Med Surg Then and Now

[Lev]

I work on an extremely busy surgical floor with frequent admissions and discharges. We get ortho, plastics, and GI surgical patients, plus a host of medical patients. Our ratio is 1:5, but very often we go up to 1:6 on day shift because we are short on nurses. We are also frequently short on techs and often have confused sitter patients, so sometimes an available tech has to sit with a patient. Our standard vitals and I&Os are q8h, but we do post op vitals and about 1/3 the patients have q4 vitals and/or q4 I&O. Patients are often really sick.

For experienced med surg nurses, what have you seen change about Med/Surg in the past 10-15-20 years. Documentation, staffing, patient demands, acuity, responsiveness of doctors and physician assistants are all things I'm interested in hearing about.

[Ruby Vee, BSN]

What about alarm fatigue? Were all the patients on tele/pulse ox way back when?

No pulse ox when I started -- that's a relatively new thing -- the 90s or so. We may have had the technology earlier, but everyone wasn't on continuous pulse ox like they are now. Our 30 bed telemetry unit had 7 tele boxes -- we picked and chose who wore them. No pumps -- only enough pumps for the heparin and aminophylline drips -- everything else was dripped in with a buretrol. If you didn't set it right, you dumped in your whole hour's worth of drips in less than half that time -- or had more than half left at the end of the hour. Not much to alarm, so no alarm fatigue. Ahhhh, the good old days!