Nursing Then and Now

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by RN WRITER NC RN WRITER NC, ADN

Specializes in Alzheimer's disease, Dementia. Has 16 years experience.

Nursing from 1967 compared to 2006 until now. What was different with uniforms, nursing school, 'high tech, high touch.' Has nursing practice been forced into quantity over quality, due to the nursing shortage?

How will nurses find their way to a more meaningful practice?

Nursing Then and Now

Imagine becoming a registered nurse fifty-plus years ago in 1967. Back then, nursing was one of two career paths for graduating female seniors in high school.  At that time, the decision for most young women was either to be a nurse or a teacher.  Those who chose to nurse wore white starched uniforms which were dresses with pinafore aprons, white stockings, and clunky white orthopedic shoes.  And don’t forget the required paper or starched cotton white cap on the head!  It would be almost five to ten years later before nurses could wear pants and more than ten years before they would do away with the caps!  The women’s liberation movement hadn’t quite kicked in yet. 

You had to really want to be a nurse!  Student nurses were taught by senior nurses, and sometimes doctors in classrooms in the hospital environment, not in the university.  Nurses got their clinical experience in the same hospital and provided care to real patients. One quickly learned that when the doctor entered the nurses’ station, you gave up your seat to him.  Just picture trying to study Anatomy and Physiology after an eight-hour shift working as a nursing student caring for sick people in the hospital.  In your second or third year of nursing school, you might be a charge nurse over the ancillary staff, even though you were not licensed.  Of course, there was always a supervisor in-house for you to ask questions or seek additional help from.  When it came time for licensing and graduation, the nursing boards were two days long. Nursing students sat in a large auditorium, with uncomfortable chairs, attached desks, and paper documents complete with numerous sections requiring a thorough understanding of disease and the human body.

I watched my sister have a successful career as a registered nurse upon graduation from a hospital nursing school in Reading Pennsylvania in 1967.  Marriage, after graduation, and then they began having children.  She worked the night shift, came home, and got the kids off to school. Then she was up in the early afternoon before the children arrived home from their day at school.  Meanwhile, her husband worked days and between the two of them, they prepared meals, helped with homework, and navigated bedtime for all before she went to work.  Her nursing career lasted almost forty years, and it gave her multiple opportunities (in the ICU, PACU, and management) to make a great living; support her three children, all the while building a retirement for herself. 

I, on the other hand, was squeamish around needles and blood so my parents did not promote nursing as a profession.  This was discovered during multiple episodes of sore throats, colds, etc. which required visits to the doctor’s office for antibiotics usually administered by injection.  I still remember my first night in a hospital at five years old for a Tonsillectomy.   Before the surgery, a blood draw was required that involved a finger stick and it was so traumatic that I cried, then fainted while Dad was holding me upright, feet flat on the floor.  After that, medical personnel and my parents had to chase me around the examining table to get ahold of me so they could give me the injection.  I wasn’t much better around blood, on either myself or another.  The fear factor rose so high, even in my teens; that one doctor suggested that I was having a vasovagal response and should try deep breathing. 

So, after graduating from high school in 1967, the same year my sister became a nurse; neither nursing nor teaching looked good to me.  But my parents convinced me to go to college and after much effort, I graduated from Oregon State University with a Bachelor of Science degree and no teaching certificate.  As I got older, I found the motivation to take that doctor’s advice and learned deep breathing, meditation, and visualization as a method to avoid fainting.  Especially, after passing out while watching the birth of a baby on film in a college First Aid class.  As a handsome boy carried me out of the auditorium, I noted after fainting that it is never cool to pee your panties while wearing a mini dress!

Throughout my advanced education and young adult years, I worked as a nurse’s aide and found that despite my aversion to blood and needles; I loved taking care of people and could make good money too.  Slowly, I became very successful at deep breathing and meditation during blood draws, and vaccines and stopped passing out altogether.  Then, I became a telemetry technician and monitored heart rhythms for abnormalities in a Cardiac unit.  During that time, I was required to measure EKG tracings and detect lethal heart rhythms during an emergency or Code Blue event.  With each new responsibility in healthcare, I grew more and more confident and less afraid of certain situations. 

Later, when I got an opportunity to return to school it was a no-brainer, I became a second-career nurse and graduated as an RN in 2006.  Thank the Lord, that I completed the nursing program, gained an incredible amount of confidence, and survived the nursing boards.  The nursing philosophy back then in school was ‘high tech/high touch.’

Unfortunately, now in 2022; I wonder what is happening to the ‘high touch’ aspect of nursing that I knew and loved when I started my nursing career.  Where is the priority of ‘high touch’ in nursing these days which dedicates a moment between the nurse and the patient or resident to connect on the higher level of the heart?  Because of the nursing shortage, nurses are denied the time they need to support their patients physically and emotionally at the bedside.  In the absence of real-time support for the patients, I fear that many nurses will leave the profession because it just, is not what they signed up for.  Reminds me of the old saying: “You can lead a horse to water, but you can’t make them drink.”  So, after many years of caregiving, and finding a niche in hospice and geriatric nursing, I plan to leave bedside nursing because of the physical demands caused by the nursing shortage.  The rewards of nursing have been many, but soon I hope to change what I have to offer patients with a different focus and a more promising way of connecting to patients and caregivers through my practice.

Margaret Scranton, RN

Resources

Interview with a retired RN; author’s older sister

Nursing Uniforms of the Past and Present – Nurse Uniforms History | Coffee Time - Pulse Uniform

Vasovagal Syncope: Causes, Symptoms, and Treatment (healthline.com)

You Can Lead a Horse To Water, But... - Meaning, Origin (knowyourphrase.com)

Health articles, Blog posts

3 Articles   16 Posts

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11 Comment(s)

Tweety, BSN, RN

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac. Has 30 years experience. 31,514 Posts

Excellent article.   I was one of the last of the people that took boards over two days back in the day...and waited eight weeks to find out if I passed or not.

I was a bedside nurse in 2006 and maybe it's because of where I am located, I don't look back with nostalgia and think things are worse now or pine for those better days.  It was as bad then as it is now.   Which begs to ask the question why I'm still at the bedside if it's so bad?   I left the beside around 2009 and lasted six months.  I hated being away from patients.  I'm crazy like that.  I think one day I might burn out for good and retire or leave the bedside for something less physically and emotionally draining but I'm not there yet.

 

RN WRITER NC, ADN

Specializes in Alzheimer's disease, Dementia. Has 16 years experience. 3 Articles; 16 Posts

Thank you so much! Yes, same here, although my physical needs say otherwise. So I am moving on to something more creative and less demanding. Starting a freelance health writing business online, my compliments to Elizabeth Hanes, (RN2WRITER) inspiration! She is a phenomenon! Check it out on Youtube or facebook. I have to have a backup plan!

Mdk1998

Mdk1998

1 Post

As a student nurse, I absolutely love reading articles like this just to see how the profession has changed over time, and how the current shortages are affecting everybody and the nursing care process. 

RN WRITER NC, ADN

Specializes in Alzheimer's disease, Dementia. Has 16 years experience. 3 Articles; 16 Posts

Thanks for your response!  I am a second career nurse of sixteen years and have just been thrilled with my career so far, despite the hurdles and all the drama.

EOC

EOC

Specializes in ICU. 1 Article; 17 Posts

I have been in ICU nursing for 40 years. I have seen so many changes. I remember when you had a head nurse. Then nurse manager and then changed to service manager. They thought taking the name nurse out would somehow improve things?? When I was PT and wound care. We used Maalox and heat lamps. OK, I went too far back. But I have also seen some great things. I have seen the transformation of philosophy in health care. Patients and families are at the forefront of what we do. I love the team approach that has developed. Dr's asking what do you think. I have always told our nurses If you are an excellent ICU RN, the doctors and APPs will ask you your opinion. EMR, your charting will be faster they said. Boy, we were suckered. I used to say when I was getting a patient on a freight scale in the morning, that someday I'll just have to push a button on the bed. Well, that happened. I think someday we'll wear headsets and talk in them to record our assessments. That would save time. I supervise now. Charting would take me a while. They wouldn't like my OT. LOL 

The new thing is wearing tee shirts with scrubs. Which one is the nurse? Who is the oriented? Try to figure that in a code.  I asked for badge identifiers. I believe looking more professional makes you think that way too. I also think people respect you more. But it is like any generational thing, what goes around comes around.

Yes, there have always been shortages. I went from 8 to 12 hr shifts, which I love. I still believe that nursing is a "calling". You have to really enjoy caring for others. If you just want a check, boy you'll work for it. I feel nursing has made me who I am. I diagnose all the time ( nursing of course). I don't have time to listen to those who blame others for their situation. I'm also good at nodding my head. Our profession is all about observation, communication, and listening.  

RN WRITER NC, ADN

Specializes in Alzheimer's disease, Dementia. Has 16 years experience. 3 Articles; 16 Posts

Thanks so much for responding! Love the stories!

KathyDay

KathyDay

Specializes in Patient Safety Advocate; HAI Prevention. 4 Articles; 70 Posts

Like you, I graduated from high school in 1967, but I went immediately into nursing school or "training" in a Catholic nursing school. I was a naive dumb kid, but I snapped to under the tutelage of catholic nuns and instructors.  It was a strict and tough course of training, but I was grateful for it when I graduated in 1970 and went to work.  I was well prepared for the work of a fully licensed RN.  I sat for boards in an armory in Augusta Maine in the Summer of 1970, and I was as sick as a dog with a bad sore throat and cough.  But, regardless, I passed my boards on the first try.  I am grateful for my excellent training and I wish they had not closed most of the schools of nursing.  I wrote an article for the Nursing Shortage article contest that you might like...take a look.  Thank you for sharing your story!

RNperdiem

RNperdiem, RN

Has 14 years experience. 4,520 Posts

I haven't been nursing as long as some of you, but over 25 years, I have noticed changes.

Computer charting and being compliant for Joint Commision in that charting (which is frequently audited) has taken a lot away from patient care. Once I could assess a patient and fill out that paper chart in the time it takes me to get through one section of EPIC. I spend more and more time on that computer with every upgrade. 

There are several things I like. The computerized infusion pumps are so useful. I don't miss all those math calculations every time I need to titrate drips. The pharmacy mixes most of our infusions; back then, we mixed almost everything. I find the doctors of the younger generations more collaborative. Of course there are individual differences, but they know that they would never get away with some of the behavior that an older generation of doctor could. 

RN WRITER NC, ADN

Specializes in Alzheimer's disease, Dementia. Has 16 years experience. 3 Articles; 16 Posts

Yes! Thank you for your response!

RN WRITER NC, ADN

Specializes in Alzheimer's disease, Dementia. Has 16 years experience. 3 Articles; 16 Posts

Absolutely!

kbrn2002, ADN, RN

Specializes in Geriatrics, Dialysis. Has 20 years experience. 3,597 Posts

I haven't been around quite long enough to have seen the 3 day in person paper and pencil NCLEX but have been around long enough that to get early results we could call a 1-900 phone number after 3 days that cost around $10 if I remember right. Only one person in our group had a home phone line without the 900 number block so we all called for our early results from her parent's  house and paid her Mom for the call, LOL! 

I have been around long enough to live through the transition from paper to computer charting and whoever sold nursing that load of boy cow feces that computer charting would "save time" could've sold sand in the desert. There's so much more ridiculous charting now than there was before the implementation of the EMAR. At least in the days of paper charting the charting we did was actually purposeful.