UPPER AND UNDER NURSEMAIDS.
2397. The nursery is of great importance in every family, and in families of distinction, where there are several young children, it is an establishment kept apart from the rest of the family, under the charge of an upper nurse, assisted by under nursery-maids proportioned to the work to be done. The responsible duties of upper nursemaid commence with the weaning of the child: it must now be separated from the mother or wet-nurse, at least for a time, and the cares of the nursemaid, which have hitherto been only occasionally put in requisition, are now to be entirely devoted to the infant. She washes, dresses, and feeds it; walks out with it, and regulates all its little wants; and, even at this early age, many good qualities are required to do so in a satisfactory manner. Patience and good temper are indispensable qualities; truthfulness, purity of manners, minute cleanliness, and docility and obedience, almost equally so. She ought also to be acquainted with the art of ironing and trimming little caps, and be handy with her needle.
2398. There is a considerable art in carrying an infant comfortably for itself and for the nursemaid. If she carry it always seated upright on her arm, and presses it too closely against her chest, the stomach of the child is apt to get compressed, and the back fatigued. For her own comfort, a good nurse will frequently vary this position, by changing from one arm to the other, and sometimes by laying it across both, raising the head a little. When teaching it to walk, and guiding it by the hand, she should change the hand from time to time, so as to avoid raising one shoulder higher than the other. This is the only way in which a child should be taught to walk; leading-strings and other foolish inventions, which force an infant to make efforts, with its shoulders and head forward, before it knows how to use its limbs, will only render it feeble, and retard its progress.
2399. Most children have some bad habit, of which they must be broken; but this is never accomplished by harshness without developing worse evils: kindness, perseverance, and patience in the nurse, are here of the utmost importance. When finger-sucking is one of these habits, the fingers are sometimes rubbed with bitter aloes, or some equally disagreeable substance. Others have dirty habits, which are only to be changed by patience, perseverance, and, above all, by regularity in the nurse. She should never be permitted to inflict punishment on these occasions, or, indeed, on any occasion. But, if punishment is to be avoided, it is still more necessary that all kinds of indulgences and flattery be equally forbidden. Yielding to all the whims of a child,—picking up its toys when thrown away in mere wantonness, would be intolerable. A child should never be led to think others inferior to it, to beat a dog, or even the stone against which it falls, as some children are taught to do by silly nurses. Neither should the nurse affect or show alarm at any of the little accidents which must inevitably happen: if it falls, treat it as a trifle; otherwise she encourages a spirit of cowardice and timidity. But she will take care that such accidents are not of frequent occurrence, or the result of neglect.
2400. The nurse should keep the child as clean as possible, and particularly she should train it to habits of cleanliness, so that it should feel uncomfortable when otherwise; watching especially that it does not soil itself in eating. At the same time, vanity in its personal appearance is not to be encouraged by over-care in this respect, or by too tight lacing or buttoning of dresses, nor a small foot cultivated by the use of tight shoes.
2401. Nursemaids would do well to repeat to the parents faithfully and truly the defects they observe in the dispositions of very young children. If properly checked in time, evil propensities may be eradicated; but this should not extend to anything but serious defects; otherwise, the intuitive perceptions which all children possess will construe the act into "spying" and "informing," which should never be resorted to in the case of children, nor, indeed, in any case.
2402. Such are the cares which devolve upon the nursemaid, and it is her duty to fulfil them personally. In large establishments she will have assistants proportioned to the number of children of which she has the care. The under nursemaid lights the fires, sweeps, scours, and dusts the rooms, and makes the beds; empties slops, and carries up water; brings up and removes the nursery meals; washes and dresses all the children, except the infant, and assists in mending. Where there is a nursery girl to assist, she does the rougher part of the cleaning; and all take their meals in the nursery together, after the children of the family have done.
2403. In smaller families, where there is only one nursemaid kept, she is assisted by the housemaid, or servant-of-all-work, who will do the rougher part of the work, and carry up the nursery meals. In such circumstances she will be more immediately under the eye of her mistress, who will probably relieve her from some of the cares of the infant. In higher families, the upper nurse is usually permitted to sup or dine occasionally at the housekeeper's table by way of relaxation, when the children are all well, and her subordinates trustworthy.
2404. Where the nurse has the entire charge of the nursery, and the mother is too much occupied to do more than pay a daily visit to it, it is desirable that she be a person of observation, and possess some acquaintance with the diseases incident to childhood, as also with such simple remedies as may be useful before a medical attendant can be procured, or where such attendance is not considered necessary. All these little ailments are preceded by symptoms so minute as to be only perceptible to close observation; such as twitching of the brows, restless sleep, grinding the gums, and, in some inflammatory diseases, even to the child abstaining from crying, from fear of the increased pain produced by the movement. Dentition, or cutting the teeth, is attended with many of these symptoms. Measles, thrush, scarlatina, croup, hooping-cough, and other childish complaints, are all preceded by well-known symptoms, which may be alleviated and rendered less virulent by simple remedies instantaneously applied.
2405. Dentition is usually the first serious trouble, bringing many other disorders in its train. The symptoms are most perceptible to the mother: the child sucks feebly, and with gums hot, inflamed, and swollen. In this case, relief is yielded by rubbing them from time to time with a little of Mrs. Johnson's soothing syrup, a valuable and perfectly safe medicine. Selfish and thoughtless nurses, and mothers too, sometimes give cordials and sleeping-draughts, whose effects are too well known.
2406. Convulsion Fits sometimes follow the feverish restlessness produced by these causes; in which case a hot bath should be administered without delay, and the lower parts of the body rubbed, the bath being as hot as it can be without scalding the tender skin; at the same time, the doctor should be sent for immediately, for no nurse should administer medicine in this case, unless the fits have been repeated and the doctor has left directions with her how to act.
2407. Croup is one of the most alarming diseases of childhood; it is accompanied with a hoarse, croaking, ringing cough, and comes on very suddenly, and most so in strong, robust children. A very hot bath should be instantly administered, followed by an emetic, either in the form of tartar-emetic, croup-powder, or a teaspoonful of ipecacuanha, wrapping the body warmly up in flannel after the bath. The slightest delay in administering the bath, or the emetic, may be fatal; hence, the importance of nurses about very young children being acquainted with the symptoms.
2408. Hooping-Cough is generally preceded by the moaning noise during sleep, which even adults threatened with the disorder cannot avoid: it is followed by violent fits of coughing, which little can be done to relieve. A child attacked by this disorder should be kept as much as possible in the fresh, pure air, but out of draughts, and kept warm, and supplied with plenty of nourishing food. Many fatal diseases flow from this scourge of childhood, and a change to purer air, if possible, should follow convalescence.
2409. Worms are the torment of some children: the symptoms are, an unnatural craving for food, even after a full meal; costiveness, suddenly followed by the reverse; fetid breath, a livid circle under the eyes, enlarged abdomen, and picking the nose; for which the remedies must be prescribed by the doctor.
2410. Measles and Scarlatina much resemble each other in their early stages: headache, restlessness, and fretfulness are the symptoms of both. Shivering fits, succeeded by a hot skin; pains in the back and limbs, accompanied by sickness, and, in severe cases, sore throat; pain about the jaws, difficulty in swallowing, running at the eyes, which become red and inflamed, while the face is hot and flushed, often distinguish scarlatina and scarlet fever, of which it is only a mild form.
2411. While the case is doubtful, a dessert-spoonful of spirit of nitre diluted in water, given at bedtime, will throw the child into a gentle perspiration, and will bring out the rash in either case. In measles, this appears first on the face; in scarlatina, on the chest; and in both cases a doctor should be called in. In scarlatina, tartar-emetic powder or ipecacuanha may be administered in the mean time.
2412. In all cases, cleanliness, fresh air, clean utensils, and frequent washing of the person, both of nurse and children, are even more necessary in the nursery than in either drawing-room or sick-room, inasmuch as the delicate organs of childhood are more susceptible of injury from smells and vapours than adults.
2413. It may not be out of place if we conclude this brief notice of the duties of a nursemaid, by an extract from Florence Nightingale's admirable "Notes on Nursing." Referring to children, she says:—
2414. "They are much more susceptible than grown people to all noxious influences. They are affected by the same things, but much more quickly and seriously; by want of fresh air, of proper warmth; want of cleanliness in house, clothes, bedding, or body; by improper food, want of punctuality, by dulness, by want of light, by too much or too little covering in bed or when up." And all this in health; and then she quotes a passage from a lecture on sudden deaths in infancy, to show the importance of careful nursing of children:—"In the great majority of instances, when death suddenly befalls the infant or young child, it is an accident; it is not a necessary, inevitable result of any disease. That which is known to injure children most seriously is foul air; keeping the rooms where they sleep closely shut up is destruction to them; and, if the child's breathing be disordered by disease, a few hours only of such foul air may endanger its life, even where no inconvenience is felt by grown-up persons in the room."
2415. Persons moving in the beat society will see, after perusing Miss Nightingale's book, that this "foul air," "want of light," "too much or too little clothing," and improper food, is not confined to Crown Street or St. Giles's; that Belgravia and the squares have their north room, where the rays of the sun never reach. "A wooden bedstead, two or three mattresses piled up to above the height of the table, a vallance attached to the frame,—nothing but a miracle could ever thoroughly dry or air such a bed and bedding,"—is the ordinary bed of a private house, than which nothing can be more unwholesome. "Don't treat your children like sick," she sums up; "don't dose them with tea. Let them eat meat and drink milk, or half a glass of light beer. Give them fresh, light, sunny, and open rooms, cool bedrooms, plenty of outdoor exercise, facing even the cold, and wind, and weather, in sufficiently warm clothes, and with sufficient exercise, plenty of amusements and play; more liberty, and less schooling, and cramming, and training; more attention to food and less to physic."