Yesterday and Today's Nurses

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    What do you think of when you hear the word nurse? Myself, I picture someone in a starched, full length white dress with matching stockings, shoes and hat. I can see her carrying a medicine tray loaded with brown bottles and a mercury thermometer. That's a pretty stereotypical thought, huh? What a blast from the past! Modern day nurses are a far cry from the old fashioned starch and hat days.

    The professionals I am about to introduce you to, Yesterday's Nurses and Today's Nurses, are very different, but remain one and the same.
    Since education is the first step, this is where we'll begin.

    Yesterday's Nurses were actually educated and trained by the physician's themselves. They learned nursing in the field, with real patient's and real life situations. When the physician's felt they had sufficient training, these nurses were put into practice. They were very fortunate to have hands on, real world training.

    In contrast, Today's Nurses are taught mostly by nurses. The bulk of their educational setting consists of mundane classrooms, filled with books and simulated situations. The amount of time spent in the clinical setting with actual hands on training is small in comparison to the amount of time spent in the classroom. Before modern nurses can practice, they must pass a state board exam to prove their competency. Today's Nurses are taught what is referred to as Ivory Tower book nursing, meaning what is ideal, not what is real. The next major difference is the conditions under which each of these professionals practice.

    Yesterday's Nurses were forced to practice under very crude conditions. Hand washing, sterility and personal protection were unknown concepts. Body fluids, germs and dirt were transferred from one patient to the next. Proper and adequate supplies were a rare commodity and there was no such thing as a private room. They dealt with uncontrolled sepsis and unclean critters roaming the floors of their domain.

    On the contrary, Today's Nurses have it made in the shade! Modern technology has produced some very nice benefits. Hand washing is highly promoted and antibacterial soaps are readily available. Procedures are performed following very strict guidelines for sterility and cleanliness. If proper procedures and protocols are followed, the transfer of micro-organisms is almost nonexistent. Stocked supply rooms are also a handy little item. If something's not there, one phone call to central supply will get you what you need. Since most modern facilities have private and semi-private rooms, Today's Nurses can care for their patient's in a comfortable atmosphere where cleanliness is promoted and visiting critters are strictly prohibited. The third issue I would like to discuss is the differences in the amount of autonomy possessed by each professional.

    Yesterday's Nurses were not allowed to have a voice. The articles I have read concerning this remind me of a scolded puppy with its tail tucked between its legs. But, this wasn't the nurse's fault, that's just the way it was at the time. The physician's were considered to be the truly educated one's and were always right. Any nurse who contradicted his decisions also faced his wrath. Quite often a patient's true needs were not met because of this. Yesterday's Nurses were taught to follow the physician and stick to tasks such as dressing changes and activities of daily living.

    The scope of practice has grown considerably and Today's Nurses have a great deal of independence and responsibility. Since they are the front line of care, they are expected to speak up and voice their concerns. Patient advocacy is a huge part of modern nursing practice. It is the nurses' duty to see to it that their patient's needs and goals are met. Nursing judgment calls can be made concerning some medications, procedures and activities.

    There is even a great deal of difference in the appearance between Yesterday and Today. Of course, the mode of dress for each fits the day and time, but Yesterday's Nurses were much more restricted in their choices. Their uniforms consisted of a full length starched white dress with wrist length sleeves and an apron, white stockings and shoes. It was topped off with that timeless symbol of nursing, the starched little white hat. I can only imagine how bulky and uncomfortable this must have been. The fitted bodice had to have been hot and quite restricting of movement while the full skirt and apron just simply got in the way.

    Today's Nurses' uniforms are fashioned for looks and functionality. They are available in a wide variety of colors and prints. The scrub tops are loose, lightweight, and comfortable and allow for ease of movement. The uniform pants are designed in the same manner and most have pockets deep enough for Today's Nurses to carry around five pounds of needed stuff such as scissors and tape. In addition, the private lives of these two professionals also hold notable differences.

    Yesterday's Nurses were expected to lead a solitary life style. They did not marry nor did they have children. These individuals were expected to be dedicated to their life's work and were on call 24 hours a day, seven days a week. Can you imagine being called out in the middle of the night and having to hook up a horse and buggy in frigid temperatures with three feet of snow on the frozen ground? I know I would have a cow to say the least!

    Conversely, Today's Nurses do have families and a life of their own. No longer is their job their life. Most employers place an emphasis on the importance of home and family. On call status for Today's Nurses means hanging out around a phone for the duration of their shift and nothing more. They also have the comforts of an engine powered vehicle with heat! Indeed there are a vast amount of differences in the professional and personal lives of Yesterday and Today.

    The practice of Yesterday's Nurses would make any one of Today's Nurses cringe in horror. I have the utmost respect and admiration for the nurses of days gone by. They were tenacious, tireless and believed every bit as much in what they did as modern nurses do. Even though the differences in the way of practice are great, Yesterday's Nurses and Today's Nurses are one and the same in that our purpose was/is to care for our fellow human beings and help them achieve the highest possible quality of life. This will never change and I think, for the most part, Miss Florence Nightingale would be proud of what her profession has become.

    One of my essays for English class..
    I'm not much of a writter, but I did enjoy this assignment & I just wanted to share.
    Last edit by Joe V on Jan 1, '08
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  3. by   zuzi are good for sure why not... is enough that you had courage to share with us your thoughts..... and this is more valuabe than anything else... hard to find open heart people on this time......sooooo.....a BIIIG HUUUUUUUUGE hug from me! Muaaaaah!
  4. by   nursemary9
    Since I have been doing this for 40+ years, I can relate to this topic.
    When I saw the title, I felt I really wanted to take the time to read it.I'm so glad I did!!
    This article is right on the button!!
    No matter when we practice, our focus is still the same--taking good care of our patients!!

    Thank You, Hlfpnt
  5. by   2longasn
    Thank you for this article. I don't know that todays nurses have it "made in the shade". But I am thankful that we don't have to sterilize IV bottles anymore it gives us just a couple of minutes to address the high acuity of our current patients and residents. With the biggest helping of GOOD customer SERVICE WE CAN DELIVER.
    Another bonus, we don't have to walk behind the doctors anymore and we are not expected to open the doors for them. I was born in 1964 but I've had instructors that would remind students of Nursing History. Thank you so much for this article.
    Last edit by 2longasn on Jan 1, '08
  6. by   hlfpnt
    The "made in the shade" & a couple of other phrases were added mostly for the sake of required word count for the instructor actually deducted 4 points for those...oh well.
  7. by   Rina10
    You are absolutely right!
  8. by   Successfully123
    Wonderful story!!!! Thanks for sharing!!!!!!!!!!!!!
  9. by   jackkat
    I am a third generation nurse and I know my mother was the white dress, clinic shoe type. Her training was a nurse without pay learning side by side with nurses and doctors. When I graduated with my BSN I was in white still wearing that horrible cap... I still like wearing white because it helps people identify you as a nurse. This is a lost concept and I might be getting old. Recently I have been mentoring new LPN's and I have found that most of them went into the field for the money and thought that it was a glamorous job.. The fake nails, hair down, and Baby Phat uniforms are a little over the top for me. Does anyone feel like I do?