How to Care for the Insane: A Manual for NursesGranger, William D.
Science
How to Care for the Insane: A Manual for Nurses
Granger, William D.
Psychiatric nursing
Many violent patients will employ themselves and be the quieter for so
doing. Light out-of-door work is the best employment for this class, and
out-of-door walking and exercise should never be neglected. On the woman's
ward knitting, sewing, mending, and ward work are suitable for many, while
some will work at the laundry, and others will go quietly to church and
entertainment; books and illustrated papers should be furnished and will
be much read and enjoyed.
As a rule the more violent patients are restricted, kept continuously on
the ward, or in a small room, and given no work, amusements, walks, and
exercise, the more noisy and violent do they become.
Attendants must learn that mere noise, and much of maniacal activity, such
as running about, jumping, or pounding, is not in itself harmful, and that
unless such patients are doing themselves injury, or so disturbing the
ward and other patients as to require interference, it is better to
control than to repress and restrict them.
Many violent patients are subject to such paroxysms of great violence as
to require immediate care and often temporary control at the hands of
attendants. Generally these paroxysms spend themselves after a short
time, but if they do not, advice and help can be called for.
By careful watching, the approach of these paroxysms can be known and
often avoided. This may be done by removing the cause, which is often the
irritation of another patient or an attendant, by a word, a joke, by
simply letting the patient alone, or by a firm show of authority, or by
any other means experience has taught to be useful in the particular case.
If necessary to hold a patient, three persons should be able to care for
the most violent. This can be done by grasping each arm at the wrist and
elbow, and holding it out straight, the attendants standing behind while
another passes the arm about the neck and holds the chin, to prevent
biting and spitting; the patient may then be walked backward and seated in
a chair.
After the violence has subsided, though the patient should continue to
scold, swear, threaten, or cry, he should, as soon as possible, be left
alone, the attendants walking away, but remaining watchful. Do not, unless
it is necessary, interfere to stop the noise, for it is often a substitute
for the violence, and the attack wears itself out in this way.
If necessary to carry a violent patient, it can be done by four or six
attendants. The face should be turned downward, thereby lessening the
power to resist, and, to prevent dislocating the arms, the patient should
be carried by the shoulders and chest; the bands about the neck should be
loosened.
Public-domain text, read in full here on John Shaqi.
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