Nursing Has Changed In The Past 50 Years

[trailerparkmedic]

This wasn't a patient, but the patient's mother.

PM: Oh, so you're a student?
Me: Yup! I'm graduating in December, and I go to University.
PM: I wish your school wore uniforms like College does. (College doesn't wear dresses but the uniforms are more like dress shirts and slacks instead of scrubs) I've seen a few of their students here and I think they just look so sharp.
Me: It's amazing how different the uniforms are at each school around here.
PM: I just can't believe that nurses wear scrubs now! It looks so sloppy. Nursing has changed so much from when I started! When we learned to make beds, we spent hours practicing and our instructor had to be able to bounce quarters off of them, and now they just throw the sheets on. Everyone who comes in here looks so rushed and tired. When I was a nurse, we had to smile every time we entered the room. <insert more "In my day" stories here>
Me: (Thinking: Yeah, and you had to give up your seat to doctors, kept surgical patients for at least a week and didn't talk about the kind of disease that your daughter is dying from.)


The patient's mother bothered me because her complaints would have been true at several hospital's I've been at, but the nurses at this hospital are generally good and the nurses on the specific floor are AMAZING. They love their specialty (most of the ones with second jobs have a second job in the same specialty) and it shows.

[Pixilated]

'Scuse me while I go see if any of my cousins are in your hospital, 'cause that dang sure sounds like my aunt!!

I've never understood how being able to bounce quarters off a bed helps heal people.

(Or keeps the enemy at bay ... this from my very brief stint in the military under a government-created youth program).

[Seshat]

Making a bed so that it doesn't have wrinkles and won't develop wrinkles as the patient turns and tosses will help prevent bedsores and other pressure problems.

That plus cleanliness matter in bedmaking. Otherwise? Nah.

[fireheart]

Making a bed so that it doesn't have wrinkles and won't develop wrinkles as the patient turns and tosses will help prevent bedsores and other pressure problems.

That plus cleanliness matter in bedmaking. Otherwise? Nah.

Oh now I get why Marge Simpson has a bundle of quarters in her ceiling

[Sapphire Silk]

Making a bed so that it doesn't have wrinkles and won't develop wrinkles as the patient turns and tosses will help prevent bedsores and other pressure problems.

That plus cleanliness matter in bedmaking. Otherwise? Nah.

That kind of bedmaking skill was more important before the advent of fitted sheets.

Mostly, that kind of bedmaking is about appearances and professionalism. Once a patient is in the bed, preventing wrinkles IS very important for a bed bound patient, but is impossible to keep that completely sharp.

When PM was a nurse (she sounds like she was one from the story), nursing scope of practice was far narrower than it is today. Modern nurses DO make beds, but it is really a tiny task in the overall scheme of what we do.

We have found through evidence based research that daily bed changes are not necessary unless the bed gets soiled (and by soiled, I mean more than sleeping in it for one night). This is a good thing; some bed bound patients who have to remain in the bed while it is made don't do well with that strain.

I get what PM was saying about the uniforms. I actually agree with her; many nurses look very sloppy in scrubs. Scrubs were meant for the OR because they get so heavily soiled during surgery; they're cheap clothing meant for heavy and frequent washings, and to have a short shelf life. Other departments with high clothing soilage rates began using scrubs (ICU and ER), and the practice trickled into other practice areas from there.

In defense of that practice let me say that, having worn traditional white nursing uniforms and shoes, traditional clothing soils easily on a Med Surg unit, is difficult to clean well, was three times the cost of scrubs, and generally not very practical for working nurses.

Unfortunately, people have a stereotypical image of nurses in their white uniforms that has been impossible to shake, even though very few nurses actually dress that way anymore.

The pendulum of anything goes is swinging the other way. More and more hospitals require scrubs to be a specific color based on your department, and forbid scrubs for non-medical employees. That's a good things, since there really is no reason for a receptionist to wear scrubs . . . and it confuses patients who don't know who the actual providers are.

My nursing program doesn't even teach bed making any more since we require all students to come to us as CNAs.

[Seshat]

That kind of bedmaking skill was more important before the advent of fitted sheets.

Either I always get crap fitted sheets, or I toss and turn more than the average.

[crazylegs]

The skills of non-doctors within the medical setting have increased dramatically in the last 50 years.

Paramedics are no longer ambulance drivers
Nurses can now prescribe on their own and are supremely important in pt care


Anyone who doesn't realise that things are different from 'their day' needs to have a quick reminder of how things have changed.

[Seshat]

My father was an ambulance driver 'back in the day'; but his depth of first aid knowledge was and is extensive.

Mind you, he never got trained to put in an IV or use a defibrillator, and while he keeps his certifications current, he's sticking to 'civilian' level certs these days.

[trailerparkmedic]

Nurses can now prescribe on their own and are supremely important in pt care

Well, RNs can't prescribe, but advanced practice nurses with masters (such as Nurse Practitioners) can prescribe. Plus, in most states, they can operate on their own and not under an MD's supervision (unlike PAs), which is kinda awesome.

Doing a bed so the patient isn't injured by wrinkles is important (but so is turning them to help prevent bedsores in the first place). Changing sheets in an occupied bed is a skill that took me awhile to get the hang of. Those are important nursing skills; bouncing quarters and perfect hospital corners, not so much.

I do always try to make my beds look pretty when I have the time. One of the nurses I worked with in my first semester looked at the bed I'd done and told me "You're at the #1 cancer center in America. Show some pride in your work and replace the sheet with holes in it." (In my defense, the holes were smaller than the diamond on my wedding ring) For some reason, that statement stuck with me more than almost anything else I learned that semester.

[Lyse]

Heck - just the changes between when my mom got her LPN in the mid-80's and when I got mine are mind-boggling.

[Sapphire Silk]

Heck - just the changes between when my mom got her LPN in the mid-80's and when I got mine are mind-boggling.

Tell me about it. I got my LPN in 1985. The job is so not what it was back then

[Amina516]

That kind of bedmaking skill was more important before the advent of fitted sheets.

Mostly, that kind of bedmaking is about appearances and professionalism. Once a patient is in the bed, preventing wrinkles IS very important for a bed bound patient, but is impossible to keep that completely sharp.

When PM was a nurse (she sounds like she was one from the story), nursing scope of practice was far narrower than it is today. Modern nurses DO make beds, but it is really a tiny task in the overall scheme of what we do.

We have found through evidence based research that daily bed changes are not necessary unless the bed gets soiled (and by soiled, I mean more than sleeping in it for one night). This is a good thing; some bed bound patients who have to remain in the bed while it is made don't do well with that strain.

I get what PM was saying about the uniforms. I actually agree with her; many nurses look very sloppy in scrubs. Scrubs were meant for the OR because they get so heavily soiled during surgery; they're cheap clothing meant for heavy and frequent washings, and to have a short shelf life. Other departments with high clothing soilage rates began using scrubs (ICU and ER), and the practice trickled into other practice areas from there.

In defense of that practice let me say that, having worn traditional white nursing uniforms and shoes, traditional clothing soils easily on a Med Surg unit, is difficult to clean well, was three times the cost of scrubs, and generally not very practical for working nurses.

Unfortunately, people have a stereotypical image of nurses in their white uniforms that has been impossible to shake, even though very few nurses actually dress that way anymore.

The pendulum of anything goes is swinging the other way. More and more hospitals require scrubs to be a specific color based on your department, and forbid scrubs for non-medical employees. That's a good things, since there really is no reason for a receptionist to wear scrubs . . . and it confuses patients who don't know who the actual providers are.

My nursing program doesn't even teach bed making any more since we require all students to come to us as CNAs.

I went to "Like" this post and then realized I wasnt on Facebook....

So, I agree Panacea..

[AccountingDrone]

Nursing has changed in the years I have been using hospitals ... from the 60s when basically nurses did everything, to last time I was in, the nurse basically did medication and interfaced between me and the doctor, there was the kitchen guy who brought food and snacks, a maintenance person who did bedmaking, moved stuff around the room and brought equipment in, a respiratory therapist who exercised my lungs [you can get pneumonia after being tubed if you don't breath deeply, more or less] and some sort of nurse aide trainee who sort of hovered around.

And I had my hubby who the Navy helpfully trained as an EMT to be my medical power of attorney just in case. Well, he also snuck me in my meds - I have learned that I do best when I get my specific meds on a specific schedule, and I am not waiting around till someone bothers to remember to bring me my cardiac meds and insulin ... if they got there at the time I took the hospital provided meds, if they didn't I took mine and bitched them out because my cardiologist specifically has me scheduled with my meds, and it is not safe to screw with a diabetic and her insulin. When the hospital sent someone to bitch at me, I pointed out that they were responsible for my health, and not getting meds in on schedule did not count as keeping me healthy and if I had complications or died because my meds were essentially withheld from me, lawsuits would ensue. I have enough health issues, I really do not need more.

[Sapphire Silk]

It is very difficult for nurses to comply with strict schedules patients use at home, especially considering the ever escalating amount of medication people take today.

Personally, I think we should do research on allowing patients to self administer medications. With few exceptions it would probably lead to increased patient satisfaction and better outcomes.

[Sparky]

My only experience with the nursing profession is as a patient, but I have some pet peeves concerning scrubs, and I am eager to know what those of you in the profession think.

Used to be the nurses wore white dresses. And hats! We can't forget the hats! The get-up was professional looking, but not easy to work in.

Gradually, nurses demanded uniforms that allowed them to, you know, do their job, and somehow this led to scrubs becoming the default uniform for every nurse, assistant, dental assistant, receptionist, and everyone in a job related in any way to health care. Panacea says the pendulum is swinging back, and I'm delighted. Scrubs used to be intended for people working in a sterile, or at least very clean, environment. Now people wear them to and from work, so obviously that's no longer the case.

I find it disrespectiful when a hospice nurse comes to a funeral (for a 70-year old man) in scrubs with teddy bears on them. You couldn't take a minute to change? Really?

I believe that nurses are highly-trained professionals, but it's hard to muster the proper respect for someone wearing what looks like rumpled pajamas. In fact, everyone at the hospital looks like they're wearing pajamas. How am I supposed to know who you are? Are you here to take my vitals or to scrub my floor? Do you feel that nurses would get more respect if they wore a uniform that looked more like clothing? Isn't it possible to design one that looks nicer and is still practical and allows nurses the freedom of movement they need?

Nurses, what are your opinions?