What was it like to be a nurse in the 1980s

Libby1987 · Apr 13, 2016

I was a nurse assistant starting 1980, became a nurse in 1994. This is my view from that perspective:
NO Universal Precautions, Gloves locked up in the Medication Room. Nurse, Patients and Doctors smoked in hospital. Nurses gave up their chairs for doctors. I heard of lots of bullying (nurse:nurse and Dr.: nurse) which was still in effect in 1990's. No Behavioral Standards. Doctors could yell at and swear at nurses with no official recourse. I remember a physician throwing a chart at a nurse and calling her a "god damned monkey" because she called him late at night out of concern for a patient. I remember the first time a physician was disciplined for treating a nurse badly at my hospital, it was in the year 2000. But for the most part, nurses still advocated for their patients and most physicians were kind and polite. I believe most health care workers are kind, caring people then and now. We just have more rules and regulations to ensure they remain that way.
I do feel that nurses got more respect from community, patients, and family members back then. Physicians did also. People were more respectful and polite to "authority figures" then. However, I was constantly being groped and grabbed by old male patients. I don't see or hear much of that happening today. I think they know legal action can follow such events, not so in the 80's. I remember a nurse being suspended because she called the police on a patient (fully sane) who purposely injured her on the job. She had to go to court to get her job back. No Patient Satisfaction Scores, no Core Measures, no Political Correctness, no cultural sensitivity . But the world was so different socially back then.
Most pain medications were IM or PO and Darvocet was considered to be strong. Wong Baker and FACES scale not widely used, pain was not "what the patient says it is" Pain was assessed and treated much less often. PCA's were not in such wide use. I now see patient with chronic pain syndrome and cyclic vomiting syndrome who get PCA's every time they come into the hospital. This was not the case even in the 2000's. People took fewer medications, especially young patients. Morbid Obesity was rarely seen, many fewer diabetics.
Before the Nursing Home Reform regulations were changed in the 80's we saw massive pressure ulcers encompassing entire lower torsos coming from patient neglect. I rarely see this anymore. Restraints were used more often in the elderly.
As a Nurses Aid I had to do the urine sugar dip sticks, we did not use glucometers on my med/surg floor. We sterilized bedpans at night in the auto clave. We did the wound care (sugar and betadine, heat lamps). Without gloves we gave enemas (milk and molasses or soap suds) and inserted foley catheters. You could have one then for being incontinent! We drew blood and performed EKG after a short training. After age 18, I was passing the HS liquor cart. With a physicians order, a patient could have 2 oz liquor or one glass wine or beer with his bed time snack. We gave bed baths and back rubs and they made people stay in bed longer. I remember most nurse being very kind toward me and the patients. I remember that they seemed to be more like nuns, or nurses with a "calling" back then. Of course I worked in a Catholic Hospital. No abortions, no birth control, no tubal ligations allowed!!
We had no hospitalists. We had to call the poor, tired PCP and wake him up at night for stuff like tylenol or sleeping pills. The attending handled most problems. They did not consult ID, Pain Management, Neurology, and other specialists as much as they do now. Because the hospital attending was often the patient's PCP, they had a different relationship. Some strange orders came from these relationships. I had orders like these: satin sheets to bed , change feeding venue at each meal, play cards with pt at HS, clip and paint nails PRN and other odd patient preferences put into MD orders and expected by them to be fully implemented.

Oh man, you bring so many more memories. Things like pain mgmt. "Pain is what the patient says it is" came around for a good reason and it wasn't for satisfaction surveys. I remember a few sadistic physicians, others including nurses were just plain wrong in how they refused to treat pain.

Anyone rememebr having oncology patients suffering from horrific pain? Literally writhing. I recall "bone cancer" being one with a reputation of suffering with unmanaged pain. Air hunger wasn't managed well either, I still have images from 30 years ago that haven't left me. I'd take a spoiled patient over those pitiful experiences anyday.

This is and others remind me of comparing the present to the wholesome 50's, where husbands could hit their wives and most women could never dream of getting a mortgage on their own.

Thr 80's weren't better than today, just different.

NutmeggeRN, BSN · Apr 13, 2016

Started as an RN in 83...

Wow, if you agreed to work weekends nights and holidays, you were hired.

We had a regular retirement plan

Wore my cap for a year or so

White unis, stockings and shoes

Smoking allowed in pt rooms

Patients were admitted the NIGHT BEFORE surgery!!!!!!!

Patients stayed in house for a week or so post op!!!

Smoking allowed at nurses station.

You got your 30 min for lunch or dinner

Carpujects for the Demerol and Phenergan (and other IM pain meds) vials

Wow, times they are a changing!

In my health office at rural high school, we are getting ready to stock Narcan. :banghead:

Kyiha · Apr 13, 2016

We wore white uniforms, white hose and nursing shoes (no sneakers) and of course our nursing caps. This was before ICD-9 (now 10) codes and DRGs so it was not unusual for us to keep elderly patients over the holidays so that family members could have a respite. There was NO orientation or preceptors; my first day on the job just out of Nursing School I was charge over 1/2 of the Unit, the second day I did charge over the entire 30 bed Unit (and it's not as if I had experience prior to Nursing School; I was not a CNA or LPN before obtaining my RN). However, most of my career was in the Emergency Dept. The ED docs loved to teach (those of us who were eager to learn). We worked as a team and it was very rewarding. Recently I worked PRN on the Unit and noticed how things have changed. The patients, especially the 30 and 40 year olds, want to be catered to. The elderly are afraid of losing their independence and want to get up on their own, increasing the risk of falls.

scuffles, RN · Apr 13, 2016

I trained in the late 80's. There was more of a hierarchy in terms of respecting the trained professionals. Much more formal in terms of no chit chat at handovers and break time for students was always adhered to and worked out as a priority before the shift began. Also the rounding's included proper visual checks of patient skin and pressure areas.Consultants were more feared when they did the rounds on the wards and it was always at the same time.

allnurses Guide · Apr 13, 2016

I've heard stories about there being orders for a glass of wine at bedtime (to help with sleep).

I've had doc's order this and I became a nurse 19 years ago. :up:

I worked on a unit that also did overnight epilepsy monitoring. The docs would write ANY order that would induce a seizure so they could track their brain activity. Several times, we had an order to allow pt to consume wine from home to induce seizure activity.

Really? Interesting . . . I drink wine and have seizure disorder. My doc said it was fine. It never induces a seizure in me. :)

If you are including the 70s in your project and have the time, read the book "Nurse" by Peggy Anderson. She wrote it shadowing a nurse for 8 weeks in 1978.

I've read that. I read Echo Heron's books the summer before I started nursing school. Her first book was about what nursing school was like, the test nurses had to take to get their license, and her first years as a nurse. I've read all her other non-fiction books as well. Probably re-read them once a year.

INTENSIVE CARE; THE STORY OF A NURSE - ECHO HERON

Editorial Team / Moderator · Apr 13, 2016

I have read both Peggy Anderson and Echo Heron's books. Love them!

I worked with an ER nurse who was in her late 60s/early 70s when I was new to healthcare (ER tech then new ER RN), and she attended a diploma program in the 1950s in the midwest. She had a scrapbook that was mind-blowing, her acceptance letter was hilarious (reminding them about proper decorum and the correct number of white hose to bring). She used to tell me stories about clinicals, like being admonished for her metal bed pans not being shiny enough. :roflmao:

NurseDiane · Apr 13, 2016

Not much different in the ICU environment. We worked all sorts of shifts, including 'regularly scheduled' 16 hours. Less tech, but relationships with physicians was the same as it is now. We were coping with the onset of HIV - the early days were pretty scary. Manual calculation of IV drips & all bags were time taped; pumps only on 'special' drugs. Buretrols were the norm. We mixed all our own IV meds from a plentiful stock the unit. Gloves were not the norm unless things got really messy.
Trauma patients were hospitalized 'forever'--- skeletal traction & body casts in the days prior to external fixation devices. There's nothing scarier than dealing with a CircoElectric bed for a new quadriplegic.
Really memorable?? Hospital employees' healthcare insurance was FREE- FREE care for employees & their immediate family members in the hospital clinics. Nursing & staff lounges were very smoky - in some departments, just sitting in report could trigger respiratory problems. No 'core measures' & a ton less mandatory documentation. 'Charts' were big paper trifolds.. each shift used a different color of ink to help differentiate.
Those were the days my friends . . . . .

I know, right? Those certainly were the days. I forgot about the 3 different shades of ink for the 3 different shifts!!!

I also remember being in the throws of the HIV/AIDS epidemic---I worked in Manhattan, where it was rampant and nobody knew anything about it.

You hit the mark, my friend. Add to that, loyalty between employer and employee, nice working relationships between co-workers, not as much petty B.S., nurses got along & didn't slit each other's throats at every corner, the patient loads were lighter, charting was far less (and if you had told us that in 20 years we'd be doing 3 times as much charting as we were then, we would have laughed at you), hiring nurses wasn't looked at the same way as hiring senior level V.P. positions at Fortune 5000 companies as it is now, with 2, 3 and 4 different interviews with different people (I was hired over the phone to work at NYU in my senior year of college), free health insurance.

The environment has changed so much because of the vast changes in Medicare and the insurance industry. Money, money money----and lack of it.

njpawarn · Apr 13, 2016

I graduated in 1982, when hospitals competed for nurses. I started with 3 weeks vacation and 6 personal days. I did question physicians and advocate for patients. It was a time in which nurses were becoming more assertive and medical students/residents were working with nurses more as team rather than their subordinates. AIDS was new. My workload included 2-4 ICU patients on the night shift. Everthing was in the same room but we rarely got breaks or lunch. When you started, you were oriented and trained by inservice educators on policies and procedures, IV pumps, dynamaps (BP machine,) etc. One year, in the mid 80's nurses across the board were given an salary increase. Then, it was close to $2 an hour which was a big deal. We prepared our medications. The pharmacy sent the bottles, pills whatever. We calculated IV rates. Our pumps did volume and rate only. Families and patients were not well educated like they are today. There was no internet. Memories...good times!

rubynrse, ADN, RN · Apr 13, 2016

I work white, pantsuits and dresses, white hose, my pin, my cap. I was so proud.

8 hour shifts.

Cardex - we wrote in pencil the info on patients and when a symptom/treatment/medication was D/C'd we erased it!!!!!!!!!! :uhoh3:

We sat down and gave face-to-face report shift to shift. Then we moved to leaving our shift report on a tape (cassette)

We got up and gave doctors the chairs at the nurse's station.

For each of our own patients: we passed pills, started IVs, did wound care, helped make beds, helped with bed baths, gave back rubs if we were on the evening shift. We were totally responsible for everything that had to do with each of our patients. There were no "teams" - except for respiratory.

We wrote in blue or black ink for days, green for evenings, and red for nights.

We rotated shifts.

Counted drops for the IV infusion rate.

Patients stayed in the hospital for much longer periods so there were relationships developed. The patients went home with a good education of what to do and were well on their way to healing.

Now I work in hospice. I will still put on my whites and cap if I know I'll be spending a lot of time in a SNF or ALF. That group of folks recognize that attire and will listen to me.

allnurses Guide · Apr 13, 2016

When I first started working, I was trained by nurses who were a good 20 years older than me and I loved the stories they told.

In a small rural hospital, the nurses basically ran the hospital. Many of the nurses I worked with started out as CNA's and sometimes they would deliver the babies or treat the patient having a heart attack.

The other thing that shocked me was that patients smoked and the docs/nurses/aides all smoked at the nurses' station. There were ashtrays everywhere!

The med room was another place the nurses would smoke and when they would open the door, smoke would billow out.

Amazing.

BittyBabyGrower, MSN, RN · Apr 13, 2016

Did you have any NICU experience with the days before surfactant?

I do, more than I care to think about. Most kids under 26-27 weeks just didn't make it, and if they did they had bad heads and even worse lungs. We always had at least two trached at any given time. We didn't have any other mode of ventilation except pressure vents, we would have kids on pressures of 26-32 or even higher PIP just to get chest rise. Most kids had at least one chest tube in their life time. We would have these kids on the unit for up to 2 years before they died.

We we also didn't feed early and they had TPN damaged livers and our NEC rates were thru the roof. Parents couldn't hold them while intubated, so months and months of no holding, we also didn't have OT/PT. They would be on months of Decadron, which we now know contributed to CP and a multitude of other problems.

Then came the trials of surfactant...a wonder drug! We could wean the vent quickly, the lung compliance was wonderful, and those kids did better respiratory wise than we ever dreamed.

Research is is a wonderful thing!

gdottie · Apr 13, 2016

AMEN! Great post! I'm so sick of the college I'm going to feeding students the line of BS that older nurses did what they were told and didn't question anything or use evidence based practice. If you say anything to argue that ADN nurses were professional, stayed cutting edge with hospital classes, conferences, and other learning, and did not just do things the way they were always told to, you would get a 0 and your post removed. MOST of this garbage they're feeding students is just reinventing the wheel. I never wore the cap (not required in ICU areas) and we were allowed to wear pants but the uniform still had to be white.