Spinoff : What We Do, What We Used to Do

[NursingAgainstdaOdds]

The HIV thread reminded me of a thread I've wanted to start here for a while. (Apologies if it's been done!)

I love to hear accounts from experienced nurses about how nursing practice used to be, or how different practices have evolved. For example, an experienced traveller shared with me recently how patients with feeding tubes used to have what everyone else had - just pureed like crazy. (Interestingly to me, she also informed me that there was no such thing as a tube-fed patient with obligatory diarrhea. She felt this was because the patients got "real" food. I thought that was very thought-provoking.)

So, please share. Nursing history of all kinds really fascinates me. I wouldn't restrict this to practice-based issues, either - nurse/patient, nurse/doctor, nurse/nurse relationships have also evolved in fascinating ways. Let's hear it!

Edited to Add : I'm also interested if anyone has experiences which exemplify where certain procedural changes originated - i.e. our vigilance with IVs.

[Agnus]

Whatever happened to Clinitron Beds and Striker Frames? Side-rails? Poseys? Tieing people to their beds or to their wheelchairs tied to the hand-rail. 4-Point posey restraints in bed...Leather straps with sheep-skin lining with locks needing keys to release for the truly unruly...

Striker Frames are still in use. Lether straps with sheep-skin lining with locks needing keys are still in use.

[santhony44, MSN, RN, NP]

Bismuth and bourbon, anyone???

[jlcole45]

For those of you who were nurses at a time when gloves weren't required, how was it to make that transition to use gloves? Was the idea to start using gloves reject at first or was it a relief that it was required? Thanks in advance.

I worked ER and the only time we wore gloves was for particularly messy traumas or poopy patrol. And then HIV hit the fan and we dressed up like astronauts when there was a suspected case! It took me years to feel comfortable wearing gloves to start IVs - of course they finally got better about providing the right size gloves - especially for those of us with small hands.

[jlcole45]

How about this --

Does anyone remember dressings with betadine and sugar?

This was old fashioned 20 years ago and came from an ancient country doctor.

[NurseNora, BSN, RN]

More OB memories:

Mouth suction DeLee catheters for suctioning nasopharnax and stomach, especially when there was meconium staining. If the baby had been drinking a lot of the fluid just before delivery, there could be more than the 12 cc tube would hold. More than once I got a mouthfull of nasty salty fluid. I was glad when they figured a way to hook it up to wall suction.

Circumcisions in the delivery room because "a newborn can't feel pain."

Mom didn't get to hold the baby for a couple of hours although in my hospital, the baby was at least kept in a warming crib next to her bed. In the DR, the baby was given to Dad to hold. I don't know why we thought the Mom couldn't hold the baby. It was a big deal when we were first encouraged to put the baby skin to skin with the mom. I remember the first time I did it, I was surprized that the baby stayed warmer that it did under our warmer. But when I went to take the baby away, I had trouble lifiting it. I put my hands on the baby and pulled and nothing happened. It wasn't until the third time I pulled (pretty hard by that time) that the Mom said, "You've got a hold of my nipple!"

As a student I once had to mix either Demerol or Morphine. You got a sterile shot glass, sterile saline and the medication tablet. Put the tablet on a sterile field, dipped the plunger of the glass syringe in the saline to moisten it and used it to pick up the tablet to drop it into the sterile saline in the shot glass, then when it dissolved, you drew it up in the glass syringe.

Anyone remember sharpening non disposable needles, or washing, turning, and powdering sterile gloves to get them ready to be wrapped for the autoclave?

[siggie13]

What an intersting idea! 40 years of nursing and I have seen many changes. Here goes:

Being in the AF during Viet Nam, we started this new procedure, feeding patients thru their veins. We had to mix up our own TPN and give it. I felt like a witch, standing there adding alittle of this and alittle of that.

No such things as PICCs or subclavians. We did cut downs on anyone who was a hard start or who had to have IV meds.

We mixed our own IV bags, IV meds and put narcotic pills in glass syringes with water, shook and injected.

Our suction was gomco bottles, with the amount of suction regulated by the height of the bottles to each other.

We NEVER wore gloves and used finger cots to insert suppositories.

White dresses, white shoes,white hose. and the mandatory cap! AND MALE NURSES WERE RARE AND HARDLY EVER SEEN.

IVs were started with needles (no catheters) and everyone had an arm board.

Glass syringes with needles that you reused and sharpened before use.

You worked your 8 hours and then and only then, did you pick up a chart to chart. You charted on your time off and were never paid overtime.

Doctors were always right, never questioned and a nurse stood and gave her seat to any doctor that came on the floor. I remember being called into the chief nurse's office because I refused to give my seat up to a doctor- I was tired, had had a child die and was not going to get up!!!

Patients could not get up after surgery and therefor, bedpans, bed baths,etc. for everyone.

BUT we had more help, more aides and oh, we had those great ORDERLIES! Orderlies, those huge strong men, who would come and pick up patients, prep patients befor surgery (everyone got shaved from nipple line to knees for any surgery), and help deal with difficult people. Loved those men!!!

Could go on forever. Good and bad moments and the one thing I remember that has changed...back then, we all worked as a team and no one sat down until everyone could sit down. Do not see that much anymore.

[ebear, BSN, RN]

Siggie13,

I tip my old yellowed nursing cap to you and so many others who have done so MUCH over the years with NOTHING BUT PURE GUTS!!! I didn't have to mix meds in a glass syringe or powder gloves or see a war...

There's a special place reserved in heaven for nurses like you! God Bless You!

...and thanks for not giving up your seat to that doc. You helped pave the way for the rest of us!

ebear

[ebear, BSN, RN]

NurseNora, THANK GOD I never worked OB!!!!

ebear

[GrumpyRN63, ADN, RN]

Smoking in the conference room during shift change !!

[siggie13]

Mixed feelings...I always could assess better when I "touched" the patient and I truly think that people feel differently about being touched by an ungloved hand versus a gloved one. Having gloves that fit have made a big difference and yet, I still have trouble starting an IV with gloves on (just can't feel that vein as well). Must admit that I get something out of being able to feel my patients but times change. Oh,well, not all changes are good all the time.

[twotrees2]

For those of you who were nurses at a time when gloves weren't required, how was it to make that transition to use gloves? Was the idea to start using gloves reject at first or was it a relief that it was required? Thanks in advance.

sometyimes even today ( though i am much much better at it now owrking with a high hiv and hep and other stuff ) i forget gloves and have to go out to the hall to get em ( not in pts room as i work in prison) at the start - it was very hard to remeber and got "busted many a time " yelled at and warned. gloves really hinder some stuff- like starting and securing iv's and dressings- but i have finally adjusted - just have to remeber better to save time of going backl to get em lol.

[husker_rn, RN]

What about " cupping " our respiratory patients to help get secretions up and out. Still can do it with the best.