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

[fatrabbit]

I'm writing a paper for one of my classes. I have to briefly discuss what the role of the nurse was in the 1970s/80s. The only sources I can find talk about events pertaining to nursing in the 1980s.

I really want to know the experience of being a nurse in the 80s. How much respect did nurses have? Where they able to question doctors? advocate for patients?

[pam.harrison]

I graduated in 1971 from a diploma school attached to a general hospital. Lived in the dorm attached to the hospital and all of our meals were hospital cafeteria food. When they were short of nurses, they called over to the dorm and we were expected to go over and help out. By the late 70's and early 80's, I was in a leadership position in an early critical care unit. It was an exciting time with many new advances, the beginnings of hemodynamic monitoring and the role of nursing expanding from "handmaiden" with little respect by doctors to doctors beginning to ask us questions and hear what we had to say. There was smoking in the nurses station and in report and patients smoked-often saw cigarette burns on linens. I remember the first time I saw DIC and we didn't know what it was or what we could do for it. We started IV's without gloves and gloves were not as readily available. The early 1980's brought the early days of HIV/AIDS called GRID originally and confusing information coming down periodically about what it was and what we need to do to protect us from it. I knew some nurses who left nursing out of fear in those days related to AIDS. We didn't have all of the interventions for cardiac patients so they were treated with bed rest and sedatives and prayer! We had a lot of patients with ulcers and didn't know about helicobactor and proton pumps and H2 inhibitors-research the "Sippy diet"-that was what we had to offer ulcer patients along with bedrest and sedatives and the sippy diet didnt make sense then or now. There was less acuity and on med surg floors often had patients several days post op, we had no IV pumps and had to calculate drip rates and watch IV's carefully! We had no electronic thermometers in the late 70's early 80's so used glass thermometers which had to be cleaned and took FOREVER to get accurate temps-especially rectal temps!

I had a cape (still have it-still proud of it) and wore white uniforms, hose and shoes and of course my nurses cap (still have it and still proud of it too!). We didn't have as many disposables-especially adult underpads/diapers/diaper wipes so used a LOT of washcloths and linens and we didn't have specialty beds and all of the treatments for decubitus ulcers. We used Circle-O-Beds and stryker frames and treated bedsores with heat lamps and some amazingly ridiculous compounds of maalox, sugar, glycerine, etc.

There was no electronic charting, every nurse had a multicolor pen-black/blue ink for days, green for evenings, red for nights in the charting on paper charts. We made recommendations to doctors cautiously-the best way was to get them to think it was their idea and they would give us the orders we needed for our patients!

Could go on and on...but have already said too much...and fyi I was in the southern part of the US in a smaller general hospital and was a diploma graduate and my experience may have been a bit different than in larger cities and on east and west coast.

[concflynn13]

hi fatrabbit,

I worked in dialysis in 2 different units all thru the 80's. the first unit was quite dysfunctional. the nurse manager had no respect for me or any of the other staff. backstabbing & tattling were promoted. getting dry weights changed for patients when they gained or lost body weight could take 6 mos. the next unit, I had free reign with my primary patients. the attendings valued my opinion. some of the residents were gods.

unfortunately in the mid 80's we became hep B & HIV aware. one day we ran out of gloves. SPD was out of them. the glove manufacturers couldn't produce them fast enough, so they cut the washing of the powder when gloves were removed from the forms. all the powder became the vector for transmitting latex proteins into the air creating an "epidemic" of natural rubber latex allergy. my symptoms didn't begin until '94 & I couldn't work with open sores. I wasn't diagnosed for 3 years. I was constantly exposed. I didn't know what to avoid so my allergy became disabling.

I wish I could give you better memories of the 80's.

[Cheyenne RN,BSHS]

Did you have capes? Did you live in hospital accommodation to train? Was it AT ALL like Cherry Ames? (Sorry, I love hearing about how nursing used to be). I also apologise if these questions are relevant about 50 years before the 80's, Cherry is my only insight into American nursing history and I am aware she is fictional :).

I don't know who Cherry is, fiction or non-fiction. LOL. I remember home health care back then. Goodness the miles I put on my car living in rural areas. It could be 110 miles between patients and that was one way. I learned every back country road there was. WooHoo the wildlife I saw...and I mean critter wildlife. I loved it.

But I remember a patient that I had who was in her 70's and she was a nurse in the day of the capes and black medical bags. She was a delight and I would go by on my days off just to check on her and hear her stories. How I wish she had written a book. She had never married "as you just didn't back then." She had pictures of herself in her nursing uniform and the full length cape. She still had a very old blood pressure machine that she had used and a set of old hypodermic syringes and needle that she used when she worked at a doctors office.

I loved to visit her. She had outlived all her family and oh my the tales she could tell! Living at the hospital where she trained and having curfews and rules and years of basically free labor for the hospitals.

[pasdequoi]

Edgar1 - I just wanted to say major, major respect for what you have experienced. Seriously, thank you for sharing this.

[Penelope_Pitstop, BSN, RN]

Absolutely everything . . . and it hurt to grow back.

Darn good thing I didn't have to do this as an L&D nurse...you should see what I do to my legs!

Wasn't a nurse in the 80s but I adore threads like this. I own a few vintage nursing textbooks - two of them are WWI-era!

[mmgarland]

I graduated in 1978 from a 2 year program. I wore a cap for my first job in a catholic run nursing home. I was there 3 months. Then to a large hospital in my area, on a 36 bed medical floor. No cap but not much orientation. I felt thrown to the wolves literally. I worked all three shifts 2 out of three weekends. On the night shift for those 36 patients. one Rn one Lpn and one aide. Some nights I just wanted to cry. No iv pumps except for aminophylline which they don't even use any more. It was also team nursing the hall divided in half. I lasted one year. My next hospital position was on a 36 bed orthopedic unit. It was divided into 2 units with 2 head nurses and separate staff. They did not do team nursing I usually got a 5 pt assignment. Passed meds and took care of my pt completely and they came in the night before surgery. They were just starting to do joint replacements. They were in the hospital for about 2 weeks. Laminectomies about 5 days. We did traction with stieman pins. We had the stryker beds and prayed every time you had to flip them. There was two nurses at night for 20 patients One in charge and one passed meds.We had a lot of respect in from some of the Ortho surgeons. I was there for 8 years until my son was born. I did come back part time. I floated, did ER nursing Home Care. My favorite still to this day was ER nursing. I am now working for a large insurance company. No more weekends,holidays,shifts. I am paid well with this position and even got a bonus this year. What I see in more in nursing I was a patient in large teaching hospital three times in the last 8 years. I find is the when i was int he nursing the sick one that are in the ICU were not alive the sick ones that were on the floor were in the ICU were in the ones on the floor are now same day and gone.

[BTSICURN]

I graduated from a 2-year ADN program in 1982. I was accepted into a nurse-internship program at a prominent teaching facility. Thus was a six-month program to ease new grads into the realities of day to day nursing care, clinically and in critical thinking. The nurses were very respected by the medical staff because we all were learning from each other and we were in a publicly-funded facility that primarily cared for the poor, the homeless, victims of violence and those afflicted by substance abuse. We needed each other because it was a sink or swim, nonstop environment. Nurses and doctors questioned each other to arrive at the best care possible for our patients. Often we found ourselves without basic supplies but together we improvised and saved lives with ingenuity and compassion. I left after two years because I couldn't live on the low pay and some nights I was the only licensed nurse on the unit. However, the spirit of the place stays with me even though I now work in a world renowned high-paying, well supplied and staffed facility.

[BackinthedayRN]

In 1980s I transfered to Surgical ICU at a 300 bed Community Hospital because I wanted to enroll in an ADN program. I was an LPN at the time with 20 yrs experience. I knew the challenge would keep me focused since the lastest was happening there. We stopped standing for doctors and giving up our chairs by the 70s and there was more of a mutual appreciation developing. The 80s introduced scrubs and many stopped wearing their nursing caps. You had to gain respect by your skills and knowledge. Always the best defence against ego maniacs. In the mid 80s we were to concentrate more on pt care plans, goals and outcomes but many didn't take it seriously. It was an exciting time for technology with new equipment, meds and advanced treatments all requiring advanced nursing skills. AIDS hit late in the decade. Till then hepatitis was the worst threat to a nurses health. Now a far deadlier one was out there. The ANA was more prominent in maintaining our professions reputation. Shows like Nurse Jackie and Scrubs were not televised. Any derogatory reference to nurses or nursing as a profession was immediately called out by the ANA and apoligies issued by the offenders. Home Healthcare was added to the hospital's services to support the chronically ill and reduce re-admissions. So I left to ICU to Manage the private side of this new department. The doctors loved home health since it cut down calls they received and patients and families loved the 24/7 support. In late 80s Advanced Directives and DNR entered the scene. HMOs and managed care reared its controlling head. Things moved along smoothly until then. Hospitals had engaged in friendly competition most of the time then suddenly it became fierce competition for contracts and labels like Prefered Providers. The entrance of the 90s saw Medicare and Medicaid hit with cuts and extreme reforms the whole thing was a devasting financial hit to hospitals and physicians The rest is history. I'm 70 now and retired I have see a great deal of transitions in our role and that which constitutes healthcare. Hope this is helpful. Good Luck.

.

[Greenthumbnurse]

I graduated in 1976. My first job was as a floor nurse in a large county hospital. We were discouraged from wearing gloves when we had to clean up a patient who was soiled. The first reason was that it "would make the patient feel dirty." The second reason (which I always figured was really the first) was the cost. Hard to believe when I look back on it!

[FlyMurse, BSN, RN]

Very fascinating! Thank you all for sharing!

Can anyone elaborate on the technology they've seen over the years? What types of monitoring would an ICU pt have? I know SpO2 came in the 90's and EtCO2 wasn't even a thing until fairly recently. What about all the invasive lines? CVP, A-lines, PAWP, etc? What would the anesthesia provider monitor during surgery? How would you know what vent settings to use? would you even manipulate FiO2? Or was everyone just at 100%? What was a code like back then? Or would they even attempt resuscitation?

Also, was anyone around for the first cath lab patients? I know the tx for AMI was supportive care and pain control. It just amazes me how much technology has evolved over the years!

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.

I worked at Mayo's EMU through nursing school and we still do this as well.

[BTSICURN]

I forgot to mention:

HIV/AIDS was an unknown. We started having male patients with inexplicable symptoms. Of course we weren't wearing gloves routinely unless it was to clean up someone's body fluids but we gave back rubs and skin care with our bare hands.

No infusion pumps for all IVs, only meds like insulin, aminophylline, amphotericin, TPN ((with lipids on the side- separate bottle)- maintenance fluid ran on gravity and were time-taped based on the order and the drip rate on the tubing box. You had to do the math, run length of bandage tape along the side of the IV solution bag and mark out the expected hourly volume with the time. So if you hung a liter of NS at 10AM to run at 100 cc/hr you placed the tape along the side over the lines that measure out the 50 or 100 cc increments, drew a line where the 100cc increments would be all the way down the tape then labeled those lines with the time: 10a, 11a, etc.

The number of drops per cc as

determined by the drip factor on the box had to be counted. If the macrodrip factor was 10 gtts/cc, you calculated :

100 (cc) x 10 (gtt factor)/ 60 minutes = 16.6gtts/min

Then you had to stand there, let the IV run and adjust the roller clamp so that it ran at 4-5ggt/15 seconds to verify the correct rate. Every hour you had to recheck the flow because it could change depending on the patient's activity or condition. Then do this for 6-10 patients. Thank goodness everything IV now is controlled by a pump.

We gave ETOH 30 cc q 4 hours po to prevent DTs. I

When I left that job and went to a trauma and burn ICU in another hospital we did primary nursing instead of team nursing.

We had Haldol drips.

The nurses determined the burn resuscitation and wound care.

[CindyMorganJackson]

I graduated in 1980 and worked in a 110 bed private hospital. There were so few RNs, I moved up the ranks quickly and within two years, I became an Assistant Director. I wore the white dresses which probably revealed my bottom every time I had to help move a patient from stretcher to bed. I hated the caps because they got dirty so easily and would get knocked off by IV lines. We smoked at the nurses station and mixed our own IV antibiotics in those heavy glass bottles. ACLS was a really big deal at the time, and I was one of the few nurses to have it. Many times, there was not a MD in the house, and we ran our own codes until the Dr came.