the
constant medical attendant, or the really observing nurse?

The most important practical lesson that can be given to nurses is to
teach them what to observe--how to observe--what symptoms indicate
improvement--what the reverse--which are of importance--which are of
none--which are the evidence of neglect--and of what kind of neglect.

All this is what ought to make part, and an essential part, of the
training of every nurse. At present how few there are, either
professional or unprofessional, who really know at all whether any sick
person they may be with is better or worse.

The vagueness and looseness of the information one receives in answer to
that much abused question, "Is he better?" would be ludicrous, if it
were not painful. The only sensible answer (in the present state of
knowledge about sickness) would be "How can I know? I cannot tell how he
was when I was not with him."

I can record but a very few specimens of the answers[1] which I have
heard made by friends and nurses, and accepted by physicians and
surgeons at the very bed-side of the patient, who could have
contradicted every word, but did not--sometimes from amiability, often
from shyness, oftenest from languor!

"How often have the bowels acted, nurse?" "Once, sir." This generally
means that the utensil has been emptied once, it having been used
perhaps seven or eight times.

"Do you think the patient is much weaker than he was six weeks ago?" "Oh
no, sir; you know it is very long since he has been up and dressed, and
he can get across the room now." This means that the nurse has not
observed that whereas six weeks ago he sat up and occupied himself in
bed, he now lies still doing nothing; that, although he can "get across
the room," he cannot stand for five seconds.

Another patient who is eating well, recovering steadily, although
slowly, from fever, but cannot walk or stand, is represented to the
doctor as making no progress at all.

[Sidenote: Leading questions useless or misleading.]

Questions, too, as asked now (but too generally) of or about patients,
would obtain no information at all about them, even if the person asked
of had every information to give. The question is generally a leading
question; and it is singular that people never think what must be the
answer to this question before they ask it: for instance, "Has he had a
good night?" Now, one patient will think he has a bad night if he has
not slept ten hours withou