Nursing: Then and Now

The nursing profession, as a whole, as well as the role of the nurse have evolved dramatically over the past several decades. I personally have witnessed the changing face of nursing during my 30+ years in the profession. Gone are the days when nurses were thought of as little more than helpers or assistants for physicians. Today's nurses are healthcare professionals in their own right, playing an important and vital role in providing excellent healthcare. Nurses General Nursing Article

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Looking back to when I was in nursing school, and then starting my nursing career, I remember many things that are no longer in use, or things that have transformed over the years. Gone are the days of paper chart, replaced with electronic medical records. Gone are the nursing caps that distinguished the nurse from the rest of the healthcare team.

Here is a partial list of things I remember from days gone by.

Back in the day...

  • Team nursing
  • Primary care nursing
  • Longer patient stays (Patients were actually able to recuperate in the hospital rather than being sent home too soon. There was no such thing as same-day surgery.)
  • Nurses wore uniforms which consisted of white dresses, white hose, white lace-up oxford shoes, and, of course ... white nursing caps!
  • Only OR staff and physicians wore scrubs.
  • The Kardex, a large folded card, was used as an important document of all patient activities, meds, etc. And it was hand-written in pencil so it could be erased and updated as needed. Talk about document tampering!
  • Requisitions were composed on a typewriter.
  • Patients were called Mr. or Mrs.
  • Gloves were used for sterile procedures only. Universal precautions did not exist.
  • The only lifting machines we had were male aides ... and of course ourselves.
  • Nurses bent and broke off needles from used syringes
  • IV pumps were used only in Peds and ICU. Nurses had to calculate the drip rate using the second hand on their watch and a roller clamp to regulate the flow.
  • Heavy glass IV bottles were still in use
  • The charge nurse made rounds with the doctors ... and carried the heavy metal charts.
  • When a doctor arrived at the nurses' station, it was expected that a nurse would stand up and offer her seat....and the doctor never refused
  • Male nurses were very rare
  • Cold metal bedpans were offered to patients.
  • All patients were offered a daily bath and back rub
  • There were no fitted sheets. Remember hospital corners??
  • Glass thermometers were still in use.
  • Nurses notes and vital signs were recorded using a pen with 4 colors of ink as different colors of ink were used on different shifts. Actually, only 3 were used since there were 3 shifts.
  • Surgery patients were admitted the night before surgery so their preps could be started that evening.
  • Nurses smoked in the nurses' lounge.
  • Cancer was almost always a death sentence
  • Medicine was dispensed by the med nurse carrying a tray with small paper cups of pills and different colored med cards.
  • Four-year BSN programs were not as plentiful. Most nurses graduated from hospital-based Diploma or ASN programs.
  • State boards were 2 grueling days of exams that were completed with number 2 pencils. No computerized tests in those days.

Feel free to add items that you remember from the past, even if that past does not seem that long ago. Changes are occurring at an even faster pace in the digital and electronic age of today. What do you think of some of the changes???

Specializes in Peds Urology,primary care, hem/onc.
I'm glad you were capable of doing this. This is definitely a nursing skill that must taught.

We have gotten to the technological age where we tend to rely too heavily on machines to do our thinking. Then when we have a malfunction, we are not mentally capable of doing things manually.

Another example....... many nurses rely totally on blood pressure monitors and have not developed the ability to take a BP manually. Back in the day, all we had were manual BP cuffs.

Totally agree with you on this....I do not like the machines for BP's, I mean obviously they are used a lot...but I totally prefer to do a manuel BP because it is so much more accurate. I hate to say it but it is also becoming a lost skill!

Specializes in Gerontology.
Totally agree with you on this....I do not like the machines for BP's, I mean obviously they are used a lot...but I totally prefer to do a manuel BP because it is so much more accurate. I hate to say it but it is also becoming a lost skill!

It certainly is! I had someone come to me and say that she was getting a low pulse reading and she tried 3 machines and each one gave her a different reading with a range from 30 - 60 BPM.

So I asked her what is was manually. she looked at me like I had 3 heads and said "Oh, I didn't think to do it that way". I checked, and the pt had a very irregular heart rate which probably caused the problems.

Specializes in Public Health, L&D, NICU.
It certainly is! I had someone come to me and say that she was getting a low pulse reading and she tried 3 machines and each one gave her a different reading with a range from 30 - 60 BPM.

So I asked her what is was manually. she looked at me like I had 3 heads and said "Oh, I didn't think to do it that way". I checked, and the pt had a very irregular heart rate which probably caused the problems.

We had a patient hemorrhaging after a cesarean, and we couldn't get a BP on her! The equipment in our recovery room would not register one, and no manual cuffs were to be found. It was very frustrating for us, and we finally borrowed one from a med surg unit. By that time, her BP was down in the scary area of just being palpable, and only one number. I think every unit should have a manual cuff for these occasions. Now I carry one in my new job, and that's the only kind I use.

Specializes in retired LTC.

The old saying is that 'NECESSITY is the mother of invention'. I hold that it really is nursing.

We all have so, so many 'tricks of the trade' that help us overcome difficulties with equipment or lack of supplies. Remember before we had the precut gtube/trach dressings. We would just chevron-type fold 4x4s. And I've made my own Montgomery straps to help secure wound dressings. I just think it's amazing how experience from the 'old days' so freq helps us out in a pinch!

Anyone remember scultetus (sp?) binders - the old fabric ones?

- The class before mine was the last class required to wear girdles!!!

OMG! I've never heard this before! How barbaric!

Specializes in Early Intervention, Nsg. Education.
The old saying is that 'NECESSITY is the mother of invention'. I hold that it really is nursing.

We all have so, so many 'tricks of the trade' that help us overcome difficulties with equipment or lack of supplies. Remember before we had the precut gtube/trach dressings. We would just chevron-type fold 4x4s. And I've made my own Montgomery straps to help secure wound dressings. I just think it's amazing how experience from the 'old days' so freq helps us out in a pinch!

Anyone remember scultetus (sp?) binders - the old fabric ones?

Scultetus binders...oh my YES! Bellies that looked like braided bread. The patients seemed to have so much more support though.

Harris drips for post op ileus with gas pains.

Wasn't there a span of several years sometime in the late 80's that everyone in the NH seemed to get sprays of granulex to one bony prominence or another? And it stained white uniforms permanently!

Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

Good grief. I remember when patients used to stay in the hospital after surgery for a week, at least. Now you have to be almost dying to stay for that long. I have a friend who was discharged the day after a total knee replacement, and another the day after a bilateral mastectomy. Before you know it, we will have drive-thru windows for surgery. LOL

And now with Obama Care......well that is a topic for another thread. But we all know that insurance coverage has really dictated many changes.

Specializes in retired LTC.

Just thought of the old metal plate addressographs that we used to stamp chart records, charge slips etc. I remember once being so annoyed that I was having to stamp a new, late-admission chart. I was just slamming that thing absent-mindedly when I slammed my thumb under the top press. Boy, did I see stars --- no fractures but I did break the skin. Got my first tetorifice shot that shift.

Specializes in Public Health, L&D, NICU.
Just thought of the old metal plate addressographs that we used to stamp chart records, charge slips etc. I remember once being so annoyed that I was having to stamp a new, late-admission chart. I was just slamming that thing absent-mindedly when I slammed my thumb under the top press. Boy, did I see stars --- no fractures but I did break the skin. Got my first tetorifice shot that shift.

I remember that thing! You could really vent some frustration with it. Ka WHAM! Ka WHAM!

Specializes in Public Health, L&D, NICU.

In nursing school, we were lucky enough to have our own home health patients, we would go out in pairs to see them. One of our patients was a retired nurse in her 80s, and this was in the mid 1990s. We would always spend a long time with her, just talking. She had great stories! Like how they would prepare baby formula, setting milk aside and letting the cream rise to the top. She got in trouble with her DON because she purchased 3 new uniforms when she was hired. Her supervisor came to her and told her they were too short, so she let the hems out. They then told her that it wasn't enough, that she should put false hems on them. Everyone was very scandalized that her ankles were showing!

It really amuses me, because we had a bit of an upheaval in our unit because some of the younger girls were coming to work wearing skin-tight babydoll T shirts instead of scrub tops, and several of them also usually had a thong visible above their scrub pants. They were counseled over these issues, and none of us got to wear t shirts ever again (we had cute unit t shirts, most of us wore them loosely fitting). Wow, how things have changed.

Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

monkeybug, your comments about Home Health patients while in nursing school reminded me of a few things.

Back in the dark ages when I was a student, we called it Community Health. We had little navy blue bags we took with us. And one of the important items was newspaper......to place under our bags before we sat them down. Does anyone else remember that?

Community Health was not one of my favorite rotations.....I guess because of some of the interesting experiences I had.

I remember one male patient I had to see. He was a psych patient who lived way out in the boonies. I think I got lost trying to find his house. When I arrived, I found a huge old house that looked like something from the Twilight Zone. He was out in the yard......which is good. Gave me the opportunity for a quick escape.

He had an axe in his hand. He said he had been working in the yard. But I was so scared. I thought for certain I would end up on the front page of the newspaper as a missing person or as the victim of a mass-murdering crazy man. LOL

He told me that he was worried about "Those people" who were trying to spy on him......that they had put satellites in his back yard and he was trying to find them. Needless to say....... I did not hang around there very long. And I was so glad that I didn't have to got back.

Ah....yes the memories of the 'Good Ol Days".........

Specializes in OR, Nursing Professional Development.
monkeybug, your comments about Home Health patients while in nursing school reminded me of a few things.

Back in the dark ages when I was a student, we called it Community Health. We had little navy blue bags we took with us. And one of the important items was newspaper......to place under our bags before we sat them down. Does anyone else remember that?

Community Health was not one of my favorite rotations.....I guess because of some of the interesting experiences I had.

I remember one male patient I had to see. He was a psych patient who lived way out in the boonies. I think I got lost trying to find his house. When I arrived, I found a huge old house that looked like something from the Twilight Zone. He was out in the yard......which is good. Gave me the opportunity for a quick escape.

He had an axe in his hand. He said he had been working in the yard. But I was so scared. I thought for certain I would end up on the front page of the newspaper as a missing person or as the victim of a mass-murdering crazy man. LOL

He told me that he was worried about "Those people" who were trying to spy on him......that they had put satellites in his back yard and he was trying to find them. Needless to say....... I did not hang around there very long. And I was so glad that I didn't have to got back.

Ah....yes the memories of the 'Good Ol Days".........

As recently as 7-8 years ago, we did the same thing! Fortunately, we always worked in pairs, so there wasn't just one of us there. We never did the newspaper thing, though.