Making Good on Private Duty: Practical Hints to Graduate Nurses

by Harriet Camp Lounsbery

ARTICLES FOR THE MOTHER'S USE.

Perhaps it is not necessary to say why it is better to use old sheets for the bed of a parturient woman, but I will repeat that old ones are to be preferred, and really new ones, that is, only once washed, never used. New towels are of course objectionable, as being too harsh. If the patient likes a rough towel, use a regular bath towel, if you can get it. Be careful, never to let loose and wet ends of the wash cloth drag along exposed parts of the body. It is a good plan to sew your wash cloth into a bag, and to slip your hand inside, and work with it put on like a mitten. A rubber or fibre sponge is to be preferred. Keep one for the face, neck, arms, and hands, and another for the feet and legs. The vulva is bathed best by means of a fountain syringe used as an irrigator, and a little sterilized gauze twisted around your dressing forceps. The gauze can be changed as often as necessary, and is much more satisfactory than anything else, especially if there has been a laceration.

The square of rubber sheeting, single width, is most useful. For the confinement the bed should be made by first spreading over the mattress the wide rubber sheet, over this put an old blanket, then the under sheet; upon the right side of the bed, where most likely the woman will lie, place the square of rubber, over that the old comfortable, four double, and hold all in place with a sheet folded like a hospital "draw-sheet." This must be firmly tucked in at the sides under the mattress. It will seldom be found necessary to change the under sheet, if the bed is made this way, and the rubber square is drawn carefully away, with the comfortable and draw sheet, when it is time to make the patient clean and dry after the birth. It is a good plan now to tear this square in two, and keep one piece directly under the clean draw sheet for the first few days. This saves much washing.

An old blanket and a small one will be found invaluable for all sorts of things—for example, to spread over the shoulders and chest when the bandage is being pinned; to warm and wrap up the feet and legs, if they show any signs of being cold; to cover one knee and part of the body when using the irrigator, which when there has been any laceration, is a delicate piece of business, as every nurse knows. Always fold up this invaluable and constant friend, and put it in some handy but inconspicuous place; it is a friend, and a good one; but it is not a beautiful object to look upon, and others not knowing its virtues would think you untidy if it was in a noticeable place. The fountain syringe is absolutely indispensable; and, though it may seem unnecessarily large, yet I think a four-quart bag better than any of the smaller sizes. To be sure, you never might need four quarts in the bag, but it is so much easier managed, so much less liable to spill over, if you have a large bag and put it only half or three-quarters full. Then, too, you get so much more force if you have more water in the bag, you need not use it all. A Davidson syringe is very nice for some things that a fountain syringe could not be used for. Oil enemas, for instance, also nutritive enemas. After an oil enema be sure to wash your syringe thoroughly with a strong solution of washing soda or ammonia, else you will find the rubber of the bulb and tubing becoming pasty, and your syringe will be utterly spoiled. The paper basin is very light and easily handled and much to be preferred to a large china affair, which may easily slide from warm, wet, slippery hands.

I often wonder that the women of our day, who are so sensible in many things, should have abandoned the fashion of short night gowns, which our grandmothers always provided for themselves at these times. I remember asking one lady, when talking over what she would need for her first baby, and for herself, at the time of its birth, if she had not something short and plain that she could wear. She looked very thoughtful for a moment and then said that she thought she did have one night-dress that did not have a ruffle or embroidery around the bottom. She could wear that. It certainly is not from motives of economy that our wealthy patients do not have these most sensible of garments. I think they know nothing about them, and they should have their virtues explained to them. A pocket could be added to this garment, I think, and it would be a real comfort to a woman. I know it would be to a nurse, who usually has to hunt up the ever missing pocket handkerchief a dozen times a day. Men always have pockets in their night-shirts, and they are not sick half as much as the women. I wonder why women do not imitate this most sensible custom. If your patient will not let you cut off any of her old night-dresses, you must use the long ones, of course, and change them as often as necessary.

Bandages should always be made of soft unbleached muslin; double is best, though I have used them of the single fold, and hemmed, but they are firmer if double. They should be wide enough to come down to the great trochanters, and up to a place two inches above the umbilicus; long enough to fit the woman before she became pregnant. She has likely some measure, or could get it from her dress-maker. Women vary so much, it is hard to give an exact measure in inches, but you might begin with a bandage fifty inches long, and if the ends are too long, cut them off, and turn in the edges of the cloth and overhand it neatly.

Obstetrical binders, or bandages are now seldom put on a parturient woman, but in case they are to be used, I give the best kind I know of. They are sometimes made to order, but I never knew one of these to fit, or wash well.

The method of their application is of course taught in the schools. The nurse should always know from the doctor, or the prospective patient, if binders are to be worn, and instructions given as to how to make them. Four or six will be enough.

Two or three yards of soft, unbleached muslin for breast-bandages should be provided in case they are needed. A six-tailed bandage is, I think, the best for this purpose. Tear down the first two "tails" to within three inches of the others, and these passing over the shoulders, and fastening to others, which are adjusted over the breasts, keep the whole bandage in place.

It is not necessary to speak of the napkins or pads; these are universally used, and readily bought, sterilized, and ready for use. All sterilization is so thoroughly taught in the schools, I have taken proficiency in this particular for granted.