Old School Nursing

[CaLLaCoDe, BSN, RN]

i was having a conversation with my sister recently. my sis is not a nurse by the way. however she's spent many a day nursing her kids back to health whenever they fell ill, she has two. well, we began to talk about mom. my mom graduated from uc san francisco nursing school. after my parent's divorce when i was seven she went back to work as a night icu nurse and hated it! a friend of hers, flo, convinced her to go into school nursing. thank god for flo! if it wasn't for her i'd never have seen my mom during the day or had spent the long summer months with her not working...way cool!

anyway, i was having this conversation with my big sis. and i mentioned that i use the old school methodology on my patients that mom used with us. immediately when after i greet my patient, write my name on their bedside board, i have this habit, mom's habit of placing my hand on their wrist to check pulse and the back of my hand placed on their forehead to check temp. now, i know we have portable robots that check these things (the machines that go beep!) but there exists nothing better when you're ill than to have someone stand there quietly listening to your state of being.

or just how my mom would come into my room. recently this memory of her coming into my room was revisited when i became ill during the holdidays. she just comes into the room and stands there. not saying a word. just that presence in the room makes you feel held aloft for a short time; a good word for it would be soothing. anyway, i've gained a goodly amount of my nursing education from her via osmosis. she is retired now. my brother and i used to chide her when ever she would say something regarding our health. "you're only a nurse!!" we'd say, thinking that her education didn't qualify her to understand anything medically...the md was the final word. i'm sure some of my patients feel the same!

i remember in nursing school when an instructor said her hubby had been at the doctor's clinic and she was concerned that he had diabetes, you know the three p's, she observed this with her hubby. the clinician had not checked his glucose. so she demanded he go back and get a fingerstick. he says, "you're only a nurse!" "why should i!?" "what do you know!" eventually he reluctantly followed her directive and lo and behold he did have diabetes. i don't quite remember what the doc said precisely but the md did want him to come back next week for something and he says,"oh, i don'd need to come back, my wife's a nurse, she can help me with that at home!!!"

anyway, any thoughts regarding either old school nursing or people's understanding of your expertise as a nurse?

[RN1989]

Most of my patients think that I know more than the doctors. Mostly because I actually speak to them like people, not stupid little kids, and explain what is going on instead of running out of the room like many healthcare professional. Anytime someone finds out I am a nurse, they often act like I am a priest - they tell me ALL sorts of stuff that you don't generally tell someone you just met.

As far as "old school nursing" - I think that it is disappearing in schools today. You can learn tons of things about your patient just by spending a few minutes talking with them, pouring them a drink, helping them move around in bed. I see many new grads who will chart that a patient is alert and oriented and able to ambulate safely - in reality these patients have Alzheimers and can't even turn themselves in the bed. Patients learn how to hide a lot of things from their families and today's new nurses aren't taught to look for the subtle cues that something isn't quite right. When I started nursing we didn't have Rapid Response Teams. We didn't need them. We knew our patients, caught the subtleties of their condition and intervened because we knew what was wrong and how to handle the situation. The RR team is just a JCAHO knee-jerk reaction to the fact that new grads are not receiving enough education and post-graduation orientation - coupled with too high ratios. Old fashioned nursing was a lot safer with less paperwork.

[YellowFinchFan]

.................anyway, i was having this conversation with my big sis. and i mentioned that i use the old school methodology on my patients that mom used with us. immediately when after i greet my patient, write my name on their bedside board, i have this habit, mom's habit of placing my hand on their wrist to check pulse and the back of my hand placed on their forehead to check temp. now, i know we have portable robots that check these things (the machines that go beep!) but there exists nothing better when you're ill than to have someone stand there quietly listening to your state of being.

or just how my mom would come into my room. recently this memory of her coming into my room was revisited when i became ill during the holdidays. she just comes into the room and stands there. not saying a word. just that presence in the room makes you feel held aloft for a short time; a good word for it would be soothing. ............

thanks for the wonderful sentiment shared and the reminder to all of us (so busy - and nursing those 'computers' too much) that touch is a wonderful thing, and so comforting.

this wknd,while working 2 12's- my sweet 80+ patients in one room (2 elderly men) told me i was the kindest most wonderful nurse.

they said it to me more than once throught my shifts and i have to say i felt appreciated and proud i was making a difference.

i took extra time with each of them and they were so appreciative (i love that generation that we are slowily losing)

i found myself with some extra time on my hands (whaaa?) and i actually pulled up a chair and spoke to them individually and got to see them as the fine men there were, now unfortunately ill and failing - and for a brief time they were lost in the converstation-telling me different things about their lives.

this job can be so tough, but the rewards are amazing.

[mcknis]

I will trully miss that generation you talk of when they are gone. They can give you so much information about the past, and about the future.

I would be very interested to hear more from those old-school nurses on here. We know you are out there, so please inform us new schoolers how things have changed. Not just those stories when you used to work with Florence Nightingale and Clara Barton (just kidding).

[CaLLaCoDe, BSN, RN]

yelowfinchfan, you write about the stories of your two patients sharing their tales... this brings back a fond memory of mine. an elderly grandmotherly type was my patient, she was originally from germany. i just remember her telling me of the first time she was in our country. she recounted riding the cable car in sfand how she fell down, the driver must have suddenly pulled that big black iron lever and had the car come to a halt right quick. well she said that she was expecting a stern, "you should know better!" however what she got was the kind man asking if she was ok and showing her the proper way to hold fast onto the wooden rail on the side of the car. welcome to america! she explained that in germany all was either ya or nein...yes or no...very strict, no allowance for foolishness. she told me about the world fair and how fantastic it was. i told her that she reminded me of my aunt mildred (an artist) and how my aunt liked to use the word 'grateful.' later on in my shift (i was a cna at the time) i took her to have an xray. i remember her telling the xray technician that her favorite word ever was grateful. i was touched. later that day i saw her daughter come to visit. i let them visit without any disturbance. i just remember how beautiful her daughter was. she looked like a china doll with white porcelain skin and deep green eyes and red hair. and i thought of my patient of how she might of looked in her youth. anyway, after telling me her life story that day she died the following day! i just felt so honored to have had her tell me her life story if only briefly with all of the highlights.

[snowfreeze, BSN, RN]

Chatting a bit with patients isn't lost, just do it. If it takes you until 11am to do your patient assessments then maybe your units needs more nurses. Slow down and do your job as you feel it needs to be done.