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In November 1971, Nursing's first issue rolled off the presses-a skinny 36-page magazine with no advertising and a scant 6,000 subscribers. The newcomer's motto was "All things change, and we must change with them."
The skinny magazine was a hit. And as the circulation grew by leaps and bounds, nurses started writing in to share their opinions about the journal, patient care, and the nursing profession. The following letters, excerpted from the journal's first two years, provide a fascinating look at nursing 40 years ago and illustrate how far we've come-and how some things never change.
Because research has shown the dangers of restraining patients, we now use restraints (including side rails) only as a last resort in limited circumstances. Forty years ago, however, the facts weren't so clear.
"May I say in answer to those who think it is so terrible that patients are restrained in their beds or wheelchairs that is it for their own protection. Many old people will stay in bed if the side rails are up but some will not. Is it not better to restrain them than to have them fall or wander about disturbing other patients? ... As a rule it is the confused or senile patient who is restrained. In these cases, memory is short. Once the restraints are removed, they are quickly forgotten."-RN, Louisiana, October 1972
In the early days, the editors struggled to find a balance between too basic and too advanced. When they missed the mark, they heard about it.
"I have never before completely read a nursing magazine from cover to cover-and yours had so many new and exciting ideas and articles that it was impossible to put down."
-RN, California, February 1972
"I am thoroughly disappointed with your magazine. The article on intravenous administration seemed geared to a first-year nursing student. I can't imagine a working nurse knowing less than the magazine implied. I hope that your magazine shapes up."
-RN, Virginia, June 1972
The controversy over entry-level education was hot 40 years ago too. One reader decried the "haggling over RNs, college graduate RNs, LPNs, and aides," and commented on unrealistic expectations for nurses with college degrees.
"It can be very traumatic to be thrown into a situation and, just because one is a college graduate, be expected to handle it. I think it can frighten a girl so badly she retreats behind a desk and lets anyone take over-or else flaunts her degree around in self-defense."
-RN, Pennsylvania, April 1972
Today, nurses expect to obtain continuing education throughout their professional careers. In an earlier era, this view wasn't universal. Responding to proposed legislation to require continuing education credits as a condition for license renewal in her state, one nurse had this to say.
"Legislators, and apparently some of our fellow RNs, cannot seem to understand that further schooling is impossible for many RNs who are working steadily to support a family ... A diploma school education is a thorough education. We experienced RNs are proud of it and no amount of college degrees will improve our abilities to work with and help our patients.... [I]f such a law is passed, then the already graduated practicing RNs should be exempt."
-RN, New York, May 1973
From the beginning, LPNs and LVNs were enthusiastic members of Nursing's readership.
"There are places where the word 'nurse' is used to mean RN only, and I am referred to as 'just an LPN.' The job description for LPNs has changed over the past 16 years, however. I know because I have worked across the USA in many hospitals. The gap is closing."
-LPN, Indiana, May 1973
"The subject matter in your magazine is excellent and to the point-and you give the LPN a fair shake."
-LPN, Montana, October 1973
In the early 1970s, female nurses wore caps and male nurses were scarce. Gender stereotypes were still firmly entrenched to the detriment of men and women alike. The letter excerpted below from a female RN generated a witty response from a male colleague several months later.
"Not only have nurses been playing handmaiden to doctors for years, but every male nurse who comes along is automatically advanced to the top of the heap. It is taken for granted that he is superior and, therefore, should be put in charge of female nurses. Not so!!"
-RN, California, November 1972
"It would be comforting indeed to be able to affirm that all male nurses are superior and should be put in charge of their female colleagues. Anyone acquainted with the facts, however, knows that, as a group, male nurses exhibit the same range of abilities as female nurses."
-RN, Ontario, March 1973
Although peer-reviewed from the beginning, Nursing didn't initially publish references for articles but made them available upon request. The editors made this choice deliberately to emphasize the journal's practical, rather than scholarly, focus. In March 1972, a lengthy editorial note explaining the rationale for excluding references generated some lively responses.
"I feel that references are unnecessary. I would rarely, if ever, use them and if in need of the information would not find it too much to write for them. Let's not fill up the magazine with superfluous material."
-RN, Washington, D.C. May 1972
"I for one am very glad that you do not include references. I like Nursing '72 because it is readable and not so scientific minded that it is no practical good."
-RN, California, May 1972
"I would like to vote for references. I do use them and sometimes go to great lengths to pursue a reference I think might be helpful. I feel they are very important in gathering data, preparing teaching material, and so forth ... We need those references."
-RN, Missouri May 1972
"Concerning references-please leave them available on request, but out of the articles. The beauty of Nursing '72 is its 'streamlined readability.' Nursing, hopefully, has outgrown the dependence on medicine for 'the answer.' Educated, thinking nurse experts should certainly qualify to contribute to the profession in which they excel without cumbersome documentation. If they don't qualify, who does?"
-RN, Texas, July 1972
All things change, and so have we. Nursing began publishing references in 1979.
Editor's note: If you were one of Nursing's original subscribers-or have fond memories of nursing in the 1970s-we'd love to hear from you. Send a note to our Letters editor at Betsy.Lowe@wolterskluwer.com.
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