Crusty Old Bats

KathyDay · Nov 30, 2023

Wuzzie said:

What happened is hospitals changed to a business model and are now driven by profit over providing care. Administration gets bonuses based on how much money they save and the first cut they always make is staff. Now we have minimal staffing with maximal expectations akin to a sweatshop. You can't blame the nurses. We are doing the best we can.

If hospitals can't afford to pay for the people to provide the basics of daily care, then they shouldn't be in the "business" of "caring". It was horrifying to me to see my husbands needs ignored the way they were, and to have staff say that he "refused" help with bathing...he never refused because he was never was offered help with bathing, unless I offered it. I helped him with hygiene. Yes, I am angry, and so very disappointed in the lack of basic care my husband received. I'm sure any nurse in this group worth their title would have felt the same way if it was their loved one.

Wuzzie · Nov 30, 2023

KathyDay said:

If hospitals can't afford to pay for the people to provide the basics of daily care, then they shouldn't be in the "business" of "caring".

I can't say I disagree with you on this point but I still won't blame the nurses. Sure there are bad apples out there but the vast majority of us want to provide quality care which is near impossible when we don't have the tools to do so.

Ruby Vee, BSN · Nov 30, 2023

When I first started nursing back in the 70s, the Crusty Old Bats were discussing cleaning and sharpening their own hypodermic needles after giving an injection.

We didn't have unit dose, so we "prepared our med pass" by taking the required doses out of a huge bottle of pills and put them in little white soufflé cups with a tiny room number for a label, all the meds for your hallway sitting on a little tray. If you dropped that sucker, you'd have to start all over again. Med rooms were small, and it was easy to jostle someone (or be jostled) while preparing that tray.

Wards, not private or semi-private rooms. A ward was essentially 14 beds (more or less) in a circle with only curtains between them. There were only two bathrooms for a ward, and often at night the orderlies would hide in them. Not, however, in the female wards because those bathrooms were bad hiding places -- always in use.

Titrating vasoactive drips with a buretrol and a roller clamp. (Dang -- I can't remember how to spell "buretrol."). Heparin got an IVAC, using regular IV tubing with a little electric eye to count the drops for you. They worked OK most of the time. But then there were the times they didn't work OK . . . . .

Doctors were God. You never failed to offer them your chair, jumping up to get them a cup of coffee and an ash tray. They commandeered all the paper charts, never put any back and then snapped at you when they didn't find the 8am vital signs in said chart at 8:05 am when they'd had the chart since 7. In a teaching hospital with multiple services rounding, you might not see your chart until it was time to go home; then you had to wait for the intern to be done with it before you could do all of your charting for the day.

If a (male) MD assaulted a (female) nurse, it was always considered to be the nurse's fault, and often there was discipline. For the nurse. I watched a physician strike a nurse across the face, and our manager told him off, then accompanied the nurse to the ER to have her face sutured. When they came back to the unit, they were both fired. The manager and the nurse, not the physician. Although the physician did get arrested and carted off to jail a few years later when he punched a nephrologist. He had to be bailed out so he could finish his cath lab schedule that day.

Mannitol came in a huge glass vial with a saw taped to it. You had to put it into hot water to dissolve the mannitol, which would be in crystal form. Then saw the top off the ampule with the provided saw, draw it up with a filter needle into a 50cc syringe and inject it before it crystalized again. As a colleague and I found out the hard way, those saws made good weapons for angry or agitated patients.

Male physicians would get handsy with the new young nurses, and if you talked to your manager about it, she'd encourage you to "just get over it, because you don't want to get him into trouble over something like that." (Male pharmacists, administrators, janitors and other colleagues occasionally got handsy with similar results.) The veteran nursing staff knew who to steer clear of and would warn the newer staff . . . usually. Sometimes a new nurse was grabbed before someone could warn her.

I have a ton more, but I have both the oven and the clothes dryer beeping at me.

Editorial Team / Admin · Nov 30, 2023

DallasRN said:

And do you remember that formula...dose desired ÷ dose on hand x cc?

I learned that one as desired over have times volume.

Things I remember in my relatively short career:

Minimally invasive surgery was a big deal and most staff weren't familiar with bigger cases like a laparoscopic bowel resection or endovascular stents for aortic aneurysms. The norm was the stem to stern incision for a big old open procedure
Reusable linen drapes and surgical gowns
Smoke evacuation? What's that? Just breathe in this bovie smoke that's like smoking 27 cigarettes in a day
Triple carbon copy documentation that only required 2 sheets of paper. Other than times, final procedure, post op diagnosis, and implants, most of the documentation was done before the patient came to the room

toomuchbaloney · Nov 30, 2023

Ruby Vee said:

When I first started nursing back in the 70s, the Crusty Old Bats were discussing cleaning and sharpening their own hypodermic needles after giving an injection.

We didn't have unit dose, so we "prepared our med pass" by taking the required doses out of a huge bottle of pills and put them in little white soufflé cups with a tiny room number for a label, all the meds for your hallway sitting on a little tray. If you dropped that sucker, you'd have to start all over again. Med rooms were small, and it was easy to jostle someone (or be jostled) while preparing that tray.

Wards, not private or semi-private rooms. A ward was essentially 14 beds (more or less) in a circle with only curtains between them. There were only two bathrooms for a ward, and often at night the orderlies would hide in them. Not, however, in the female wards because those bathrooms were bad hiding places -- always in use.

Titrating vasoactive drips with a buretrol and a roller clamp. (Dang -- I can't remember how to spell "buretrol."). Heparin got an IVAC, using regular IV tubing with a little electric eye to count the drops for you. They worked OK most of the time. But then there were the times they didn't work OK . . . . .

Doctors were God. You never failed to offer them your chair, jumping up to get them a cup of coffee and an ash tray. They commandeered all the paper charts, never put any back and then snapped at you when they didn't find the 8am vital signs in said chart at 8:05 am when they'd had the chart since 7. In a teaching hospital with multiple services rounding, you might not see your chart until it was time to go home; then you had to wait for the intern to be done with it before you could do all of your charting for the day.

If a (male) MD assaulted a (female) nurse, it was always considered to be the nurse's fault, and often there was discipline. For the nurse. I watched a physician strike a nurse across the face, and our manager told him off, then accompanied the nurse to the ER to have her face sutured. When they came back to the unit, they were both fired. The manager and the nurse, not the physician. Although the physician did get arrested and carted off to jail a few years later when he punched a nephrologist. He had to be bailed out so he could finish his cath lab schedule that day.

Mannitol came in a huge glass vial with a saw taped to it. You had to put it into hot water to dissolve the mannitol, which would be in crystal form. Then saw the top off the ampule with the provided saw, draw it up with a filter needle into a 50cc syringe and inject it before it crystalized again. As a colleague and I found out the hard way, those saws made good weapons for angry or agitated patients.

Male physicians would get handsy with the new young nurses, and if you talked to your manager about it, she'd encourage you to "just get over it, because you don't want to get him into trouble over something like that." (Male pharmacists, administrators, janitors and other colleagues occasionally got handsy with similar results.) The veteran nursing staff knew who to steer clear of and would warn the newer staff . . . usually. Sometimes a new nurse was grabbed before someone could warn her.

I have a ton more, but I have both the oven and the clothes dryer beeping at me.

The mannitol was a trip in the way back machine for me. Thanks for the memory jog.

DallasRN · Nov 30, 2023

Ruby Vee said:

I have a ton more, but I have both the oven and the clothes dryer beeping at me.

Please hurry with the oven and the clothes dryer! I want to hear more. Fascinating. I started school in the late 70's, finished early 80's. That's about the time things were slowly (verrryyy slowly) beginning to change for the better. I just barely escaped some of what you mentioned.

heron, ASN, RN · Nov 30, 2023

DallasRN said:

Please hurry with the oven and the clothes dryer! I want to hear more. Fascinating. I started school in the late 70's, finished early 80's. That's about the time things were slowly (verrryyy slowly) beginning to change for the better. I just barely escaped some of what you mentioned.

Yes, please do.

I saw those circular wards at Peter Bent Brigham on a tour with a nursing instructor who graduated from there. I remember being envious of them while sprinting up and down looooong hallways at the old Boston City. Imagine being able to see all your patients at once!

To go off topic, I'm glad to see you Ms Ruby. Hope you can come by again soon.

Pepper The Cat, BSN, RN · Dec 1, 2023

Oh, nitropaste? Remember that? The dose would be 1 inch, 1 1/2 inches etc. you'd measure it out on a paper patch. Oh, the headache if you got some on your finger!

heron, ASN, RN · Dec 1, 2023

Pepper The Cat said:

Oh, nitropaste? Remember that? The dose would be 1 inch, 1 1/2 inches etc. you'd measure it out on a paper patch. Oh, the headache if you got some on your finger!

And goddess forbid you should forget to remove the old patch(es)!

Pepper The Cat, BSN, RN · Dec 1, 2023

What was the med we gave sublingual for high BP? Adalat? You'd pierce then end of the capsule and squeeze the contents under the tongue.

Tenebrae, BSN, RN · Dec 1, 2023

Having to draw up my own flushes. Now its just prefilled all the way

Been there,done that, ASN, RN · Dec 1, 2023

Ruby Vee said:

When I first started nursing back in the 70s, the Crusty Old Bats were discussing cleaning and sharpening their own hypodermic needles after giving an injection.

We didn't have unit dose, so we "prepared our med pass" by taking the required doses out of a huge bottle of pills and put them in little white soufflé cups with a tiny room number for a label, all the meds for your hallway sitting on a little tray. If you dropped that sucker, you'd have to start all over again. Med rooms were small, and it was easy to jostle someone (or be jostled) while preparing that tray.

Wards, not private or semi-private rooms. A ward was essentially 14 beds (more or less) in a circle with only curtains between them. There were only two bathrooms for a ward, and often at night the orderlies would hide in them. Not, however, in the female wards because those bathrooms were bad hiding places -- always in use.

Titrating vasoactive drips with a buretrol and a roller clamp. (Dang -- I can't remember how to spell "buretrol."). Heparin got an IVAC, using regular IV tubing with a little electric eye to count the drops for you. They worked OK most of the time. But then there were the times they didn't work OK . . . . .

Doctors were God. You never failed to offer them your chair, jumping up to get them a cup of coffee and an ash tray. They commandeered all the paper charts, never put any back and then snapped at you when they didn't find the 8am vital signs in said chart at 8:05 am when they'd had the chart since 7. In a teaching hospital with multiple services rounding, you might not see your chart until it was time to go home; then you had to wait for the intern to be done with it before you could do all of your charting for the day.

If a (male) MD assaulted a (female) nurse, it was always considered to be the nurse's fault, and often there was discipline. For the nurse. I watched a physician strike a nurse across the face, and our manager told him off, then accompanied the nurse to the ER to have her face sutured. When they came back to the unit, they were both fired. The manager and the nurse, not the physician. Although the physician did get arrested and carted off to jail a few years later when he punched a nephrologist. He had to be bailed out so he could finish his cath lab schedule that day.

Mannitol came in a huge glass vial with a saw taped to it. You had to put it into hot water to dissolve the mannitol, which would be in crystal form. Then saw the top off the ampule with the provided saw, draw it up with a filter needle into a 50cc syringe and inject it before it crystalized again. As a colleague and I found out the hard way, those saws made good weapons for angry or agitated patients.

Male physicians would get handsy with the new young nurses, and if you talked to your manager about it, she'd encourage you to "just get over it, because you don't want to get him into trouble over something like that." (Male pharmacists, administrators, janitors and other colleagues occasionally got handsy with similar results.) The veteran nursing staff knew who to steer clear of and would warn the newer staff . . . usually. Sometimes a new nurse was grabbed before someone could warn her.

I have a ton more, but I have both the oven and the clothes dryer beeping at me.

Nothing in my house beeps, they are all disabled. I have heard enough beeps in my life.