The care of each patient is a tactful adjustment of the prescribed routine to the condition, habits and temperament of that patient. It is carried on through a combination of visits which the nurse makes to the patient’s home and visits which the patient makes to the nurse at the Maternity Centre in her district. The advantages of this combination of visits are, that the nurse first knows the patient in her own home, and can help to plan for the desired care with the conditions of this home in mind, and perhaps evolve from the patient’s simple belongings the equipment needed for her care; also that at the Centre it is possible to assemble the patients and give them a certain amount of informal group instruction. There is at each Centre a doll model of a baby; a model of a baby’s bed (Fig. [144]), showing that a box or a basket may be used with entire satisfaction; a model of the mother’s bed, prepared for delivery at home and protected with newspaper pads; a complete layette (Fig. [145]) to show the mothers how simple such an outfit can and should be; patterns for making each garment and some one to help the women to make them; a breast tray (Fig. [146]) and a baby’s toilet tray (Fig. [147]), so complete and yet so simple that no woman with a few chipped or cracked cups to spare need be dismayed.
Fig. 144.—Separate bed for the baby improvised from a market basket. (By courtesy of the Maternity Centre Association.)
In the course of this group instruction the women are taught how to prepare for, and later care for their babies. One week, the nurse demonstrates to the group how to handle the baby, dressing and undressing or bathing it; or explains the reason for making each article in the model layette, or the purpose and use of each article on the toilet tray, and shows them how to make boric acid solution and swabs. In short, each detail in the care of the baby is gone over. Every alternate week the mothers demonstrate to the nurse. They dress and undress the doll model; explain and demonstrate how to make boric acid solution; how to prepare sterile water and give it to the baby. Many of the mothers attend the classes for several weeks in succession, and frequently a mother returns with her three-week-old baby to make sure that she has not forgotten any of the details of infant care which the nurse tried to teach her before the baby came.
Fig. 145.—Layette recommended to patients by Maternity Centre Association:
A. Flannel binder.
B. Knitted band with straps.
C. Shirt.
D. Petticoat.
E. Dress or nightgown.
F. Diaper.
G. Pad for basket-bed.
H. Flannel square.
Fig. 146.—Breast tray improvised from articles to be found in any home, contains: Jar of cotton pledgets; bottle of liquid petrolatum; soap on saucer, covered with cup for water to bathe nipples. (By courtesy of the Maternity Centre Association.)
A patient is not asked to go to the Centre for any reason if she seems very reluctant to go; or if her going is inadvisable for physical reasons or if it would entail great hardship, because of young children who would have to be taken with her, or left at home alone. But when they can go, it simplifies the work and enables each nurse to supervise a larger number of patients than if she did all of the traveling and visiting.
