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 retired LTC.

Oh yeah, just remembered too, that when the fire bells went off, someone was suppposed to tape the chute shut. Had a big role of 2 inch surgical tape hanging next to the key. Was part of the fire drill protocol.

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"

When they stop letting patients run the show then perhaps this is a reasonable request.

Specializes in Rehab, critical care.

My question is: how did nurses have time to smoke back in the day? lol

I always call patients Mr or Miss ______ unless they prefer something else or are my age or younger. I'm in my 20's; is this not standard practice? I think it's rude to call someone 50 years older than me by his/her first name.

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

Just had to come back and add another one --- "then" you waited for ☞6 weeks☜ for the results of your "state boards" - (pre-cursor to the NCLEX) so I get amused when people freak out if they don't get "the good pop-up" in a few days. sarcastic.gif

Specializes in ICU, step down, dialysis.

One thing I remember and see a huge difference now is when I started back in the mid 1980s, is how patients and families had a lot more trust and respect for you.

Specializes in Critical Care.

I remember the two day all day affair of nursing boards back in the day! And you only learned if you passed, not how well or poorly you had done. Months would go by while you were working and waiting and if you failed you could lose your job or at least be demoted till you passed. Talk about pressure! I passed but a couple coworkers didn't, one lost her job and had to go to a different hospital, the other worked as a HUC/CNA till boards were passed.

Specializes in Med Surg, Parish Nurse, Hospice.

Very interesting posts. We did peritoneal dialysis on our floor back in the 70's. MD would come and put a temporary cath in place in the "treatment room" and then we would hang the large glass bottles. Usually we did the PD in a semi private room. The caths would usually leak after a short time. I remember drawing up chemo in the med room, just like any other med. All our TURP pts got IM tobramycin every 8 hrs. The worst was probably the cataract pts, they had to get eye drops every 5 mins prior to surgery, yes as an in pt. They would come back from surgery in the bed. A RN would need to go get them from the OR. Often the wheels of the bed would get stuck in the crack in the elevator, alot of lifting involved. They stayed in the hospital for a week, had to be fed and the male pt's shaved, sand bags at the head. Now it is done in 20 mins and out the door you go. I learned many things as a new nurse and one of the things I remember most " do things the right way" My 1st head nurse was a stickler on this. Just to add a comment on the earlier post about calling the pt Mr or Miss etc due to the age difference. Now days as a 56 yr old RN, I'm often older than my pts. I usually ask what the pt wants to be called and 99% respond with their first name.

I remember having a brown glass bottle of whiskey in the med closet to give a Doctor ordered measured dose (in a med cup)

We mixed chemo IV's at the start of shift.

We also added yellow vitamin to IV (I loved the smell, so my co-workers would save those for me)

My grandfather had pernicious anemia and needed a vitamin B shot 1x/month. As a student nurse I gave it to him in my aunt's (nurse) absence. The syringe was glass and the needle needed to be sharpened!

Specializes in MDS RNAC, LTC, Psych, LTAC.

@Do good.. I went to school in the early 2000s and we learned gravity drips as well. You are right all nurses should know how and I am glad that I do so if in a natural disaster or no pumps.. I can do it "old school" and I am darn proud I am old school and new school both.. Love this post.... love hearing how nursing has changed... ;)

Specializes in kids.

Dont think I saw this but patients were admitted the night BEFORE surgery!!!!!!:roflmao:

Specializes in LTC, medsurg.

I'm not old enough to remember this but my charge nurse told me that before Lovenox or Heparin, pts use to "drop like flies"They'd get up to walk with P/T and get back to bed only to throw a PE. :(.

Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

Post op patients did not ambulate as soon and as often as they do now.