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Graduate of the Woman's and Children's Hospital, San Francisco. 

We do not labor to-day under the same difficulties in private nursing 
that we did a dozen years ago. The common consent of the people seems 
to be that nursing is one of the modern successful movements, and surely 
an educational project, such as this, should result in the uplifting of the 
profession. We are still trying to solve the problem of how to teach 
people the hygiene of healthful living. The masses are living in appalling 
unsanitary conditions. 

A tubercular case comes to mind to which I was called, not many 
weeks ago, that made me heart-sick. Go with me, if you will, into one 
of the most deplorable of homes, where sanitation was unknown, and 
imagine the scene. The patient, a man of thirty-six, had been confined 
to his bed for eight months, almost entirely in an unkempt condition. 
Newspapers were spread about on the floor, and about three feet from the 
bed was an old bucket into which he was expected to expectorate. More 
often he missed it, and the sight that met my eyes made me gasp. 

Needless to say, the patient, who had not had a bath in all this time, 
was transformed, put into as good a condition as could be, and the room 
cleaned of as much poison as possible. Fortunately the month was 
unusually warm for May, and he was encouraged to stay out of doors 
most of the six weeks of life which remained to him. In the absence of 
sputum cups, we cleansed a bucket and half filled it with earth; this 
was kept on a box level with the bed. When used, the sputum was cov- 
ered over, and emptied, as often as need be, in a trench dug for all 
excretions. The people were very poor, and the item of expense had to 
be considered. 

It is not much wonder that nurses are wanting in this line of work. 
We have in our well-equipped hospitals all the tools with which to perfect 
our work, but in the homes we must demonstrate our practical teaching 
in the art of improvising. Sick room supplies are often sadly missing, 
also plentiful linen. It is quite a problem to make people see the need 
of fresh linen daily, which often means daily washing, — a serious objec- 
tion. The tactful nurse who is trying to bring about health reform will 
have two. sets of linen, using them alternately, airing one well while the 
other is in use, unless the case is infectious. 


568 The American Journal of Nursing 

To employ " an ounce of prevention " is another helpful means. The 
use of newspapers is of great value, substituting them for the better pro- 
tectives. Spread a newspaper under the patient before giving the bed 
pan, place one, also, just under the knees for an added precaution. While 
making the morning toilet, use one to protect the pillows. Papers may 
be made into obstetric pads. 

The improvised operating room, which has often been described in the 
Journal, makes great demands on our resources. The difficulty of sub- 
stituting utensils and having them sterile, and of the actual preparation 
of the whole, no one but the nurse knows. 

After an operation, if one has no pus basin, a shallow hand basin can 
be made useful for the evacuations of helpless patients, gently pressing 
down on the bed and holding in place, if need be. 

Protection from draughts can be made by throwing a sheet over backs 
of chairs, or an improvised screen, by having a frame with material 
tacked on. 

Labor may be saved by using the ordinary cotton roll purchased at the 
dry goods store. A pad placed beneath the hips of a helpless patient 
serves a good purpose. 

On one occasion I was in need of a drinking tube; not having one, 
the druggist, a very ingenious individual, to my amazement sent a nipple, 
short glass tubing, and longer rubber tubing. We all enjoyed the joke, 
especially the patient, a boy of sixteen. 

The nurse who can adjust herself to existing circumstances is fortu- 
nate, indeed, and has solved one of the great problems in private nursing. 
Many practical suggestions published in the Journal have been helpful 
to me; they are always read with much interest. The steady upward 
movement of the nursing profession is one to be highly commended. 

Men and women are taught to-day how to care for all economic 
animal life, but they are not taught as much as they should be about 
caring for themselves. A man who takes care of his residence is a 
wise man, but he who takes care of the physical house in which his life 
resides is wiser. 

Popular education can do more to improve sanitary and hygienic 
conditions than any other force. When fathers teach their sons, and 
mothers teach their daughters, improvement of the race will speedily 
follow. An education that makes for clean bodies, clean hearts, clean 
morals, clean thought and clean life in every way will do more to con- 
serve and uplift the race than anything else.- — Chase S. Osborn, in 
Public Health.