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APPENDIX CHAPTER V WHAT THE HOME NURSE OUGHT TO DO ISABEL GORDON CURTIS WHAT AN INVALID MAY EAT-WHAT AN INVALID MAY DRINK - PROVEN "HOME REMEDIES" - HOT WEATHER CARE OF INFANTS AND YOUNG CHILDREN WHEN a rubber hot-water bag is not at hand, a very good substitute is a stone bottle with a perfectly tight cork. The hottest water can be put into it without fear of cracking, and it will retain heat the greater part of the night. Even a glass bottle can be used in an extremity; for occasionally, during a severe chill, a doctor orders hot applications put all around the body, and it is impossible always to find enough hot-water bags to supply the demand. The greatest care must be exercised in seeing that the corks are perfectly tight. If the bottles are too hot, slip them into stocking legs, tying them at each end.
Simple as the task of making poultices is, a certain knack is needed: Mix flaxseed with boiling water, stirring constantly with a palette knife. When the mixture is thick enough to drop from the knife, lift it from the fire, beat well to make it light, and spread, a quarter of an inch thick, between old soft muslin or surgeon's gauze. Turn over the edges, lay it on a hot plate, cover with another plate, and carry it to the sick room as hot as possible. Before laying it on the patient, test its temperature by holding it against your own cheek.
If it is too hot for you, it requires cooling before applying. When put on by degrees, as it were, letting down one small piece at a time, it will not feel as hot as if put on all at once. No poultice should remain on longer than an hour; by that time it is not as warm as the body.
After removing, wipe the skin dry, and rub the sore place with oil or vaseline.
Fomentations are not easily applied, unless one knows exactly how to handle them. In every household which has due care for emergencies, there ought to be a set of fomentation cloths: three large ones of heavy blanket flannel, about three quarters of a yard square. These are necessary in cases of pain in the stomach or abdomen, or in any extended ache in the body. Smaller fomentation cloths of a thinner flannel are necessary in an attack of neuralgia, pain in the muscles of the neck, toothache, or pains about the head. These cloths should be about eight or ten inches square. Some a few inches smaller are handy for pain in the ears or eyes. The way to use a large fomen tation cloth is to carry into the sick room on a tray a kettle of water which has been taken off at the boiling point. Fold the large cloth four times. Hold the ends, dipping the center of the cloth into the hot water, but keeping the ends dry. Then twist the flannel into a rope-like roll until every drop of moisture is squeezed out. It will be very hot, still almost dry. Lay this on the ach- WHAT THE HOME NURSE OUGHT TO KNOW 1131 ing part of the body, folding it quite smooth, and applying it gradually, keeping the hand beneath to save from a sudden shock of intense heat.
Over the fomentation cloth lay a second square of flannel, dry and warm, to keep in the heat. If this is bandaged loosely around the body, a fomentation cloth will retain its heat for ten or fifteen minutes. Pain may sometimes be relieved with one application. If it continues, take the other flannel square and wring from the water in the same fashion. An easy way to wring the smaller cloths used about the head is to fold them into a square and lay in a potato ricer. Dip the ricer into boiling water and squeeze the cloth dry, covering it with another flannel to keep in the heat. After these squares have been used, launder them and lay away, ready for another emergency.
A very handy thing to have in the sick room is a small nursery refrigerator; but when it cannot be obtained, you can keep ice with small amount of waste by a simple, homemade contrivance. Get a large flowerpot with a saucer a size or two bigger than the pot. On the saucer set a wire trivet. Put the ice on this, and over it turn the flowerpot upside down, stopping up the hole in the bottom with a wad of absorbent cot ton. Cover with a piece of flannel, and uncover only when ice is needed.
The quietest thing to use for an ice pick is a strong hat pin; stick it in the ice, pick with a small hammer, and break off a piece as large as you want.
In the summer when the range fire is allowed to go down and there is no gas stove, or where the sick room is some distance from the kitchen, it is a good plan to have some way of heating water in the sick room. Do not use a stove which burns kerosene or gasoline; in spite of utmost care, it will exude odors. The use of gas is no better, as it consumes oxygen, and it is seldom that a pipe can be attached tightly enough to prevent all odor from the gas. The best arrangement is an alcohol lamp. If that is not in the house, you can manage with a five-o'clock teakettle or a chafing dish, which over a hot alcohol flame will boil a pint of water in a few minutes.
The instructions that a doctor lays down about medicine, feeding, or any sort of treatment, must be carried out to the letter. The best plan is to write his instructions concisely during every visit. If he orders medicine to be given every two hours, do not trust to memory, but reckon the time ahead and write it down-medicine at ten, twelve, two, four, or whatever the case may be. Be perfectly accurate in measuring, using a medicine dropper for drugs and the average-sized teaspoon for a teaspoonful.
A small clock is a necessity in the sick room; but frequently its ticking will irritate a nervous patient. The best way to cvercome this is to cover it with a glass shade. In this way it can be sea but not heard.
Occasionally a doctor orders an application of hot spirits. This is a process which must be very carefully carried out, as the alcohol is liable to take fire. The best way to heat it is to set the whisky into a cup, put in a chafing dish, pour hot water around it, then put on the lid. Afterwards light the flame of the lamp and let the water boil gently for a few minutes. Fold old muslin or gauze into the shape required, dip it in boiling water, and press dry in a potato ricer. Dip it again in hot whisky, squeeze as dry as possible, apply it as hot as can be borne, and cover with a piece of dry flannel. Keep the whisky hot as long as it is needed, and have two bits of muslin, so one can be changed while the other is on the patient.
When it is necessary to change a nightshirt or nightgown, and the patient is too sick to sit up in bed, draw it well up under the arms, slip off a sleeve at a time, and push it up toward the neck, getting it over the head as deftly as possible. Roll the skirt of the fresh nightdress into a coil till it reaches the sleeve, slip the patient's arm into the sleeve before lifting the head from the pillow, and the nightdress can then be pulled down over the neck very quickly, afterwards straightening the skirt. The easiest plan in severe sickness is to have a nightdress which is open all the way down the front. It can be easily changed by turning the patient on one side and adjusting the nightdress from head to foot, then doing the same on the other side.
The patient's hair should be combed twice a day at least. If it is a woman's, part it in the middle and back, brush and comb one side at a time, and make it into two neat braids.
When a patient is allowed to sit up for the first time, it is a good idea to make it half an hour at meal time.
It is much easier to eat when in a comfortable, upright position, as the food tray can then be put in a more convenient place. Besides, the novelty of being able to sit up and eat is apt to create a new relish for food.
If it can be obtained, a handy thing to have in a sick room is a one-leg adjustable table, which can be set high or low, as needed, and be used for various needs to serve a meal on, to place the basin on, for the patient to wash his face and hands, or during convalescence to hold a book or for a game of solitaire. Although it is not quite as handy, a good substitute for this useful bit of furniture is an ordinary sewing table. Unfold two legs, set it on the floor beside the bed, leaving the other legs tucked under. To prevent the weight of the table from resting upon the patient's body, put a couple of props under it on the bed. If nothing else is handy, a few books or wooden blocks will serve to keep it steady.