any kind. All woolen stuffs easily become infected, and are extremely difficult to disinfect. If any curtains are used, they should be of light, washable and frequently-washed material. Carpets even are much better dispensed with. Rugs may be used, as footsteps are noisy on a bare floor, but they must be small enough to be daily removed, shaken and aired. If there is a carpet, it can only be thoroughly swept and cleaned when the patient can be got out of the room, but the surface dust can be removed quite effectively and noiselessly by means of a damp cloth wrapped around a broom.

The essential furnishings of the sick-room are, a bed, a bedside table, an easy chair, a lounge, and a large movable screen. The latter can be readily improvised by fastening a shawl or a sheet over an ordinary clotheshorse. Convenient tables are made with the point of support very much on one side, so as to reach well over the bed. They may be raised or lowered to any desired height. Bed-trays, with a low rim around three sides. may be used by the patient for all the purposes of a table. They are about thirty inches long, by fourteen broad, and stand on legs high enough to keep the weight entirely off the body.

A bed-rest, a commode, and similar small conveniences may be desirable, but the fewer superfluous things the better. All the furniture should be of the simplest possible style; elaborate carvings only afford lodgingplaces for dust, and whatever adds to the difficulty of maintaining absolute cleanliness is to be avoided. Everything should be substantial and in good repair. Ill-fitting blinds, rattling windows, and creaking doors, are nuisances demanding speedy remedy.

Many slight and apparently unimportant noises, which are nevertheless peculiarly annoying to the sensi

tive nerves of the sick, may easily, with a little care and forethought, be done away with. Keep rocking-chairs out of the room. Avoid wearing clothes that rustle, or shoes that squeak. If coal must be put on the fire, bring it in wrapped in a paper, and lay it on, paper and all. Use a wooden rather than a metallic poker to rake the fire. Noise which is understood and inevitable is far less trying than a much slighter noise, unexplained or unnecessary. Intermittent is more hurtful than continuous noise. Sudden, sharp, and jarring sounds are especially bad. A good nurse never startles her patient. Even in such a small matter as your way of addressing him, be considerate of his weakness. not speak abruptly from behind him, making him first jump, then turn round, then ask what you said, but get his attention before speaking, and use a clear, distinct, though not necessarily loud, voice. Whispering in the sick-room, or just outside the door, is one of the worst of the many distressing forms in which the solicitude of the patient's friends will manifest itself. There are few things more tormenting, though it is usually done with the very best intentions of not disturbing him. A low, distinct tone, when conversation is necessary, will seldom annoy. Whispering always will, as will any sound which strains the attention, or creates a sense of expectation. It should be laid down as a rule that whatever the patient is not intended to hear should not be said in his presence.

These seem very small points to dilate upon, but good nursing depends largely upon attention to details so apparently trivial that a careless person would never think of them, but which yet make or mar the comfort of the invalid. Small things assume momentous proportions in the limited interests of a sick-room. Noth

ing is insignificant or beneath notice which has any bearing upon the welfare of the patient. To keep the sick-room in a proper condition is as important a part of your care for him as more personal ministrations. A nurse ought not to be expected to do housework, which can be equally well done by some one else, for she has enough other and more fitting demands upon her time and strength, but, in order to direct others, she should know how it ought to be done. The work of a nurse in a private family varies so much with circumstances that its limits can not be precisely defined. The position is a somewhat anomalous one, and, with all due regard for your professional dignity, surely you will rather perform the most disagreeable and commonplace tasks than let them go undone to the detriment of your patient. With the extra work which sickness always brings, there is often insufficient service, and the nurse will be obliged to share the burden. You must be prepared to encounter many inconveniences; your ingenuity as well as your patience will often be taxed; and sometimes you will find yourself looked upon as a kind of machine, expected to run night and day without ever needing to be wound up.

In a hospital there are no difficulties of this sort. Everything is planned with reference to the needs of the sick; the most convenient appliances are at hand as a matter of course; the duties of each person are definitely assigned, and the work as much as possible simplified by systematic arrangement and regular hours.

In a ward of twenty patients, with the average number of bad cases, there will be usually three nurses, with a maid or an orderly to do the scrubbing and heavier work. The head nurse has the oversight of them all, and, present or absent, is responsible for everything

done or left undone. Some assistance may be given by the convalescent patients, though it is an uncertain dependence. Care must, of course, be taken not to overtax the strength of any one, but they can be made useful in a good many little ways, and are usually glad of some light occupation. Their work is, however, little to be relied upon, for a patient able to do much is likely to be soon discharged.

Ward work, in spite of its variety, may, if skillfully planned and systematized, be reduced very much to a routine. Minor arrangements vary in different institutions, but the fundamental principles of the nursing service are everywhere the same. The nurses appear in the ward, ready for duty, punctually at the appointed hour. The patients should previously have had their morning toilets made, under the direction of the night nurse, that there may be no delay in getting them ready for breakfast. The head nurse first reads the report of the night, and ascertains any changes that there may be in the condition of the patient, or in the orders given. Unless she has very competent assistants, she will then herself attend to the care of the worst cases among the bed-patients, and to the giving out of the medicines. There are also all the beds to be made, the temperatures to be taken, soiled clothes to be collected and sent to the laundry, the ward generally to be cleaned up, and the diet distributed. All these tasks are divided as the head nurse may direct. One assistant must take charge of the breakfast, see that each patient is served with his appropriate allowance, and those fed who are unable to feed themselves. Convalescents should not be allowed to begin until all the bed-patients are attended to. After the meal is over, the dishes are to be picked up and carried out, and the ward made ready for the doc

tor's visit. All this takes time, for sick persons can not be hurried. The nurses must all be ready to attend the staff upon their rounds. The head nurse must be informed as to the condition of every patient under her care, ready to answer any questions that may be asked. She must be provided with a note-book, in which to take down on the spot whatever orders are given, and she should call attention to everything which it is important for the doctor to know. If there are three nurses in the ward, the senior goes on in advance of the staff, and expedites their progress by preparing each case for ready examination. She will know from the nature of the case what is to be done; the clothing must be conveniently arranged without undue exposure; sometimes it will be necessary to put screens about the patient, or to remove the dressings from a wound. The junior nurse, or probationer, following them, restores things to their previous orderly condition, so that, when the rounds are completed, the ward will not be in a state of general confusion. Provision should be made for the doctors to wash their hands before they leave the ward. After they have gone, the head nurse will explain to her assistants the orders which she has received, assigning to each such part of the work as she wishes her to do. The rest of the morning will be occupied with the execution of these orders. The nurses take turns in going to their own meals, that the ward may never be left without a responsible attendant. The senior and junior nurses will together attend to the distribution of the patients' dinner; it is usually too much for either to manage alone. One must, however, always be held responsible for the state of the dining-room. She must see that it is in order before she leaves it, the dishes washed and put away, the refrigerator clean,