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[33] 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 without waking.  Another does not think he has a bad night if he has had intervals of dosing occasionally.  The same answer has actually been given as regarded two patients—­one who had been entirely sleepless for five times twenty-four hours, and died of it, and another who had not slept the sleep of a regular night, without waking.  Why cannot the question be asked, How many hours’ sleep has ——­ had? and at what hours of the night?[34] “I have never closed my eyes all night,” an answer as frequently made when the