OK- need some help with ancient nursing history

Whispera, MSN, RN · Aug 7, 2011

I graduated from nursing school in 1992 and there were sharps containers in all rooms throughout my time in school...so here they were around at least in 1989.

GreyGull · Aug 7, 2011

The containers we know today came out around 1980. Needles were often tossed into the trash along with everything else prior to that. Throwing them into the trash was a hard habit to break along with recapping. Use of the sharps container was definitely stressed by 1985. We stopped using glass syringes about that time also.

Early IV pumps go back a couple of centuries with modern advancement for today's models taking off in the 1950s after developments made during WWII and even WWI.

brownbook · Aug 7, 2011

All I remember for sure is around (approximately) late 1980's when the safety IV cathalon's were introduced, the stylette retracted into the handle. Prior to that the needle was just left lying around HOPEFULLY in an out of the way safe place while tape was applied, drip started. etc. I remember some staff insisted these new IV's were harder to use, didn't like them, we intentionally kept some of the "old" IV cathalon's around for patients who were a hard stick.

Almost 100 percent of the safety features introduced in the 1980's came about due to AIDS. Sadly ironic benefit of that awful disease.

MrChicagoRN, RN · Aug 7, 2011

As a student & then RN during the early 80's, we had med carts with individual bins that we rolled from room to room.

After giving an injection we would insert the needle into a slot and pull a lever to slice the needle from the syringe before dropping the barrel into the larger slot. This was a small container mounted on the cart, with a large container mounted in the dirty utility room and in the nurses station.

**canoehead, BSN, RN** · Aug 7, 2011

We had sharps containers in 1987 when I started. IV pumps existed but my hospital only used them in ICU until 1990, when we saw 1 or two on the floor. Central lines were just barely starting to be used and definitely only in the ICU.

canesdukegirl, BSN, RN · Aug 7, 2011

XT-you make me giggle. I adore you...

I used to see older nurses stick a used needle into the bed mattress for safekeeping till they were done with the task at hand. Thank GOD for sharps containers.

GreyGull-we still have glass syringes. Our MSO4 and heparin still come in glass syringes that we have to use a Carpuject to draw up. At first I thought they were just hard plastic syringes, but the ones we have at my hospital are indeed glass. Oh, and speaking of glass, I HATE GLASS AMPULES! I cut myself ALL the time on these darned things. I will never forget the time when my pt coded in the PACU and we broke out the crash cart. I can't remember now what drug I was drawing up, but I cracked the ampule and the top splintered, cutting me in the process. I can't think of a worse time to have to discard a med and draw a new one up while gloving my bleeding hand.

Pyxis machines are the bane of my existence. I understand the rationale behind them, but when a surgeon wants a certain drug (I work in the OR, so when a surgeon needs Surgicel, they need it yesterday) I can't help but get irritated when I have to stand in line behind 2 other nurses/CRNAs to get the daggum Surgicel.

Our scrubs are now delivered via Pyxis. Many times, the linen services person does not load the scrub Pyxis in a timely manner, and the only choice of scrubs available are 3X. I am 5'6" 130#. I look like a homeless person when I have to wear scrubs this big.

I like the IV pumps for everyone. Takes the guess work out of formulas and drip factors. It has been a LONG time since I have used one of these, however.

XT, did you ever use computerized charting?

LisaMR · Aug 7, 2011

I graduated from college in 1984 and we had sharps containers at that time. Most of them had you cutting off the needle and then putting the rest of the syringe in another container, sometimes it was made of heavy cardboard....and occ something sharp would poke through, not the best design, lol. The biggest problem was when there was a code and we'd use a lot of syringes of meds. There were needles everywhere, and it wasn't uncommon to see a nurse or resident in a hurry, uncap the needle with teeth, inject, and put the empty into the mattress. NOT accepted practice, but it happened pretty often.

IV pumps were widespread at that time, too. My first job out of school was in the SICU of a large teaching hospital, and the pumps were actually pretty similar to what I've seen used recently when I did an RN Refresher course. In the mid-80's the only patients I saw that didn't have an IV pump were the ones with an IV with a very slow rate, just to keep vein open, that sort of thing.

The pyxis was after my working time, and I last worked fulltime in 1993. In both ICU and L&D, we kept stock drugs on the floors and would even add our own KCl, MgSo4, Pitocin, and other meds to the IV bags ourselves.

LisaMR · Aug 7, 2011

"Almost 100 percent of the safety features introduced in the 1980's came about due to AIDS. Sadly ironic benefit of that awful disease"

Sad, but true. When I first worked in ICU, we didn't wear gloves to start IVs, suction patients, empty gastric suction containers, any of that. Most gloves were sterile and then just used to protect the patient from infection, not the staff. Within a few years, we were all wearing gloves, masks and even goggles/eye shields. Even when working in L&D at first, gloves weren't mandated or widely available in boxes like they are today. I remember having to scrape the vernix from a newborn from under my fingernails after a delivery, when I was the one to dry off, assess, band and print the baby.

Ruby Vee, BSN · Aug 7, 2011

the containers we know today came out around 1980. needles were often tossed into the trash along with everything else prior to that. throwing them into the trash was a hard habit to break along with recapping. use of the sharps container was definitely stressed by 1985. we stopped using glass syringes about that time also.
early iv pumps go back a couple of centuries with modern advancement for today's models taking off in the 1950s after developments made during wwii and even wwi.

needle boxes used to be about two inches square. they'd sit on the med cart and after you used a needle, you were supposed to cut it with the built-in needle cutters and just the tip went into the box. it was that way when i graduated in 1977. when i started in micu in 1983, we had five or six iv pumps . . . most of our drips were in buretrols. you'd drop in enough dopamine or nipride for an hour's worth at the current dose, and then count drops. if the blood pressure went up you'd decrease the dopamine or increase the nipride, and vice versa if it went down. heparin required a pump, though. there were no tube feeding pumps, so you did a bolus every couple of hours.

glass syringes went away between 1985 and 1988, and using gloves happened in about that same time frame. prior to the mid 80s, there was one box of gloves on the unit -- for the interns to use for rectal exams. mannitol came crystallized in glass ampules and you had to dissolve it by sitting it in a pan of boiling water and then file open the ampule.

GreyGull · Aug 7, 2011

GreyGull-we still have glass syringes. Our MSO4 and heparin still come in glass syringes that we have to use a Carpuject to draw up. At first I thought they were just hard plastic syringes, but the ones we have at my hospital are indeed glass.

But the difference is they are now single use. The glass syringes used for ABGs and injection prior to 1985, as with many other pieces of equipment, were reused. We also had buckets of Cidex, along with some other chemicals now labeled harmful to one's health, for some equipment to be cleaned by the staff after use. Nothing like getting a nebulizer with lipstick stains on the mouthpiece that wasn't your shade.

We also mixed medications for IVs and nebulization without much protection. This included Ribavirin and Pentamidine which at that time came in crystals to be mixed just prior to administration. We were also a little lax on using scavengers or isolation precautions for these meds when they were being nebulized also.

xtxrn, ASN, RN · Aug 8, 2011

XT-you make me giggle. I adore you...
I used to see older nurses stick a used needle into the bed mattress for safekeeping till they were done with the task at hand. Thank GOD for sharps containers.
GreyGull-we still have glass syringes. Our MSO4 and heparin still come in glass syringes that we have to use a Carpuject to draw up. At first I thought they were just hard plastic syringes, but the ones we have at my hospital are indeed glass. Oh, and speaking of glass, I HATE GLASS AMPULES! I cut myself ALL the time on these darned things. I will never forget the time when my pt coded in the PACU and we broke out the crash cart. I can't remember now what drug I was drawing up, but I cracked the ampule and the top splintered, cutting me in the process. I can't think of a worse time to have to discard a med and draw a new one up while gloving my bleeding hand.
Pyxis machines are the bane of my existence. I understand the rationale behind them, but when a surgeon wants a certain drug (I work in the OR, so when a surgeon needs Surgicel, they need it yesterday) I can't help but get irritated when I have to stand in line behind 2 other nurses/CRNAs to get the daggum Surgicel.
Our scrubs are now delivered via Pyxis. Many times, the linen services person does not load the scrub Pyxis in a timely manner, and the only choice of scrubs available are 3X. I am 5'6" 130#. I look like a homeless person when I have to wear scrubs this big.
I like the IV pumps for everyone. Takes the guess work out of formulas and drip factors. It has been a LONG time since I have used one of these, however.
XT, did you ever use computerized charting?

Yep- used computerized charting, order entry. I didn't like it for some things, but did like it for order entry so nobody could tell me it wasn't in the system- HA- got them on that one !!

I used glass syringes for paraldehyde...and even though I knew about not disposing of paraldehyde into plastic containers, I thought I had gotten all of it out of the ampule...WRONG.... left a nice hole in the trash bin The glass syringes I used weren't carpujects- though I used those a lot in the late 80s ... they had the huge metal needle hubs, and were about 10cc sized...looked like some archeological find

I've autoclaved my own stuff at a LTC back in the mid 80s... that was fun :) Would have loved to have a pot roast to throw in and pressure cook

I remember the mattress pin cushions - usually by a doc inserting a central line at bedside...he also made a mess w/blood, so I'd take towels to put under the patient. If he wouldn't use those, I'd go get linen for a total bed change, and tell him he'd need to leave the bed clean before he left...he'd use the towels (he was a sweetheart and good natured- but a slob w/central lines !!).

Pyxis can be horrible for new meds/stats....we had a way to override the system for those at the rural hospital in Texas. It was good. And it got rid of narc counts, with a quick printout...once a week we'd have to go through the drawers, but pharmacy would find anything wonky when they restocked- it made it better for keeping track of things.

Anybody use Dial-a-Flows? Those were the BOMB when we had those (since pumps were only for heparin, hyperal, or some really scrawny old person w/CHF and a lot of IVPBs .... the Dial-a-Flows weren't fool proof, but they helped...fewer dry bags :)

As a patient, I've seen some of the newer things (I've only been off work for 7 years- so it's not like they were still carbon dating patients when they arrived...). I HATE the insulin pen needle cages...I've given my own insulin for ages, with regular pen needles (and have my own 2 1/2 gallon sharps containers!!) without the stupid cage...I can understand why hospitals use them, but I hate them...back in 'the day', if you got stuck, you paid more attention next time (and this was after the big HIV influx of the mid 80s).

It seems that a lot (not all) of things have come about because of lawsuits, and the refusal of facilities to insist that their employees have any personal responsibility... some things are for the better- but not all. JMHO.

Gonna go find my pet dinosaur, and round up a pterodactyl for dinner