How nursing has changed over the years...

DoGoodThenGo · Sep 5, 2009

Most nurses were not allowed to start IVs, only MDs. If an order came for a KVO IV at 3am, good luck trying to find a resident or other doctor to get the thing started. It usually required a series of pages and calls to their beepers.

Nurses could not say a patient was "dead" or "expired". That was making a diagnosis, however one could say "it appears the patient is no longer breathing"..

Bed making with mitered corners (all three types) was standard part of nursing education and something one was expected to know and do. Some hospitals had strict rules about which way the open end of a pillow slip was to face.

There were no Chux, one used a draw sheet, usually with some sort of washable padding.

Most floors ran on the "team nursing" model.

Most hospitals did not allow nurses to give meds via IV Push. Or, if they did the list of meds was restricted.

L&D was off limits to everyone except the patient (obviously) and perhaps (grudgingly) the father. Everyone else went to the waiting room.

Dress code strictly enforced for nursing staff, often right down to the colour sweater one could wear. Scrubs were strictly verboten for nursing staff not assigned to the OR or units. If something happened to one's uniform whilst on duty, obtaining permission to wear anything else normally required the request go up the ranks and be signed off upon. Normally best one got was permission to wear an isolation gown over the stained uniform.

Sexual harrasment of female nurses by male medical staff has been mostly nipped in the bud. Doctors are no longer free to paw at one or refer to one as "sweetie", "honey", or refer to one as the "cute blonde with a nice rack". Well not to your face at least.

AnnieNHRN · Sep 5, 2009

To prevent bedsores we were told to rub all pressure areas with every repositioning... totally contradicted today!

Didn't give much/if any IV pain meds. Demerol/Vistarel IM was the drug of choice.

The average Pt took only about 1/3 of the meds a Pt takes today.

I remember bringing pts to a smokers lounge for a smoke. Even pregnant pts were allowed to smoke! Crazy.

Documentation was so much simpler. % of time spent on pt care vs documentation was much better.

Rnandsoccermom · Sep 5, 2009

LOL, this thread takes me back! How about GI bleeds being treated "conservatively"- no GI lab with endoscopy. They all got a Salem sump to suction and IV fluids for 5 days. It was especially fun to put the tube in while they were trying to vomit on you. No matter what you did, coffee ground emesis was on you somewhere!

txredheadnurse, BSN, RN · Sep 5, 2009

I remember, very fondly, strict visiting hours. One could actually get things done, the unit, room and patient tidied up and then retreat to chart, straighten up things, etc. during visiting time. There was none of this catering to visitors or them camping out with entourage and baggage for days on end.

I remember nurses actually ran the units. We applied our critical thinking skills (called common sense and experience in those days lol) and figured out the best way to manage the patient loads, the physical environment and the duties specific to each shift while working as a team.

I remember a dirty utility and a clean utility room and bedpan hoppers. We thought we had died and gone to heaven when disposable plastic bedpans and emesis basins came into use. No more terminal scrubbing of those metal monsters.

I remember every abdominal or GYN surgery patient getting a 3H enema pre op (high, hot and a h...va lot) done the night prior to surgery. Of course there was little to no outpatient surgery in those days.

And well I could go on for quite some time. IMHO we have gained some valuable evidence based approaches to common nursing issues (pressure sores, early ambulation) and the technical aspects have certainly boomed but we have also lost a lot of our clout and prestige as a profession when ultimately all decisions are based on how much revenue and how customer friendly we are even when these concerns compromise patient care and optimum outcomes. It used to be if the nurse said such and such is what we need to do then that is generally what happened.

nurse2be2010 · Sep 5, 2009

Thanks so much for the responses! It sure does look like a lot has changed over the years!:)

pagandeva2000, LPN · Sep 5, 2009

Actually, nursing was REALLY nursing back in those days.

HeartsOpenWide, RN · Sep 5, 2009

This is an interesting thread. For those of you who have been around, what things do you like best about what has changed and what things do you wish didn't change?

DoGoodThenGo · Sep 5, 2009

One of my favourite nursing websites.

If you really want a good chuckle about things then versus now, pipe:

http://www.dlmaxwell.com/Etiquette.htm

DoGoodThenGo · Sep 5, 2009

My favourite quote:

"If it wasn't written -- it wasn't done."

And that my girls, pretty much sums things up! *LOL*

PICNICRN, BSN, RN · Sep 5, 2009

Back in the day.... there was a list of all the NICU staff who were 0 neg blood type. When a baby needed transfused- O- nurse sat down and they pulled off 20mls and gave it right to the baby. :eek:

AnnieNHRN · Sep 5, 2009

Back in the day.... there was a list of all the NICU staff who were 0 neg blood type. When a baby needed transfused- O- nurse sat down and they pulled off 20mls and gave it right to the baby.

:eek: :smackingf :eek:

cmonkey · Sep 6, 2009

When my husband was born (52 years ago) after an uneventful lady partsl birth, his mother stayed inpatient X 7 days, then was taken home BY AMBULANCE, carried up the stairs, and on bedrest for another week.

NICE! Clearly I was born too late. :chuckle