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November 05, 2008
Imagine Working as a Nurse in 1889!
In New York, Columbus Square, the fall colors have not erupted to brilliant reds, yellows, and golds quite yet. Yet, everyone seems to be taking advantage of the 70 degree weather -- jogging, walking their dogs, strolling along 5th Avenue, and seeking hidden shopping deals at Bloomingdales. I just finished working a 3-day weekend, which wasn’t that bad although my body seems to be in a constant state of movement as my DBS battery has a lifetime of 5% left. Yikes! I've noticed that lace seems to be making a comeback in clothing trends -- rather popular in the 1890s as well!
Can you imagine working in 1889 as a nurse? This list is a partial one of duties left to nurses of that time. (Wonder what physicians were doing?) The list (Nurses' Duties were Different in 1889) starts out, "In addition to caring for your 50 patients, each nurse will follow these regulations:"
* Daily sweep and mop the floors of your ward, dust the patient's furniture and window sills. (Now called the Dept. of Housekeeping or Environmental Services!)
* Maintain an even temperature in your ward by bringing in a scuttle of coal for the day's business. (A responsibility of BioMedical Engineering!)
* The nurse's notes are important in aiding the physician's work. Make your pens carefully; you may whittle nibs to your individual taste. (Anyone know how you “whittle nibs”? I’m clueless!)
* Each nurse on day duty will report every day at 7 a.m. and leave at 8 p.m. except on the Sabbath on which day you will be off from noon to 2 p.m. (Does this refer to Ethnic origin and religious practices?)
* Graduate nurses in good standing with the director of nurses will be given an evening off each week for courting purposes or two evenings a week if you go to church regularly. (Ahh, a prerequisite required to maintain good standing…)
I find this list fascinating as it reflects how much nursing responsibilities and duties have changed over the past 100 years or so. While you may not remember back to 1889 (!), how about those of you who were practicing 30 or 40 years ago? What are the biggest differences you see?
November 5, 2008 in Beka | Permalink
Comments
I am currently in my second year of nurse training and am a mature student. I have found the ward stressful and a negative place to be, until I am with a patient. I feel that nursing should be a caring environment but sometimes is more of a school ground for frustrated and power crazy nurses. I have worked in health care for over 10 years in various settings but since my training have been disheartened at the lack of caring that is shown. Nursing is hard, demanding emotionally and physically but I feel that changes havegone too much forwardwhich has forced nurses to become document fillers and less the carers. Real shame... maybe its the reason for the unhappiness and frustration of nurses as they are struggling to do the very thing they entered the profession for in the first place..... TO CARE
Posted by: CAGODFRAY | Jan 8, 2011 8:10:58 PM
we still mop and sweep the floors.. sometimes we even change light bulbs and transport oxygen tanks..because hospitals in our country are understaffed even though almost hundred thousands of nurses are graduating every year.. but still proud of what we are doing.. :)
Posted by: nelc | Dec 21, 2009 4:15:11 AM
Its awesome to working as Nurse . i think its a great honor to be a nurse and serving and take care the people in the critical condition its amazing .
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Posted by: minakrytnab | Mar 29, 2009 11:00:09 AM
I graduated from a three year diploma program in 1966. My training was much as described by some of the comments already posted. My training was in a county hospital with many training programs in place. My first year as a student I was allowed to work as a unit clerk or nurses aide on the floors one day a week. My second year I was the equivalent of a LVN during my work time. I learned about CPR when I graduated and remember caring for MI patients with the aid of a "bullet" monitor. (No way to recall or record anything and the leads were metal limb leads only) MI patients were kept in rooms with no extra light, no stimulation and not allowed hot or cold beverages or foods and very limited visitors. They stayed on bedrest for 7 days. I also remember caring for a mitral valve replacement patient and being required to replace blood loss cc for cc with chest tube output! Aramine and Levophed were drugs of choice for low BP and hyperstat for hypertensive crisis. Many things have changed for the better and I am happy to say that I would do it again, even though my body tells me this is very hard work. Fortunately, I see some very dedicated younger nurses but also some very arrogant ones. Having a patient or their family member tell you that you did a good job remains the best reinforcement of the value of my nursing practice. Oh, yes: I made $2.13 hr night shift charge nurse wages when I graduated -- that was considered a very good wage for a woman back then.
Posted by: Robin | Feb 15, 2009 7:55:59 PM
I also am a product of nursing education 1970's style, but some of these idyllic memories aren't doing it for me. I never had the hospital laundry doing my uniforms, never ran a floor as a student nurse, never worked anywhere that there wasn't serious discord at one time or another. I DO recall the mercury in everything, the training not to use gloves (to this day, I hate them) the tapes on the glass IV bottles....and what about the glass suction bottles on the floor!!
The point I really wanted to make is, that it's all in our heads, the give and take of what is very often, a back-and -heartbreaking job. Our memories of crazy things like smoking doctors and nurses at the station, and cleaning bottoms without gloves, underscore that change is part of life. My Mom, who nursed in the 1940's recalled a surgeon changing dressings with a lit cigar in his mouth! Maybe in 50 years they will be astounded that a human being did our job at all!
As for me, I have tried to ask my coworkers regularly, if they are doing ok, or need any help. That one detail has helped me to feel appreciated and well-liked at work, because everyone needs help at times.My coworkers scoff at me because I do as I'm told, without howling that I shouldn't have to. Those two philosophies, don't complain, and help others, have kept me working 30 years, and probably will another 30, if some robot doesn't come along to take my place.
Posted by: norma lester RN | Jan 26, 2009 3:57:35 PM
I graduated with BSN in 1962. We had to calculate drops/min for IV's and used tape on glass IV bottles showing how much fluid/hour. We had stock bottles of preop meds we had to draw up ourselves, and stock bottles of aminophyline etc. Of course we wore caps and white uniforms; had O2 tents, just got circoelectric frame beds, formerly used Stryker frames; also had iron lungs on polio floor; learned about CPR. I now work as a Family Nurse Practitioner in primary care. I have been an NP for 32 years as of January 09.
Posted by: MaryEllen Sorensen | Nov 30, 2008 8:04:18 PM
Wow! Alot has changed since my Hunter -Bellevue NYC Graduation in 1975, and alot remains the same. It has become so acute and difficult to spend time with the patients now. I think that has changed immensely. The paperwork is supposedly less now with computer documentation but I do not see that at all, as a matter of fact, I believe we have more paperwork than ever.
I remember being able to take the LPN test as a junior nursing student and working as a float LPN at an inner city hospital on the night shift while attending classes by day. I was the only nurse on "a ward" and to get the medications for pts. you had to call the RN who went from floor to floor with the med. keys.
As a new graduate, I remember starting my first job (1975) in Labor and Delivery during a time when a Nursing shortage was declared. Now that Nursing Shortage has grown to even larger concerning levels. I remember being frightened of the senior nurses who challenged my every move to teach me "the ropes", but taught me well. Lifelong friendships began in those early days of my nursing career.
I remember working very hard (being on call for C-sections and working overtime with out any questions asked) but loving every minute of my job caring for patients. I remember working through a blizzard and living in the hospital for 3 days straight working shifts around the clock ( and sleeping in a storage closet when I was given some downtime) until other staff could get into the hospital to relieve us.
So much has happened in my 33 years as a RN, labor and delivery nurse, Clinical Specialist, Educator, Author, Director of Nursing, Legal Nurse Consultant, but I always look back on my early years with fond memories and I never forgot my early beginnings and the nurses who taught me. When it was my turn to teach the new nurses I never forgot my first days and it always helped me educate the new nurses better.
Posted by: Lois | Nov 19, 2008 8:28:36 AM
I am completely appalled at DAR's comment from November 13, 2008. I'm sure a lot has changed from 1976. (And we're all glad that it has!) To say that "newer" nurses are not professional, dedicated, nor have work ethics is an ignorant remark. I'm sure that the theory of nursing has not changed: Caring for others. I guarantee that if you were to ask most nurses nowadays why they wanted to be a nurse, I doubt they would answer "for the money." It may be hard to believe, but there are still young professionals ( and even aged ones!) who would do for their patients before they would for themselves. I would be careful of your perception of current nursing programs. Being a "true" nurse can't be taught in nursing school: most times we have to rely on our peers and wise nurses on how to approach unusual problems while still maintaing a caring attitude. We can only hope those who have come before us will realize that caring cannot be learned from a book. And hopefully the only ones who are being spoon-fed are the patients.
Posted by: Crystal Ayers | Nov 18, 2008 6:19:54 PM
I graduated in 1954 from Jewish Hospital in Cincinnati, OH. We cared for cardiac patients "on the floor" in their O2 tents with complete bedrest. Post-op pts. were recovered on the floor after a "shot of O2" in OR. OB pts. stayed a week. Was called back from my week "vacation" on receiving my cap after six months and put on a 28-bed Medical floor with one aide who had the "Food Cart". She was gone for about 2 hrs. in the middle of the night. I went on to do Industrial Nsg., Public Health, Asst. to the Med.Dir. at Blue Cross/Shield, etc. I would do it all over again!
Posted by: June | Nov 18, 2008 8:24:42 AM
Wow, how nursing has changed in the 40 years since I graduated from Bellevue School of Nursing (NYC)! I have specialized in oncology since 1976 and now practice as an oncology CNS (lots of years back in school). The technology has been tremendous. A few chemo drugs to now hundreds of them, targeted agents--the human genome--what a difference that has made--every day one can read newly discovered information about the genetic causes of disease. Precise radiation therapy--no more "burns" from those old cobalt machines. Students have to learn so much more information now. It would be impossible to come out of school ready to practice like we did from the diploma schools back then. The state of insurance and reimbursement. It's frightening how patients and providers of care need to move so quickly and precisely and to have good outcomes--cost effective good outcomes! I look at my textbooks from nursing school and laugh! I look at pictures of myself in my starched uniform and cap and laugh. Those were good times and so are these. I have loved my career as a nurse and am so glad in today's economy that I don't have to worry about a job. I have been able to practice all over the country as my husband transferred with his job. Nursing has given me so many opportunities. Maybe most gratifying of all is the fact that now my 38 year old daughter (college graduate) is going back to school to become a nurse! No, most gratifying of all are still the times when a patient tells me I have made a difference.
Posted by: Mary Ann Emerson | Nov 14, 2008 8:46:56 AM
I have been a nurse in the United Kingdom since 1972.
I remember having to stand when ever the sister entered the room, no cardigans or earrings were aloud, and trouble would be looming if you were caught off duty in your uniform. I also remember Sunday mornings and having to collect all the urine samples and checking the PH etc. Being band to the sluice when the consultant appeared to clean the bedpans (lovely) and set visiting hours for the patients and back rounds. but most of all the great parties in the doctors hall.
Posted by: SU Robson | Nov 13, 2008 4:15:08 PM
I graduated as a Registered Nurse in 1976. At that time you had aquired enough basic knowlege and skill to be competent at the bedside on graduation day. You knew enough to be afraid of making an error as lives depended on you. We were professional, dedicated and had work ethics. No one spoon fed us for the next 5 yrs as is done now. We assumed responsibility for our knowlege and actions. I have worked full-time for the majority of time between '76 and now. Have been a bedside nurse, nurse manager, educator, etc. When I look at the quality of nurses graduating today I fear for our future. It's wonderful that they are able to research, recite nursing models,etc. but somwhere they were not taught how to utilize this knowlege in practice. And worse they are not wanting to be the one giving the "CARE".
Posted by: Dar | Nov 13, 2008 3:42:19 PM
I graduated in 1969 from a three year diploma program.
And when I say three years I mean 3 whole years. No summers off. No Christmas vacations, just 2 weeks off the first year and a week each the following years. Tuition was $350/year plus uniforms.
We staffed the hospital.
We could work for pay on time-off junior and senior year and on the 11-7 shift we were often in charge. Sometimes we had to help cover two floors and we'd have to run up and down the back stairs to aid a fellow student. I swear!
When I graduated I truly felt like a nurse. I was ready for nearly anything. "Anything" came in the form of more school to become a dialysis nurse.
Dialysis was still in its' infancy. It was viewed as a last resort, when all else had been tried and failed. We would get patients in their final stages. Patients so debilitated by this time that they would often code on the machine.
I was part of the surgical team for preparing the patient for dialysis including assisting in the OR during implantation of the shunt. The dialysis machine was like a big washing machine. We had to mix our own baths (dialysate), a litle of this, a little of that, some salt, a speck of pepper, a little parsley, mix it all up with our arms and we were done. Next, the resident would come in and we'd put the patient on the machine. There were giant tubes everywhere. I was always in peril of tripping or hanging. Once on I'd begin doing clotting times, giving heparin, drawing labs, adjusting the bath, doing CPR.
It was very exhausting, scary and exciting all rolled up into one.
Here I am today, 39 years later, and still working, but not in dialysys. That's too easy, now!
Posted by: Paula | Nov 13, 2008 2:30:54 PM
I started in the mid 70's. I remember drawing up D50W from a bottle, and having the plunger disengage, covering the code cart in sugar. Also, pulling the code cart out of the utility room, not realizing there was big ashtray behind the defibrillator. Ashes went everywhere. No phones in patient rooms, so you ran to the hall and yelled Code 99 B16! Lots of patients hospitalized for stuff done as outpatients now.
When you are a nurse, the greatest reward is to have someone come up to you when you are out in the community and say "I remember you. You took good care of me, my family, etc."
We don't get to save lives everyday, but we do touch lives every day in ways that they never forget.
Posted by: susan | Nov 13, 2008 12:24:43 PM
I graduated from an AD program in 1974. It was really fun to read the musings above, a trip down memory lane. My first job as a GN was on a 48 bed med/surg unit in a 1000 bed teaching hospital. Team leading was the standard: 16 pts to a team usually consisting of an RN, LPN and aide. We also had a med tech who passed all po meds/routine stuff. RNs did the IV Abx (of which there were few) and the prn injectable pain meds. Our head nurse (no nurse managers in those days) rounded w/each team leader daily w/the kardex in hand. She was one heck of a good instructor/mentor AND drill sgt! Our patients were much less sick in those days. We had "executive physicals" staying a week and getting their annual colonoscopies, etc. We had a lot of low back pain laying around getting pain meds and strict bedrest and PT. (Do we wonder how come the insurance companies got so picky???) My hospital was in the inner city, and we also saw some of the sickest. I was fortunate enough to open an oncology unit and pilot primary nursing in 1975. The halcion days! We had to call interns to start IVs (we got that changed), hang blood, give IV push meds. Now, mind you, WE were the ones teaching THEM...but the common wisdom was that they had to learn sometime, and we were always there. It was a grand time for a new nurse...and when we moved in 1980 to a small southern community, my big hospital experience was invaluable...even to some of the physicians who'd been out of school for awhile. And, contrary to popular opinion, these small-town physicians were amazingly open to new ideas from a sassy Yankee. It was a wonderful career (I just retired...by now w/Master's in Nsg)and my only regret is that our profession didn't take up the challenge of putting a "value" on our services in the early days of DRGs...we might actually be a revenue center now rather than a recurring expense and first to be cut when the budget is tight!
Posted by: Linda | Nov 12, 2008 4:58:07 PM
I worked as a nurse's aid in a very small hospital during the summers while attending a BSN program in a much larger city. This was in the early to mid 70's and we used stainlees steel cans for enemas. For soap suds enemas we collected used hand soap in a large container in the utility room and mixed that with water. We usually supported the cans on an IV pole, since they were quite heavy when filled. Imagine my surprise, during my clinicals in the "big city" hospital, seeing disposable enema kits! I was the only nursing student who truly appreciated those kits!!
Posted by: Maribeth | Nov 12, 2008 4:49:52 PM
In 1966 after 3 months in nursing school I was in charge of 14 emergency admission beds and 20 urology patients on nights. Yes we took our own bloods, cleaned syringes and repackaged/resterilized then sharpened and did likewise for the needles. The Iv's were managed by slide clamps but we had almost no IV meds. Most antibiotics were IM. We rarely had gloves available, but had finger cots for suppositories and put a piece of toilet paper over the enema tubing where it was held. Disposables were just arriving and were were lucky that we had disposable enema kits- no one else in our province dod at that time.
I loved nursing then and still do. I went on to complete my degree right out of the 3 yr diploma school, it took another 3 years and 120 credits. During this time I worked 3 shiftss a week to apy tuition.
I subsequently worked as a staff nurse, AHN, HN and staff educator. I taught in a diploma program and at university. I subsequently completed a BEd teaching Nursing, a MEd in adult education and counselling and a MScN as a dual GNP/CNS.
Of interest to me is that a friend brought a speech her aunt had written about how nursing had changed in 1945 and the complaints have not changed much: workload, pressures of new technology, having to educate doctors, need for ongoing education to enable one to "keep up". etc. The examples are different but the titles continue to be burdensome. As students, if we did not get weighed in the first 48 hours of every month, we lost "days off". The aim was to to prevent pregnancy by having people get weighed! Ha Ha- nurses aren't stupid the first few just filled in the weight of several -up or down a pound to complete the list.
I worked 36 weeks of nights and 32 weeks of evenings during my training and preferred them to days when all the "big-wigs were around. Working days we commonly had split shifts 7-11 then 3-7 so it was no gift to work days.
I officially retired a few months ago but am back working casual as a staff educator and have set up my own counsulting business. I also volunteer aa a ESL educator. What I mind today is the negativism and lack of professional behaviour seen when nurses speak so badly about everything. It is de-moralizing and it poisons the workplace draining energy for the day. We have been short staffed before but in some areas now nurses are their own worst enemy demoralizing new and inexperienced staff who then leave for greener pastures.
My wish for nurses is to think about thanking someone for something every day, and 2nd finding something positive to say to reinforce the positives of a newer nurse every day.
Posted by: Phyllis | Nov 12, 2008 4:28:25 PM
I became a nurse in 1976 and went straight to a large hospital in Chicago on a neuro / ortho ward with 39 beds. Evening shift was staffed by 3 nurses-2 RNs and an LPN--metal bed pans, metal emesis basins, and no gloves except for really "dirty jobs". Our evening shift was to take vitals twice a shift, change dressings, get frest post op patient back to the floor,pass meds at 5p and 9p, empty the garbage,fill water pitchers and give back rubs to all patients. I felt the hospital was very progressive because we could wear colored tops and didn't have to wear our cap. We clipped needles off at the hub before we threw them away, and sterilized most equipment because we had few "disposables" back then. We kept cataract patients on flat bedrest for a couple of days and had our Harrington Rod patients on circoelectric beds that turned them over by rotating them in a circle. Length of stay was never less than 3 or 4 days for any surgery, and most of the time patients were admitted the night before surgery for all of their preps. We have come a long way from then until now!!!!!
Posted by: Jan | Nov 12, 2008 3:23:05 PM
I have been an RN since I passed Boards after graduating from a 3 yr. hospital school of nursing in 1963. I was told that "in one more year, you can get your BSN." I hired on at a major teaching hospital where I was assigned to the new "ICU"--a 4 bed ward full of critically ill patients and only one person (me) to do everything. I literally ran from bed to bed taking vital signs, reattaching a ventilator to a pt. with myasthenia gravis, and keeping a confused pt. from getting out of bed. I went back to school, only to find that I was given 4 hours college credit for my 3 yr. nursing school. I started back at a community college, got an AA, then went into the College of Nursing. As one of only 12 RNs in the class of generic students, I had to retake everything. Finally I switched majors and got a BS and MA in Health Education. Years later, still working in nursing, I returned to the same college of nursing and fixed all of the other degrees with a Masters in Nursing Administration. In 45 yr of nursing, I worked 10 yr. as a staff nurse, 8 yr teaching AD Nursing, 13 yr. as an administrator, and 14 as a Clinical Specialist. I have never wanted for a job, and have never regretted going into nursing. It is amazing to me that I used to be the only RN on evening shift for 30 orthopedic pts., with 2-3 aides, and I gave all the meds and started all the IVs. Today one nurse spends her whole day passing meds to less numbers of patients, carefully scanning each pt's bar code to decrease med errors.
Posted by: Linda Jones | Nov 12, 2008 2:04:12 PM
I graduated with an associates degree in nursing in 1982. I remember my last year, in clinicals, wearing gloves while performing colostomy care on a fresh colostomy patient. When we left the room, my professor reamed me out for the WASTE in resources and my insensitivity for the poor patient dealing with his fresh colostomy; that I would distance myself with the gloves! We never wore gloves to start IVs. When you needed gloves, they were down the hall in the clean utility room, not on the wall of every room. Needles had to be broken off syringes prior to throwing away the syringe. Thermometers were all mercury and had to be sterilized. . . they were placed in the utility room in an emesis basin until the end of the shift and then sent to be cleaned. Bedpans were metal, not plastic and the kind nurse would warm it with water then dry it prior to placing it under a patient.
Posted by: Deb O | Nov 12, 2008 1:51:56 PM
I graduated from a BSN program in 1980. Our professors told us outright that they were training us to be supervisors. As a result, I could write a 20 page paper on how to do a bed bath but couldn't actually do one. Funny how I wasn't hired right out of school to be a supervisor :-)
We were also told in school not to routinely wear exam gloves as they were a psychological barrier between the nurse and the patient.
Posted by: Maggie | Nov 12, 2008 1:48:37 PM
I graduated in 1967 from a three year hospital school. We went to school year round for three years. The first six months we were "probies", the probationary period. If you made it, you then received your cap at "capping" ceremony. We held lamps and recited the Florence Nightingale pledge. We wore starched uniforms with stiff, white aprons! I will always be grateful for all the clinical training we had, even though, at the age of seventeen when I started, it was shocking to give physical care to the opposite sex!!! By the time you were a senior student, you would be in charge on 3-11 and 11-7 shifts on a forty bed ward with two aides! After graduation you were "good to go" though! No "on the job training" required. What a thrill it was to be able to wear a white uniform and a graduate's cap!!
We got to know our patients and their families and often formed close relationships. We all worked very much as a team and took great pride in our work. Things were more formal and regimented, but nurses were respected for their knowledge and skills. We had a lot more "scut" work than today with everything disposable now, and machines to do so many things, but we were expected to care for the whole person and we did! I remember those days as hard but happy!!
Posted by: Brenda | Nov 12, 2008 11:30:59 AM
I started as a medical assistant in 1988 in a Drs office and later graduated with my LPN in 1992. It dosen't seem that long ago but recent changes have changed my job significantly. Your nurse in the primary care setting used to be a mentor. There to guide the patient and reprimand bad habits such as smoking and poor diet. Give information on child care and keep the patient honest and the Dr. informed. Now with the new attitude that the patient is a customer its more like working retail. We have to use kid gloves when patient teaching so as not to offend anyone. Neither the nurse or the Dr. is as respected as they used to be. Patients show up late for appoints, or don't show up at all. And if they don't like the way they were treated they file a complaint or change offices. House is fictional charecter who would never be allowed to practice in todays medical setting with his bedside manner. Even if it is for the patients own good.
Posted by: Kim | Nov 12, 2008 9:31:40 AM
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