Since I've started, I've noticed the acuity is a bit worse. I've noticed ICU bed are much more in short supply so sicker patients stay on the unit, or they take a long time to get transferred out.
I've also noticed while we've gone to computer charting and flow sheets, instead of those dreaded long narrative notes, we keep getting a new form to fill out, either by hand or on the computer. Usually the forms are driven by JACHO or to prevent lawsuits, or in response to a lawsuit we've had. Things forms include pain control issues, restraints, and teaching, all of which have been a major focus of JACHO.
Since I've started nursing there have been major studies published about the prevalence of medication/hospital errors, as well as studies proving better patient outcomes/safety, as well as less nurse burnout related to lowered RN to paitent ratios.
No, I don't long for the good old days, they were rough then and are still rough. I try to do my best, to advocate for better, but if I didn't like it, I can always quit and find another profression or job.
I might add that when I advocate and complain about my current 8:1 ratio, it does me no good whatsoever to say "when I was a nurse in the old days I had 12:1, so quit your whining".