Nursing Education Through the Eyes of a Long-Term Practitioner
In the early days of nursing, technology and knowledge had far less advanced forms, which significantly impacted the daily routines and practices of healthcare workers. Reflecting on my journey as a nurse, I have come to realize that the educational foundation and skills acquired throughout my career remained largely relevant. Technology, although more limited, played a crucial role in advancing the field, and the introduction of new methodologies transformed the way nursing was practiced.
Retro Reflections on Nursing Education
When I began my career in nursing, the educational landscape was vastly different from what it is today. At that time, computers and digital tools were still in their infancy. Our workspaces were primarily filled with glass IV bottles, manual syringes, and handwritten charts. The IV bags we used were spacious, and we had to pour medications for numerous patients at a time, which required a high level of precision and organization.
Our responsibilities were extensive. Managing a 20 to 30 patient load with minimal support from one Licensed Practical Nurse (LPN) and two aides was the norm. These aides handled tasks such as feeding, taking Accu-cheks for blood glucose monitoring, and performing intravenous cannula (IV) measures. The LPN would execute dressing changes, while I handled administration, verifying lab results, and contacting doctors with abnormal values. Verbal interviews were also part of our routine to gather detailed patient information.
The Advent of Technology in Nursing Care
While the education was not obsolete, it certainly expanded with the advent of new technologies and techniques. The development and introduction of cardiac monitors in ICU settings marked a significant transformation. The invention of IV pumps and the ability to program and monitor fluid administration precisely using drop rate calculations and visual monitoring through cc markings on tubing are examples of how technology improved patient care. The idea of therapeutic monitoring and real-time data collection was revolutionary and paved the way for more advanced practices.
Another noteworthy development was the introduction of Swan Ganz catheters and arterial lines. I still have an archived AJN magazine from 1970 that mentions the Swan Ganz catheter, which was a game-changer in critical care monitoring. The hands-on training and experience gained from these new devices were invaluable, especially when working with a doctor who invented the arterial line technology. The lack of formal training and the necessity for
Specialized Nursing Units and Continuous Learning
The evolution of nursing practice into specialized units like NICUs highlighted the increasing complexity and diversity of patient care. The introduction of BIRD ventilators and the ability to measure oxygen saturation through a percutaneous sensor marked a significant leap forward in neonatal care. In adult ICU settings, the development of devices to measure exhaled carbon dioxide levels provided more nuanced data, further enhancing critical care.
The critical care of long-term acutely ill patients (LTAC ICU) presented unique challenges and opportunities. Managing patients in a coma for as long as four years without do-not-resuscitate (DNR) orders required a deep understanding of patient conditions and the ethical considerations surrounding end-of-life care. These experiences underscored the importance of continuous education and professional development in nursing.
Conclusion: The Irreplaceable Role of Nursing Education
Reflecting on my journey, I cannot stress enough the importance of nursing education. While the specific tools and technologies were different, the core principles and practices did not become obsolete. Instead, the educational foundation provided a strong base that allowed us to adapt and thrive as new technologies and methodologies emerged. The integration of physiology and equipment skills into our repertoire of knowledge was crucial, ensuring that we could provide the best care possible to our patients.
The field of nursing has undergone numerous transformations, but the dedication and skill required to provide compassionate and skilled care have remained constant. The evolution of technology has undoubtedly enhanced our capabilities, but the educational underpinnings and the hands-on experience that we bring to our roles are the fundamental elements that have kept the profession strong and forward-moving.