Traditionally,
nurses couldn’t make major medical decisions -- in fact, they couldn’t make any
medical decisions. They act as the very important link between the patient and
the doctor – in other words; they carry out the doctor’s instruction in
providing care for their patients. They will draw blood, make the beds, empty
the bedpans, change dressings and sometimes remove stitches. They are not
primary health care givers, but without them, most hospitals would cease to
function.
However, some
nurses do have enough experience and qualifications to be the primary
caregiver.
Related: 5 Ways to Organize Your Paperwork
There are
different levels of nursing:
●
licensed
vocational nurses (LVN),
●
registered nurses
(RN), and
●
Advanced practice
nurses or nurse practitioners. The first 2 qualifications are of a degree
standard – either an associate or a bachelor’s. The advanced practice nurse
will have specialized in a particular medical field, such as midwifery,
pediatrics or anesthesia for example.
●
Some nurses carry
on studying until they achieve a Doctorate of Nursing Practice (DNP) – they are
now at the highest possible qualification for a nurse, and they are able to
work as a primary health care giver – like a doctor – they can write
prescriptions, they can make the decision to admit a patient to hospital, they
can order tests and so on.
In 1985, nurses
were told not to wear gloves for the simple reason that they implied that the
patient was “dirty,” and the patients felt offended. If children needed
medication, nurses had to look it up in the text book and see what they were
instructed to do. Nowadays, we all know how nursing has changed and almost become
an “art”.
Let’s look at
five ways in which nurses duties’ have changed over the last 40 – 50 years.
1.
General Changes
●
Years ago, the
only working professions open to a woman were teaching, nursing, and
secretarial work.
●
Nurses were
trained on the job, in the hospital and they were very well respected.
●
The equipment
they were taught to use included iron lungs, oxygen cots and rocking beds (used
to rehabilitate the patient after using the iron lung – which breathed for
them).
●
There was no such
thing as CPR. If a patient needed a drip, the doctor had to set it up – the
nurse could only take it down.
●
When patients
needed injections, tablets had to be melted over an old Bunsen burner. Nurses
would be hard pressed to tell you if anyone ever got an infection from this
method – it never happened.
●
Nurses were not
allowed to marry – if they did, they never became certified nurses.
2.
Technological Changes / Advancements
●
If you did some
research, you would probably find an old nurse or two who remembers patients
dying from Pneumonia and from whooping cough, and becoming crippled with polio
●
A patient with a
temperature required 24 hour care to try and bring the fever down, as there was
no medication to help them. Instead, patients were given cool sponge baths and
enemas to try and lower the fever
●
Disposable
equipment lightened the nurse’s loads considerably. Before that
Nurses had to sterilize glass syringes and
carefully check needles after sharpening so they would not catch on the
patient’s skin. But, on the downside, disposable materials seem to have
contributed to the rising costs of health care. And the reusable ones were of a
much better quality.
●
The important
point is that the wonderful advances in technology have not literally
translated into less work and more free time because the population has grown
so much with the advances in health care
●
Some elderly
nurses remember patients dying on the operating table during open lung biopsies
as the doctor tried to confirm pneumocystis pneumonia, which was the only way
to confirm the presence of HTLV 111 (AIDS). There were no blood tests and no
bronchoscopes.
3.
Mind your Manners Doctor!
●
Nurses had to
give doctors their chair when they visited the ward. And they were not allowed
on the doctor’s side of the nurse’s station. They got given a report of the
entire ward and had to make the rounds together with the doctor. The nurses had
to keep track of the patient's chart, make the notes for the doctor, and find
out any information the doctor required.
●
These days,
nurses no longer walk around with the doctors, and they battle to keep
well-informed about every patient in their ward.
●
Long ago, nurses
could read nurses journals and keep up to date with new advances and
treatments, today, they competing with patients who think they know everything
from looking it up on the internet. Sometimes, a little bit of information can
be dangerous.
●
It does not seem
to matter which nursing degree you have, most nurses earn the same pay.
Salaries increased in the 1990’s, but since they have not moved much.
●
All RNs, except
APRNs, take the same exam – the NCLEX – it does not matter which degree you
study for.
Related:
How do an RN and CRN differ?
4.
Disadvantages of being a Nurse Today
●
Nurses today are
far more educated and certified in what they have learnt, however, they are
still expected to be competent at every menial job on the ward. Consequently,
the workload and the stress do not match the salary scale of what they should
be earning.
●
They also do not
get enough respect. Even new graduates are not very mindful of the existing
nurses they join on the ward – it is just another job for them.
●
Nursing is still
one of the most trusted professions around for a woman – or a man – but the lack
of respect is a problem. Nurses are overwhelmed with work and they haven’t got
time to support their colleagues.
●
As for the public
– they are not aware of the nurse's job entails. There is no such thing as it
being a “calling” – it is actually a profession.
5.
How Nursing has become an “Art”
“We can all make
a difference in the lives of others in need because it is the most simple of
gestures that make the most significant of differences.” This
quote by Miya Yamanouchi demonstrates exactly what this section is about – it
is about the very heart of care, literally. Pay attention to this; it is a big
chunk of food for thought.
Learning how to care in nursing is a fine art –
you might think you do care and that you are much attuned to the needs of your
patients – however after you have read this, you may think again. This is the
perfect ending for this piece about how nursing care has evolved.
We all agree that
nursing is a science, but it also includes matters of the heart, and very few
people measure this aspect of it. This is what puts nursing on the map, not to
race against other scientific disciplines, but simply to show you how to have a
heart. The most important thing might be to keep the patient alive, but the
best part is how you do it, how you carry it out.
The heart is the
most important organ in our body – it is priceless – day after day it pumps our
blood and keeps us healthy and alive as it regulates all the other systems in
our bodies. This is the science of nursing – our life blood being taken to
every cell in our bodies.
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