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!