AJN Facebook Readers on Influences, Public Attitudes to Nursing, Practices of Yesterday

We loved readers’ contributions to AJN’s celebration of Nurses Week.  For those who missed our Nurses Week Questions of the Day on Facebook, here are some highlighted responses to some of the questions:

What nurse has most influenced your nursing career?

There were many shout-outs to mentors by name, lauded for their grace, commitment, integrity, vast knowledge, and patience, or described as nurses who “role-modeled intelligence, compassion, and professionalism.”

Moms, grandmothers, and wives were often mentioned, as were instructors in both RN and LPN schools, and charge nurses. One nurse described being mentored by a paramedic, who “showed me how to remain caring in a system that so many times does not have time for the small things.” Another cited “every nurse I’ve ever worked beside” as a mentor, because other nurses model both the best and worst of nursing practice.

What do you think the general public doesn’t understand about nurses and nursing?

The number one frustration expressed in these answers was that we are often thought of as caring but not intelligent—that “we don’t know what to do until a doctor tells us.” But as one nurse succinctly put it, “We know what’s going on with you before you or the doctors know what’s wrong.”

Also high on the list: people who don’t understand that nursing can be physically and mentally exhausting. Part of this stress seems to stem from the commitment that most of us feel to our work: “It isn’t just three 12-hour shifts, it’s life.” Or, particularly maddening to hear: “You work too many hours! Why? Can’t you just leave?”

One nurse reminded us that the stresses of work that keep us deeply involved with people in crisis can also yield unexpected joys.

What do you remember from early in your career that would never be seen or done today?

We “nurses of a certain age” remember!—and we’re amazed at how far our profession has come. As one nurse commented, in response to early nursing practices that seem primitive today, “Oh my goodness, how has humanity survived?!”

There were, of course, our caps, white dresses, white hose, and white shoes. One nurse recalled that we always wore our school pins on our uniforms. These seem not much in evidence these days, but were always a source of pride and connection (and sometimes, lighthearted rivalries) back in the day.

In addition, nurses pointed out that the scope of practice has certainly changed. Nurses mixed soft soap for enemas, mixed weak solutions of Lysol (!) for vaginal douching. Wound care has, shall we say, evolved. Nurses recalled packing wounds with eusol (chlorinated lime plus boric acid—“cleaned wounds by removing patients’ flesh with it!”), Savlon (chlorhexidine combined with a chemical later used for disinfecting floors), Milton (a bleach solution), or sugar mixed with Betadine or egg whites. Some remembered “vigorously rubbing talc onto bums to relieve pressure” or “Maalox and heat lamp for sore butts.”

Are automated medication dispensing systems (for example, Pyxis machines) and bar codes part of your daily routine? Several comments described pouring meds from stock bottles on the unit or mixing chemotherapy solutions in the medication room. There were no medication carts, just medication trays with cups and handwritten cards for each patient (different colored cards for b.i.d, t.i.d., etc.).

“Point of care” lab testing didn’t include quality checks. One nurse remembered “burning urine samples in a glass tube over a Bunsen burner to check sugar levels.” DeLee suctioning of newborns—“I ended up with a mouth full of stomach contents more than once”—or pipetting blood and urine samples for the lab via mouth suction were also routine.

Many comments reminded us of tools rarely seen in today’s hospitals. There were time-taped IV bags, glass syringes and IV and chest tube bottles, mercury thermometers, crank beds and egg-crate mattresses, “gloveless everything,” and no hand sanitizer.

Routines and work practices of years ago may be hard to imagine today. Nurses recalled smoking during report, and patients smoking in bed. Patients were admitted “just for observation,” or a day or two prior to surgery. Each shift charted in a different color of ink. Nurses recalled time to talk with patients, and actual “acuity-based staffing” (“RIP,” as one nurse commented).

Another nurse summed up a certain sadness as she described some lost aspects of patient care:

“morning care before breakfast, clean sheets every day, evening care with back rubs, trash emptied, fresh water and being aware of the patient’s environment. [We] took time to assess the patient by the RN and listening. The care was impeccable because of the nurses who controlled the patient experience.”

Clinical editor, American Journal of Nursing (AJN), and epidemiologist


  1. Dennis Suero July 14, 2017 at 6:38 pm

    I sincerely understand the brief bit about the general public not understanding our role or even how demanding our job can be. This extends to even family and friends to be quite honest. All too many times people’s automatic response to learning of our work schedules is simply: “oh, you only work three days?”. I work in a busy ER ad I can attest to the fact that I spend more time running around in one shift than most 9-5ers do all week. I don’t think many people can truly empathize with our demanding work schedule except a few others who also work bedside us in that setting.

    Its also interesting to note that you touched on the concept that many people assume nurses don’t necessarily have any autonomy and simply carry out orders. Like you said, many times the nurse knows what is going on before the Dr does. At least for me, in my capacity where I work we have the autonomy to order a wide variety of things before an ER doctor even sees a patient; this includes anything from basic blood work, to ultrasounds or XRs and CTs.

    Like you mentioned however, the high stressors of many of our jobs also bring great joy and rewards. Something many of us wouldn’t trade.

  2. Melissa June 11, 2017 at 4:20 pm

    Enjoyed the anecdotes of “the old days,” and still have some left over habits; for example when planning times of meds at the beginning of shift, next to each name I’d use a reminder series of small boxes, so I could check off on my own record (this is harder to explain than it was to do)..at any rate, I still use those boxes next to a task as reminder that it’s a priority..
    As staff nurses, we functioned as physical therapists, social workers, respiratory therapists, and provided the total care…I learned SOOO much and remember so many wonderful patient vignettes

Comments are moderated before approval, but always welcome.

%d bloggers like this: