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.