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.
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 CCU, SICU, CVSICU, Precepting & Teaching.
Hi,
I have been a nurse for 4 years. I have talked to a few nurses who had been nursing in the 70's and 80's. They all say the biggest change is that you had more time with the patient back then then now. Way more charting these days.
Does anyone else think this is the biggest change?
The biggest change is that in the old days, patients and their families respected the nurse. We focused on patient care, not "customer service", which means if the diabetic with the blood sugar of 600 requested ice cream, the answer was "no". And that "no" was usually respected, both by the patient and by the family. No one screamed about their "rights", no one made demands for immediate "service" despite the code going on next door. Nurses were treated like respected professionals, and patients and their families were grateful for the things we did.
I can remember washing gloves, placing them on a drying rack, and checking them for leaks before they were autoclaved. I remember cleaning glass syringes and sharpening needles. Catheters were soaked, cleaned and placed in a hot water sterilizer. If a new medication was needed, the "team leader" had a key to the pharmacy and got the medication. Glass thermometers were kept together in a small tray, used, soaked in alcohol, rinsed, dried and placed in the tray to be used again. No individual thermometers at that time. Rectal thermometers had a red tip and a separate section in the tray. Gloves were never used in patient care--well, maybe for a fecal impaction. LOL
Who else worked in a TB san? Remember what we used to do with TB patients? Lots of fresh air. Gruesome surgical procedures. Isoniazid was brand new. Ten years. . .TB sans were gone.
I actually did clysis (done when routine IV access wasn't available).
And NG feedings of REAL FOOD. It was the 24 hour diet menu blenderized by dietary dept and sent up to the floor in a huge mayo jar. We had a presecribed amount of formula to be poured out, mixed with water to thin it, and then to be administered in several boluses at specific times. Each pt had his own big blenderized jar, based on a Physician-ordered, REAL 2400 or 1800 cal, or bland diet (whatever was ordered). And we KNEW what was served on the regular trays that day, as we could "see" spaghetti red sauce, or "smell" cabbage, etc.
Now we have Ensure, Glucerna, Osmolyte, etc.
And I too, remember the glass thermometers soaking in alcohol in the little metal trays. And when CNAs made up 'linen packs' for the day shift to start.
I just thought of another one. Years ago, nurses were not allowed to check a patient's cervix lady partslly do to the risk of infection, nurses could only check rectally. I have spoken with an older nurse who said you really could tell when they got complete, but I seriously doubt I could distinguish 2cm from 3cm that way.
Ruby Vee, BSN
17 Articles; 14,051 Posts
The biggest change is that in the old days, patients and their families respected the nurse. We focused on patient care, not "customer service", which means if the diabetic with the blood sugar of 600 requested ice cream, the answer was "no". And that "no" was usually respected, both by the patient and by the family. No one screamed about their "rights", no one made demands for immediate "service" despite the code going on next door. Nurses were treated like respected professionals, and patients and their families were grateful for the things we did.