Duties of the Nurse
Duties of the Nurse.—On first going to the house the duty of the nurse is to find out where everything that will be needed is kept, then to wait on herself quietly and without intruding.
The time of the nurse belongs to the family employing her, but she has full control of the patient and the sick-room. There is no place where the presence of mind and powers of observation of a nurse show so plainly as in the operating-room; so do the gentleness, modesty, refinement, and cheerfulness of a nurse shine clearly in the sick-room.
A nurse should be as little trouble to the family as possible, and improvise all she can, remembering that they are under very great expense. The same caution should be observed in dealing with the servants: she should be kind to them, and add as little as possible to their work in the kitchen or the laundry. She should wash and put away all glasses and dishes used for the patient, as is done in the hospital; they must not be left in the kitchen for some member of the family or the servants to wash; the nurse must do it herself.
The patient should closely be observed, and all that can be done to make her comfortable should be anticipated, not waiting to be asked for anything. The nurse should wear noiseless shoes, and move about the room quietly; she should look where she is going, and not knock against the bed or the furniture; and she should avoid everything that may annoy the patient.
The nurse should begin early in the evening to prepare for the night—to get everything that may be needed, and when moving around in the night she should make no noise, so that the patient and the family shall not be disturbed. Sleep must be taken when it is most convenient for some member of the family to relieve her; the same with meals, which should be taken alone, unless the family really wish her presence at their table. At such times, when she is away from the patient, written orders for the substitute must be left, and she should make sure that the one who takes charge understands thoroughly how everything is to be done.
The answer to the question, Should a nurse refuse to take her meals in the kitchen? depends on the circumstances of the family. It does not at all lessen the dignity of the nurse to eat in the kitchen, a gentlewoman is always treated as one wherever she is. It is not degrading to assist in the kitchen when emergencies arise; it shows the true spirit of a nurse, and the kindness is not lost.
A nurse must not talk of her hospital days; she will find a number of patients very curious to hear of the different cases and operations that she has seen, but they must not be talked of; it has a depressing effect on the patient. A nurse must be cheerful and talk of cheerful things. Nor must she tell of her experiences in other families: all that she hears or sees in the family for whom she is working must be kept secret; she has no right to speak of one patient to another in private or hospital practice, or to criticise or discuss her patient’s peculiarities outside of her report to the physician.
The directions of the doctor must faithfully be carried out, and in the absence of directions the nurse should think what he would like to have done. When she makes a mistake, it should be confessed at the first opportunity; the physician will always be found very kind; but if mistakes are left for him to find out, he will naturally lose confidence in his nurse.
If any trouble should arise regarding meals, sleep, getting fresh air, or anything else, the nurse must not worry the patient about it; she should speak to the physician, who will always be found a warm friend.
A nurse will often work for doctors who treat their patients differently from the way she has been used to seeing them treated. The doctor makes the diagnosis and gives his orders as to the treatment of the case, and, no matter what the nurse may think, it must not interfere with her accurate and faithful execution of those orders. She should never be guilty of making suggestions to the doctor: she is there to carry out his orders, to observe every little thing about the patient, and to report to him in a clear, simple way; her judgment must never be allowed to prevent her from doing her duty to the physician in charge.
Some families may question the nurse very closely about the attending physician. She must be very careful how she speaks of him, and inspire all possible confidence in him, whether she has or has not worked with him before. The family may likewise question the doctor about the nurse; the battle is half won when the family has confidence in both physician and nurse.
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