Over the
years, medical advances have come to bring huge strides in treating patients
with better care and less pain. In the
1980s, a gallbladder surgery was a major surgery, but today it’s laparoscopic
and the patient is out of the hospital in a day. These advances have been beneficial to
doctors, nurses, and most of all patients. Medical advances continue on a day to day basis, and it's hard to
imagine what the future may hold. Much
has changed in Nursing as well. No longer are nurses expected to wear dresses,
white hats, and white shoes, and nurses are recognized now more than ever
before for the hard work and dedication they offer.
Through the
Years
1960
·
Nurses were expected to stand when a physician entered the room
·
Most nurses still wore white dresses, and starched nurse caps
·
It was recommended a Bachelor of Science in Nursing as the
minimum education requirement for entry into the profession of nursing
·
Male students were admitted to nursing schools, a first in most
cases
·
The first nurse practitioner (NP) programs were born
·
President Lyndon Johnson signed Medicare into law, promising
that “no longer will older Americans be denied the modern medicine.
·
A key theme of the 1969 American Hospital Association annual
convention was the crisis in healthcare. Sound familiar? In some ways things have not changed much at
all.
1970s
There were no mechanical medication dispensing systems such as
Pyxis and all controlled drugs were locked in a cabinet with a key. There was no pharmacist on duty after about
10 pm. So, if you needed to give a narcotic, you had to find the nurse who had
the keys. It was not unusual for one to drive home with the keys in
a pocket only to have to turn around and take them back so the unit could
function.
Charting, in most hospitals, was color-coded. Day shift wrote in
blue ink, evening shift in green and nights in red. Everyone owned one of those
little four-color pens. Doctors’ orders were written in blue or black on yellow
sheets of paper so as not to be overlooked. The order pages had at least two
pages, one for the pharmacy and the original to be kept on the chart.
There were no fax machines, so often on day shifts couriers
picked up order sheets and delivered them to the pharmacy or lab. If you needed something in a hurry or on an
off shift, well, you had to run the order sheet to the pharmacy or
central supply and pick it up.
The State Board Exams (now known as the NCLEX) were administered
twice yearly in June and January. The test was split into five sections:
Medical, Surgical, Peds, OB and Psych. If a nurse did not pass one or more
sections, he or she was allowed to retake those parts again only after a course
of review was completed. In the interim, the “graduate nurse” status was still
in place, allowing them to continue to work and learn.
In many hospitals, protocol
required nurses to stand and give up a chair when a PHYSICIAN entered the unit. Orders during MD rounds were often dictated to the nurses
and then co-signed by the MD. in truth,
for many it was the ONLY way to decipher what the orders were. Physicians’ assistants did not yet exist,
although an MD might have “his” nurse who made rounds just ahead of him and who
often assisted him in surgery.
The best part about “back
in the day”? Staffing was done according to patient ACUITY
and not simply the total census of a unit. It was more sensible and
safety was the critical factor.
Nurses’ skills were also a consideration. When a new ICU opened
up with six specialty beds, only four were in use initially because there were
not enough qualified RNs to staff all six, no matter how much the hospital
administrators wanted the beds filled. Most
nurses still wore the whole dress uniform, with white hose and shoes, topped
off with a hat. The ratio of male nurses
was only 1.5%, it was still considered a woman's profession, and the profession
of M.D. Was still primarily male.
1980s
More males were entering into the field of nursing, the ratio
was 12%. Nurses were in many hospitals,
allowed to wear pants in stead of the traditional white dress. Scrubs had been reserved for the operating
room, and not yet worn by nurses as a general uniform. Laparoscopic surgery was for the most part
unheard of, and all charting was still done manually.
1990s
Finally, nurses were gaining the respect they deserved, as a
shortage allowed doctors and hospitals to learn just how valuable they
were. Uniforms changed to scrubs, and
facilities began to try to accommodate nurses with desired shift
rotations. The goal was to keep the
nursing staff happy to retain good staff.
2000
Laparoscopic surgery was in the early stages of existence and
nurses were taking on more responsibility with patients. Continuing education for nurses was producing
more trained nurses, with a higher degree, and the ability to perform more duties.
2015
Nurses have come a long way, and today's nursing staff is
approximately 30% male in most areas. Nurses are a well-respected part of the medical teams at hospitals and
offices. Most facilities do what they
can to accommodate their nursing staff in order to keep them, since great
nurses are much of what makes a hospital. Nursing has evolved with medicine, and is now recognized more than ever. Nurses really have come a long way, and it is well
deserved.
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