Nursing Changes Since the 80s?

  1. I originally entered college for my nursing degree in the late 80s, changed majors due to all the negative I received from those around me, and now changed careers to go back to school for nursing.

    I am still receiving tremendous grief on the horrors of nursing (though not as much!). Can those of you who have been in the field for the past 20 years provide your observations on the biggest changes in nursing since the late 80s?

    I really appreciate and thanks!
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  2. 13 Comments

  3. by   karenG
    we dont do back rounds any more!!!! and patients seem to be discharged on a regular basis with horrific pressure sores- something I would have been hung,drawn and quartered for! actually think there have been some great strides forwards with regards automomy and developing professional practice. But I think that the basic nursing care seems to have gone out of the window! But I dont work in a hospital anymore...........just seem to pick up the pieces when my patients are discharged. so......waiting to get flamed on this (puts on flame proof jacket!)

    Karen
  4. by   P_RN
    You don't get to know your patients as well. Hospital stays are often less than a shift. I've had as many as 3 different patients in a bed in a 12 hr shift.

    People on a general floor are sicker than they ever were in the 80s. "Ordinary" problems/surgery are done outpatient.

    The amount of responsibility is greater now. You are expected to know more and act faster. It's a "watch your back" because no one else does.

    The pay is better but has not increased with the rest of the workforce.
  5. by   imenid37
    with the advent of computer charting and federal regulation from one end of the alimentary canal to the other and back...there's EVEN MORE CHARTING and busywork than ever. i remember graduating in 1987 and thinking my goodness what a ton of chartin g i have to do. now even worse! good luck. it's still great to be a nurse in many ways, but a real drag too!
  6. by   mattsmom81
    From DRG's to managed care, nurses are now expected to do more with less in all aspects of our work as hospitals strive to maximize their profits. We are the biggest group of employees, so it's easy to make cut backs with our group so managers can see results quicker. More nurses are supervising more unlicensed assistive personnell on the units, after a shift to primary care we are now moving back to team nursing. (but with less nurses)

    Case management is a biggie with docs getting pushed to discharge more patients sooner. Home health nurses are caring for more ill patients at home, forced out of the hospital too quickly.

    I was treated more like a professional early in my career (70's and early 80's) than I am now. Now I am a 'customer service person.' If I save a life, but the family is not thrilled with my demeanor in any way, I may be in trouble with my boss.

    The shortage has worsened as nurses tire of all the BS in our job, and receiving so little thanks or consideration. MOT and now the push for no overtime PAY is looming over us, when we stay on because there is no replacement for us we may now not get paid OT for it...

    I've just touched on a few things...there are lots of older nurses here who can elaborate more. Just go in with your eyes wide open if you go back. And have a plan to take care of YOU...it is harder than ever to not get overwhelmed and burn out.

    It has it's rewards day by day, and person by person, to help them through a difficult hospital stay and back to their optimal level of health. We find our rewards where we can...
  7. by   KristinWW
    Gulp! Don't see anything here that I can report back to the naysayers criticizing my return to nursing studies! As the song goes, "Tell me something good......"
  8. by   mageean
    Patients now tend to present with more complex needs and are discharged faster!!. Increased community resources are not always able to keep up. The additional paperwork and national target setting takes away from any concept of person centred care. After 30 yrs I am now looking forward to retiring!!!
  9. by   mattsmom81
    Kristin, what made you think things would be better now than in the 70's and 80's??? Or were you just hoping?

    Nurses are now talking amongst themselves and openly admitting to the problems. This did not occur 20-30 yrs ago like it does now. The basic problems were around back then (lack of respect, etc) but have worsened. Women have more career choices now, so intelligent women don't have to take demeaning jobs. The word is out and kids aren't choosing nursing, and those who choose to leave have....thus the shortage.

    The responsibility alone in our jobs should give students cause for pause. Read your nurse practice act; it's a real eye opener. Attend a legal seminar. It's gotten to the point where families and facilities (and their attorneys) can find a way to get us iif they want to. We learn to be soooo careful; and then we may find it may not be enough.....

    One example: in my state nurses have lost their licenses and been sued because a doctor's decisions caused harm. Due to the wording in my practice act, the nurse is responsible if this happens. So...we are supposed to supervise doctors?....<sigh>

    It is not an easy profession, one's heart must be in it to last. After years feeling used and abused, many get stuck and WISH they could leave, but don't have the resources or energy to start over, return to school, etc. They keep pluggin' doing best they can day by day.

    I like the flexibility to work PRN and agency, or take a travel position if I choose. This is a plus for me. I do feel good helping people, so that is another. I do my best to keep my knowledge current and my patients as safe as I can keep them. As I said, nurses get our rewards where we can find them.

    While I'm sure every profession has its problems, my opinion has formed over a 27 yr career, and if my daughter/son told me they wanted to be a nurse I would speak the same words to her.

    Sorry so long. Best wishes whatever your choices.
  10. by   CCL"Babe"
    More technology.

    CNAs do finger sticks, VS.

    We are expected to do more with less.

    Lot's more paperwork.

    Hospitals seem to be cutting more corners.

    Less housekeeping services. (which means I empty a whole lot more trash cans)

    Sicker patients.

    More educated consumers.

    More aggressive family members, patients and families less likely to follow hospital rules.
  11. by   BadBird
    More needleless systems, increased use of personal protective equipment, more recycled items such as pulse oximeter probes, scd's. softer mattresses, improved skin care products, less mixing of medications, you no longer add potassium to your iv's where they used to be lying around in vials, medications locked up more now, nurses used to smoke at the nurses station. more use of computers, more colorful nursing uniforms, cleaner hospitals back then, more NP's and PA's now. That is all I can think of now.
    Last edit by BadBird on Jul 1, '03
  12. by   disher
    Positive changes that have occurred are:
    -greater diversity in the workplace and a greater acceptance of peoples differences
    -increased diagnositic technology and improved ability to detect problems while they are still manageable
    - nursing has become more research based (less anecdotal) and this has improved our professional image and our effectiveness on interdisciplinary teams
  13. by   karenG
    Originally posted by disher
    Positive changes that have occurred are:
    -greater diversity in the workplace and a greater acceptance of peoples differences
    -increased diagnositic technology and improved ability to detect problems while they are still manageable
    - nursing has become more research based (less anecdotal) and this has improved our professional image and our effectiveness on interdisciplinary teams
    hmmm yes nursing is becoming more research based- but I think we have thrown the baby out with the bath water at times. when I trained, ok back in the dark ages, we used honey as a wound dressing. no evidence- it just worked! now there is evidence and hey presto we are using it again!

    hospitals were cleaner, the patients went out better, no pressure sores, not malnurished (a claim that is made over here) ok we didnt have the technology but that is not necessarily (sp) a bad thing. how often have I as a midwife watched a doctor talk to the fetal heart monitor rather than the mother in labour?? I think we had more nurses on the ward and yes I was terrified of the ward sister, her word was law. so I think the care was better or maybe different. we didnt work under the same stresses as today- a patient for a vitrectomy was in for 2wks! so maybe its not really fair to compare today with yesterday. we all try to do a good job and deliver the best care we can- that hasnt changed. I do think we need to be given the tools to do the job.

    ok off soap box now:roll

    Karen
  14. by   OKNURSE
    Actually, I graduated from nursing school in the 60's and have seen many changes. Some changes upset me. Being of the "old school" so-to-speak, I hated to see white uniforms & nursing caps
    go "by the wayside". I am certain that all of you younger nurses love the colorful scrubs (and I have a closetfull myself), but most new graduates say they are glad they don't have to wear a cap. I, among many others in my era, were proud & honored when we had our capping ceremonies. The epitome of what a nurse should look like used to be a starched white uniform, white stockings, white shoes and a nursing cap designed by her schcol of nursing. However,I still feel, since I went to nursing school in the era where nurses still looked like nurses, that the professional appearance, as well as the professional demeanor no longer exists.

    Technology in the past 30+ years, of course, has improved significantly, and I am all for progress-----however, I still think that the "old-fashioned" form of narrative charting was much better and more descriptiive & complete then "charting by exception", "check-list charting" or computerized charting.
    Another change is that nurses are no longer taught to respect the physicians. When I was in school, we were taught to get up if the physician entered the nurse's station, and offer him your chair. Now, it seems that nobody respects anybody!

    On a positive note, nursing salaries have improved significantly (since the 60's). However, for me, it was too little, too late!
    And ,even after 34 years, I still don't make as much as I should be making or could be making elsewhere.

    There is also an extremely diverse selection as to what type of nursing is available. You can become specialized in any area , or you can become a flight nurse, work for a home health agency, be an industrial nurse, work for hospice, a dialysis center, rehabilitation, etc. The choices are endless.

    I, for one, have seen many changes & improvements as far as equipment & supplies and diversity of career choices. I have seen many changes(not all for the better) in health care in general with DRG's, PPO's. HMO's, PPS, as well, as the different statuses of patients treated in the hospital setting; acute care, ambulatory care/outpatient surgery skilled/Swing Bed, Observation, etc.

    Nursing has come a long way in the last 30+ years, but I will always reflect on the way nurses & nursing used to be and feel that some degree of pride, ethics & professionalism in the nursing profession has been lost forever.

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