Could you have handled home health nursing in the 1970s?

Vintage nurse, retro nurse, old fashioned nurse, RN, vintage RN,When I first started in home healthcare, my mother had this romantic notion that I would be taking care of the well-to-do in their fine houses, with manicured lawns and perhaps at least one or two domestic servants. The kind of folks that you read about who left something of great worth to their home nurse in the will.

My father-in-law had a vision of the old-time horse and buggy doctor making house calls and taking medical care out to the people in the idyllic countryside.

Little did they know…

Back in the 1970s, most of our home health patients were card-carrying “frequent flyer club” members at the local hospital. The most common diagnoses were: Diabetes, hypertension, heart disease, sores that were treated with wet-to-dry dressings (the moist dressing standard was yet to come) and surgical wounds that had dehisced and/or become infected. The magical, marvelous wound vacuum systems had not yet been invented.

Instead of fancy mansions, most patients lived in mobile homes, housing projects or structures that could almost not be referred to as dwellings for humans. One patient lived in a converted tobacco barn that had one light bulb and a fireplace. A cat literally crawled through a hole in the back wall and birthed a litter of kittens.

Lack of indoor plumbing was still not uncommon in the country. In some cases, neighbors would share a well by running garden hoses across the yard or road to the next house or trailer. Sears still printed a catalog that was put to use in the outdoor loo.

Some of the older family doctors still accepted whatever the family could afford in lieu of payment: eggs, pecans or a side of beef, depending upon what was in season at the time. Nurses would bring in bags of squash, peaches, and onions to share with the rest of the office.

Directions to patients’ homes were very often dependent upon the location of dumpsters or old landmarks such as abandoned gas stations. (This was before 911 systems made it to the Deep South and all of the roads were given names.) There was no GPS to guide you and heaven help you if the county moved a dumpster!

We once had a patient who went to the hospital with what was finally diagnosed by the CDC as Rocky Mountain Spotted Fever. It was discovered that he lived in a tent just outside the city limits and had probably contracted the disease from a tick bite.

All of the paperwork was done by hand, in the pre-HIPPA era, and only two pages of documents were necessary for Medicare. This was BEFORE Congress “improved” things with the Federal Paperwork Reduction Act. Now we have 15 pages of OASIS to complete!

Today, I work for a small agency and we often get the cases that have been turned down by the “big dogs” in the home care industry. You know the ones: people with horrendous circumstances, no money or insurance and who don’t qualify for Medicare or Medicaid yet.

Sounds ancient, doesn’t it? But consider that this was only about 35 years ago!

┬áTo Boldly Go… (Capt. James T. Kirk, USS Enterprise)

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Nurse Rene

Nurse Rene has been an RN since 1978; CCRN since 1989 and attained a BSN in 2010. She has worked in virtually every specialty from Neonatology to Neurosurgery and is a Member of Sigma Theta Tau International Nursing Honor Society with a particular interest in helping students and new grads develop to their full potential. She's been married for 33 years and has a keen interest in history and in current issues as nursing continues to develop as a Real Profession. When not spoiling the grandchildren, she enjoys sewing, cooking, kayaking, camping and travel. She likes all music which does not hurt her ears, watching NCIS, Leverage, Top Gear and Criminal Minds and reads books written by Clive Cussler, Miss Manners, Erma Bombeck and Tom Clancy. She enjoys collecting Quotations for use in her writings.

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6 Responses to Could you have handled home health nursing in the 1970s?

  1. Ivy RN

    So cool to read about this: In the Adirondack Mountains, where I grew up, this is still not a far stretch, even now.

  2. nurse mary

    it sounds like Home Care Nursing today

  3. Nurse Rene RN

    Thank you both for reading and commenting on the article! You are both correct-not much in Home Nursing has really changed since ‘back in the day’! We have more ‘high tech’ therapies that would have only been done in the hospital before and the ‘new’ burden of computer charting, cell phones and such WHEN they work!
    Here in the Deep South time seems to just ‘stand still’ in many of the poorest areas as Ivy noted. About the only thing missing is paying the doctor in produce, eggs, etc. instead of cash. Still, those who are the most grateful for what we do for them seem to be the poorest.
    Thanks again for your input!

  4. peglatt RN

    nothing much has changed. I started in the home care in the early to mid 90’s after being an ER or ccu nurse for 30 years.We were in the pilot study for OAISIS in 1999. We told the phd running the study what we liked and did not like and as you can see no one listened. I find the “Law” has basically not changed too too much but the people reading the law has changed and come up with dandy ideas for improvement.Has anybody ever said,ok now that we have this “paper” to sign can we get rid of one that is redundant ?And here on Cape Cod we have a lot of low income and very wealthy.

  5. skaz53 RN

    Home Care of 2012 has become more complex and High tech. We are doing things now that were done in ICU only. Pt. are discharged too soon and then we get punished for readmits. The paper work of the 80’s was short and sweet. Now it is 2+hrs on the computer, perform our skill then another hour at home to fine tune. Even with GPS(they are wrong freq) we still get folks tell us it is the 2nd right after the red barn with chickens. Oh yes it is a 9pm admit so chickens are in the barn. BUT would I ever trade my Home Care Job for hospital or other. NO NO NO

  6. Nurse Rene RN

    You are SO right about OASIS! Back in the 80’s, BEFORE the Federal Paperwork Reduction Act we had only 2 pages to send in for a Medicare/Medicaid patient. After everything ‘improved’ with OASIS, we now have 15! Plus, the agency I work for still has not gone ‘online’ and we have to do all of those forms by hand!