My mind is boggled when I think about how far the fields of medicine and nursing have come since my mother trained in the early 1940’s. We both trained at the same nursing school, as did my sister. But we graduated in 1972 and 1973. I worked as a nurse from 1972 until 2010. I am so thankful for the advances in medicine and nursing since then! I think you will be too after you read this and Part 2.
Back then the hospital where I received my training was built in 1911. It grew over the years to have six(?) floors. It was closed a few years after my sister graduated in 1973. A new modern hospital was built on Grove Road, Greenville Memorial Hospital.
The T shaped floors had long halls with mostly two bed rooms and several four bed rooms. There were also two twenty bed units where each bed was separated only by curtains at the sides and foot of the bed. I believe there was one bathroom for all 20 patients! One unit was for men, the other for women. I think these units were for the people who couldn’t afford the regular two or four bed rooms or were indigent.
Back then the beds were similar to the ones seen on MASH. At the foot of each bed there was a crank for the head and one for the foot of the bed. The crank was folded out and turned to position the bed and hopefully folded back inwards when adjustments were finished. Many a busy student or staff member caught unaware as they rushed around fulfilling their duties received shin bruises when someone forgot to fold the crank up and out of the way! I was thrilled when I saw the new beds with buttons that let the patients adjust their own beds.
My mother told me that during World War II, mostly senior student nurses ran the hospital at night due to the nursing shortage when nurses went into the military nurse cadet program through the school.
She amazed me when she informed me about the duties of a hospital nurse back then. Aside from patient care (bathing, feeding, medicating, assisting with activities and assisting doctors, the nurses had to do the housecleaning, mopping, dusting, and even cooking for the patients! They did not give intravenous medicines nor insert intravenous needles. The intern or residents usually performed that task.
Back then during my training and probably before, nurses prepared small trays for patients’ medicines, with a stack of 2 X 2 cards with the names of the patient and medicine, times they were due and the patient’s room number on them. The cards of course were checked against the medication record which was updated for new orders by the “ward secretary” and double checked by the charge nurse.
The pills were placed in one or two little paper (souffle) cups or plastic cups for liquids. (Instead of intravenous medicine, intramuscular injections were more commonly given.) While carrying these medicines, along with injectable medicines on a tray the nurse walked to each patient’s bed with the tray. There were obviously risks with this form of medicine distribution.
Fortunately by the time I was a year out of training, large, new locked carts were introduced with drawers for each patient with their medicines neatly separated. Even though one cart was shared by two nurses, it was still a vast improvement.
A couple of years later this procedure improved when the new hospital opened. Each patient had a locked medicine box built into the wall with access from the inside and outside of the room for their medicines.
Then later the Pyxis was a central, locked cart where each patient had a drawer for their medicines.
Intravenous Fluids and Medicines
Back then we didn’t have IV pump machines to regulate the flow of intravenous medicines or intravenous fluids. I still remember holding my watch, with a second hand, to the drip chamber of the tubing that led to the glass bottles of fluid, counting the number of drops per 15 seconds and multiplying by 4 to be sure it was infusing at the prescribed rate! It sometimes took a few minutes to get the rate just right! This hadn’t changed since the 1940’s or earlier!!
We had to regulate the rate of the drips with a roller clamp! Can you imagine how hard it was to roll the adjustment to perfection; and how easily it could be readjusted accidentally or on purpose if a confused patient decided they wanted to get the medicine or fluid run in in a hurry? Later a locking feature was added so it couldn’t be changed accidentally.
Back then in the late 1970’s I worked in a Coronary Care Unit/Intensive Care Unit in Mississippi. Many vital medicines are given intravenously for critically ill patients. For most of the first year I was there, the pumps that controlled the IV fluids were kept downstairs in “Central Supply.”
We had to wait until one was brought up or we had to go down stairs to get one! Can you imagine in an emergency having to set an IV rate by hand until the pumps arrived?? Before I left there was a supply of them in the unit itself, as there should be.
What do you think? Was it easier back then, or easier now? There is more to come in Part 2 Nursing Back Then!