cardiac nursing--back in the day

BEDPAN76 · Apr 1, 2010

I remember in the late 70's the cardiac pts. were on a clear liquid diet and could NOT have ice water. Had to spend at least 3-4 days in CCU before they came out to the telemetry unit. :)

nursej22, MSN, RN · Apr 1, 2010

In 1985 while I was doing my ICU rotation for LPN training, cardiac patients were on strict bedrest, that meant full bedbath daily in addition to bedpans, and no hot or cold po fluids due to possible vagal stimulation.

I can remember when my dad had his first heart attack in the '70s he stayed in the hospital for a week, part of the time on a lidocaine gtt. When he came home he was on warfarin and procainamide and had to follow a strict low sodium diet.

elkpark · Apr 1, 2010

In my cardiac rotation in nursing school in the early '80s, MI clients stayed in the hospital, on strict bedrest, for weeks. Not only did they get bedbaths every day, at our hospital there was a special protocol for the bedbath (the cardiac bedbath), to avoid them getting chilled or too warm (even more so than with an ordinary bedbath), and the unit was kept especially quiet to avoid startling or over-stressing the clients -- we all tiptoed around, whispering. (The clinical rotation really impressed upon me that I did NOT want to work in cardiac nursing ... :))

LoveANurse09 · Apr 2, 2010

Wow, strict BR for MI's?! I love hearing these..I've heard stories about patients smoking in there hospitals beds in the 70's/80's. They would room pts together by smoking or non smoking like in a restaurant! I can only imagine walking into a room where both pts are chain smoking!

surferbettycrocker · Apr 3, 2010

it's nice to hear of the differences between then and now. let's not have cardiac patients drink ice water, but let's cohort the smoking patients!

i find it ironic that my cardiac unit is possibly the most noisy,chaotic,stressful UNQUIET unit on the block! it is anything but therapeutic. i wonder if its just so common to find adults

living with cardiac dz. that we treat em and street em. as opposed to back in the day where it seems the care of the cardiac patient was a little more conducive to rest and recoup.. :twocents:

General E. Speaking, RN, RN · Apr 13, 2010

I remember having to take out every other staple on the patients legs (from graft site) and replace with steri strips. Some of those staples were imbedded and painful to remove!

franciscangypsy · Apr 17, 2010

do you think that the way we care for cardiac pts was better then or now? It's so interesting to hear how we used to care for cardiac pts. That would never fly now, although it sometimes seems that some pts seem to make their second home on our floor. lol

elkpark · Apr 29, 2010

do you think that the way we care for cardiac pts was better then or now? It's so interesting to hear how we used to care for cardiac pts. That would never fly now, although it sometimes seems that some pts seem to make their second home on our floor. lol

Again, I've never worked cardiac as an RN (my only experience in that area was my school clinical rotation), but I've had friends who worked on cardiac units over time who have commented that, in the "old days," when people were in the hospital for a long time after an MI, it was extremely clear to them that something seriously bad had happened; they were open to learning about their condition and what changes it would be helpful to make in their lives (because they were scared to death! :)); and the nurses had plenty of time to do this teaching. With the move to shorter stays and quick discharges, you can now have a major MI and be out of the hospital within a few days -- my cardiac nurse friends say the difference is that people leave the hospital now with little or no teaching, and completely unaware/unconvinced that anything serious has happened to them (after all, how bad could it be? They were only in the hospital a few days ... :rolleyes: ), and completely unconvinced that they need to make any lifestyle changes -- and you see them back in the hospital, with another MI, later on ...

LoveANurse09 · May 6, 2010

Again, I've never worked cardiac as an RN (my only experience in that area was my school clinical rotation), but I've had friends who worked on cardiac units over time who have commented that, in the "old days," when people were in the hospital for a long time after an MI, it was extremely clear to them that something seriously bad had happened; they were open to learning about their condition and what changes it would be helpful to make in their lives (because they were scared to death! :)); and the nurses had plenty of time to do this teaching. With the move to shorter stays and quick discharges, you can now have a major MI and be out of the hospital within a few days -- my cardiac nurse friends say the difference is that people leave the hospital now with little or no teaching, and completely unaware/unconvinced that anything serious has happened to them (after all, how bad could it be? They were only in the hospital a few days ... ), and completely unconvinced that they need to make any lifestyle changes -- and you see them back in the hospital, with another MI, later on ...

So true! Some of our pts really take it seriously and want to prevent it from happening again..others..well are coming back getting stented every other month. I actually had another one last night on his 7th stent, luckily this cath was normal :confused: . I wish we had more time for teaching too. In my experience alot of the docs are not telling people "yes, you had a heart attack and you had damage to your heart" unless its a major one. I've had many pts tell me no I've never had a heart attack,but i have X amount of stents!

ljc71108 · Jun 29, 2010

You can actually have stents and not have a "heart attack". Some at risk patient's will have other symptoms but no EKG changes and no elevation of enzymes. The MDs will do a catheratization for diagnosis purposes and find something that is borderline and stent it.

But yes I agree we need more education for these patients