Patient Care

the various measures that aim to alleviate illness and to create optimum conditions for treatment. In a hospital, such care is provided by paramedical personnel. Under the USSR’s two-stage system, patients may be treated by the physician and/or by the ward nurse, the latter being chiefly responsible for patient care. Nurses are assisted by hospital attendants. At home, patients may be cared for by relatives under the supervision of the district physician and nurse.

A distinction is made between the standard type of patient care—with general rules, applicable in all cases, varying in practice in accordance with such factors as patient’s age and severity of illness—and such special care as may be required in any given illness. General care includes maintaining the rules of hygiene and proper diet, carrying out the prescribed course of treatment, monitoring the patient, and preventing possible complications. Depending on the regimen prescribed by the doctor, patients may be confined to bed rest or allowed to walk about. Cleanliness is maintained in the patient’s surroundings: the floor, walls, radiators, windows, and furniture are cleaned regularly. The patient’s bedding and garments are changed frequently; articles used in patient care are kept clean, and dishes are washed thoroughly. Body temperatures are measured in the morning and at 5 P.M.; in the hospital, the figures are recorded on a special chart, and records are kept for home patients as well. Such information is useful for monitoring the patient’s condition and detecting symptoms of complications. Morning ablutions are followed by the administration of prescribed medications that are to be taken on an empty stomach. The nurse or attendant must record any changes in the patient’s condition (such as the development of edemas, rashes, phlegm, or a particular mouth odor or facial coloration), as well as measure the pulse, respiration, and physiological functions, obtain needed analysis material from the patient, and prepare the patient for roentgenographic and other examinations.

The special care of patients strictly confined to bed rest includes ensuring that the patient remains in the position prescribed by the physician (for example, lying on the back or side or with the head or foot of the bed raised) and effecting whatever changes are required, such as turning the patient over every hour. Depending on the patient’s condition, treatment may include physical therapy. The nurse is responsible for feeding patients who are seriously ill. A patient who is unable to take any food by mouth may be fed artificially through a stomach tube or intravenously. Patients may be washed in their bed; for those who are seriously ill, maintaining cleanliness of the skin is an important means of preventing bedsores.

Patient care also includes giving baths (full, partial, or sitz baths), lavage, body rubs, and the application of compresses, dry heat, and cold (in the form of an ice bag). If two or more medications are prescribed, a schedule is devised for their administration in order to preclude incompatible combinations or combinations that may weaken (or unnecessarily intensify) their effect. Medications are taken by the patients at the time they are distributed. Drugs are stored in accordance with instructions on the labels (for example, in a dark, dry, and cold place) and tightly covered. In administering medication, the prescribed timing—before, with, or after meals—must be carefully observed, since the therapeutic effect often depends on it. Fortifying the patient’s nervous system and restoring his peace of mind play an important part in recovery; these goals can be achieved by patiently and attentively responding to the patient’s requests, eliminating all sources of disturbance or irritation, and providing diffuse lighting, fresh air, and comfortable room temperatures.