CHAPTER III.

Beds-Bedsteads-Bedding-Bed-making-How to move a patient from one bed to another-Pillows-Bed-rests and other appliancesAir- and water-beds-The care of a bed-Bed-sores-preventionsymptoms-treatment.

It is the common notion that anybody can make a bed, and possibly also that it is of very little account exactly how a bed is made. To a thoroughly healthy person, who will sleep soundly all night and turn out of bed as soon as he wakes, it does not indeed matter much, although he spends a third of his life in it, whether his bed be well or ill made, so long as it is clean and warm. But the invalid, whose confinement to it is more or less permanent and compulsory, and the acuteness of whose sensations is aggravated by disease, finds few things more seriously affecting his comfort than the condition of his bed. To know how best to arrange and take care of it, is very important for the nurse. When you go to take charge of a private patient, who has been till then cared for by home talent, in nine cases out of ten the first thing you will find it necessary to do will be to reconstruct the bed, and often the skillful rendering of this simple service will at once call forth the gratitude of your patient, and instant recognition of your efficiency.

Let us first consider the frame upon which the bed

is supported. Wooden bedsteads should not be used for the sick when anything else can be obtained. The best kind is that common in our hospitals, entirely of metal, iron or brass, with a mattress of woven wire. This can be more easily than any other kept in a clean and wholesome condition, and is for sick-room uses far superior to those ordinarily found in private houses. They are non-absorbent, and afford no hiding-places for vermin, which, in spite of all precautions, will sometimes appear, even in well-cared-for homes, and to which public hospitals, with their miscellaneous class of patients, are especially liable. The first sign of a bug should be the signal for a most careful search and extermination, for, once having gained a foothold, they multiply, as every housekeeper knows, with alarming rapidity. Corrosive sublimate is the surest remedy, but, being a violent poison, must be handled with caution. Another exterminator, recommended for all kinds of vermin, consists of the following formula: Aqua ammo. nia, two ounces; saltpetre, one ounce; soap, scraped, one ounce ; and soft water, one quart.

Bedsteads should be on castors, to be easily moved, and no heavier than is necessary for strength. The best dimensions for a bed in which a sick person is to be cared for, are six and a half feet long, three feet wide, and two, or, at most, two and a half, feet high. If it is too wide, the nurse will be unable to reach the patient without getting on the bed herself, always an objectionable proceeding; if it is too high, it adds to the difficulty of raising the patient, and makes it harder for convalescents to get in and out.

Over the wire springs will be placed a mattress of some kind. For this various materials are used-hair, straw, jute, compressed sponge, etc. Straw has the ad

vantage of cheapness, and the ticks can be frequently emptied, washed, and refilled, while the old straw is burned; but hair of good quality makes the most comfortable bed, being at once firm and elastic. It can be cleaned and subjected to a disinfecting temperature without injury. Hospital mattresses are frequently made in sections, as they wear more evenly, and a part can be renewed without taking to pieces the whole. When this is done, it is well to have the sections tacked strongly together, as they are otherwise apt to slip apart, leaving an uncomfortable crack under the patient. Still, an expert bed-maker will get the under sheet tight enough to hold them in place.

A feather-bed is a thing never to be thought of in connection with the sick-room, being a combination of every objectionable quality. Its use is nearly equivalent to putting the patient into an immense poultice; it is warm, soft, absorbent, and consequently nearly always damp. Unless it is stuffed uncommonly full, the patient sinks at once into a hole; it is impossible to keep it level, and, if it once gets wet, there is no way of renovating it. Once in a while one comes across some old lady, who, by long usage, has become so attached to her feather-bed as to fancy that she can not sleep on anything else. If she is able to get out of it daily, to have it shaken up and rearranged, it is scarcely worth while to struggle against the prejudice; but, if she is likely to be confined to bed for any length of time, the first thing to be done is to get her off it, for, offering as it does every condition favorable to the development of bed-sores, it will be a source of danger as well as of discomfort. After a few days' trial, even the most persistent lover of the feather-bed will usually be convinced of the superiority in sickness of an unyielding support.

If not, and the sufferer still clings to her old habits, then we are sorry for the nurse, for she has a hard task before her. In many surgical cases it is of great importance that the bed be kept flat and level. Where extra firmness is required, a thick board, the size of the mattress, is placed under it. This is known as a fractureboard. It should have holes bored in it for ventilation.

The propensity of hospital patients to stow away their personal property under the mattresses should be provided against. Give them other safe and convenient places to put their things, and insist upon having the beds kept clear.

For sheets, cotton is a better material than linen, except, perhaps, in very hot weather. Linen being a good conductor of heat and rapid absorber of moisture, has a tendency to chill the surface of the body; cotton does not conduct away the heat so rapidly, and is, therefore, safer for the use of the sick. Sheeting comes in widths adapted for beds of different sizes. Whatever the width of the sheet, the length should exceed it by three quarters of a yard. There should not be a seam in the middle.

To make the bed, spread the lower sheet smoothly and tightly over the mattress, tucking it in securely on all sides. It can be made still more firm, if the bed is being prepared for long occupancy, by fastening with safety-pins to the mattress. Be careful that the sheet is put on straight, for, if not, it will draw into wrinkles, and, if pinned, be likely to tear. There should not be a blanket between the under sheet and the mattress. may be necessary to protect these from discharges by a piece of rubber cloth, covered by a second folded sheet, or a narrower draw-sheet." The latter, as its name implies, may be easily drawn from under the patient

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When rubber sheeting cloth or oiled muslin will

with very little disturbance to him, while another is at the same time slipped into its place. The water-proof and draw-sheet must both be stretched as tightly as possible, and well. tucked in. can not be obtained, enameled answer the purpose, or, in an emergency, heavy brown wrapping-paper is said to be a fairly good substitute. The rubber, being only for the protection of the bed, should not be retained longer than is really necessary, as the patient may be more comfortable without it.

The upper clothing should be enough for warmth, but no more; for too much warmth is enervating, and too much weight impedes respiration. There will be first another sheet, tucked in well at the foot, that it may not be pulled out of place, but left long enough to turn down for some little distance over the blankets. A woolly surface coming in contact with the face is usually very disagreeable, though, in some cases, where there is special need for warmth, as in acute rheumatism, the patient will be put directly between the blankets. Blankets of good quality are the best bed-covering, being warm, and not weighty. They should come up high enough to tuck in snugly around the throat, if desired; but the patient should not be allowed to sleep with his head under the bedclothes, breathing the noxious emanations from his body. Several thin coverings will be warmer than a single one of equal weight, because of the non-conducting air enclosed between them. Heavy quilts and counterpanes will be found burdensome. The old-fashioned cotton comforter is heavy, and not proportionately warm. Eider-down quilts, or duvets, are luxuriously light and soft, but can not be well cleaned or disinfected. A patient sleeping under one should be carefully watched, as it is likely to in