Nursing: Then and Now - page 12
by tnbutterfly 87,685 Views | 188 Comments Admin
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... Read More
- 1Nov 1, '12 by monkeybugI just thought of another one. Years ago, nurses were not allowed to check a patient's cervix vaginally do to the risk of infection, nurses could only check rectally. I have spoken with an older nurse who said you really could tell when they got complete, but I seriously doubt I could distinguish 2cm from 3cm that way.
- 0Nov 1, '12 by tnbutterfly AdminQuote from dirtyhippiegirlFeel free to copy any of those posts here. I'm sure our members would enjoy reading some of the older posts. However, many of those older threads are now closed and no longer open for comments.Kind of sad-face that the several other threads in this vein (some dating back 10-plus years) weren't linked.
Staff is trying to continuously start new threads and articles.
- 2Nov 1, '12 by turnforthenurseRNQuote from monkeybugyou can check labor progress rectally? would have never guessed...but I'm not an L&D nurse...I just thought of another one. Years ago, nurses were not allowed to check a patient's cervix vaginally do to the risk of infection, nurses could only check rectally. I have spoken with an older nurse who said you really could tell when they got complete, but I seriously doubt I could distinguish 2cm from 3cm that way.
- 3Nov 1, '12 by DoGoodThenGoUse of the word "appears".
Nurses couldn't come out and state an event occured and or pronouce a patient's illness or condition, that was considered medical diagnosis and reserved strictly for physicans. You could get your head handed to you on plate by any MD from an intern to attending if they didn't like what they overheard or read in nurse's notes regarding their patient. At best a physican would complain to supervisors and have you taken off caring for his patient, at worse it was the dreaded FTV (Float,Transfer, Vacation) until the offended MD relented and could stand the sight of you again.
So nurses simply wrote "appears" in front of their observations when charting and or conversations. Instead of saying someone was dead, it went "pt appears to have ceased respiratory activity".
Thing is that often nurses knew what they were speaking about and noticed early signs of disease or conditions that if treated could nip things in the bud. Scores if not hundreds of patients probably had adverse reactions and or simply died because physicans either refused to read nurse's notes and or took offense that a *mere* nurse was observing and by extension diagnosis.
- 0Nov 1, '12 by amoLucia"Appears sleeping" is my first favorite, then "appears to cease breathing"is my second fav. How stupid.....
Like others, I am careful with dropping diagnoses, and that IS a throw-back to the old days. I will qualilfy any diagnoses with my observational S&S. Physicians ARE NOT interested in our fancy, schmancy nsg diagnoses when I call on 11-7. So I have progressed to using medical diagnoses - DVT is more to the point than 'alteration in...'
- 1Nov 3, '12 by tnbutterfly AdminHere is a great post from Penguin67, who posted this in a similar thread in 2009.
Hmmm, let's see, alot has changed...
We used to manually sign our own timecards, not punch a time clock. Still wish for those days, as nurses should not have to punch in and out.
Chest tubes drained into glass jugs that you taped to the floor, not a pleuravac.
Charts were on paper, not on the computer. Those were the days!
Same thing with labs. You ordered tests on a carbon set of papers, and sent it with the specimen.
There were no Pyxis machines. You had one narcotics box, and the charge nurse kept the keys. If you went home with the keys, you returned soon after with the keys.
All unit supplies had a charge sticker, that usually ended up on your nametag or on the floor. Omnicells took care of that.
There were no nurse zone phones. There were call lights.
MRSA and VRE weren't as big of a thing. Probably around, but we didn't know much about it.
Nothing was on the computer. There was a care kardex, used for report, and a med kardex used to record all meds given. You hand wrote on these.
Most IVs were on gravity drips. And you had to calculate them. Pumps were rare.
You could take all of the styrofoam water pitchers from all the patient rooms and put them on a cart to refill the ice water from the ice machine. Now, due to infection control, you never take the pitcher back in to the ice machine, you only take plastic bags of ice ot the patient.
Heat lamps were used pospartally to assist with healing of the perineum. You set up the heat lamp on the bed, then placed a cradle -like cage around it and covered it with the blanket, to provide for privacy. What a fire hazard!
NCLEX was a two day ordeal. Paper and pencil. Most state had one site, and larger states had more than one site. Given twice a year only. New grads got temporary licenses until results were known. NCLEX was for 12 hours, two 3-hour sessions each day. Then, you waited about 8 weeks to get your results in the mail.
Twelve hour shifts pretty much weren't anywhere utilized as they are now. It was standard to work 7-3, 3-11 or 11-7. Some straight shifts, and some got rotating schedules. And I honestly didn't see the level of burnout and call-ins that we see today on 12 hour shifts.
- 1Nov 3, '12 by NBMom1225It seems like today's tube feed formulas (Glucerna, Osmolite, etc) always cause diarrhea...did the 'old' way of using thinned blenderized real food do the same? It seems like those patients always end up with diarrhea and skin breakdown, maybe the other way was better...