Monday, September 28, 2015

A Tangle of Tubes and Wires

I just know you whippersnapperns have it much more complicated today because I could not even venture to guess all the parameters that you monitor in ICU.  But I bet we have this in common, Don't you just hate it when a new patient is admitted to the ICU directly form the OR?  The anesthetist rattles of a quick report and then quickly heads back to the tiled temple.  You are left with a  rat's nest of wires, tubes, and who knows what else all balled up somewhere on top of or beside the patient.

It's tough to know where to start, but at least you know how a cat feels playing with a couple of balls of yarn simultaneously. This is really a job for more than one nurse. You can draw straws with a couple of discarded needle caps to decide which nurse gets to do the wires and who does the tubing. Wires are  usually the easiest task unless there has been an intra-operative EEG, then both tasks are about equally daunting.

Patience is the key and be sure not to yank on anything to free it up. Try to prioritize, get that arterial line and EKG wires hooked up before you free up that Foley drainage tube. That way you can watch the monitor go wild if you put too much traction on the Foley. At least you know the patient is beginning to react after anesthesia.

This problem is not unique to contemporary whippersnappern's. As this old photo from the late 1940's (that was even before my time!) shows, it requires 5 students and an instructor to untangle this ridiculous hodge-podge conglomeration of tubing and who knows what else. In my time, we would have received demerits for failing to draw the curtain. That spectator gawking in the bed to the left is probably not HIPPA compliant.

It's nice to realize that some problems in nursing remain timeless and serve as a sort of glue to spiritually unite us through time.  These nurses from yesteryear are faced with the same untangling dilemma as nurses today. They might not be dealing with a line from an intracranial pressure screw, but nonetheless go about their task with the same diligence as today's nurse. The sense of caring is always present in nursing.

Friday, September 25, 2015

Downey VA Hospital..... A Lost Empire

Decades ago VA Hospitals were divided in 2 camps, General Medicine and Surgery or GMS and
Neuropsychiatric or NP. Downey was an NP  faciltity  and the countries largest VA Hospital at 1800 beds. It was located about 35 miles north of Chicago adjacent to Great Lakes naval training center. It was constructed right after WWII and designed to provide a lifetime of care via institutionalization for people with chronic mental illness. There was even a full scale medical hospital with ORs and critical care units with strange names (critical care units were called GPUs or General Purpose Units)  The OR was always called EOR or emergency OR. God forbid anyone should mistake them for a "real" medical surgical hospital. That is the only rationale I could deduce for the funny names.

It was really a self contained city with it's own zip code, 60064. There was a movie theater, bowling alley, golf course, swimming pool, and various work areas for the patients such as the spoon factory where patients spent the day tossing plastic spoons into plastic bags. There was a greenhouse where the most common activity seemed to be digging compost and also a metal and wood shop. All the buildings were connected by underground tunnels which always reminded me of catacombs, with poor lighting and spooky dead ends. Staff moved from building to building topside whenever possible.

Patients were housed in multiple 2 story brick buildings with 2 wards on the first floor and 2 on the second with  total census of 104 patients n each building. Windows were covered with vertical iron bars. There were no elevators and the stairwells had imposing walls of cyclone fencing through the middle core to prevent patients from jumping. Radiators provided heat and there was no air conditioning. The buildings were like brick ovens in the summer. Open windows had no screens and various birds and flying insects entered the buildings. Electricity was delivered by underground lines which were not very reliable. Building 66 where I worked was once without power for 3 days. We used flashlights and battery operated lanterns as a backup. The patients barely noticed, but there was definitely a Halloween atmosphere with bizarre shadows and spookiness throughout. The souls of over 100 schizophrenics all in one poorly lit area.  Yikes, get me out of here!

Almost every patient had the same diagnosis (SCU) or schizophrenia, chronic undifferentiated. About 2% of the population was bipolar and added some spice to the mix. All patients smoked constantly while in the dayroom producing a dense ever present haze. Smoke Eater machines mounted on the ceiling did little to clear the air. A typical ward included the day room with connecting hallway to the dorm which was just a huge open room with beds. Just off the hallway was a restraint room with four heavy beds bolted to the floor. The beds were usually all occupied. My claim to fame at Downey was teaching a couple of very violent patients a self restraint technique. I got them to the point when they felt like slugging someone to come to me and ask to be put in restraints. I readily complied with their request and let them decide when they should be released. It worked like a charm for a couple of patients and I always thought I should have received some kind of performance bonus for my idea. The VA was always handing out bone head awards of one type or another, but I got passed over.

In the mid 1970's things began to change at Downey. When liberals and conservatives have common objectives, things happen in a hurry. I really hate political labels and politics in general, but the liberals thought chronic psych patients needed to be freed from the chains of custodial care and some thinkers like R. D. Laing even questioned the whole concept of mental illness. According to R.D. "Insanity was a rational adjustment to an insane world." The conservatives did not like to spend tons of tax dollars on what seemed like a lost cause. Downey began to change. Long term patients were discharged with terrible end results. Patients wreaked havoc in the community by strolling into restaurants and failing to pay. Camping in city parks and the homelessness we still witness today.

The "Downey" name was first changed to "North Chicago VA" then "Great Lakes VA."  The Chicago Medical School built a huge campus smack dab in the middle of the golf course. Today Downey is gone for good replaced by the James Lovell Federal Health Center. Real medical stuff without EORs or GPUs.  I tried Googling Downey and nothing even came up. I guess some things really are best forgotten.

Tuesday, September 22, 2015

An Old Nurse Poem

I found this old poem on printed on our graduation program and thought it was clever. There is no author listed

Like an angel hovering near,
Shielding us from doubt and fear,
Face so gentle, sweet and bright,
Like a moonbeam in the night.

Ever constant through the day,
Fearlessly you go your way,
Seeing that no one grows worse....
Heaven bless you,
                         Faithful Nurse

Sunday, September 20, 2015

Terrific Terrazo Floors

Terrazo floors were common place in old hospitals, found in halls and heavy foot traffic areas like operating rooms. They were created by mixing small stones, usually of different sizes, in a dyed concrete mix. The mixture was then  poured into forms that were cross-hatched with metal dividers spaced a couple of feet apart.

After the concrete set, the floor was ground down with progressively finer discs on a big grinding machine that resembled a super heavy duty rotary floor polisher. The end result was a very beautiful floor surface that resisted stains such as betadine or blood and lasted practically forever.

As a youngster I had the opportunity to talk with workers installing a new terrazzo floor in an operating room. They were Italian (Terazzo means terrace in Italian) and they were a proud, hard working group of men. The process was very loud and dusty from the grinding down of the concrete stone matrix, but they actually seemed to enjoy their work. The end result was truly a work of art. I am sure the cost of doing this today would be astronomical and I suspect this is the reason terrazzo floors disappeared.

These are two beautiful examples of a terrazzo floor with a silver metal dividing strip down the middle. Our operating room had much darker terrazzo floors with a greater diversity in size of the stones and beautiful gold dividing strips.

In the foreground is a very nice illustration of a terrazzo floor in an older operating room. Notice  how the ceramic tiled walls and terrazzo floors combine to create a certain ambience.  Important things are going to be happening here. These are hallowed halls.

I have seen plain white flooring in contemporary operating rooms heavily stained a yucky yellow color from the prep. A dirty looking floor in the OR does not inspire confidence. Plain looking flooring looks like it belongs in an airport or school, certainly not in a sacred place like the tiled temple of an operating room.

Now for some foolishness. A typical scenario for a scrub nurse on call would be to awaken to a call in the middle of the night stating,"There has been a multi vehicle accident on Lake Shore Drive we need you in the operating room ASAP." I would jump up out of the call room and run to the scrub sink and begin my scrub and  about 10 minutes later I was ready for showtime with my mayo stand set up and my back table loaded for bear. I was chomping at the bit and ready for any thing. Let me at 'em.

Now for the fun part. Sometimes we had to wait up to an hour before the patient arrived in the OR. I really don't know all the reasons for the hold up, but suspect it had to do with stabilizing vital signs and establishing an airway or further diagnostic studies. Peritoneal taps to evaluate internal bleeding were common before CT scans became available. Sometimes the poor soul died in the ER before even making it to the OR.

Dr. Oddo, my favorite neurosurgeon, frequently reminded us that in our line of work it was important to have diversions and relax when you have the chance. He was a really affable, pleasant man  outside the OR with lots of good friendly advice. His diversion was a sailboat docked at Montrose Harbor where he spent much of his spare time.

One of the most important times to stay loose and relaxed was during that wait for the trauma patient to arrive. I would stand between my Mayo stand and back table, guarding their sterility, then begin meditating on the beautiful terrazzo floors. It was a lot cheaper than a sailboat. Once Dr. Oddo observed me deep in my meditative trance and said "How nice, Old Fool was praying." I didn't say anything to contradict him, but I was really exploring cosmic frontiers in the terrazzo floor.

These  floors could be like exploring the solar system if you studied them closely. You could easily identify the planets from the different sized stones imbedded in the floor. For more visual props, distant galaxies like anesthesia can contribute things like yellow tops from KCl multi dose vials to represent the sun. Does Mars have water that could support life? According to that pool of I.V. fluid that was just dripped onto the floor, it does.  Wow is that a meteor shower? Nope, just the lights being reflected through anesthesia's IV bottles.

Staring at the straight gold dividing lines and comparing them to random round stones always made me wonder why there are no straight lines in the natural world. Those straight metal dividers always reminded me of the big straight incisions and what a contrast they were to soft round organs and tissue. Were we doing the right thing here?  I also sometimes wondered if all those little stones in the floor were symbolic of the rocky recovery faced by some of the unfortunate victims of trauma. Life can change in the blink of an eye.

Wow things are getting out of hand here, it sounds like a catastrophic meteor shower out in the hall. Nope, it's the arrival of our patient attended by a band of frenzied care givers. As Dr. Oddo would say, "Let's hit it!"

Wednesday, September 16, 2015

Scrub - a - Dub

I once got into a heap of trouble because I mopped the floor before cleaning the bed frame. The correct procedure  was to scrub the bedframe free of  stalagtite - like mucous formations  and blood, then proceed to the floor mopping. We were also supposed to damp dust all the flat surfaces in the room, but our instructors only checked the top of the door frame. The moulding around the top of the door was always meticulously dusted.

Before performing this advanced floor cleaning skill, we practiced in the nursing arts lab. Our instructors frequently reminded us of how lucky we were that we did not have to shovel coal into the boiler as they did. We always referred to an older nurse as a "coal shoveler."  It was a badge of honor in that it defined a really tough, experience nurse that could be counted on to do anything for her patients.

Another part of cleaning a patients room was to scrub the ashtray. We had round metal ashtrays with a spring-like device around the circumference to hold the cigarette. The spring had to be removed from the ashtray and all signs of ashes scrubbed out.

We did have environmental service workers janitors to clean the common areas, but the patient room or ward was strictly the nurses' responsibility.

Another rule required the nurse to clean the dietary tray and dishes if there was emesis present on the tray. Student nurses sometimes argued unsuccessfully that the food made the patient sick and dietary should do the clean up.

I always liked that strong disinfectant smell when we were done. It meant our clean up duties were complete and we could learn more advanced skills like sharpening needles

Tuesday, September 15, 2015

A Blue Finger Bigot

Methylene Blue which was supplied to us in 10cc glass ampules had many uses in the OR. It was used to test for tubal patency by inserting a Foley in the cervix and then injecting it to observe if the blue dye could be visualized. It was used to dye white silk suture and as a general marking agent on tissue.
Dr. Oddo, our internationally famous neurosurgeon who separated the conjoined twins had to have a medicine cup of methylene blue on the Mayo stand at all times. He usually applied it with round (they had to be round) toothpicks.

The circulating nurse was tasked with breaking these big ampules and carefully pouring the dark liquid into a waiting medicine cup. It was almost impossible to break these big ampules and not get a splash or two of the tell tale blue dye on your index finger or thumb. We tried aggressive tapping the ampule to get all of the dye out of the break zone, but nothing seemed to work. We were not permitted to use gloves for anything other than sterile procedures so an occasional blue finger or thumb was inevitable.

When Dr. Oddo noticed the blue stain on our fingers, he would begin his bitter diatribe. "That's disgusting, how clumsy of you." He would scream. He would then begin to gown and glove while muttering, "Deplorable and disgusting." The way he carried on you would think we contaminated the sterile field. He was fairly even tempered and we could never figure out how the blue fingers got him going.

This got to the point where some nurses on purpose accidentally got Methylene Blue on their  fingers just to get the berating over with. On one occasion I had to crawl under the table to tape down the pedal switch for the Mallis bipolar and Nancy, the scrub nurse dripped a big blue dot of the dye on the back of my scrub shirt. Dr. Oddo never said a word so we concluded his anger was blue finger specific.

One day during a Cloward  Procedure, the resident nicked a vertebral artery with an angled curette. Dr. Oddo quickly managed to clip it, but not before being squirted with bright red arterial blood squarely in the forehead. It dripped down and clotted in his bushy eyebrows.

When the dust settled, Nancy and I looked at each other with mock disgust. As soon as Dr. Oddo stomped out of the room we began our tirade, "That was disgusting AND deplorable" Nancy said and I readily concurred.

Sunday, September 13, 2015

Cojoined Twins

As a young scrub nurse, I did many cases with a Chicago neurosurgeon that was the first to separate twins joined at the head where one survived. The neuro residents always made a big point of this, pointing out the length of the procedure (10+ hours) and the fact that 6 Liters of blood were replaced.

Nurses were not so easily impressed, raising the issue that one twin never regained consciousness and died 34 days post op. The other twin was mentally and physically retarded living to age 11. The surgery was done when the twins were 15 months old and certainly not able to provide informed consent. We wondered how the twins would have done without the epic surgery. Maybe they could have adjusted to life as conjoined twins. Maybe our values of having separate bodies were being forced on people that were happy to be joined. The issue provided lots of fodder for philosophizing in the break room between cases.

Recently, I came across a much earlier and primitive attempt to separate twins joined at the sternum that raised some issues in my mind. Radica and Hodica, two  Hindoo  girls that were a part of The Barnum and Bailey Circuus.  Hindoo is an old reference to being Indian and today considered an ethnic slur.

One of the girls developed a respiratory problem and the circus physician recommended they be separated. (I did not realize that a circus had a dedicated physician, but it sounds like an interesting job.) On 2/10/1902 Dr. Eugene Doyen separated them at a Paris Hospital.

Paradoxically, the weaker twin, Radica survived the procedure, but soon died. Here are some notes from the surgeon: "In severing the membrane connecting their bodies, 3 arteries were cut and blood in the amount of 30 to 40 grams was lost." It sounds to me like the good doctor failed to recognize that the twins shared components of their circulatory system and went in wily- nily chopping away. In nature things don't exist in odd numbers so who knows what he cut.

That the patients are still alive, says Dr. Doyton is due to the "rapidity of the operation." Aside from the lack of aseptic technique this photo raised a couple of questions in my mind.

Where is the scrub nurse? Who do they have to yell and scream at?  How can you keep things neat and orderly without a scrub nurse?  Same sex groups always get into trouble acting on their own. Remember the Taliban or criminals in the NFL. Some women are needed here to balance things out.

Historically, women have always been superior to men in tasks like sewing and putting things back together. Remember Betsy Ross? Putting things back together and suturing is a more advanced skill set than taking things apart.

Five men working with sharp metal objects on undefined anatomy is not a good idea.

Saturday, September 12, 2015


Make sure that scultetus binder is nice and tight before you begin suctioning!

Wednesday, September 9, 2015

Hospital Hacks from History

People are hard-wired to enjoy novel solutions to problems using whatever is available to them. We used to call them "work-arounds" and today the common term seems to be hacks. Decades ago there were fewer regulatory and oversight agencies breathing down your neck, so we probably got away with hacks that would not fly today. Here are some memorable hacks.

Old time hospital beds were simple devices that were controlled by three hand cranks. The left crank raised the head, center raised the whole bed, and the one on the right raised the foot. Frequently, the wooden handles on the crank would break rendering the bed inoperable. Here is an effective hack for a non-functional left sided hand crank on an old hospital bed.

I never thought electrical hospital beds would come to widespread use because of the danger involved with patients having lines attached to them like EKG wires. If you whippersnapperns have a power failure rendering your beds inoperative, I imagine this hack would still work. It is rather crude, but very effective which is the hallmark of a good hack.

Many medical procedures were done on the ward at the bedside. Here is a hack for a proctology table with the objective of elevating the pelvis and lowering the trunk to pull the abdominal viscera down. Position a chair at a right angle to the bed with the back of the chair facing the bed. Now lower the entire bed so that it is about even with the seat of the chair. The patient is positioned kneeling on the chair facing the bed. For comfort (?)  pad the top of the chair  back with a bath blanket. Finally have the patient bend over the top of the chair back so his head is resting on the bed. An old time surgeon always referred to this as the "flying buttress" position. Patients were not amused.

The nurse sets up the proctoscope, swabs, etc on an overbed table and stands on the opposite side of the bed from the surgeon to restrain comfort the patient during the procedure. I always thought these procedures resembled a sword swallowing act done by someone that got their basic anatomy confused. The patients did not like it and the arthritic ones had aches and pains all over as a result of being twisted up like a pretzel.

Always use a big metal bath basin if your patient is vomiting. Whoever called those little kidney basins "emesis pans" never threw up. Maybe they just trying to put a good spin on vomiting, but I bet they never had to clean up the mess when someone overshot their puny little emesis basin with projectile vomiting.

Having trouble with that black band sliding around on your nursing cap? This hack works every time. Run a thin bead of KY jelly along the back of the black band before applying it to your cap. It will hold it in place and guaranteed not to leave a stain.

Radiators make excellent blanket warmers. Just stack them up and use as needed. On cold wards, your patients will love this hack.

An enema can is the perfect way to keep your patients'  flowers hydrated.  That tubing lets you access hard to reach vases and control the flow. Just remember to reassure nervous patients as you approach them with the enema apparatus that your only mission is to fill the flower vase.

Traction frames can be hacked for hanging just about anything from enema cans to IV bottles.

Finally, I saved the best for last. It's called a code brown containment system and I bet you are surprised an Old fool like me knows that Whippersnappern vernacular. The goal here is to keep all the stool on one level. When it starts running over the mattress into the bedframe or on the siderails it is much more difficult to clean up. Keep it all on one level. Get a shower curtain and cover the entire bed, then roll up bath blankets and position them under the shower curtain in a circle around the area expelling the effluent to act as a dam. This should effectively contain the mess to one level. The shower curtain area out of the containment zone can be covered with a drawsheet or towels so the patient is not lying on the bare plastic.

Monday, September 7, 2015

Ancient Auditory Acoustic Abominations

Despite posters at every nursing station of this nurse encouraging silence, old hospitals were loud places. There were even signs posted on the street advising QUIET HOSPITAL ZONE. The smooth terrazzo floors, tiled walls, and plaster ceilings amplified and projected noise everywhere. Some of the noises were not really an abomination and I actually miss them, but sometimes I get carried away with alliteration in the titles. Blame it on my advanced age.

The most prominent and persistent noise in hospitals was the ever present squacking of the public address loudspeaker system paging doctors. I am not really fond of cell phones and do not even own a smart phone, but the elimination of constant verbal paging in hospitals justifies their existence.  The most common pages were for things like "Dr, Slipdidgit call 302...Dr. Slipdigit call 302" Every now and then you would hear alarming ones like "Any general surgeon to the OR" and you just knew bad things were happening. Really bad things had number codes a "33" was a cardiac arrest, a "55" was a fire and a "77" was for an assaultive patient, usually in the ER. The following page was actually made at our hospital: "This is a test of the public address system. If you cannot hear this page, please call the operator immediately."

Some of our older rooms did not have call lights. The nurse was summoned by the patient ringing an actual bell. Some of our older instructors thought call bells and call lights were not necessary. According to their thinking the nurse should be close by and aware of her patients' needs. On the wards of 8 patients, the nurse was always in the same room with them. Lights flashing or bells ringing were a sign of poor nursing care because the nurse was not anticipating needs.

Dropping anything made of metal or glass on terrazzo floors made a very loud CRASH. There is nothing like being aroused from your sleep deprived stupor at 4AM by the crash , splash, and swearing that goes along with a full metal bedpan dropping on a terrazzo floor in the middle of the night. Dropping glass IV or suction bottles also makes an impressive noise. A common scenario would involve  setting a round, glass IV bottle on a flat surface to make a time strip, getting distracted and letting that glass bomb roll. The crash would disperse glass shards to all corners of the room and if it was D5W you had the added element of stickiness to contend with. Yes, I have personal experience with that kind of embarrassing mess. The breaking glass always brought a large crowd of onlookers that seldom offered to participate in the cleanup.

Portable suction machines (no wall suction) made a loud buzzing noise that always reminded me of  those new-fangled electric alarm clocks. Combine that with the coughing, hacking, and gurgling noise of viscous green mucous dancing in the suction tube and you had a very distinctive sound. Sort off  like a Maytag on the rinse cycle in the midst of a TB sanatorium full of patients coughing and hacking.

Here is one hospital noise experience I really miss. We sent out our linen via chutes that were similar to large sewer pipes that ran vertically throughout the hospital. For real fun head up to the 6th floor or higher and fill up a linen bag so the diameter of the bag matches the caliber of the chute. Drop that bag down the chute and you will hear a noise that resembles a 747 on takeoff roll. All that air being sucked down the chute even resembles the jet wash from the plane taking off. WHOOSH -  Really impressive.

In the lab, CBCs were done manually with a technician physically counting the different types of cells. They used little clicker devices to keep track of the count. The lab sounded like a newspaper press room with all the typewriters blazing away..oops, today  we don't have those either.

Our elevators had a big gap between the car and the floor. Dietary carts were loaded with actual ceramic plates and cups. When one of these carts got stuck in the gap, a terrible thud and crash noise would occur sounding like every plate and cup on the cart broke.

When working as a scrub nurse I used to love that splat noise a diseased gall bladder made when the surgeon tossed it in the kick bucket. It was a conditioned response denoting that all that remained was closing up. We were almost done. The circulating nurse always recorded the anesthesia start and surgical start time, but many of the surgeons were really interested in their "bucket time" and frequently asked the nurses to back them up when they bragged, "I got a gall bladder in the bucket in 12  minutes."

Metal chart racks filled with metal clipboard paper charts were rolling noise makers. Patients always knew when the MDs were rounding because of the crashing and banging of metal against metal. Every time a chart was retrieved or returned it sounded like a mini car wreck. Just what a patient needs to hear lying in bed recovering from an invasive open surgery.

We had autoclaves in central supply and a couple of smaller ones in the OR used mainly for "flashing" instruments that were needed at the last minute. The OR autoclaves vented their steam outside on the exhaust cycle. The noise made by all that steam being vented sounded like an old time locomotive. Even more impressive was that huge white contrail-like cloud of steam visible out the window. For thanksgiving, I am going to provide my hospital tested procedure for cooking a turkey in an autoclave. Yes, we really did that when on call, but it was anesthesia's idea.

If you liked this post, you might be interested in "This Place Smells Funny," a previous post about olfactory abominations.

A special thanks to everyone toiling in a hospital on this Labor Day and I hope you are being justly compensated for your sacrifices.

Wednesday, September 2, 2015

The Stryker Wedge Frame - Putting a Spin on Healthcare

In 1946 Dr. Homer Stryker, an orthopedic surgeon decided to develop a device to turn spinal cord injured patients while maintaining spinal traction. He came up with a device that  consisted of two canvas stretcher-like devices which were the surfaces the patient reclined on. For turning, the patient was sandwiched between the two stretchers and quickly rotated along the horizontal axis. Three heavy belts were tightly  wrapped around the two stretchers to secure the patient. The complete assembly resembled a giant rotisserie. It did not work with overweight patients and had a 190lb weight  limit.

Dr. Stryker enlisted the aid of The Kalamazoo Sled and Toy company to manufacture the device. Interesting, a toy company manufacturing a medical device. Any port in a storm, I guess. Paradoxically I think, some of the equipment manufactured  today by medical companies could pass for toys. I'm thinking of those disposable suture  sets that were available in my final years as a nurse. These were definitely toy like. Everything that was once metal or glass is now made out of plastic. Metal and glass had that substantial feel to them that made you feel like you were doing something important. Plastic feels toy-like.

This old photo shows a Stryker Wedge frame in action. The nurse is securing the retaining straps. When ready to turn she will grab that black handle on the metal circle ring-like device and rotate it 180 degrees. A patient with a Foley or IV line in this bed could be in for a rather rude and painful surprise. If the nurse forgot and left the Foley bag tethered on the floor, the turning would wrap the drainage tube around the patient shortening it and pulling it out. Likewise for the IV line

These beds were a big patient dissatisfier and were really hated.  As students, we were required to be a "patient" in one of these beds for the turning experience. It was really frightening with the feeling of falling out combined with the dizzying effect of being flipped like a pancake. A total feeling of loss of control. Imagine having to stare at those terrazzo floors for two hours at a time when suddenly rotated to the prone position.

These were the days when tough old nurses told patients what the treatment was going to be and they just went along with it. Healthcare was definitely not patient centered. When a tough, burley nurse that had just extinguished her cigarette in the palm of her hand came in to turn you, what choice did you have?

These Stryker frames always reminded me of that iron lung mentality. Instead of stabilizing just the area of spine that was broken, put the patient in a device that immobilizes his entire body. The treatment could be almost as debilitating as the problem being treated. Don't ask that tough old battle axe of a nurse any questions, things could be a lot worse if that Foley got ripped out.

Stryker frames were replaced by CircoLectric beds at our hospital in the late 1960's.  Patients liked these much better. We did have a Stryker Frame in the school's nursing arts room and it was a constant source of comment. I think one of the best ideas we had was to take it out into the courtyard and use it as a rotisserie for a pig roast. This thing was really an unpleasant medical device.