If, unfortunately, the doctor should not leave full and adequate instructions on any point, the nurse should ask for them, and if it becomes necessary for her to act -without instructions, she should do so quietly and without calling the patient's attention either to the doctor's omissions or her own cleverness in doing with out them. The knowledge of either of these two things would be disturbing to a great many patients.
No first-class nurse is noisy ; she does not bang the door when she goes out, nor yet does she continually leave it creaking ajar; she is not continually knocking against the furniture; she does not mend the tire with much rattle of fire-irons at any time, still less when her patient is asleep.
No nurse should be engaged who expects any alcoholic drink to her meals or at any other time.
Difficulties will be prevented if the patient, when engaging the nurse, lets her know exactly what the size and arrangements of her house hold are, and to what extent the nurse can depend on assistance. This is easily done if the nurse calls on the patient at her own house, and sees the room, &c., before the engagement is made.
The Room, as the room is called in which the mother expects to spend the time of her confinement during and after delivery, should be selected some time before the event is due.
It should be as large an apartment as is available, well-lighted, with a fire-place. That the chimney is clear, and that the fire will burn properly, should be made certain. The windows should be capable of opening above and below. If the sashes are loose, so that the window rattles in its frame, a little wedge should be attached to the window to prevent this. Such little wedges are now purchasable for a copper in any ironmonger's.
The room should be so shaped that there is a space in which the bed can stand out from the wall, without being in the draught between door and fire or window and fire.
If the floor is well made and jointed, it would be best bare, except for a rug here and there, which can be lifted and carried outside for shaking. The floor, in such a case, would be thoroughly scrubbed in anticipation of the confinement. If the room is carpeted a very thorough brushing is needed beforehand.
Hangings of any kind are an abomination in the lying-in room, harbouring dust. All hang ings should be removed wherever possible; all that is needed is something of the nature of a fresh muslin curtain to shade the room in bright sunshine.
Bare walls, free of brackets and heavy pic tures, are also desirable, and it would be well to have them brushed down iu time.
The less furniture there is in the room the better. A plain wooden table, covered with a white washable cover, and two plain chairs are sufficient. A chest of drawers, which have been cleared of all accumulated rubbish, and which are devoted to the materials and clothing for mother and child, would be useful. A plain or marble-covered washstand, with a plain water jug and basin, a soap-dish, a water-bottle and tumbler, a dish for nail and tooth brush, these are also permissible. But the water-jug must have a wide enough mouth to permit the hand to get in with a brush to cleanse it thoroughly inside, and the other dishes should also be of size and form to permit of thorough cleansing outside and in. The water-jug ought not to be converted from its proper use to a receptacle for dusters, soiled handkerchiefs, and sundry odds and ends, but should daily be washed out and filled with fresh water. If the wash-stand has small cupboards, they should be washed out and kept empty. A pedestal for a chamber should be banished from the room. No other furniture should be in the room if it is possible to avoid it. If heavy wardrobes or such articles can by any means be moved elsewhere, this should be done well before the expected date.
Furniture, it must not be forgotten, occupies air space, of which there cannot be too much for a woman who is to be confined there day and night for two or three weeks.
All hangings and ornaments should be re moved from the mantel-piece, and all the knick knacks, that harbour dust and dirt, from any dressing-table that is allowed to remain in the room.
If in the house there are two rooms opening into one another, and the domestic requirements do not prohibit it, these should be selected, and one given up to the nurse. As far as possible the nurse should make all her preparations, and arrange that the child shall be washed and kept there, except when at the breast, to give the mother as much quiet as possible. All these arrangements should be made in good time, lest the birth occur sooner than is expected and everything be found in confusion.