Sitting at my husband’s hospital bedside recently, I marveled at the changes I saw in nursing since I retired just seventeen years ago. I know I sound really old, but here’s a list of what I saw being done differently:
The endless use of gloves: I only wore gloves if a patient was in isolation.
Computerized charting: I charted on a clipboard at the end of the bed and on medication sheets in a notebook on top of a medication cart, later placing those sheets in an aluminum or plastic top-loading binder kept at the nurses station.
No overhead paging and nurses carrying phones: Overhead paging was at a minimum in my late practice, but nurses did not yet carry phones for communication.
Nurse practitioners as hospitalists, along with physicians: There were no hospitalists in the hospitals where I worked, nor were there nurse practitioners. (Hospitalists are defined as in-patient physicians who work exclusively in hospitals.)
Nurses giving lab results to the patient: When I was practicing, physicians relayed all results to patients. We’d have to wait for hours for the results to “get to the floor” and then tell patients they would find out the results when their doctor came in (or the intern or resident). Now, the nurse told us one result just twenty minutes after the blood was drawn. That was so much nicer than having to wait and worry!
A spaghetti arrangement of tubing looped on and over and around the patient: At most I dealt with two IVs, a chest tube or two, a stomach tube, a wound drainage tube, and a urinary catheter. And maybe an oxygen cannula. My husband’s array of tubes prompted him to ask what the stats were on patients dying by strangulation.
Practically instant dietary service: I’d have to “call down” for food for a patient at an off hour and then wait for a long time to get the food. Here the nurse called down, talked personally to “Tom” who said he was finishing making some sandwiches and would be up in a jiff. And he was.
Written materials assuring us of hourly rounding: We had no such thing. Patients would never know exactly when we’d be coming back. If they needed help, they would press their call bell and hope someone would come within a reasonable time. With assurance of hourly rounding, if a need isn’t an emergency, the patient knows that someone will be checking in and they can get help then.
Being discharged ambulatory: We always had to take our patients to the front door in a wheelchair. We had to make sure they got in their cars safely. We were told we were liable to be sued if anything happened enroute. On the contrary, my husband and I practically ran a race to get out the door and to my car!
I’m sure more things will come to mind as time passes, but I wanted to get these things down before I forgot them. I was enormously impressed by the improvements in care and the expansion of the nurse’s role. In my early days, we even had to call the physician for an order to shampoo a patient’s hair.
So, I want to give a shout out to all the nurses of today who are knowledgeably and competently carrying on in the profession I love. Those of us who are aging know that the likelihood of our waking up to see a nurse grows every day!
Write Along with Me 
I also marvel at some of the changes in nursing from when I started in 1974! I thought $8.00 per hour was like – WOW! I’ve arrived! Back then in our little hospital people were admitted overnight to receive a complete physical which included a sigmoidoscopy and an EKG. We had to set up all of our patient medications in little cups on a tray with a little card telling the name and room number. The tray was carried from room to room as we passed out medications! We also mixed all of our IV medications and had to calculate dosages for pediatric patients. And we had to wear hats! My school had a really nice hat, but I am thankful that those are a thing of the past! And I am thankful to be retired from the profession!!! Thanks for sharing! I enjoy your posts!
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Thanks, Denise! I graduated diploma school in 1962 and remember all the things you mentioned. Those overnight stays for tests are a fun memory! And those med cups—if somebody bumped you in the hall, they’d go flying. I still have one of my caps, yellowed but still full of starch. We sound like museum pieces😊.
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Ah yes, the changes. When I first started working after graduation in 1960 I earned $17.25 per day – worked out to about $2.15 per hour. Over the past 3 years my niece has been in and out of the hospital and ERs. Things I’ve noticed – prefilled saline syringes for flushing IV lines; showers, not bed baths, and at any time of day per patient preference; pre-packaged tape for securing the IV line in place (no need to cut lengths of white adhesive to secure the needle in place); scrubs specific to unit or hospital in place of white uniforms; and almost any comfortable shoe goes. Plus probably multiple other changes. Hospitalists, yes, but I don’t like them. I think it affects continuity of care due to lack of communication with family physician. But the thing that strikes me most is the 12 hour shift that now seems to be standard despite research evidence that it is not the best from both nurse and patient perspective. And the craziest shift of all, 3 am to 3 pm (or 3pm to 3am). I would hate to be driving to or from work in the wee hours of the morning, especially during a winter snow storm. At least nurses no longer have to sharpen needles and clean syringes! I recall doing that as a young student. Disposable syringes a vast improvement over glass syringes. Dating myself.
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As a ‘62 grad, I’m right behind you! Glass syringes and autoclaved needles that bent when they went in. Oh my! Fun memories, though.
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Cynthia,
I read your account of the experience in the hospital setting. I too marvel at the changes in the nursing profession, – some good, most not. I have spent 35 years as a Masters degree prepared RN who has worked in multiple areas of nursing. These settings have both inside and outside of the hospital setting. I am shocked at the changes on “both sides of the table.” Both hospital and nursing administration appear to view the hospital nurse as an enemy, as someone who automatically must be seen as the “other.” Therefore, the resources and attitudes toward the floor nurse are regulated and restrained.
The quality of the “nurse” working on the floor in a hospital setting has definitely changed. Anyone who puts on a pair of scrubs can now call themselves a “nurse.” The wearing of a name tag is definitely a thing of the past. Every CNA and technician wants to pretend that they are educated and versed in the fine art of nursing and healing. When a staff member enters the patient room they do not identify themselves or tell the patient what they are going to help them accomplish.
I also agree that the 12-hour shift is not beneficial for either the practitioner or the nurse. It is however financially helpful for the hospital investors and profiteers. It is beneficial for the hospital budget to pay two nurses for a 24 hour period instead of 3 nurses for a 24 hour period. Therefore, there are fewer employee benefits to provide also. It’s a good thing for the hospital, it’s a profit maker.
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It sounds like the dollar dictates all. Scary. Thanks for your perspective.
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The latest issue of Journal of Christian Nursing contains an interesting article on the impact of 12 hour shifts on nurses (Kupperschmidt, B. “12 Hour Shifts: Literature Reviewed, Wise Use Challenged,” Journal of Christian Nursing 35:1, 26-32). [Sorry Lois, my APA is rusty]. It addresses the negative impact of such shifts that includes such outcomes as acute and chronic fatigue, decreased vigilance, sleep deprivation, neurobehavioral changes, etc. And all of this can negatively impact patient care. It’s too bad the bottom line has become a driving force.
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For sure. I asked several nurses how they liked their 12hour shifts and they all liked them because it gave them more time at home with their families. As a patient’s wife, I liked the continuity too😀.
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I enjoyed reading your article. I am writing a book on my 3 year nursing class called the Mercy Girls. I have been reading books on the history of nursing as well as medicine. I worked more recently than you. It was the nineties where much of what is in place today was in practice. Cell phones and scanners hadn’t reached us but most computer technology was a normal practice. My experience of recent years has been with nurse practitioners who are excellent. Hospital nurses seem to be task oriented with clearly defined skill sets to perform and not as impressive as nurses I’ve known from ICU or CCU.
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Thanks, Mary. What a nice idea to write about your class. Our stories reflect an important historical era. I retired in 2000 and, as a clinical instructor, I was oriented to the “new” computers, but not allowed on them. So my students did their charting on pieces of paper and gave them to their primaries to put into the computer. I’ve not been on a regular floor lately, so I can’t speak to that. Unfortunately, our experiences have been mostly ER or specialty areas! I love to reminisce. Nursing will always be in my bones!
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My last position before retiring was as a Care Manager for a surgery department at the Veterans’s Administration at Nellis AFB in Las Vegas, NV. This was the culmination of my nursing career. Most of my patient encounters were in a clinic environment and entered into a digital patient record. However, my career began in NICU in Honolulu, HI using the hand written chart to document my encounters. I surely have seen an evolution…
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I know! So many changes. Remember glass IV bottles, funnels for enemas, counting drip rates… I feel nostalgic about it all! Must really be getting old. Ha.
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I still remember that first time that I saw an IV infusion pump on the Med/Surg. floor. I couldn’t understand what its’ function was. I had been calculating dosage and using the drip factor for years and now all of a sudden a machine could magically figure this out ????????? However, I quickly learned that if I let it, the machine could “run” my life.
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I never learned to use the pumps. As an instructor, I was not allowed to have my students work with them, so I didn’t either. Now it seems like all they do is beep too often!
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