What things have changed in nursing since 1997???

flowerchild · Dec 2, 2002

HI Cheerfuldoer! Glad to hear your going to make it back to the bedside. Others have already said what I was thinking about pain mngt, JCAHO, staffing, etc. I thought of one more thing for you, that drug book your going to buy is a whole lot bigger than the one you already have. A ton of new meds, esp. hybrids, have entered the market in the last few years. Good Wishes to you!

Dr. Kate, BSN, RN · Dec 2, 2002

Glad to hear you're headed back. Enjoy your refresher course.

Here we put returning nurses through the same type of orientation we give to new grads, not because we think they're the same as new grads but because we want them to have every opportunity to succeed. You might want to ask any hospital you are interested in about what kind of an orientation you will receive.

I can't add too much to whaat has been said about the changes since 1997, except to say that the increased work load and acuity of the patients demands that you be organized. If you want to spend any time with your patients you have to add to that the skill of being quick while seeming to be relaxed with all the time in the world.

Q. · Dec 2, 2002

I can't add much that hasn't already been said either. I started my nursing career 5 years ago, and what I've noticed is you can basically start in any speciality area: NICU, ER, L&D; things that were once closed without med/surg experience.

Other than that I'd have to agree the medications are the biggest thing - that and probably procedures/treatments. Here at one of our teaching hospitals we have a Gamma Knife Center - things like that - alternative therapies are more common and used in conjunction with traditional medicine, etc.

Good luck and welcome back.

live4today, RN · Dec 2, 2002

Hey, hey, heyyyyyyyyy allnurses sibs!

Wow! Thanks for all the updates offered! I'm so excited about re-entering nursing, I feel like a "new grad"!

I'm ready for the challenge, and ready to get caught up on everything no matter what it takes!

Dr. Kate...thanks for your comments as well. One day I will be called "Dr. Renee"...with a Ph.D...not because I'll feel like a "better nurse", but only because it is a childhood dream of mine that I want to turn into a goal for personal satisfaction...not to say it won't help me in the career field of my choice, mind you.

The type of orientation I've been told that is offered to returning nurses is much like the new grads. We are buddied up with an RN who will precept us on the med/surg unit (the only unit they allow returning nurses to be refreshed on). The orientation lasts between 12 and 16 weeks...depending on how long it will take the nurse being orientated to catch up (so to speak). We are paid as full time staff during this process, and have the option of choosing which unit we wish to work on when the refresher program is over.

As for the pay???? It hasn't been discussed as yet, but it won't matter much to me as long as I'm getting the benefits of the refresher program so I can get caught up. It's an education as I view it, only I'm being paid while being re-educated/re-oriented to the latest trends of nursing. After the refresher program is over, I want to work full time weekends so I can go back to college for my RN to BSN/MSN/Ph.D...and be done with college (per se) in five years. I'm not interested in monkeying around anymore, but want to pursue my nursing career very seriously, and on a full time basis. As a newly single (not quite, but won't be long) woman with no one to care for but myself, I see no reason why I can't accomplish those goals for myself in a five year time span. :nurse:

Q. · Dec 2, 2002

Yanno Renee, speaking of grad school: UW Milwaukee has a BSN-Ph.D program here. Some like the interim MSN in between (like me) as it's a learning experience, some like getting it all done at once.

Worth looking in to if you want to get the Ph.D.

Good luck! Grad school is hard, but definitely fun!

live4today, RN · Dec 2, 2002

Hi Susy, thanks a bunch for the information about that program. I'll check it out and have them mail me some information about their program, school, etc. :kiss :nurse:

adrienurse, LPN · Dec 3, 2002

Two words "nursing shortage". Nursing is getting more desparate and burnout is commonplace. Teamwork is less cohesive because everybody has so much anger.

Everyone that I work with who has been around for a while is always lamenting about the "old days" before staff restructuring.

NancyRN · Dec 3, 2002

Hi Cheerful! I entered nursing just 2.5 years ago, so I don't have any comparison. It seems most of the nurses my age (over 50) have worked their way into something easier than floor nursing. I don't have the stamina to work my way up the ladder, which is very frustrating. Kind of a Catch-22!

live4today, RN · Dec 3, 2002

Adrie and NancyRN...I hear ya! Thanks for your contributions to my quest to learn what's been happening in nursing over the past five years since I've been inactive in the field. :nurse:

CATHYW · Dec 3, 2002

Hey, Renee! Good to see your photo again!

Since I was out of hospital nursing for nearly the same length of time until 4 weeks ago, I feel pretty qualified to answer your question:

-the biggest change I have seen, without question is how staff is utilized. They are moved like chess pieces to accomodate staffing needs. Just because you are assigned to an aarea does NOT mean that is the area (or even the CAMPUS-our hospital has 2 in the same town) you will be working. I move between the medical and surgical floors frequently during the day because of my position. I rarely see the same folks in the same place twice!

-IV pumps have changed since I last worked in-house. They are all digital, and are becoming smaller and smaller!

-while our charting remains all done on paper, all meds are charted on computer. All orders are entered on the computer, which is nothing new for me, from before.

-there are quite a few "younger" nurses, as you might expect to find, in 5 years away. We are looked at as senior nurses, and as good resource folks. I've already been called that, and used by younger nurses in that capacity. Kind of like an "elder stateswoman", if you will! LOL! It is a little bit weird, but I guess we have to expect this, the older and more experienced we get!

I'm sure that you will be fine. It is kind of like riding a bicycle.

Long Term Care Columnist / Guide · Dec 3, 2002

Hi Renee! I'm another RN who graduated in 1997, and while all the basic stuff probably NEVER changes (poop is still poop, and it's still found in all the usual--and UNusual--places) I've noticed a lot of changes just since I started practicing. There's a lot more emphasis now on cost-effectiveness, which means we have to know something about insurance, Medicare/Medicaid etc. (Of course, I work in LTC, but even back then we always had to make sure we charged everything to the resident that we could, including disposable razors!!) Then, nurse-patient ratios are definitely worse than they were, and I think that's true everywhere---1:8 not unusual in hospitals, more like 1:50 in LTC.

12-hour shifts also seem to be the norm now; a lot of nurses like them since you get more days off, but they're really hard for some of us who are older and not in as good a shape as we used to be.........Anyway, good luck, and I hope you enjoy your comeback!:)

live4today, RN · Dec 3, 2002

Hi Cathy! Hi mjlrn97!

Thanks for the input. I see I'm in for a new way to "ride the bicycle" Cathy! :rotfl: Change!!! Don't cha just love it!

I know I'm not as "young" as I use to be, but I was already in my mid-thirties when I graduated from college/nursing in the first place, so I wasn't exactly a "spring chicken" then either. :rotfl: I'll give as good as I've got as I always have in past years of nursing, and look forward to my return to the "walls of learning" so I can graduate with more options to choose from down the road, especially since I'm "getting even older now". :chuckle