joyful2beeblogs

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.