Making Good on Private Duty: Practical Hints to Graduate Nurses

by Harriet Camp Lounsbery

There should always be a disinfectant or antiseptic of some sort on hand.

Carbolic I-30, Platt's chlorides, permanganate of potash, or something that will answer the purpose; bichloride of mercury, etc. You must find out from the physician which he prefers, and of what strength.

I must not forget to say that when you go to see you prospective patient, and she shows you the room she expects to occupy, it would be well to cast your eyes about for some rug, that you can, if necessary, turn wrong side out and spread at the side of the bed. Some doctors are very neat about their work, but some are— well, perhaps I better not say it; we must not criticise the doctors.

But sometimes it is best to have protection for the floor, it gives the nurse a comfortable feeling quite beyond description to know, that, no matter what may happen, the carpet will not be ruined.

XII

AS TO WASHING THE BABY

In the first place get together everything you will need for the bath and subsequent dressing. Have the clothes all laid in order over a chair-back before an open fireplace, or over a radiator, or if no better expedient suggest itself, fill bottles with hot water, or get a hot water bag and fill that, and lay it over the clothes arranged in the order you will need them, beginning the pile with the dress and having the band the last. Have two large, soft towels and keep them warm. If possible, have an apron made of rubber cloth to tie about your waist. At your side, on the floor, have a small blanket ready to lay over the rubber apron when needed. Put your baby basket where you can reach it, be sure that it contains all the things you will need—sponge, soap, powder, pins, vaseline, etc., and an extra diaper or two. Now get the tub (tin) and pour in the water until it is about four inches deep. Have the water no warmer than 100 degrees F. Bath thermometers are made that are quite cheap, and a great convenience; one should always be at hand, as no nurse should ever trust her feelings as to whether the water is hot enough or not. Always test any water to be used for the sick or the delicate with a thermometer. Another point a nurse should be most careful about, is to be careful that her hands are warm before she takes the baby, as her cold hands on his warm flesh will surely make him scream.

All being now ready, take the baby and sit down with him, spreading the blanket over your knees as you do so, and having the tub just in front of you on another chair. The sponge is best to use for the washing, but a piece of old table damask is very good. Wash the eyes very carefully first, then the face, and dry on the towel. Now hold the baby's head over the tub and give that a good washing with soap on your bare hand, and rinse it well with plenty of water, always holding the left hand under the head and neck. Bring him back on your lap and thoroughly dry his head, then wash and dry the ears carefully.

When you get this far you may undress the baby completely, being most careful yet not taking any unnecessary time. When he is quite ready for the tub, grasp him firmly with the right hand, letting the buttocks rest in the palm of the hand, the fingers being outspread, and the thumb coming up almost to the pubic bone. With the left hand hold the head and shoulders. Lower him very gently into the water. Any sudden movement is most injurious, as a baby must never cry when the band is off, if it can be avoided. He will often put out both hands as if trying to catch hold of something. If he seems frightened at the same time, and cries violently, let the buttocks rest on the bottom of the tub, and with the right hand hold both of his, and he will be comforted.

I think it well to wash the whole body with your bare hand, well soaped. Be careful to wash under the arms, in the bend of the elbows, the groins, and under the knees, rinse him with the wash cloth or sponge, and now lay one warm towel on your lap, and take up the baby just as you put him in, slowly, and without shock, and lay him in the warm towel. Lay the second one over him, and draw over all the blanket, wrapping him up warm and snug. Put your hand inside the blanket and dry him. This can be easily and quickly done without at all uncovering the child. Pass the hand with a slight squeezing movement over each arm and leg, and over the front of the body. When this is done, you must undo the blanket, and take the upper towel and dry most carefully all the creases, and powder everywhere, especially if he is very fat. Get down to the very bottom of every crease, and be sure it is dry and powdered. Lay over the navel a compress of absorbent cotton, unless the child is over four weeks old, and over this the band, which should be unhemmed, and wide enough to extend from the hip to the armpit. Lay the palm of your right hand firmly over band and pad and turn the child carefully, holding your right hand still under him, and with the left, clear away all damp towels, and then straighten out the band that is wrinkled under one side. Keep your knees close together. Now take away the right hand, and see that the baby's knees are on the right side of your knee, and the elbows well over the other side of your lap. Now you have the baby where he can kick, but he can't wriggle or spring off your lap. See that the back is dry, rub it a little with your hand, and powder. Look carefully in the deep dimple just at the coccyx and see if it is clean. Now pin the band snugly, but not too tight. Use the smallest safety pins, and never pin directly over the spine. Sometimes the abdomen is very large and it will be necessary to make two little tucks in the lower edge of the band in front to make it fit snugly.