NUBSma. 299 



meanwhile thoroughly freshened by opening the windows, spreading out the 

 bedclothing, and leaying the mattress or bedding uncovered for some hours. 

 If, on the other hand, the only available room is downstairs, it will be prudent 

 to postpone the change for a few days longer. 



If it happens to be mild, bright summer weather, and the patient's recovery 

 has been rapid and satisfactory, the medical attendant may, in an exceptional 

 case, consent to her taking a short walk or drive, at the end of three weeks. 



After confinement a patient's linen requires to be frequently changed, both 

 for health's sake and her own comfort. The patient must on no account be 

 allowed to sit up or make any exertion while the clothes are being changed; 

 the nurse must take off the soiled clothing by drawing down the sleeves from 

 one arm, gathering up the clothes on that side into a handful, passing them 

 gently over the head, and then drawing off the sleeves from the opposite arm. 

 The clean linen, well aired, must then be put on as the patient lies. 



The first binder should always be placed next to the patient's skin; after 

 the first twenty-four hours this is a matter of less consequence. Each morning 

 during the first week a clean binder should be applied with moderate tightness, 

 the nurse re-adjusting it from time to time during the day in case it should 

 become wrinkled or loose. 



The patient's hands and face should be washed, and her hair straightened, 

 as far as is possible without raising her, every morning. The hands and face 

 having been attended to, the external genitals should be thoroughly cleansed 

 over a bed-bath by means of a sponge and some water. In the absence of a 

 bed-bath, a large slipper bed-pan may be made to answer the purpose, and if 

 neither is obtainable, the patient must be made to turn on to the left side, with 

 the thighs close to the edge of the bed, and the knees drawn up, when, the bed 

 being duly protected by means of a rubber and warm folded sheet, the nurse 

 can proceed with the sponging in the manner ordinarily adopted immediately 

 after labor. For the first few days, while the lochia are somewhat abundant, 

 it is well to repeat this process again in the evening. 



Should the nui-se while bathing the patient, discover a wound or raw sur 

 face, or any unusual swelling, she must quietly mention it to the doctor at hi? 

 next visit; and so, too, if she finds any piles protruding. In the event of the 

 patient complaining of severe pain from piles, the nurse must frequently foment 

 the part, or apply a bread-poultice, until she receives instructions from the 

 medical attendant. 



Vaginal injections and douches are only to be used under medical direction. 



The mind requires rest equally with the body. No painful news, or other 

 exciting or disturbing influences, should be allowed to reach her. The visits of 

 friends to the lying-in room must be entirely forbidden, except in the case of 

 those who have obtained special permission. 



It should never be forgotten that a peculiar and distressing form of mental 

 derangement is liable to attack lying-in patients. Hence, if a nurse finds her 

 paiient irritable in temper and difficult to manage, she must avoid anything like 

 contention or direct contradiction. By a firm, quiet, decided manner, a good 

 nurse will be able to carry her point without exciting her patient. 



