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

I remember when almost all surgeries were a bigger deal than they are today........ or rather the patient got to stay in the hospital and recover a bit longer. For instance, back in the day, one would never dream of sending mastectomy patients home the day following surgery. That just blows my mind.

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

I think the whites caused patients to view the nurse as one who has authority. That's so out of fashion now it's almost as quaint as standing up to give the doctor your chair. Nurses aren't allowed to do anything that could "tick" someone off anymore. It would be bothersome to me if the marketing mavens brought back the whites because the patients see it as a novelty, without the level of respect that was also associated with traditional nurse whites.

We had to call our classmates "Miss White" and "Mr Edwards" even in a classroom miles away from the clinical site, and there were less than 20 of us at the end.

Specializes in Public Health, L&D, NICU.
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!!!!

I went into a 3 year fugue state and went to law school (okay, not a fugue, just bad judgment). The Bar exam is still a 2.5 days of torture, with all the law students in one large room in the state capitol. At one point during the day, I got up to get a drink of water and just rest for a second, and I noticed that one of my classmates who had been sitting 5 feet from was missing. Turns out that he had passed out and an ambulance had come and carried him out on a stretcher. Five feet from me. And I didn't notice because I was so focused on the exam. Oh well, passed it, didn't get a job, and went back to the hospital, but it does give me some interesting stories.

Specializes in Psych, LTC/SNF, Rehab, Corrections.

Someone turned on the 'Way Back' machine. LOL

Requisitions were composed on a typewriter.

I had one of those as a kid! I'm glad for computers. You know how many bottles of white-out I went through trying to type a page? Error after error. Back then, most who typed actually HAD to look at your fingers.

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.

I still try to retain this skill. Actually. Why?

Anything could happen. My former occupation, radiology, has gone digital...but it's still important for techs to know how to shoot on regular film, calculate time 'techniques' by hand, process film, duplicate film without a CD and operate/troubleshoot the processer.

The system went down twice and the techs were having to do everything manually and there's a whole mess of xray techs out there who can't change processor chemicals or shoot with their own 'techniques' unless the computer's helping them out. The technology is great. Saves time and money, but it actually does tend to produce techs who are less skilled. In my opinion.

I've no idea why we were ever paid as much as we were. Not that I'm trying to be the barrier to anyone's cashflow, but...seriously. A robot could do it. A fair amt of xray techs get paid $23+/hr to robotically do their jobs to begin. That's why, to those whom I suspect of only entering nursing for the money/stability? I tell them to go straight to radiology. I'm serious.

You're not the quarterback. The nurses are. LOL Unless it's on the table, housekeeping cleans it up. You don't have to 'tap-dance' for the rude pts.

I don't see that nursing has been revolutionized to such an extent (where everyone's literally and completely dependant on technology) as xray techs, but it's something to think about.

Stay up on the old skills. You never know when they might come in handy.

"State boards were 2 grueling days of exams that were completed with number 2 pencils. No computerized tests in those days."

LOL I had to explain to one of my aunts about the process. She was kind of confused when I told her that 'the machine shut off at 85 questions'. Her brow furrowed. 'Well, when I took boards, I had 200+ questions. Ya'll do it by computers now? Hmm..."

Nurses notes and vital signs were recorded using 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.

Now, this I remember. Those in my family who are nurses used to always have these.

"Patients were called Mr. or Mrs."

I still do this and this still goes on. I feel weird about calling someone 20 years my senior by their first name. It just shows a complete lack of home-training (manners), in my opinion.

Nurses wore uniforms which consisted of white dresses, white hose, white lace up oxford shoes, and, of course..........white nursing caps!

I actually like 'whites'. I've always thought it very professional looking, in my opinion. I thought this way even before I became a nurse. I'm prior svc military and dress/appearance are pretty important in my eyes. 'Whites'... just scream 'authority'. Position. Nurses in whites look...'important'.

Its kind of like with medical doctors or NPs. You can tell who they are because they're always running around with a clipboard and a lab-coat over their casual professional attire... looking 'important'.

I'm just not sure how realistic it is to wear. Personally? I could imagine myself fussing (primping) with it all day...and don't let them give me a swing cape! LOL

I would be forced to 'don'... The Cape...every single day. I'd be whooshing and swinging all over the hall.

You know how I know? Again - ex-military. Sometimes, we'd have to wear our service (dress-up) uniforms. Worked in the hospital. Still...it was hard to not be conscious of your clothes with every movement. Doesn't matter what you're doing. When you're in a service dress uniform and not up to par, everyone will clock it. It was no thing to see someone within the dept stop a coworker to fix their slightly askew necktab. Crisis averted. Actually, even when it came to the old BDU's (the battle green).

"What? No creases...?" *rolls eyes in disgust*

Military folk do fuss with their uniforms. It's just done in a very serious and 'manly' way. LOL

Or, they 'did'. The new uniforms don't require much. It's actually pretty difficult to look a mess in them, but some do the impossible and manage to pull it off.

Then, there's the subject of dirt. I wore a white top and 2 hours into my shift, I had:

- blood on the back (from where a resident grabbed to alert me that they'd scratched themselves)

- chocolate pudding down the front. I was trying to lift a resident and got it all over my shirt. (it was pudding, FYI. Not pooh...although that's happened, too)

- dots of Prostat and depakene on the bottom of the shirt. I just said 'the hell with it' and wiped my hands on my shirt/pants. It was already DIRTY!

Not around THAT long, but did work in a nursing home where we had to rinse the poo out of linens before they could go in the linen bag. That was a fun time after getting everyone up the morning after beef stew nights.

Specializes in Med/Surg, Academics.

About the manual drip rates.

I had to do one yesterday for the first time as a working nurse because of a STAT order, Central Supply wasn't answering their phone to bring up a pump, and there were no pumps to be had on the floor.

I calculated that thing over and over for a few minutes, worrying that I did it wrong! Then, I counted the drops about a zillion times, making sure I got it right!

At my school, we learned how to calculate drip rates manually as one of our first nursing skills, so it's not completely gone from some schools. It is a skill that should be learned.

Specializes in Education, FP, LNC, Forensics, ED, OB.

I still have my cape. :)

Suctioning newborn trachea: Would bite a hole in my face mask, insert one end of Delee trap in my mouth, insert other end in babe's trachea, and suck. More times than I can count, would get secretions (meconium/amniotic fluid) in my mouth. Spit, and continue.

Scrubbing in OR and saving time: After 10 minute scrub, don cloth gown and sterile gloves. After surgery, you did not take off gown/gloves. Washed off body fluids/blood, etc, ate your lunch. That way, you didn't have to do a full 10 minute scrub for the next case because you were still considered sterile. :)

Specializes in Education, FP, LNC, Forensics, ED, OB.
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- The class before mine was the last class required to wear girdles!!!

And, if you did not wear a girdle, you were sent home.

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

LOL. I never was required to wear a girdle. But there weren't any pantyhose back then.

I never had one of those cool-looking nurse capes, sirI.

And, if you did not wear a girdle, you were sent home.

Know "nice girls don't giggle", but the mind reels as to what method was used to determine what one did or did not have on in terms of undergarments. Suppose it was the hold house-mother trick that involved using a thumb.

Whilst were on the subject of vintage uniforms .... Looking Fashionable in All-White Nursing Uniforms

LOL. I never was required to wear a girdle. But there weren't any pantyhose back then.

I never had one of those cool-looking nurse capes, sirI.

Next to vintage nurses caps the second "in" thing seems to be those capes. Don't know who is wearing them but just as with caps they are going for big money on eBay and elsewhere. Perhaps it has something to do with the recent explosion of "Twilight" and other vampire related media.

SirI you could always don your cape and swoop down the halls scaring the students! *LOL*

Specializes in Public Health, L&D, NICU.

I participated in a webinar this morning on the subject of Preterm Labor presented by March of Dimes. The doctor discuss old methods of tocolysis, including IV alcohol. I actually work with a couple of older nurses who remember doing this for preterm patients. Sounds like a lot more fun that MgSO4!