,,making ,,good ,,on ,,private ,,duty ,,making ,,good ,,on ,,private ,,duty ,,practical ,,hints ,,to ,,graduate ,,nurses ,,by ,,harriet ,,camp ,,lounsbery1 ,r4,n4 ,,president ,,west ,,virginia ,,state ,,nurses' ,,association ,,sanitary ,,school ,,inspector ,,for ,,charleston ,,independent ,,school ,,district ,not to be ministered unto1 but to minister ,,preface ,though technic is constantly changing1 methods improving1 and the teaching in our schools grows better and more comprehensive1 the old problems in private work are ever to be faced1 and still the young sister in our nursing world needs to be counselled1 guided and helped4 ,it is for these young private duty nurses that this book has been written4 ,for six years ,i went up and down one of our large cities doing private nursing1 and ,i can remember1 as if it were but yesterday1 the curious little sinking of the heart ,i used to feel1 as ,i mounted the steps of a house where there was a new patient needing my care4 ,would ,i do everything right8 ,could ,i please the patient and the friends8 ,would the doctor be satisfied with my efforts8 ,how would ,i feel when ,i was leaving8 ,encouraged or hopeless8 ,happy or sad8 ,a strange house looks so forbidding1 would this one ever look friendly8 ,there is time1 while walking up the steps1 for these and many more such thoughts to crowd into the nurse's mind4 ,once in the presence of the patient1 however1 all this quickly changes1 and action puts all wondering and doubt to flight4 ,the hints here given are the fruit of my own experience and that of the graduates of the school of which ,i was the superintendent4 ,many long talks we had1 when they felt the need of coming back to their hospital home for advice and comfort4 ,it is an earnest wish to help the young graduate over the intricate paths that the inexperienced nurse must often tread that has led me to revise some early contributions ,footnote3 ,printed by permission of the ,trained ,nurse4 to the ,trained ,nurse and write a few new ones1 which have within the past year appeared in the ,american ,journal of ,nursing4 ,in the chapter ,hints to the ,obstetrical ,nurse1 there is little or nothing that is commonly taught in the class-room4 ,all of that is so well done1 repetition here would be tiresome4 ,all the asepsis is familiar to every graduate4 ,she knows how to sterilize any and every thing1 but sometimes she does not know the best way to wash and dry the baby's little shirts or knitted shawls4 ,sometimes she will not realize that if the layette cannot be purchased at a store1 old table linen makes the best diapers for the newborn baby1 and that his pillowcase should not have embroidery in the center4 ,i wish in this part to give the nurse such hints that she may be able to help any woman who wishes to prepare for her confinement4 ,i have been asked so many times to tell a young expectant mother just what to get1 that ,i have made for convenience as full a list as is necessary for any baby or mother1 with some hints as to the washing of the baby4 ,the rest it is expected every nurse who graduates from a training-school would know4 ,the table for calculating an expectant confinement was cut from a medical paper and given me by a physician some years ago4 ,he did not know who wrote it1 nor do ,i1 but he always used it1 and ,i have found it most accurate4 ,the recipes ,i have given are1 ,i know1 reliable1 having all been tested many times4 ,most of the articles of food every nurse has probably prepared1 but exact proportions have a dreadful way of slipping out of one's memory4 ,whether it is a pint of milk or a quart that must be mixed with two eggs for a custard might not seem much of a problem to a housekeeper1 but to a nurse who has perhaps not made a custard for a year it might carry many difficulties4 ,i have tried to help in this most important part of a nurse's duty1 and not only as to the food served the patient1 but the manner of serving it1 which last is truly to a sick person of as much importance as the food itself4 ,the few leaves ,i have left blank are for such additional recipes as every nurse will gather as she goes from house to house4 ,any cook will be glad to give some hints as to how she does this or that1 and no nurse should be too proud to learn from the cook1 or anybody else4 ,i shall never forget the fat little ,irish woman who taught me to make clam broth1 or how much pride she took in my first success4 ,to ask the family cook for advice is sometimes good policy2 she is often so ready to resent any extra work caused by the sickness or the nurse1 it pays well to conciliate her1 by asking for her aid or counsel4 ,to feel that she can teach the ,trained ,nurse will often make a friend of the cook1 and this will make things pleasanter all around4 ,it is with the hope that these homely and perhaps somewhat old-fashioned hints may be of real service1 that this little book is sent forth to do what good it may to those who are setting out on their professional careers4 ,it is ever to the young that we elders look1 knowing1 as ,mrs4 ,isabel ,hampton ,robb has truly said1 ,work shall be lifted from our hands and carried on to loftier ideals and higher aims by the strong young hands1 hearts and brains of future nurses4 ,h4 ,c4 ,l4 ,charleston1 ,w4 ,va4 ,,contents ,,chapter ,i4 ,,the ,,nurse ,,and ,,her ,,patient ,,ii4 ,,the ,,nurse ,,and ,,the ,,doctor ,,iii4 ,,the ,,nurse ,,herself ,,iv4 ,,the ,,nurse ,,and ,,her ,,patient',s ,,family1 ,,friends ,,and ,,servants ,v4 ,,general ,,remarks ,,on ,,foods ,,and ,,feeding ,,vi4 ,,the ,,nurse ,,as ,,relating ,,to ,,her ,,training ,,school ,,and ,,to ,,her ,,fellow ,,nurses ,,vii4 ,,why ,,do ,,nurses ,,complain8 ,,viii4 ,,the ,,nurse ,,as ,a ,,teacher ,,ix4 ,,convalescence ,x4 ,,how ,,shall ,a ,,nurse ,,occupy ,,her ,,days ,,of ,,waiting8 ,,xi4 ,,some ,,hints ,,for ,,the ,,obstetrical ,,nurse ,,xii4 ,,as ,,to ,,washing ,,the ,,baby ,,xiii4 ,,the ,,valley ,,of ,,the ,,shadow ,i ,,the ,,nurse ,,and ,,her ,,patient ,you may think it unnecessary for me to tell you any more about the patient4 ,you will say1 perhaps3 ,have ,i had all this training1 and must ,i yet be told how to treat a patient8 ,i answer that you have been taught how to watch the progress of disease1 how to follow intelligently the doctor's orders1 also certain manual arts1 your proficiency in which is unquestionably most necessary1 but there is much more comprehended in the meaning of the term a good nurse than this4 ,how often do we hear stories of nurses who were good--but--who were skillful--but-- and after the but comes a long list of such faults as do not show so much in hospital life1 where the routine and the many rules and the constant supervision make them less likely to become prominent4 ,she bangs the doors4 ,she breaks the fine china4 ,she wears heavy shoes1 or ,she talks too much1 or ,she is pretty and spends too much time over her front hair--but why go on8 ,you have all heard such tales--ad nauseam1 and if you are wise1 you will set up a sign-post against every one of these snares into which your sister nurses have fallen1 and on this you will print in large1 clear letters3 ,danger6 ,walking on this place forbidden4 ,so much by way of apology for treating you once more to a lecture on the patient4 ,the relation between nurse and patient should1 from the first1 be a more than amicable one4 ,you have come to bestow the priceless blessing of unwearied1 skillful care upon one who should thankfully receive it1 and believe me1 if you do not go to your patient with a feeling of thankfulness to ,god for allowing you to assume such a sacred trust as the care of a human life1 you are in no condition to undertake the work4 ,your nursing should be1 in a way1 an exponent of your own spiritual state2 looking at it in its highest aspect1 an outward and visible sign of an inward and spiritual grace4 ,in the first place1 then1 you must be in entire sympathy with the sick one--and here do not mistake me--by sympathy ,i do not mean sentimentalism4 ,the two emotions are as far asunder as the poles4 ,sympathy1 then1 you must have1 and if you do not intuitively feel it1 let me tell you what to do to rouse your dormant feelings4 ,try earnestly to put yourself in the patient's place4 ,has she had an operation of some kind1 and you have all night been trying to keep her quiet on her back1 and she has been begging you to let her turn never so little8 ,when you go to lie down1 and have1 perhaps1 a backache1 and feel tired1 instead of settling yourself in the most comfortable position you can1 lie straight and square on your back and say to yourself1 ,now ,i can't turn over1 and imagine you have by your side a nurse who will not let you turn4 ,you will find out in the course of an hour that your patient has had a good excuse for all her complaints1 and the next night you will know just where to slip your hand in the hollow of the back or under the shoulders to give a little ease4 ,the patient will profit by such exercise on the part of the nurse1 and your sympathies will be quickened4 ,never forget that the patient is sick1 and you are not4 ,you can1 you must be firm in what you know is for your patient's best good1 but you must never be dictatorial or argumentative4 ,it is hard1 ,i know1 to bear with all the foolish1 unreasonable whims of sick people1 but if you are true nurses you will do it4 ,there are1 however1 several consoling thoughts which have always helped me1 and which ,i will tell you4 ,in the first place1 always remember1 as ,i said before1 that the sick one is sick1 and on that ground you can overlook much4 ,in the second place1 remember that it will not last long4 ,a few days or weeks will surely bring a change4 ,she cannot1 in the nature of disease1 remain for long in the very trying stage1 unless indeed she have some kind of mania1 and of course if that is the case1 you need pay no attention to her whims4 ,if she says white is black1 let it go4 ,it does not make it so to have her say so1 but if you argue the point1 and bring all your wisdom to bear upon your demonstration1 you may bring her pulse and temperature up to a point that will do her a real injury4 ,tact1 as you know1 is worth everything to you1 and by it you will win your way to all hearts4 ,try then to feel as the patient does1 and you will know by instinct how to treat her1 and will1 perhaps1 be often rewarded for some little deed by the pleased surprise with which she will say1 ,how did you know ,i wanted it done8 ,you need not tell her how you knew1 but you may be sure she will appreciate you all the more for your prescient thoughtfulness4 ,her pillows may be flat and hot1 her hair uncomfortable1 her under sheet wrinkled or untucked from the bottom2 all these and a dozen more little things can be arranged so easily1 and they conduce so much to the sick one's comfort when done1 that you must ever have them in your mind4 ,be most careful also as to your patient's belongings1 her top drawer1 her various boxes1 and her linen closet4 ,you must keep all these things just as she did4 ,you may think it a very foolish thing for her to have three piles of handkerchiefs1 each of a different age1 or degree of fineness1 but if that is her way1 she will be better satisfied if she knows you will not lay a fine handkerchief over a more common one4 ,so keep them as carefully divided as if they were the two parts of a ,seidlitz powder4 ,hang her clothes up carefully whenever she goes back to bed1 be it once or oftener during the day4 ,separate them and hang them up2 don't pick all up together and put them over a chair4 ,put her shoes away1 lay the stockings on a shelf or put them inside the shoes4 ,fold her pretty shawl or kimono and lay it in a drawer4 ,let her see that you know a good thing1 and know how to take care of it4 ,put away fine china or glass and bric-a-brac1 if she is very ill1 and you need space for necessary glasses or other articles4 ,it will be a pleasant way of beguiling the tedium of some long day in her convalescence to bring forth and arrange them in their accustomed places4 ,be careful of books1 table-covers1 and all the articles of luxury and beauty you will find in many of our city houses4 ,remember that these things belong to some one else1 though you are for the present custodian1 and think how provoked you would feel if some stranger should come to your home1 and1 even if she did nurse you back to health1 she left many nicked plates1 broken vases and handleless cups behind her4 ,i think you would not want her to nurse you again4 ,i saw recently in an ,english magazine devoted to nursing1 a very clever article on ,talk4 ,the writer1 a nurse1 thought subjects were scarce4 ,she says3 ,we must not talk to the patient about her own complaint1 that would make her morbid2 or about the doctor1 for that would be gossip2 or the hospital1 for hospitals are full of horrors2 or the other nurses1 for that might lead to talking scandal2 or about other patients1 for that would be betrayal of confidence4 ,now what are you to talk about when a patient is well enough to talk1 and your talking to her will not hurt her 7but on this point be very sure before you air your eloquence78 ,it is indeed quite a question1 and the nurse must often use all her ingenuity to keep the patient to the right subjects1 for even patients1 though they hold it so reprehensible in a nurse to talk gossip1 do not disdain to serve up their neighbors occasionally to the nurse1 with some very highly seasoned scandal sauce1 and here the honor of the nurse must come into play2 let her forget it if possible1 as woe will betide the poor girl if in her next place she unwittingly lets out any of the secrets she has heard in these long talks4 ,try then to steer clear of the neighbors4 ,if your patient be a cultivated person1 and you yourself know anything about books1 you have a never-failing topic4 ,all the latest books1 the famous books1 the most entertaining books1 and if you can read aloud and the patient likes to hear you1 read to her1 and it will do both good--only be sure not to tire her by reading too much at one time4 ,talk of interesting places you have visited and she will do the same1 of pictures you have seen1 and last1 but not least1 you can talk about clothes4 ,generally the first serious piece of business a convalescent concerns herself about is the purchase and making of some new clothes4 ,she wants something new and fresh1 and if you can give her any new ideas on the subject or tell her of any pretty materials you have seen in the shop windows1 you will prove as entertaining as if you talked on any of the forbidden topics1 and many times more useful4 ,i would like1 in closing this chapter1 to say a word as to reading the daily papers4 ,if your patient is a woman1 she will want to know just about what you1 yourself1 would be interested in1 and this is very easy2 but if your patient is a man1 it is harder to know what he will want2 politics1 the money market1 etc41 which most women skip over4 ,if then your patient is a man1 commence on the first page and read slowly the headings of the news items1 when one strikes him1 as desirable to hear1 he will tell you to read it2 when you get through the news you may turn to the editorial page and do the same there4 ,unless you know your patient very well do not attempt to enlighten him as to the stock market quotations1 for it is1 ,i suppose1 well nigh impossible for an ordinary woman to read them so that a man will understand her4 ,he will probably laugh over your well meant endeavor1 and ask you to kindly let him look at the paper1 when he will in a moment find out what you have been trying to say4 ,,ii ,,the ,,nurse ,,and ,,the ,,doctor ,i suppose no nurse goes through a training school without being duly impressed by all the doctors on the staff of lecturers that they1 the doctors1 are the generals of the campaign4 ,she and her fellows are the aids1 and that she will be kind enough to remember this fact1 and not make suggestions to him1 the doctor1 or give him the fruits of her ripe experience of three years in a hospital1 and more or less time1 as may be1 since she has graduated4 ,but though this ,i think you all know1 there are some points of your connections with the doctor which may not be quite so clear4 ,in the first place1 then1 remember that you are his aid1 you are to help him in every way you can1 you are never to work against him1 never weaken the patient's confidence in him4 ,if you do not understand why he does thus and so1 ask for an explanation1 if you know him pretty well1 and if your questions are reasonable ones1 and intelligently put1 he will be glad to answer you1 and explain all you wish explained2 but if you do not know the reason of a certain order1 and1 moreover1 if he will not tell you1 do not assume that he does not know1 or that he is cross2 it may be some very uncertain1 delicate experiment is being tried1 and all he wants you to do is to tell him1 with a free unbiased mind1 what you see4 ,always1 however1 be loyal to him with the patient4 ,when you are asked a thousand questions as to1 ,why doesn't the doctor do this1 or why does he do that8 you can always say that he does it1 or does it not1 for the patient's best good1 of that you are assured1 and they must be also4 ,you collect the facts and put them in an orderly way before the doctor2 upon your observations and reports he bases his theories of the disease in many cases4 ,you can see what perfect faith he must have in you1 and how true you must be to him in order to secure your patient's best good4 ,i have often heard doctors say1 when speaking of a favorite nurse1 as if it was the only virtue worth mentioning3 ,i am perfectly certain that when ,i am not present she will faithfully carry out my orders4 ,entire faithfulness takes precedence1 ,i think1 and deservedly so4 ,your accomplishments may be many1 but if you have not this faithfulness1 this obedience to the doctor as a rudder to the ship of your professional character1 no matter how great may be the load of learning and accomplishments and good intentions1 your self-will and vanity will bring you to the rocks where ruin is inevitable4 ,do not fear losing your own individuality and independence4 ,he who obeys well1 governs well1 is a very old1 and a very true saying1 and your responsibilities will never cease4 ,the more faithful you are to orders1 the more trust and confidence will be reposed in you4 ,you will have not only your patient1 but the entire family looking to you for directions1 for1 upon your faithfulness1 and the tact with which you administer your authority1 will depend much of your success as nurses4 ,be careful not to sever your relations with any patient unless your doctor knows all about it4 ,never leave your charge1 no matter how urgent the reason may be1 unless you tell him4 ,you may be sick1 or the place may be unsuited to you1 or you to the place1 and you may know that it is best for you to go4 ,but speak first to the doctor1 tell him candidly why you wish to go1 and take counsel of him how you should act4 ,if he tells you you may go1 and you know that your place must be filled1 do not offer as your substitute your best friend1 or anyone else4 ,if he wishes your counsel he will ask1 and then you may tell him of anyone you think will suit the position1 but do not offer your friend1 as he may have some favorite of his own to put in your place4 ,of course the patient or her friends must know about the contemplated change-- that ,i take for granted4 ,having consulted the doctor1 will make everything satisfactory to the most careful practitioner4 ,so1 as said before1 never go away from your patient1 leaving in your place a nurse whom the doctor does not know4 ,he has1 in most cases1 selected you for his patient1 and he wants you1 you may not be all he wishes you were1 but still such as you are1 there you are1 he knows what you can and what you cannot do2 and it is a great piece of impertinence for a nurse to go away unknown to the doctor1 leaving a stranger in her place4 ,the consequence1 so far as he is concerned1 will most likely be to have her name crossed off his list as unreliable--so be careful4 ,as to your records1 keep them faithfully2 the doctor usually looks them over very carefully1 but sometimes you find one who passes them over in a lofty manner1 rather trying when you take such pains with them4 ,you may conclude that it is not necessary to keep them accurately in such a case1 but this same doctor may ask you some day how long ago it was that the patient's temperature took such a sudden rise1 or how many days it is since she first had solid food1 and if you have accurately kept and carefully preserved your records1 you can tell without a moment's hesitation4 ,it is better1 more business-like1 and every way to be commended1 that the nurse should keep1 and be exceedingly particular about these records4 ,if the doctor will write his orders on the fresh daily record at his morning visit1 it is a great help to the nurse1 but very often he is in a hurry and you must write them yourself4 ,if you have to do this1 take your record and write as he tells you1 when he tells you4 ,if the orders are at all intricate it is your only way of being absolutely sure you have everything correct4 ,it is a protection to you also1 if the family are inclined to criticise4 ,a nice little point for you to remember is always to leave the doctor alone with the patient for a few moments1 if it is at all possible1 at each visit1 ,wait until he has asked all the questions he wishes1 or until you have told him all that is necessary to tell before the patient1 and then on some errand1 real or imaginary1 leave the room4 ,of course1 if the patient is desperately ill1 you cannot do this1 nor will it then be necessary4 ,it is a good plan to wait for the doctor at the head of the stairs1 or at the foot1 if you are likely to be over-heard1 and tell him there all you could not say before the patient as to her condition1 etc4 ,he likewise may have something to say1--some final instruction to give1 some caution he would not wish the patient to know of4 ,this is also the time to speak about yourself if you are sick or tired1 or unhappy in your position4 ,perhaps neither of you have anything to say1 and a friendly nod and a patient is doing nicely1 nurse1 will send you back to the sick- room feeling that your work is appreciated1 which always goes a long way toward making the hard places easy4 ,your patients may be very curious as to what you have to say to the doctor1 but you can readily and truly tell them that there are many things you have to say to him1 that would be hard for you to say before them1 and hard for them to hear too1 and these are things you arrange outside4 ,always be sure to have on a convenient table1 if your doctor be of a homoeopathic school1 a little covered tray1 and on it two glasses1 clean1 and turned upside down to keep them from dust1 teaspoons and covers for the glasses1 also a small pitcher of fresh water4 ,many doctors of the old school also use some medicines in water1 so it is best to have glasses always at hand4 ,do not sit down when the doctor is making his professional call1 unless he or the patient requests it4 ,he will probably sit at the side of the bed1 your place is at or near the foot4 ,if the doctor knows the patient well1 as a friend1 and is inclined to stay a long time1 chatting1 you can go quietly to another part of the room1 and take up your work or reading1 but be sure the doctor has finished asking you questions before you go4 ,use sparingly technical terms4 ,if your patient's feet are oedematous1 tell the doctor they are much swollen2 if he ask if they are oedematous tell him yes1 but do not volunteer to name the peculiar kind of swelling4 ,if the abdomen is tympanitic1 tell him it seems much distended2 and if he questions much further1 answer the questions fully and intelligently4 ,if your patient has the symptoms of phlebitis1 tell him of the rise of temperature1 the swelling of the leg1 the tenderness along the course of the vein1 and he will know that you know and appreciate the gravity of the disease2 but be sure you do not attempt to give the symptoms a name1 that is not your place4 ,i would have you be very careful as to what instruments you carry2 have them of the best4 ,let your thermometer be of the very best make4 ,there is nothing more trying in a small way than to have your thermometer doubted1 and if you know it is the best the market affords1 if you take it to the instrument maker and have it tested once in a while1 you need not fear1 when you find an unusual temperature1 and report it to the doctor1 and he quietly proceeds to test your thermometer by his1 which of course is always correct4 ,be sure that your hypodermic syringe will work2 if the piston slips loosely after much using of brandy1 aromatic ammonia1 etc41 take it to be repaired1 and see that the needles are sharp1 they become dulled very quickly2 keep also the tiny wires pushed through them4 ,it is just as well to keep this syringe in the room1 its little case is very small and unobtrusive1 and if you keep it near your thermometer in some safe1 handy place1 you will have it when some unforeseen emergency arises1 and you do not want to lose time going to your room for it4 ,,iii ,,the ,,nurse ,,herself ,it is just as necessary for the nurse to be careful of herself as of the patient1 though her care must be manifested in a far different way4 ,always remember that to do really good work you must have really good tools4 ,no man owning1 and intelligently working a valuable machine1 would keep it going at its highest speed all the time4 ,he takes care of it1 keeps it clean1 renews defective parts1 oils it2 and then he expects it to run for so many hours1 and to run well1--to do its work thoroughly4 ,but with all his keeping it in order he does not make it work night and day for weeks or months4 ,such folly is never heard of in an engineer2 but with us human beings1 who own and manage a far more wonderful machine than any steam engine1 we hear of it often1 and always1 always the tale winds up with the inevitable catastrophe4 ,the business man develops paresis1 the clergyman loses his voice or his eyes1 the nurse contracts some disease that incapacitates her for work1 in every case mother ,nature makes the careless or ignorant owner of the wonderful machine pay the penalty of the misuse4 ,it does not matter to ,nature what the reason is for our breaking the great laws2 we can kill ourselves with philanthropic work just as surely as with over indulgence4 ,one trouble is1 that it does not always kill4 ,a paralytic may live for years1 so does a man with paresis4 ,when the wonderful ,god-given machine works badly1 or stops entirely1 we look on1 and sometimes wonder why it is that those who are so helpful1 such fine examples of courage1 of skill1 of virtue1 so hardly to be spared1 are the ones to be taken away4 ,do we wonder1 we who are nurses8 ,do we not know what did it8 ,ah6 yes--we know1 we know1 that such and such a nurse was tired out when she went to still another case-- and when we heard she herself was ill we were not slow to say1 ,foolish girl6 ,did she suppose she was made of wrought iron and sole leather8 ,but will we take heed1 and not do likewise1 or will we wonder1 with the unthinking ones1 why it is that the good1 useful people are always taken away8 ,do not deceive yourselves2 they are not taken away1 they take themselves away1 for ,god will not reverse ,his wise laws because we 7no matter how good we are7 act in defiance of them4 ,please remember ,i am only speaking now to the good nurses--the enthusiastic ones1--poor nurses1 lazy nurses have no temptation to overwork themselves4 ,they may die of indigestion1 but they will not die of exhaustion4 ,it seems to you so natural for others to be sick4 ,you have seen the sick by scores in the hospital1 and have waited on them1 felt sorry for them1 sympathized with them2 but have you thought that it was within the bounds of possibility that you could ever come into such a pitiable condition8 ,you go from house to house in your private nursing1 always you find the sick1 and it seems natural1 quite the proper thing4 ,you care for them1 they get well1 or die--and on you go to the next--but reflect on what made them sick1 and though you know you are made of like flesh and blood1 do not conduct yourself as if you were not4 ,oh1 yes 7how often have ,i heard it said71 ,i know she worked too hard1 but ,i am so strong1 you never heard me complain2 ,i can nurse a fever case for two weeks and never go out of doors for air or exercise4 ,is it not foolish8 ,is it not wrong for any sensible woman to talk thus8 ,now listen to some few practical hints as to how to keep yourselves in good working order4 ,in the first place1 then1 never go to a case unless you are feeling well4 ,it is far wiser1 as far as you are concerned1 and better also for the sick one1 for you to say so frankly1 if you are not well4 ,tell the one who comes for you1 that you could not do justice to the case1 as indeed you could not4 ,sick people are as sensitive as babies to the subtle influence exerted by the one who is so constantly over them4 ,if you are in full health and strength1 your rubbing will be quieting and effectual1 your very presence1 if you are careful and gentle1 will be soothing4 ,on the contrary1 if you yourself are suffering and are using the nervous force you ought to be giving your patient in hiding your own malady1 your presence will not be so eagerly welcomed2 your patient will not know what is the matter1 but she feels rather a relief when you are absent4 ,going to a case feeling perfectly well1 the next thing is to keep well4 ,be careful about your eating4 ,your meals will of necessity be often irregular1 that is unavoidable1 but eat only wholesome things4 ,do not eat candy2 and at dinner1 which you will probably have in the evening after the family are through1 avoid patties1 and rich puddings1 ice cream1 and such like4 ,you will always find plenty of plain food and fruit in the most luxurious homes2 eat these and let the rest alone4 ,if you want to keep your stomach and whole digestive apparatus in good order1 you must care for it1 and not overtax it4 ,if you have a pretty good stomach it will bear a good deal of abuse1 but in the end it will grumble1 and a dyspeptic nurse is not an attractive object4 ,as to your night suppers1 which you should always have1 should your case require constant watching1 ,i would recommend plenty of coffee1 tea1 or cold milk1 if you can drink it1 bread and butter1 cold meat and fruit4 ,never eat candied fruits1 cake1 or pies at night4 ,have eggs if you care for them1 and pickles if you like4 ,remember1 the plainest food1 the most easily digested1 the most nourishing is what you must have4 ,believe me1 you will be rewarded for the temperate use you make of all the dainties you see1 by a clear complexion1 and good color1 which will make you good to look at1 especially good for a sick person to look at4 ,as to the nurse's night toilette1 it is quite a problem sometimes as to just what is best to wear4 ,when the patient is not ill enough for the uniform to be retained for night duty1 the nurse should be comfortable enough so that she can sleep2 yet dressed enough for any emergency4 ,i think a house gown of pretty material much neater than the kimono4 ,be sure this fits about the shoulders1 and never have loose flowing sleeves4 ,a white frill in the neck looks very trim1 and is always becoming4 ,the corset and all tight clothes should be removed1 stockings and underwear kept on4 ,the hair should be arranged simply1 but not allowed to hang in a loose braid1 unless you are very sure you will not see any but the patient1 and even then it may be unwise1 as a braid of hair has an exasperating way of slipping from its proper place 7hanging down the back7 and dipping into whatever you are stooping over4 ,dressed thus1 with night shoes to protect the feet1 one can lie down on a lounge and sleep very comfortably1 being freed from tight clothes1 and yet being entirely presentable1 no matter what happens4 ,to undress regularly and put on the diaphanous low-necked short sleeved night dress of the present mode1 and go to bed1 when you are sure you will have to get up one or a dozen times during the night is not good judgment1 ,i think4 ,you get out of a warm bed1 and if you only put on your shoes and stockings1 your patient must wait while you do it4 ,if anything serious occurs suddenly1 you either run the risk of taking cold from being insufficiently clad while doing what must be done1 or your patient must wait while you dress--both bad4 ,never get into bed with your patient4 ,this seems to most people a quite unnecessary caution1 but it is the commonest experience of the successful nurse1 that a woman1 feeble and nervous1 should ask and almost insist that she shall lie down by her1 or get into bed with her4 ,i always wonder that a sick woman can not realize that she is not a pleasant bed-fellow1 but she seldom does4 ,of course you are not to tell her that she is not fit to sleep with1 but you can say that she needs and ought to have the whole bed to herself1 and you will sit by her and hold her hand1 or if she insists on it1 you can lie down1 with your house gown on1 on the outside of the bed1 being careful to give her plenty of space1 and when she is asleep1 get up quietly and lie down on your lounge1 which should be placed so that you can see her every movement4 ,never let the patient think for a moment that you fear her disease2 if she has diphtheria1 do not tell her or the family that you have a delicate throat or that it is sore1 and do not examine it by the help of a hand-glass where any one can see you4 ,do not go to such cases if you really fear them1 but if you go1 and have reason to feel that you have contracted the disease1 tell the doctor as soon as you can1 and if he thinks you ill1 he will send you home4 ,never tell a patient you have a weak back or any weakness4 ,tell the doctor and he will see to it that you have rest or medicine1 but do not let the patient know it4 ,never go about a sick room with a long face2 it is enough for the sick one to have to be sick2 the family sympathies are all enlisted for her4 ,you are there to be a help and a comfort1 not an added anxiety4 ,of course these remarks do not apply to any of you who are tired from a long1 exhausting case4 ,the family in such instances are ready and willing enough to let you rest4 ,keep your cheery manner3 all higher considerations aside1 it is money in your pocket to look cheerful4 ,i have known one or two good1 faithful1 conscientious nurses who were dismissed from case after case1 merely because they looked so doleful4 ,it may seem curious to place a commercial value on a smile1 but in reality it amounts almost to that4 ,be very careful to have your dresses fit you perfectly1 and have them well laundered1 especially do not have them too stiff4 ,in this connection ,i cannot do better than to relate an incident that ,i heard of some time ago4 ,a nurse went to care for a patient whose first nurse had been called to her own home1 and she had not been in the room an hour before the patient called her and taking her hand said1 ,my dear1 ,i can't tell you how thankful ,i feel that your dress is not too short in the waist4 ,miss----'s dress was frightful6 ,this was only a nervous woman's whim1 but our success as nurses depends in many cases on just such whims1 so it is well to be careful4 ,when the patient is well enough for you to come to the family table at meal time1 be sure to have on a spotless apron1 and let no sickroom odors announce your presence4 ,it is worth more to a nurse to have soft1 dry1 warm1 sympathetic hands1 than to have the prettiest face ever seen under a cap1 so be careful of them2 after using any antiseptics always have at hand glycerin and rose water1 cold cream1 or something soothing to use4 ,never put a cold or clammy hand on a patient4 ,if it is cold and dry it can be laid on a hot1 aching head1 but never do so if it is the least damp4 ,if the hand is always damp1 pour on it a little alcohol1 or eau de cologne1 if that is preferred1 or some toilet water1 then put it on the patient's head1 and it will be all right4 ,a simple and very cold lotion is alcohol and water1 about equal parts1 and a piece of ice added4 ,hold your hand in this a moment and then gently comb the patient's hair 7that which grows on top of the head7 with the dripping fingers1 taking care not to let any cold water-drops fall on the face4 ,this is wandering somewhat from my subject1 but ,i will let it stand and speak of one more thing that is good to remember4 ,never lay a warm hand on a patient's head1 or a cold one on the body4 ,if you have to rub your patient's body1 and your hand is warm and damp1 shake a little talcum powder into it1 or use a little cold cream1 cocoa butter1 or lanolin1 and the dampness will not be perceived4 ,alcohol may also be used1 or bay rum4 ,some nurses are much troubled by excessive perspiration1 especially under the arms1 any hard work making the dress quite wet4 ,the ordinary shields are not very good1 as they are not absorbent enough4 ,a piece of flannel basted inside of the shield is a help1 as that is absorbent4 ,the auxiliary space might be bathed with a solution of alum2 alcohol is good or alcohol with white-oak bark4 ,many preparations for this trouble are on the market1 most of them are good but some are expensive4 ,a late copy of the ,journal of ,nursing gives the following3 ,take two ounces of baking soda1 mix with half an ounce of corn starch1 and use as a dusting powder1 after the parts have been thoroughly cleansed and dried4 ,it will check the perspiration and remove every particle of odor4 ,this is very successful1 but ,i find it leaves a slight yellow stain on a white dress4 ,another remedy from ,journal of ,nursing is this3 ,zinc oxide applied to axillae twice a week1 after bathing at night1 will dissipate the odor4 ,if the perspiration has a disagreeable odor1 no effort should be spared to free oneself from what is a serious drawback to the acceptableness of a nurse4 ,be very careful not to contract any little annoying habits1 such as frequent clearing of the throat1 sniffing1 etc4 ,you may have a catarrh1 but use your handkerchief quietly2 such noises are very disgusting1 and these habits1 ,i am sorry to say1 are not rare1 and seem very hard to conquer4 ,i suppose that ,i have better opportunities to hear stories of nurses and their doings1 good and evil1 than some have4 ,i certainly hear some very curious things4 ,the most extraordinary was of a nurse who always made it a rule1 when she went to a patient's house1 to stipulate immediately for her hours off duty4 ,she thought she was doing a very clever thing1 and making a most commendable business-like arrangement4 ,it will not be necessary for me to show you what a lack of tact she exhibited1 and what an antagonistic feeling she aroused4 ,never kiss your patient or allow yourself to show any demonstrative affection1 unless you are very sure it will be welcome1 and be careful even then4 ,a kiss for goodbye when you leave the patient is usually quite enough1 and many ladies are repulsed by anything of the kind4 ,if you feel an affectionate regard for your patient1 you can show it by your constant thoughtfulness and your care4 ,do not fear that you will lead lonesome1 repressed lives2 if you are the nurses you ought to be1 you will have all the affection you want1 and often more than you know what to do with4 ,never do any sewing or fancy work for yourself until you are sure there is none you could do for the patient4 ,remember that she pays for your time1 and govern yourself accordingly4 ,read to her1 sew for her1 play cards with her1 but do not amuse yourself or regulate your wardrobe at her expense4 ,when ,i say sew for her ,i do not mean make her dresses1 but do the little odd things that mothers of families always do1 and which must remain undone if she is sick1 unless you do them4 ,do not write letters when on duty1 and1 above all things1 do not write with a scratchy pen4 ,to a nervous person the sound of a scratchy pen traveling over the paper is torturing1 and it can be heard even if you are in the next room4 ,a fountain pen is1 ,i think1 the best to use4 ,see that it is full before you go to your case1 and it will need no attention for three or four weeks4 ,this pen makes no noise as you write1 and you have it always at hand1 and if you have to leave your letter in haste1 you can put the cap on the pen and slip it in your pocket1 and no one is in any danger of finding fault with the nurse for leaving an open ink-bottle for somebody to tip over4 ,remember finally 7and ,i think1 from what ,i read in the daily papers1 you are in no danger of forgetting this71 that you are not domestics1 and1 while in an emergency ,i would have you shrink from nothing that needs doing1 ,i do not think you should do any washing4 ,cooking you will very often have to do1 but the ordinary housework does not come at all into your province4 ,if your patient is a chronic invalid1 ,i would have you make yourself useful in the house4 ,do the shopping1 order the meals1 anything that will show your patient you are anxious to help make the wheels of domestic machinery run more smoothly4 ,you must use all the tact you possess2 you will not find two houses just alike1 or two patients with the same tastes4 ,a lady in an emergency does many things she usually leaves to the servants4 ,so must you4 ,there is sickness1 trouble with the servants1 every domestic wheel turning with difficulty1 and1 if you have time1 if you can leave your patient without doing her an injury1 you can1 perhaps1 by some little service earn much gratitude from the family1 and help to remove the impression that trained nurses are so helpless and need so much waiting on4 ,in conclusion1 let me tell you1 with all the earnestness of which ,i am capable1 that upon each one of you rests not only the reputation of your school1 but1 in a measure1 the reputation of the profession4 ,no one needs to be told how much more widely known is an inconsistent ,christian than a faithful one1 how much harm one does and how comparatively little good comes of the others' faithfulness4 ,and it is just so with you nurses1 a careless nurse makes a far wider reputation than a careful one4 ,if one physician is unskillful or unprincipled1 the whole profession is not found fault with1 but the individual is blamed and another one found who will do better1 but it is not so in most cases where a nurse proves unsatisfactory4 ,the whole profession suffers and every nurse sinks more or less if one of her sister nurses commits an indiscretion1 or does any of the thousand things she ought not to do4 ,i recollect very well1 many years ago1 a ,brooklyn nurse1 of about thirty-five years1 married her patient1 a boy nineteen years old4 ,it made a great stir in the city1 and1 as ,i was living there at the time and the superintendent of a training school1 ,i had to bear my share of the odium cast upon all nurses4 ,for months after1 almost every one ,i met took pains to tell me that hereafter they would keep their young sons out of the clutches of the designing nurse1 and ,i doubt not1 such slighting remarks were borne by every nurse in town1 and it was not pleasant1 to say the least of it1 for any of us4 ,keep your standards high4 ,let nothing but the very best satisfy you1 as far as you and your work are concerned4 ,keep your mind well informed2 if it is full of scientific facts1 of skillful methods1 of good literature1 or fine pictures1 there will be no room in it for the memory of all the disagreeable things every one must encounter in one's work1 and if you do not remember them1 you cannot tell others of them4 ,finally1 remember 7and this lies at the root of it all7 to keep your hearts right1--ever thankful that you are permitted to pursue this high calling1 and ever striving to be more worthy of it1 with many prayers that your life and conduct may show1 what is better lived than talked about1 the grace and peace of ,god1 which verily do pass man's understanding4 ,,iv ,,the ,,nurse ,,and ,,her ,,patient',s ,,family1 ,,friends1 ,,and ,,servants ,try to realize when you go to a house where there is dangerous illness1 that the family is glad to see you when you come4 ,you have come to help them1 to stay with them1 to comfort them by your presence1 by your knowledge1 by your experience4 ,they have needed you1 have sent for you1 and are to pay you for your time4 ,there is a general sense of relief when you are once fairly installed in your place by the bedside1 yet you are a stranger4 ,your friend1 the doctor1 has told them what a treasure you are4 ,mrs4 ,this and ,mr4 ,that have perhaps let them know how invaluable you were when at their houses2 but yet they must look at you a little1 they must note if you make a pleasant impression on the invalid1 if you are as skillful here as you were somewhere else1 if you look with scorn on the plain furniture1 or how much you will be displeased that the bath-room is at the other end of the house4 ,they do not feel exactly critical3 they are too tired or too anxious for that2 but still1 unless everyone is too exhausted from watching to do anything but thankfully surrender everything to you1 you will be pretty closely looked after at first4 ,you must look for some espionage2 and it is only right that you should be subjected to it4 ,if your mother was lying very sick1 and some stranger1 having knowledge and strength superior to your own1 had to come and care for her1 would you not feel that though you were glad to see her1 glad she would give your mother the benefit of her superior skill1 yet you would wish to consider her a little1 to note when she did thus and so2 or if she did something you did not understand1 could you refrain from asking her why she did it8 ,be patient1 therefore1 with the suggestions of the family1 after all1 though you know the disease and the probable course it will run1 the chances for recovery1 and what to do in emergency1 etc41 they know the patient1 all her peculiarities1 her likes and dislikes1 and if you are wise you will get and keep many little hints from those who have cared for her before you came4 ,if she likes milk1 will she insist upon tea8 ,does coffee keep her awake8 ,does she hate the sight of gruel1 or beef-tea8 ,does she like much sugar in her drinks8 ,all these are little matters of individual taste that you must find out for each patient1 and if you have the necessary tact and forethought1 you never need ask the patient one question2 usually the friends are pleased to be consulted on such small matters1 and gladly tell you all you wish to know4 ,to be sure1 they generally tell much more than you asked for2 but that does not matter1 it is better to listen patiently for five minutes to someone's tiresome descriptions than to repulse them1 and so lose just so much kindly feeling from the one who wished to talk to you4 ,if the amateur nurse has been doing something actually wrong for the patient1 do not tell her so4 ,she did the best she knew how2 but say1 as pleasantly as you can1 ,i think perhaps this would make our patient more comfortable1 or ,the doctor thinks such and such things are not now necessary1 and it would be better to do this way4 ,then you can do what you know to be right1 and not hurt the feelings of the one who has preceded you1 and1 feeling your way carefully1 have everything just as it ought to be1 and no one's feelings will be hurt1 and no one will feel that you are looking down upon their ignorance2 and here ,i would say that in your little confidential talks with the doctor1 you could ask him to say a word to the family if they persist in doing what you know to be wrong4 ,ask him to give you orders before some of them1 and that will set you straight in a moment4 ,with tact1 that most invaluable gift1 you can get on with almost every one1 and when you find that there is no such thing as making friends with the family1 you can tell the doctor1 and he will let you go2 but such places are very rare4 ,let all see that you are thoroughly interested in your patient1 and do not hesitate to perform any little kindness that falls in your way for the rest of the family1 and you will win all their hearts without a struggle4 ,when you go for your rest1 be sure to leave carefully written directions for the one who is to take your place1 just as you do when in charge of a hospital ward1 you leave your orders written out when you go for your off duty4 ,show her how to keep the sick-room record1 and be sure she understands it all before you leave4 ,as for the visitors1 they are often difficult to manage1 and here again you must have the family help you4 ,of course no visitors are allowed until the doctor gives permission4 ,so far all is easy1 but when they are admitted you will do well to make a little plan with the family4 ,tell them the patient may be seen at such an hour4 ,perhaps between eleven and twelve1 perhaps between two and three1 just as you consider her brighter in the morning or afternoon4 ,ask them who of the first and dearest friends is the quietest and most discreet1 and then say that if they will kindly arrange for one visitor only to come each day1 it would be so much better for the convalescent4 ,the friends can always do this and they never object4 ,they tell ,mrs4 ,jones to come on ,monday at two1 and stay just fifteen minutes4 ,on ,tuesday ,mrs4 ,smith can come1 and so on1 until by the end of the week the arrangement ceases to cause any comment1 and soon1 if all goes well1 and the convalescence goes on without interruption1 your rules and extreme care can be relaxed to suit the patient's own fancy4 ,always carefully note if any visitor tires your patient1 and manage so as not to let her come again until the sick one has more strength4 ,it is better1 ,i think1 to sit in an adjoining room when your patient has a visitor4 ,this gives you a chance to come into the room when the person has stayed long enough1 and generally your entrance tells her very plainly that she ought to go1 and she departs without you saying a word4 ,if she does not1 you will have to tell her that the doctor is very particular about not letting the patient talk too much1 etc41 etc41 and get her out in that way4 ,be careful1 when the visitor has gone1 not to sit down and talk at length yourself4 ,give the patient a little nourishment1 turn over her pillows1 and if she seems at all wearied make her comfortable for a nap and let her sleep4 ,as to the servants they require pretty careful handling4 ,above all things1 keep on the right side of the cook4 ,if you have to go to the kitchen to do any of the cooking1 do not make a mess1 or1 if you do1 don't run off upstairs and leave it4 ,gather up your utensils and put them into the sink1 and let the water run over them1 and ask for the dishcloth3 and if you do it pleasantly1 the cook will probably tell you to ,niver need thim things1 and you will thankfully obey her4 ,if you really cannot stop to make all tidy after your cooking1 you can say1 ,i'm sorry to make you extra work with these dishes1 but ,i must hurry back upstairs4 ,some such little speech1 with a pleasant smile1 will make all things easy for you below stairs1 and for the sake of all the friction it will save you1 it is well worth the trouble4 ,often the cook will be glad to do the cooking if you tell her how2 be careful to tell her1 if it is eaten and enjoyed2 and never let her know if it is rejected4 ,get rid of it upstairs by some contrivance1 and be sure not to order that dish again4 ,in many cases of course the cook will know all the little dishes the sick one will fancy1 and you will have very little to do with her4 ,such instances are somewhat rare1 and very delightful when they occur4 ,if there is much extra washing1 you may have to use much diplomacy as regards the laundress2 and if it is very disgusting washing1 it is well to have a large pail1 with a cover1 upstairs4 ,thoroughly disinfect the clothes before you send them to the washing1 as the odors are often sickening1 and the laundress1 like other servants1 is very much afraid1 usually1 of clothing from a sick-bed4 ,carry or send the clothes to the washing as soon as possible after removing them from the bed2 never1 on any account1 allow them to remain in the room4 ,the nurse cannot be too careful as to the amount of clothes she sends to the laundry4 ,she should of course keep herself and the patient scrupulously clean2 but she must reflect that private families do not have an unlimited store of towels and sheets1 and if she is extravagant in this matter it will seriously detract from her acceptability4 ,in concluding1 let me remind you that all these hints are intended for nurses going from one strange place to another1 as you would in nursing fevers1 or short surgical cases4 ,nurses who have chronic cases need none of these rules4 ,they fall into a routine1 and if they are detained in the family for any length of time1 that shows that their work and methods are right1 as far as that patient and family are concerned4 ,but let them be careful when at last they leave the case1 and go amongst strangers4 ,the ways of one family are not the ways of another1 and they must exercise much discretion to accommodate themselves to the new environment4 ,v ,,general ,,remarks ,,on ,,foods ,,and ,,feeding ,always have all food presented to an invalid as tempting as possible4 ,use pretty china and glass1 if you are permitted to do so1 yet not the very finest the house affords2 that might make the patient nervous lest some evil befall it4 ,absolutely clean napkins and tray cloths1 a few green leaves about the plate1 a rose on the tray2 the chop or piece of chicken1 the bird or the piece of steak ornamented with sprigs of parsley1 the cold things really cold1 and the hot ones hot1 these are necessities of invalid's feeding1 that mark the nurse who has a proper appreciation of a sick person's delicate sensibilities4 ,have all plates1 cups and saucers hot1 when they are for the reception of hot toast1 coffee1 tea1 etc4 ,hot water plates are very convenient1 and easily procured at any large china shop2 but if they cannot be found1 put the hot plate containing the chop over a bowl of boiling water1 and cover with a hot saucer1 fold a napkin around the baked potato1 and you can carry the tray containing the dinner through cold halls and up staircases and it will arrive at your patient's room hot4 ,be careful not to fill the bowl so full of hot water that it will spill4 ,never fill a cup so full that it will spill its contents over into the saucer1 it makes a disgusting looking mess4 ,have all fruit cold1 oranges and grapes especially4 ,always look over a bunch of grapes and cut off the soft ones before you hand them to a patient4 ,if you have foreign or ,california grapes1 hold them for a moment under the cold water faucet and let the water run through the bunch1 and all the cork dust will then be washed out4 ,if you peel and quarter an orange for your patient never let her see you do it1 unless you are perfectly sure you will not get your hands covered with juice4 ,wash your hands before you bring it to be eaten4 ,be careful not to have any suspicion of grease about the beef tea1 broths1 etc4 ,a quick and easy way to remove all grease1 is to fill a cup or bowl brimming full1 let it stand a few moments that the grease may rise to the top1 tip the cup a very little to one side1 and the grease1 to the last atom1 will flow over the side of the cup2 pour your broth carefully into a clean hot cup1 and serve4 ,beef juice is more palatable with a little very brown toast4 ,remember1 that an invalid hardly ever likes any food made sweet4 ,no matter what the taste may be in health1 in sickness1 sweet things are nauseous2 for this reason ice cream bought at confectioners' is often rejected4 ,salt also must be used with caution1 if the mouth and lips are tender1 as is often the case2 use the salt sparingly in all broths1 etc4 ,if your patient cannot take milk1 when1 as in typhoid fever1 the doctor wishes the diet to be wholly or for the most part of milk1 try at first to remove the thick1 bad taste by giving a little pure water or carbonic acid water after it4 ,if that will not do1 mix the carbonic acid water with it1 and have both nice and cold4 ,if a glass of milk is too much 7and it will be in nine cases out of ten1 especially if it is cold71 give half a glass2 if that is still too much1 give quarter of a glass1 or put more water with it4 ,never repeat a dose 7of food7 if it nauseates the patient4 ,make some change in quantity or quality1 and you will1 if you watch carefully1 find out the right proportions4 ,a person lying flat down in bed cannot1 of course1 drink from a glass or cup1 and a feeding cup is apt1 by pouring too freely1 to cause choking4 ,a bent glass tube is the best arrangement1 the patient can drink easily through this1 and can regulate by sucking1 the rapidity with which the food is taken4 ,the tube should be cleaned immediately after each using1 and if any beef tea or other food cannot be dislodged by letting water run through it1 pass a string with a knot tied in it1 through4 ,make the knot big enough to touch all sides of the tube1 have it thoroughly wet1 and the cleansing will be easily and quickly accomplished4 ,if a patient prefers drinking from a glass1 and can be raised in bed1 always lay a napkin under the chin before you give the drink1 and on no account have the glass or cup more than half full1 if you do1 it will surely spill4 ,in giving medicine that tastes very bitter or unpleasant in any way1 bring1 at the same time with the medicine1 some water1 milk1 or whatever may be preferred1 to take after it4 ,also a napkin to wipe the lips1 especially if the patient be a man4 ,always keep milk1 beef tea1 etc41 covered in the refrigerator1 and1 if you can1 see that this is cleaned every day4 ,but this might cause the cook to feel aggrieved1 so ,i put it as a suggestion merely4 ,but if the refrigerator has a smell1 and the cook seems touchy1 the milk1 etc41 better be kept upstairs on some sheltered window-ledge1 and carefully covered4 ,if you have your own little refrigerator upstairs1 see to it that it is cleaned every day4 ,never put away anything in tin pails2 always use earthen or china bowls or pitchers4 ,,beef ,,tea4 ,beef from the round1 finely chopped and free from fat4 ,proportions1 #a lb4 beef to #a pint of water1 cold4 ,let the beef soak in the water1 stirring occasionally1 for two hours2 then put it on the stove and heat it until the red color disappears2 never boil it4 ,skim off all grease1 salt to taste4 ,,beef ,,juice4 ,round steak cut an inch thick2 slightly broil like beefsteak for the table1 cut into squares of an inch1 squeeze in a lemon squeezer1 skim carefully and salt4 ,serve either very cold1 or place the cup containing the juice in a bowl of boiling water1 stir carefully1 and as soon as the juice is warm serve4 ,if left a moment too long it is spoiled1 as it curdles4 ,one pound of beef makes an after dinner coffee cup almost full of juice4 ,,beef ,,tea ,,in ,a ,,bottle4 ,put into a ,mason's preserve jar1 tightly corked1 one pound of beef chopped as for ordinary beef tea4 ,put this into a kettle of cold water1 with a saucer on the bottom1 let it come slowly to a boil and boil for an hour4 ,take out of the bottle and squeeze the beef4 ,,scraped ,,beef4 ,take a piece of lean round steak1 scrape with the edge of a spoon until the place scraped has no more meat on the surface1 but only the white fibre1 cut this off with a sharp knife1 exposing once more a fresh surface4 ,season1 and spread raw on bread and butter1 or make into little cakes and broil slightly1 according to the doctor's orders1 or your patient's taste4 ,,mutton ,,broth4 ,mutton from the neck4 ,proportions1 #a lb4 of mutton to #a quart of water1 put the mutton and the water 7cold7 on the back of the stove1 let it come slowly to a boil1 boil until the meat is ready to fall from the bones4 ,after straining out all the meat etc4 add one tablespoonful of rice or barley4 ,simmer half an hour after adding rice or barley4 ,,clam ,,broth4 ,,no4 #a4 ,take #a qt4 clams4 ,strain off the juice and chop the clams fine1 return clams to the juice and simmer one hour4 ,put on to scald as much milk as juice4 ,strain out the clams1 thicken with a little corn starch1 making about as thick as cream1 pour juice into a bowl and add the milk4 ,,clam ,,broth4 ,,no4 #b4 ,same as above1 only cut off the hard part of the clams1 chop the soft parts and leave them in the broth4 ,for convalescents4 ,,clam ,,broth4 ,,no4 #c4 ,take little neck clams unopened1 wash them very clean with a brush4 ,place them on the top of the stove in a clean dry pan1 and when the shells open take them off1 remove the clams and pour the juice into a cup4 ,to be served hot4 ,if it is too strong1 add a little boiling water4 ,this is for very sick people2 give only a teaspoonful at a time4 ,it sometimes corrects nausea4 ,,chicken ,,broth4 ,a fowl1 not too young1 cut in pieces1 #a qt4 water to #a lb4 fowl4 ,put it on the stove in cold water1 let it heat slowly1 then boil gently until the meat is ready to fall from the bones1 strain1 skim and add rice1 boil once more for #a_/b hour4 ,salt to taste4 ,serve with toast or hot crackers4 ,,oyster ,,broth4 ,equal quantities of juice and milk1 put each in separate vessels on the stove2 when the juice comes to the boil1 skim and slightly thicken1 pour in the milk boiling hot1 add the oysters one by one1 let them remain on the stove about five minutes1 or until the beards begin to curl1 and they are no longer slippery4 ,serve with crackers heated very hot4 ,,oysters ,,broiled4 ,dry the oysters1 large ones are best1 in a towel1 have a piece of toast slightly buttered on a hot plate1 near1 pour over this a little hot oyster juice1 not enough to make the toast wet through4 ,arrange the oysters on a fine buttered broiler1 cook over a brisk fire like steak1 until the beards curl4 ,turn them often4 ,it takes about five minutes4 ,arrange them on the toast1 add a little salt and a very little butter1 serve very hot4 ,,broiled ,,chicken4 ,the chicken must be young1 split down the back4 ,lay on the gridiron and broil evenly1 turning frequently4 ,serve on a piece of buttered toast1 salt and slightly butter the chicken4 ,a little parsley garnishes the dish prettily4 ,all birds to be broiled should be split down the back and broiled evenly1 laid on thin toast and served hot4 ,,beef ,,steak4 ,steak must be cut #c_/d inch thick1 and evenly broiled1 rare1 unless particularly requested to do otherwise4 ,be careful not to smoke it2 the grease dropping into the fire may make trouble in this way4 ,,oatmeal ,,gruel4 ,take two large iron tablespoonfuls of oatmeal freshly cooked for breakfast1 add one cup of boiling water1 slowly stirring all the time1 then add an equal quantity of milk4 ,let all boil for ten minutes1 and strain through a fine wire sieve4 ,if you have no cooked oatmeal put #a_/b cup raw oatmeal in a double boiler with two cups of boiling water and cook for two hours1 then proceed as above4 ,it makes the gruel richer to add all milk1 or #a-a_/b cups of milk and #a cup of cream4 ,be sure not to forget the salt4 ,never put any sugar in unless requested to do it by the patient4 ,,koumyss4 ,dissolve a third of a cake of compressed yeast 7,fleischmann's7 in a little warm water 7not hot74 ,take a quart of milk fresh from the cow1 or warmed to blood heat1 add to it a tablespoonful of sugar1 and the dissolved yeast4 ,put the mixture in beer bottles with patent stoppers1 fill to the neck1 cork1 and let them stand for twelve hours where the temperature is about #fh degrees or #gj degrees1 then put the bottles on ice1 upside down4 ,,milk ,,punch4 ,one glass of milk1 #a or #b tablespoonfuls of brandy1 #b teaspoons of sugar4 ,shake well or beat with an eggbeater4 ,give cold4 ,have patient take slowly4 ,,egg-,,nog4 ,one egg1 half glass of milk1 #b teaspoons of sugar1 #b teaspoons of sherry or brandy1 ice4 ,beat the yolk of egg in a glass1 add the sugar and beat1 then a little milk1 continue beating1 then four or five pieces of ice about as big as a hickory nut2 add brandy-- regulate to the taste of your patient--add rest of milk2 beat whites of eggs and add all but a teaspoonful with which garnish the top4 ,it should make a glass brimming full4 ,have a spoon with which to eat it4 ,,egg ,,lemonade4 ,one egg1 one-half a lemon1 #b teaspoonfuls of sugar1 beat the white and yolk separately as for egg-nog2 add the sugar to the yolk1 then the lemon juice1 then the ice1 lastly the white beaten to a stiff froth4 ,,wine ,,whey4 ,one pint of boiling milk1 one-half pint sherry2 add sherry to the milk while scalding hot2 stir a moment until the curd gathers2 strain through a fine muslin1 sweeten4 ,to be taken cold4 ,this takes a little practice to gather the curd as it should be done4 ,,poached ,,eggs4 ,the best way of cooking for an invalid4 ,slip the egg1 previously broken into a saucer 7the fresher the egg the better71 carefully into salted water which is boiling in a frying pan1 then immediately set the pan at the side of the stove so that the water does not boil1 keep it there for about five minutes4 ,let the water be about two inches deep in the iron frying pan4 ,each egg must be broken separately and slipped carefully into the water4 ,when cooked so that the white is firm but jelly like1 no part being raw or hard1 take it out with a skimmer and slip it on a piece of thin buttered toast1 sprinkle a little salt and pepper on top1 serve immediately4 ,garnish with parsley4 ,,scrambled ,,eggs4 ,beat two eggs until thoroughly mixed1 add two tablespoonfuls of milk1 salt and pepper4 ,pour into a very hot frying pan1 buttered1 and stir constantly for about two minutes4 ,pour over buttered toast4 ,,shirred ,,eggs4 ,heat the shirring cup very hot4 ,put in a piece of butter as big as a large pea4 ,shake it about and break in the egg4 ,let it remain on the stove a few moments and serve in the shirring cup4 ,sprinkle salt and pepper on it4 ,,omelette4 ,beat very stiff two eggs1 whites and yolks separately1 add two tablespoonfuls of milk and a little salt4 ,pour carefully into a small frying pan1 hot and buttered4 ,as soon as the egg is set1 slip a knife under one side and fold one side over the other4 ,slip on a piece of toast and serve at once4 ,a little finely minced ham or parsley flavors it very well4 ,,rennet4 ,one pint of milk slightly warmed and sweetened and flavored1 add one large teaspoon of liquid rennet4 ,stir for a moment and set it in a refrigerator4 ,to be eaten with sugar and cream4 ,,boiled ,,custard4 ,one pint of milk and #b eggs4 ,beat the eggs1 add the milk heated almost to the boiling point4 ,stir in #b tablespoonfuls of sugar4 ,return to the double boiler1 and cook for about #c minutes1 stirring gently all the time4 ,when done it will be about as thick as cream4 ,be careful not to let it cook too much as it will separate and be spoiled4 ,,baked ,,custard4 ,same ingredients and proportions as for boiled custard1 only let milk be cold4 ,pour into custard cups4 ,stand these in a dripping pan half full of warm water and bake in a pretty hot oven4 ,watch carefully1 bake #ae minutes4 ,,thin ,,bread ,,and ,,butter4 ,have a loaf of good home-made bread1 yesterday's baking1 cut off the crust1 then butter the loaf and cut the slice in this way1 buttering first and cutting afterwards4 ,the slice can be made very thin and dainty1 and the thinner it is1 the better4 ,a patient will sometimes relish this when tired of all kinds of toast or crackers4 ,,vi ,,the ,,nurse ,,as ,,relating ,,to ,,her ,,own ,,training ,,school ,,and ,,to ,,her ,,fellow ,,nurses ,always be loyal to your own school and hospital4 ,it may not have been in every respect perfect2 but it is not necessary to tell strangers of its imperfections3 probably those in authority are just as sensible of its short-comings as you are1 and perhaps they work harder than you do to right its wrong2 in any case it does no good to tell others of the things you disapproved4 ,it may indeed be that your criticism is one-sided and unfair1 that the very rules you hated and found hard to keep are the wisest ones1 and1 if you let strangers see that you disapprove of these wise regulations1 the opinion they will form of your intelligence will certainly not be flattering to you4 ,when you meet other nurses in your work1 as you are sure to do1 and when you compare your school with the one the other nurse came from1 try to realize that the other school is neither wholly above nor wholly below your own2 each has probably its own merits and its own drawbacks4 ,you should not tell the other nurse any of your own school's shortcomings1 any sooner than you would tell them to any other stranger2 be loyal everywhere to the place where you were fitted for your work4 ,never tell revolting hospital stories to your patients4 ,some people have the most morbid wish to hear dreadful details4 ,i remember a patient of mine1 years ago1 asking me in all good faith to tell her the most horrible thing ,i had ever seen in all my hospital experience4 ,i asked her why she wished to hear such things1 and after some reflection she acknowledged that it was a foolish1 morbid curiosity4 ,it is best to keep the dreadful side entirely out of sight2 there are plenty of bright1 interesting1 pleasant things always occurring2 tell of these4 ,tell of the cunning little babies in the lying-in ward1 the absurd little black ones1 the fat little ,german and ,swede babies4 ,tell of the surly drunken men that come1 and how a week of cleanliness in bed1 with a broken leg1 or it may be a cracked skull1 will change them into quiet1 polite1 pleasant patients2 and how1 later1 they will take their turn at washing dishes1 with a docility that would make their wives stupid with amazement4 ,all such matters 7and the more you try to think of them1 the more you will be able to recall7 will amuse and really edify your patient1 many of whom think of a hospital only as a place of terror4 ,never gossip about your sister nurses2 of the stupidity of one1 the untidiness of another1 or the overbearing nature of the third4 ,it can do no good1 and it lowers you in the estimation of every one who hears you talk4 ,as for your duties to each other1 ,i would have you always observe the same punctilious etiquette outside that you do in the hospital4 ,when you are called to assist another nurse1 remember that she is the head nurse2 the case is hers4 ,she gives directions1 and you follow them2 be sure you do it faithfully4 ,if you have some one to assist you1 be sure you arrange for her rest and exercise1 and that you leave intelligently written orders when you go for your own rest4 ,some very awkward complications may arise where there are two nurses1 and the worst1 ,i think1 is for the patient and family to like the second nurse better than the first one1 and to criticise her and find fault with her to the other nurse4 ,this is hard all around4 ,the second nurse expects the first one to be preferred1 and usually dislikes to go to such a case1 for that very reason2 but if any of you find that under such circumstances you are preferred1 never allow the people to retail to you the faults of the other nurse1 and never gossip about her4 ,she may not suit them1 but she is probably doing the best she can1 and such idle talk can do no good4 ,if they will talk1 make all the excuses for her you can1 and never let her suspect from any action of yours1 that you are preferred above her4 ,if1 on the other hand1 you are the first nurse and some second one is called in1 and preferred before you1 study her well4 ,see how it is that she wins the patient's confidence1 when you did not4 ,try to find out1 in a quiet way1 wherein lies her charm4 ,if it is quietness1 exactness1 cheerfulness1 or ready tact--it must be something--and if you are clever you must see how it happens that she is preferred4 ,it will be a good lesson for you4 ,perhaps you will never have such another chance for learning what you have found out by experience you lack4 ,so do not waste your time by allowing yourself to feel jealous1 but use it as a time of study1 and you may reap a rich reward by winning your next patient's confidence4 ,,vii ,,why ,,do ,,nurses ,,complain8 ,it seems to some of us1 judging from the prevailing tone of nurses' conversations1 that this is a veritable age of discontent4 ,we hear that a nurse's life is confining2 that it is wearing on the nerves2 it keeps one from enjoying society2 it is not sufficiently remunerative1 etc41 etc4 ,we all know1 without going into further particulars1 what a nurse could complain about1 and though each one's tale of woe may be perfectly true1 it seems to me we are not wise1 as nurses1 to allow the trials of our professional life to occupy such a prominent position in our thoughts4 ,let us glance at some of the other professions1 and see how the members of each regard their chosen work4 ,what is the prevailing theme of the religious newspapers8 ,is it complaints from the ministers that they are not appreciated1 or that their life wears on their nerves8 ,not that surely1 but we read of more and more work to be done2 more and more need of the gospel to be preached and lived1 that all may be attracted to it4 ,what do we read in the medical journals8 ,not how often ,dr4 ,jones or ,dr4 ,smith has been called up at night1 or how often they have been dismissed or maligned by ungrateful patients2 neither do they talk of such things4 ,do they complain that they are kept from the presence of ,society8 ,not so1 and why8 ,their enthusiasm is such that these matters are accepted as part of the inevitable1 and the higher1 nobler aim is so real that the lower and meaner consideration of personal comfort sinks into insignificance4 ,what is the soldier's favorite tale8 ,not that all through the war he had to drink his coffee without cream1 that he did not have sheets on his bed1 and that he ate from a tin plate4 ,would he ever speak of such things1 except to show that a man can for a noble aim accept inconvenience1 and laugh over it8 ,yet the soldier has probably been used to these comforts and many more all of his life in his home2 but viewed in the light of his enthusiasm for the country he is striving to save1 and seen by the side of her peril1 such inconveniences sink into their merited nothingness4 ,now the profession we have entered is1 we are told1 a noble one4 ,we have been ranked shoulder to shoulder with the doctors1 we have been compared to soldiers1 we have been assured that our opportunities for doing good to souls are second only to those of the ministers4 ,what more do we want8 ,we want this1 and we want it very much4 ,we want the courage to accept our trials which must come if we are to have any glory4 ,it is all very fine to be called a ministering angel1 but it is pleasanter to minister to those who are appreciative4 ,we can be heroic1 in an emergency1 but if we are not properly thanked1 we do like to growl a little4 ,it is gratifying to our vanity to be ranked with our masculine associates1 but when it comes to the hard1 thankless tasks which they accept without a murmur1 then we proceed to show that we know what is what1 and that our refined tastes cannot be so inconsiderately treated4 ,the trouble with these fretful nurses is that they are nurses4 ,if they are not satisfied with the profession they have chosen1 why do they not make a change and enter some other8 ,do they not know when they enter the work that it is hard1 do they not hear on every side that it is exacting and confining8 ,they knew it perfectly well before they began1 why then do they complain8 ,why not say candidly1 ,i cannot have such enthusiasm for my fellow-men that ,i can forget myself1 and then do something that is easier8 ,the ,superintendent of the training school shows each new aspirant for the nursing profession that the life is not an easy one1 that patience is one of the most necessary characteristics for the nurse4 ,she tells her of the trials1 the irritations1 the unreason1 the tiresomeness of sick people1 and still women will come to the school1 and forgetting the warnings1 they will complain when some exasperating incident occurs4 ,if a nurse1 from overwork and the consequent weakening of her nervous energy1 has lost her patience1 she will be a wise woman if she drops out of nursing work for a year or more2 this will probably help her1 complaining never will4 ,do you feel that your patient is cross or unreasonable8 ,that is most likely1 and is to be expected in nine cases out of every ten4 ,put yourself in your patient's place for a little while2 try to realize what it is to have a pain1 constant and sickening2 to have it every minute of the twenty-four hours2 try to imagine the fatigue of a respiration of forty2 the ache and restlessness of a fever of #ajc degrees2 the agony of longing to change a position when it cannot be done2 the despair of a hope for recovery growing daily less1 or the realization of absolute weakness that comes with early convalescence2 try to imagine yourself bearing some of these ills with nerves and brain weakened by disease1 and you will not wonder that your patient is irritable1 that he thinks the minutes of your absence are hours1 that the unevenness of the bed is hard lumps1 that the food is slops1 and the medicine no good4 ,remember that he is a prisoner1 and he has a cruel jailer2 his bed is his prison1 his disease is his jailer1 and he suffers whatever torments his jailer chooses to inflict4 ,now prisoners are not1 as a rule1 a happy class of men2 so bear with your prisoner and help him4 ,complaining about his shortcomings will never make them any the less4 ,he is sick4 ,oh6 the pathos of that short sentence1 ,he is sick2 that says all4 ,you are well1 or you ought to be2 therefore bear with him4 ,you have chosen a hard profession1 but we are told it is the noblest one a woman can follow4 ,why is it noble8 ,exactly because it is hard1 and the hardness consists in your forgetting yourself and giving your strength to others4 ,there are many hard lives that are not in the least noble1 but there is no noble life that is not hard4 ,a coal miner has1 ,i suppose1 a hard life1 yet no one calls it a noble one2 why8 ,because he works solely for his wages1 and he complains and strikes when his wages and his hours do not suit him2 but a doctor going from house to house1 and in spite of all discouragements carrying cheer and hope2 a city missionary going to the degraded1 the ignorant1 and by his own efforts helping his fellow-men to a better life1 to a knowledge of ,god--these are noble lives4 ,you can see ,i am sure the difference1 and you will not gainsay me when ,i assure you that the doctor and the missionary1 though they may not be satisfied with themselves1 or with their manner of working1 are happy men1 happy because they live outside of themselves4 ,the coal miner who is not content with his wages is miserable1 because he himself and his needs loom up before him so large that every thing else is shut out4 ,it is because you take a hard task and do it well1 that so much praise is given to nurses4 ,if you undertake a difficult task and fret over it all the time you are doing it1 if you propose to benefit your fellow creatures and grumble because you have not comforts1 or appreciation1 or gratitude1 where does the nobility go8 ,where is the heroism8 ,if the task is easy1 agreeable1 delightful1 the idea of heroism1 of nobility1 of all high aspiration dies directly4 ,did any one ever do a grand work and have an easy time while doing it8 ,did ,florence ,nightingale have all the comforts of life when she did her great work8 ,was it not by her indomitable perseverance1 her great patience1 and her enthusiasm for others that she won such an honored place for herself8 ,you know almost before ,i say it1 that there can be no loftiness of purpose1 no enthusiasm1 if there are not difficulties to be conquered1 and you all know that complaining about sick people will never alter their characteristics1 and that complaining about the nervousness of the relatives will never make less unreasoning1 when they are fearful that a loved one is going to die4 ,do we want gratitude and appreciation8 ,we get it very often1 and very often we do not2 and when this last is the case1 we may reflect that we are in very good company4 ,how did the ,french reward ,joan of ,arc8 ,the warmth of their gratitude led her to the stake4 ,galileo1 as reward for his discovery1 was put into prison and loaded with chains1 as were also ,christopher ,columbus and ,sir ,walter ,raleigh1 a notable company these1 and every one suffered from the ingratitude of their fellow-men4 ,many more examples you must call to mind1 of ingratitude more base than any thing we shall ever be called upon to bear4 ,the profession of nursing is still one of the most recent that women have engaged in4 ,the world had until the past few decades been so used to being nursed by the old-fashioned nurse1 who was a servant1 and who never expected any treatment but that of a servant1 that it has taken some years to always remember that we are not servants1 in the usual acceptation of the term2 but no one will be convinced of the fact that we are ladies by our telling them so4 ,if you are a lady1 with a lady's refinement1 every one in the house will know it1 will feel it1 and you will never mention the subject2 they must feel it1 then there will be no arguing on the subject4 ,it must be demonstrated by your deftness1 your quietness1 your cheerfulness1 your education1 your intelligence1 your quick appreciation of other good qualities4 ,we must all of us show the world that it is being nursed by its compeers1 that a lady can do even the most revolting service in a way that robs it of its difficulties2 and when the hard part of the illness is over1 when your patient is ready and anxious to be entertained1 you can show that you are not a machine for carrying out the doctor's orders2 that you are capable of something more than the ability to take temperature1 pulse1 and respiration4 ,we must remember that even yet we are1 in a way1 pioneers of one part of that great woman movement in the world4 ,it is not enough to educate one family up to the realization that we are its equals2 the next house we go to1 the same work may have to be done over again2 but each time it is done1 and done well1 the whole profession has been benefited1 which is an aim worth striving for4 ,,viii ,,the ,,nurse ,,as ,a ,,teacher ,it does not occur to every nurse1 when she graduates1 that she has been preparing herself1 during all these strenuous years of study and hospital work1 for the life of a teacher4 ,she fondly imagines that she is a nurse1 and only that2 but after she has been doing private duty for a year or more1 she realizes that she is generally a teacher as well as a nurse1 and that often she is a missionary also4 ,perhaps no private duty nurse needs to be told what subject she must teach2 the patient or the patient's friends never let her rest until she has told the why of every thing she does1 or does not4 ,there are1 however1 some important subjects that the nurse- teacher should try to make very clear to every patient4 ,we will begin with the baby1 as the babies are with us always1 and if doctors and nurses1 science and sanitation have their way1 there will some time be no call but that of the baby1 for nurse or doctor either4 ,the ignorance of the young mother is proverbial2 her wish to know about her baby and its care is pathetically earnest4 ,the new life is so precious1 she would take such good care of it1 if she only knew how4 ,here is a pupil eager for knowledge1 ready to do all that can be intelligently taught to her4 ,the nurse should have very clearly in her mind all the mysteries of digestion1 all the reasons for regularity in feeding1 the necessity for fresh air1 for long and uninterrupted slumber1 for loose clothing1 for regular bathing4 ,she should be able to give the mother the rules for her own living that she may be able to provide the best milk for the baby1 or1 if the little one has to be artificially fed1 the methods of preparing the particular food chosen should be explained1 and the indications of indigestion pointed out4 ,all this is real teaching1 real missionary work1 and if well done will help the mother immensely and probably save the baby many attacks of colic or worse4 ,washing the baby is usually regarded by the young mother as a terrible ordeal4 ,no nurse should leave her young-mother patient until she is fully able to perform this task4 ,let the mother watch1 a few mornings1 while the nurse does all the work1 then let her undress the baby1 when the nurse can take him and finish the operation4 ,day by day let her do a little more1 as her strength and ambition permit1 until at the end of a week she is fairly used to handling the child and can1 perhaps1 keep him until the last finishing touches are put on4 ,the nurse should always be near1 to help1 to advise1 to take the child should the mother become exhausted4 ,finally1 she should go into another room1 and1 leaving all things ready1 allow the mother to perform the duty by herself1 letting her know that at any time she will be relieved if necessary4 ,in this way the mother becomes accustomed to the child1 and the bath is always a pleasure to her4 ,how many times have we heard pathetic stories of a young mother trying for the first time to wash the baby8--the tears of despair1 the nervous blunders1 the exhaustion when the performance was brought to a hasty close4 ,all such stories mean that the nurse in charge was not a teacher and that her work when she left the case was not completed4 ,suppose that this baby is the third or fourth1 the mother knows what to do for the new little one1 but how about the others8 ,she is still anxious to do what is right1 or perhaps she is not anxious1 and her attitude toward the children is not what it should be4 ,perhaps she does not realize that she will be called to account for these souls intrusted to her care1 that these bodies will do their part in life1 well or ill1 as she treats them wisely or foolishly4 ,here is true missionary work4 ,a thoughtful1 intelligent1 judicious nurse can show a mother that an adenoid may be responsible for ,johnny's inattention1 as it causes dullness of hearing1 how ,mary's fretfulness is caused by too little sleep or by insufficient ventilation of her room at night4 ,she can explain how irregular eating causes the children to be cross and irritable4 ,she can show why the first teeth should be removed when the second begin to push towards the gum4 ,she can teach the mother that the headaches so often met with1 in children who go to school1 are due1 perhaps1 to eye strain1 and can not be corrected with pills1 and should never be soothed with headache powders4 ,she can show the evils of the gallons of soda water too many young women swallow1 of the injudiciousness of allowing young girls to congregate in drug stores4 ,these last two evils1 soda water and the drug store habit1 the mother may know nothing about4 ,she is busy at home with the little ones1 and the fourteen- or sixteen- year-old girl only too often is allowed to wander off down town with other young girls1 and what she does there would astonish many a mother4 ,every nurse should know how to teach her patient to guard herself and her children from tuberculosis4 ,she should be able to show what the early symptoms are1 what is then necessary to do1 what care should be taken of the sputum1 of the patient's food1 of his eating and drinking vessels1 his bed and bedding4 ,she should know how to teach a tuberculosis patient to care for himself1 how he can avoid giving his disease to others1 if he stays at home2 and where he will find proper hospital or sanatorium accommodations if he goes away4 ,most mothers are very thankful for practical hints from one who is supposed to know1 and who1 during a four to six weeks' stay1 makes herself one of the family1 and offers advice in the right way and at the right time4 ,the great sex question is almost sure to be discussed at such a time4 ,the advent of a new baby is such a wonderful thing that nearly always the other little ones want to know 7very naturally7 where it came from4 ,little folks are brimful of curiosity4 ,it is ,nature's way1 ,i suppose1 of teaching them4 ,every new thing fills them with admiration1 with joy1 and they must know all about it4 ,oh1 mamma1 what a lovely new pony6 ,where did you get it8 ,is it really mine8 ,oh1 papa1 what a dandy1 new sled6 ,where did you get it8 ,can't ,i use it right now8 ,oh1 have we got a new baby8 ,a real baby8 ,is it ours8 ,where did it come from8 ,can't ,i hold it8 ,all are familiar with these expressions of wonder1 of delight1 of joy of possession1 but how to satisfy the eager mind aright is a problem requiring our most careful thought4 ,books1 papers1 and magazines tell us what to say and how to say it4 ,all this should be talked over1 and1 if the mother does not know1 the nurse should know what books to tell her to read4 ,the medical world to-day is much concerned over the question of prostitution and its effect upon the coming race1 through the transmission of syphilitic taint to an innocent wife1 who is thereafter barren1 or who bears syphilitic children4 ,the folly of the double standard1 purity insisted on for the wife1 unchasity condoned in the husband2 all these subjects are sure to be brought up1 and the nurse who goes prepared on these and kindred topics can do an immense amount of good to the women she nurses4 ,she can show how useful the knowledge of chastity is to a boy-the strength that comes from self-control1 the weakness that follows self-indulgence1 the danger to himself and to those he really loves when he contaminates himself with prostitutes4 ,a young man once said to a friend of mine1 ,oh6 if my mother had only warned me of the suffering ,i would cause myself and others1 ,i never would have polluted my body and shamed my soul4 ,the nurse should know how to instruct the mother as to the signs of self-abuse in her little boys1 so that she may know what causes the nervous movements1 the pallor1 the fitful appetite1 the dark circles under the eyes1 the listlessness1 the fondness for being alone--any one of which should call for extreme watchfulness4 ,all these things a nurse should be sure to know1 so that1 as far as in her lies1 she should be one more earnest woman striving to make the world better for her having lived and worked in it4 ,a wise man has given this quaint description of a perfectly educated man3 ,when a man knows what he knows1 when he knows what he does not know1 when he knows where to go for what he should know1 ,i call that a perfectly educated man4 ,so with the nurse4 ,when she finds a social problem with which she is not familiar1 let her turn to this list of books1 magazine articles1 and pamphlets upon the subject3 ,chapman1 ,rose ,r41 ,the ,moral ,problems of ,children2 ,dock1 ,lavinia ,l41 ,hygiene and ,morality2 ,hall1 ,winfield ,scott1 ,reproduction and ,sexual ,hygiene2 ,henderson1 ,charles ,w41 ,education with ,reference to ,sex2 ,lyttelton1 ,e41 ,training of the ,young in the ,laws of ,sex2 ,morley1 ,margaret ,w41 ,the ,renewal of ,life2 ,morrow1 ,dr4 ,p4 ,a41 ,social ,diseases and ,marriage2 ,saleeby1 ,caleb ,w41 ,parenthood and ,race ,culture2 ,wilson1 ,dr4 ,robert ,n41 ,the ,american ,boy and the ,social ,evil1 ,the ,nobility of ,boyhood1 #ej cents 7contained in ,the ,american ,boy and the ,social ,evil72 ,hall1 ,stanley1 ,educational ,problems1 ,chapter on the ,pedagogy of ,sex1 ,adolescence1 ,youth2 ,northcoate1 ,h41 ,christianity and ,sex ,problems2 ,janney1 ,dr4 ,edward ,o41 ,the ,white ,slave ,traffic in ,america2 ,report of the #c #hth ,conference of ,charities and ,corrections1 in ,boston1 ,june1 #aiaa1 ,sex-,hygiene ,section2 ,kauffman1 ,reginald ,wright1 ,the ,house of ,bondage2 ,summary of the ,chicago ,vice ,commission1 in the ,may number of ,vigilance2 ,education with ,reference to ,sex in the ,august number of ,vigilance 7published monthly at #aef ,fifth ,ave41 ,new ,york ,city1 at five cents per copy72 ,the ,cause of ,decency1 ,theodore ,roosevelt1 ,outlook1 ,july #ae1 #aiaa2 articles on ,the ,causes of ,prostitution in ,collier's ,weekly1 from time to time1 since ,april #a1 by ,reginald ,wright ,kauffman2 articles on the ,necessity for ,teaching ,sex ,hygiene1 in ,good ,housekeeping1 beginning with the ,september number2 ,dr4 ,dale's articles on ,moral ,prophylaxis1 in the ,,journal ,,of ,,nursing since the ,july number2 ,instructing ,children in the ,origin of ,life1 ,elisabeth ,robinson ,scovil1 in ,october ,,journal ,,of ,,nursing2 ,leaflets and pamphlets published by ,american ,motherhood1 #ahh ,main ,street1 ,cooperstown1 ,new ,york2 ,publications of the ,american ,association of ,sanitary and ,moral ,prophylaxis1 ,new ,york ,city1 ,,journal ,,of ,,nursing1 ,february1 #aiab4 ,one last word and ,i have finished4 ,be careful1 oh so careful1 that your instructions are acceptable1 that your pupil is anxious to be taught4 ,most mothers are anxious on these subjects2 if one is encountered who does not care1 first try to make her care 7and this is a task1 indeed71 and then teach her what to do and how to do it4 ,,ix ,,convalescence ,one frequently hears the private duty nurse deplore the necessity of her remaining with a patient during convalescence4 ,i wish1 such a one would say1 that ,i never need stay with a patient after the temperature has been normal for ten days1 or1 ,i do not mind the first two weeks of an obstetric case1 then there is something to do1 but after that ,i am ready to leave1 or again1 ,when my patient is ready to go out driving1 ,i always wish she would drive me home2 half-sick people are not to my taste4 ,i have often wondered if this feeling is not caused by the atmosphere of the hospital which has1 during training1 been the nurse's home1--the hospital1 where the patient leaves at the earliest possible moment of recovery1 to make room for someone else4 ,the pupil nurse gets used to the excitement of critical illness1 used to the hard work of constant watching and fighting for the patients' lives1 and that1 and only that1 it seems to her1 is nursing4 ,so when she goes to her private cases1 and her patient has a long period of convalescence1 she feels out of place1 she does not seem to be doing what she was trained to do1 and she frets over it1 until some happy day when the doctor releases her1 and she is at liberty to go once more to some one who is at death's door4 ,nurses seem to feel that caring for a convalescent is not nursing1 but there they are mistaken4 ,after a serious illness it takes a long time to restore the patient to perfect health1 some function may need the close watching which only trained eyes can give1 and it is not beneath the dignity of the nurse to remain1 and keep watch until every part is once more in perfect working order4 ,many nurses feel that it is not nursing to amuse a patient1 but it is nursing to help him on to the healthy plane from which he has fallen1 to play games with an invalid and to watch him1 to read with him1 and to watch1 to walk or ride or travel with him1 and to watch1 always to watch1 that the dreaded symptom does not appear1 that the one part which still needs care gets it4 ,a surgeon does not spend all day1 every day1 with his gloves on1 and his scalpel in his hand2 he is not always operating1 or even arranging for operations2 he can find time to see patients1 to sit and talk with them1 to advise them1 to cheer them1 even to tell funny stories to them1 but all the time he is watching them4 ,a lawyer is not always pleading in the court room1 a clergyman is not forever in the pulpit4 ,the lawyer when talking to his client is just as truly a lawyer2 the clergyman1 when visiting his congregation1 is just as truly a clergyman1--the sermon on ,sunday is the climax1 if ,i may so express it1 of his week's work4 ,the lawyer's speech to the jury is the point to which all his efforts tend after1 perhaps1 weeks of preparation4 ,so the convalescence of a patient is the post climax of the nurse's undertaking4 ,she begins with the climax1 severe illness1 operation1 or obstetric case1 whatever it may be1 gradually the stress lessens1 the whole atmosphere of the house becomes natural as the patient progresses toward recovery2 but the process is not complete1 and the nurse's work is not done until the doctor pronounces her trained care no longer necessary2 then she may go1 and feel that her work has been thoroughly done-no small comfort surely4 ,i wish ,i could show my young sister nurses how good for them this period of the patient's convalescence might be4 ,the delightful rest of regular sleep1 and regular meals comfortably eaten at a table instead of in solitude from a tray1 the opportunity for regular exercise--these things come as a real luxury when one has been nursing a critically-ill patient1 and anxiety has been with one1 night and day4 ,this is the period when the nurse's nerves1 strained to their utmost1 can regain their tone1 where the responsibility borne by the doctor and shared by the nurse is not so great a weight1 and the knowledge of one more victory over death1 one more human life saved1 gives a joyousness to the day that is good to experience4 ,the satisfaction of knowing that by your help the patient has come1 perhaps1 from the gates of death2 the pleasure of noting day by day the return of healthful sensations1 the gradual ever- growing desire to once more take his accustomed place in the life work that has been interrupted--all these are missed by the nurse who flies from convalescents4 ,may it not be that the change in occupation has something to do with this unwillingness to remain with a patient when he is convalescing8 ,when a temperature has to be taken but once a day1 or when the doctor only makes visits twice a week1 when all the routine of the sick-room gives way to a more natural atmosphere1 many nurses do not feel at ease1 they do not read aloud pleasantly1 they do not care for books1 and1 if the patient asks for this amusement1 the reading is a torment to the nurse1 and ,i imagine it does not afford much pleasure to the listener4 ,a nurse once gave me a graphic description of her efforts to read ,romola to a convalescent typhoid patient4 ,the poor nurse knew nothing of ,florence or of the ,italian language1 and her struggles over the foreign words in that book must have been funny enough4 ,her patient was not much edified--of that ,i am certain4 ,if a nurse does not read aloud understandingly1 she should make every effort to learn4 ,she thereby increases her usefulness1 and makes herself more acceptable to her patients4 ,she adds to her own value4 ,she is worth more4 ,no nurse can tell when this method of passing the weary hours will be required of her1 as it is almost certain that a patient of intelligence will ask for some mental refreshment4 ,another pleasant way to pass the long hours of convalescence1 is by playing games with your patient4 ,i am sure no training school for nurses has added the study of cribbage1 pinochle1 bezique1 chess1 checkers1 backgammon1 or dominos to its curriculum4 ,all these are two-handed games1 the playing of which will help the convalescent to forget himself and his past illness and present weakness4 ,the nurse1 if she knows only one game that is unfamiliar to the patient1 gives him new thoughts while she teaches him1 and it is quite astonishing how much pleasure such simple things can give both to teacher and pupil4 ,i would suggest that nurses in their club houses or homes could profitably fill some vacant evenings practising these two-handed games4 ,i am sure they would never regret the time so spent4 ,if the convalescent is a woman1 the means of amusing her are more varied and more congenial perhaps4 ,in addition to reading aloud and playing games1 there is the vast realm of fancy work1 where most women feel at home4 ,it is a pity1 so few women nowadays know anything about knitting1 crochetting or tatting1--many do not even know which is which4 ,a lady asked me very innocently1 not long ago1 how ,i could tell the difference between knitting and crochetting6 ,since ,irish crochet has returned to favor1 however1 many have once more taken up their crochet needles4 ,the nurse who can deftly turn her hand to these dainty arts1 and can teach them to her patients1 or any of the patient's family1 has the means of making herself a very acceptable companion1 apart from her nursing skill4 ,embroidery is very fascinating1 and appeals to every woman4 ,a dainty little garment for your patient1 embroidered while you watch her return to health1 will be long treasured by her4 ,for a nurse1 what art1 what accomplishment can she have that will not help some poor invalid1 that will not shorten the weary hours for some sick body1 or bring consolation to a weary soul8 ,a perfect nurse is one who brings comfort to her patient4 ,it is because trained nurses bring more comfort that they have replaced the old style nurse2 the more comfort the nurse brings1 the more successful she is4 ,the ability to talk well1 when talk is needed1 to read well1 to amuse understandingly1 to wisely meet each need of the invalid as it presents itself1 this is to be the ideal nurse4 ,x ,,how ,,shall ,a ,,nurse ,,occupy ,,her ,,days ,,of ,,waiting8 ,to many nurses the time between cases is dreaded as a period when money is being spent for necessary maintenance1 and none is coming in2 a nervous time1 as the ring of the telephone which may mean a call is wished for or dreaded1 perhaps both2 an anxious time1 as no one knows how long she may have to wait2 a dreary time1 as the days drag on and still no call comes4 ,it is a trying time1 but much can be done in these days of waiting that is delightful in the doing1 and that will prove a source of pleasure to all future patients1 and no little profit to the nurse also4 ,let me preface my few hints by saying that all patients and patients' friends expect the nurse to know all about the diseases and their cures1 the care and management of the sick1--that is common1 ordinary nurses' business1--but there too many nurses stop2 they often can go no further2 and when one comes to a family and adds to this a broad culture1 and an intelligent interest in the topics of the day1 the respect and admiration of the patient and family are unbounded1 and their surprise genuine4 ,i would like1 if possible1 to impress upon the nurse graduate that really there is much to learn after she has left the training school4 ,all the technic of hospital and operating room is fresh in mind1 but there is so much that lies necessarily outside the walls of a hospital1 and this knowledge that comes with experience is a great part of what makes a successful nurse4 ,i will not touch here upon what every nurse knows so well1 relating to the preparedness of clothes1 satchel1 and instruments4 ,we take it for granted that all this is ready4 ,the case before has been a hard one1 we will imagine1 and several days have been given to the luxury of whole nights in bed1 and whole days of resting2 this is all done1 and the next case is awaited4 ,the best thing to do first is for the nurse to examine a little her mental equipment1 see what she has stored away in her mind that can help the next patient1 or that can assist in fighting the battle of hygienic cleanliness versus disease-bearing dirt4 ,let her consider whether she reads aloud acceptably1 understandingly4 ,has she a good list of books which most women would enjoy8 ,does she know what books to suggest for the children8 ,can she tell what would interest the boys1 or what a man would like to listen to8 ,does she know humorous books1 interesting histories1 or biographies8 ,here1 then1 is occupation for many idle days4 ,to go to a public library is always a pleasure1 to make friends with the librarian is an added pleasure1 as is also the making one's self familiar with some good books that can always be procured1 and that will give pleasure and profit to patient after patient4 ,this search for good literature will give happiness in the quest1 and happiness in the reading4 ,librarians are usually glad to direct one to the books needed1 and many delightful hours may be spent in the library1 and all the while the comfortable feeling experienced that the pleasure felt will be transferred later to future patients4 ,the subject of hygiene is taught in most training schools1 and indeed in many day schools as well2 but this is a branch of knowledge that is growing so rapidly that1 unless the very latest discoveries are learned1 the nurse may find herself of use merely when the infection has done its work4 ,i wonder how many nurses have made use of the bulletins issued by the ,u4 ,s4 ,department of ,agriculture in ,washington4 ,these are called ,farmers' ,bulletins1 but many of them are of use to all mankind1 be they farmers or not4 ,they are free to any who ask for them1 and up to the present time about five hundred have been issued4 ,they are upon all sorts of subjects--,flies1 ,malaria1 ,the ,destruction of ,rats1 ,care of ,food in the ,house1 ,fruit as a ,food1 ,cereal ,breakfast ,foods1 etc41 etc41 subjects ad infinitum4 ,here1 then1 is a mine of information open to anyone who asks2 all one has to do is to write to the ,secretary of ,agriculture and ask to have sent a list of the ,farmers' ,bulletins published by his department1 and from the list any bulletins may be selected1 and they will be sent4 ,ask for what is needed2 it is all meant for the education of the public4 ,the information is absolutely reliable1 and represents the best thought of the country--expert advice by the foremost scientists4 ,i have often thought that a nurse who made the nursing of children a specialty1 or even those who nursed children occasionally1 would be much profited by a course in a ,kindergarten ,training ,school4 ,the private duty nurse1 however1 having but a few days at her disposal1 cannot do anything as extensive as that2 but a very good substitute is at hand1 in the kindergarten department of any of our public schools4 ,it is most interesting to go to a public school1 ask to see the ,principal1 and let the nurse explain her visit1 and show her how helpful it would be to future little sick folks1 if she might be allowed to study some of the kindergarten methods1 and permission will readily be given4 ,when the nurse reaches the room of the littlest ones1 let her sit down1 and quietly watch what is done for them1 and how they are managed4 ,the kindergartner will be glad to tell where she finds the charming stories she relates2 she will give models of the wonderful things her pupils cut out of paper1 the canoes1 the men to sit in them1 the wigwams1 the sleds1 automobiles1 swings1 stoves1 trees1 apples1 etc41 etc41 articles well-nigh innumerable1 and all so simple and so deftly made4 ,a small convalescent could be amused for weeks with the things one could learn in a few hours in one of our city kindergartens4 ,i speak of the things ,i know1 for ,i have tried it1 and ,i never yet found a ,principal who was not glad to have her kindergarten studied1 nor a kindergartner who was not pleased to know that she could assist in the work of nursing sick children1 even in this seemingly roundabout way4 ,in all of our large cities are fine art galleries1 and in many there are fine loan collections on exhibition every summer4 ,there are1 besides pictures in these loan collections1 many things2 some curious1 some beautiful1 and all of them interesting4 ,some days spent in these galleries will bring much knowledge and beauty into one's life4 ,time must be taken for these visits2 no one can appreciate the patience and skill of oriental handiwork in a hurry4 ,if unacquainted with the exhibits1 a catalogue should be purchased1 and each one studied until one knows why it is there1 and what is its beauty4 ,i remember seeing1 one day1 in a collection1 a cup of jade1 with a very finely wrought handle2 ,i thought it fine1 but did not appreciate it until the ,custodian told me that it took the artist twenty years to carve that one cup1 jade is such a hard stone4 ,this cup was so valuable that the ,kensington ,museum1 in ,england1 had paid an immense sum of money for it1 as a nearly perfect specimen4 ,this information was my reward for close study of an exhibit4 ,in these exhibitions one could spend many vacant days with much pleasure and profit4 ,in whatever town a nurse lives she should familiarize herself with the philanthropic efforts of the place4 ,in the largest cities it is not possible to know them all1 but she should know about some of the settlement work1 the day nurseries1 the babies' hospitals1 the rescue work1 the homes for aged4 ,of course she will know about the hospitals and dispensaries1 but what is done for the poor1 the ignorant1 the sinful1 and the stranger--these she should learn4 ,many times she could do much to help these institutions1 by relating1 simply and truthfully1 when occasion offers1 what she has seen1 of the great needs of such efforts1 and the heroic work of those who go down and live amongst the needy and try to uplift them4 ,many a rich1 idle patient might become interested and give money1 if not time1 to help in these good works2 and my experience shows that they generally need all the help they can get4 ,so the nurse should know about the anti-tuberculosis work1 the night schools1 the playgrounds on the roofs of the school-houses1 all the philanthropic work of her town1 and she cannot know about it unless she takes some of her vacant days1 her days of waiting1 and turns them into days of learning1 and the expansion of both her mind and her heart4 ,another pleasant way to spend some days of waiting is to study the trolley system of the town where you live4 ,learn how far it can go1 to how many other towns4 ,if a river is near1 become familiar with its steamboats4 ,excursions on boat or trolley will be delightful1 and will teach the best routes1 the best terminal stations1 and the best restaurants1 and some day when a patient is well enough to take an excursion1 some part of his own immediate neighborhood may be shown him which he has never seen before4 ,believe me1 all this will be appreciated4 ,space fails me to tell of music to be heard1 theatres to be enjoyed1 and all to be used hereafter for the benefit of those to whom you will be called to minister4 ,the information constantly gathered in the days of waiting1 rightly used1 intelligently imparted to the patient or her friends1 will make of the nurse such a broad-minded1 sympathetic woman that everyone who employs her will appreciate the fact that she has a wide culture1 and brings to her patient something besides mere technical skill4 ,,xi ,,some ,,hints ,,for ,,the ,,obstetrical ,,nurse ,,the ,,baby',s ,,wardrobe4 ,when a nurse goes to see a woman who wishes to engage her1 some months hence1 to care for her baby and herself1 it is very nice to be able to give her1 should she ask1 a list of all the things she will need1 both for her own comfort and the baby's4 ,the following is a good sensible wardrobe1 and will be found ample1 though many articles more or less fanciful will1 most probably1 be added by friends4 ,the things enumerated below should last the baby until he is put into short clothes3 ,slips1 #aj4 ,dresses1 #h to #aj4 ,pinning blankets1 #d4 ,flannel skirts1 #d4 ,white skirts1 #e4 ,shirts1 #d4 ,bands1 plain flannel1 #d4 ,bands1 ,jersey made1 #d4 ,diapers first size1 #ag inches square1 #bj4 ,diapers second size1 #bj inches square1 #cj4 ,diapers third size1 #bf inches square1 #cj4 ,knitted blankets1 plain white1 #b2 if with any color1 #d to #f4 ,knitted sacques1 #d 7two sizes74 ,little pillow 7hair71 #f cases4 ,crib sheets1 #f4 ,crib blankets1 #b4 ,,for ,,basket4 ,two small gold safety pins4 ,large safety pins1 ,i box4 ,small safety pins1 i box4 ,powder box and puff4 ,coudreay's powder4 ,small box of equal parts borax and powdered sugar4 ,old damask towels4 ,one cake old white castile soap1 or ,colgate's nursery soap4 ,one bottle unscented vaseline4 ,as many sachets as you can get4 ,some few yards of the narrowest ribbon1 pink and blue4 ,two old handkerchiefs4 ,one lap protector4 ,brush and comb4 ,absorbent cotton4 ,,for ,,the ,,mother4 ,all the old sheets in the house4 ,rubber sheet1 double width4 ,a square of rubber sheeting single width4 ,an old comforter4 ,footnote3 ,when the ,kelly pad is used for the delivery1 the old comfortable1 the blankets and the single width rubber sheet need not be provided4,two or three old blankets4 ,fountain syringe4 ,paper basin4 ,towels ad libitum4 ,six or seven night dresses1 three of them old4 ,undershirts1 if worn in bed1 #d 7large74 ,bandages1 #f4 ,cheese cloth1 #aj yards4 ,absorbent cotton1 #b lbs4 ,a large flannel sacque1 or a nightingale4 ,soft unbleached muslin1 #b or #c yards4 ,colgate's fumigating wafers1 ,i box4 ,bedpan1 ,i4 ,layettes can be purchased at any good department store1 but many expectant mothers prefer to make all the clothes for the little one4 ,these lists are for the benefit of these mothers4 ,these look1 perhaps1 like two very formidable lists1 but a second glance will convince any one that all these articles are absolutely necessary1 and none of them are expensive4 ,the slips should be made very plainly4 ,the material may be as fine as can be bought1 but beyond a few tucks about the yoke1 and a little lace or fine embroidery about neck and sleeves1 should be perfectly plain4 ,the dresses1 of course1 are somewhat more elaborate1 but the fashion now decrees that infant's clothing shall be perfectly plain1 and a most sensible fashion it is4 ,pinning blankets are open all down the front1 and are usually made in the shops with a broad band of stiff white muslin1 which shows that the people who made them never tried to dress a baby4 ,the band should be of flannel or coarse linen many times washed so that it may be soft1 and the pins will go through many folds of it4 ,flannel skirts are usually made of two breadths of flannel1 and are more or less embroidered4 ,these are not left open1 except just enough to make the dressing easy4 ,shirts are made so well in stores that few people care to knit them4 ,they should always be high in the neck and long sleeved1 and it is better to get two sizes1 as1 if the baby is small1 it never can be comfortable in a large shirt that does not fit4 ,the four flannel bands should be #f inches wide by #ag or #ah long1 torn the length way of the flannel and left just as torn4 ,not hemmed or ornamented in any way4 ,no hemming or stitching can be so fine that it will not mark the baby's flesh4 ,besides this1 if you have these plain bands and find they are several inches too big1 nothing is easier than tearing off a strip and making them fit4 ,if the child has a very large1 round abdomen1 they can be made to fit over it nicely by taking two little tucks on the lower edge1 about half an inch from the middle of the band1 and letting the tucks run up about an inch or a little more1 tapering it off gradually4 ,when these are discarded and the ,jersey made bands are put on1 always put them on the baby feet first1 as it is hard to get them over the shoulders4 ,the very best material for the first small diapers is old1 soft table damask4 ,the better the quality1 the softer it will be2 be sure they are exactly square4 ,nothing is more trying1 in a small way1 than to get a diaper that cannot be folded true4 ,these should be made double and the edges turned in and sewed around4 ,by the time the baby has outgrown them they will be fit only for the rag- bag1 and may be thrown aside4 ,the second size diaper1 also the third should be many times washed to make them soft enough for use4 ,these may be used at first folded eight times and put under the baby next the damask diaper1 between that and the pinning blanket1 and will often save the nurse the trouble of changing the baby's clothing1 because it is wet through4 ,in this way they will get more washings and be softer when you have to use them next the baby's skin4 ,cotton flannel1 with a good nap and not a very close web1 is very good also and can be used instead of the damask where that cannot be procured4 ,put it on with the nap next the skin4 ,it is an excellent absorbent4 ,the baby should have at least one little 7rather flat7 hair pillow1 covered on one side with blue or pink silk1 on the other with plain white over the ticking4 ,the prettiest pillow cases ,i ever saw were made of broad hemmed pocket handkerchiefs4 ,two sewed neatly together round three edges1 and on the fourth button holes for mother-of-pearl studs4 ,the handkerchiefs may be fine or not1 embroidered or plain1 and may have lace sewed on the edge1 but they can't help being pretty1 and the embroidery will never be in the middle4 ,i shall never forget my pity for one poor little mite ,i saw once1 who1 on waking from his sleep1 was discovered to have the print of an embroidered ,s on his cheek4 ,it had been worked in the centre of the little pillow case by some loving but ignorant hands4 ,when the baby uses the pillow1 let him sleep on the white side2 at other times turn up the colored side and the pink or blue will show very prettily through the linen4 ,if you let the child sleep on the colored side he may1 most likely will1 vomit some sour milk on it1 sooner or later1 and the beauty of your pillow will be gone4 ,if the regular little crib blankets are thought too expensive1 a very good substitute may be made from white eiderdown cloth1 which is warm1 soft1 and not at all costly4 ,the gold safety pins are intended for the final pinning of the dress in the front and in the back4 ,of course any little ornamental baby pin answers the purpose just as well1 and1 indeed1 an ordinary safety pin will do should no other be at hand4 ,the little box of equal parts of borax and sugar should not be forgotten4 ,mix the two very thoroughly1 and if any little white aphthous spots appear on baby's lips1 tongue or cheeks1 apply a little of this mixture several times a day1 and they will probably all be gone by night4 ,put it on very carefully with the tip of your finger slightly moistened so that some of the powder will adhere4 ,examine the baby's mouth every day for these spots4 ,they are likely to appear any time after ten days or two weeks1 and are more often seen in weak children1 or those who are fed by a bottle4 ,if the spots appear on a child who is taking the breast1 the nipples are very apt to be sore4 ,much care1 therefore1 must be exercised in this matter4 ,sachets are a real luxury in the drawers of the baby's bureau4 ,atkinson's sachets are the best1 though ,colgate's violet is very delicate and pleasant4 ,put one or two amongst the little shirts1 and some among the knitted blankets1 but mostly have them in the dresses1 and be sure when you take out a clean dress1 or slip1 to take the sachet and slide it into the neck of the slip that will be worn tomorrow4 ,nothing can be more attractive than a clean1 sweetly smelling baby1 and1 per contra1 nothing is more disgusting than a wet1 sour1 cold1 crying baby4 ,if he be wet and sour he will surely have cold feet and hands1 and as surely will he cry4 ,poor little thing6 ,it is his only way of expressing his opinion of the state of his toilette4 ,it is very pretty1 when the baby is fresh and clean1 and has on a fine slip with lace edging the sleeves1 to tie around the wrist1 outside of the sleeve1 a piece of pink or blue ribbon4 ,make a nice little bow and let the lace fall over the fat little hands1 like a frill4 ,be careful not to tie the ribbon too tight1 and keep it clean4 ,if it becomes soiled or wet1 take it off directly4 ,a lap protector is made by covering a piece of rubber cloth about #ad inches square with several thicknesses of old blanket4 ,to cover this have some slips like pillow cases1 of linen or cotton1 plain or fancy1 as the lady may have time or money4 ,slip the protector in its case1 and lay it on your own1 or any one else's1 lap who wishes to hold the baby1 and it perfectly protects from all wetting4 ,,table ,,for ,,estimating ,,the ,,probable ,,duration ,,of ,,pregnancy ,two hundred and eighty days1 forty weeks1 ten lunar months1 or nine calendar months are here estimated as the usual duration of pregnancy 7the actual computed average being #bgf-b_/c days74 ,the exact day of conception 7not the fertile coition71 can never be accurately determined2 the only date from which conception can be dated1 and the probable confinement day predicted with some chance of certainty1 is the first day of the last menstrual flow1 adding to this one week 7seven days7 for the average duration of the flow 7with a few days lee-way74 ,we count nine calendar months forward1 and have the approximate date of the expected confinement4 ,the most ready method is to add seven days to the first day of the last menstrual flow1 count back three months1 and add one year1 when we have the future date when1 or about when1 delivery may be expected4 ,an exact estimate is but guess work2 errors of one or two weeks either way may be made by the most experienced1 as in cases where conception occurred shortly before the next menstrual period1 which did not then appear4 ,the present table is constructed on the above principle1 the second column representing the day of quickening1 nineteen weeks after the beginning of the last menstruation1 with seven days added2 and the third column still twenty weeks later4 ,the date of quickening is still more variable than that of delivery1 from one to four weeks4 ,intermediate dates may be fixed by adding the necessary number of days to each column4 ,thus1 for ,jan4 #aath1 the second column should read #cast of ,may1 and the third column1 ,october #ahth1 and so on4 ,beginning of last ,quickening4 ,confinement4 ,menstruation4 ,jan4 #ast444444444,may #bjth444444444,oct4 #hth4 ,feb4 #ast444444444,june #bjth444444444,nov4 #hth4 ,march #ast444444444,july #ahth444444444,dec4 #dth4 ,april #ast444444444,aug4 #ahth444444444,jan4 #fth4 ,may #ast444444444,sept4 #agth444444444,feb4 #eth4 ,june #ast444444444,oct4 #hth444444444,march #hth4 ,july #ast444444444,nov4 #agth444444444,april #gth4 ,aug4 #ast444444444,dec4 #ahth444444444,may #hth4 ,sept4 #ast444444444,jan4 #ahth444444444,june #fth4 ,oct4 #ast444444444,feb4 #agth444444444,july #hth4 ,nov4 #ast444444444,march #bjth444444444,aug4 #hth4 ,dec4 #ast444444444,april #aith444444444,sept4 #gth4 ,,articles ,,for ,,the ,,mother',s ,,use4 ,perhaps it is not necessary to say why it is better to use old sheets for the bed of a parturient woman1 but ,i will repeat that old ones are to be preferred1 and really new ones1 that is1 only once washed1 never used4 ,new towels are of course objectionable1 as being too harsh4 ,if the patient likes a rough towel1 use a regular bath towel1 if you can get it4 ,be careful1 never to let loose and wet ends of the wash cloth drag along exposed parts of the body4 ,it is a good plan to sew your wash cloth into a bag1 and to slip your hand inside1 and work with it put on like a mitten4 ,a rubber or fibre sponge is to be preferred4 ,keep one for the face1 neck1 arms1 and hands1 and another for the feet and legs4 ,the vulva is bathed best by means of a fountain syringe used as an irrigator1 and a little sterilized gauze twisted around your dressing forceps4 ,the gauze can be changed as often as necessary1 and is much more satisfactory than anything else1 especially if there has been a laceration4 ,the square of rubber sheeting1 single width1 is most useful4 ,for the confinement the bed should be made by first spreading over the mattress the wide rubber sheet1 over this put an old blanket1 then the under sheet2 upon the right side of the bed1 where most likely the woman will lie1 place the square of rubber1 over that the old comfortable1 four double1 and hold all in place with a sheet folded like a hospital draw-sheet4 ,this must be firmly tucked in at the sides under the mattress4 ,it will seldom be found necessary to change the under sheet1 if the bed is made this way1 and the rubber square is drawn carefully away1 with the comfortable and draw sheet1 when it is time to make the patient clean and dry after the birth4 ,it is a good plan now to tear this square in two1 and keep one piece directly under the clean draw sheet for the first few days4 ,this saves much washing4 ,an old blanket and a small one will be found invaluable for all sorts of things--for example1 to spread over the shoulders and chest when the bandage is being pinned2 to warm and wrap up the feet and legs1 if they show any signs of being cold2 to cover one knee and part of the body when using the irrigator1 which when there has been any laceration1 is a delicate piece of business1 as every nurse knows4 ,always fold up this invaluable and constant friend1 and put it in some handy but inconspicuous place2 it is a friend1 and a good one2 but it is not a beautiful object to look upon1 and others not knowing its virtues would think you untidy if it was in a noticeable place4 ,the fountain syringe is absolutely indispensable2 and1 though it may seem unnecessarily large1 yet ,i think a four-quart bag better than any of the smaller sizes4 ,to be sure1 you never might need four quarts in the bag1 but it is so much easier managed1 so much less liable to spill over1 if you have a large bag and put it only half or three-quarters full4 ,then1 too1 you get so much more force if you have more water in the bag1 you need not use it all4 ,a ,davidson syringe is very nice for some things that a fountain syringe could not be used for4 ,oil enemas1 for instance1 also nutritive enemas4 ,after an oil enema be sure to wash your syringe thoroughly with a strong solution of washing soda or ammonia1 else you will find the rubber of the bulb and tubing becoming pasty1 and your syringe will be utterly spoiled4 ,the paper basin is very light and easily handled and much to be preferred to a large china affair1 which may easily slide from warm1 wet1 slippery hands4 ,i often wonder that the women of our day1 who are so sensible in many things1 should have abandoned the fashion of short night gowns1 which our grandmothers always provided for themselves at these times4 ,i remember asking one lady1 when talking over what she would need for her first baby1 and for herself1 at the time of its birth1 if she had not something short and plain that she could wear4 ,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 bottom4 ,she could wear that4 ,it certainly is not from motives of economy that our wealthy patients do not have these most sensible of garments4 ,i think they know nothing about them1 and they should have their virtues explained to them4 ,a pocket could be added to this garment1 ,i think1 and it would be a real comfort to a woman4 ,i know it would be to a nurse1 who usually has to hunt up the ever missing pocket handkerchief a dozen times a day4 ,men always have pockets in their night-shirts1 and they are not sick half as much as the women4 ,i wonder why women do not imitate this most sensible custom4 ,if your patient will not let you cut off any of her old night-dresses1 you must use the long ones1 of course1 and change them as often as necessary4 ,bandages should always be made of soft unbleached muslin2 double is best1 though ,i have used them of the single fold1 and hemmed1 but they are firmer if double4 ,they should be wide enough to come down to the great trochanters1 and up to a place two inches above the umbilicus2 long enough to fit the woman before she became pregnant4 ,she has likely some measure1 or could get it from her dress-maker4 ,women vary so much1 it is hard to give an exact measure in inches1 but you might begin with a bandage fifty inches long1 and if the ends are too long1 cut them off1 and turn in the edges of the cloth and overhand it neatly4 ,obstetrical binders1 or bandages are now seldom put on a parturient woman1 but in case they are to be used1 ,i give the best kind ,i know of4 ,they are sometimes made to order1 but ,i never knew one of these to fit1 or wash well4 ,the method of their application is of course taught in the schools4 ,the nurse should always know from the doctor1 or the prospective patient1 if binders are to be worn1 and instructions given as to how to make them4 ,four or six will be enough4 ,two or three yards of soft1 unbleached muslin for breast-bandages should be provided in case they are needed4 ,a six-tailed bandage is1 ,i think1 the best for this purpose4 ,tear down the first two tails to within three inches of the others1 and these passing over the shoulders1 and fastening to others1 which are adjusted over the breasts1 keep the whole bandage in place4 ,it is not necessary to speak of the napkins or pads2 these are universally used1 and readily bought1 sterilized1 and ready for use4 ,all sterilization is so thoroughly taught in the schools1 ,i have taken proficiency in this particular for granted4 ,there should always be a disinfectant or antiseptic of some sort on hand4 ,carbolic ,i-#cj1 ,platt's chlorides1 permanganate of potash1 or something that will answer the purpose2 bichloride of mercury1 etc4 ,you must find out from the physician which he prefers1 and of what strength4 ,i must not forget to say that when you go to see you prospective patient1 and she shows you the room she expects to occupy1 it would be well to cast your eyes about for some rug1 that you can1 if necessary1 turn wrong side out and spread at the side of the bed4 ,some doctors are very neat about their work1 but some are-- well1 perhaps ,i better not say it2 we must not criticise the doctors4 ,but sometimes it is best to have protection for the floor1 it gives the nurse a comfortable feeling quite beyond description to know1 that1 no matter what may happen1 the carpet will not be ruined4 ,,xii ,,as ,,to ,,washing ,,the ,,baby ,in the first place get together everything you will need for the bath and subsequent dressing4 ,have the clothes all laid in order over a chair-back before an open fireplace1 or over a radiator1 or if no better expedient suggest itself1 fill bottles with hot water1 or get a hot water bag and fill that1 and lay it over the clothes arranged in the order you will need them1 beginning the pile with the dress and having the band the last4 ,have two large1 soft towels and keep them warm4 ,if possible1 have an apron made of rubber cloth to tie about your waist4 ,at your side1 on the floor1 have a small blanket ready to lay over the rubber apron when needed4 ,put your baby basket where you can reach it1 be sure that it contains all the things you will need--sponge1 soap1 powder1 pins1 vaseline1 etc41 and an extra diaper or two4 ,now get the tub 7tin7 and pour in the water until it is about four inches deep4 ,have the water no warmer than #ajj degrees ,f4 ,bath thermometers are made that are quite cheap1 and a great convenience2 one should always be at hand1 as no nurse should ever trust her feelings as to whether the water is hot enough or not4 ,always test any water to be used for the sick or the delicate with a thermometer4 ,another point a nurse should be most careful about1 is to be careful that her hands are warm before she takes the baby1 as her cold hands on his warm flesh will surely make him scream4 ,all being now ready1 take the baby and sit down with him1 spreading the blanket over your knees as you do so1 and having the tub just in front of you on another chair4 ,the sponge is best to use for the washing1 but a piece of old table damask is very good4 ,wash the eyes very carefully first1 then the face1 and dry on the towel4 ,now hold the baby's head over the tub and give that a good washing with soap on your bare hand1 and rinse it well with plenty of water1 always holding the left hand under the head and neck4 ,bring him back on your lap and thoroughly dry his head1 then wash and dry the ears carefully4 ,when you get this far you may undress the baby completely1 being most careful yet not taking any unnecessary time4 ,when he is quite ready for the tub1 grasp him firmly with the right hand1 letting the buttocks rest in the palm of the hand1 the fingers being outspread1 and the thumb coming up almost to the pubic bone4 ,with the left hand hold the head and shoulders4 ,lower him very gently into the water4 ,any sudden movement is most injurious1 as a baby must never cry when the band is off1 if it can be avoided4 ,he will often put out both hands as if trying to catch hold of something4 ,if he seems frightened at the same time1 and cries violently1 let the buttocks rest on the bottom of the tub1 and with the right hand hold both of his1 and he will be comforted4 ,i think it well to wash the whole body with your bare hand1 well soaped4 ,be careful to wash under the arms1 in the bend of the elbows1 the groins1 and under the knees1 rinse him with the wash cloth or sponge1 and now lay one warm towel on your lap1 and take up the baby just as you put him in1 slowly1 and without shock1 and lay him in the warm towel4 ,lay the second one over him1 and draw over all the blanket1 wrapping him up warm and snug4 ,put your hand inside the blanket and dry him4 ,this can be easily and quickly done without at all uncovering the child4 ,pass the hand with a slight squeezing movement over each arm and leg1 and over the front of the body4 ,when this is done1 you must undo the blanket1 and take the upper towel and dry most carefully all the creases1 and powder everywhere1 especially if he is very fat4 ,get down to the very bottom of every crease1 and be sure it is dry and powdered4 ,lay over the navel a compress of absorbent cotton1 unless the child is over four weeks old1 and over this the band1 which should be unhemmed1 and wide enough to extend from the hip to the armpit4 ,lay the palm of your right hand firmly over band and pad and turn the child carefully1 holding your right hand still under him1 and with the left1 clear away all damp towels1 and then straighten out the band that is wrinkled under one side4 ,keep your knees close together4 ,now take away the right hand1 and see that the baby's knees are on the right side of your knee1 and the elbows well over the other side of your lap4 ,now you have the baby where he can kick1 but he can't wriggle or spring off your lap4 ,see that the back is dry1 rub it a little with your hand1 and powder4 ,look carefully in the deep dimple just at the coccyx and see if it is clean4 ,now pin the band snugly1 but not too tight4 ,use the smallest safety pins1 and never pin directly over the spine4 ,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 snugly4 ,while the baby is still on his stomach1 lay in place the diaper1 and next the shirt1 which should be open in the front1 and the pinning blanket4 ,lay all of these just as they should be1 as regards the back1 and turn him1 being careful to hold all the clothes in place4 ,if he is liable to chafe1 or the movements of the bowels are in any way irritating1 use vaseline about the buttocks4 ,now put the arms in the shirt sleeves and tie or button it up1 and then pin the petticoat or pinning blanket4 ,lay an extra diaper folded many times under him1 and fold the pinning blanket just in three1 bring the hem up to the waist and pin in place4 ,the dress goes on feet first4 ,slip it on over the pinning blanket1 and pass the right hand up under the buttocks1 and with the left1 pull the dress into place1 put the little hands in the sleeves1 and get it perfectly straight and smooth over the chest4 ,now pass the fore-finger of the left hand down inside of all the clothes1 beginning at the neck1 until you find the band 7the first garment71 take a small safety pin or any small ornamental pin1 and pin thoroughly through everything4 ,this last pin ,i consider most necessary1 as it keeps the dress1 shirt1 band and all in place4 ,turn the baby over once more and put a similar pin in the back of the dress1 being very careful to get at the band4 ,while the baby is in this position put the blanket he wears during the day over him1 and a final turn brings him around1 and he is washed and dressed all but his mouth1 which must be carefully washed with clean1 warm water or borax and water4 ,this should be also done many times each day1 if the mouth is sore1 and always a sharp watch kept for white patches on lips1 cheeks and tongue4 ,if the baby has hair to brush1 it is well to brush it4 ,it makes him look very cunning1 but if he is tired or sleepy1 do not trouble him4 ,this washing and dressing should not occupy more than twenty minutes1 ,i have done it in fifteen where the baby was very well behaved4 ,be sure that the room is warm and that the windows and doors are kept closed4 ,do not allow admiring relatives to come and go1 opening and shutting the doors as they do so4 ,if they want to see the operation1 let them come and stay4 ,a baby should never be bathed in a tub until the stump of the cord is off and the navel well and strong4 ,if there is any inclination to pouting of the navel1 wash the child on your lap and do not take off the band until the rest of the baby is all washed1 dried1 and powdered4 ,then take off band and compress1 and put on fresh ones as quickly as possible1 turn the child and pin as before directed4 ,in taking the clothing off1 it is not necessary to turn the child at all1 the band being the only thing pinned in the back4 ,n4 ,b4--,this method of bathing is for a normally healthy child1 from the time it is one week old1 until it is six months or more4 ,until the stump of the cord has sloughed off1 a baby should never be put into the tub4 ,if after the stump has sloughed there seems to be any protrusion1 or indeed any ulcerated look about the naval1 it is best to bathe the child on your lap4 ,in all such cases undress the baby as previously directed1 until you come to the band 7flannel belly band74 ,wash1 rinse1 wipe and powder him1 being careful to make every part absolutely clean and dry4 ,if the band is soiled or wrinkled1 or out of shape in any way1 remove it and put on a fresh one--looking every day1 after three days1 to see if the stump has come off--and if it is still adherent1 being most careful not to disturb it in any way4 ,apply the fresh band immediately4 ,turn the baby on its stomach1 and when the back is exposed1 wash and rub the back gently with your warm hand4 ,if the band does not need changing1 unpin it1 rub the back1 pin it up again1 and proceed in dressing as before4 ,when the cord is once fairly off1 and the navel smooth and clean1 you can put the baby into the tub1 very gently1 slowly1 and cautiously1 remembering that a sudden movement on your part may1 in fact1 always will make him scream1 and screaming with no band or compress on is for a baby a very frequent cause of umbilical hernia4 ,if the cord is small when the child is born1 there will be less danger of hernia1 but if it be a large one1 then beware6 ,it will not always be your fault if the baby's navel is not small and flat when you are leaving your case1 but you will always be blamed for it1 if it is not4 ,notice carefully every morning when you bathe the child if there is any umbilical protrusion1 and report it without delay to your doctor1 if there is any1 no matter how slight4 ,this is not1 however1 the place to treat of umbilical hernia1 and we will go on with the washing1 ,if the child's skin is very tender1 chafing easily1 wash with castile soap suds1 rinse and dry carefully1 after every time he urinates1 as well as when you bathe him4 ,powder with talcum powder4 ,sometimes no powder will do it any good1 then try vaseline4 ,if that will not do1 ask the doctor if you can try oxide of zinc ointment4 ,ordinarily1 extreme care in washing1 drying and powdering will be sufficient1 but it must be done every time the diaper is changed4 ,in this1 as in other things1 eternal vigilance is absolutely necessary4 ,when the baby is about two or three weeks old1 it is a good plan to put some alcohol into the water in which he is bathed--two or three ounces to the amount of water used in bathing4 ,have a small bowl of cooler water1 #gj degrees to #hj degrees1 for the face1 and after that is washed1 add a tablespoonful of alcohol to that also1 for the head4 ,it helps to toughen the skin1 and prevents the baby from taking cold so easily4 ,if the baby seems much frightened by being put into the tub1 spread a bath towel or small thin blanket over it and have someone hold his hands1 so that he will not clutch so wildly at everything1 then lower him into the water1 towel and all1 and he will not notice it so much4 ,i know of no place where deftness of handling shows to such advantage as with a baby4 ,he knows well enough if he is handled properly or not1 and his fretful cry1 or violent screams1 will tell you without delay if he is not comfortable4 ,once more1 let me impress upon the minds of all who read this1 the necessity of having everything used about the tub and subsequent dressing1 warm4 ,anything cold will make the little one scream1 and ,i think all nurses will agree with me1 that there is no more nervous work than washing and dressing a baby who is crying 7and once he begins1 he is only too apt to keep it up during the entire time74 ,this is especially true if a weak1 ignorant mother is made nervous by the noise1 or a doting grandmother hovers about1 making remarks about new fashioned ways1 and wondering why this child should cry when his mother was always so good1 as a baby1 in her bath4 ,now1 as to the time of washing a baby4 ,the morning is unquestionably the time1 but if the baby be very young 7less than two weeks7 and has been wakeful during the night1 ,i would let him have his nap1 even if it did delay you and interfere with your plan of work4 ,if he sleeps he is comfortable1 and1 unless for some more serious reason than the bath1 he ought not to be disturbed4 ,this1 for babies in private practice4 ,hospital babies cannot be so tenderly cared for4 ,when there are ten or eleven to be washed in one morning1 choose1 of course1 the ones that are awake1 as far as you can1 but there will always be one or two sleepy1 warm little ones about whom you will have some twinges of conscience as you begin to wash their faces1 but the work presses so1 it must be done4 ,a baby should not be bathed just after nursing1 or when he is hungry4 ,yet1 most little babies go to sleep at the breast1 and very often do not waken until they are once more ready for eating4 ,this seems like stating a difficult problem1 and ,i know it is not always easy to select just the proper time1 but the best way1 ,i think1 is this4 ,if the baby is nursing from the breast1 tell the mother1 after this nursing you wish to wash the child1 and not to let him go off for sound sleep4 ,she can prevent it1 and keep him for the twenty minutes or half an hour it is necessary to wait after his meal1 meantime you have time to get everything in readiness for the bath4 ,it is a great mistake to attempt to bathe a baby when he is hungry4 ,he will scream for his food from the beginning to the end of the performance1 hesitating occasionally when something warm touches his mouth1 and he eagerly seeks his meal1 only to redouble his cries when not satisfied4 ,nothing is so persevering in its endeavors1 as a hungry baby4 ,satisfy its appetite first and wait a reasonable length of time1 wash him deftly and quickly1 and he will be so sleepy by the time you are through1 you can lay him in his bed and he will be asleep in a moment1 when you can pick up all the soiled clothing and the general mess of the bathing operation1 and leave the room once more tidy4 ,and just here1 let me say a little about the washing of the baby's clothes4 ,of course the dresses or slips1 skirts1 and the diapers go to the laundress4 ,begin every morning on an entirely new1 that is newly-washed1 set of diapers4 ,gather up all that have been used the past twenty-four hours and have them washed4 ,perhaps they may not be ironed1 but washed they should be1 every twenty-four hours1 even if you have to do it yourself1 and ,i do not think a nurse should ever be called upon to do this4 ,still1 ,i would rather do it than use a diaper over and over again4 ,but it is of the little shirts ,i particularly wish to speak4 ,i think the nurse should wash these1 also the socks when they need it1 and the knitted shawls most babies wear4 ,it takes very little time to do this1 and if you know how1 you will do it much better than any laundress4 ,the best way to wash these things is in cool borax water1 and if there is any one place the baby has vomited on1 put a little dry powdered borax on 7the place being wet71 and rub it in4 ,then wash by plunging it in the water and squeezing it out4 ,do this again and again until the garment is clean4 ,rinse in clear cool water1 and wring as dry as possible in a towel2 then pull in shape and lay it on a clean towel to dry4 ,it is a good plan to lay it on a folded towel over a half shut register and place a single fold of towel over4 ,it will dry very soon4 ,if you are washing a baby's knitted shawl1 be very careful about the wringing4 ,lay a large towel 7bath towel is the best7 out flat1 and1 having squeezed the most of the water from the blanket1 lay it carefully on the towel and roll both together1 and wring very tightly4 ,if this towel gets wet take a second4 ,when you are satisfied that it is as dry as you can make it1 lay it out on a folded sheet on the floor1 in some room not much used1 and pull and arrange it into its original shape and size4 ,anything made of ,germantown wool stretches terribly1 but you can arrange it as it ought to be4 ,it will look ruffly here and there and ridgy all over1 but when it is dry it will shrink down all right4 ,only do not hang it up1 and when it is dry you will be surprised to find it looks as good as new4 ,if you are ever consulted beforehand as to what would be nice for the baby1 use all your eloquence against any color being put into these knitted shawls4 ,germantown wool is the best to use1 and plain knitting or brioche stitch is the best to wear and wash1 and these things must be washed with the most careful handling4 ,on the nicest baby they will become dirty1 and the delicate blues and pinks become the dismalest wrecks when washed4 ,therefore1 tell your patient not to put any color in these first plain little comfortable shawls4 ,they should be a yard long by about three- quarters wide4 ,two or three will be all you will need1 and do not use any of the fancy blankets sent in by friends4 ,lay these all away1 with a sachet bag or two1 in some convenient drawer1 and never take them out unless the baby is required to look very fine for a brief display to some friend4 ,these delicate1 fancy trifles when once wet through or vomited on are ruined1 and it should be your aim to leave everything as good as you found it when you go from the house4 ,there will be plenty of time after you have left1 for the fond mamma to spoil all the pretty things1 and as she does so she will appreciate more and more your care of them4 ,,xiii ,,the ,,valley ,,of ,,the ,,shadow ,i suppose that no nurse deliberately chooses to go to an incurable case1 yet most of us who have done private nursing have found ourselves at some time caring for one who slowly1 and painfully1 creeps nearer day by day to the great ,end4 ,we have gone perhaps to stay a few weeks1 for some acute disease1 but symptoms have changed1 and instead of recovery1 a long1 slow decline is to be faced1 the nurse feeling she is needed1 decides to stay and do what she can for the poor failing body1 and so the weeks drag on in the dreadful monotony of that one sick room1 until we feel that we have been left out of the real nursing world1 that we are stranded with our patient upon an island of pain1 that there is no outlook but the one dread ,valley1 no moving object but the river of ,death1 and no hope for the life we are guarding4 ,each week we grow more and more rusty as to our hardly-won surgical technic1 more out of touch with those who come and go to one patient after the other1 and who not unnaturally count upon so and so many victories over the very enemy who we know will overcome the life we are fighting to save4 ,yet we realize that all our care will never bring victory1 all our skill can but help to smooth the rugged pathway1 down which the feet must tread alone4 ,the endless repetition of the same symptoms is wearying1 the only possible variation being some new pain1 which indicates another stage in the development of the disease4 ,an improvement hardly cheers us1 as we know it is but temporary1 and maybe followed by an exacerbation of the trouble4 ,often the actual nursing calls but for a portion of the day1 but that portion is so necessary that the nurse's presence is imperatively demanded4 ,the remainder of the time little is to be done1 except perhaps a guard maintained over the failing strength1 a watch kept for untoward accidents that might snap the frail thread that binds the spirit still to earth4 ,probably the bedroom must be kept tidy1 and the patient's clothing cared for1 and the nurse feels she has degenerated into a servant4 ,one who has gone through with an experience like this1 and who has courageously remained with her patient to the end1 has passed through a training more severe than any she has had in her hospital life1 and she has earned a new diploma4 ,there are some things which the nurse may do to lighten these dark days1 some things which may help both herself and her patient1 and these ,i will try to show4 ,firstly1 it is well to study your case from a pathological view point4 ,find out the heredity1 the manner of the daily life1 the first manifestation of the disease1 what circumstances led to it1 how it was treated1 what success the treatment seemed to have1 what symptoms can now be noted1 what complications have shown themselves1 and their influence on the original disease4 ,a careful history could be written embracing all of these points1 and as new symptoms appear they should be observed and noted4 ,all this should be valuable and should help some future day to show some one who has but started on the dreaded pathway1 how to avoid what will surely be a fatal disease4 ,many a valuable paper could be written in the long hours when the nurse feels she is losing her time1 if she would intelligently study her case1 and write the story of the disease1 what led to it1 and how it is being combated4 ,perhaps1 if it could be arranged1 the nurse might be spared part of a day once or twice a week1 and she could go to her hospital out patient department1 or to some dispensary and do some work that carries a little feeling of success with it2 work in a babies milk station1 or almost any of the numerous charitable activities1 would rest and refresh one who has for months been with the same patient4 ,secondly1 as a psychological study4 ,we all know we must die1 we feel that we talk to people every day who perhaps will not be alive a twelvemonth hence2 but we are not actually certain that ourselves or any of our friends will so soon be dead1 and we habitually act and speak as if we all were to live on indefinitely4 ,so to be closely associated with some one who we know is drawing closer and closer to the life beyond the grave1 is a very solemn thing2 whether the sick one knows it or not1 the nurse knows it1 and such an one must be viewed with peculiar interest4 ,she is so near to knowing the great ,mystery4 ,she will so soon see those who have gone before4 ,the present helplessness will so marvelously become ,life ,everlasting4 ,it seems1 as the end comes nearer1 and yet more near1 as if1 perhaps1 one could send a message to some of our own loved ones gone on before1 ,if you see some of my dear ones1 on that other shore1 bear them a loving greeting from me1 tell them ,i am trying to live as they would have me live4 ,such a thought trembles on the tongue1 so near does the unseen seem to come to us4 ,in the face of these things1 how small do the thoughts of our own dignity seem4 ,it is all service1 and service is what we were made for4 ,i pass this way but once1 if1 therefore1 there is any service ,i can perform for my fellow man let me do it now1 for ,i shall not pass this way again4 ,this quotation is familiar to all1 and especially does it come to mind when we minister to those who are to die4 ,when they are gone there will be no bringing them back to explain duties slighted or left undone4 ,we pass this way but once4 ,thirdly1 from a religious point of view4 ,it is quite impossible to say1 what exactly is the nurse's duty as regards the religious side of her ministration1 though the wish to help must be often in the mind of every thoughtful nurse who has charge of an incurable case4 ,the patient may not know her condition1 and the doctor may not wish her to be told1 then1 of course1 the nurse's lips must be sealed1 as to any allusion to the dread truth4 ,the religious views of the patient and her friends may be different from anything that the nurse knows1 or perhaps the family pastor comes frequently1 and instructs and comforts the sick one1 and the family4 ,a patient will sometimes ask for the reading of some portion of the ,bible1 and unless the part is specified the nurse may be at a loss just where to turn4 ,some parts of the ,scriptures are so generally known and accepted1 that they can hardly fail to give hope and comfort1 no matter what the religious teaching may have been heretofore4 ,i will suggest then in case readings are asked for4 ,the ,psalms are full of beautiful comforting thoughts and prayers4 ,the #bc;d has helped many a poor soul about to take its last journey1 the #cgth1 which begins ,fret not thyself1 shows that those are truly blessed who trust in the ,lord1 the #east1 ,have mercy upon me1 ,o ,god1 teaches repentance1 the #db;d1 ,as the hart pants after the water-brooks1 so longeth my soul for ,thee1 ,o ,god1 shows the desire of the soul for ,god4 ,in the ,new ,testament1 the #adth chapter of ,st4 ,john's gospel is a universal favorite1 on account of its comforting thoughts ,in my ,father's house are many mansions4 ,in ,st4 ,luke's gospel chapter #aeth1 verse #aa1 we have the parable of the ,prodigal ,son1 to show how complete and perfect is ,god's love1 and ,his forgiveness1 when sin is forsaken4 ,in #ast ,corinthians1 #aeth chapter1 verse #bj1 we have a masterly argument for the resurrection from the dead1 and a life beyond the grave4 ,in ,revelations1 #adth chapter1 #acth verse1 is a very comforting thought for those who have led a strenuous life and are in much suffering4 ,these few references will help1 ,i hope1 if any nurse is called upon to read the ,bible1 and she feels a little nonplussed as to exactly where to turn4 ,there are of course innumerable passages besides these1 that could be found by the aid of a concordance1 and which it would be wise to note on a slip of paper1 ready for any call4 ,sometimes a patient will ask for a prayer1 and it is not often that a nurse would feel competent to kneel down by the bedside and make an acceptable extemporaneous prayer1 so ,i would suggest buying a volume of ,prayers for the ,sick4 ,very tiny1 dainty little books can be purchased at the church book stores1 full of these prayers4 ,in the ,episcopal ,book of ,common ,prayer are many helpful prayers4 ,the sentence1 the collect1 and the whole of the ,easter service in this book are radiant with the truths of the ,resurrection1 and the ,easter hymns are tuned to the same inspiring theme4 ,this last thought ,i leave with you4 ,what more helpful consideration can come to a weary nurse1 than that the sick one to whom she has ministered for so many weeks or months should at last1 on entering in to the life ,eternal1 lay before the ,lord of ,glory1 the name of the one who was with her1 who helped her1 who cared for her1 and who was faithful to her trust to the end8