Don't think any posting now were practicing in 1906, but this vintage OB nursing manual is an interesting read. Makes the 1940's and 1940's seem almost like another era.
My aunt remembered a time when a bunch of surgical nurses would get together at work and get washed surgical sponges for, attach safety pins in them (so they could be radiopaque), then autoclave them. She said it was a lot of fun to talk and gossip with the other nurses. This is going WAY back, around WWII.
I have several WWII and even 1920's copyright nursing texts, covering primarily OB and Surgery - my two favorite services. You all would likely be totally horrified at some of the things that were "just what we did back then" - for instance, in the 1920's, using gasoline as an emergency skin prep for OR because it evaporated from the skin so quickly!! . And plenty of other equally frightening things. The Scrub up process for OR staff involved procedures and chemicals that sounded more like processing and tanning leather! Boy, are WE lucky!
My first job as an RN (after having waited about 6 weeks for my State Board results), I worked in the old part of the hospital where some of the beds were either "male" or "female" -- and it had NOTHING to do with the patient in the bed. The beds were so old that raising or lowering the bed involved finding the correct crank to fit on the part of the bed at the head and the foot of the bed to perform that function -- and some of the cranks fit over a protrusion there and some fit into a small cavity there. So, the first were male beds and the second were female.
Same job -- the hospital had recently joined with several others in the city to have all of the hospital's laundry done at a central location. One night, in the entire hospital (I called EVERY adult unit and the ER) having ONE unit admit to having ONE clean patient gown. Having to decide whether to leave an elderly woman with dementia who had been incontinent in her bed in a wet gown or naked.
Valium was KNOWN, PROVEN, and ADVERTISED as being non-addictive. Brown prescription bottles containing several hundred 5 mg tablets on a shelf in an unlocked cupboard in the medication room.
Having to call an intern to remove an infiltrated Jelco (short, plastic, IV device) because if the tip broke off during removal, the intern would be prepared to prevent the embolus from traveling to the lungs. Being told at about 3 a.m. by an exhausted intern I had called for this reason that most of the nurses found a way to have the things "fall out" at that time of night. LOL
Providing care for the first patient in my hospital who was on total parenteral nutrition (TPN) and trying for 2 or 3 night shift-to-day shift reports to convince the day shift nurses to ask the physician to monitor the patient's blood sugars since the clinitests were so rapidly getting to 4+ that there was no telling how high the blood sugars were. No one seemed ready to make the connection between a solution of 25% dextrose going in IV and sugar spilling into the urine.
Clean gloves only to be used when patients were on "contact isolation" -- usually for active hepatitis or a draining wound.
Giving L-dopa when it was still investigational to a man so contracted by Parkinson's that he was totally helpless.
SQ31245 ( I think) given on a research protocol to see if it was safe and efficacious for hypertension -- it became Captopril when first marketed.
As a student, giving Keflin (the FIRST cephalosporin) IM, and the patient finding it so painful he informed his physician he'd rather die that get another shot. The physician chose to "risk" giving it IV, and it worked fine.
A reason that every student needs to learn the basics of controlling an IV with a roller clamp is that in any major disaster with large numbers of seriously injured patients hospitals will at least temporarily not have enough IV pumps. The least critical patients, those on maintenance fluids, for instance, will need an IV controlled so they get approximately the amount ordered.
Positional IVs. IV boards to hold an extremity in exactly the right position so the IV device didn't get dislodged and infiltrate and, when the IV device was a metal needle, the tip of the needle didn't penetrate the wall of the vein leading to infiltration.
Hearing that the men who pushed brooms cleaning the streets in San Francisco made more per hour that I, as a new RN, made.
Talking with a couple of RNs who were part of the group who organized the first strike by RNs in the San Francisco Bay area -- who said, among other things, that one day, after work, they were sitting somewhere, chatting, and came to the realization that they loved being nurses and wouldn't want to do any other kind of work, BUT they only worked because they needed the money, and therefore, they needed to be paid what they were worth.
It was a long ride -- highs, lows, in betweens. I'm glad I'm now retired, though.
Reading these posts and coming up with my own has afforded me a review of my nursing career, so I've asked myself, "If you had to do it over again, and were aware of the outcomes, would you change anything about your career path?"
How about you?
Well considering what I've gone through in the past few years...I had to pause before answering, but yes!
Demerol and Phenergan IM q4h for pain (never IVP). IM preop meds. LVN/LPN primary nurses doing vital signs, assessments, meds, dressing changes, bed baths and patient teaching with one RN charge nurse. No nursing care plans. T-tubes with every cholecystectomy. Caldwell-Luc sinus surgeries. Smoking lounge full of nurses and respiratory therapists. Glass chest tube bottles. Betadine, maalox or sugar and heat lamps for pressure sores. Metal trach tubes without disposable inner cannulas (I suppose Tucker and Jackson tubes may still be used sometimes...). Shared electric razors. Posey vests on the commode. (Some of this is hard to admit...)
Hearing that the men who pushed brooms cleaning the streets in San Francisco made more per hour that I, as a new RN, made.
Oh, my, yes -- I was paid $2.73 when I graduated from university (minimum wage was $2.35 then) while my husband, an unskilled laborer in the steel mill, was paid $8; his father, a tool&die maker was paid up to $20/hr for a weekend shift (and yet thought of himself as part of the downtrodden poor). I remember getting a $0.02/hr raise -- the respiratory LPNs were given a penny.
Remember when the only "correct" way to secure a trach was to cut 2 pieces of twill tape, cut a slit near the end of each, then thread the other end through the appliance slit then the tape slit? What insane person decided that?
***Admissions the day before surgery for testing testing and education.
***I remember doing that as a patient, even in 1986, when I had a hysterectomy and Birch procedure (bladder/urethral resuspension) five years following the damage inflicted by 18 hours of labor, shoulder dystocia, and vag delivery with 3° tear sans epidural of a 10# 22½" baby (?) boy in 1981!
On New Years Eve my surgery was scheduled in order to beat the deadline of my insurance deductibles! We had been going through the gamut of testing for bladder problems for a couple of months, including something involving having my bladder inflated with sterile saline, then having to sit on a kind of potty chair for grownups, and peeing while some kind of metering process was done to measure stream force, and volume! And something else involving sterile applicators being inserted and left hanging while I was in lithotomy, and measuring the angle! I don't remember what this whole series of diagnostics was called back then, but it had some specific term.
Anyway, I got admitted, the old fashioned way, on paper, the night before, through the admissions office, then trundled upstairs to "the old building" in a wheelchair, where the Gyn surgery ward was, and for the first time since delivering my second child, into a semi-private room, barely big enough to stretch your arms out in and almost touch both walls! To also share it with a cranky old lady who liked to tie up the one room phone every night hollering at various family members who apparently didn't want to come visit her! Can't imagine why.....
Unfortunately, while there, recovering from my extensive surgical procedure, I managed to contract a staph infection which oddly enough manifested itself as mastitis! It wasn't obvious for several days, though I was running a low grade fever the whole time. By the time it actually showed itself, the administration had me moved from the hospital to a room across the street, in a hotel building connected by a Skyway the hospital owned. It was half the price and about 10 times as nice as the hospital room. I have always wondered if they did that to placate me, and possibly avoid a lawsuit?
There were a couple of floors used for "self care" patients who could manage to follow their care instructions for measuring and recording temperature, and taking meds on schedule, but still needed a nurse nearby for emergencies or medical issues that just appeared all of a sudden, like mastitis in a woman who had just had a hysterectomy! Once it was identified, and the right antibiotics started, I finally got to go home - after 16 days!
The room I was in was just like any other high dollar hotel suite at the time, with a queen size regular bed, a dining area in the room, free TV and phone, an enormous bathroom, with a whole wall mirror, two level shower in the tub, and all meals came up on trays from the restaurant downstairs! My husband brought the two kids up in the evenings to visit, for a snack, and we would get them baths, and he'd take them home in their PJs ready for bed.
Another floor, just below, was being used for an experimental project for OB patients, who came up with their babies to actually keep in their rooms right there with them, and take care of them themselves, with no nursery to do it all for them! Only vag delivery patients could do it, since C-section patients needed more care. Quite an experiment, eh? They could only stay four whole days! Now, they shove them out the door in under 36 hours straight to home. Insurance companies practicing medicine - It seems it's here to stay.
Specializes in OR 35 years; crosstrained ER/ICU/PACU.
Those large blow-bottles instead of today's little plastic incentive spirometry thingy's. Having to thread needles in surgery; & the needles were resterilized. This was before swedged needles made our lives in the OR so much easier! But back then, we had cloth drapes & gowns; often having to change scrubs when a case was so bloody, the blood went through our scrub gowns! IV pumps - Only for heparin, NTG, Dopamine, etc. We had glass IV bottles, & yes, had to calculate flow rate, then count using the second hand on our watches, controlling with the roller clamp. Anesthesiologists didn't have pumps for propofol or anectine drips....they eyeballed them too! There was no pulse oximetry when I started in the late 70's, nor capnometry. EKG, BP, Pulse were the big ones monitored in surgery. The times have sure changed in 40 years!!
Bossynurse, I haven't heard about Caldwell Lucs in years! Had one myself back in the 80s. Waking up later I forgot the preop advice not to sniff (had packing in my nose too from deviated septum repair) and a whole bunch of air went in through the little window. My whole cheek pooched out like a balloon! First I panicked a little then I took my fingers and just pressed my cheek flat again. Never did admit to the ENT what I did.
. And plenty of other equally frightening things. The Scrub up process for OR staff involved procedures and chemicals that sounded more like processing and tanning leather! Boy, are WE lucky!
DoGoodThenGo
4,133 Posts
Don't think any posting now were practicing in 1906, but this vintage OB nursing manual is an interesting read. Makes the 1940's and 1940's seem almost like another era.
Obstetrics for nurses - Joseph Bolivar De Lee - Google Books