Page 1

5 Ways a Nurse’s Duties have Evolved 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. Related: Leading Registered Nurse Patricia Gaye Proo, RN to be Published in the Worldwide Leaders in Healthcare as New Member of the International Nurses Association Please follow us on Facebook, Linkedin, Pinterest and Twitter

5 Ways a Nurse’s Duties have Evolved  

Traditionally, nurses couldn’t make major medical decisions -- in fact, they couldn’t make any medical decisions. They act as the very impor...