Those who have to take charge of the sick in the hot season of the year find it much more difficult to keep their patients quiet, restful, and comfortable, because of the trying effects of the heat. In towns especially, when the oppressive heat is almost unbearable even for the strong and healthy who are going about their daily work, the patient and the nurse often suffer considerably. The difficulty of sleeping through almost tropical nights, the lack of fresh currents of air, the weight of the bedclothes, all contribute to retard recovery, and increase the difficulties of the nurse.
It may be that in future every hospital will be liberally supplied with open shelters and verandahs, which will largely take the place of the sick-wards we are accustomed to at the present day. There is no doubt that many cases of illness would recover far more rapidly and completely if they were nursed in the open air all the time. The same thing is true of. home nursing, but most people have to be content with an ordinary bedroom, which, however careful one is about ventilation, is sadly apt to become stuffy during the hot weather. Few patients will tolerate the idea of a fire in the bedroom in summer, and yet, when this can be borne at all, it helps ventilation by causing a suction or drawing of air from windows and doors up the chimney.
It goes without saying that, during the hot weather, the windows should be kept open as much as possible. In the first place, one ought to choose a room with a north exposure in order to avoid the direct entrance of the sun's rays into the room. In the winter, on the other hand, the southern exposure is preferable.
When one is fortunate enough to be provided with a room with more than one window on different sides of the room, proper ventilation can be more easily managed, and every effort should be made to keep the room as cool and fresh as possible. An open window with Venetian blinds, which keep the sun out and yet permit air to pass between the slats, will help matters. Then a sheet occasionally wrung out of cold water hung up at the window keeps the air moist and cool. Another plan is to suspend a large sponge, saturated with equal parts of water and eau-de-cologne, from the ceiling. Evaporation goes on all the time from this, and the air is kept fresh and cool.
In nursing a lung case, when breathing is difficult, such as bronchitis, for example, the sponge may be wrung out of water and then sprinkled with a few drops of creosote or Friar's balsam, which are sedative to the respiratory passages. Emphasis has already been placed on the importance of permitting no superfluous articles of furniture or apparel to remain in the sick-room, and this is especially true in summer. Even if the case is non-infectious, the carpet should be removed, and a strip or two of clean matting substituted in its place. The colouring of the room should be of the soft-toned variety. Greys, blues, and greens are cool, whilst red and pink are less soothing and less cool in their general effect.
The bed must receive special attention, as it is most important to get the patient to sleep well during the hot weather, when restlessness and insomnia are only too likely to be present. The mattress must be smooth and rather hard. Anything lumpy or soft will be extremely uncomfortable. A firm hair mattress and the ordinary metal spring bed is best for the purpose. Linen sheets are preferable to those of cotton, as they are much cooler for the hot weather. One light blanket will be sufficient, and sometimes, instead of blankets, a very fine, light eiderdown will keep the patient sufficiently guarded from chill, and yet not prove too heavy in weight. A low, firm pillow should be chosen to sleep on, whilst, during the day, a second pillow will perhaps provide a better support for the head and shoulders.
The bed should be so placed that the patient does not face the light, which is apt to wake him in the early morning, and it ought to stand in the middle of the room, in order to allow plenty of air round about. No curtains, draperies, or valances of any kind should "decorate" the bed in the sick-room at any time; but, in summer especially, such superfluous accessories will simply add to the patient's air hunger and feeling of suffocation.
There are various devices which can be employed by the careful nurse for keeping her patient cool and comfortable. A simple point, which is important, is to change the nightdress night and morning. When the washing-bill has to be considered, and the patient cannot get a clean nightdress each time, they should be aired carefully on removal, and laid aside for another time. The patient is thus provided with one garment for day and one for night, and this adds very much to his comfort. Frequent sponging is another measure which should be attended to often. If even the neck, arms, and face are sponged occasionally the patient feels much more restful, and when it is very hot the body can easily be sponged over quickly after slipping a bath-towel underneath. Flicking the body over with a towel wrung out of cold water can also be tried, whilst perhaps the best thing of all is sponging the body with cold whisky, and this will often induce restful sleep during hot nights, when the patient tosses, weary and sleepless, from side to side.
When there is undue sweating, which may occur in the early morning hours after a hot and troubled night, the body should be dried with a towel and a clean nightdress, provided. When irritable, the patient will be soothed at once if the scalp is saturated with eau-de-cologne or whisky.
The patient's food must be light and appetising. The making of drinks to allay thirst should be specially studied. Cold weak tea is refreshing. A little iced water would be much appreciated.
but long cold drinks should not be given in large quantities.
Toast-water is made as follows :
Toast until they are a rich brown colour the crusty parts of a loaf, and put these in a clean jug. Pour boiling water over, and when cold strain through muslin. This may be flavoured with sugar and lemon.
One of the most delicious drinks for hot weather is orange whey. The juice of one orange is squeezed into a pint of milk. This is boiled and strained, and should be drunk when cold, with two or three pieces of ice floating on the top. The making of barley-water has been described in the article on " Sick-room Diet " (see page 1702, Vol. 3, Every Woman's Encyclopaedia).
Light diet is really all the patient will be willing to take, even in convalescence, in hot weather, when meat and strong food appear distasteful to the healthy. Junket, curds-and-whey, with cream, custards, milk shapes, gruel, eggs, and a little light fish provide a good deal of variety with stewed fruits and bread-and-butter.
Koumiss is very useful in the sick-room. It originally came from the milk of mares in some parts of Russia, but it is now artificially made from cow's milk in this country. It is extremely valuable for many wasting diseases, in the sick-room, and in convalescence. It can be ordered from the chemist, or made at home by taking two pints of fresh milk and one pint of buttermilk, and mixing them with a dessertspoonful of powdered sugar. These should be stirred together in a jug, then covered with a clean muslin cloth, and placed near the fire for twelve hours. It should then be bottled and corked, and the bottles laid on their side to allow fermentation to go on.
It is most important in hot weather to guard a sick person against contracting diarrhcea from contaminated milk. The milk should always be boiled and protected from flies, for it is during the hot season that disease germs are introduced into the milk by the flies, and these are especially dangerous to sick people, whose digestive organs are liable to succumb to infection.
The competent nurse takes care that her patient's food is specially dainty when appetite flags owing to the heat. The smell of cooking should be kept from the sick-room by shutting the kitchen doors and opening the windows. It is much wiser, during the hot weather, at any rate, not to cook strong-smelling foods, such as onions and fried fish, in a case of serious illness. All these little things affect very much the progress of the illness, when the patient's appetite is very feeble, and it is important that he should take as much nourishment as possible.
Lastly, the nurse should do her best to keep well, to guard her own comfort, and mitigate the effect of the heat as much as possible. Thin, cool stockings and comfortable shoes with low heels, a light summer print dress, short and trim, with elbow-sleeves and collarless neckband, make nursing less of a strain and discomfort. Both the nurse and patient should have an afternoon nap, and the nurse must obtain a certain amount of exercise in the cooler parts of the day, when her patient can be left in charge of someone else. A good night's sleep also is essential. Otherwise sleeplessness, headache, and general ill-health rapidly develop, and the nurse is very soon converted into a patient herself.