Making Good on Private Duty: Practical Hints to Graduate Nurses

Part 1

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MAKING GOOD ON PRIVATE DUTY

MAKING GOOD ON PRIVATE DUTY

PRACTICAL HINTS TO GRADUATE NURSES

HARRIET CAMP LOUNSBERY, R.N.

PRESIDENT WEST VIRGINIA STATE NURSES' ASSOCIATION SANITARY SCHOOL INSPECTOR FOR CHARLESTON INDEPENDENT SCHOOL DISTRICT

"Not to be ministered unto, but to minister"

PREFACE

Though technic is constantly changing, methods improving, and the teaching in our schools grows better and more comprehensive, the old problems in private work are ever to be faced, and still the young sister in our nursing world needs to be counselled, guided and helped. It is for these young private duty nurses that this book has been written.

For six years I went up and down one of our large cities doing private nursing, and I can remember, as if it were but yesterday, the curious little sinking of the heart I used to feel, as I mounted the steps of a house where there was a new patient needing my care. "Would I do everything right?" "Could I please the patient and the friends?" "Would the doctor be satisfied with my efforts?" "How would I feel when I was leaving?" "Encouraged or hopeless?" "Happy or sad?" A strange house looks so forbidding, "would this one ever look friendly?" There is time, while walking up the steps, for these and many more such thoughts to crowd into the nurse's mind. Once in the presence of the patient, however, all this quickly changes, and action puts all wondering and doubt to flight.

The "hints" here given are the fruit of my own experience and that of the graduates of the school of which I was the superintendent. Many long talks we had, when they felt the need of coming back to their hospital home for advice and comfort. 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 [Footnote: Printed by permission of the Trained Nurse.] to the Trained Nurse and write a few new ones, which have within the past year appeared in the American Journal of Nursing.

In the chapter "Hints to the Obstetrical Nurse," there is little or nothing that is commonly taught in the class-room.

All of that is so well done, repetition here would be tiresome. All the asepsis is familiar to every graduate. She knows how to sterilize any and every thing, but sometimes she does not know the best way to wash and dry the baby's little shirts or knitted shawls. Sometimes she will not realize that if the layette cannot be purchased at a store, old table linen makes the best diapers for the newborn baby, and that his pillowcase should not have embroidery in the center.

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 confinement. I have been asked so many times to tell a young expectant mother just what to get, that I have made for convenience as full a list as is necessary for any baby or mother, with some hints as to the washing of the baby. The rest it is expected every nurse who graduates from a training-school would know. The table for calculating an expectant confinement was cut from a medical paper and given me by a physician some years ago. He did not know who wrote it, nor do I, but he always used it, and I have found it most accurate.

The recipes I have given are, I know, reliable, having all been tested many times. Most of the articles of food every nurse has probably prepared, but exact proportions have a dreadful way of slipping out of one's memory. 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 housekeeper, but to a nurse who has perhaps not made a custard for a year it might carry many difficulties.

I have tried to help in this most important part of a nurse's duty, and not only as to the food served the patient, but the manner of serving it, which last is truly to a sick person of as much importance as the food itself. The few leaves I have left blank are for such additional recipes as every nurse will gather as she goes from house to house. Any cook will be glad to give some hints as to how she does this or that, and no nurse should be too proud to learn from the cook, or anybody else. I shall never forget the fat little Irish woman who taught me to make clam broth, or how much pride she took in my first success. To ask the family cook for advice is sometimes good policy; she is often so ready to resent any extra work caused by the sickness or the nurse, it pays well to conciliate her, by asking for her aid or counsel. To feel that she can teach the "Trained Nurse" will often make a friend of the cook, and this will make things pleasanter all around. It is with the hope that these homely and perhaps somewhat old-fashioned hints may be of real service, that this little book is sent forth to do what good it may to those who are setting out on their professional careers. It is ever to the young that we elders look, knowing, as Mrs. Isabel Hampton Robb has truly said, "Work shall be lifted from our hands and carried on to loftier ideals and higher aims by the strong young hands, hearts and brains of future nurses." H. C. L.

Charleston, W. Va.

CONTENTS

CHAPTER

I. THE NURSE AND HER PATIENT

II. THE NURSE AND THE DOCTOR

III. THE NURSE HERSELF

IV. THE NURSE AND HER PATIENT'S FAMILY, FRIENDS AND SERVANTS

V. GENERAL REMARKS ON FOODS AND FEEDING

VI. THE NURSE AS RELATING TO HER TRAINING SCHOOL AND TO HER FELLOW NURSES

VII. WHY DO NURSES COMPLAIN?

VIII. THE NURSE AS A TEACHER

IX. CONVALESCENCE

Part 2

X. HOW SHALL A NURSE OCCUPY HER DAYS OF WAITING?

XI. SOME HINTS FOR THE OBSTETRICAL NURSE

XII. AS TO WASHING THE BABY

XIII. THE VALLEY OF THE SHADOW

THE NURSE AND HER PATIENT

You may think it unnecessary for me to tell you any more about "the patient." You will say, perhaps: "Have I had all this training, and must I yet be told how to treat a patient?" I answer that you have been taught how to watch the progress of disease, how to follow intelligently the doctor's orders, also certain manual arts, your proficiency in which is unquestionably most necessary, but there is much more comprehended in the meaning of the term "a good nurse" than this. 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 life, where the routine and the many rules and the constant supervision make them less likely to become prominent. "She bangs the doors." "She breaks the fine china." "She wears heavy shoes," or "She talks too much," or "She is pretty and spends too much time over her front hair"--but why go on? You have all heard such tales--ad nauseam, and if you are wise, you will set up a sign-post against every one of these snares into which your sister nurses have fallen, and on this you will print in large, clear letters: "Danger! Walking on this place forbidden." So much by way of apology for treating you once more to a lecture on "the patient."

The relation between nurse and patient should, from the first, be a more than amicable one. You have come to bestow the priceless blessing of unwearied, skillful care upon one who should thankfully receive it, and believe me, 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 life, you are in no condition to undertake the work. Your nursing should be, in a way, an exponent of your own spiritual state; looking at it in its highest aspect, an outward and visible sign of an inward and spiritual grace.

In the first place, then, you must be in entire sympathy with the sick one--and here do not mistake me--by sympathy I do not mean sentimentalism. The two emotions are as far asunder as the poles. Sympathy, then, you must have, and if you do not intuitively feel it, let me tell you what to do to rouse your dormant feelings. Try earnestly to put yourself in the patient's place. Has she had an operation of some kind, and you have all night been trying to keep her quiet on her back, and she has been begging you to let her turn "never so little?" When you go to lie down, and have, perhaps, a backache, and feel tired, instead of settling yourself in the most comfortable position you can, lie straight and square on your back and say to yourself, "Now I can't turn over," and imagine you have by your side a nurse who will not let you turn. You will find out in the course of an hour that your patient has had a good excuse for all her complaints, 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 ease. The patient will profit by such exercise on the part of the nurse, and your sympathies will be quickened. Never forget that the patient is sick, and you are not. You can, you must be firm in what you know is for your patient's best good, but you must never be dictatorial or argumentative. It is hard, I know, to bear with all the foolish, unreasonable whims of sick people, but if you are true nurses you will do it. There are, however, several consoling thoughts which have always helped me, and which I will tell you. In the first place, always remember, as I said before, that the sick one is sick, and on that ground you can overlook much. In the second place, remember that it will not last long. A few days or weeks will surely bring a change. She cannot, in the nature of disease, remain for long in the very trying stage, unless indeed she have some kind of mania, and of course if that is the case, you need pay no attention to her whims. If she says white is black, let it go. It does not make it so to have her say so, but if you argue the point, and bring all your wisdom to bear upon your demonstration, you may bring her pulse and temperature up to a point that will do her a real injury.

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