Medical Advancements


Afterword from The Naked City

Medical Advancements in My Lifetime 

© Caroline Rosdahl 2020


GENERAL CHANGES 

  • More male nurses, much better salaries for all nurses 
  • More female doctors 
  • Nurses of all races and ethnicity; ability to wear traditional ethnic/ religious clothing at work 
  • Computer use widespread; ability to access patient records from a distance; improved monitoring of medications; much medical information available online 
  • More attention given to ethnicity; language translators available, ethnic customs followed
  •  9-1-1 system available in most US locations for emergency services 


NURSING/ MEDICAL EDUCATION CHANGES

  • More complex education for all levels of nurses 
  • Nurse specialists: e.g. Nurse Practitioner, Physicians’ Assistant 
  • Changes in delivery of nursing education: simulation, distance learning, self-study, learning at one’s own pace, less hands-on clinical experience, clinical specialties included in some nursing programs 
  • Doctors in several locations can conference regarding a patient 
  • Continuing education required and readily available for medical personnel 
  • Physicians more often specialized in area of practice; fewer General Practitioners
  • Nurses wear scrub suits, rather than white uniforms, no nurses’ caps or school pins worn


HOSPITAL CHANGES/ CHANGES IN DELIVERY OF HEALTH CARE 

  • Virtual/ distance care provided when possible; patients may see non-physician; much care delivered by non-physicians 
  • Hospital admissions based on severity of illness; fewer overnight stays 
  • Nearly all single or double rooms; no large wards 
  • Community clinics available to treat homeless and indigent patients 
  • Many surgeries performed in Day Surgery; no hospitalization necessary 
  • Interim rehabilitation care provided, rather than longer hospital stay 
  • More safety in blood transfusions; ability to use only blood components 
  • Premature infants often survive; many abnormalities can be determined and treated early; conditions may be treated in utero (before birth) 
  • Better and earlier care for children with disabilities (mental, emotional, physical, educational) 
  • Early identification and treatment for special needs (e.g.: autism, various physical disabilities) 
  • Psychiatric and Chemical Dependency facilities available for all patients
  • Immunizations available for many childhood diseases; new ones constantly being discovered; 
  • Hundreds of new medications; more broad-spectrum antibiotics; some older medications found to be dangerous and removed from the
  • Nurses wear scrub suits, rather than white uniforms, no nurses’ caps or school pins worn
  • Older medications found to be dangerous and removed from the market 
  • Many birth control methods now available; abortions now legal in most states 
  • Much better cancer management; many combinations of chemotherapy agents 
  • More use of stem cells for treatment 
  • Much improvement in nursing home care and home care services; provide activities and stimulation 
  • School Nurse works with a team, including social workers, dentists, physical therapists, and personal caregivers; home visits are common 
  • Many improvements in Rehabilitation Care and equipment; stand-up walkers, specially-adapted wheelchairs, walk-in bathtubs, circle beds, electronic muscle stimulation (to facilitate movement) 
  • Hotel swimming pools often have patient lifts, to assist disabled people 
  • Hospital rooms have patient lifts, piped-in oxygen, wall suction, etc. 
  • Service dogs and other animals trained to assist clients with disabilities, such as poor blood sugar control, seizures, limited vision, and limited mobility 
  • Physical restraints rarely used in Psychiatry; better understanding and treatment of mental health disorders; many new psychiatric medications; 
  • ECT often used for maintenance 
  • Ships and medical teams go to underserved parts of the world to deliver care 
  • Genetic studies and DNA testing used to improve care Injections given by nurses and pharmacists, as well as physicians 
  • Many changes in infant delivery: midwife, home delivery, rooming-in 
  • Breast milk pumped for working mothers to give to baby later
  • Helicopter transfer available in many locations 
  • Greater awareness of physical disabilities; ramps, power doors, adapted automobiles, special parking places, etc. 
  • More specialized treatment available, e.g. 
  • Physical Therapy, acupuncture, massage, chiropractic, and other non-traditional methods more accepted by the medical community 
  • Many new disorders discovered and requiring specialized care (e.g.: HIV/ Aids and other autoimmune disorders) 


SURGICAL ADVANCEMENTS 

  • Huge advancements in surgery (open-heart, heart surgery via blood vessels); tiny incision, e.g., stents, heart valve replacements, treatment for patent ductus 
  • Incision closures done with glue, staples, as well as stitches 
  • Ability to do many surgeries without major incision (“stab wound”), e.g.: gall-bladder removal, appendix removal, hysterectomy, stomach stapling and other bariatric procedures, etc. 
  • Brain surgery often done with patient awake 
  • Repair of fractures with pins and/ or external fixators; joint replacements 
  • Heart, lung, kidney and other transplants 
  •  Ability to reattach severed limbs 
  •  Ability to repair severed blood vessels, replace blood vessels New modalities for tremors, Parkinson’s and other brain disorders, e.g.: Gamma Knife, DBS (Deep Brain Stimulation), ultrasound, etc. 
  • Microsurgery performed, such as eye surgery (cornea replacement, cataracts, etc.) 
  • Laser surgery used, especially in eye conditions
  • Many advancements in bariatric surgery (stomach sleeve, stomach stapling, etc.) 
  • 3-D body parts can be artificially manufactured and used 
  • Sex-change surgeries commonly done 


EQUIPMENT CHANGES 

  • Many patient rooms have cardiac monitors, blood pressure monitors, etc. 
  • Wrist blood pressure monitors; temporal thermometers available 
  • Blood sugar levels measured externally Insulin pumps implanted, to deliver specific doses of insulin; other medication pumps available, such as for pain control 
  • Bariatric equipment available for morbidly obese patients: beds, wheelchairs and other special equipment (may have 500 pound limit) 
  • Mechanical beds alternate pressure, to prevent bedsores and other deformities 
  • Beds can tilt to treat shock; beds can be made firm, to allow for CPR 
  • Hospital beds can weigh patient with the patient in bed 
  • Mechanical CPR available 
  • AED (Automatic External Defibrillators) available for community emergency use 
  • Automatic defibrillators can be implanted for clients with chronic cardiac conditions 
  • Ambulances fully equipped with rescue items; staffed by Paramedics; ability to stand up in ambulance to deliver care 
  • Seat belts and air bags installed in automobiles; use mandatory in many places 
  • Hyperbaric chambers available in most locations; fixed system or portable
  • Mechanical suction widely used 
  • Mechanical ventilators available 
  • IV pumps monitor delivery of IV fluids; IVs mixed by Pharmacy, not nurses 
  • Many more diagnostic systems available; ultrasound, mammogram, colonoscopy, CT scan, cardiac monitors; improved x-ray procedures for diagnosis and treatment 
  • Retractable injection needles, to prevent needle sticks 
  • Most medical supplies used for one patient only and then discarded 
  • Portable oxygen and oxygen concentrators available, to provide mobility for clients 
  • Autopsies more definitive in forensic medicine
©Caroline Bunker Rosdahl 2022 • Bunker Hills Media •  PO Box 41307, Plymouth, Minnesota 55441 / 612-805-3349 / 032322