How has nursing changed?

[RN007]

There have been comments on the board lately about the current state of nursing and how challenging it is to be in this profession. As a soon-to-be graduate nurse choosing to do something meaningful as a second career, I worry if I'll be able to handle things. What I'd like to know is, how has nursing changed in the last, oh, 20 to 30 years or so? Any long-term career nurses out there want to talk about the good ole days, assuming things were better? If they were?

[bargainhound, RN]

Over 30 years ago, nurses were respected.

That is what I noticed first that eroded.

But, doctors have also experienced the same stress/loss of respect/

ill treatment from the public.

Nurses are not the only ones to go through the changes of our society.

[Grace Oz]

We use torches nowadays instead of gas lamps! :rotfl:

Sorry, just couldn't resist!

[traumaRUs, MSN, APRN]

The life expectancy is growing in leaps and bounds. What killed people 30 years ago doesn't today. So...folks live a generally longer life which leaves them vulnerable to more sickness and trauma. In other words, people are sicker.

I remember working as a nursing assistant in 1977 and taking care of a trauma pt who had a fractured femur and lacerated spleen. She underwent a splenectomy (rarely done today) and was placed in skeletal traction for 2 months (again rarely done). People stayed in the hospital much longer. I worked night shift and had two RN's and 3 NA's for 24 patients.

[RNLifesaver]

Increased risk of lawsuits. I am pretty sure people weren't "sue-happy" 20 or 30 years ago. Increased risk to lose your license coupled with the increased NEED to keep that lic to Work!! I know that if I ever lost my license, I would be finished! I wouldn't even know what to do. I depend on this income to live and raise a family!!

[muffie, RN]

pts are much sicker and go home quicker

mountains of paperwork

we learn something new we must do about each week or month[too few people to do too many things]

[TrudyRN]

I have been a nurse for 40 years. Things I've seen change:

more nurses are married and have kids - or single with kids, widowed or separated with kids. When I started out, there were no married students at our school at all and we were all fresh out of high school. We had to live in the dorm. If we got married, it could only be in our last semester of school. And if we got pregnant, we could not be showing if we wanted to continue clinicals and be in the graduation ceremony. Yes, you read that right.

The only employment we were allowed was as aides at our hospital school and that was no more than twice weekly. Now, so very many students not only do full-time school but are raising children, making a home for a family, and working full-time. I think it's too hard and am not surprised that new graduates often are lacking in skill and knowledge. They are torn in too many directions and their loyalties are to children and family, more than to Nursing. It's only natural but I think it's asking too much of themselves to be able to truly do it all and do it well.

nurses have degrees - AD, BSN, MSN, Ph.D.; it used to be almost exclusively hospital school diploma;

no more glass IV bottles or metal IV needles;

far more meds; IV pumps and controllers. The only thing we had way back when was a blood pump. We used to timetape our IV's and check them at least q1h. It was good, as we had to make rounds at least that often to keep up with the IV's.

far less awareness of basics like keeping things within the pt's reach (kleenex, phone, call bell) and of safety issues, like locking bed wheels, having rails up (often illegal now, so stupid);

microwaves; cordless phones, Nextel's; computers; remote controllers for TV's;

less cutting and more imaging, more endoscopic and laser surgery;

many more known microbes;

much more paperwork and less time to do it;

INSURANCE COMPANIES CALLING THE SHOTS; MONEY BEING THE DETERMINING FACTOR IN THE CARE THAT PEOPLE RECEIVE;

much sicker patients; much shorter hospital stays;

I don't know if ER's were used so much for routine care but they sure are these days. It is a shame.

mandatory overtime, working staff into the ground after sucking the life right out of them; not even the pretense of spiritual or religious values being the guiding light in health care, except in the Catholic hospital where I worked - I'm not putting down other religions, I'm not even Catholic, I'm just telling you what I've experienced;

traveling staff;

home health more prevalent (This is good, I think, as not too many people actually want to be hospitalized if they can be home and still get care.)

uniforms hardly ever white, almost totally scrubs; no more caps; pants uniforms; unsafe clogs and sloppy tennis shoes allowed; hoop earrings, load of jewelry, heavy use of perfume and scented lip products, deodorants, after shave, hair spray, shampoo - all those scents, plus air fresheners are very, very hard on some patients who have compromised immune systems, faulty livers, or allergies - like diabetics, pregnant women, older people, especially women over 40, probably others - truly nauseating, cause headaches and dizziness, resp distress; loud nail polish colors, some of which also smell;

more nursing homes but, over all, better care provided there, i.e., fewer restraints used, disposable diapers cutting down on the length of time incontinent patients are left wet or dirty, better nutrition, fewer bedsores (I know there are exceptions to this but I'm going by what I have personally seen.)

more men in Nursing, more women in Medicine and Management;

abortion legal, greatly increased drug abuse, more openness when discussing domestic abuse, elder and child abuse but I'm not so sure we address these things very well as a society. I bring them up because we do not nurse in a vacuum and nurses either will or will not help with abortions, for instance. We are mandated reporters for the abuses mentioned. That is new (since the '80's).

med techs;

chiropractic sometimes covered by insurance;

recognition (not by insurers but by lots of people) of alternative medicine and of the importance of spirituality in health care (holism);

increased cultural and ethnic sensitivity;

taping report;

changes like nurses not jumping up to give doctors their chairs or run around and gathering up charts for them, although I do whatever I can to help doctors who are pleasant toward me, since I am helping the patients that way; I'm afraid I do make myself scarce when meanies are around. I'm too old to be forcing myself to help those who disrespect or are rude to me. I'll work on it, though, as that attitude is really not so good.

I'm sure there's lots more but hope this helps.

[muffie, RN]

well said trudy, thanks