Wednesday, March 15, 2006

When I was 25-nursing circa 1979

Very busy week for so many reasons, not the least of which is a milestone for my family: my oldest baby is 25 years old. I can hardly believe I have lived long enough to have a child who is a quarter century old (although she cringes when she hears me describe her age in terms of fractional centuries...).

When I was 25, the world was a different place, and I don't mean disco dancing and hair with wings. I was 25 in 1979 (do the math, if you're interested) and here's what it looked like:

~~Navy enlisted wife living and working thousands of miles away from home and family.
~~Half of the nursing staff: ditto above.
~~I worked in a mid-size community hospital on a med-surg floor that had a few telemetry beds.
~~I worked rotating shifts: days, evenings, and nights. Occasionally a night shift would be followed by a "day off" and then a day shift.
~~I became enamored of coffee in any form, due to above. An addiction that has followed me into middle age.
~~I wore a cap, white uniform, white hose, white socks.
~~Nurses were called by their last names. Period. If you were Jane Smith, everyone addressed you as "Smith". This was a Southern cultural norm for hospitals at the time; it was a token of respect. NO DOCTOR EVER addressed me by first name, after I called him (most were him!) by his full title. I called them "Dr. Smith" and they called me "Smith".
~~Evenings and nights, there was no ancillary staff. Nurses did all the 12 lead EKGs and breathing treatments. 12 lead EKGs were done by--gasp!--moving the leads around and then taking a six second strip of each lead placement. One walked around saying to oneself "first intercostal space right sternal border; first intercostal space left sternal border..." and praying no one needed an EKG because:
~~I had 21 patients on evenings, 42 on nights. On evenings, I was the "team leader" on one entire side of a nursing unit, with ten double rooms and one single. I had two LPNS and two nursing assistants for my team. On nights, I had one LPN and one assistant on each team. Me, 2 LPNs, and two assistants for 42 patients.
~~Need it be said no one sat in front of the telemetry monitors? When one got a chance, one picked up the strips that were piling all over the desk and floor from unanswered alarms, hoping not to see some horrible thing. Especially as that would mean pulling out the EKG machine with the little rubber squeezy lead things.
~~I started my own IVs. However, not all patients had IVs as they do now. Probably only ten out of 21. Nights, probably 20 out of 42.
~~Everyone needing a drip of IV meds of any kind (except antibiotics) went to ICU.
~~Post-op cholecystectomies went to ICU overnight.
~~Post-op open heart patients stayed five days in ICU.
~~I was younger than all the doctors.

I worked long enough in that hospital (almost five years, a long time for a Navy family to stay in one place!) to see many changes. Caps became optional a few years later. Staffing ratios were improved by adding RNs to each shift. The telemetry beds were moved to a new "subacute ICU", which I transferred to and which was exciting enough that I eventually moved to ICU. Acuity levels went up. People that used to stay five days post hysterectomy (for instance) stayed one or two.

Now, I am older than most of the doctors.

Things change.

I still like that last-name policy, though.



Anonymous Moof said...

That was sure a blast from the past! I went to nursing school in 1969, and had worked in a hospital - in one position or another - for several years before that. I didn't stay in nursing very long, but the stuff you just described brought it all back.

I guess things hadn't changed much in a decade ... but they sure have now. 0.o

9:28 AM  
Blogger Peggy Lou Morgan said...

I loved that walk back since I was 25 four years before you. It is amazing to look back on how things were done as opposed to now.

12:58 PM  
Blogger Kim said...

I turned 22 in 1979 and had been a nurse for a year and married in June.

Did you write in red for nights, green for PMs and Black/blue for day shift?

I was lucky. We had EKG techs and RTs for treatments. It was always easier to draw our own bloods.

I worked a tiny hospital with a 6-bed CCU. Strictly Coronary Care. None of that messy ICU stuff! LOL!

And I STILL love the Bee Gees...

11:28 PM  
Blogger mary said...

Did you write in red for nights, green for PMs and Black/blue for day shift?

Oh my, yes. I'd forgotten that. Remember how everyone had a ballpoint pen with all three colors-you clicked on the color you needed?

And funnily enough, we did have lab techs to draw blood on all shifts.

But you just reminded me of something else: we had no pharmacy coverage on nights. If we needed meds, the nursing supervisor went down and got them from pharmacy. On nights, the nursing supervisor was GOD.


1:17 AM  
Anonymous Anonymous said...

I started laughing while reading this article because just last week my mom (an RN, now a BSN) was telling me that at one of her first jobs, a woman who worked under her (not an RN) always called her by her last name. We're in the midwest, and it must not have been a tradition around here, because Mom HATED being called by her last name and finally asked the lady to stop doing it. I can't wait to tell her about your blog!

3:54 PM  
Anonymous Anonymous said...

What a walk down memory lane! I worked nights in an ER in the earliest 70's. We had one nurse in ER and one covering ALL IVs in a 150 bed hospital. The ER docs were residents who had just come off 24 hour shifts and just wanted to sleep. You only woke them when the patient was truly ready to be seen. It was pretty scary sometimes. The doc might be a psych or opthamology resident. The night supervisor was God and we wrote in red. Valerie

6:51 PM  
Blogger mary said...

Thanks for all the comments! Jennifer, I think you're right. I only encountered this "last name" thing when I worked in the Deep South. I got used to it and then liked it!

Valerie, the thought of one nurse in the ER is enough to make me faint. But then, there was one RN on our night shift med-surg unit with 42 beds (and up to six tele units)...and I survived to tell the tale.

I remember having to call the night supervisor before calling a doctor in the middle of the night, too.

Maybe the acuity level wasn't as high at all times as it is now, but Lord we worked our butts off, didn't we? :-)


7:43 PM  
Anonymous John the Nurse said...

Very nice memory aid. I am a young nurse, graduated in 83 from a diploma school. What thrills me is KCL and Antibiotics. Remember how you would put 20 of K in a liter, yea, whatever, it looks right. It always had a red label. Sometimes, We even filled them out, like KCL, 20 MeQ's, Jul 3, 83.

Now, they would never allow a vial of KCL anywhere but in the open heart OR.

11:37 PM  

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