Now what is a nurse to do in
such a case? Not cry, "Lord bless you, sir, why you'd have thought he
were a dying all night." This may be true, but it is not the way to
impress with the truth a doctor, more capable of forming a judgment from
the facts, if he did but know them, than you are. What he wants is not
your opinion, however respectfully given, but your facts. In all
diseases it is important, but in diseases which do not run a distinct
and fixed course, it is not only important, it is essential that the
facts the nurse alone can observe, should be accurately observed, and
accurately reported to the doctor.
I must direct the nurse's attention to the extreme variation there is
not unfrequently in the pulse of such patients during the day. A very
common case is this: Between 3 and 4 A.M. the pulse becomes
quick, perhaps 130, and so thready it is not like a pulse at all, but
like a string vibrating just underneath the skin. After this the patient
gets no more sleep. About mid-day the pulse has come down to 80; and
though feeble and compressible is a very respectable pulse.
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