. But
what can remedy a smoky chimney, or a grate where all the heat goes up
the chimney, or windows that rattle, and doors that open in every
direction except the right one? How can an outside landing or lobby be
created at a moment's notice, or a staircase moved a yard further off?
Of course if an illness gave notice before it seized its victim, if
people ever realised that a house should be so constructed as to reduce
the chances of illness to a minimum, and raise its possible comforts to
a maximum if it did come, then everything would go on quite smoothly and
we should certainly live, and probably die, happy. But this is exactly
what we do not do, and this chapter would never have been written if I
had not seen with my own eyes innumerable instances where neither want
of money, nor space, nor opportunity for improvement were the causes of
a wretchedly uncomfortable sick-room.
I have known bed-rooms which looked nests of rosy, luxurious comfort
until their owner fell ill, and then turned suddenly, as it seemed, into
miserable comfortless abodes of frippery and useless, tasteless
finery--where a candle could scarcely be placed anywhere without risk of
fire, and where the patient has deeply complained of the way the
decorations of the room "worried" her. As a rule, in a severe illness,
sick people detest anything like a confusion or profusion of ornaments
or furniture. If I am in authority in such a case, I turn all gimcracks
bodily out, substituting the plainest articles of furniture to be found
in the house. Very few ornaments are allowable in a sick-room, and I
only encourage those which are of a simple, correct form. I have known
the greatest relief expressed by a patient, who seemed too ill to
notice any such change, at the substitution of one single, simple
classical vase for a whole shelf-full of tawdry French china ornaments,
and I date the recovery of another from the moment of the removal out of
his sight of an exceedingly smart modern dressing-table, with many bows
of ribbon and flounces of lace and muslin. I do not mean to say that the
furniture of a sick-room need be ugly--only that it should be simple and
not too much of it. Nothing confuses and worries a person who is ill
like seeing his attendants threading their way through mazes of chairs
and sofas and tables; but he will gladly look and find relief and even a
weary kind of pleasure in gazing at a table of a beautiful, simple form,
placed where it is no fatigue for him to look at it, with a glass of
flowers, a terra-cotta vase, a casket, anything which is so
intrinsically beautiful in form as to afford repose to the eye.
I have often observed that when people begin to take pleasure in
_colour_, it is a sure sign of convalescence--for in severe illness,
unless indeed it be of such a nature as to preclude all power of
observation, form is of more importance to the patient than colour. One
learns a great deal from what people tell one _after_ they are well
enough to talk of such things as past, distempered fancies. For
instance, I was once nursing a typhoid fever patient, who lay for some
days in an agony of weakness. He had been deaf as well as speechless,
and all his senses appeared to have faded away to the very brink of
extinction. Yet afterwards when he became able to talk of his sensations
at different stages of his illness, he mentioned that particular time,
and I found he had been keenly conscious of the _forms_ of the objects
around. He spoke of the pleasure which the folds of a curtain had
afforded him, of the "comfort" of the shape of the old-fashioned
arm-chair in which I used to sit, and of how grateful he had felt when
he observed that divers gimcracks had been removed from his sight.
Later, as he grew better, and the weary eyes craved for colour, I found
it necessary to pretend to be busy dressing dolls or making pincushions,
to afford myself an excuse for a little heap of brightest coloured silks
and fragments of ribbon placed where he could see them, and the daily
fresh bunches of flowers were a perpetual delight to his eyes.
An ideal sick-room then should first of all possess walls which will not
weary or worry the sick person, and no _good_ pattern will do this. The
low bed should be so placed that whilst it would be sheltered from
draught (the aid of one or two screens will be useful here) the light
would not fall disagreeably on the patient's eyes. No rule can be given
about light. In some cases the sick person loves to look out of the
window all day, whilst in others a ray of light _on_ the face is agony.
In such circumstances the bed should, if possible, be so arranged as to
allow the light to come from behind, for it is only in rare and
exceptional cases that sunshine as well as outer air may not be admitted
daily into a sick-room. We are fast getting beyond the ignorance of a
north aspect for a bed-room, and most of us know that sunshine is quite
as necessary to a bed-room as to a garden. No children will ever thrive
unless they have plenty of sunshine, as well as air in the rooms in
which they sleep, and a sick-room should also have both in abundance. If
the weather be hot, it is easy, in England, to modify the temperature by
means of outer blinds, _persiennes_, open doors, and other means. Few
people understand what I have learnt in tropical countries, and that is,
how to exclude the outer air during the hot hours of the day. The
windows of the nursery or sick-room (for we all need to be treated like
children when we are ill) should be opened wide during the early cool,
morning-tide, and the room flooded with sun and outer air. Then, by nine
or ten o'clock, shut up rigorously every window, darkening those on
which the sun would beat, _out-side_ the glass--by means of blinds or
outer shutters--until the evening, when they may all be set wide open
again. All woollen draperies, curtains and valences should be done away
with in a sick-room. If the windows are unsightly without curtains, and
the illness is likely to be a long one, then substitute soft,
patternless muslin or chintz, or, prettiest of all, white dimity with a
gay border, but let there be no places of concealment in a sick-room.
Every thing unsightly or inodorous should be kept out of it, and herein
is found the convenience of a well-planned and well-arranged house,
where clothes-baskets, and things of that sort, can be so bestowed as to
be at the same time handy and yet out of the way.
If it were not for the unconceivable untidiness and want of observation
which exists in the human race, such cautions as not to leave about the
room the clothes the sick person has last worn, hanging up or huddled on
a chair in a corner, would seem superfluous. But I have actually seen a
girl stricken down by a sudden fever, lying at death's door, on her
little white bed, whilst the wreath she wore at the ball where she took
the fatal chill, still hung on her toilette glass, and her poor little
satin shoes were scattered about the room.
She had been ill for days; there were two ladies'-maids in the house,
besides anxious sisters, parents, and nurses, and yet no one had thought
of putting these things out of sight. The first rule, therefore, to be
observed in nursing even bad colds, where the sufferer may have to stay
in bed a few days, is to send all the linen he has been wearing to the
wash _at once_, and to put away everything else in its proper place.
Boots should never be allowed in a sick-room, for the leather and
blacking is apt to smell disagreeably and they ought immediately to be
removed to another place.
Then there should be if possible _outside_ the door of the sick-room,
either on a landing or in another room, a convenient table, covered with
a clean, white cloth, on which should be ranged spare spoons, tumblers,
glasses, and so forth, and whatever cooling drinks are wanted, all so
managed that dust shall be an impossibility. Inside the room, on another
small table, or shelf, or top of chest of drawers, according to
circumstances, should be kept also on a snowy cloth, just whatever is
actually needed at a moment's notice--medicines and their proper
glasses, &c., and a spoon or two, but the instant anything is used, it
should be an established rule that the nurse puts the spoon or glass
_outside_, and supplies its place with a clean one. In most cases, a
servant need only renew the supply outside twice a day.
As for keeping trays with nourishment in the room, it is a sign of such
careless nursing that I should hardly dare to mention it, if I had not
more than once gone to relieve guard in a friend's splendid sick-room at
daylight, and seen the nurse's supper-tray of the night before _on the
floor_ whilst the room, in spite of all its beautiful decorations, smelt
sickly and disgusting with the odour of stale beer and pickles. It is
incredible that such things should happen, but in the confusion caused
by a sudden and severe illness, untidy and careless habits are apt to
come to the surface, and loom largely as aggressive faults. Sickness is
not only a great test of the sufferer's own character and disposition,
but of those of the people around him, and as a general rule, I have
discovered more beautiful qualities in sick people, and those about
them, who dwell in cottages or even hovels, than in more splendid homes.
Everyone knows how really kind poor people are to each other, and never
more so than when the angel of disease or death is hovering over the
humble roof-tree.
Food, or nourishment as it is called in sick-room phraseology, would not
so often be refused by the patient if it were properly managed. Who
does not know the wearisomeness of being asked, probably in the morning,
when the very thought of food is an untold aggravation to one's
sufferings what one could "fancy"? And this is probably followed by a
discussion on the merits or possibilities of divers condiments, to each
of which as it is canvassed before him the wretched patient is sure to
declare a deep-rooted repugnance. A sick person, until he reaches that
happy stage of convalescence when it is an amusement to him, should
never be allowed to hear the slightest discussion on the subject of his
nourishment. Whatever the doctor orders should be prepared with as wide
a range of variety as can be managed, and offered to him in the smallest
permissible quantities, exactly cold or hot enough to take, and served
as prettily and daintily as possible, at exactly the right moment. The
chances are a hundred to one that, if it is within the range of
possibilities that he can swallow at all, he will take it. If he does
not, there should be no argument, no attempt at forcing it on him; it
should at once be taken quite away and something different brought as
soon afterwards as is prudent. Few people realise how extraordinarily
keen the sense of smell becomes in illness, and how the faint ghost of a
possible appetite may be turned into absolute loathing by the smell of a
cup of beef-tea, cooling by the bed-side for ten minutes before it is
offered.
I am always guided in a great degree about nourishment by the instincts
of my patient, and I never force stimulants, or anything equally
distasteful on a sick person who is at all reasonable upon such matters.
I once had a patient to nurse, whose desperate illness had brought him
very near the shadowy land. It had left him, and the doctors assured me
that his life depended on how much brandy I could get down his throat
during the night. I told him this, for he was quite sensible, when he
refused the first teaspoonful, and he whispered in gasps, "I'll take as
much milk as you like; that stuff kills me." So I gave him teaspoonfuls
of pure milk all through the night every five minutes, and not a drop of
brandy. The doctor's first reproachful glance in the morning was at the
untouched brandy bottle, and he shook his head, but when he had felt the
sick man's pulse his countenance brightened, and he graciously gave me
permission to go on with the milk. Of course there are cases when the
patient never expresses an opinion one way or other, and then the only
safe rule is to obey the doctor's orders, but I never fly in the face of
any strong instinct of a sick person rationally expressed. So now I
hope we have some glimmering idea of what a sick-room should be: cool in
summer, warm in winter, but deliciously sweet and fresh and fragrant
always. Simple in its furniture, but the few needful articles, of as
agreeable shapes and as convenient as possible--a room which can be
looked back upon with a sort of affection as a place of calm, of
discipline, and of organization, as well as of the mere kindness and
willingness to help, which is seldom, if ever, absent from a sick-room,
but which is not the beginning and end of what is necessary within its
walls.
There are bed-rests and bed-tables to be hired for a sick person's use
in almost any town in England; or, if it is preferred, any village
carpenter could make a table with legs six or eight inches high, and a
top of a couple of smooth light planks, about two feet six long, scooped
out in the middle. This is very convenient when the patient is well
enough to sit up in bed and employ himself. The bed-rests are equally
simple, the upper half of a chair, padded, and made to lower at
convenience, while a loose jacket or wrapper, easy to slip on, of
flannel, should also be provided to throw over the patient's shoulders
when he uses chair and table. When the patient can sit up and occupy
himself this sort of table will be found a great comfort. It might just
as well be used when lying on a sofa.
[Illustration: FIG. 30.]
One word more, like a postscript, for it has no real business to intrude
itself here. It is only an entreaty to all nurses or those in authority
in a sick-room, to wear the prettiest clothes they possess. Not the
smartest, far from it; the simplest cottons, cambrics, what you will,
but nice and fresh and pleasant to look at. If it is only a
dressing-gown it may be a charming one. No hanging sleeves, or dangling
chains, or streaming ribbons, but sufficient colour for weary eyes to
rest on with pleasure. An ideal toilette for sick-room nursing would be
a plain holland or cambric gown, made with absolute simplicity--long
enough to be graceful without possessing a useless train--rather tight
sleeves, and no frills or furbelows; a knot of colour at the throat and
in the hair, or on the cap--only let your ribbons be exquisitely fresh
and clean--and a nice large apron, or rather bib, with one big pocket in
front. This apron may be tied back--not too tightly, please--with the
same coloured ribbons, and a little change of hue now and then is a
great rest and refreshment in a sick room. There are charming linen
aprons now embroidered in School of Art designs of the shape I allude
to, but they can be made equally well in print, or plain holland, or
linen.
No garment that rustles or creaks, or makes its presence audible should
ever cross the threshold, but the toilette of the nurse should always be
exquisitely clean and neat, and yet as bright and pretty as possible. No
sitting up at night, no anxiety or unhappiness should be an excuse for a
dirty, dishevelled attendant in a sick-room. It is _always_ possible to
steal half an hour morning and evening to wash and change, and do one's
hair neatly, and the gain and comfort to the patient as well as to the
nurse, is incalculable. This also would not be touched upon if my own
recollections did not supply me with so many instances, where all this
sort of care was considered to be absolutely worthless, and yet sick
people have remarked afterwards how perfectly conscious they had been of
all such shortcomings, and how such and such a tumbled cap, or shawl
pinned on awry had been like a nightmare to them. Beauty itself is never
more valuable than in a sick-room, and if laws could be passed on the
subject, I should like to oblige all the pretty girls of my acquaintance
to take it in turn to do a little nursing. I venture to say that no
ball-room triumphs would ever compare with the delight their possession
of God's greatest and best gift would afford to His sick and suffering
creatures. But a nurse may always make herself look pleasant and
agreeable, and if she have the true nursing instinct, the ready tact and
sympathy which a sick-bed needs, she may come to be regarded as "better
than pretty" by her grateful patient.