Part 32

BY EVELEEN HARRISON, Graduate of the Post-Graduate Hospital, New York.

From the American Journal of Nursing.

Of necessity this is far more extensive than the requirement of a minor operation, and should be commenced the day before if possible.

The selection of the room comes first, and as an abundance of clear light is more essential than anything else in an operating-room, let the choice of the room depend on that. When possible avoid using a room into which the sun will shine directly during the time of the operation; but in any case, take the room that gives the most light.

When the house is large enough to allow it, and your choice is not limited, use a room adjoining, or at least on the same floor as the one to be occupied afterward by the patient, and as near the bath-room as possible.

Sometimes it is necessary to use your patient’s bedroom, in which case the bed, after being prepared, should be pushed up in a corner out of the way.

All the furniture that it is possible to remove is taken out of the room; any large piece that has to remain should be covered completely with sheets fresh from the laundry. Carpets and curtains must be removed, unless the surgeon prefers to have them covered with moist sheets, and the room thoroughly cleaned, floor scrubbed, windows washed, etc.

As the surgeon will need all the light you can give him, cover only the lower panes of the window with thin muslin curtains, cheese-cloth, or—what will answer the purpose equally as well and is ready at hand—a thick lather of soap rubbed all over the panes and allowed to dry, thus shutting off the gaze of outsiders without excluding valuable light.

The temperature should be about 75° F. and the room well aired beforehand, as no window will be opened during the operation.

A list of articles usually required for a major operation is as follows:

Bandages. One strong kitchen table. Four small tables. Three common chairs. One fountain syringe. Three large basins and pitchers. One small basin and pitcher. One piece of rubber sheeting for table. Two slop-jars or foot-tubs. One gallon of hot boiled water. One gallon of cold boiled water, and always keep a kettle of water boiling on the stove. Antiseptic solutions as ordered. Alcohol. Safety-pins. Green or synol soap. Absorbent cotton. Sterilized gauze. New wooden nail-brush. Two dozen towels, and plenty of clean soft cloths.

This list is an outline of the articles usually required; the surgeon will supplement what is necessary for each particular operation, but when a nurse is called upon to prepare for an operation in a private house, where the conveniences of the hospital are not at hand, she will be thankful to have ready a list of the things that are indispensable. I well remember my first operation outside the hospital, and how difficult I found it to construct a modern operating-room from the limitations of a small country house.

All supplies, when possible, should be on hand the night before the operation, and the room cleaned ready for work.

Facing the best light, and about five or six feet from the window, place the kitchen table, and cover it with a double blanket or comfortable, rubber sheeting, and a sheet fresh from the laundry, the whole pinned firmly at the four corners with safety-pins. Lay on the top a small single sheet, a blanket, and very small, firm pillow.

The little tables are to be arranged around the large one, leaving plenty of room to walk between. Cover them with sterilized sheets; if they have polished tops, first put on a piece of oilcloth or rubber sheeting to prevent damage. These tables are for the instruments, gauze, sponges, sterilized towels, and basin of solution for the surgeon’s hands.

A strong screw must be fastened in the wall near the window at the height of about seven feet to support the fountain syringe, which will be filled with whatever solution the surgeon requires for irrigating the wound.

One slop-jar stands at the side or end of the large table, the other beside the table that holds the basin of sponges.

The bureau (covered with a sheet) or the mantle-shelf will serve to hold the dressings and rubber gloves. A small stand or table will be needed by the doctor who gives the anesthetic for his hypodermic, clean towels, and ether or chloroform.

All the basins, towels, and pitchers to be used during the operation must be thoroughly washed in warm soap suds and then boiled for an hour, or—when that is not possible—allowed to stand all morning in a 1: 1000 bichlorid solution, and then rinsed off with sterilized water before using. Two of the basins are filled with sterilized water or salt solution for washing the sponges, another basin holds the wet sterilized towels, and the fourth the solution for the surgeon’s hands.

A small bowl is needed for the soft soap to wash off the part of the body to be operated on, also a small pitcher of 1: 2000 bichlorid and some alcohol.

In the bath-room arrange plenty of clean towels, a bowl of 1: 2000 bichlorid, and one containing alcohol, synol, or green soap, and a sterilized nail-brush for the surgeon’s hands. The surgeon will send instruments, sutures, and anesthetic.

You cannot err in having ready a good supply of sterilized water, as an emergency may arise in which a double quantity would be required. Clean the wash-boiler thoroughly, fill it almost to the top, and boil for half an hour. One boilerful must be prepared in time for the water to grow cold before the operation; it is then poured into pitchers that have been washed in warm soap suds, and rinsed off with the sterilized water. Cover the pitchers with sterilized towels or napkins.

It is of the utmost importance that everything should be in perfect readiness when the surgeon arrives. The nurse will do well to go over the list carefully, so that nothing may be missing.

TO PREPARE A ROOM FOR AN OPERATION.

BY JESSIE MCCALLUM,

Graduate Johns Hopkins School for Nurses.

From the American Journal of Nursing.

1. The room selected for the operation should be near the bath-room, as a porcelain tub filled with bichlorid solution of the strength of 1: 1000 makes an excellent arrangement for disinfecting the washbowls, pitchers, platters, plates, etc., which are to be used during the operation for the solutions, instruments, needles, and ligatures.