When sutures, instruct the family how to irrigate after urination and movement of the bowels.
Normal maternity cases should be visited daily until after the 8th day of puerperium and at least once a week for supervision until the 5th week. The case is then transferred to Child Welfare nurse.
Additional visits should be made if the patient is still in bed and there is no intelligent adult to give care, or if the baby’s condition is not satisfactory.
A SUGGESTION FROM MONTREAL
Ingenuity, resourcefulness, and quick wit on the part of an intelligent nurse can almost always apply hospital ideals to circumstances which would at first seem hopeless. It is the nurse’s knowledge of obstetrical nursing and principles, rather than her equipment, that counts in saving lives. The following directions given to visiting nurses, by Cecil A. K. Dawkins, R.N., Supervisor of the Outdoor Department of the Montreal Maternity Hospital, indicate the possibility of clean, efficient care in conditions far from ideal:
“MATERNITY CASE CONDUCTED IN A HOUSE WHERE THERE IS VERY LITTLE TO WORK WITH
“Appliances You Are Likely to Find in Any House:
“Bed, table, chair, two boxes, basin, pail, kettle, saucepan, plate, two cups, spoon, several fair sized bottles, sheet, two towels, pillow, pillow case, handkerchief, newspapers, old clean rags, small package boracic powder, small bottle vaseline, soap, baby clothes.
“Doctor’s bag will usually contain towel, clamps, scissors, ergot, chloroform, creolin, rubber apron, hypodermic syringe, nail brush.
“1. I would take a look at the fire. Put on the kettle to boil, also saucepan containing scissors, clamps, hypo (cord ligatures), clean rags to use as sponges, if absorbent is not available. I would put several pieces of clean rag (some small for cord dressings, others large for vulva pads) on a plate in the oven to bake. This will only take a minute. “2. Attack the bed. Strip it, place a good pad of newspapers where the patient is to lie. Then the sheet. Cover this all over with newspapers, particularly where the patient lies. Here I would form a Kelly pad, rolling the paper up at the top and bottom and left side, the right side falling over the edge of the bed into the pail. Cover with clean rag. Paper under the pail. “3. Place basin, towel, soap and nail brush on table. Wash up and prepare patient. Braid her hair. Put on a clean nightdress. “4. Clip away the pubic hair with scissors, if razor not available to shave. Give S.S. enema, provided you have the time to do it in, and the syringe to do it with. Wash the vulva well with soap and water. Put on pad, rag wet with disinfectant. “5. The instruments, swabs, etc., should be boiled by this time. Place scissors and clamps on plate, and swabs in basin. Get hypo ready. Water for ergot. Boracic for baby’s eyes. Baby’s clothes together,—also warm cloth to wrap baby in. Fold handkerchief crosswise, and make funnel for chloroform mask. “6. When baby comes, wrap him up warmly, and place on the right side in a safe place. If no other place available, pull bureau drawer half open and put him in, but be careful not to close it again. The plate that has held the scissors and clamps may be used for the placenta.