Association Of Ideas
After the first few years of life practically nothing enters
consciousness that cannot by some likeness or contrast or kinship be
connected with something already there. Were it not for this saving
economy memory would be helpless. So the nurse who is in earnest and
eager to master her new work will not only perceive carefully each
detail of arrangement, but in two or three days at most will know each
patient there; she will have worked out a system of associations,
remembering not a meaningless name, but an individual with certain
characteristics which she ties up with her name, and so gives it a
definite personality. She thereafter recalls not merely a patient, but a
very special patient; and as she comes to mind she brings a title with
her, which is her symbol. Likewise when her name is spoken or thought,
she herself comes into the nurse's immediate consciousness. A bed in a
certain part of the room will be no longer merely a bed, but
Mrs. Brown's bed. Remembering can be made easy by using some such method
The first bed to the right as you enter is Mrs. Meade's. She is the
woman with the broken hip. The next is Mrs. Blake's, that blonde, big
woman who wants more attention than any one else. The third is
Mrs. Bunting's. She has wonderful, curling black hair, and a nice
response to everything done for her. The next beyond is Mrs. O'Neil's.
She looks as Irish as her name sounds, and you will remember her by
that. So each bed comes to mean a certain patient, and each patient
comes to suggest the ones on either side of her--her neighbors.
Blondeness and bigness together call Mrs. Blake to mind. Broken hip
means Mrs. Meade, etc. Each individual on that side of the ward becomes
associated with a name which stands for definite characteristics.
Then you begin at the left bed nearest the door and follow the occupants
back on that side. You may remember better by jotting them down in
order of the beds, with names and a brief comment on each patient. Keep
that list on a small card in your pocket for reference for a day or two,
then depend on memory entirely. I have personally found this an
You are expected to be able to turn quickly to any medicines needed in
emergency, and you soon learn to remember them and where they are placed
by the arrangement into classes or kinds, which most hospitals require.
Cathartics are together, hypnotics together, etc. So when you want
cascara you associate it with cathartic and turn to that shelf. You
learn very soon that poison medicines are kept apart from the others,
and quickly associate the poison label with danger to patients,
necessity of locking safely away and hiding the key from any but those
responsible for the care of the sick.
Learning to look closely at the patient's face, instead of casually
glancing at her when you care for her, makes it possible for you to note
changes of expression, heightened color, dilated pupils, a trace of
strain, etc. Then try to find the exact word that will express what you
see. Such experiments in perception and attention, association and
memory, repeatedly demanded of yourself--i. e., the being able to
recall and describe in detail the room- or ward-arrangements and to
place the patients accurately, as we have just described--will prove
invaluable practice, helping you to attend to every change in your
patient's demeanor and expression, which may prove significant symptoms.
And remember that while the mind can only contain so many isolated
facts, yet there is no limit to its possibilities when the power of
association of ideas is employed.
Your first step to clear thinking is accuracy of perception, with
attention to the thing reason chooses; your second is association of the
things perceived, a grouping of them to fit in with each other, and with
what is already in the mind. And both imply the third--concentration,
aided by emotion and will. For passive attention and haphazard
associations assure the opposite of clear thinking.
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