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January 06, 2007
Those Were The Years!
Beka - I just came home from working all weekend in the ICU. I watched the Times Square Ball drop from a patient’s room on New Year’s Eve this year. Over a million people had crowded the Square.
Thinking about another new year makes me remember the good old days. Beds were non-electric. One had to use a crank at the end of the bed to raise the head or the foot of the bed. Blue air mattresses and egg crates were used to prevent bed sores. Ace bandages were wrapped around a patient’s legs as DVT prophylaxis --Venodynes had not yet been invented. Chloral Hydrate, Halcion and Xanax were the agents of choice for sleep and the control of belligerent, anxiety-ridden, and confused patients. SOAP notes were the standard form of nursing documentation as were nursing diagnoses. (What happened to them? Are they still in use?) Today electronic computerized charting is the way to go. Dinamaps or automatic BP cuffs were used in the ICU. Glass suction bottles were used, as were the dirty utility rooms. Glucometers were just becoming vogue for patients with diabetes who had used glass insulin syringes and urine testing kits for years. Arterial lines were nonexistent. Pavulon was the drug of choice for the paralysis of a patient. Ventilators were called “Bear 1, 2, and 3.” Bretylium drips were used to control arrhythmias. Pacing Swans were used more often than not. Insurance plans covered all aspects of care. Appeals were not necessary.
In some ways, it seems that nursing has come a long way, evolving into a high-tech job. Our median salary in 2005 was $54,670. Twenty years ago it was a third (or less) that amount. Are we headed for a few more good days? The projected job openings for RNs from 2004 to 2014 will be 712,000!
Tell me what you remember from the good old days. And what are your thoughts about what lies ahead for nurses?
January 6, 2007 in Beka | Permalink
Comments
I can't image what it was like without IV pumps!
Posted by: MTRHealth IV Pumps | Jul 26, 2010 11:26:10 AM
This is my first time visiting your blog and i must say i like it a lot.
Your message was a good read.
I will definetly check back here more often!
hooka
Posted by: hooka | Aug 27, 2008 2:35:17 AM
I graduated from a 3 year diploma school in 1978. We went all year long until it changed my junior year. I remember when hair had to be off the collar, uniforms were all white. Caps were mandatory. Only navy blue or white sweaters could be worn. No polish on fingernails which had to be short in length. You were not to fan the linens when making the bed. No fitted sheets. Everyone got a bath daily and everyone was assisted at least with washing their back. Feet were soaked in a basin of water while sitting in the chair. Preop medication consisted of a series of 3 meds; one oral such a Valium and the next about 30min. later of a narcotic and antiemetic given IM. The cafeteria was on the Mesanine floor. The usual choice of color on the walls was of the greenish persuasion. The head nurse would follow the doctor around while he made rounds and take notes of any changes he made. The style of cap worn revealed the nursing school you attended. Caps were not to be worn while you traveled to and from work. It has been fun traveling down memory lane.
Posted by: Michelle | Apr 6, 2007 1:20:09 AM
Graduated in 1987.
I remember in my peds rotation pulling some urine out of a diaper and dropping it into this metal tube in the dirty untility room that would calibrate the specific gravity.
Remember placing a drop of blood on those glucose strips that had different shades of blue on it. You would then compare the shade of blue to the back of the bottle to get a range that the blood sugar was in.
Remember aminophylline drips? and Isuprel drips? Putting 2 posey vests on people... one backwards to provide "extra" security?
Posted by: mom | Mar 19, 2007 9:28:11 AM
I remember giving Morphine IM for chest pain and the advent of cardiac enzymes which included CPK, SGOT, & LDH. Then HBD replaced CPK. Then the breakdown of CPK to CK-MB, CK-BB. I remember when an amp of bicarb was the first thing given during a code and then given every 5 minutes. I remember the stage that ACLS took when we had to do perform "stair-step" breaths on the Resussi-Annie who had a monitor strip that printed out the 3 initial quick breaths which had to show a stair step pattern for us to pass.. I remember giving 5000units of heparin every 6hrs. IV push as one of are r/o MI protocol. I remember smoking in report, in the staff Bathroom behind the desk and monitors so I could keep an eye on things. I remember when the vents we used were the MA-1, then the MA-2. I remember giving levophed to patients through a peripheral IV with no arterial lines and with dynamps monitoring the BP.
Posted by: pamela Smeberg | Feb 11, 2007 4:42:26 PM
I graduated in 1965 after a 3 yr program. I worked abt every area at one time or another. I have seen all the changes nentioned. Things that come to mind additionally are (chronological) rising when Drs came into the station or allowing them to go into the elevator 1st, routine qid rubbing Sunlight soap into bedsores (who heard of gloves on the ward) and using a lamp to dry. Glass chest drainage with latex tubing. Strapping broken ribs with Ace then Elastoplast bandage. Mercury thermometers in own holder at bedside. Mercury lots of things! During student rotation having to gavage preemies with a syringe and red rubber cath (never worked there again) Worked CCU when the latest was to premix Lidocaine boluses at each shift rather than run in and open up the minidrip when VT occured. Monitor leads were held on with 3 suction cups and a latex strap and the video that kept the 10 sec delay had to be rewound q 8 hrs. It worked and patients lived more than you would think. Because of good nursing care, I believe - healthy food, real baths, and Valium (or Librium/Haldol for very stressed...LOL). I worked 20 yrs Cardiac ICU and now many yrs in homecare. This is where I feel I make the most difference. Over 40 yrs and still giving - tho we have to make a living, it has never been primarily the money. Cudos to the young ones now doing the hard, stressful stuff, to you we give the torch. All you can do is your best. You will build your own history, so build one you will be proud to tell.
Posted by: Carol | Feb 1, 2007 9:26:16 AM
I remember when I use to scrub in the OR and having to thread the needles with loose suture and make our own reuseable needle books. I also see the BIG difference in the bedside nursing of today vs yesterday when I worked the floors. The patients are not cared for the way they use to be. We use to have to get the pts out of bed, dangle and sit them up in a chair. The bedbaths of today is not a bedbath and nursing assessments are not head to toe any more....
I still do not believe we are not paid what we are worth!!!
Posted by: Debra | Jan 31, 2007 9:50:25 AM
I remember doing peritoneal dialysis using glass bottles and a dixie cup cut to secure the abdominal catheter! We warmed the bottles in a sink of warm water. I also remember smoking in report, and doctors coming into the ICU with pipes and cigarettes. I also remember ice water lavages for GI bleeds until your fingers pruned because we didn't wear gloves. We always thought about that afterwards. Thanks for this opportunity. I have enjoyed reading all of these postings. Nursing certainly is a labor of love.
Posted by: Pam | Jan 31, 2007 8:43:11 AM
I remember being told by my nursing school instructor that "the hospital is no place for laughter".
I recall a neurologist that would take every opportunity to (grab) a nurse and get her to sit on his lap. I remember giving up my chair to doctors when they entered the nurses station, regardless of how busy I was. I remember having to place the rubber NG tube into ice in order to stiffen it for easier insertion. How about (accidentally) dropping a vial of mercury on the floor, and then having a good laugh (or cry) as you tried to scoop it up?? I can't count the number of times my nurses cap fell into my sterile field. I remember putting a cut onion under the patient's bed in order to quell odors (ya, I still don't get it). I remember having charts thrown across the room by irrate physicians....oh wait, some things never change, but NOW I write them up:)
Posted by: Cathy | Jan 25, 2007 12:32:27 PM
We may have advanced in technology and some other areas but our advances in being recognized as professionals equal to physicians has not. If nurses were not there to care for the patients, hospitals wouldn't need to fall over physicians to bring their patients. The culture of continuing to allow physicians to not be accountable for their own practice has never changed. I don't think i can take the inequities anymore. How much have salaries increased over the years? Is it equal to the number of times a nurse continues to get yelled at in the clinical setting by a physician? Physicians don't answer pages and then claim they were never paged or they had to "wait" to long for the nurse to come to the phone. They run in and spend 3-5 minutes with the patient and we pick up the pieces. What kind of health care system have we become. Nurses today want to work 12 hour shifts so they can work at two hospitals and work way too many hours. Travel nurses and agency nurses don't want to be accountable either. If no one is accountable, how can we ever provide good let alone safe patient care....One nurse looking to buy a Starbucks!
Posted by: kathy | Jan 24, 2007 7:42:31 PM
Well- how things have changed over time...
Anyone remember using plastic buckets filled with crushed ice to perform a cardiac output !!
Wow- nurses smoking at the desk ? Nowadays things would go up in flames after a few puffs...
beka
Posted by: beka | Jan 19, 2007 10:49:46 AM
Everything changes. I do remember so many of the things everyone has posted. Gomco suctions, glass bottles for chest tubes, white dreses , caps etc. Physicians, nurses and patients all allowed to smoke throughout the hospital. I remmber being scared out of mind as a new Graduate-Nurse and when we signed our charting with a GN number.
But I disagree with the post where there is no more patient contact. I stll can calm my frightened, fresh post-op CBAG by talking quietly and confidently to him or her and by stroking his/her head or arm as I reassure him and let him know that ETT will only be temporary .
And there you see---some things never change.
Power to the Nurses !!!
Posted by: Therese | Jan 16, 2007 8:41:34 PM
I remember working 10 12 hour night shifts straight then 1 day later back on for ten days shift. We could still find the energy to go to a nightclub until 6.30am. We worked split shifts and non resident nurses were allowed to rest in the sitting room of the nurses home. At 1pm we would remove our starched collars, aprons and cuffs, wrap ourselves in the black nurses cloaks (UK) and sleep until back to work at 4.30pm, Very handy after those nightclub nights!!
Posted by: Pat | Jan 15, 2007 2:03:42 AM
What a wonderful blast from the past it is to read all your comments! I started nursing in 1976 (after teaching school for 10 years) and am still working fulltime as a hospital-based peds RN. I also do a great deal of precepting of new RNs (also also RNs new to our hospital) and often regale them with stories from the "good ol' days."
Curiously, on my very modern unit, which seeminly has the latest, greatest everything, we still do use some of the old therapies, remedies, etc. For example: milk and molasses enemas (works great with kids!), ACE bandages on legs for DVT prophylaxis, vinegar/water soaks for dry and crusty feet, wet-to-dry dressings for open wounds. As well, we still do have docs who write their D/C orders on the condition of the completion of patient/parent teaching (by the nurses).
Thankfully, we are assigned fewer patients to care for than in days of yore (max. of 4 on my floor); however, the accuity is higher with every passing year. Patients who would have been in the ICU 30 years ago are now cared for on general medical floors (chest tubes, vents, and all).
Although I am grateful for some of the new technologies, in some ways the "good ol' days" really were!
Posted by: Sally | Jan 14, 2007 10:14:14 AM
I have a big smile on my face..what a great trip down memory lane! Here's a few that came to my mind. I can remember feeding cataract patients for 5 days..and sand bags on either side of their face for the duration of their stay! Every patient being prepped for surgery recieved an enema the night before. And who can forget soap and water baths for all! Shaving the face of a male patient was part of A.M.care. Bucks traction, Thomas splints, side-arm traction ..and we set it up! Remember the white "clinic" shoes?? I thought they were very stylish and comfy.
I'm afraid that for most nurses, the days of hands on nursing care is a thing of the past.
Posted by: Kathy | Jan 12, 2007 7:25:22 PM
I graduated in 1963. My student public health rotation included homes w/ no indoor plumbing. The families had to have a pitcher of water & basin for handwashing. My first job was in a TB Santatorium. Stretomycin IM was big there. We checked the metal needles for burrs and sharpened needles daily. On my next job we had a young patient w/ Guillian Barre syndrome who begged not to go on a vent, so our Dr. had an old iron lung brought up for her. The state police had to bring the replacement rubber gaskets from the airport where they had been rushed from the manufacturer. The thought of a RN starting an IV was just begining to be considered. I had great teams w/ my LPNs, aides. Back then the LPNs had 18 months of training. And todays associate degree nurse has 2 years! Are there even any LPN schools left? I really enjoyed the hands on care too. Eventually I became a NP because floor duty was too physically demanding and I wasn't interested in administrative duties. As a NP I had more direct patient contact again. What a long journey it has been.
Posted by: Louise | Jan 10, 2007 11:56:02 PM
I REMEMBER GLASS CHEST TUBES BOTTLES, TUBEX SYRINGES FOR INJECTIONS, GLASS IV BOTTLES, GLASS THERMOMETERS, GOMCOS FOR NGS. WE MIXED ALL IV AND ANTIBIOTICS..ALSO CHEMOS WERE MISSED ON FLOOR. WE TOUCHED EVERYTHING BREATHED IN EVERYTHING WHILE IT WAS MIXED. MY FIRST CODE..I LEFT MY NURSES CAP HANGING ON THE OVERHEAD TRAPEZE WHEN I DID CPR. I HAVE BEEN DOING THIS FOR 30 YEARS NOW AND BOY HAVE THINGS CHANGED..I HAVE A DAUGHTER WHO IS NOW AN RN IN EMERGENCY ROOM OF LARGE HOSPITAL AND ALSO HAVE ANOTHER GOING INTO 3RD SEMESTER OF NURSING.
Posted by: DARLENE | Jan 10, 2007 11:29:19 PM
I remember all of the above started nusing in 72' is that a long time? seems like yesterday. Anybody remember pt swallowing mercury weighted balloon for small bowel obstruction? Sure, we mixed up all of our own chemo for patients on the floor and there was no hood. We boiled glass syringes and taught diabetic patients how to care for and reuse needles and syringes (my husband was one of them). Glycosuria and or ketonuria was the only way to monitor diabetes. No gloves; we didn't have aids to worry about. Team nursing with a designated number of aids and LPN's for patient loads of up to 25 at times, of course we couldn't leave the floor for breaks if we were the only RN on the floor. As team leaders we knew our support teams and they were as good as we taught them to be. We didn't have an ICU initially. When we did have capability to monitor patients, tele patients were on the floor and ICU called the floor and told us to go check the patient if they saw an arrhythmia. Heart problems were dealt with by rest and wait treatment. When we started developing "code teams" intracardiac injections were often part of the heroic effort, there was no standardized ACLS. You are so right, a big injection of PCN was the ultimate antibiotic. Lot's more... but we were very cognisant of nursing niceties too, back rubs were a part of HS care, teaching and patient understanding of what was going on was a priority, we didn't have hospices it was a new idea, we had to prepare patients and their families for what they would experience and how to cope. Oh, and a big one, in those days in my state we had in patient facilities for people with mental illness needing psychiatric supervision and medication, when I went to school our psych rotation was in the state hospital, patients ahd daily group sessions with peers and weekly sessions with the psychiatrist they always got their meds, and they had food, clothing. and housing taken care of. Now I see these patients in the ED on a daily basis: they are street people who are looking for a meal and shelter; or they haven't taken their meds because they can't afford it; felt better and didn't need it; forgot how to get it; or they are being taken care of by the state in the jail system and don't get treatment or meds unless they have an acute episode (then they come to see us). Of course we can only hold these patients in the ED until a psych bed may become available. I am not sure this is better for these people or for society, I think our system fails them profoundly and this makes me profoundly sad.
Posted by: wendy | Jan 10, 2007 8:41:37 PM
I gradualted from a deploma program in 1983. I remember my first job, mixing chemo agents without any protection, no airflow. I mixed all the IV meds. Drew up heparin flushes, saline flushes. I remember walking into the nurse's station and a cloud of cigarette smoke hitting me when I came to work for my 11p-7a shift. I remember my health insurance premium was $6 a paycheck. I remember being taught to give all my pts a back rub as part of thier pm care.
Posted by: Amie | Jan 10, 2007 4:25:13 PM
Hi there,
I've enjoyed reading all your posting. Wow what a great way to make that trip down memory lane huh?? I graduated 25 years ago and am currently working in public health in Southern Ontario.
What I remember is fighting the curtains with my nursing cap and not having enough pins to keep the darn thing on. How many of us came out of a room all disheveled from getting caught up with the bedside curtains? I also remember the uniforms being white only and how excited we were to finally be able to wear coloured uniforms and decent running shoes ...
When I worked in the hospital, I mostly worked on Peds and I remember the night when USA started bombing Iraq. I was rocking a young child who was dying of leukemia. His parents had left for a quick bite to eat and I remember watching the news channel with tears in my eyes thinking that the world as we knew it was going to change and would not be the same again. That moment is forever in my mind ... I also remember to good times and the dark humour we would sometime engage in when faced with difficult situations.
I sometimes miss the hospital setting but have been away too long to be able to return to the fast pace it has become.
Posted by: Nik | Jan 10, 2007 1:44:20 PM
I graduated in 1966 from a Canadian hospital school. I remember all of the above and I did use a mustard plaster. My memories include also:
mercury thermometer metal holders with alcohol in them by the beside; paying for any thermometers you broke at 50c a piece; metal forceps in an antibacterial liquid the fumes of which burned your eyes; mixing morphine tablets with sterile water for injections;wagenstein suction; loadable OR suture needles as well as 'swedged on'; making tonsil packs in the OR utility room on evening and night shift and being in charge of the ward on weekends and nights as a second year student.
I no longer practice but am a lawyer providing health care advice to hospitals and other facilities and organizations. I'm still an RN though and my experience continues to serve me. Not sure I could nurse on the floor now, too strenuous let alone I'm out of date. Kudo's to all of you who are still nursing directly.
Jen
Posted by: Jennifer | Jan 10, 2007 1:13:46 PM
As I read all these over, it brings back fond memories, smiles and some winces. We did survive and survived well back then. I miss sitting on the bed with a patient teaching, reading, keeping a patient in rehab until they and we were ready for them to go home, not knowing what the payor source was because it wasn't any of our damn business and it didn't matter anyway, working in a teacing hospital where every moment was a teachable moment, new interns and residents (all the while dreading July 1st of every year), wearing whites and our caps, not looking at the clock to see if it was time to go home...it would come fast enough and probably working a double any way. How far we have come...my first job as a GN was $6.50/hr but rent was only $300/mo, no gloves, no worry, and yes smoking on the unit...got a lot more work done. Every era brings its challenges...I'm glad I lived as nurse when I did and appreciate everyone who is one now...
Posted by: lisa | Jan 10, 2007 11:37:07 AM
I remember when betadine was new, and we almost killed our head nurse by leaving her in bed for 2 weeks after a laminectomy.
Cardiac patients begged for liquids that were cold or hot, not just luke warm.
and of course, my favorite thing to remember was that in the city hospital where I worked we had open windows with no screens. We,too, smoked in the med room and in the treatment rooms.
Who remembers hoppers that you slide the bedpan into?
once I dropped an empty metal bedpan in the MICU and a patient with tetanus seized until her death 2 days later.
Barbaric!
Posted by: anita | Jan 10, 2007 11:09:22 AM
I remember when we assessed patients by looking at them, not monitors. We cared for patients at their bedside, not sit in stations with banks of monitors that had readouts of heart rate, blood pressures and anything else you can measure.
I miss patient contact, being able to touch my patient without having to "glove up". I love being a nurse and I don't want to be distanced from the bedside.
Posted by: Phyllis Smith | Jan 10, 2007 10:37:27 AM
It's been almost 40 years (June 7, 1967) since I was graduated from nursing school - with my BS degree. In some ways it seems like yesterday but in reviewing the changes it seems like centuries.
Setting up meds in the med room on a metal tray while smoking a cigarette (yes, it's true)and, as someone has already mentioned - who wore gloves (yuk!). Pressure ulcer treatment was so barbaric - maalox, rigging things up to tape the buttocks to a side rail and turning on the heat lamp!! We weren't allowed to wear pants!! (can you believe it - in the era of the miniskirt, no less).
Counting the micro or macro drips - heaven only knows how many patients we may have harmed with miscalculations!!
I remember that cardiac monitors and CVP lines (glass ones taped to an IV pole) were such great tools for monitoring patients!
Also, yes the crank up beds - at least it was a way to get in a little more strength and flexibility training on the job.
Peritoneal dialysis was a BIG deal and only done as an almost desperation measure.
My first annual salary was a about $10,000 and I thought it was great - and that was living in New York City!!!
Those were the good (??) ole days. We sure have come a long way - and still have a ways to go... Happy New Year all.
Posted by: Suzie | Jan 10, 2007 10:36:01 AM
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