Chapter 21 - Domestic Management of the Sick Room
Choice of the Sick Room
Fumigation
Freezing Mixtures
Attendants
Prognostics
Bed Sores
Diet in Disease and Convalescence
Fluid Aliments

21.4 Attendants

Unhired Attendants. The selection of a good nurse, however eminently qualified she may be for her duties, does not supersede the attendance of a relative or friend in the sick room; on the contrary, I can conceive no condition so deplorable as that of an invalid left altogether to the care and management of a hireling. It is, nevertheless, too true that few ladies, even those who are wives and mothers, have any acquaintance with the arrangements of the sick room, and the management of the invalid; they are, consequently, too often forced to be guided by, and to rely for instruction on, the nurse, instead of being able to superintend her conduct, to ascertain that she performs her duty, and to correct her failings. The degree of intelligence which is demanded in a nurse is very different from that which is requisite for a wife or a relative in the sickroom. The intelligence of the nurse is directed to supply the wants of the invalid, to administer to his comforts, and to obey the instructions of the physician; that of the friend or relative involves the power of discriminating disposition and temper; of watching the progress of the disease, and judging of the propriety of not pursuing certain measures, which, although indicated by the symptoms at the time of prescribing, yet may require to be altered, and consequently detailed to the physician, whose presence may be requisite before his next intended visit. It is of the utmost importance, also, that relatives attending in the sick room should be able to control their feelings in the presence of the invalid. Nothing is more essential, in the domestic management of diseases, than a knowledge of the natural disposition and temper of the invalid. An irritable or a passionate man requires a very different management from that which is proper for a man of naturally mild and easy disposition. Disease awakens, in an augmented degree, the irritability of the former; he becomes impatient of contradiction; and every time his opinions are injudiciously opposed, the turbulent agitation of the nervous system which follows either increases the disease or weakens the influence of the remedial agents. On the other hand, a mild and gentle disposition often leads to extreme sensitiveness, when disease attacks the body; a word, a look, is sufficient to touch some sympathetic cord: to unstring the whole nervous system; and to augment the morbid susceptibility already present in the habit to a degree that is not always devoid of danger. Much discretion and judgment, therefore, are requisite in both instances; in the one case, to prevent ebullitions of temper; in the other, to refrain from anything that might be construed by the invalid into harshness; and yet at the same time, in each case, to maintain that influence over the patient which the treatment of every disease demands in an attendant on the sick. Prejudice and Antipathies. In those who are imperfectly or erroneously educated, the judgment is apt to be biased by prejudice and antipathies; and, under the influence of these, it is misdirected in a manner of which the individual is often wholly unconscious; thence the necessity of freedom from prejudice in the attendants in the sickroom, and the farther importance of the friends or relatives of the sick being able to superintend the conduct and the management of hired nurses. On the other hand, the judgment, even in the well educated, is apt to be misled by the affections, the influence of which is as much opposed to the healthy exercise of discrimination as the prejudices of the ignorant. Self control, therefore, is also an essential qualification of the sick room. It is only from knowing that the attendants of the sick are possessed of intelligence and self control, that a physician can rely upon having his orders correctly and duly executed; when those qualities are absent, be has to dread, on the one band, the presumption of ignorant prejudice; and on the other, the improper yielding of sensitive indulgence. To the invalid, also, it is important to know that the directions of his physician are filled by an intelligent person; for, even in the most severe diseases, as long as the mental faculties remain unaffected, a sick man is capable of detecting ignorance, or the effects of prejudice, in his attendants; and, when he is convened of the existence of either, all the influence of the individual, whether nurse, or friend, or relative, is at an end. Were the business of the sick room (independent of the wants and comforts of the invalid) confined to the mere observation and collection of facts namely, the noting of the symptoms of disease and reporting them to the physician, it would be superfluous to urge the necessity of superior intelligence in its superintendent; but many of its duties require not only a well regulated understanding, but an equally sound condition of the moral feelings and the benevolent affections, with a recognition of the authority of conscience in the whole operations of life. In the period of sickness, under the direction of the judicious and discreet, an invalid may be led to the investigation of his moral and religious condition, and to review his past conduct, with the determination of turning the result to his future, welfare, should he happily recover and re enter society. Surely such important duties as these cannot be in trusted to the unqualified, or the ignorant, or the hireling; nor can more be required to demonstrate the importance of adding to the other branches of female education a knowledge of the various important duties of the sick room, which females, whether as mothers or daughters, or wives or friends, are likely to be called upon to fulfill.

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