Can someone help out a student nurse in need?

P_RN, ADN, RN · Jan 14, 2002

1. How has health care changed since when you began nursing?

In the 80's the mix of patients was much less intense than today

You may have had more patients, but the needs of those patients were much lower. Now these patients are either treated as outpatients or home care patients. The admission rate has decreased. The work of the nurse has increase geometrically.

Patients are sicker now. Patients are being admitted to general floors who would not have survived even 5 years ago in an ICU.

The numbers of Nurses employed in hospitals have not changed, but the acuity has. The number of other ancillary department employees has increased.

The age of the average nurse is higher now that ever before.

Fewer nurses are being graduated and entering the field. The shortage will be of "available Nurses."

2. What is one positive change? Why?

Patients survive today who would not have survived 20 years ago. However the "grade" of health care in America in below that of some much poorer countries. I believe US is the only one of theFirst World countries that do not have a national health care program, not including Medicare/Medicaid.

3. What is one negative change? Why?

The impact of cost containment, AEB managed care, HMO and the restructuring of health care. Patients are not necessarily being cared for by Nurses. The person at the bedside may be a tech, aide or PCA with minimal training. Hospitals have begun to consider reducing the Nurse FTE by the increase of the numbers of these UAP's.

IMHO

P ( REALLY OLD NURSE)

prn nurse · Jan 19, 2002

And I really like your signature line. I need to be reminded of that. I may copy it and put it on my computer. It is soooooooooo true.

hoolahan, ASN, RN · Jan 19, 2002

1. How has health care changed since when you began nursing?

Well, when I started in nursing school, we were taught that we were to wear the least amount of protective equpiment in order to spare the pt's feelings. Eg, not wear gloves when emptying a bedpan (which fotunately no one practiced!) And AIDS was not a recognized diagnosis, at least not widely when I graduated in 1981, we were still taught to recap and break needles, and then to break the hub of the needle so that if found in trash, they could not be re-used. Universal precautions did not exist then. The worst paperwork we did was a nursing care plan, which we usually hand wrote, no check-off lists. No fast-track surgery, everyone checked into the hospital the eve before surgery at a minimum. Open heart pt's stayed a minimum of ten days, now they stay five. And of course the technology is greatly advanced sine then.

2. What is one positive change? Why?

Well, maybe it's b/c of the negative effects I will discuss, but there are more opportunities for nursing to move away from the bedside now. IN the past there was not so much a nurse could do when her back gave out, now there are research jobs, case manament, occupational health, etc...

3. What is one negative change?

Without a doubt, managed care. The concept of enforcing a system of control on docs who ordered too many tests or sent pt's for procedures w/o needing to meet a criteria, or get kickbacks. That was all well and good, but it went to the extreme, and everyone reacted in the extreme, cutting back nursing staff, utilizing unlicensed staff. No more IV team, lab techs doing our labs, and forget about EKG tech! Now the nurse is all of these rolled into one. Less time is available to do actual nursing, since we are so busy trying to be six people.

P_RN I liked everything you said.

nur20 · Jan 19, 2002

Technology has advanced beyond belief. There are more opportunities for those with a nursing background. Universal precaution was introduced. All hospitals still utilized L.P.N's................. Positive change..Regulations and laws are being looked into to acommadate the rapidly advancing aging group. People are living longer due to research and technolgy that we eventually use in nursing, hospitals are considering re-introduction of L.P.N.'s.... .Negative change....Revealed medicare fraud .increase in paperwork, short staffing, patients have shorter stays in hospital which is good for my area(homecare), and managed care

Mijourney · Feb 1, 2002

Originally posted by Annamarie
For a school project I need input from a nurse who has been working in the nursing field since the early 1980's. If you could take a couple of minutes to answer a few questions it would be much appreciated.
1. How has health care changed since when you began nursing?
2. What is one positive change? Why?
3. What is one negative change? Why?
Please help!
Thank You;)

Hi. Over 20 years in fact. To answer your questions:

1. Healthcare in many ways to me has become more like a fad or trend with different flavors of biotech and advanced tech every day, week, month or year. Very much like upgrading cars and computers. Healthcare makes up a larger portion of the GDP then under the old GNP. Lots and lots of money in health care today. More healthcare users.

2. This question is hard, because I see healthcare only from nursing's perspective. Nurses have proven our worth by being valued by a wide range of employers. This is increasing by the day as more and more healthcare is done outside the hospital.

3. Greed or the focus just on money as the bottom line seems to be rampant in healthcare. There just doesn't seem to be enough policing or oversight of people who come into healthcare at the expense of patients, families, and frontline workers.

Best wishes with your paper.

nehi · Feb 1, 2002

Hi,

I have been a nurse for 23 years. I started as a CNA and worked my way to a RN MSN. In the 80's we didn't have Universal precautions! It was 1987 before my first inservice on that topic. There have been so many changes. We went from behind the scenes to part of the team. We threw out the glass IV bottles and discovered plastics. We began dressing for comfort and effiency vrs all whites. If there is one thing I dislike or have found negative that changed it would be we somewhere lost the "sisterhood" of nursing. Maybe that's why I founded an Organization! Good luck in your journey and NEVER give up, it is all worth it!