"Nevers"

When Speaking

At Night

in the morning, with complete change of clothing, will be found very refreshing.

Dresses of light wash material should always be worn when attending the sick, but dresses and skirts must never be stiffly starched, as the rustling noise they make is very annoying to patients. Squeaking shoes are another abomination.

Never whisper in or near the sick-room.

Never discuss the patient's condition with her, or with anyone else in her hearing.

Never tell the patient what her temperature, pulse, etc., are, not even when they are normal.

Never tell the patient what medication you are giving her.

Never lean nor sit on the patient's bed, and be careful not to knock against it in passing.

When speaking to a patient always stand in front of her, where she can see you; be particularly careful not to speak to her suddenly from behind, for when people are ill and nervous they are easily startled.

Keep door and window hinges well oiled; nothing is more aggravating than a squeaking door.

When windows rattle, wedge them apart between the sashes with pieces of wood or newspaper.

Especially at night, or, rather, when getting ready for the night, attention must be paid to anything likely to prove a disturbing element to the patient's rest.

Before the patient goes to sleep see that you have everything at hand that you are likely to need for the

night: Extra blankets-a shade for the light, if necessary-coal prepared in paper bags, as previously described-milk-water-all the medicines you will require-ice, etc. Wrapping the ice in flannel or newspaper will keep it from melting. A hat pin makes an excellent and noiseless ice-pick. A large tin pan, enveloped in a blanket, will make a serviceable refrigerator in which to keep your ice, broth, milk and water.

A shade for the lamp or gas can be easily made out of green or other dark colored cambric, but be sure that the globe over which it is pinned is far enough from the flame to avoid scorching the cambric.

An uncomfortable bed is a great addition to the miseries of an invalid, therefore, one of the first essentials to be learned is how to make a bed.

The mattress is covered by a sheet, stretched tightly and tucked firmly as far under it as possible; folding the corners like an envelope helps to keep it firm.

Another sheet called the "draw sheet" is also used under the patient; this is put on with the length across the bed, thus allowing a considerable fold under the mattress, thereby securing a further means of keeping the sheet tight. When putting the draw sheet on care must be taken to have it perfectly straight; it is first tucked in on one side, well under the mattress. In tucking in the second side it is best to begin in the middle, going first towards the bottom, then from the middle to the top, pulling it very tightly. The top sheet and blankets (single blankets are preferable to

Bed
Making

The
Draw Sheet

Protecting the Mattress

double) should be put on separately, the corners being folded in, in the same manner as the under sheet. If it is not convenient to obtain a spread of dimity, or other light material, it is better to use a sheet, as the ordinary spread is heavy and gives comparatively little warmth.

When it is necessary to protect the mattress a rubber sheet is placed between the lower and draw sheets. White double faced rubber is the nicest for home use. The single faced rubber will answer the purpose and is cheaper, but it is not so easily kept clean. Either can be obtained at any rubber store.

When impossible to get the regular rubber sheeting thin oil cloth, such as is used for covering tables, will serve. In cases of emergency, several thicknesses of newspapers may be used until something better can be obtained.

CHANGING THE BED OF A HELPLESS PATIENT

Before starting to change the bedding be sure that you have everything necessary near at hand, and that the bed clothes are all well aired, perfectly dry and

warm.

First take off the spread, fold it neatly; next take off the top blanket, and hang it out to air. Fold the other blanket and upper sheet over the patient, leaving the ends just long enough to cover her when you turn her over. This method answers a threefold purpose: (1) it has a neat appearance; (2) it replaces the

Changing the Night Gown

discarded blanket, and (3) the clothes are not in the way while you work. Loosen the lower sheets by raising the mattress with one hand while drawing out the sheets with the other. Raising the mattress is important, because the draw sheet has been tucked so far under the mattress that otherwise you risk not only jolting the patient but also tearing the sheets. Remove the pillows and if the patient does not object to lying flat for a while leave them out; if she does, one can be replaced. It is necessary to take them out to turn them and to make sure that there are no crumbs caught between them or in the pillow cases.

The night gown is the next thing changed. Have the patient lie on her back and flex her knees; if she is well enough she can easily raise herself while in this position; if not, place one hand under the buttocks and raise her, as you draw the gown up with the other hand, then raise the shoulders in like manner, drawing the gown up over them and the head before taking out the arms.

In putting on the clean gown roll the skirt up, and put the patient's head through the hole. Putting your hand through one sleeve grasp the patient's hand and draw it through; then do likewise with the other sleeve. The gown is then pulled down in the same manner as the soiled one was taken off.

The easiest way to change the under sheets is first to turn the patient on her side.

To do this, stand on the side towards which you will