Nursing Then And Now: Some Surprising Similarities and Differences

I started my nursing career in 1972. I 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. I retired in 2012.

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 would shoot mercury out the end of the thermometer. As you know mercury is poisonous.

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 can be hard and time consuming. 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. Some hospitals now have a large cart for each hall or floor section with the patients’ medicines.

Intravenous fluid and medication administration has thankfully changed. To set the prescribed rate of the infusion in the earlier days of nursing, we had to count the drops of intravenous fluid as it dripped into the drip chamber. We held our watches beside the drip chamber and increased or decreased the drip rate repeatedly with a roller clamp until the drips were at the proper rate. Now we have IV controllers that we set to deliver the medicine or fluid at the correct set rate.

Part of a nurse’s uniform was “her glory,” another name for the school nurse’s cap. Bobby pins held them in place and had to be readjusted during the day when knocked around by IV tubes or patients. White uniforms, white 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 evolved to a styled top with matching solid colored pants or scrubs, like they wear in surgery or recovery rooms. The color of your uniform depends on the color chosen by your unit or hospital. Good quality walking/running shoes with socks are allowed now instead of the clean, freshly polished clinic shoes.

Patient advocacy was part of the nurse’s responsibility. Patients looked to us to be their advocates with the doctors, pharmacy, material supply, housekeeping, sometimes other family members and unwanted company. Now, sometimes, the doctors depend more on us to communicate for them to their patients at times.

Patients had a variety of attitudes about being in the hospital. 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.

Althouh nurses now have computerized charting and drug distribution, the stresses of nursing includes increasing patient loads, lack of help, increasing, and necessary demands to learn new techniques, treatments, tests, diseases, medicines, and procedures. This means there are more classes, certifications, and updates to learn about too. 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 were a primary trait of nursing when I started my career. 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.

But lately with the decrease in nurses there is a greater load of work for the nurses to carry out. Often time is of the essence and bedside nursing seems like less of a factor in care. Nurses seem to not have as much time to hear all the details of anything not associated with nursing care or urgent needs of a patient.

There are some 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 with relief, and nod off to sleep after receiving their pain medicine is always rewarding. Decreasing a patient’s fears by spending a few extra moments with them until they go to sleep is always 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.

All people have the same basic needs. Over the years I 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. 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 life and 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.

10 thoughts on “Nursing Then And Now: Some Surprising Similarities and Differences

    1. Wow! Why, thank you, Coastalmom! I am so glad you liked this! That is a high compliment for me. I wrote it originally for a site which has since closed and decided to share it and some other of my articles here. Hugs! Hope you are doing well!!


  1. I spent, I think 3 days in Wake Med-Cary a couple of months ago, and found too, that there are different kinds of nurses. Some are clearly better at multi-tasking than others are. Some clearly care more than others are. I had one young nurse that came over as a fill in from ICU. She moved the bed down so I could scoot right over from my walker. Others had made me climb up into the bed from my walker while in terrible back pain. And then there was a nurse’s aide that was a gift from heaven. Cleaning up after me when I had had an embarrassing accident because I wasn’t allowed to get out of bed alone. I wish I had gotten her name.
    There was a team that came by from social services, I think they said. They too were a gift from heaven, asking me all kinds of questions about what I’d need when I got out of the hospital. One question they asked is if I wanted to make good or bad comments about any of the doctors. I told them about the nurse’s aide, so maybe she did get recogized for her good care, and I told them I hadn’t seen a doctor since leaving the ER.
    Well surprise, the doctor showed up in my room a short time later. 😉
    And my sister Nancy called me the first day I was in to remind me to thank everyone for every thing… that it was their job and most wanted to be there doing it, but few received thanks, so I was certain to thank everyone for every thing they did for me.

    Liked by 1 person

    1. Anne, we have come a long way and every day it feels like the medical field is discovering something new to heal, or lessen. It gives me great hope for those who suffer illnesses or disease. Thank you for commenting!!


  2. Thank you, RB for sharing your observations. As you pointed out, I too have seen some nurses, doctors, nurse techs and other staff who for whatever reasons did not have an inkling of what it is like to lose a loved one; to be totally dependent; to feel left in the dark with no one to help; to feel the warmth of compassion, of a smiling face asking how you are doing. Having been a patient I can understand the anxiety of having one who was not focused on my well being. On the other hand I do believe their are more who do care and want to help. But even some of them have bad days due to home problems or more new tasks added to their assignments when they are already behind. I believe most of the hospital staff are working the best they can. Some have better education or been trained by better teachers. I am glad that you had more episodes of kindness than of unkindness. I hope you are feeling much better now and healing well..


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