shall begin, as, unless their calendar is definitely arranged, they
are unable to earn a livelihood. This leads to a question which is
difficult to answer, for the precise day of delivery is uncertain;
consequently to fix the beginning of the engagement may prove a
troublesome matter. On the one hand, there is risk of having to pay
the nurse for a time before her services are actually needed; on the
other, a false economy may result in the absence of the chosen nurse
at the critical moment. In finding a way out of this dilemma a
patient must be guided by her means and the location of her home.
Those who can afford it will not hesitate to employ a nurse from one
to two weeks in advance of the expected date of confinement; and for
those who live where nurses cannot be procured quickly, a similar
course is recommended. But persons of only moderate resources, living
in a city where, in an emergency, a substitute can be gotten from the
local "Nurses' Directory," will find it convenient to engage the
nurse from the calculated date. The substitute will remain with the
patient until the arrival of the nurse originally engaged.

Occasionally, it may happen that a patient will prefer to keep the
substitute. Such a course, however, would be unjust to the nurse who
was first selected, unless she could immediately secure other work.
She has reserved a definite period of her time for the patient, and
probably has declined work which seemed likely to conflict with the
engagement already made. She is fairly entitled, therefore, to assume
charge of the case, and the patient who refuses to make the change is
obligated to pay her according to the terms of the agreement.

How long will a nurse be needed after the child is born? The answer
to this question may be altered by so many circumstances that a hard
and fast rule cannot be given. Before the advent of "Trained Nurses,"