Nursing 10 years ago

CoffeeRTC, BSN, RN · Jun 8, 2007

Hmmmm...10 years have changed a lot in LTC. Restraints, lots of foleys, more bed sores, clinitron beds, side rails, pschy drugs. The patients weren't as sick and many were longer term.

Now...sicker patients (med surg or sub acute type patients), tons of IVs, complex wounds (less pressure ulcers inhouse acquired..more hospital aquired sores), more short term stay patients, more patients with worse infections (just about everyone has cdiff, mrsa or vre or all of them), less psyche drugs, no restraints (heaven forbid you want to put a side rail up or use a recliner chair. Tons more paper work. Less staffing.

LOL...when I started 12 or so years ago the res/ families smoked in the lobby.

ZippyGBR, BSN, RN · Jun 8, 2007

Checking with an air bolus makes a lot more sense and is quicker. The other way you'd have to secure the tube, check the pH, and if it's not in the right place undo everything and start over.

air bolus does not prove the tube is i nthe stomach

there are 2 fool proof ways

1. aspirate gastirc content and check the strongly acidic pH

2. use radio opaque tubes and X ray everyone after tube changes

Long Term Care Columnist / Guide · Jun 8, 2007

I graduated 10 years ago, and things are indeed WAY different.

One of my nursing instructors told me once, "In five years, you won't even recognize your own profession---that's how quickly things change." She was right, too! In 1997 I was taking care of med/surg patients with only 1 or 2 IVs at most; when I left hospital nursing in 2005, many of them had multiple IVs and we were doing insulin drips on the floor instead of in ICU. We used to put hip abductor devices on all ORIFs; I haven't seen one in years now. We are also, I think, less afraid of caring for AIDS patients than we were back then, and we deal so much with MRSA that maybe we've become a little too complacent.

There's lots more, but I'm at work and I need to use what little brainpower I have left after a long week to finish my tasks for the day!:chuckle

TazziRN, RN · Jun 8, 2007

One of my nursing instructors told me once, "In five years, you won't even recognize your own profession---that's how quickly things change."

When my mom was referred to a university hospital to attempt a coil on an aneurysm, we were told the procedure's been around for about 5 years (at that time). My mom gasped in horror, "Is that all??" The doc and I were laughing as we both tried to explain to her that in medicine, 5 years is a long time!

GadgetRN71, ASN, RN · Jun 9, 2007

Okay - maybe someone can clarify this one for me, but 10 years ago urine caths were sterile. Now, a nurse recently told me that they are a "clean" procedure (I'd taken a few years out of nursing, just back to Emerg). Has the whole sterile thing changed in 10 years? Or does this nurse need to go back to school?

No, I was taught in school they are sterile, and when we cath a patient in the OR, it is most definitely a sterile procedure. Some surgeons will even cath the patient themselves because they are afraid of the patient getting a UTI..

**RosesrReder, BSN, MSN, RN** · Jun 9, 2007

What? They don't? I guess I am out of the times, our whole floor does this and new grads say they are still being taught this.
Never heard of "check the pH"

I'm on my last semester and we are only taught pH there is a whole evidence based practice on why

KYCNM · Jun 9, 2007

Future RN Jess, what is that little pepper (your avitar) doing. Looks like he is spelling out YMCA???

**RosesrReder, BSN, MSN, RN** · Jun 9, 2007

Future RN Jess, what is that little pepper (your avitar) doing. Looks like he is spelling out YMCA???

Haha! Beats me! That is why I chose it, but I think he's just dancing :lol2:

CRNI-ICU20 · Jun 9, 2007

dontcha know that ten years in nurse years is equal to 100 years in regular people years???

WE move at 186,000 miles per second (the equivalent of the speed of light) I went back into my nursing journal from ten years ago....

I feel old...

We used bedside humidifiers, instead of direct inhalation therapy.

Cardiac patients were not sent direct to cath lab....but often to whatever bed was available, and then not monitored.....(shocking.)

BLS was considered all that was necessary to resuscitate a patient, and ACLS was being taught, but it was so scarey, most nurses wouldn't take a class....my first ACLS class was a week long fourty hour course, and we had to memorize drugs that most doctors didn't know about....remember rapid sequence intubation algorhythms????

There was no such thing as an air bed; only egg crate mattresses.

Hypodermic needles for IM injection.....in a re-usable stainless steel needle holder.....in fact...needles were everywhere....on the beds...on the floors....stuck in a port of an IV line connecting lines together....and forget about needle/sharps disposal containers in each patient room.....you got to RECAP the needle and walk down the hall with it.

remember when delivery of a baby was a completely STERILE procedure??? sterile drapes, etc...? everyone got an episiotomy, and everyone got to bite down on a big stick (just kidding) for pain control.

Doctors back then believed that giving terminally ill endstage patients large doses of Morphine would "make them addicts"....so they refused to prescribe the level of medication that was needed to keep them comfortable....

THE ONLY THING THAT HASN'T CHANGED IS THE HOSPITAL FOOD....IT'S PRETTY MUCH THE SAME... THEY STILL HAVE WHITE FOOD NIGHT AT MOST HOSPITALS...CAULIFLOWER, MASHED POTATOES, POACHED WHITE FISH, VANILLA PUDDING....BLEH.

I loved this walk back in time.

QTRN74 · Jun 9, 2007

I graduated in 1997 and my first ICU job we made our own KCL bags! We used 0.9NS and injected the 10,20, or 40meq's ourselves! Now that is NOT done anymore!!!

Also, in ICU each nurse only was assinged ONE vented patient...now we can have up to three!

We also were the only unit to have drips...now the regular tele, med-surg floors do some of the drips.

We didn't have as many "specialty" beds, nor did we have so many obese patients needing them!

General E. Speaking, RN, RN · Jun 9, 2007

I remember patients dragging in their old egg crate mattresses when they were readmitted because they didn't want to pay for another one- yuk!

AIDS patients did get very ill and emaciated and always died horribly- very sad.

I remember a lot of Aminophylline drips on the floor and squirting Procardia (?) under tongues to get BPs down fast.

Wearing all white (jackets with a white background and a modest color design were ok)

Med carts, I miss med carts.

Having pharmacy tech yell over the PA system "Narcotic keys to the desk, please. Narcotic keys to the desk" so he could refill the double metal lock narcotic box hanging on the wall.

Having to stay after your shift because the narcotic count was off.

vamedic4, EMT-P · Jun 9, 2007

You want a trip down memory lane?. . .
When I graduated from nurses training, CPR had not been invented. Nurses were not taught to interpret EKGs (woe be unto those who had the temerity to suggest that a mere nurse could do such a thing. We wore caps, dress uniforms and stood when the MD entered the nurses station.
Disposable syringes had just become available. We were still recycling catheters (CSR cleaned and set up catheter trays).
Moms stayed 4 days for a first born and three days for a multip. C/S moms often stayed a week.
Chest suction was three bottles attached to wall suction. Chest tubes were milked every 15 minutes on fresh post op open hearts.

:bowingpur :bowingpur :bowingpur

WOW!! Now THAT was a while ago. And you're still a nurse...kudos to you.