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???

Specializes in Alzheimer's, Geriatrics, Chem. Dep..

I feel very old reading this thread!!! because I remember most of what was brought up here!

Diabetic's sugar was determined by a urine test. Remember dropping pills into a test tube of urine and then comparing the colour of the urine to a chart to see what the sugar was. + 1, + 2 and so forth.

Yes and as the pill dissolved the test tube got quite hot.

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Ah yes..........Clinic brand shoes. I remember them well.

They were quite comfy!

Heat lamps for decubiti

and I remember someone coming up with the "secret" of using maalox to the decub and then applying the heat lamp ... (and how dangerous to rely on a busy nurse like myself to remember to come back and check in 20 minutes!)

Of Nightingale wards and trolleys.

For those of you youngsters that never experienced them Nightingale wards (named after their creator Florence Nightingale) were those big open rooms with multiple patient beds arranged in rows down each side. The purpose was to allow (then) air to circulate, general cleanliness and the comfort of patients and improve the efficiency of the nursing staff. This is where those trolleys/carts come in.

As one only has but two arms there is a limited amount a nurse could carry, however to get down those long wards there had to be away to haul what was required; hence the trolley carts. Everything from meds,meals linens for bed making, supplies for procedures and or treatments, and so forth would be loaded onto those carts and pushed from one end of the ward to the other. When doing beds we (then) NA's would leave the cart loaded with fresh linens at one end of the ward (usually front near the door) and fetch what was needed as beds were stripped and or made.

The problem with a ward is then as now everyone wants Nurse's attention and she or he cannot be in two places at once. You may enter Ward B to give patient "X" his meds but then patient "A" spies you first and shouts "NURSE".

Often there was a nurse's desk at the head or end of the ward and that is where the nurse on duty sat/used as a nurses station. One could sit there and gaze down the nice neat rows at all one's patients and observe what was going on. On nights when things were dark and quiet it could get down right gloomy. Of course you also had to fight the urge to fall asleep!

There were several downsides to large open mulitpatient wards not the least was risk of cross infection. Then there was the fact there was limited to no privacy for patients or staff for that matter. Drawing the curtains and speaking in hushed tones only went but so far. Everyone knew everyone else's business, especially during visiting hours when you'd get less than discrete family members showing up.

Here is a clip from an old BBC television production of "The Singing Detective" which shows NHS nurses managing their patients in a ward. For some reason NHS hospitals have held onto open wards longer than us in the United States where they are no longer found.

1 OF 6 - The Singing Detective: Skin (ENTIRE SHOW) - Dennis Potter BBC TV Miniseries 1986 - YouTube

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.

This post: I LOVE IT!

Specializes in ortho, hospice volunteer, psych,.
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Ah yes..........Clinic brand shoes. I remember them well.

I've shared this elsewhere on allnurses. On one of my earliest first job evaluations when I hastily polished my white Clinics, I didn't take time to dip my laces in Clorox.

It was just that one time, but all that was written on that week's probationary eval was "Katherine does not polish her laces when she polishes her shoes." :sarcastic:

Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.
I've shared this elsewhere on allnurses. On one of my earliest first job evaluations when I hastily polished my white Clinics, I didn't take time to dip my laces in Clorox.

It was just that one time, but all that was written on that week's probationary eval was "Katherine does not polish her laces when she polishes her shoes." :sarcastic:

LOL. :laugh:

Do you think nurses today even think about dipping their laces in Clorox much less polish their shoes........or clogs.......or whatever. HA HA HA

Specializes in RN, BSN, CHDN.
LOL. :laugh:

Do you think nurses today even think about dipping their laces in Clorox much less polish their shoes........or clogs.......or whatever. HA HA HA

:roflmao: :roflmao:

Specializes in Critical Care.
- Blood pressure devices (sphygmamonometers) had real mercury in them

- Chest tubes got 'milked/stripped', either by hand or with strippers

More later!

*middle school giggles*!!!!!/ thats what she said!!!!!!

ok ok, im done now, time to appreciate how my profession has grown, evolved and of course, gone back to basics! :-)

Specializes in Critical Care.

may i create a sub-post within this post???

what are the old school nursing things you WISH you could still use?

and "what EBP nursing care that you gave tonight, do you predict will be out of touch in 5 years???

this is not to shame, it to learn!!!!

Specializes in Critical Care.

nowadays, dp the MD apreciate the RN trying to round on their patient together? or it is more, im Meds, your Nursing, lets do our own thing???

Specializes in PeriOp, ICU, PICU, NICU.

I absolutely love hearing stories from my seasoned co-workers. One that comes to mind is they tell me they used to foil TPN all the way from the bag to the tubing to protect it from light along with other meds. I smile at the mental picture.

Specializes in Gerontology.
may i create a sub-post within this post???what are the old school nursing things you WISH you could still use?
As I said earlier, I think we need to return to the old style of isolation. Double bagging everything. Pts stayed in the rooms. I think there would be much fewer " outbreaks"
Specializes in retired LTC.

Remember the old linen chute with the hanging key that was in the hall??? When you put the dirty linen in, it would vacuum 'whoosh' down - just hope you didn't mix anything into the dirty laundry as it was now GONE!

And the higher floor you were on, the greater the vacuum 'shoosh' was.