Nursing 10 years ago

TazziRN, RN · Jun 10, 2007

You guys keep talking about getting the hospitalists involved or whoever.....you gotta remember that not all of us are in big hospitals with hospitalists and specialists at your fingertips. Little dinky rural hospitals are doctorless in the off hours except for the ER doc, who has nothing to do with inpts unless they're actively coding. In any other situation you gotta get the PMD on the line and get them in asap.

And every EKG machine I've ever worked with has the computer program to interpret EKGs, but like people they are not infallible. Not often wrong, but often enough that it cannot be depended on.

rnparrot · Jun 11, 2007

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

i agree!! he is doing the YMCA!!!!

:lol2:

rnparrot · Jun 11, 2007

one of the things that is new where i work in LTC....if there is a change for the patient, we have to write the MD a note, and FAX it to his office. when he gets a chance he will FAX back a note sometimes including orders.

How many of you think this is OK? i don't like it at all...

other changes i've seen in the last 10 years is no more nursing caps, a ton more paperwork, more DNR's due to more education...i'll think ofmore

TazziRN, RN · Jun 11, 2007

The faxed orders is fine, but I don't like having to fax the doc a note. There's no chance for the doc to ask questions that might clarify the problem.

angel's RN · Jun 11, 2007

What's a "hospitalist"? I also work in a small CCU.

's RN

Indy, LPN, LVN · Jun 11, 2007

What's a "hospitalist"? I also work in a small CCU.
's RN

A hospitalist is a lovely thing. It's a doc who works specifically for the hospital. Actually there's usually a practice of them, consisting of someone rounding in the AM, someone on call at night, etc. which basically gives you someone 24/7 that you can call for their patients and that person is in the building.

Meaning, a patient who needs to be admitted but has no outside doc to admit him or her, the hospitalist service can do this. In the hospital I just left they have that service, and a lot of the primary care docs are contracted with the hospital so that if their patients come in, the hospitalist service handles them. It makes the PMD's job easier with less phone calls in the middle of the night and no rounding at 6am before office hours.

The hospital I'm in now, does not have this lovely creature. I miss them.

RunningWithScissors · Jun 11, 2007

Let's see.....going back JUST 10 years ago:

There was less focus on "customer service". The patients did not expect 4-star treatment and food.

Smoking was allowed on premises and half the staff would be off the floor smoking at any given time.

Not much emphasis on care plans, as long as SOMETHING was written down.

Much less paperwork. NO chart audits.

No cell phones, just pagers.

Hospitals had picnics and holiday bonuses and employers acted like they needed you.

angel's RN · Jun 11, 2007

:smokin: OFF the floor, smoking?!?!? Shoot---we smoked at the nursing desk 10 years ago!! And yes, RunningWithScissors, the paperwork was a lot less of a hassel, and we actually got to do real nursing!! We didn't have to watch our backs as much, and only had to cross MOST of our t's and dot MOST of our i's. (:innerconf only teasing, guys--ALL of our t's were crossed!)

I think that nursing was more fun 10 years ago. You could take care of your patient, instead of your chart.

's RN

olediploma · Jun 12, 2007

I remember scrubs only being worn in area where you where most likely to get soiled and dirty tennis shoes worn on the basketball court.

psychnurse37 · Jun 12, 2007

Lts has changed in 10 years, even more in 20, 30 and so on. Some of the changes have been for the better, some for the worse. We used to give back rubs. We used to reuse equipment after it was steralized. We used to not have sonograms or ultrasounds and know the sex of a baby before it was born. Hospital stays were longer. People were admitted for tests that are done as outpatient now. All surgeries were inpatient. There were wards instead of private or semiprivate rooms. Nurses wore WHITE and had caps. Now, I'm not saying all was great back then, but all isn't great now either. At least nurses are paid a little better, even if we work harder and care for sicker patients. I'm still glad I'm a nurse after 38 years!

oneillk1 · Jun 14, 2007

Patient equipment wasn't sized for obese patients. Stretchers wide as ironing boards, and a morgue cart with a 350lb weight limit.
Beds were simpler with fewer "functions". Even a few hand-cranked beds were about.
Non-digital ventilators were still found. You peered at manometers for settings.
Nursing uniforms that were not scrubs were still worn outside ICU, OR and L &D. Scrubs were making their way in though , but true tailored uniforms could still be seen.
No internet at work. More printed manuals and drug books about.
Pyxis was less seen. You counted narcotics at the end of each shift and handed over the keys.

Hmmm I knew I still lived in the 90s!

We still have hand cranked beds in most wards in the hospital (though fortunately not in ICU)

I wear tailored pants and shirt in ICU, although scrubs are an option. (Just so happened that the uniform supplier's scrub sizes cater only for Big Betsy or Tiny tina - not for me!)

We still have drug keys for the narcotic cupboards, and manually count every time we remove a drug and at the end of every shift.

And yes I think my fluoro bike shorts are the coolest things out....And loving that new band New Kids on the Block!

chrissoo · Jun 16, 2007

:redlight: For info . In school of nursing they are still teaching air bolus to check the N/G tube placement. And also to check palcement via aspiration of gastric juices to check ph and placement is not very reliable as even if the aspiration shows that the acidic that does not mean it is not in the stomach as it can be the residue of fluid in N/G tube. Therefore in my experience the most reliable would still be the air bolus test as you would physically ausculate the stomach and listen for the sound of the air being intrioduced into the stomach via the N/G tube. Of course, there has been a research lately that doing CXR would be the most accurate.

:madface: Unfortunately I feel that it would not be very feasible as in a home siuation and also very costly to the patient.