Post-Natal Orders:
Thrush: Solution of Soda Bicarbonate (1 tablespoonful to 1 glass of water); apply to spots with swab before and after nursing. If not effective send baby to dispensary or doctor. Constipation: Olive Oil and Glycerin, equal parts of each, minims 5–15 to dose. Circumcision: If penis is not thoroughly healed, dress with Aristol powder. Excoriated Buttocks: Castor Oil and Bismuth Paste, equal parts of each. Oozing Umbilicus: Cleanse with alcohol on swab, dust with Aristol powder, apply dry sterile dressing. Protruding Umbilicus: If dry, strap with well covered button or coin, using wide adhesive tape.
ROUTINE FOR POST-NATAL FOLLOW UP
Hospital Cases
See patient as soon after she is dismissed as possible, to make sure she understands how to care for baby. Urge her to take baby to nearest baby health station (see Blue Card) when baby is three weeks old. Telephone health station to see if she does register. Urge her to bring baby to your own station when one month old. At that time arrange for post-partum examination: if it is the practice of the hospital, at which the patient was delivered, to instruct patient to return for post-partum examination, urge her to go at time set by hospital; if not, urge her to come to your station for such examination. If she fails to come, visit her to learn condition of baby, and to urge post-partum examination. If during the post-natal follow-up work, any abnormality is discovered in baby or mother, report that at once to the resident of the hospital, where patient was delivered, and carry out his orders as to whether patient is to return to him or be referred to gynecological or baby clinic.
Patient Delivered at Home
Urge all pre-natal cases to send you post card when baby is born. When postal is received, visit as soon as possible to see that everything is all right; arrangements made for care of home and children so as to keep mother in bed proper time, etc. If a Henry Street nurse is doing post-partum bedside nursing, make no other visit but urge mother to bring baby to see you at station when the baby is one month old. If a practical nurse or a midwife case, visit every day or so, but do not interfere with her conduct of the case. If you find it necessary to report any irregularity to the Department of Health communicate with the midwife before doing so. After she has dismissed the case follow the routine outlined above. Make special effort to get all midwives’ cases to come for post-partum examination, and also private physicians’ cases if they dismiss case before baby is six weeks old.
CHAPTER XX
CARE OF THE MOTHER AND BABY BY VISITING NURSES
The preventive value of post-partum care is now so generally recognized that maternity care by visiting nurses is given not only in the larger cities, but is being extended even to rural communities. The routine of the Visiting Nurse Society of Philadelphia, under the direction of Miss Katharine Tucker, may be taken as an example of effective post-partum care, in which daily visits by a nurse bring to large numbers of patients the minimum of necessary attention. As the same kind of work is effective and possible in smaller communities, the routines and instructions used by the Philadelphia Society are reproduced on pp. [439] to 445. These include
1. The equipment of the nurse’s bags. 2. Delivery routine. 3. Routine technique in caring for mother and baby.