The cause of her trouble is not apparent to the patient’s associates but they are aware of its manifestations in the shape of moods, temper tantrums, strange conduct and all sorts of nervous and mental symptoms. If such a patient does not get relief through talking things over, but continues to brood and worry alone—to repress the cause of the conflict—she may not be sufficiently adaptive to endure its ravaging effects, and have a nervous or mental breakdown as a result.
It is hoped that the nurse may understand from this discussion that the conflicting thoughts which her patient does not discuss, but buries and keeps below the surface of her mind, are the factor that works harm in her mental life. If the nurse can get her patient to ventilate these thoughts, they will be robbed of much of their power to injure. But this patient, like any one else, will talk freely only when she talks spontaneously and she will do this only when she senses in her nurse a sympathy and a sincere concern over her troubles.
Accordingly, the nurse should try to so attune herself as to be receptive to evidences of the patient’s moods and impulses, and possibly from a chance remark get a clue to the repressed desires which are working harm. She will then be able to meet the patient on that ground.
It is not that the relief of the patient by means of mental catharsis is necessarily a nurse’s function. It is simply that a patient suffering from a conflict should talk freely to some one, it does not matter who, and by virtue of the long hours which they spend together, the nurse very often happens to be that some one. People do not ordinarily find it easy to lay bare their inmost thoughts before the members of their family and the patient may not discuss her conflict with her physician, which of course is the ideal, because his visits are relatively short and do not favor the ambling, desultory conversation into which the nurse and patient may so easily drift.
On the other hand, the nurse must not look for trouble, in order to be useful, nor by the slightest intimation give her patient an idea that it is a common practice among expectant mothers to worry, be fearful or alarmed. If the patient displays these emotions the nurse must be ready, but she must not be suggestive. Her attitude must be entirely passive for she is simply a receptacle into which the patient may pour her conflicting thoughts. But the receptacle must be always available.
The positive course which the nurse may take is to be unfailingly hopeful and courageous and take it for granted that her patient is filled with joy and pride over her pregnancy. The gratification is there by instinct, but it may be so buried and complicated by other emotions that the patient is not wholly aware of it. It may be surprisingly clarifying for the nurse to say quite simply, “But, after all, it is a wonderful thing to have a baby and you are proud and glad that he is coming. He will be worth any sacrifice.”
If the nurse will so far put herself in the patient’s place that she is glad, sincerely glad, that the baby is coming, this attitude will communicate itself to the expectant mother. Happiness and enthusiasm are very infectious.
To sum it all up: The expectant mother who habitually has not made satisfactory adjustments during her life may be bending under a mental burden that is a little heavier than her slender, unevolved powers can bear. The nurse’s part is to recognize this possibility and realize that while she cannot attempt to correct the difficulty she can be a prop by simply being optimistic and reassuring. A patient who may be suffering from a mental conflict is often saved from a breakdown by little more than a ready sympathy which is born of understanding.
CHAPTER VIII
THE PREPARATION OF ROOM, DRESSINGS AND EQUIPMENT FOR HOME DELIVERY
It sometimes devolves upon the nurse to give advice in selecting and preparing the room to be used for a home confinement, and very often to help the prospective mother in preparing and assembling adequate equipments for the delivery and for the care of herself and the baby afterwards.