V. Thermometer Technique
1. Prepare for thermometer technique by making a paper sack of newspaper.
2. Arrange beside it a folded newspaper on which is placed a paper napkin.
3. From a roll of second-grade cotton, pull six irregular bits of cotton, about I x I inch, and arrange in order of use. The pieces should be just large enough to clean the thermometer thoroughly.
4. Moisten two pieces of cotton with green soap, two with tap water ; two remain dry.
5. The end of the thermometer is grasped by thumb forceps and lifted from a cylindrical glass tube that contains 70 per cent alcohol.
6. A dry piece of cotton is used to wipe the thermometer from the bulb end in a zigzag motion toward the tip end held by the fingers.
7. The thermometer is shaken down, if necessary, and inserted in the patient's mouth.
8. After removal of thermometer, the same dry piece of cotton is used to wipe it in a zigzag motion from the end held by the fingers to the bulb end.
9. The thermometer is held over a newspaper sack, and one of the soapy pieces of cotton is next used, starting at the tip and wiping until the bulb end is reached, at which time the dry cotton piece is discarded in the sack, and the second soapy cotton piece is started at the tip end of the thermometer to be brought in the same manner to the bulb end, when the first soapy cotton ball is discarded in the sack.
10. Cleanse in a similar manner with the two water-saturated cotton pieces. Complete the procedure by wiping with the second dry cotton piece.
11. The thermometer may then be returned to the alcohol container.
12. The aftercare technique for rectal thermometer is the same as for the mouth thermometer. Lubrication for the rectal thermometer may be mineral oil, butter, cold cream, etc.
VI. Hypodermic Technique.
The sterilization of the hypodermic syringe may be done by boiling the barrel, plunger, needle, and a tablespoon in a basin of water. Following the boiling, the tablespoon is used to hold parts of the syringe back as the water is drained off. Using care, one may pick up the end of the plunger with the aid of the tablespoon, then the barrel, and finally the needle, which is grasped by the hilt only.
Simplifications of records to be kept by the patient or by his caretakers are often devised by ingenious nurses. Squares may be drawn to show periods of the day, or spaces to be filled with a cross when a glass of fluid is taken by the patient. This is oftentimes most effective in stimulating interest in children, and serves as something very tangible to show the nurse on her return visit. (See Illustration I.)
2. Enema Equipment.
The enema apparatus which is usually to be found in the home may be used. When a colon tube is used, the hard rubber tip may serve as a connector between the enema tubing and the colon tube. After procedure is completed, boil the tubing in a basin. When no enema apparatus is available, a colon tube to which a length of tubing and a funnel have been connected may be used. (Colon tube, tubing, and funnel are a part of the nurse's bag equipment.) A clothes tree may be used to elevate the can, or the nurse may raise and lower the can at will.
3. Preparation of A Fomentation. (See Illustration II.)
The best material to use for this treatment is an old part-wool blanket, about 3 x 3 feet in size. This size can be used for various parts of the body. An inner piece and an outer covering are required for each fomentation. Smaller fomentations can be prepared by wetting, wringing quite dry, and steaming in a colander over boiling water or in a double boiler. Larger fomentations may be dipped in rapidly boiling water, twisted, and wrung dry. (Step A.) The inner, wet fomentation is placed on an outer dry one, and the outer one is folded over the inner one. (Step B.) This is then rolled or folded (Step C), and carried to the patient's bedside. One or more dry turkish towels should be used to protect the area. If necessary, oiled silk may cover the area, should the treatment be given over a surgical dressing.
To provide sterile surfaces, use either a freshly ironed towel or a pie tin which has been used to cover a utensil that contains rapidly boiling water or live steam. The sterile surface should be the one which was exposed to the steam.
To sterilize linen, place linen in oven. Also place a medium-sized potato in oven, and when the potato is done, the linen is sterilized. Linen sterilized in this way should be wrapped in an outer cloth or in strong brown paper. When it is not possible to sterilize linen by this method, ironing is usually satisfactory.
5. Group Tent.
Place a raised umbrella on the bed at the back of the patient's head. Hang a blanket and a cotton sheet over the umbrella. Place a teakettle of steaming water on a chair, protected by a newspaper, at the side of the bed. If a continuous inhalation is desired, place the teakettle on a hot plate on the chair. A funnel-shaped cone resembling a cornucopia, constructed of light cardboard or several thicknesses of paper is fitted over the spout and directed toward the patient's head, but far enough away to prevent burning. Have someone sit by the bedside to observe the patient.
___ To be concluded in December