working on the old-style wards

[RNperdiem]

In so many historic nursing pictures I see the wards. They have about a dozen beds along each side of a long open room.

My uncle remembers starting on a 6-bedded ward at the VA when he graduated in the 70's. An Aunt in the UK remembers when her hospital discontinued the last traditional ward not so long ago.

I have worked in private and semi-private rooms. I worked one day in the PACU with ICU patients boarding there. I liked being able to see all my patients easily.

Has anyone worked in a setting like that? What did you think? Did it affect patient care for better or worse?

[sissiesmama, ASN, RN]

I was a patient -- rather I was tortured -- as a teenager in 1971 in one of the last Scottish Rite Crippled Children's hospitals, which had those old wards with the old staffing system and horrifically poor pt care. It is a world unto itself, that has thankfully disappeared from the U.S. This particular hospital was torn down in the early 1980s and was forced to revamp its entire care system when the new one was built. There was maybe 1 or 2 RNs on the floor, LVNs and CNAs provided the care, for very sick kids. I was literally dying of several complications (massive wound infection, high temps, DIC) and did not get adequate treatment that if I was in the private hospital on the other side of town I would have been in the ICU. My family was deemed "low class" by the orthopedist which is why he funneled me into that hospital and not the private one. I have a copy of all my records and this is all documented. Documentation was abysmally poor and would not meet any current standards. I won't forget the metal bedpans, the forced enemas, the rude and rough CNAs, the awful smell of the sheets, the rock hard bed (agonizing after back surgery), the lack of PT/OT, horrible food, families only being able to visit 1 hour a day and could not bring food or treats in, the lack of adequate pain medication (I was told I would become an addict if I got enough morphine), the wound debridement in the room without anesthesia of any kind, the near death experience .... it just goes on and on. I cannot make this stuff up. I was so thin and sick my mother actually snuck in some food I liked a couple of times, and she is scared to buck authority. That was my adolescence. Those hospitals are a whole different world the rest of society knows nothing about. I'm not the only one with a horror story, either.

Selke - My God, that is horrible! I am so sorry you had to go through that, you are blessed to have lived through that ordeal! Those kinds of nightmares, you just can't fathom experiences and living through them to tell about them. I know you are a blessing to your patients!

Anne, RNC

[annmariern]

I trained in a old victorian hospital, in the mid 80's in the UK. It was good to be able to look up and see all your peeps and what they were up too; they could see you to and therefore didn't think you were off filing your nails if you weren't with them. people also seemed to behave a bit better for having an audience of other patients. Maybe that was just the times were different. pts had a sense of camaraderie too. The privacy was non existent, germ city with them so close. Had a friend working with paraplegics, one was having a particularly bad time adapting, very angry, hostile and generally giving the staff hell. He went missing for a few hours once. Seems his fellow paras had reached their limit with him and locked him in a dayroom. When he came out, he was a changed man, seems being shamed by people dealing with the same issues just stopped him from wallowing in his misery. Pt power. Can't imagine that here in the US now though.

[Natkat, BSN, MSN, RN]

Aside from the lack of privacy and the infection control issue, I kind of wish that wards still existed. At least patients would realize that it's not a hotel and there are other people who might be worse off. They might be more tolerant of the nurse not being by their side every second.

Just the other day I was feeling so frustrated at having to move furniture around to accomodate my dialysis machine. I was thinking of how ironic it is that, while today patients spend less time in the hospital than they ever have in history, we do more to make it more like home for them.

And as for infection control, I don't think having upholstered furniture in a room is a good idea. I was returning a patien'ts blood and opened a clamp. A mixture of blood and saline shot out of the line and sprayed all over the overstuffed chair. This was a new patient and we hadn't gotten back his Hep B titer or HIV test, so who know what the status is. I did what I could to wipe it up but most of it was absorbed by the chair. If this patient has Hep B it is now happily living in the chair.

[abbaking]

open wards are still around in the USA - its called the emergency department. Our ED has 26 beds in a circular layout with the nurses station in the middle.

[madwife2002, BSN, RN]

I have worked on may old type wards, the last time in 2005 just before I came to the US.

I like working on old type wards because I can see all the patients and know what is going on at any time, especially when a pt is very sick.

But a huge lack of privacy for the pt.

Nursing wise very easy as you are not in and out of rooms continously

[RNperdiem, RN]

My mother has told me of her stays in the Labor ward in the 1970's in Jamaica. She said the call bells were literally bells. The little bells rang all over the ward the whole time she was there.

[XB9S, BSN, MSN, EdD, RN, APN]

In my first hospital we had bells , you've just given me a blast from the past I'd almost forgotten that.