3. Newspapers and magazines, books and toys used by an infectious patient, should be burnt. A pack of cards has been known to spread infectious disease to a dozen people. A letter, again, will carry infection to the recipient.
5. Blankets and woollen garments must be baked in an oven of 2000 before washing.
The strength of carbolic disinfectant for flushing drains is one in sixty of water. But many doctors do not care for this strong poison to be used, and each doctor should be asked to recommend the one of the patent disinfectant fluids he prefers.
The nurse, however, must remember that heat, sunlight, and fresh air are natural and safe disinfectants at her command. Pure fresh air will dilute infected matter, and in many cases destroy the microbes of disease. Microbes also die on exposure to sunlight, and if a liberal allowance of fresh air and sunlight is provided in the sickroom and house generally, the risk of infection is enormously reduced. Then, if everything possible used in the sick-room is boiled, safety is largely ensured. For example, all feeding-cups, basins, plates, etc., should be disinfected with boiling water. Bed-linen and cotton or linen under-garments can also be boiled, as also can any instruments used in the sick-room.
The nurse must be very careful to guard against infection herself. She will require to
The floor and furniture should be wiped with a clean cloth wrung out of a disinfectant fluid. For this reason cushioned chairs are out of place in a sick-room wear a short washing dress and large white apron. She must try and avoid unduly coming in contact with the patient's breath. She should, for example, sit between the patient and the open window, so that the fresh air passes over her before reaching the patient, not vice versa. She should always wash her hands in some disinfecting solution after attending to an infectious patient, and take a warm bath with a disinfectant soap every evening, washing her hair regularly also. If the hair is worn plainly braided and covered with a white cap, the risk of infection is diminished. Remember that it is when the vitality is lowered that everybody is most liable to infection. It is specially important, therefore, in nursing a fever patient, for the nurse to attend to her health. She must have her meals served regularly. She must have special hours off duty, and get sufficient exercise out of doors. Everything should be done methodically and in order. When she has swept and dusted the room in the morning, for example, the collected dust should be burnt. The floor and furniture should be washed over with a cloth wrung out of the disinfectant solution recommended by the doctor. The patient should be covered up carefully, and the room flushed with fresh air several times daily. If the window is kept open day and night, this will ensure proper ventilation.
Special precautions have to be taken in typhoid and scarlet fever, in diphtheria and measles, so that the nursing of the commonest types of infectious fevers will be considered in a later article. Afterwards the disinfecting of the sick-room will be described in detail, so that the amateur nurse may know exactly how to care for her patient and at the same time prevent the spread of infection to other people. No one who is easily alarmed about infection should ever try to nurse a case of fever. Fear of infectious disease will increase the liability to contract it. When we are in good health, strong in mind and body, we are not susceptible to infection. If we take proper hygienic precautions, the risks of contracting it from a patient are inconsiderable. At the same time it is wise to have someone in physically good condition in charge of a fever case, as continual attention and care are necessary, and the strain cannot be ignored. In some cases relapse during convalescence, if the nurse is in the least degree careless in her work, is very apt to occur; and it is in fever cases especially that strict obedience to the doctor is called for, and a trustworthy nurse is absolutely essential.
Common disinfectants used for nursing infectious cases are:
1. Chlorinated lime for flushing drains. Add two ounces of this to a gallon of water, and use it liberally for pouring down the drain.
2. Certain proprietary disinfectants made from coal tar are useful and safe. The doctor will always recommend one of these.
3. Carbolic acid is an excellent disinfectant, but very poisonous, especially in the pure state. The most useful strength is one in sixty of water. If, for example, a teaspoonful of carbolic acid is stirred up in a basin containing about eight ounces of water, a useful solution is obtained. This can be used for washing linen, dishes, etc. A stronger solution is one in twenty, which is generally used to keep the carbolic sheet moist.
4. Permanganate of potash is a safe but not very strong disinfectant. The usual strength is one ounce of the crystals to three pints of water.
5. Carbolic and other disinfectants can be purchased from any chemist.
6. Use plenty of sunlight, fresh air, and boiling water for disinfecting purposes.