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Now let me see how it is done, in fact. And you find that the triceps has three origins high above its one attachment as a tendon, to give it a good strong pull. These are in the outside of the humerus and in the scapula. That is logical, and you will remember it.

Now how does the arm bend? What pulls against the triceps? And you are interested before you know it.

There is nothing, good, bad, or indifferent, but has some points of interest if the mind turns its entire attention to it. But our tendency is to grow tired of calling back our wandering thoughts again and again to the thing that is hard, dry, or stupid. And we need more incentive than just the doing of the duty because it is to be done. We need a compelling interest in the goal to encourage our wills to concentration on the less interesting. Let us first think out the why of knowing anatomy if we are to be nurses. And if the profession of nursing is the goal, let anatomy become just the next stretch of the road that leads to it.

Concentration can be acquired. It may require three hours at first to learn your lesson; but later on you will do it in two, then in one, and perhaps in less. And when you can sit down with your notes and learn them with voices about you—perhaps; with some one else in the room; with a party an hour ahead; when you can disregard all but the work at hand, then you can concentrate, and the big battle of your life as a student is won. Study is no longer drudgery. Lessons occupy much less of your time and leave you more free hours. Because you give them your whole mind you learn them in a fraction of the hours hitherto wasted upon them, when you studied with divided attention. When you are doing clear thinking on the thing at hand, satisfactory results are assured.

Self-training in Memory

Hand in hand with clear thinking goes reliable memory. But so many of us have it not, and feel its need so strongly that we shall consider for a moment some means of training it.

William James holds that brain-paths cannot be deepened; that memory is not strengthened in that way. There is a natural retentiveness with which some of us are born—the men of colossal intellect—and they remember and are able to use infinitely more things acquired in the past, because they have a brain substance of greater tenacity in holding impressions than others possess. James compares some brains to wax in which the mark left by the seal is permanent; and others he compares to jelly which vibrates at every touch, but retains no dent made in it. From our study of the subconscious we know that the dent did leave an impression on the brain; but it was in the subconscious. So we beg to change the figure and liken, in all mankind, that part of the brain that handles the subconscious to wax, while granting that in some rare cases parts handling the conscious material also hold impressions, as does the wax.

Consequently, according to this theory, we do not strengthen our memories by repetition of facts, lines, or phrases. We cannot grave any deeper the memory paths which nature has provided at birth. But the attention to the thing to be remembered, which repetition has required, has made a larger number of connections of the words with each other, of thought with thought, and of the new with the old. So we have tied the new together with the old by that many more strings, as it were; and any bit of the new tugs at other bits; and the old to which it is tied brings the new with it when it comes to the fore. In other words, careful attention, at the time, to the new stimulus, and its association with the already known, together with repetition, will form a whole system of relations in the mind, and the newly entered material soon become so well-known that it will be difficult to disregard it.

When, in spite of determined effort to remember, the thing is forgotten, especially in the nurse’s case, it is usually because the emotional reaction to weariness or to some like obstacle has interfered with proper attention. James advises us if we would improve memory, to improve our thinking processes; to pay more and keener attention, so that we will link things closely together. This in itself will help to arouse interest in the thing to be remembered; and keen interest alone, or careful attention at the time of introduction of the new, and repetition of the thing to be retained, with a will which holds the attention fast, will assure a good, workable memory in any normal mind.

CHAPTER XIII
THE PSYCHOLOGY OF THE NURSE (Continued) Emotional Equilibrium

Suppose that when you first enter the ward you are wishing with all your heart you had never decided to become a probationer. Perhaps the white screen and its possible meaning has so frightened you that your thoughts refuse to go beyond it. Suppose the very sight of so much sickness has agitated you instead of strengthening your determination to help nurse it. That is, suppose your emotions, your feelings, so fill your mind that perception is necessarily inaccurate and blurred. Then tomorrow your account of the ward will be hazy, and your desire will probably be against returning to a place where so many unpleasant feelings were aroused.

The emotional balance which refuses to allow feelings to obscure judgment by leading reason astray is a necessary safeguard for the work of the nurse. There is little place in the profession for the woman who is “all sentiment,” but perhaps there is less for the one without sentiment.

Feeling, we found, is the first expression of mind—feeling which in the early months is entirely selfish. The happiest baby you know is not sweet and winning to please you, but because he feels comfortable and happy and cannot keep from expressing it. His universe is his own little self and you exist only in your relation to him. If you give him pleasure he likes you; if pain, he does not want you. His mother often fails to please him, but satisfies him so much more frequently than anybody else that he loves her best. Then comes nurse or father—if he proves the satisfactory kind of father, or she a nurse he can love. To the baby whatever he happens to want is good. What is not desirable is bad. And such emotional responses are altogether normal in early months, yes, even until the child is old enough to use reason to choose between two desires the one that will in the end prove more satisfying. But they are defects in adult life.

The nurse who would always act as her first feeling dictates would not be in training many days. Unpleasant sights and sounds, the fear of making a mistake which might harm a patient, the undesirability of long hours of hard work in caring for patients who frequently only find fault with her best efforts, would early decide her in favor of another life-work. Comparatively few so-called “grown-ups” are guided only by feeling; and most of those are in institutions that are well safeguarded. But a great many mature men and women allow feeling to unduly influence their thinking. The sentimental nurse, for instance, may find it very difficult to give an ordered hypodermic. The patient dreads the pain and the nurse fears hurting her. Suppose she were to fail to give it on such grounds. This is an almost unthinkable case. But the very nurse who agrees that such an emotional weakling should not be allowed to train, will help her patient, even when recuperating nicely, to grow inexcusably self-centered, by sympathizing with every complaint, warning her at every turn, by allowing her and even encouraging her, perhaps, to discuss her illness and suffering in the minutest detail. This nurse is more damaging than the sentimentalist who fails to give the hypodermic; for that slip is easily discovered, and the transgressor must immediately reform and obey orders, or be dismissed. But the second nurse may take perfect care of the sick body, and the doctor never realize that she is developing the sickness idea in her patient’s mind.

In both of these instances reason has followed the leadings of feeling. It is unpleasant to hurt the patient, and she is disagreeable, too, when you insist on carrying out the orders. It is easier to agree with her ideas and sympathize with her troubles, much easier than to find some other avenue for her thinking, or to search for feeling substitutes. It is pleasanter right now to allow her mind to slip unmolested into sick reactions than to lead her, unwilling as she is, into the ways of health. Reason follows feeling’s logic, which suggests that it is much better for the patient to talk of her ills than to keep them pent up inside; and judgment is sadly obscured.

The emotionally balanced nurse hears the story once, that she may have the material for helping the need. Feeling, perhaps deep and genuine sympathy with a real trouble, is aroused, and rightly. But this brings a keen desire to help the situation. Reason insists that talking of sufferings, real or fancied, only makes them more insistently felt; that there must be some better way to meet them. It suggests various methods to divert the patient’s attention, to change the train of thought until she is able herself to direct it into healthful channels; judgment weighs the propositions and decides upon the one which will lead toward establishing a health attitude.

The nurse is continually meeting the necessity of acting contrary to fear and discouragement and weariness of spirit. How can she secure emotional equilibrium for herself?

Keep in mind the fact that most sick people are very suggestible; that you have a definite responsibility to make your suggestions to your patient wholesome; and that your mood is a constant suggestion to him. Remember that he needs your best. Then, if your own trouble seems too great to bear, determine that, so long as you remain on duty, you will not let it show. Try an experiment. See if you can go through the day carrying your load of sorrow, or disappointment or chagrin, with so serene a face that the sick for whom you are caring will not suspect that you have a burden at all. That is a triumph worth the striving. Then—if you can let it make you a little more comprehending of others’ pain, a little more gentle with the sickest ones, a bit more patient with the trying ones, more kindly firm with the unco-operative, realizing that each one of them all has his burden too—you have not choked feeling, but you have fulfilled reason’s counsel: that sick people are not the ones to help you in your stress; that a good nurse should rise above personal trouble to the duty at hand. Your judgment has compared your reasons, and decided that you should act before your patients as you would if all were well. And will holds you to emotional equilibrium. Such a thing can be done in a very large measure; and no better opportunity for emotional control will ever be offered than the necessity of being calm and serene before your patients, no matter how you feel.

But, while reason and judgment teach us to control the expression of certain feelings, they urge that this control be exercised in transforming those feelings into helpful ones and giving them an adequate outlet.

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