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???

Going back to whites would not be all bad. But no caps - they didn't get cleaned often enough, and men don't wear them.

Clean shoes would be nice.

Modern Kay's "Perma-Starch" caps require nothing more than a swishing in soapy water, rinsed and laid flat to dry. Perhaps ironing with a cool iron if you've got that kind of time. *LOL*

Now if you want to go old school get yourself a box of Argo, Faultless or Linit powdered starch and knock yourself out! *LOL*

Specializes in Peds/outpatient FP,derm,allergy/private duty.

Some of these may have been mentioned . . .

Laundry would send up a gigantic stack of unfolded cloth diapers. All the nurses pitched in to fold them when we had a spare minute. Disposable diapers only used for very young or babies on strict I and O. We weighed the Pampers (Huggies hadn't been invented yet :-)) and stacked them up, weighed again after baby voided.

Most of our IVs were a butterfly in a scalp vein with a Dixie Cup cut in half taped on to protect the site. (some of the babes looked right jaunty in their paper cup hats).

Suction machines had glass cannisters, trach care was done with a pre-sterilized cloth wrapped packs with 3 glass cups, hemostat, pipe cleaners, gauze, etc. All trachs were metal.

Isolation gowns were cloth, too. Just about everything that is plastic or paper now was at one time glass or metal, it seems. We did not sharpen and re-use needles, though.

No computers, just paper and typewriters as mentioned. Charts were a 3-ring binder. Everyone (doctors, nurses, social workers etc) wrote their "SOAP" notes in the progress notes. I really liked that.

Smallpox vaccine.

Specializes in RN, BSN, CHDN.

UK

Hair had to be up, no hair could touch your collar!

No make up

Mainly younger students-we had an older lady in our class who was 40 and it was unheard of

Student nurses were in abundance in the hospital before the education became University based

1st, 2nd and 3rd year students nurses knew their place

Urine was never left draining in catheter bags it was emptied hourly

Every nurse/student nurse knew every diagnoses and test of every pt on the ward.

Nightingale wards with 20-30 pts

All beds made and all pts washed before 11am

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
WOW, you all have seen a lot! I hear stories of how everyone used to smoke at the nurses' station. It's so crazy to me when I think about it.

Yes we did.....and so did the MD's. The MD's would walk into then patients room after getting off the elevator and snuff out their smoke. We would have to watch some patients .....we had this Little ole lady who was confused....she would go to the ashtrays outside the elevator door and steal the butts to smoke in her bathroom.

Nothing sounds (or feels) like a metal bedpan hurled at you (or dropped) in the middle of the night.

We charted in blue/black for days, brown for evenings and red for nights.

There were 3 bottles in the floor for water seal chest tubes.

Calibrated the monitors with the mercury sphygmomanometers

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White uniforms....dresses only. White panty hose.

The sisters would round every shift for "idleness".

Dr Clancey's butt ointment.

Pepper.....I agree.....double bagging isolation contents needs to come back.

Specializes in ICU + Infection Prevention.

OP thanks for the post. I'm glad I'm not living in the NOW. THEN doesn't stack up to NOW in any respect except the quality of the people who did the job.

So much has happened in the nursing profession and hopefully more changes for the better will come in the future.

Specializes in geriatrics.
"Nurses had to calculate the drip rate using the second hand on their watch and a roller clamp to regulate the flow"Knowing how to manually (or mentally) calcuate drip rates and regulate flow is skill that IMHO all nurses should know and keep keen upon. You never know where your practice will take you and or under what conditions you will be nursing.Everthing from terrorist attacks and natural disasters to simply a poorly run facility, you'll never know when you're going to be short of even absent of pumps and going to have to go "old school".
When we were learning IV skills in nursing school, we first learned how to manually calculate drip rates. I'm glad we did. I have had to count drip rates a few times already because we didn't have an automatic pump on the unit. They were all in use.
Specializes in neuro/ortho med surge 4.

Hi,

I have been a nurse for 4 years. I have talked to a few nurses who had been nursing in the 70's and 80's. They all say the biggest change is that you had more time with the patient back then then now. Way more charting these days.

Does anyone else think this is the biggest change?

Cool thread!

Enemas were not disposible plastic bottles-we mixed them in a metal can with castille soap and a long rubber tube-we called them "3 H enemes," the nurse had the last word with the patient; if we told you not to get out of bed, then you stayed there until the nurse came and told you it was okay to get up! We used KY jelly for a variety of tasks from glueing the stripe to our caps to physically assisting with bowel evacuation. Ah, the good old days! LOL

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

anyone remember sippy one and sippy two diets????

Red rubber NGT's

Heat lamps for decubiti

Enemas were not disposible plastic bottles-we mixed them in a metal can with castille soap and a long rubber tube-we called them "3 H enemes," the nurse had the last word with the patient; if we told you not to get out of bed, then you stayed there until the nurse came and told you it was okay to get up! We used KY jelly for a variety of tasks from glueing the stripe to our caps to physically assisting with bowel evacuation. Ah, the good old days! LOL

In the excellent PBS/BBC series "Call the Midwife" the senior nurse midwife instructing the new young one tells her to give the enema "high, hot and a hell of a lot". So there are your three "H's" for you.

Video: Episode 1 | Watch Call the Midwife Online | PBS Video

In their bags the midwives carry all sorts of things that might seem totally alien to us today, well at least in the form shown. For instance the rectal tubes were made of glass. When another young new nurse-midwife points this out her senior quips back "why is there a problem? Do you break things?". The gag is that "Nurse Chummy" is a great big girl and quite dead awkward,but her heart is made of gold.