Nursing: Then and Now Nursing: Then and Now - pg.10 | allnurses

Nursing: Then and Now - page 10

Looking back to when I was in nursing school, and then starting my nursing career, I remember many things that are no longer in use, or things that have transformed over the years. Gone are the days... Read More

  1. Visit  amoLucia profile page
    0
    "Appears sleeping" is my first favorite, then "appears to cease breathing"is my second fav. How stupid.....

    Like others, I am careful with dropping diagnoses, and that IS a throw-back to the old days. I will qualilfy any diagnoses with my observational S&S. Physicians ARE NOT interested in our fancy, schmancy nsg diagnoses when I call on 11-7. So I have progressed to using medical diagnoses - DVT is more to the point than 'alteration in...'
  2. Visit  tnbutterfly profile page
    2
    Here is a great post from Penguin67, who posted this in a similar thread in 2009.

    Hmmm, let's see, alot has changed...

    We used to manually sign our own timecards, not punch a time clock. Still wish for those days, as nurses should not have to punch in and out.

    Chest tubes drained into glass jugs that you taped to the floor, not a pleuravac.

    Charts were on paper, not on the computer. Those were the days!

    Same thing with labs. You ordered tests on a carbon set of papers, and sent it with the specimen.

    There were no Pyxis machines. You had one narcotics box, and the charge nurse kept the keys. If you went home with the keys, you returned soon after with the keys.

    All unit supplies had a charge sticker, that usually ended up on your nametag or on the floor. Omnicells took care of that.

    There were no nurse zone phones. There were call lights.

    MRSA and VRE weren't as big of a thing. Probably around, but we didn't know much about it.

    Nothing was on the computer. There was a care kardex, used for report, and a med kardex used to record all meds given. You hand wrote on these.

    Most IVs were on gravity drips. And you had to calculate them. Pumps were rare.

    You could take all of the styrofoam water pitchers from all the patient rooms and put them on a cart to refill the ice water from the ice machine. Now, due to infection control, you never take the pitcher back in to the ice machine, you only take plastic bags of ice ot the patient.

    Heat lamps were used pospartally to assist with healing of the perineum. You set up the heat lamp on the bed, then placed a cradle -like cage around it and covered it with the blanket, to provide for privacy. What a fire hazard!

    NCLEX was a two day ordeal. Paper and pencil. Most state had one site, and larger states had more than one site. Given twice a year only. New grads got temporary licenses until results were known. NCLEX was for 12 hours, two 3-hour sessions each day. Then, you waited about 8 weeks to get your results in the mail.

    Twelve hour shifts pretty much weren't anywhere utilized as they are now. It was standard to work 7-3, 3-11 or 11-7. Some straight shifts, and some got rotating schedules. And I honestly didn't see the level of burnout and call-ins that we see today on 12 hour shifts.
    lindarn and C-lion like this.
  3. Visit  NBMom1225 profile page
    2
    It seems like today's tube feed formulas (Glucerna, Osmolite, etc) always cause diarrhea...did the 'old' way of using thinned blenderized real food do the same? It seems like those patients always end up with diarrhea and skin breakdown, maybe the other way was better...
    Junebug903 and turnforthenurse like this.
  4. Visit  turnforthenurse profile page
    1
    We still have charge stickers, but only for certain things like dressing supplies (Aquacel, etc) or a foley cath...and they end up on my badge
    amoLucia likes this.
  5. Visit  FlyingScot profile page
    2
    Metal syringe pumps that you programmed using the "syringe factor"...no digital read out or even ml/hr dial. Mixing our own IV fluids in the NICU! It was night shift's job. We just laid a towel on the work counter by the sink and pulled out the "recipe" book. This included fluids with potassium in them....for preemies!
    Junebug903 and Teacup Pom like this.
  6. Visit  whichone'spink profile page
    0
    IV pumps were used only in Peds and ICU. Nurses had to calculate the drip rate using the second hand on their watch and a roller clamp to regulate the flow.
    Just last week I had to count drips instead of using a pump. I work in the ED, and pumps are few and far between. They're only used for peds patients, geriatric patients and for medications that MUST be put on a pump, such as Heparin. This was the first time I did this.
  7. Visit  tnbutterfly profile page
    0
    Quote from whichone'spink
    Just last week I had to count drips instead of using a pump. I work in the ED, and pumps are few and far between. They're only used for peds patients, geriatric patients and for medications that MUST be put on a pump, such as Heparin. This was the first time I did this.
    I'm glad you were capable of doing this. This is definitely a nursing skill that must taught.

    We have gotten to the technological age where we tend to rely too heavily on machines to do our thinking. Then when we have a malfunction, we are not mentally capable of doing things manually.

    Another example....... many nurses rely totally on blood pressure monitors and have not developed the ability to take a BP manually. Back in the day, all we had were manual BP cuffs.
  8. Visit  DoGoodThenGo profile page
    4
    Quote from tnbutterfly
    I'm glad you were capable of doing this. This is definitely a nursing skill that must taught.

    We have gotten to the technological age where we tend to rely too heavily on machines to do our thinking. Then when we have a malfunction, we are not mentally capable of doing things manually.

    Another example....... many nurses rely totally on blood pressure monitors and have not developed the ability to take a BP manually. Back in the day, all we had were manual BP cuffs.
    Two words: Hurricane Sandy. Ok, need to add a few more: NYU-Langone Hospital evacuation.

    Those nurses had to care for then move >200 pts in the dark and without pumps and the other machinery/computers that have become part and parcel of modern nursing/hospital care.

    Posted a link elsewhere to an interview ABC news did with the NICU nurses and the one question the woman had for the nurses was "how did you know what to do?" especially in relation to venting and otherwise keeping those very ill newborns alive not only on unit without power, every moment until the transfer was complete and they were at a new NYC hospital.

    What did the nurses answer? To a one "you just know..."

    To a lay person that may sound like an easy answer but to any seasoned nurse it comes down to knowing one's stuff and basically it all comes flooding back and one simply gets on.
  9. Visit  tnbutterfly profile page
    1
    Most excellent point, DoGood!!!

    Just think of all those nurses had to cope with. Most of all that modern technology does rely on electricity.

    Nurses at all times need to rely on their brains and basic, but very important nursing skills. Skills that do not require electricity but are important for monitoring the lives of their patients. These are the same skills we learned and practiced "back in the day".
    lindarn likes this.
  10. Visit  rnsrgr8t profile page
    2
    Quote from tnbutterfly
    I'm glad you were capable of doing this. This is definitely a nursing skill that must taught.

    We have gotten to the technological age where we tend to rely too heavily on machines to do our thinking. Then when we have a malfunction, we are not mentally capable of doing things manually.

    Another example....... many nurses rely totally on blood pressure monitors and have not developed the ability to take a BP manually. Back in the day, all we had were manual BP cuffs.

    Totally agree with you on this....I do not like the machines for BP's, I mean obviously they are used a lot...but I totally prefer to do a manuel BP because it is so much more accurate. I hate to say it but it is also becoming a lost skill!
    Silverdragon102 and tnbutterfly like this.
  11. Visit  Pepper The Cat profile page
    2
    Quote from rnsrgr8t
    Totally agree with you on this....I do not like the machines for BP's, I mean obviously they are used a lot...but I totally prefer to do a manuel BP because it is so much more accurate. I hate to say it but it is also becoming a lost skill!
    It certainly is! I had someone come to me and say that she was getting a low pulse reading and she tried 3 machines and each one gave her a different reading with a range from 30 - 60 BPM.
    So I asked her what is was manually. she looked at me like I had 3 heads and said "Oh, I didn't think to do it that way". I checked, and the pt had a very irregular heart rate which probably caused the problems.
    DizzyLizzyNurse and tnbutterfly like this.
  12. Visit  monkeybug profile page
    0
    Quote from Pepper The Cat
    It certainly is! I had someone come to me and say that she was getting a low pulse reading and she tried 3 machines and each one gave her a different reading with a range from 30 - 60 BPM.
    So I asked her what is was manually. she looked at me like I had 3 heads and said "Oh, I didn't think to do it that way". I checked, and the pt had a very irregular heart rate which probably caused the problems.
    We had a patient hemorrhaging after a cesarean, and we couldn't get a BP on her! The equipment in our recovery room would not register one, and no manual cuffs were to be found. It was very frustrating for us, and we finally borrowed one from a med surg unit. By that time, her BP was down in the scary area of just being palpable, and only one number. I think every unit should have a manual cuff for these occasions. Now I carry one in my new job, and that's the only kind I use.
  13. Visit  amoLucia profile page
    0
    The old saying is that 'NECESSITY is the mother of invention'. I hold that it really is nursing.

    We all have so, so many 'tricks of the trade' that help us overcome difficulties with equipment or lack of supplies. Remember before we had the precut gtube/trach dressings. We would just chevron-type fold 4x4s. And I've made my own Montgomery straps to help secure wound dressings. I just think it's amazing how experience from the 'old days' so freq helps us out in a pinch!

    Anyone remember scultetus (sp?) binders - the old fabric ones?

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