Marie Hodgkins, RN, MBA, patient care director at Loma Linda University Heart and Surgical Hospital, has over 30 years of experience at her facility.
She graduated from Loma Linda University School of Nursing in 1973.
, 61, the most dramatic differences between her
early career and today are the changes in overall patient acuity and how short patients' inpatient stays have become.
For example, early in her
career, a cardiac bypass would often entail 10 days of hospitalization, but the procedure now averages just three days.
"It puts more responsibility on the family," Hodgkins
"There are surgical drains and dressing changes."
The shorter hospital stays are in part a result of the Balanced Budget Act of 1997, which changed how healthcare was paid by Medicare.
Instead of paying on a fee-for-service basis, Medicare now made prospective payments, predetermined amounts based on the illness or condition, which encouraged providers to cut costs by limiting in-patient stays.
There have also been changes in technology, with notable improvements in diagnostic tools, monitoring and documentation.
"There is more consistency between caregivers," Hodgkins
"The change has been dramatic.
The nurses interviewed do not report much change in uniform since they started at their facilities, but Hodgkins
did have to wear all white early in her
career and Reyes recalls wearing a white nursing cap in one of her
first nursing jobs at a small facility in Michigan.