An inviting tray for an invalid.
Cleanliness and daintiness are essential in serving meals for an invalid
For gruel, mix two tablespoonfuls of oatmeal with water and a pint of milk. Boil gently, stirring all the time, and flavour to taste questionably clean in attending to the small accessories. The four most important things a nurse has to ensure are:
2. Good cooking.
4. Regularity and dainty serving.
1. Everything about an invalid should be scrupulously clean, especially all dishes, glasses, cutlery, and, most important of all, the food itself. Even in health a sensitive person's appetite will fly at the slightest suspicion that food is not absolutely clean. In sickness the appetite is extremely capricious, and the well-trained nurse sees that, so far as she is concerned, nothing is done to put the patient off her food. No scraps or remains of food must be allowed to stay in the sick-room. The meal is brought to the patient's bedside, and whenever the appetite is satisfied, the tray and all its contents should be carried out again at once. Clean linen, shining glass, fresh water, dainty butter-dish, salts, etc., are all points which must be attended to.
2. With regard to the preparation of sickroom dishes, here we shall only touch upon beef-tea, gruel, and broth, because these are invariable articles of diet in the sick-room.
A slice of the top side of the round of beef should be asked for, with all skin and fat removed. This must be minced fine, put into a stone jar with its own weight of water, and allowed to soak for an hour and a half. It is then covered with a saucer, and put in a saucepan of boiling water. It should be allowed to remain for three hours, and served as required. The nurse must remember that beef-tea is not a nourishing food like milk or eggs, but it is an excellent stimulant, and makes a delightful drink, and, when served with fingers of dry toast, it is very useful in the sick-room.
Raw Beef-essence is really uncooked beef-tea. It is made by chopping half a pound of beef, and adding a teacupful of water, and a little salt to this. It should stand for three hours, and then be strained. If it is served in a coloured wineglass, and sipped slowly, the red colour is disguised. Another way to make a useful meat-essence is to take half a pound of the best minced steak, add a little water to it, and press all the juice and nourishment out in the water. It is then strained through muslin, and may be given in milk or alone. Some children will take it mixed with breadcrumbs.
Broth is made from mutton, fowl, or chicken. Half a pint of water is used to a pound of meat. It should be put on the stove cold and cooked slowly, so as to get all the nourishment out of the flesh-fibre.
Two tablespoonfuls of oatmeal are mixed with a little water, and a pint of milk is added to this; the mixture is placed in a saucepan and boiled gently for half an hour, stirring all the time. The gruel can then be flavoured with sugar or salt, and served with thin bread-and-butter. It makes a very appetising and nourishing food for invalids.
3. The choice of food must, of course, be left to the doctor, as it depends to a large extent upon the patient's condition. A patient with " fever "-that is, rise of temperature-for example, must on no account have solid food. He will probably be ordered small quantities of milk every hour, or every two hours. When the temperature comes down, beef-tea and broth may be given to vary the milk meals. As he becomes convalescent, custards, milk puddings, especially arrowroot, and lightly boiled eggs are first given. Then perhaps fish, chicken, and, as the patient progresses, a little meat, vegetables, and other ordinary articles of diet are allowed. In certain cases, such as ulceration of the stomach or typhoid fever, the least deviation from the strict rules of the doctor as regards eating may prove fatal. The foolish nurse who listens and yields to the patient's desire to have a cutlet, when solid foods have been forbidden, runs the risk of terminating the case fatally. Not even a trained hospital nurse can go against what the doctor has ordered the patient to have, and one of the unbreakable resolutions that every amateur nurse should make is that of implicit obedience.
4. Regularity and dainty serving. The hours at which the patient is to have meals will be noted by the careful nurse in the chart which was described in an earlier article of this series. A doctor may wish the patient to have a meal every two hours. The nurse must ask if the patient is to be awakened for food, or left to sleep, as this is an important point, the answer depending upon the illness and the condition of the patient. Punctuality must be observed. The nurse should never keep the patient waiting past the expected hour. Prompt to the minute, she should carry in a dainty tray with everything served as nicely as possible. A little vase of flowers will add an artistic touch. The food should be nicely served on a hot dish. Toast must be daintily cut and placed in a toast-rack, the butter should be nicely rolled, and a scrap of parsley adds to the effect. It is important to keep the patient bright and happy during mealtimes, as any little irritation or depressing thoughts will banish appetite at once.
Drinks for the Invalid
To keep water cool, the glass bottle or jug should be wrapped in a piece of linen, and placed in cold water near an open window. The linen or wrapping should be kept wet. Fever patients require a good deal of water, which they can sip from a wineglass, so that they do not get too much at one time. Weak coffee, cold weak tea, rice-water with a little citric acid added, and oatmeal-water are all useful. A quarter of a pound of oatmeal is boiled in three quarts of water, and sweetened with a little brown sugar. Rice-water is made by taking three ounces of well-washed rice, and boiling this quantity in a quart of boiling water. Strain and sweeten, and add a few drops of citric acid.
Barley-water is made by putting two ounces of well-washed barley in a jug, and pouring a pint of boiling water over this. After cooling, strain, and add lemon-juice.
A sick person is much more likely to suffer from thirst if the mouth is not kept absolutely clean. For this reason the teeth should be washed several times daily, and the mouth rinsed with borax-water (half a teaspoonful of borax to a teacupful of tepid water). A little glycerine may be added to this if desired. The choice of food in convalescence depends a good deal on the type of illness. In anaemia and consumption, for example, milk, cream, eggs, and butter are very-important foods, because of their nourishing qualities. Yolks of eggs are more nourishing than whites. Cream and butter supply the necessary fat. Cream may be taken alone or added to gruel, cocoa, stewed fruits, or blancmange.
It is better to take cream several times daily in small quantities than in a large amount at one time, as in that case it is liable to cause indigestion. Butter should be spread on thin slices of bread or toast. In intestinal diseases, especially diarrhoea, a person must avoid meat, fruit, and vegetables; and foods should be taken warm, neither hot nor cold. Invalids should never be given tinned food, fried food, nor solid food. Condiments are best avoided, and such indigestible foods as pork, ducks, geese, pastry, pickles, etc., must never be given.
Foods to be Avoided
Nurses ought to know what foods are to be avoided in certain illnesses, such as asthma, gout, dyspepsia; and what is the best dietary in constipation, anaemia, obesity, and other complaints.
Low Diet or Fever Diet
The patient gets, at regular intervals stated by the doctor, milk, broth, or beef-tea, albumen-water, milk diluted with barley-water, fresh whey, and some of the well-known patent invalid foods served with milk.
Breakfast: A breakfastcupful of milk, cocoa, or tea, bread, or toast, and butter.
Dinner: One pint of nourishing soup with toast, a little fish, or egg or milk puddings.
Tea: Same as breakfast.
Supper: Half a pint of milk, with bread-and-butter or arrowroot and milk, or gruel and bread-and-butter.
Breakfast: A little fish or lightly cooked egg can be added to the breakfast menu.
Dinner: A pint of nourishing soup with bread, four ounces of freshly cooked meat, or six ounces of fish should be allowed, with six ounces of potatoes, and custard or lightly cooked milk pudding.
Supper: As in middle diet.