The amateur nurse ought to know something about the type of cases likely to benefit from a modified rest cure. The rest cure proper is generally undertaken in a nursing home, because isolation from sympathetic friends is a very important part of the treatment. There are, however, so many ills and ailments which can be satisfactorily dealt with by a modified rest cure at home that a series of nursing articles would not be complete without reference to this treatment. There are many people who, although they have no real disease, are obviously ill. The woman who is constantly worrying, fretting about little crosses of life, miserable from no apparent reason, and incapable of much exertion without exhaustion would be a new woman if she could get a few weeks' rest at home.
Then there are are thin, dyspeptic people who do not seem able to eat without pain, who cannot digest the smallest meal, whose whole digestive systems are out of gear. They also are in real need of a rest cure. There are workers suffering from nerve strain and brain exhaustion who keep at work with an effort, who are so run down nervously that every noise jars, and the daily routine becomes almost more than they can bear. No drug is of avail in such cases. Rest treatment is the natural remedy, the only thing that will restore health within a reasonable time.
Rest treatment proper, as formulated by Dr. Weir Mitchell, aims at restoring the healthy action of the nervous and digestive systems, first, by taking the patient to a new and restful environment, and, secondly, by feeding systematically in order to promote body nourishment.
In bad cases the patient is taken to a nursing home, and kept there for six or eight weeks absolutely cut off from communication with friends. The type of person who needs so rigorous a rest cure is so highly sensitive, so introspective, so acutely conscious of her own health or ill-health, that ill-advised sympathy from friends and relatives only make matters worse. For this reason a new environment, where cheerfulness is the keynote, is found to be invaluable, and, indeed, a necessary part of the treatment.
In less serious cases, when the doctor has advised a rest cure, it can quite easily be accomplished at home with a little ingenuity. A great many cases which end very sadly in melancholia and complete nervous breakdown might have been
-saved years of suffering and unhappiness if a rest cure at home had been advised in the beginning. The most cheerful member of the family should undertake the nursing. A room should be made as attractive and as bright as possible, and the patient should not be allowed to have any communications from outside likely to upset her nerves.
The patient should be kept happy by cheerful conversation or pleasant reading, if the rest cure at home is to be of full benefit to the patient
The Choice of a Nurse
Absolute physical and mental rest is necessary from the first. The patient, for the beginning of the treatment, at any rate, should be kept entirely in bed lying on a comfortable spring mattress; and, whenever possible, there should be two beds, one for day and one for night. Very few people understand how much rest can do lor the ills of the mind, flesh, and spirit. One day's complete rest in bed will often ward off an illness. A week-end in bed is sometimes the best holiday that anyone can have.
In dealing with nervous, dyspeptic, and hysterical cases, at least a week or two should be devoted to the rest treatment. The nurse has to supply cheerful subjects of conversation, and to keep the patient's mind from morbid thought.
The temperament of the nurse is most important. Anyone in charge of a case requiring a rest cure should be able to combine kindness and firmness, to command obedience without fretting or irritating the patient. A bright and cheerful manner and personality will interest and provide a tonic to the person whose mind is sick and depressed.
Lack of appetite and disinclination for food are almost invariably present in the patient requiring a rest cure. For weeks or months past systematic under-feeding has been the rule, so that the body and mind have been hall-starved, and literally require what seems to be an excess of nourishment. The patient is generally very thin, and the great aim is to put on weight, which can often be done at the rate of about one pound a day. Milk is given in abundance, either fresh or peptonised or mixed with soda. Then the patient has to take small meals of raw meat-juice and liquid peptonoids, and plenty of meat, fruit, vegetables, and wine.
The rest cure at home should be modelled on the plan of the Weir Mitchell treatment as it is organised in the nursing home :
11 a.m. .. 1 p.m.
Milk or milk and coffee.
Emulsion of iron or some prepared food.
Nourishing soup or meat extract.
A good solid luncheon of three courses.
2 30 p.m. 3.30 p.m. 5 P.m.
Milk or prepared food.
7.30 p.m. 8.30 p.m.
This large amount of food could not possibly be assimilated but for the massage which is such an important part of the rest cure treatment.
Massage must at first be light, as the patient may complain of discomfort owing to the highly sensitive condition of the nervous system. Later, rubbing movements can be more firm as the patient gets accustomed to the treatment. The massage of the spine should be applied last of all, as it has a soothing effect on the nervous system, and makes the patient sleep. The massage movements stimulate the circulation, and this improves the nutrition of every organ. In a week or two various exercises should be practised, and with massage, electricity, and passive and active movements, the patient is taking as much exercise as if she were up and about. As a rule, some preparation of iron, such as are Blaud's pills, is given at the same time, and the patient may put on as much as half a stone a week. It is most remarkable how this increase of weight is associated, with the disappearance of worry and sleeplessness, which, as a general rule, are very marked symptoms at first.
The ankle joint is covered by the figure of eight, one loop of which is carried round the ankle and one round the instep
Quietly but firmly insist upon the patient eating all the food ordered by the doctor. The patient's fears regarding the pains of indigestion can be very much allayed by a suggestion from the nurse that the diet chosen will not cause pain, and that every meal helps to forward the cure. Serve every meal daintily, as this type of patient is very sensitive to appearances
Allow no visitors into the room at all without the doctor's permission, and, if visitors are allowed later on, warn them against anything but cheerful conversation.
The nurse must not forget that good nursing is just as important in these cases as in dealing with an accident or an infectious fever. When the doctor recommends a rest cure, the patient is really ill, although there may be no apparent sign of disease
Rubbing oil into the limbs and the neck and chest when massaging is an excellent measure, as oil nourishes the tissues, and in ninety per cent, of cases the patients are extremely thin.