Before starting to change the bedding be sure that you have everything necessary near at hand, and that the bed clothes are all well aired, perfectly dry and warm.

First take off the spread, fold it neatly; next take off the top blanket, and hang it out to air. Fold the other blanket and upper sheet over the patient, leaving the ends just long enough to cover her when you turn her over. This method answers a threefold purpose: (1) it has a neat appearance; (2) it replaces the discarded blanket, and (3) the clothes are not in the way while you work. Loosen the lower sheets by raising the mattress with one hand while drawing out the sheets with the other. Raising the mattress is important, because the draw sheet has been tucked so far under the mattress that otherwise you risk not only jolting the patient but also tearing the sheets. Remove the pillows and if the patient does not object to lying flat for a while leave them out; if she does, one can be replaced. It is necessary to take them out to turn them and to make sure that there are no crumbs caught between them or in the pillow cases.

The night gown is the next thing changed. Have the patient lie on her back and flex her knees; if she is well enough she can easily raise herself while in this position; if not, place one hand under the buttocks and raise her, as you draw the gown up with the other hand, then raise the shoulders in like manner, drawing the gown up over them and the head before taking out the arms.

In putting on the clean gown roll the skirt up, and put the patient's head through the hole. Putting your hand through one sleeve grasp the patient's hand and draw it through; then do likewise with the other sleeve. The gown is then pulled down in the same manner as the soiled one was taken off.

The easiest way to change the under sheets is first to turn the patient on her side.

To do this, stand on the side towards which you will turn her, slip one hand over and under her, with your arm slightly crooked, so that the hand and forearm will support and control one shoulder, the elbow support the back of the head, and the arm the other shoulder. Slip your other arm under the patient slantwise across the buttocks, so that the hand is under the small of the back. In this way the patient is well supported as you gently turn her towards you. If there is an assistant, one can hold her thus while the other manipulates the sheets; if not, and the patient needs to be supported, a pillow placed well up against her back will answer the purpose.

The sheets to be changed are folded close to the back of, the patient, making the fold as flat as possible. The clean sheet is either folded fan shape or rolled to its centre, the roll or fold, as the case may be, is placed close to the sheet being removed, the loose edge is tucked in, as far under the mattress as possible, the patient is then rolled gently over on to the clean sheet, the soiled one removed, and the clean sheet well stretched, and tucked in according to the directions given in the making of the bed.

The top sheet is next changed. Placing the clean sheet over the sheet and blanket which are still over the patient; on top of this put the blanket which has been airing, draw the other blanket and sheet from underneath, then tuck in the clean ones, put on the second blanket, if one is necessary, then the spread, and arrange the pillows.

Changing The Draw Sheet

The draw sheet, upper sheet, and night gown should be changed twice a day when the patient is not too ill; if they are not soiled when removed, air them well, after which they may be used again.

When the patient is not allowed to be bathed, her back should be washed with soap and warm water, rubbed with alcohol and powdered with talcum powder. This should be done while she is turned on her side for the changing of the sheet. When the night gown is closed in the back it is sometimes more convenient not to put the clean gown on until the patient's back has been washed. In such circumstances wrap a small shawl around the patient.

When for any reason it is inadvisable to move the patient, and it is necessary for her to lie on her back, it is convenient to have short gowns, open in the back, buttoned at the back of the neck and shoulders. The skirts can be drawn from under the patient, enabling her to lie on the sheet, which it is comparatively easy to keep free from wrinkles. Another important advantage of the short gown is the ease with which it can be changed. Large collars or ruffles at the neck of the gown are very objectionable in illness.

When changing the gown of a patient whose arm is disabled, the sleeve should be taken from the affected arm last, and the sleeve of the fresh gown put on first.