The nurse may find herself in any one of three situations during the second stage. The doctor may arrive in ample time to conduct the delivery; he may be slightly delayed and the nurse endeavor to retard labor, according to instructions; or the baby may be born, with or without the expulsion of the placenta, before his arrival.
When the doctor arrives at the onset of, or during the second stage of labor, the nurse acts solely under his direction, the nature of her offices depending somewhat upon the condition and surroundings of the patient, and whether or not the nurse is the only person at hand to give assistance. In any case, the gloves, and instruments for repairing a tear should be boiled and in readiness; the dressings and other articles to be used are to be conveniently arranged upon the tables and opened at the proper time.
Fig. 80.—Instruments for normal delivery shown in boiling basin on table in Fig. [79]: Needle holder. Blunt hook. Blunt scissors. 2 small Kelly clamps. Mouse tooth forceps. 4 towel clips. 2 large perineal needles and 2 cervical needles in gauze sponge.
After having everything ready and at hand for the delivery, the nurse may be called upon to clean up and act as an assistant, or to give the anesthetic. If she cleans up, she should wear a sterile gown and gloves, and if it is the doctor’s custom, a cap and mask as well, having prepared her hands somewhat as follows:[[6]]
1. Scrub hands and arms with hot water and green soap for five minutes, paying especial attention to the fingers and nails. 2. Clean and trim nails and scrub again for five minutes.
Fig. 81.—Old prints illustrating early ideas of suitable methods of making examinations and conducting deliveries, furnishing interesting contrast with present-day methods. Concern seems to be divided between the patient and the signs of the Zodiac in the picture at the right.
Fig. 82.—Patient draped with sterile towels, leggings, sheet and delivery pad for delivery. (From photograph taken at Johns Hopkins Hospital.)