Hints To Nurses And The Sick In 1837

Lately, I’ve been in the role of caregiver and nurse, and honestly, I’m not very good at it. I wouldn’t recommend getting sick at my house. I assure you that I would only do about a tenth of the caregiving things that Lydia Maria Child recommends in her 1837 book The Family Nurse; Or, Companion of the Frugal Housewife.

Child has a fascinating history as a poet, author, journalist, and domestic manual writer. She was a fervent abolitionist and activist for Native American and Women’s Rights. And there’s a tie-in with the US holiday Thanksgiving happening this week. Child wrote the Thanksgiving song “Over The River and Through The Woods.”

Hints For The Preservation Of Health

NEVER meddle with medicines, unless some disorder of the system renders them really necessary.

Take meals at regular hours. Do not eat a variety of things at the same meal; nor indulge merely for the pleasure of it, when the wants of nature are satisfied. Avoid rich and stimulating articles of food and drink.

To preserve the digestive organs in good order, may almost be called the one thing needful, as it regards bodily health. Observe the effects of particular articles on your system, and indulge or refrain accordingly. If not as well as usual, eat nothing. Fasting and cold water are the best physicians, nineteen times out of twenty.

Many think distilled liquors are necessary for those who work in cold, damp places; but in fact they only increase the danger of taking cold. Their effects are evil continually.

Sleep in rooms with a free circulation of air. Have no fire burning, or fragrant flowers in the room.

Do not cover your face with the bedclothes. Have clean bed-linen once a week. Do not have a current of air blowing directly on your bed.

Feather beds are debilitating, except in very cold weather.

Rise early, and retire to rest in good season. Regularity in food and sleep is a great preservative of health.

Be not afraid of fatigue. That kind of exercise is best which employs body and mind. A walk in connexion with active business, or to relieve the necessities of the destitute, is worth ten walks merely for exercise.

Very many humours and diseases originate in a want of personal cleanliness. Wash your whole person thoroughly, at least once or twice a week; and rub yourself with a coarse towel, or brush, till the surface glows. This is particularly salutary for those who sew a good deal, or lead any kind of sedentary life. If done at night, it is apt to induce refreshing sleep. Consumption might in many cases be prevented by proper regard to this suggestion.

Clean your teeth with a brush and cold water in the morning, and rinse them once or twice a day; above all, have them clean when you go to bed, that they may not collect impurities during the night. To chew charcoal slowly once or twice a week, sweetens the breath, and tends to preserve the teeth from decay; it will sometimes even arrest it when begun. To use it merely as a tooth-powder is far less salutary. Toothpicks, by keeping the teeth well separated and cleansed, help to preserve them. Metal ones are injurious; those made of quill are uncleanly, being commonly kept for some time; the best ones are made of willow, or some pliable wood, they do not hurt the gums, and are thrown away when used. All substances very hot, or very cold, are hurtful to the teeth; likewise smoking and chewing tobacco; and too free use of very sweet articles, and excess of animal food.

The frequent use of a fine ivory comb is not good for the hair. It is better to wash the head often in cool water, and brush it very thoroughly. If the hair comes out very much, sea-water, or water with salt dissolved in it, is much recommended as a frequent bath. Cleanliness is advisable for the hair as well as for other parts of the body.

Wash the eyes thoroughly in cold water. Do not sew, or read, at twilight, or by too dazzling light. If far-sighted, read with rather less light, and with the book somewhat nearer to the eye, than you desire; if near-sighted, read with a book as far off as possible, gradually increasing the distance at which the book is held. In this manner near-sightedness is cured in Russia, where it is very prevalent, but the practice must be adopted from an early period, in order that it may be successful. Both these imperfections may be thus diminished. When long-sightedness is dependent on age, it cannot be removed.

If flannel has been worn, choose the morning of a mild day to remove it, and be careful about exposure to the cold for some days after.

If stockings and shoes get wet, change them. It is a mistaken idea to dry them on.

Be careful not to put on clothes before they are well aired. Avoid sitting upon the damp ground, or sleeping in damp sheets.

A feather-bed is the safest place in a severe thunderstorm. The middle of the room is a better seat than near windows, or fireplaces. Metals attract lightning. Trees are an unsafe shelter,

After exposure to severe cold, do not suddenly approach a fire, or drink hot drinks; but acquire warmth very gradually.

If you find yourself seriously ill, send for a good physician-one who understands his profession.

Hints To Nurses And The Sick

THE first and most important duty of the nurse is to follow scrupulously and exactly the directions of the physician. Let no facts be concealed from him, or only half told. Let no entreaties of the patient, or faith in your own experience, induce you to counteract his orders. If a person be trusted at all in this capacity, he must be trusted entirely; for health, and even life, may be sacrificed by different individuals trying experiments unknown to each other. If you think of anything which seems an improvement upon his practice, suggest it to him, and mention your reasons.

Keep the chamber well aired. Fevers are often prolonged by an unreasonable timidity about fresh air. The only precaution that is necessary is to keep your patient out of the current of it, and away from damp walls. Garments and bedclothes should be changed more frequently in sickness than in health, and always carefully aired. If the patient is too ill to have his clothes changed every night and morning, they should be washed the oftener.

The personal cleanliness of the sick is of very great importance. The face, hands, and neck, should be washed with lukewarm soap and water every day; do not let this be neglected from an unreasonable superstition about taking cold; there is not the slightest danger of this, provided the patient be kept from a draught of air, and is not allowed to remain long wet. The feet should often be bathed with warm soap and water, dried with a soft cloth, and immediately covered up. Where it is possible, the hair should be combed, and the teeth brushed every day; if weakness prevent this, let the teeth and tongue be washed with a fine linen cloth.

It is an unspeakable comfort to feverish and nervous patients to have their face, hands, and feet frequently sponged with warm water. It promotes moisture of the skin, and often induces a sweet sleep; even gentle rubbing with the hand is often quieting. In cases of high fever it is very refreshing to sponge the entire person with a solution made of one tea-spoonful of pearlash, dissolved in a pint of lukewarm water-afterwards wiped off with a fresh sponge dipped in warm vinegar and water. [Patients with fever and hot skin, frequently derive great relief from the application of vinegar and water, without the previous employment of pearlash]. Weakly and consumptive patients are benefited by being washed in warm white rum.

Remove all impurities from the room immediately, and make use of the chloride of lime [solution from time to time].

Frequently wash the glass, crockery, and spoons that are used in a sick chamber, and do it with as little noise as possible. Keep them covered with a clean towel.

Sweep with a hand-brush and dusting-pan, to avoid dust and noise.

Let food be prepared in perfectly clean vessels, and served up to the patient in the neatest and most agreeable manner; a sticky spoon, or a greasy bowl, will often quite destroy the feeble appetite. All nourishment for the sick should be made fresh; when warmed over, it tastes less pleasantly, and is not so wholesome. Never first taste the food yourself, or blow upon it, lest it disgust the invalid. When necessary to taste it, to ascertain its warmth or seasoning, put away the spoon you use, without dipping it a second time.

Wash your hands frequently; and use your fingers as little as possible in preparing food or medicine. Always carry a towel under the food or medicines offer.

Let no importunities persuade you to indulge a patient in forbidden food; if this give great offence, inform the physician, and ascertain if any pleasant change can be safely devised. In all diseases, the safest side to err upon is keeping the diet low and mild.

Do every thing as quietly as possible. Step lightly and gently; avoid creaking shoes, rustling garments, and banging doors; have hinges and locks oiled; lay the coal or wood upon the fire with your hand, protected by an old glove. A slight jarring of the bed, or the unfolding of dry paper, sometimes makes a nervous patient restless for the whole night. The buzzing sound of whispering in the room is often even more distressing than loud talk. A sudden stream of light from an opened shutter, or a candle placed where the light can be seen, is often perfect torment.

Use no snuff, or any article of food, the smell of which may be offensive to weak nerves. As for ardent spirit, no person who tastes it is fit to minister to the sick.

Do not ask unnecessary questions. Avoid the repetition of what you perceive to be irritating. If the mind be wandering, appear to fall in with the train of thought, and do not fatigue the patient by asking explanations. Keep a cheerful countenance. Tell no gloomy stories about fatal accidents, especially such as occurred under the very circumstances in which the invalid is placed; incalculable mischief is often done by exciting the imagination in this way, especially during pregnancy [and the confinement].

Under the head of gloomy remarks, I do not mean to include Christian conversation concerning another world. Where it is a settled case that a human being is departing, I have always thought it kind to talk openly, and with serious cheerfulness, of the prospect before him. In these particulars, however, a nurse must be guided by the wishes of relations and friends.

Preparations for the night should be made early in the evening; for if a drowsy patient is disturbed with whispering, stirring the fire, passing in and out, &c., it often breaks up sleep for the whole night.

Be very careful to get exact directions respecting the food and medicine to be taken during the night: it is prudent to make a memorandum of them. Be scrupulous in measuring medicines: it is best the physician should see the size of the spoon you intend to use. In extreme illness, important results often depend upon not varying five minutes in the prescribed time of giving medicines. It is well to keep a record of what occurs between the physician’s visits, that he may accurately know the progress of the disease.

Always have a second lamp in the room, and facilities for obtaining hot and cold water.

Unless especially instructed so to do, never wake an invalid from sleep to administer nourishment. Guard their slumbers well; for “Sleep is tired nature’s sweet restorer.”

In preparing medicines, remove the sticks and pods from senna; other seed from [lin] seed; dirt from roots; and all mouldy or musty parts from herbs.

When the feet are put in warm water, have the limbs [and body] well protected by blankets or flannels. Wipe one foot dry with a warm cloth, and put on a warm stocking, before the other foot is taken from the water. If the water becomes cool, add warmth to itbeing careful not to scald.

When a patient is to be rubbed, it is better to use mittens of flannel, because they present a more even and agreeable surface than a cloth that slips about in your hand. Do not rub backward and forward, and be careful not to injure the skin.

When you make the bed, arrange the feathers so that the head and shoulders will be elevated; and tuck in the under sheet well. Feather beds and pillows are heating when fever is present; mattresses, or straw beds, and hair pillows, should be obtained.

Have something to throw over the patient’s shoulders when sitting up. Support the back with a footstool or chair behind the pillow, and let the feet have something firm to press against. Change of posture oftentimes affords inexpressible relief.

When an invalid walks with difficulty, he may be drawn from the bed to the fire in a rocking-chair, comfortably arranged with blankets and pillows. See that the shoes are warmed in readiness; and if pillows are brought from another room, have them well aired. Rocking-chair gently tipped back, and securely supported by blocks, is an easy position for the weak. [The reclining chair at present in use will afford great relief by the changes of position which it allows an invalid, and which may be made with but little trouble, and without giving rise to any uneasy sensations.]

When a person is too feeble to sit up long, have two sets of pillows, sheets, and blankets, that one set may be aired in readiness to put on.

If an invalid is removed from his own bed to one beside it, have the head of the second bed placed toward the foot of the first. The patient will thus be laid in the same direction after moving, as before; and much unnecessary fatigue, and awkward lifting, will be avoided.

If the patient cannot be moved from the bed at all, half the sheet can be turned over in smooth folds; a warm clean one can be substituted, with one-half of it likewise in smooth folds; the patient can then be moved to the clean side.

In common cases, a good nurse can judge when a gentle emetic, or cathartic, or cooling beverage, is necessary; how much exercise is salutary; and when a cheerful guest may be admitted. Loud, rapid talkers, and excitable nervous visitors should in no case be admitted into the sick chamber. That you may know what to avoid, observe the countenance and pulse of your patient, the temperature of the skin, and the effect of food.

A really good nurse must have a tender conscience, as well as a feeling heart. She must feel convinced that the slightest deviation from truth, even to screen herself from blame, is not only a violation of the trust reposed in her, but is a sin against God.

When her patience is severely taxed by unreasonable caprices, she must remember how sickness weakens the mind, and try to apply the golden rule.

When infants are fretful, she must beware of the temptation to administer opiates. To endanger the health, or dim the intellect of a human being, for the sake of temporary convenience, is a fearful responsibility.

[Too many instances have occurred of late in which a contrary line of practice on the part of the nurse has been attended with the most fatal results. Whenever it is deemed necessary to give the infant an anodyne, other than by the express direction of the medical attendant, by whom in such a case the proper quantity only will be sent, it will be essentially requisite to ascertain the strength and dose of the syrup of poppies or diacodium, which is used, as they are not often met with possessing exactly the same quantity of opium in two shops.]

Invalids too, have … duties to perform. Giving of necessity a great deal of trouble, they should endeavour to diminish it as much as possible. They are bound to pay a kind regard to the comfort and convenience of those who nurse them. This may be shown by complaining as little as possible; by a pleasant acknowledgment of affectionate attentions; by trying to think of all they want while the nurse is up, that they may not be obliged to call her from her chair the moment she is seated; by swallowing disagreeable medicines without any unnecessary annoyance; and by not coaxing her for food, which the doctor has forbidden.