Nursing “Back Then”Part 2

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This post is a continuation of my memories and some memories from other graduates from my school from before 1973. Thankfully patient care continues to improve along side the field of medicine. https://joyful2beeblogs.com/2019/02/04/nursing-back-thenpart-1/

Sharing the first blog “Nursing Back Then Part 1” with other nurses from my school and training era, triggered memories they shared with me.

Shift Report

One shared memory was that we used to tape report on a recorder so we could be staffing the floor while the new shift listened to the report. We used a cardex with a card with each patient’s diagnosis, physician’s name, activity, tests and care regimen prescribed. It was a real problem when the recorder broke, or the reporting nurse was in the middle of a crisis and couldn’t tape report.

Now where I worked last bedside reports were given involving and informing the patient as it was given. (Often not practical but the idea behind it was nice unless the patient had had a bad night and slept little and had just finally gone to sleep!)

Student nurse taping report.


More Medication History

Some fellow graduates, including Betsy Floyd Black, Sandra Lee Godfrey and Vivian Lyons, reminded me how we had to mix saline or Demerol with a crushed pill, {atropine or scopolamine (used as a preoperative injection with Demerol)} or other powdered medicine to give the patient an injection in a muscle of the thigh, buttock or lateral hip and occasionally the deltoid muscle of the arm.

Student nurse carrying medicines to patient.

I was appalled after Vivian Lyons reminded me we used to draw up Demerol from a 30 milliliter bottle and subtract and record the amount we withdrew on a narcotic record! We then marked the side of the bottle at the level of medicine left. By the way those little pills I mentioned above were not sterile and we handled them with ungloved hands!

These medications could sting, not to mention the pain when the needles had to be thicker for the thicker antibiotics like Penicillin to be given. OUCH!! Thankfully the route of administration has changed due to the increased risk of the needle or medicine irritating or damaging the sciatic nerve.

Later in the hospital setting antibiotics were mixed in the pharmacy with a small bag of saline or dextrose and given intravenously with a short tube that ideally hung the piggyback bag above the regular bag of fluid with a y-connection.

When the little bag ran out the main bag of intravenous fluid took over
to prevent the intravenous catheter or needle from clotting off. However, there were times when the piggyback medicine did not all run in, or ran in too fast. We were so thankful for the IV controlling machines that are used now.

Thermometers

Back then during the old days and in my early years as a nurse we didn’t have electronic thermometers. We had the old mercury, glass thermometers. Each patient had a receptacle with alcohol in it for the thermometers at each bedside.

To take a temperature we removed the thermometer from its receptacle, wiped it off, then shook it sharply to bring the level of the mercury in the thermometer down until it was below 95 degrees Fahrenheit. Then we placed the thermometer into the appropriate orifice.

I remember my wrist hurting when a stubborn thermometer seemed stuck on 97 degrees! Imagine what it felt like after up to 8 patients twice a shift, or more often if a patient had a fever which needed frequent assessments?

Back then we didn’t know about the environmental pollution caused by mercury spills when one of these thermometers was dropped and broken! We didn’t have hazard kits to safely clean up the spills back in the early 1970’s. I am not entirely sure how it was cleaned up. But I think a towel was used since mercury was kind of liquid.

Now there are electronic thermometers with disposable, firm, plastic covers on them to shield the thermometers for use under the tongue or underarm, or of course in the rectum. Smaller, similar thermometers can now be used in the ear; some thermometers even work on the forehead since I retired in 2010!

Bedpans

One of the oldest parts of “back then” which remained in the old hospital was the steel bedpans. Many times a cold, metal bedpan was pulled out of the bedside cabinet or cold bathroom and was slid under a poor bed-rest patient. (I still remember the gasps.)

Now we have plastic disposable bedpans that stick to the patients’ behinds unless some thoughtful person sprinkles powder on the pan. Still plastic is a vast improvement.

The Hopper Rooms

Back then we cleaned the metal bedpans by carrying them covered with a towel, to the utility room, where the chutes for dirty linens were and where the trash was kept. There was a small, metal door in the wall that opened where we put the bedpan. When we closed the door steaming hot water flushed the contents down a pipe and essentially sterilized the bedpan. These were called hoppers. Now bedpans are sprayed by a sprayer head connected to the toilet’s water source. The sprayer then folds back up against the back of the toilet.

We were trained in a three year diploma school, which I will talk about in another post soon. But the nurses of that time had fewer implements and much less scientific knowledge about some things than nurses have now. But we/they delivered the best quality patient care that we/they knew how to give. We had more patients to take care of and more potentially dangerous and especially infectious diseases to work with, when little was known about how dangerous some of them were.

The Fear of AIDS (HIV Virus)

When AIDS came out, HIV patients were put in isolation. At first we were afraid of catching it by just breathing the same air they did or having contact with the patient. There was one patient I remember who had the AIDS Dementia Complex, who threw urinals, spit at us and was quite a handful. It was terrifying to take care of him, but we did it as carefully as possible, because he had to be cared for and needed our help. That is just what nurses do.

It turned out that AIDS was not spread by contact with the patient but only their body fluids if they came in contact with broken skin, mucous membranes, or open wounds.

Needles used on an AIDS (HIV) patient could transmit the virus if a nurse or staff member were stuck by it. We didn’t know all of this back then but did the best we could to treat them with kindness, respect and professionalism.

People complain now about how things are sometimes. But so much progress has been made. I am thankful for the experiences I had because I know things are better and will continue to get better.

Soon I will publish a post on what student nursing was like in the 1970’s.


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