Uniforms should be in keeping with her position and becoming to the individual nurse. They should be well tailored and in good condition. Uniforms with collar and cuffs should be worn at all times when the nurse is on duty and never worn when off duty.
Dark blue silk, made shirt waist style with detachable white linen collar and cuffs.
Plain tailored hat of dark blue or black felt for winter and straw in summer.
Plain tailored coat usually of navy blue or oxford gray heavy weight for winter.
Sweaters for outdoor wear are generally worn under coats. In any case they should be of inconspicuous colors and harmonize with the coat.
Shoes should be of comfortable oxford type with medium heels preferably black with hose to correspond.
Jewelry is restricted to wrist watch and school pin. The school pin is to be worn on upper left front of blouse.
Every nurse doing home visiting should see that her bag is clean and fully equipped before starting the day. Each nurse is responsible for keeping her equipment in good condition. Bags are usually provided by the agency and remain the property of the agency. Lost or broken articles are replaced at the nurse’s expense. Bottles should be neatly labeled “poison” on Lysol bottles. Linings should be changed or cleaned often as necessary. A thorough cleaning of equipment and the detachable lining is essential at least once a week when in use.
Glass articles – wash and boil three minutes.
Rubber Goods – Wash and wrap in gauze and boil three minutes than dry.
Hand Brush – Boil for five minutes after using
Instruments – Boil for five minutes, dray and clean, oil frequently enough to keep in good condition.
Communicable Disease Service
The nurse hat, coat and bag are never taken into patient’s room. No article which cannot be sterilized, disinfected or burned are taken from nurses bag into patients room. A gown is worn in place of the regulation apron and is folded, wrapped in newspaper and carried (not in nurses bag) to the office to be boiled. The nurse should carry her own supply of newspapers. A thermometer and supplies for its cleaning should be provided by the family if possible. The thermometer from the nurses bag may be used when necessary which must be cleaned and returned to her bag at the end of visit. All supplies needed should be collected before the nurse enters the patients room, so that she can remain in the room until care is completed. The nurse should request the family to assist her by opening and shutting doors. The nurse should explain the method and danger of contact infection which necessitates extreme precautions, but she should aim to carry out her technique as simply as possible so that the person who is to give care during her absence will not be overwhelmed by the tasks imposed upon her. The attendant should war a gown or large apron which will cover her dress when giving care to the patient.
Important things to remember regarding the bag are:
- Bag should never be placed on the floor or sidewalk.
- Interior treated as surgically clean, always wash hands before removing articles.
- Carry no drugs or equipment except that which has been approved by the Health Department.
- Introduce self by name and organization.
- Place bag on chair, which nurse has first covered with newspaper from her own supply.
- Remove hat and coat.
- Inquire about patient.
- Remove wraps in following order:
- Gloves – put in pocket of coat
- Hat – put upside down on chair (same chair with bag)
- Coat – fold right side out put on back of chair.
- Take bag to bath room or kitchen, cover a table or flat surface near running water to received bag and supplies.
- Roll sleeves up above elbow. Make three paper bags and while doing this ask the attendant for the following articles:
- Thermometer, cotton, alcohol, vaseline.
- Gown for attendant, basin for nurse, basin for patient, covered soap dish for nurse.
- Covered pail for wash water.
- Covered receptacle for patients dishes. Pitcher of hot water. Pitcher of cold water.
- Bed pan and toilet paper. Wash boiler or tub for soiled linens.
- Linen for bed (if going general care)
- Cord for tying up waste parcels. Newspaper to spread on floor for linen and pails
- Tray for patients toilet articles
- Have attendant place all these articles just outside the patient’s door.
- Open bag and remove green soap, paper towels and 3 paper napkins
- Spread out napkin near bag, place other napkin and towel on it
- Uncork green soap and place on napkin
- Put wrist watch on one folded napkin to be carried into patients room
- Wash hands and arms to elbows, dry on paper towel and put towel in newspaper bag.
- Put on gown, tie top string, lap right side of back cover left side and tie strings, at waist, return envelope for gown to bag.
- Remove alcohol bottle, place on napkin
- Remove cotton, place 6 pledgets in end of basin, return container to bag, moisten 2 pledgets with alcohol
- Remove thermometer and return case to bag, cleanse with soaped pledget, wiping down spiral motion, holding over paper bag. Rinse under running water. Dry and wrap in cotton moistened with alcohol, place in napkin.
Nurse will carry into patients room the following articles:
- Thermometer wrapped in cotton pledget and placed on napkin.
- Watch inside paper napkin.
- Paper towel
- 2 paper bags, one for waste and one for gown.
- Paper napkin for thermometer when leaving room
Inside the patients room:
- Cover table or chair with clean newspaper to receive paper towels, paper bag gown, newspaper and paper napkin.
- Thermometer and watch inside napkin may be placed on back of table or dresser
- Cover floor near door with newspaper to receive following articles
- Bag for waste
- Covered receptacle for dishes
- Place newspaper on floor near foot of bed for soiled linen.
- Inspect patient – note appearance
- Take temperature
- Take pulse and respiration, holding watch inside napkin, being careful not to contaminate watch. Use pledget taken into room for wiping off thermometer. Read thermometer and place in second alcohol pledget.
- Give other care indicated as suggested by physician
- Carefully explain and demonstrate to attendant or assistant all procedures, which she is expected to carry out before nurse returns, gives special emphasis to care of mouth, nose and disposal of bodily discharges.
- Place soiled linen into container outside door.
- Empty all fluids into pail ( use disinfectant if ordered by physician)
Place near door the following articles
- Dishes in covered receptacles
- Wrapped waste bags, Which have been tied securely.
- Empty all fluids into pail (Use disinfectant if ordered by physician )
Place soiled linen into container outside door, before leaving patients room.
- Untie back of gown at waist.
- Wash hands with soap and water.
- Untie neck of gown, remove and fold at shoulders with contaminated side in, being careful to lap left side over right side, then crease do\vu center front with back folded in, roll firmly, beginning at neck, so that bottom of gown will be on outside when finished, place in paper bag, fasten top
- Put watch in pocket.
- Pick up thermometer, carry out and follow specific technique before putting it into bag. Paper bag containing gown should be taken out at the same time.
After leaving patients room
- Scrub hands with brush, clean nails with orange stick, wash arms to elbows and dry
- Boil brush and orange stick in basin for 5 minutes.
- While brush is boiling nurse should see that helper takes everything out of door of patients room, clothing covered with a 2% Lysol solution for 2 Hours before washing, dishes put on the stove to boil for 15 minutes, all waste tied in paper burned and waste water emptied, after being treated as per physicians orders.
- Nurse should then take patients record out of the side of her bag, using a clean newspaper to place it on, write record before leaving and return to bag. If the nurse wishes to assist the helper in removing things from patients room, she may use a clean napkin to protect her hands.
- Final instructions should be given to helper just before the nurse leaves.