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???

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.

Oh there was time to smoke, go to the powder room, go to have your meals (in the cafeteria for days and perhaps evenings), take breaks, have a quick convo with one's bf, hubby or fiancé (then as now many nurses were dating or involved with a member of staff or someone who had regular business at the hospital such as LE ), and so forth.

Depending upon your unit there could be a decent census of stable patients whom today would be discharged home or to LTC. So aside from meds, treatments and what not there really wasn't *that* much else to do. Even for many CC patients treatments/interventions may have been limited compared to the options today.

With team nursing it also was (again depending upon the unit and staffing) sometimes easy to sneak off for a break or what not. That is until your head nurse sniffed you out.

Finally there was end of shift charting. If not the nurse's station then the lounge or anyplace else one could find room and smoking was allowed.

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

Neither often did new moms.

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

Patients were often admitted night or even a day or several before scheduled surgery or procedure. Much depended upon what sort of tests/lab work the MD wanted run beforehand, or required prep.

So many things are done today on an outpatient basis and or much of the prep done at home before patient arrives that "youngsters" forget there was a time that didn't happen. A two or even three day bowel prep for a colonoscopy was done inpatient. You'd find those soda pop looking green bottles of magnesium citrate in many fridges on the floor, but getting patients to drink them all down was another matter cause it most certainly did not taste like pop. *LOL*

Depending upon what tests or whatnot were ordered the physican or physicans may wish to see the results early enough before the night before.

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.

Welcome to the new world of assumed informality.

Telephone your credit card's customer service department and the rep named "Bob" (even though they are most often in India ) acts like he has known you for ages and begins addressing you by your Christian name. Go to a restaurant and your waiter is now also your close friend and upon seeing your name on the credit card begins calling you again by your Christian name.

Back in the old days it was "Nurse Rogers" or "Miss. Kent", or "Doctor Jones". Patients were Mr, Miss. or Mrs, unless some other honorific such as "Father", or whatnot applied.

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!

Ahh Vitamin B, the essential ingredient for making a nurse's best IV friend the "banana bag". Slap some tape on the thing and you've got a system nearly if not equally as accurate for most gravity infusions as today's pumps.

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.

In Manhattan, NYC the boards were usually given IIRC at the New York Coliseum on Columbus Circle (now the Time Warner Building).

Twice a year you'd pass and see scores of mainly women and girls in various states of panic stretched out with Lippincott and other review manuals doing some last minute reviewing.

@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... ;)

Quite honestly regulating the flow manually probably is the easy part. It's getting to that point, the actual math that seems to scare most student nurses. Thing is the standard formulas haven't changed much over the years, and long as one knows basic math it's all pretty much plugging the numbers in then solving the problem. Oh and knowing when to round up or down unless you've found a way to give fractional drops! *LOL*

Student nurses today by and large have it easy as most progams allow them to use calculators and various formulas/methods to solve. Back in the day it was pencil,paper, showing all work an in most cases using only the formula one's med dose calc teacher gave, PERIOD.

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

Oh the days when one could graduate on Friday and start working as a GN on Monday without skipping a beat. The biggest question usually running around a class of grads was those who would work before taking the boards versus those who wanted to take some time off and or use the period to study.

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

Speaking of the harrowing 2-day ordeal of State Boards...... One of my classmates was so worked up about taking the boards that she fainted and missed part of the first day's testing. In fact, I don't know what became of her....whether or not she was even allowed in the testing room at all. I try to block out all memories of those 2 days.......except for the miraculous fact that I passed!!!!

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.

Know am going to get *****slapped for saying this but..... part of that "trust and respect" came from the professional pulled together look of whites with or without a cap.

Yes, one knows in shouldn't matter but dress does play a powerful role in how others perceive us in our employment roles.

There is no reason why airline pilots still need to wear those military inspired uniforms, I mean aside from going to and from the plane no one actually sees them at their job, but yet they do and when they saunder (or in some cases strut) through the airport some people stand at little straighter.

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

I think the uniform does make a difference. Many times today, it is hard for the patients to tell who the nurse is as so many are dressed in scrubs. It used to be that "the nurse" was the one in white with the cap.

Specializes in Gerontology.

Remember when a cholecystectomy was a Huge surgery? Big incision. NPO for days, nothing per os until they "passed gas" (farted) . I remember dragging pts out of bed to get the, to move so they could fart and get the NG tube out.