Nursing Then and Now

By Evelina Echols-Sutton, BSN, Director of Women’s and Children’s Services, Methodist Charlton Medical Center

It’s hard to believe there was a time when nurses wore starched, white uniforms, stockings, and caps pinned to their heads. They even had to polish their shoes (white, of course) every few days.

The uniform is just one symbol of how nursing has changed over the years. Nursing responsibilities used to be more task-oriented and regimented. Typically nurses took vital signs, changed bed linens, and worked to make patients comfortable for what may have been a week long stay in the hospital.

We’ve come a long way since then. Patients are in and out of the hospital within days, sometime hours, so time is of the essence. Today’s nurses rely on critical-thinking skills and technology to help care for patients and continually prioritize next steps. Nurses have more autonomy and are viewed as colleagues and important members of the health care team. Physicians are in partnership with nurses, relying on them to help promote positive outcomes for the patient.

Computer technology is one of the single biggest changes in nursing over the last decade. We’ve gone from manually charting vital signs and nursing interventions to depending on computers for interdisciplinary communication and medication administration verification. Nurses have become more tech savvy and proficient at assimilating the information daily.

Because of technology, care is more evidence-based with processes that are determined to be more effective at delivering desired outcomes. Now, at the touch of a button, the data we need is at our fingertips. With this accessibility, we can enter the patient’s history, symptoms, observations, and vital signs into a computer. It will then develop appropriate care plans and assign patient acuity levels. This allows nurses to determine nurse-patient ratios when making patient assignments, as well as establish triggers to alert interdisciplinary health care team members of patients’ care needs.

Computer technology impacts patients as well. Patients can go online to research information about their medical issues or nursing care. Unfortunately, not all websites provide information that is evidence-based, and patients may receive inaccurate information from the Internet. As a result, nurses have to help educate patients and set realistic expectations.

One thing is certain: Nursing care will continue to change in order to meet the demands of the changing health care industry. How do you deal with continual change? Here are some tips:

  • Participate in continuing education. Learning doesn’t stop once you obtain your nursing degree. In order to manage change and stay abreast of advances in health care, we have to take advantage of learning.

  • Pick your attitude. We can decide how change affects us. What kind of attitude do you have? What can you do differently tomorrow that will make it better than today? As a nurse, look for ways to change. Don’t wait for someone else to do it. You do it — become the trendsetter.

  • Engage your patients. You may have only a few days to prepare patients to leave the hospital. Make the best use of that time. Determine the best way to teach your patients. Learn about their home resources. Help connect them with local resources.

  • Be positive. In your mind, imagine what will happen with your patient tomorrow. Be forward-thinking and imagine the healing process taking place.

  • Be a team player. Look for nurses who realize they are not working in a silo. With the many demands of nursing today, be willing to help each other.

To be part of a team that builds on the past to create brighter futures, visit

© Methodist Health System


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