Community Connections for Health Care

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by Joan Bachman
I was hospitalized in December 2018 for hip replacement. My stay was 96 hours long which included an extension of 24 hours due to an unexpected medical complication that was apparently a transient event with no lasting effect. I am a very satisfied customer when talking about the professional medical care I received during my stay. The health care professionals who cared for me throughout the episode were professional and personable. It would be wonderful if the health care corporations displayed the same attitudes.

My care consisted of group preadmission instruction, pre-op, surgery, post-op pain relief, basic vital signs monitoring, medications, substantial diagnostic testing, IV therapy, initial mobilization, some personal attention, and preparation to go home – all performed in a personal manner by professional hospital staff members. There was an absence of concern for my personal hygiene, but I survived that. High quality home care for 2 weeks was a continuation of the good service. The limp is gone!!

I find myself now comparing today’s hospital care with my beginning years in health care. Actually, comparison is nearly impossible, with the exception of the trust that is necessary - and exists or not - between patient and each individual caregiver.

I graduated from a school of nursing in 1959, receiving my diploma as a Registered Nurse. A review of the policy/procedure manual from that date (yes, I do still have that 1955 publication!) reveals the scope of nursing care we practiced. We had not any part of today’s technical resources except for lab, x-ray, and electrocardiography. Our monitoring equipment consisted of a mercury thermometer, watch with a second hand, blood pressure cuff, and urine glucose strips.

The list of available medications was much shorter than that of today and there were few (no?) generics at the time. One of our patients was a polio victim who became infected before the Salk vaccine was available and was totally paralyzed. She lived only through means of artificial ventilation in an iron lung, and total care including feeding. She remained in the hospital until a portable system was available and she could go home with complete personal care. Her Mom was a saint!

We performed treatments such as hot packs, dressing changes, exercise, diathermy, irrigations, suction, and skeletal traction. I’d forgotten that we used hypodermoclysis to treat dehydrated babies and peds patients with diarrhea by administering fluid through a 22g needle inserted into each thigh. IVs were not as prevalent as today. Oxygen therapy was supplied from a large tank at the bedside. We were all proficient at getting a new tank from the basement and using a crescent wrench to change the gauge to the new tank.

There were virtually no disposable utensils or supplies. We washed and sanitized bedside utensils and washed and sterilized syringes, needles, and gloves. I don’t know that hospital-acquired infection rates were any higher then than they are now!

A routine day in the late 50s at Mercy Hospital: 5:30 – 6:30am - AM Cares (toileting, wash face and hands, set the patient for breakfast), deliver breakfast; 7:30 – 10:30 – bath time (everyone received a bed bath, full or partial, complete with back rub and clean bedding – well, move the top sheet to the bottom and put on a new top sheet. Don’t forget the drawsheet! and get the pillow placed correctly); 8:30 – 10:30 physician rounds and treatments; 11 – 12:30 – noon meal; 12:30 – 4pm – naps, ambulation, treatments, visiting hours; 4:30 – 5:30 – PM Cares ( toileting, wash face and hands, backrub if limited to bed); 5:30 – 6:30 – supper; 6:30 – 8pm – visiting hours; 8:30 – 10pm HS Care [hour of sleep] (toileting, backrub), treatments. Meds were passed at 8am, 10am, 12n, 2pm, 4pm, 6pm, 8pm, etc. The emphasis in those years was definitely on personal care and attending the patient for comfort and safety. Nursing home and rehab care was just being developed in the late 50s, so, many chronic care patients remained in hospital for long stays of weeks or months.

I remember complaining about the Ladies Home Journal sometime around 1970 for introducing articles about medical and health issues that caused patients to ask questions and make suggestions. Even as a nurse, it was easier to just do what I knew than to consider the patients’ preferences. This new trend must have been extremely difficult for physicians. That was probably when we began to develop patient education programs.

And that’s your history lesson for today. As a result of the nearly unbelievable changes in technology, techniques, devices, and pharmaceuticals, we have made major changes in our expectations regarding personal health and longevity [and costs]. I missed the backrubs during my stay, but wouldn’t prefer a return to the 50’s.

About the Author

Joan Bachman

Joan Bachman is a Registered Nurse, Licensed Nursing Home Administrator, Registered Health Information Technician, and Faith Community Nurse. She earned a Bachelor of Science degree in Business Administration. Joan has experience as a Nurse, Administrator, Developer, Trainer, Grant Writer, and served as Administrator of SD State Survey Agency. She has consulted with health care facilities and nonprofit organizations and presented leadership training. Joan is the author of Guidebook for Assisted Living Facilities and Senior Service Providers and Guidebook for Physician Services in the Nursing Facility, and she has published in professional journals.


Gini Duval

I remember the wrenches and O2 tanks. Fun column.

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