I started my nursing career in 1977 after graduating from an excellent NYU nursing program. I moved upstate to work in a community hospital’s Cardiac Care Unit.
It was wonderful to care for a manageable number of patients who were afflicted with a variety of cardiac conditions. At that time, nurses were allowed to insert IVs and NG tubes, manage various medicated drips, and follow standing orders in emergent situations. Every patient was visited by their own family doctor who was committed and passionate about their patient’s care.
After awhile things began to change. Cardiac patients were often transferred to higher levels of care such as cardiac catheterization. Transfers were sometimes delayed and complicated. Nurse’s aides and LPNs were no longer working in Critical Care and our patient loads increased. ICU and CCU were now one unit: Critical Care. Ventilated patients were now added to the mix, and there were many with chronic respiratory conditions. Computer charting was introduced which infrigned upon our time for compassionate patient care.
Then came the introduction of “the hospitalist.” Patients entering the hospital were now at the mercy of a physician hired by the hospital for their care, and many focused on the computer for data rather than considering the patient as a whole. Big Brother was always watching; security cameras monitored hallway activity, including patients ambulating in their hospital gowns. Patient loads increased to the point that now a single nurse had to care for as many as three intubated patients with IV drips that needed to be titrated.
Our hospital changed its name three times during my forty-three years, and merged with another facility, with the main goal of the corporation being increased revenue, not improved patient care. By my forty-third year, I dreaded going to work, worrying what would be in store for my twelve-hour shift.
I recently became a patient for three days, and I did not see the same nurse from one day to the next. I felt like a prisoner at the mercy of the hospital.
I truly hope medical care will change for the better for the new generation of nurses!
Marian P. Harrison
Forestburgh, New York
1 thought on “The Changing World of Nursing”
Marian, I can relate to your article. I started my nursing career in 1972 after being a nursing assistant for 8 years. I looked forward to going to work and caring for the patients and families UNTIL the environmental changes limited my time for assessing and caring for the patients and families. I also experienced the frustration of being a post-op patient with a hospitalist, case manager, different nurses and assistants, and very little personal care contact. Now, I experience the realities of eldercare -or lack of- in this healthcare a system.