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?

[Yep, Me]

I worked as a nurse in the 1980's. I will answer your questions.

[DoGoodThenGo]

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 :).

Am going to go out on a limb and assume you meant caps not "capes".

By the 1980's at least here in NYC most hospital floor/unit nurses no longer were required to wear caps. This varied by facility and you still had some who showed up for duty each shift with cap case in hand, but by and large you found more caps on floors or scattered around locker rooms than on anyone's head. The exception by and large were students who still wore distinctive uniforms with caps. Most schools here still had formal capping and pinning ceremonies. Some BSN programs began to phase out caps in the 1980's here, but virtually all the ADN and what was left of diploma schools still gave them out.

Even where caps were supposed to be worn often those on evenings or nights took the things off and laid them aside. Less chance of being spotted by administration/supervisor or even chief of department I suppose. If word got out a supervisor was on her way up to your floor you put the thing back on until the coast was clear, then it came off again.

As for capes private schools like the various Saint Vincent's here in NYC, still issued capes through the 1980's IIRC. Cannot recall a single instance of ever seeing anyone going to and from duty in capes, this incudes riding subways or buses.

Some hospitals here still had nurse's residences well into the 1990's if not on campus close enough to it, though often by then called "housing" and could be open to post graduates (residents and interns back then), and other staff as well. Many nurses did not like living in staff housing especially close to their facility. While in theory it was housing it also meant your employer knew where to lay hands on you if needed. It also could mean your personal business could be spread all over said facility. Who you were dating, crowd you ran with, who stayed overnight......

Everyone wore uniforms/whites. Though by the 1980's you could wear pantsuits. Clogs were usually forbidden or at least frowned upon, so you wore white nurse's shoes with any type of uniform. The only nurses who usually escaped whites/uniforms were those working on psych wards/floors. Despite the image of Nurse Ratched from the 1975 film it had become accepted that clothing could be one of the triggers for those suffering from mental illness. Thus the sight of nurses in starched whites and men in white coats was to be avoided. Even students from most programs by the 1980's wore street clothing for their psych rotation.

There was often still a distinct hierarchy that could be determined by uniform. Floor nurses wore whites (with or without a cap), unit nurses could be either the same or scrubs. OR, post-op/ recovery, L&D, and a few others got to wear scrubs (dresses or tops and pants) and were often the source of "scrub envy". Not only were they exempt from whites but their "uniforms" were laundered by the facility. In cafeterias you could tell usually who worked where by what sort of uniforms they wore.

Head nurses, assistant head nurses, supervisors, assistant directors of nursing and directors of nursing all still by and large wore uniforms. Most facilities still considered nurses "nurses" regardless of their actual job title so that meant wearing a uniform, no street clothes like today. The only concession is that usually administration weren't required to wear caps.

Late as the 1980's floor nurses still couldn't get their hands on scrubs if their lives depended upon. If you somehow soiled your uniform and a clean spare couldn't be found (could you send home? borrow from someone living in nurse's residence? etc..) you simply just couldn't put on scrubs or even a lab coat without permission. Prevailing thought was you would be mistaken for a doctor.... That aforementioned permission required contacting your direct superior who may or may not have the authority to grant approval. She may have to contact someone above her up to and including going to the DON. Approval might be granted with conditions such as the nurse in question had to remain within the confines of the nurse's station for the duration of her shift.

In practice many reached for an isolation gown (back then these were thick cotton with knitted cuffs and quite roomy. Many nurses also reached for isolation gowns to cope with chilly floors/units in those old barns of facilities with unreliable heating.

The 1980's probably was the last period of a truly real nursing shortage both here in NYC and elsewhere. Schools were closing due to low enrollments/demand. You could get into most programs with just the bare minimum pre-nursing qualifications because places rarely had more applicants then open slots for incoming classes.

Downside of that shortage was after working your eight hours there could be the real possibility the next shift was short or worse there wasn't anyone available to relieve you. Nurse's faces would drop when a supervisor showed up an hour before her shift was supposed to end saying "I have no one to relieve you..." which effectively often meant forced OT until coverage could be arranged.

Ironically it was out of the serious shortage that facilities finally had to begin to cede to certain demands from nurses/the profession. Manuals of standards and practice that hadn't been updated since the 1950's (if even then) were changed addressing some long standing grievances. Whites began to fade out in favor of scrubs for everyone, caps had already pretty much died off. Nurses gained more professional accountability. Many of the boarding school/convent type rules and regulations (such as dress codes that mandated sweaters only of a certain color) were gotten shot of as well.

[DoGoodThenGo]

Oh and the other unit that by the 1980's had begun to ditch caps and whites was peds for pretty much the same reasons as psych. It was felt the sight of a nurse in whites (with or without a cap) was unsettling to children/infants. This is when you start to see the beginnings of the cutesy scrub/uniform tops with cartoon and other fun characters or calming images.

Speaking of peds, well into the 1980's lots of places still used cloth diapers and pins. Those who had babies already or had cared for them know how to fold based upon the gender of who one was changing, much less how to pin the thing together without sticking the kid.

[Kooky Korky, BSN, RN]

I started Nursing in the 70's. I experienced the things people have already said - like glass IV bottles, no HIV and little protective gear. No gloves to do colostomies or suctioning, so as not to make pt feel bad.

People smoking right in your face.

Much better work loads, usually got breaks. Some great bosses and peers, others mean (people who were jealous of young beginners because they themselves were aging and their lives were personally miserable). no electronic charting, no computers, period, no calculators.

The tumult, upheaval, turmoil, and huge social changes of the Sixties carried over into the hospital, too. The birth control pill "liberated" women from a lot of the fear of becoming pregnant and this resulted in things like communes, Woodstock and"free love".

There was a greater number of women starting to become doctors, dentists, engineers, lawyers, and lots of things other than secretaries, social workers, teachers, nurses, store clerks, and waitresses. Drugs - LSD, marijuana, etc., rock music starting (?)

Long hair, bell bottom pants, women nurses tossed their whites and caps, not sure when scrubs came in. Men entered Nursing in higher numbers. We students had to live in the dorm if we weren't married. We had 4 males in my class and 3 married students. Everyone else (about 80 students) seemed fresh out of high school.

Steel IV and blood draw needles.

[Ruby Vee, BSN]

I know this is a homework assignment, but it's an interesting topic, so I'll bite. Besides, now that I'm officially old, I can't seem to resist talking about "the good old days." Not that they were so perfect, but I was young and gorgeous . . . Anyway, I digress.

When I graduated in 1977, our class had to purchase caps to wear to our pinning ceremony. With the exception of Halloween a couple of times and a Nurse's Week a while back, that's the only time I've ever worn mine. I couldn't wait to get out of my student uniform and into a "real" nurse's uniform: a white polyester double knit dress (scratchy as all get-out, not to mention that white makes me look like I've died and the body is still walking around), white nylons and white "NurseMates" shoes. Pantyhose were relatively new, and all of us brand new nurses were encouraged to wear them as they were considered "more modest" than thigh-high hose and a garter belt. Since nursing involves a lot of bending, stretching, lifting and sometimes crawling around on the floor to retrieve that errant Percocet or the chest drainage cannister that someone inadvertently kicked under the bed, pants would have been a lot more modest. Those came a few years later. When I first became a nurse, it was all about the dresses.

The nurses station had ashtrays at every charting station, mostly for the physicians who were making their rounds. Cardiologists, pulmonologists and oncologists who surely knew the score continued to smoke. Nurses smoked, too, but not in the nurse's station. The break room had a constant blue, smoky haze and I couldn't even go in there without my throat closing off. Patients were allowed to smoke in their rooms -- even in their beds. After a few patients set themselves on fire smoking in bed, in some cases while wearing oxygen, that was considered to be unsafe and it fell upon the nurse to explain to the patient who was allowed to smoke in bed when he was here for esophageal varices last month that he could no longer do so. Then we had to take them outside to smoke . . . That task usually fell to a nurse who wanted her own cigarette break.

There weren't many male nurses then, and the only ones I knew were either former Catholic monks or priests or they were gay. The stereotype still persists in some areas, and it doesn't have much basis in fact these days. But in the 1970s, the straight male nurse was a rarity. I used to love working with Bill, who was gay and would tell me stories that both shocked and entertained me and with Matty, who left the Catholic Church shortly before being ordained as a priest because of the sexual assaults that were even then being covered up. Male nurses were subject to a lot of abuse from patients and other staff who "didn't like queers." Most of them bore it well, and I'm sure I could never have done it as well. By the 80s, straight men were entering the field and nursing was beginning to change.

It was the male nurses who advocated for us to be allowed to wear scrubs. As my husband claims, the white uniforms they were forced to wear made them look like butchers or bakers. We fought hard for the privilege of wearing scrubs, to decide what we wanted to put on in the morning when we dressed for work. All of those gains we made, today's nurses are throwing away because they WANT to look uniform. Ah well.

There were no glucometers. We tested urine by dropping little tablets into it and comparing the color it turned with a chart. It wasn't particularly accurate. Heparin locks were new, Hickmans hadn't been invented and our chemo patients had veins only a junkie (or a very seasoned nurse) could find. We gave a lot of IM injections in those days -- something that fortunately seems to be less and less common.

This is getting long, so I'll stop. Thanks for the trip down memory lane.

[Ruby Vee, BSN]

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

Yes, that was true. I remember one lady who had to have her highly cocktail -- the liquor was locked up in the narcotics box and the recipe for her cocktail was on the MAR. She used to accost the AM nurse every morning and demand to check the level of liquor in her bottle to make sure the night nurses weren't drinking it.

[Ruby Vee, BSN]

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.

I find that I'm not groped nearly as much now as I was in the 80s, as well. Do you think it's partly because we're older now?

[PMFB-RN, RN]

It was the male nurses who advocated for us to be allowed to wear scrubs. As my husband claims, the white uniforms they were forced to wear made them look like butchers or bakers. We fought hard for the privilege of wearing scrubs, to decide what we wanted to put on in the morning when we dressed for work. All of those gains we made, today's nurses are throwing away because they WANT to look uniform. Ah well.

This breaks my heart. Its like factory workers saying they don't want decent and safe working conditions that the unions fought for back in the day.

I started my nursing career wearing all white. Mostly I wore white Levi 501 jeans and a white polo. My manager hated it (white jeans), but it complied with the dress code, which specifically forbid "blue jeans".

In the late 90's I signed up with a local agency. They sent me a copy of their (obviously old) dress code that stated "all employees will wear a brazier at all time while on duty". I SOOOO wanted to go and buy the largest one I could, stuff it and wear it to make a point, but I needed the work.

Whites were AWFUL! Now I see nurses just throwing away things we fought for like scrubs, 12 hour shifts, ect and it breaks my heart.

[Kooky Korky, BSN, RN]

I don't recall us having ultrasound or CT scans, definitely not MRI in the Seventies. Only X Rays; maybe Ultrasound - I don't recall exactly.

Very limited visiting. There were set hours, like 2-4 and 7-9 or something like that. Bathing and bedmaking had to get done early so visitors wouldn't see that happening.

Parents could not stay in ER with kids getting stitched up. I'd have gone nuts if I'd been forced to leave my ill child alone in the ER or on the ward or in the ICU. No one was allowed in L & D, even fathers were consigned to the waiting room pretty much.

[Kitiger, RN]

Nurses smoked, too, but not in the nurse's station. The break room had a constant blue, smoky haze and I couldn't even go in there without my throat closing off. Patients were allowed to smoke in their rooms -- even in their beds. After a few patients set themselves on fire smoking in bed, in some cases while wearing oxygen, that was considered to be unsafe and it fell upon the nurse to explain to the patient who was allowed to smoke in bed when he was here for esophageal varices last month that he could no longer do so. Then we had to take them outside to smoke . . . That task usually fell to a nurse who wanted her own cigarette break.

I used to dread having to go into that smoke-filled break room for report. I didn't go in until the last minute, and I came out as soon as I could. It was hard to breathe in there, and it made me cough.

And then, I had to explain to my patients that they couldn't smoke, when the stink of the cigarettes permeated my clothes.

No, I have never smoked! My Mom, on the other hand, was told as a student that she was not allowed to smoke, so she started! She used to laugh about that. She quit smoking when they got us, as she didn't want to teach her kids to smoke. (My Mom was the only person I knew who could smoke while on vacation, and then not smoke when we got home.)

[Feral.Cat.Herder, RN]

Those were the 80s I remember them as well!

[sjrosenfeld91]

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

Hey, that still happens!