MEETING
PATIENT'S NEEDS - NURSES' RESPONSIBILITIES.
Assisting
with domestic ward management.
Every woman should learn the art of
cleaning; everyone should be able to keep a home clean. Every nurse should know
how to keep her ward clean, and this is best learned by practice.
A ward head nurse-in-charge is able to train her domestic
staff and guide her nurses in ways of cleanliness because she understands
methods of cleaning.
Germs live in dust and are a source of infection. Hence,
some authorities state that dusting and cleaning should be done by domestic
staff and not touched by the nurses. This also means that domestic staff, i.e.,
ward workers (class IV workers) should not do anything for the patients, e.g.,
carrying of crockery.
It
is necessary that the ward is kept clean so that growth of germs is inhibited.
A nurse should be able to keep her ward clean. However, too much domestic work
is not advocated.
1). Cleaning of ward
1.
Unnecessary articles such as
crockery should be removed.
2.
High dusting is done, for ceilings
and walls.
3.
The beds are made so that bits fall
to the floor.
4.
Beds, etc., are pulled out.
5.
Sweeping is done
A tray is prepared for dusting and cleaning
1.
Two dusters, one wet, one dry.
2.
A bowl of water.
3.
A receiver of bits.
4.
Metal polish.
5.
Furniture polish and dusters.
6.
Soap in a dish.
Some method should be chosen, such as following: (The ward
cleaning is usually supervised by the nurses).
1.
Begin at one end, and work round.
2.
When things are washable they should
be dusted with wet and polished with dry duster.
3.
Dust is wiped into the duster and
not flicked on the floor.
4.
Furniture surfaces are polished with
furniture polish and tiled surfaces washed with soap and water.
5.
Dusting of the lamps depends upon
their height, but they must not be forgotten. Dust must be removed from windows
and doors. Usually furniture is polished once a week.
6.
The inside of the lockers are washed
once a week.
7.
The floor is washed by the class IV
workers.
Gusts
of wind will disturb dust. It is usual to open the windows on the opposite side
from which the wind is blowing whilst dusting is in progress.
Screens must be dusted.
Oiling is done periodically. Fluff must be removed from
chair legs and screen wheels.
Washbasins require to be washed with vim powder.
2). Care of kitchen
1.
Food cupboard is cleaned daily. Each
article should have a definite place.
2. Sinks must not be allowed to become blocked. Waste food
should be placed in the rubbish bin and removed daily. The bin should be
emptied and cleaned daily.
3.
Both bucket and rubbish bin should
have tightly fitting lids which should be properly replaced.
4. Should the sinks become blocked, simple measures may be
tried to unblock it. A label should be placed on the sink with "out of
use" on it.
5.
Food must not be left exposed in the
kitchen. Milk must always be kept covered.
3). Care of Linen
1.
This must be properly stamped with
the ward and hospital names so that it is not lost in the laundry or in the
ward.
2.
New articles should be washed before
use.
3.
Torn linen should be put aside for
repair.
4.
Stains should be removed at once
before they become fixed.
5.
Wet articles must not be left in the
dirty linen bin.
6.
Dirty linen should be sent to
laundry promptly.
7.
Linen is carefully sorted, on its
return from the laundry and discrepancies reported.
8.
Stock-taking must be accurate and
frequent so that track is kept on lost articles.
9.
Dirty linen is sorted and account is
written when sending to laundry.
4). Care of Rubber Articles
1.
All mackintoshes and rubber articles
should be washed in warm soapy water, rinsed and carbolised with 1 in 20
carbolic lotion. Dry thoroughly in a cool place and french chalk powder is
sprinkled and either rolled or hung up, never folded. Dry heat and hot sun
destroy rubber. Sun causes it to blister. Turpentine will do this too.
2.
Two rubber surfaces should not come
together but must be separated. In the case of hot water bottle, the surfaces
are separated by air.
3.
Mackintoshes in the store cupboard
should be examined weekly. If the air is moist, the mackintosh may become
sticky.
4.
Kinking the rubber tubing is
ruinous.
5.
Excessive steam causes rubber gloves
to become hard.
6.
Ointments spoil rubber.
7.
Excessive boiling makes rubber limp
and overstretched.
8.
Rubber articles should be stored in
the dark.
5). Disinfecting the ward equipments
Linen and
bandages: Receive into a bucket at bedside containing disinfectant
lotion-carbolic lotion 1:40. Keep for 4 hours.
Pus, urine, stools, vomit and sputum are disinfected before
disposal in carbolic lotion1: 20 for 2 hrs.
Immerse receptacles in phenyl lotion 1:20 for 2 hours Rinse
them before use.
Infected
furniture and mackintoshes: Mop
with carbolic lotion 1:20 before
routine cleansing.
Infected
blankets, pillows and mattresses: In
most hospitals these are submitted
to steam sterilisation e.g. 25 1bs. pressure at 260º F for ½ an hour.
Crockery
and glassware when it is inconvenient to boil:
These may be immersed in carbolic lotion 1:20 for 2 hours.
Wash thoroughly before use.
6). Care of the sanitary annexe:
A. Care of
the sanitary annexe is considered to
important and the steps are,
This is cleaned thoroughly daily, tidied at frequent
intervals and well ventilated.
Insides and outsides of the sinks are cleaned.
Bedpans and urinals are washed with hot soapy water.
Bedpans and urinals are stored in large tanks containing a
suitable cheap disinfectant, which is changed daily.
Ventilated cupboards may be provided for bedpan storage.
Enamelware is washed daily and stains removed before they
become fixed.
The sanitary
annex should have the following:
A.Lavatory
brush and mop.
A bucket with a tightly fitting lid to receive dressings
prior to their removal to the incinerator.
Soil linen box.
B. Care of
the flush out
This is cleaned daily.
Frequent flushing is required.
The lavatory brush is stored in a disinfectant, which is
changed daily.
C.Care of
the bath room
Walls and floors of bath room should be washed daily.
7). Stock Taking
Stock taking is done periodically of all kitchen utensil,
cutlery and dressing instruments.
This ensures the nurses with a sense of responsibility.
Stock taking of linen and equipment is taken at definite intervals, e.g. every
three months.
Certain days are allocated for reporting of repairs, losses
and breakages.
8). Hospital Economy
Economy of time is too often neglected. If a nurse is
undecided about the method of carrying out a duty, she should ask for guidance
and not waste time in her efforts of trial and error. It is quicker in the long
run to do things correctly.
A nurse should look after her health so that working hours
are not lost through illness.
Daily inventories of important instruments will prevent
their loss.
Dressings
-Dressing should be large enough to
cover the wound only. Old blankets
are used for medical fomentations and not lint. A wide bandage should not be
used when a small one will do. Dressing lotions should be carefully measured so
that there is no waste.
During dressing, the bed-linen is protected by a dressing
mackintosh and dressing towel.
Taps, lights and gas should be turned off when not in use.
Faulty taps must be reported. Kettles sterilizers and saucepans must not be
allowed to boil dry, or left on the gas unnecessarily. The kettle should not be
filled when a small quantity of hot water is required.
Articles must be used for the purpose for which they are
made.
Medicine and drugs must be accurately used as ordered. Many
deteriorate from exposure or evaporation.
Soap must not be allowed to stay in water.
Disinfectants should not be wasted or used in wrong
strengths.
Cleaning powders, furniture polish and metal polish should
be used sparingly.
Torn linen must not be used without mending or it may be
torn further and rendered useless.
Bed linen should be protected wherever necessary.
During meals patient' s wear and bed lines are protected
with towels.
A small amount of diet should be given to a patient and a
second help if desired and permitted. Excess food should be returned to the
main kitchen.
Although patients should look as nice as possible, it must
be remembered that laundering involves wear and tear and is very expensive.
Crockery must be handled carefully and not allowed to chip
or crack.
Nurses should be taught the prices of articles, lotions etc.
False economy is stupid and even criminal on occasions.
Nurses must remember that hospitals are maintained with the
public's money. The people can often ill afford their contributions.
Each ward is assessed separately and list of expenses sent
round to the wards. They impress the nursing staff and encourage economy.
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