I have known a nurse in charge of a set of wards, who not only carried in her head all the little varieties in the diets which each patient was allowed to fix for himself, but also exactly what each patient had taken during each day.  I have known another nurse in charge of one single patient, who took away his meals day after day all but untouched, and never knew it.

If you find it helps you to note down such things on a bit of paper, in pencil, by all means do so.  I think it more often lames than strengthens the memory and observation.  But if you cannot get the habit of observation one way or other, you had better give up the being a nurse, for it is not your calling, however kind and anxious you may be.

Surely you can learn at least to judge with the eye how much an oz. of solid food is, how much an oz. of liquid.  You will find this helps your observation and memory very much, you will then say to yourself, “A. took about an oz. of his meat to day;” “B. took three times in 24 hours about 1/4 pint of beef tea;” instead of saying “B. has taken nothing all day,” or “I gave A. his dinner as usual.”

[Sidenote:  Sound and ready observation essential in a nurse.]

I have known several of our real old-fashioned hospital “sisters,” who could, as accurately as a measuring glass, measure out all their patients’ wine and medicine by the eye, and never be wrong.  I do not recommend this, one must be very sure of one’s self to do it.  I only mention it, because if a nurse can by practice measure medicine by the eye, surely she is no nurse who cannot measure by the eye about how much food (in oz.) her patient has taken.[4] In hospitals those who cut up the diets give with sufficient accuracy, to each patient, his 12 oz. or his 6 oz. of meat without weighing.  Yet a nurse will often have patients loathing all food and incapable of any will to get well, who just tumble over the contents of the plate or dip the spoon in the cup to deceive the nurse, and she will take it away without ever seeing that there is just the same quantity of food as when she brought it, and she will tell the doctor, too, that the patient has eaten all his diets as usual, when all she ought to have meant is that she has taken away his diets as usual.

Now what kind of a nurse is this?

[Sidenote:  Difference of excitable and accumulative temperaments.]

I would call attention to something else, in which nurses frequently fail in observation.  There is a well-marked distinction between the excitable and what I will call the accumulative temperament in patients.  One will blaze up at once, under any shock or anxiety, and sleep very comfortably after it; another will seem quite calm and even torpid, under the same shock, and people say, “He hardly felt it at all,” yet you will find him some time after slowly sinking.  The same remark applies to the action of narcotics, of aperients, which, in