Nursing: Then and Now

The nursing profession, as a whole, as well as the role of the nurse have evolved dramatically over the past several decades. I personally have witnessed the changing face of nursing during my 30+ years in the profession. Gone are the days when nurses were thought of as little more than helpers or assistants for physicians. Today's nurses are healthcare professionals in their own right, playing an important and vital role in providing excellent healthcare. Nurses General Nursing Article

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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 of paper chart, replaced with electronic medical records. Gone are the nursing caps that distinguished the nurse from the rest of the healthcare team.

Here is a partial list of things I remember from days gone by.

Back in the day...

  • Team nursing
  • Primary care nursing
  • Longer patient stays (Patients were actually able to recuperate in the hospital rather than being sent home too soon. There was no such thing as same-day surgery.)
  • Nurses wore uniforms which consisted of white dresses, white hose, white lace-up oxford shoes, and, of course ... white nursing caps!
  • Only OR staff and physicians wore scrubs.
  • The Kardex, a large folded card, was used as an important document of all patient activities, meds, etc. And it was hand-written in pencil so it could be erased and updated as needed. Talk about document tampering!
  • Requisitions were composed on a typewriter.
  • Patients were called Mr. or Mrs.
  • Gloves were used for sterile procedures only. Universal precautions did not exist.
  • The only lifting machines we had were male aides ... and of course ourselves.
  • Nurses bent and broke off needles from used syringes
  • 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.
  • Heavy glass IV bottles were still in use
  • The charge nurse made rounds with the doctors ... and carried the heavy metal charts.
  • When a doctor arrived at the nurses' station, it was expected that a nurse would stand up and offer her seat....and the doctor never refused
  • Male nurses were very rare
  • Cold metal bedpans were offered to patients.
  • All patients were offered a daily bath and back rub
  • There were no fitted sheets. Remember hospital corners??
  • Glass thermometers were still in use.
  • Nurses notes and vital signs were recorded using a pen with 4 colors of ink as different colors of ink were used on different shifts. Actually, only 3 were used since there were 3 shifts.
  • Surgery patients were admitted the night before surgery so their preps could be started that evening.
  • Nurses smoked in the nurses' lounge.
  • Cancer was almost always a death sentence
  • Medicine was dispensed by the med nurse carrying a tray with small paper cups of pills and different colored med cards.
  • Four-year BSN programs were not as plentiful. Most nurses graduated from hospital-based Diploma or ASN programs.
  • State boards were 2 grueling days of exams that were completed with number 2 pencils. No computerized tests in those days.

Feel free to add items that you remember from the past, even if that past does not seem that long ago. Changes are occurring at an even faster pace in the digital and electronic age of today. What do you think of some of the changes???

Technology has helped nursing progress but the care is not as good as 30 years ago!!! We also lost respect when we stopped with hats n white. We never worried about getting sued. We had less pt so good give better care. Hospitals were clean!!

Does anyone else remember cleaning thermometers? After vital signs were taken on the floor thermometers were cleaned of any matter and soaked in alcohol or benzylkonium chloride. In four hours or when vital signs were due again, they were dried, placed in a cute little tray and passed around the floor again. Seems abhorrent looking back from today's world, doesn't it?

Specializes in retired LTC.

Anybody remember something called an "ortho prep"? Pts were admitted days before surgery (no such thing as PAT) and on the night before the ortho surgery we had to do the prep on 11-7.

The site, usually a limb, would be shaved and scrubbed and it was sterile technique. After the prep, the limb would be wrapped in sterile linens.

Specializes in retired LTC.

And I remember HATING Sunday nite/Monday mornings. Major POOP time. All the barium enemas preps were done for Monday morning testing. Pure torture that prep of liquid diets days, mag citrate, dulcolax tabs and then a dulcolax sup in the AM. Code browns and falls!!!

The GI/GB prep for tests was easier, but I HATED working the weekends when I had to because of that prep.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Technology has helped nursing progress but the care is not as good as 30 years ago!!! We also lost respect when we stopped with hats n white. We never worried about getting sued. We had less pt so good give better care. Hospitals were clean!!

I don't know about you worrying about getting sued thirty years ago, but it certainly crossed MY mind. Not only did the schools warn against it, but our employers talked about "suit proofing" your care. We lost respect not when we gave up the white caps and white uniforms, but when we started letting management and "customer service" dictate nursing care. Thirty years ago, I had 15 patients on the day shift and 30 at night on a Med/Surg floor -- the ratios are better now. And I remember hospitals that were clean, but I also remember the housekeepers sitting around smoking pot in the linen rooms while the feces dripped down the walls of the patient bathrooms.

35 years . Male nurses where rare. .. Started ward nursing.. Yes "head nurse" usually had tattoos. And smoked unfiltered cigarettes, and butted out in their palms.. Oh god they where tough no nonsense women :)

Retiring next year after critical care, flight nursing. What a career. Not a job.. A career.so proud to have been a nurse

Perhaps it varied in parts of the country, but as an RN I carried malpractice in the early 1970s. In school it was stressed that we should do so.

No such thing as ultrasound in OB. We would use Leopold Maneuver to assess fetal position before preforming an amnio in the treatment room.

I love to hear past stories of nursing, and how things were done then, I always ask senior nurses about stuff when I meet one, when I first began nursing we had paper charts and a kardex

Like you, I have been in nursing since 1982, my first year as an orderly, for you whipper snappers, that was a male nurse's aide. I trained for 3 days with my mentor, and on the fourth day, was asked to take the assignment, much to my shock, the floor was short that day! I graduated from my training in 1983 as a proud LPN. I was blessed to train in a program that taught at more of an RN level. How many times have I heard a new grad RN say "The difference between an RN and an LPN is the RN knows why". Funny, that's what we were told all those years ago, but then, the LPN knew why, the nursing aide knew how. We had line up before our clinicals, and your shoes had better have been white, your uniform clean and pressed, no fancy jewelry, and God forbid your fingernails trimmed so you couldn't see them from the palm side of your hand! No gloves, only for sterile procedures. Fingercots for suppositories, etc. We were taught your hands washed, and you would make your patient feel even more ill if you approached them with gloves on.

The biggest change has been the loss of the professionalism in nursing. How often do I hear "F" bombs by peers and management, even on the floor! New grads come with college degrees, and can't nurse their way out of cardboard box! They need weeks of orientation to even function on the floors. They approach us "old farts" for help with staffing issues, critical patients, policy and procedures, yet are supervising us, and making a heck of a lot more money than we. What is wrong with nurses? Why is it in most fields you work your way up in a company. Not in nursing! I still am a PROUD LPN, proud of my battle scars, proud of my profession, proud of the many fellow nurses and aides I have worked with and for. I have wiped fannies, held dying peoples hands till they cease to breath, held their loved ones in my arms and comforted them. I have coached my sister through 2 births, have intervened when needed to settle disputes between family members and the physicians. I have managed floors in 4 different nursing homes over the course of my 32+ years, conferring with MD's, NP's, PHD's, RN's, etc etc. My state surveys/audits were all great. Was the Infection control nurse/employee health nurse at a facility for over 4 years, in that time organized a mess to have the preemployment requirements on track, wrote policies on and helped educate the staff on Standard precautions, was audited by OSHA and passed with flying colors, created and wrote policy for skin care and pressure ulcer prevention still in use today! I have left the management circus now, enjoying my tenure on a short term rehab unit. It is too difficult these days to be in management unless you have at least your bachelor's degree in nursing. I do not. I lived through the school of hard knocks. I continue to go to work and make a point to learn something every day! My life has never given me the opportunity to go back to school. But I still have RNs asking "how" or "help!", and when they do, I smile.

Thanks for the trip down memory lane. Having graduated from a Catholic diploma school in 1971 I remember all these things as common practise.we had an instructor, WW2 vet that taught us how to bathe from a helmet and a trach using a pen. She was sure one of her girls were going to be military. The sisters controlled everything! They handed out the linen packs, the trays. A great many sisters were in classes with us and went on to college and became our administrators. It was a culture shock to go to another hospital and see how it was done elsewhere.