est trial of a nurse is the well-meant interference of the patient's friends. If there are any among them to whom you can leave your patient, you must bear in mind that many details, matters of course to you, are likely to be unfamiliar to the inexperienced, and leave with your relief the clearest and most explicit directions about everything that is to be done. If in writing, there will be so much less room for mistakes. If you have no such relief, and find that your strength is being overtaxed, state the case to the doctor, and ask for help. If, for any reason, you find it necessary to give up a case the care of which you have once assumed, you must at least not leave it until you have seen your place adequately supplied. To leave, unadvisedly, a patient in a critical condition should be regarded as a breach of contract; no conscientious nurse would feel justified in doing it. With a chronic case, of probable long duration, you are under no obligation to stay on indefinitely, but when you wish to go, you will, of course, give notice of the fact in time for other arrangements to be made. Under no circumstances ought you to threaten the patient with leaving him.

In speaking of the relations between nurse and patient, it should not be necessary to more than refer to the fact that a nurse occupies a position of trust, and is perforce admitted to a knowledge of many private affairs. No one with any sense of delicacy can regard as otherwise than inviolably sacred what is thus tacitly left to her honor. It is true that your patients will be largely dependent upon you for society, and that it is often difficult to produce conversation on demand, but it is certainly possible to be bright, cheerful, and entertaining without resorting to gossip.

In a hospital, the intimate intercourse of the home

nurse with her patient is impracticable and undesirable. Over-familiarity is to be avoided, and strict impartiality preserved, but at the same time the greatest patience and gentleness may be exhibited, and all possible regard for the comfort of the patients.

2

CHAPTER II.

The model sick-room-Its choice, contents, and arrangement-The care of the sick-room-Noise, etc.-Hospital routine-The care of a hospital ward-Cleanliness-Order-Economy.

THE comfort and well-being of the invalid depend to so great an extent upon his surroundings that, in consideration of the universal liability to illness and accidents, there ought to be in every well-arranged house an apartment chosen and especially fitted for the use of the sick. But the matter, in spite of its importance, is so generally ignored that it is very rarely that a nurse will have the good fortune to find any provision made for such contingency. You will be called upon to nurse in all sorts of places, and often under the worst possible sanitary conditions. It is important to have a clear idea of what a sick-room ought to be, in order to know how to choose the least among unavoidable evils, and how best to utilize such advantages as you may chance to secure.

A model sick-room is spacious, light, airy, clean, and quiet. The larger the room, the better can it be aired; the more airy it is, the cleaner will it be; and, the cleaner it is, the more favorable is it for the recovery of the patient. Space is therefore an important consideration from a hygienic point of view. The sick-room should be located on the sunny side of the house, having a south or west aspect. Only in exceptional cases, such

as inflammation of the eye or brain, is it necessary to have the room darkened, and even then a south room, with the light carefully moderated by blinds and curtains, is to be preferred to a darker one on the north side. Light is a healthful stimulus, and in the majority of cases not only light but direct sunshine is to be desired, partly for the additional cheerfulness which it imparts, but still more because of its actual physical effects. The Italians have a proverb, "Where the sun does not enter, the doctor does," showing their recognition of it as a powerful remedial agent. Have as many windows as possible, certainly no less than two. They should be such as can be opened at both top and bottom, and should reach nearly to the floor, that the patient may easily see out of them. Bars and streaks of light are to be guarded against, as they may occasion a great deal of annoyance.

The sick-room should be as far as possible remote from the noises and odors of the house and of the street. It should be solidly built, having walls thick enough to deaden external sounds, and floors substantial enough not to vibrate under every tread. Where this is not the case, manage, if possible, to have the room above unoccupied. There are numerous advantages to be gained, especially in cities, by having the sick-room at the top of the house. It will be more quiet, in a stratum of purer air, and in case of contagious disease can be more completely isolated. On no account should there be stationary basins in the sick-room itself. If you find there such modern conveniences, cork up the overflow holes, or stop them with plaster of Paris, and fill the basin with water, which must be changed from time to time, or cover it entirely and closely with a board. The increased security will more than compen

sate for the extra trouble. Only with the utmost precautions against leaky and defective traps are drainage pipes to be allowed even in the adjoining dressing-room.

The latter is an important adjunct to the sick-room. In it are to be kept the bath and toilet appurtenances. Ample closet room is also desirable, with shelves and drawers for the reception of linen, and of the various medical and surgical appliances which may be needed, but which should never be visible in the sick-room. It is a common, but very reprehensible, practice to have food, medicine, and all sorts of paraphernalia lying about, in a confusion that would be enough to make a well person sick. They should all be banished, except at the moment of actual use. Growing plants, and freshly cut flowers of not too strong odor, may fill their place, if desired. They are quite unobjectionable. The water in which flowers are kept must be daily changed, and the flowers themselves thrown away as soon as they begin to fade. Do everything possible to make the sick-room the brightest and cheeriest in the house. A certain amount of depression is the inevitable accompaniment of sickness. It can not be entirely dispelled, but all counteracting influences should be brought to bear. Dark, gloomy, and unpleasantly suggestive surroundings do much to intensify it.

The walls and ceilings are best of some soft, uniform, neutral tint, as pale-green or French-gray. Avoid wallpapers of conspicuous tone or regularly recurrent figures. Better than any paper is paint, or a hard-finished surface which can be scrubbed. The monotony may be broken by pictures, but judgment needs to be exercised in their selection. The wood-work should be severely plain and flat. There should be no cornices or moldings, and no woolen curtains, portières, or drapery of