What’s changed since 2004?

That’s working on twenty years out of practice. I’m sure so much has changed. I would think you’d need more than a simple refresher course, as I know so much has changed practice wise since I started 7 years ago.

Good Luck. I think you may find this more difficult than you envision.

EMR

Patient attitudes. There's been a hotel.attitude for ages. It's now 100x worse.

Staffing ratios (except CA). You will take care of more patients with less resources, both human and medical supplies

So much has changed since I started in 98, I don't think I can type an answer that long.

I would talk to HR where you plan to apply. You have been out of the game a very long time, and it's going to be an issue, regardless of taking a refresher course. The nursing shortage is a myth, except in select locations and/or specialties that has trouble with staffing. I wish you all the best on your job search, keep us posted on how it's going

Thanks. Yep, I’m taking my time to explore the idea. When I went into nursing before, it was through an accelerated BSN program and I really think everything about how I went into it before was just too rushed.

According to the BON where I live, all I need is a nurse refresher course (it does involve clinical hours). But I know myself a lot better now than I did then, and I know better than to rush back in with only the refresher course. Hence the reading and researching and exploring on my own first (including rejoining Allnurses to talk to currently employed nurses!).

And I know 15-20 years is a long time. The world, in general, is so different now than it was then! I know the technologies, tools and practices/skills will have changed. I’m guess I’m mostly asking here about things like structural and organizational changes—like the implementation of RRTs etc.—and any big-picture trends. Thank you!

I think that the issues you're focusing on (RRTs for example) will be the least of your concerns if you get back in. Honestly, getting familiarized with those kinds of changes will come quickly; it's the hands-on practice that you would do best to concentrate on.

(Also, they're not uniform changes and people who are currently practicing still have to make adjustments/get used to it if they change employers...)

42 minutes ago, Jedrnurse said:

I think that the issues you're focusing on (RRTs for example) will be the least of your concerns if you get back in. ... it's the hands-on practice that you would do best to concentrate on.

Of course! Hands-on practice will definitely be the bigger focus and concentration. I’m just *curious* about anything that’s had a really big impact on the profession as a whole in the last 15-20 years—if anything.

1 hour ago, Jedrnurse said:

I think that the issues you're focusing on (RRTs for example) will be the least of your concerns if you get back in.

Agreed. Pharmacology, diagnostic testing and treatments have exponentially changed in the past 2 decades.

"What’s changed since 2004?"

Absoluty everything (ok 95% of things) and none of it for the better (ok maybe 5% of things, example RRT was a good change).

5 hours ago, RenRN said:

Have there been any really big changes in the last 15-16 years, things that have changed what it’s like to work as a nurse?

Lack of autonomy, lack of resources, lack of leadership, customer service models. All of these have had a huge impact on the profession and on the individual nurse (and not a good one).

I dont want to sway you from nursing, just want to be realistic as that is what you are asking.

The patients are sicker, a pt that would of been in ICU IN 2004 is now managed on the floor.

Pharmacology, NOAC, DOAC, Insulin, OHG agents, new meds of every class. New indications for old meds e.g. thalidomide.

So many things that my brain is trying to remember all of the changes since I graduated in 2006.

EMR...

The IV pumps have computers so in ICU when we need to hang a drip, we just type in the parameters and the pump calculates the rate. No more calculations like we used to do.

The most obvious change is the electronic med records. It takes longer than paper charting and is heavily audited- some places expect perfect charting. On the other hand, you don't have to deal with the chart going missing. Most of our meds are scanned before giving. This is more cumbersome too, but it really does help decrease med errors if done correctly.

I remember more wildly patterned scrubs in 2004. Things have calmed down since then. We wear solid colors depending on the job. Nurses wear solid ciel blue here.

The ward clerks/health unit coordinators are an endangered species today. There are a few who have not yet retired, but when they do the job disappears. Our CNAs are crosstrained to the job the HUC used to do. Computers were supposed to eliminate most of the HUC work, but the phone still rings a lot and the nurses find themselves picking up the slack.

Visiting hours were already receding in 2004 in many places. They have receded more towards more open visitation.

Orientation is more structured. When I graduated, I never heard of hospital residencies for new grads. Orientation was more unit specific and informal. With plenty of nurses available, some units just never hired new grads at all to save themselves the problem of long orientation.

32 minutes ago, K+MgSO4 said:

The patients are sicker, a pt that would of been in ICU IN 2004 is now managed on the floor.

Some are even now at home or LTC