Old School Nursing

This week marked another year and another birthday for me.  It was also Nurse Appreciation Week when facilities and agencies show appreciation for the job we do.  As I sat down to write another article for all my travelers I reflected back on the way it used to be.  How many times have you had some oldtimer say “in the old days” we did blah, blah blah.  Well, I thought I would list a few of my favorites.

I know there is an evolution taking place that will ensure better patient outcomes but we old-timers laid the foundation for what is and what will be nursing in the future.  Nursing skills have changed quite a bit over the last many decades. Technology has taken over some skills and others have been discarded completely for the sake of safety and efficiency.

Reusing syringes and urinary catheters

When I first started my career in the medical field we didn’t have all of the disposable items we use today.  In the operating room we reused needles and syringes,  Red rubber urinary catheters were washed and resterilized.  Yep, we had to check needles for burs and then sterilize them until it became too costly and disposable items became the norm.

Charting patient care on paper

 There are still times I resort to paper charting but it is not the norm.  You may find some rural or small-scale clinics that still use paper charting. I believe that most health-care facilities today use electronic charting because it is more accurate and efficient.

Using urine dipsticks with sliding-scale insulin

Have you ever had to use a dip stick to check urine for sugar?  In the old days, we used sliding-scale insulin based on dip stick results.  Nowadays the glucose meters are the instrument of choice.  A urine-dipstick isn’t as accurate as a glucose meter, so it’s no surprise we don’t use them anymore.

Manually regulating IV fluids

How many I.V. bags have I hung and manually counted drops to figure drip rate?  The invention of an infusion pump was a miracle.  In the old days, nurses had to count drops and calculate drip rates for each patient receiving IV fluids. Infusion pumps have made administering IV fluids easier, more accurate, and much faster.

Palpating for blood pressure

What a difference the automatic blood pressure machines have made.  I can tell you that having to palpate a blood pressure on some patients was almost impossible.  The majority of health-care facilities in the United States use automatic equipment that not only takes the B/P but also the heart rate.  To palpate a B/P the nurse would inflate and deflate the compression cuff while feeling for the disappearance and reemergence of the radial pulse.  This is one piece of equipment that is for sure more accurate and saves time.

Mercury thermometers

I am sure most of you have never even seen a mercury thermometer since they are considered hazardous. Imagine having to use this glass instrument filled with mercury to take a temperature rectally on a small child.

The sight of a nurse shaking a mercury thermometer is very rare these days. In the past, however, nurses shaking mercury thermometers was a daily occurrence. These thermometers were reused and to clean them between uses you would wipe them with an alcohol sponge.  They would soak in an antibacterial solution between patients.  Before taking a temperature reading you would shake the thermometer to bring the majority of the mercury back down into the bulb to ensure accuracy.

Shaving patients prior to surgery

In the old days, hairy patients had their incision sites shaved the day before surgery. The OR nurses would make the rounds the day before to prep the patient.  Later it was determined that this could be a source of infection.  The prep was then done in the OR once the patient was brought into the sterile environment.  Now many hospitals have eliminated this practice and instead of a razor, nurses use clippers to cut away excessive hair as a part of their preoperative preparations.

Rotating tourniquets to treat congestive heart failure (CHF)

Before the wide variety of diuretics, we now have CHF patients were treated with rotating tourniquets. Tourniquets were applied to the lower limbs to decrease venous return to decrease the strain of excess fluid volume on the heart. The use of diuretics is more comfortable for patients than applying tourniquets and it’s much more effective.

As you travel to new assignments get to know some of the old school nurses and have them share stories of how it used to be.  Do you know any old school nurses?  Are you one of those old-school nurses?  Let us know about the old days!

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Cheryl Roby, RN

Cheryl J. Roby is a retired RN and US Army Nurse Major. She has over 30 years of nursing experience and 26 years of military experience in the Army Nurse Corp. During her nursing career she has traveled as part of her military experience visiting many of the 50 states and once to South Korea. Her medical training began during the Vietnam era when trained as an army medic. She went on to train as an OR tech and then as a LVN/LPN. She completed nursing school and was direct commissioned into the reserve Army Nurse Corp. nurse. She appreciated the challenge of working in various specialties and expanding her clinical and professional skill sets. Her time in the Army Reserves and California National Guard gave her the opportunity to travel to most of the 50 states and working in other medical facilities. During her career she spent years as an OR nurse, Occupational Health Nurse, Hospice Nurse, Forensic Nurse, Nurse Case Manager for developmental disabilities, Parish Nursing as well as being a Nurse Entrepreneur.