Published Sep 4, 2004
Hi! I'm doing a research paper on LPN's. What I need to know is R/T the job duties/expectations of nurses of yesteryears to the present? Has the role changed? Is the duties more or less? Your knowledge is greatly appreciated!
LPNs in the 60's were like nurses' aides. In an emergency they could administer medications and give injections. Mostly they did the work that the CNA's do today.
I graduated from LPN school in 1984. I was told LPNs would never put down NG tubes, never put in IVs or draw blood. Also that LPNs would never remove surgical drains. In less than five years I was doing all of the above and peritoneal dialysis and hypodermoclysis (it was a WAY old fashioned place) as well as PCA pumpsand IV push meds. So much for "never".
I graduated as an L.P.N. in 1971. This was from a large hospital, built in 1892. Quite gothic looking. The R.N.'s were strictly at the desk, doing paper work, answering the phones and making assignments. The aides and L.P.N.'s reported back to the R.N who then filled in the appropriate paperwork. The R.N. also made rounds with the attending physician and dealt with the interns & residents. At that time, nursing assistants were hired off the street. No high school diploma needed and only a short training course in the hospital. They received an assignment of total patient care for the less ill patients, and took vital signs and passed water for all patients. The L.P.N.'s had total patient care of the sicker patients, and we did any treatments necessary and passed meds. There were 30 bed wards, with two bathrooms - so most of the patients used bedpans. The big, cold metal ones. There was no air-conditioning and the heating was from a few radiators. If you were near them, it was hot. Otherwise, you froze. The only telephone was at the nurses station. Oxygen was available from those huge tanks that were rolled near the bedside. Blood pressure was taken with the large, rolling machines. Glass thermometers were used. Many patients were on total bedrest and required full bedbaths and shampoos using those trays under the head. Backrubs were offered at least twice a day. We cleaned the beds and tables after a patient was discharged. When we were working in the delivery room, the L.P.N.'s were the ones who washed all the equipment, and mopped the floors afterwards. We also took instruments to Central Supply for sterilization. We assisted our patients to ambulate and fed patients if needed. We did not give Insulin or Heparin, nor were we allowed to give I.V. meds. Only the R.N.'s were allowed to start or stop an I.V. A lot of L.P.N.'s worked in the newborn nursery, as at that time, the babies were only brought out to the moms every four hours, and usually not at night. Even if the moms were breast feeding, they were encouraged to rest at night and the nurses bottle fed the babies. At that time we wore ironed dress uniforms, along with white pantyhose,and definately only "nursing" shoes. Along with the dam caps, which were always falling into all the wrong things. Like wounds.
I worked in a newborn intensive care unit in 1974, when that was a brand new specialty. Because no nurse - L.P.N. or R.N. - had training for those units, we did exactly the same duties, except the R.N.'s did charge duty. We went on state-wide transport, did ABG's - interpreted the results and made adjustments accordingly - all without asking a doc, nasogastric feedings, assisted with transfusions, started I.V.'s etc. Had tremendous backing and encouragement from the neonatologists. The smallest baby saved weighed 1 lb. 10 oz.
Compared to today's nursing - well, it can't be compared. It is like the difference between a one speed bicycle and a Harley. Assignments were very reasonable, we never felt rushed, always had time to give excellent care to our patients, and lots of time for talking with them and teaching, no one worked overtime, families were so grateful - no one ever worried about being sued. We rarely missed breaks, and if there was a learning experience somewhere else in the hospital, the nursing supervisor would come and tell us to send as many people as we could spare to watch it. Patients stayed in the hospital for much longer. After a normal delivery, the moms stayed 4 days. We were responsible for a lot more, yet although (as in the NICU) the responsibilities could be pretty awesome, we always worked together, and got respect from the physicians. It was a kind of pat on the head respect, but they enjoyed teaching us and had a fatherly attitude, I guess you'd say. I simply do not recall ever having any problems with management or anyone having any cause to be upset with them. Selective memory?? or great management!!
I certainly didn't start out trying to make this a novel although that is what is has turned into. Sorry for rambling, and hope you can find some useful tidbits amongst all the memories. My, my the differences!!!
Weetziebat-----That was a wonderful insight into your career as an LPN. I tilt my nursing cap to you. You are very remarkable. I have been a LVN/LPN for 15 years and have seen many changes. I enjoy nursing memories from long ago to see how nursing has changed. Thank You.
:imbar Gee.....thanks Nurse Q.
When I went to LPN school in the 70's it was mostly practicum and skills and what to look for and report...to the RN. We did very little when it came to independent nursing judgment and action. My LPN board exam had numerous questions asking what would you do if you saw A,B or C.....and the correct answer was likely 'tell the RN.'
MyLPN job in the 70s was tasking...treatments, dressings, meds..the RN supervised, asessed, assigned and monitored my work, planned care, called docs, etc. Today's LPN's get a lot more in school than I ever did and function in a much broader role than 30 yrs ago.
I want to say thank you to everyone who has responded to this thread. Please keep posting. I need all the information I can get....:) Sandi
NurseyBaby'05, BSN, RN
I was just speaking to my MIL. Her mom went back to school and graduated in the mid-1950's to become an LPN. In some ways she was ahead of her time. All of the other girls (no guys) in her nursing class were right out of high school. She was the only one married with a family. She was forty. She also graduated first in her class by a mile. She had waited until her daughter (my MIL) was in junior high and could get herself off to school.
Even the LPN schooling has changed. She had to take gym and swimming. :stone She was one of the first LPN's in our city to be able to give injections.
I'll have to ask my MIL what else her mom did as an LPN back then.
I graduated from LPN school in 1975. I worked as a charge nurse at a LTC which in those days were called convalescent hospitals. I loved it. As the nurse you were expected to make your own decisions. You went into a nice quiet room where you could concentrate and pre pour the patients pills for pill pass. There was much much less paperwork. I think we should go back to the "good old days" when a nurse could use her brain and make her own decisions. Nowadays I feel like a "robot" who has to follow a certain protocal that all nurses are required to follow whether it makes any sense or not. Nursing has turned into a total paperwork nightmare. :angryfire
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