I started my nursing career in 1972. I have worked in hospitals from South Carolina to New Orleans, to Mississippi, to Western and Eastern North Carolina. After 38 years of nursing (17 years of that in ICU/CCUs) I consider myself an expert on how the nursing field has changed.
Glass Mercury Thermometers
In 1972 we used glass thermometers that contained mercury. Mercury expands when it’s heated, so if a thermometer was washed in hot water it could shoot out and contaminate God only knows what. I wonder how many people were poisoned because a kid or untrained person unknowingly dropped, or worse still, washed a thermometer in hot water!
When taking temperatures for 7-10 patients, each patient’s thermometer had to be shaken down sharply to get the mercury down below the 97 degree mark. Shaking your wrist sharply to get all of those thermometers down is hard. Now we use electronic thermometers with little plastic covers and the thermometer resets after each use.
In the 70’s nurses had little trays with all of our patients’ medicine cards, and each card was topped with a souffle cup full of each patient’s pills. (It was a miracle more mistakes weren’t made!) Now we pull each patient’s medicines out one at a time from a central machine, which allows only medicines to be removed from that patient’s file.
Intravenous Medications Have Changed
To calculate the rate the infusion in the earlier days of nursing, we had to count the drops per minute. We held our watches beside the drip chambers and increased or decreased the drip rate repeatedly until the drips were at the proper rate. Now we have computers that deliver the medicine or fluid at the correct set rate.
Nurses once wore “their glory,” another name for their school caps. Bobby pins held them in place and had to be readjusted during the day when knocked around by IV tubings or patients. White uniforms, stockings or socks if wearing pant suit uniforms) and white clinic tie-up shoes were the ONLY uniforms allowed.
I never understood why white was chosen in such a potentially messy profession. These days, no one wears a nurse’s cap. Your uniform is now a styled top with matching solid colored pants. The color of your uniform depends on the color chosen by your unit or hospital. Clogs, good quality walking/running shoes with socks are allowed now instead of the clean, freshly polished clinic shoes.
Patients looked to us to be their advocates to the doctors, pharmacy, material supply, housekeeping, sometimes other family members and unwanted company. Now the doctors depend more on us to communicate for them to their patients at times.
Patient Attitude about Hospital Admission
Many older patients thought of the hospital as the place where their older family members went to die. Now, hopefully, most people think of the hospital as a place of healing and care.
Stresses of Nursing
The stress of nursing comes down to patient loads, lack of help, and increasing demand to learn new things. Now nurses have many of the same stresses but also have computerized charting and drug distribution.
There are also constantly new medicines to learn about, and new policies to go to class for or be responsible for. There are more treatments, tests, orders, procedures, known diseases, symptoms, and complications to be aware of and a greater potential for lawsuits. More emotional and physical stress comes from under-staffing and patient loads, less time to take breaks or even go to the bathroom sometimes.
Bedside Nursing Skills
Sick and suffering people need not only our technical training, but our compassion and support. Today we have these same challenges but we have more understanding of emotional stress and its effects on our patients, how they deal with it and its effects on us. We have learned to be patient with the “demanding patient,” the angry family, the overloaded co-worker, and ourselves when we are stressed out.
Unchanged Facets of Nursing
Many technical changes have taken place over my career in nursing began. But there are many things that have not changed. Seeing a suffering patient relax, smile, and nod off to sleep after receiving their pain medicine has always been rewarding. Decreasing a patient’s fears by promising to stay with them until they go to sleep has always been rewarding.
Watching a paralyzed patient progress from depression, anger, grief and frustration to enthusiasm and independence again has always been a pleasure beyond words! Comforting a dying patient after a long illness, though sad, gives relief to the patient and their families. It gives nurses feelings of pride that we can provide some support for them.
People Have the Same Basic Needs
Over the years I have also found that people from different cultures or beliefs all have basic needs, fears and emotions; all of them love someone and most are loved by someone. They all need our patience, understanding, education, and emotional support.
Nurses Have the Same Basic Caring Attitudes
Nurses have not changed that much in their innate compassion, responses to the pain or suffering of others. They still weep with families. They still spend time with patients when they really don’t have the time to. They still give a good night hug to a child or elderly patient or even a kiss on the cheek to someone lonesome. I have found the emotional and physical strength of nurses to be amazing.
Nurses are Healers
Nurses touch, help, teach, support, heal and comfort in death. Our very presence, knowledge, compassion, and action is vital to our patients’ care. We are with them all day and see changes when they happen, get lab results and notify the doctors, admit patients, share their concerns. We forge relationships quickly with total strangers and gain their trust, which is a miraculous feat in itself both then and now.
There have been many changes in nursing over 38 years. Nursing has grown and changed in some ways. But the basic people skills we have may be the most important unchanged healing offering we have to give.