"ritual" or "traditions"

hoolahan, ASN, RN · Sep 26, 2001

I'm not ignoring you, just need to give this one some more thought.

Not sure I would think of report or I&O as rituals or traditions, because the are necessary.

But maybe a particular way I assess a pt, or the way a unit is prepared for an admission, that can vary somewhat from idividual to individual, not so sure that would be a ritual either.

The only thing I can come up with right this second is checking the crash carts. It is methodically checked to ensure that all emergency eqip is in working order, defib paddles tested q shift, etc... Even if we haven't used the crash cart in quite some time, it must be ready for any emergency.

The origin of this practice is clear. Somewhere in the past, a vital peice of emergency equiptment was not in a ready location, or was in the crash cart, but was not in working order i.e. laryngoscope w/o working bulb, which resulted in a delay of emergency treatment and possibly a poor pt outcome.

The knowledge required would include knowledge of CPR, basic life support, and for some or all members of the code team, advanced life support. IT would also involve knowledge of the maunfacturers recomended use and maintenance of the equipment. (Ex, if we have to put in a IAB/P in a pt stat, we need to be sure we have the correct cables for the pump, the monitor, and the adaptors for transport if needed. We also need to know how to manully manage the IABP in the event of battery failure, and/or balloon rupture.) One would have to know in a NICU or peds unit the appropriate sizing of ETT's IV's and correct dosing of meds for weights. So a pharmacology knowledge is needed. You also have to know the procedure for codes, and the abilities of those who come to assist you, and what each person's role will be, as to how the code cart is used. What to document, and how often.

Hope that helped, if I think of a better example, I'll post. Interesting question.

Hey! Thought of a good one. IN my old CT ICU, on nights, we were told we had to weigh pt's between 3 and 5 am. Well, with 16 pt's and one old sling scale, it was tough to get all the weights done in that time frame. Many of us would give our pt's their baths at midnight, and wanted to weigh then, b/c closer to 5 was tied up lab collection, am CXR's etc. I pushed my nurse manager for a rationale as to why weights could not be done sooner.

I was told it was just the way it was. No one could answer that specifically. Finally I found out the origin of the problem. As it turns out we used to have to share a scale with the MICU, they always had the scale from 12 to 3 am, and we had it from 3a to 6a. So, as it turns out, it would not be a problem after all, there was no scientific rationale for waiting to weigh pt's later in the shift.

Not sure what knowledge I would say was needed for this except proper operation and saftey of the scale.

But, to me this is more of a ritual, which is something that , to me, is regularly practiced, but not necessarily based in science. Maybe what I am thinking is really more along the lines of habit rather than ritual???

P_RN, ADN, RN · Sep 27, 2001

This is so weird! My niece came home Friday with the SAME assignment. Do the schools all get together or something?

MollyJ · Sep 27, 2001

q 4h vital signs even on stable patients--a ritual or tradition

Insisting that people call for help with ambulation--can be ritual, can be an intelligent thing to do

ALL post ops used to get cl liqs, then full, then whatever and I think this was ritualistic and had little to do with their vomiting or aspiration risk.

Wheel-chairing people out on dismissal, regardless of their ambulation status (although this can be great PR; I just don't think you should get into arguments over it).

Early discharges challenged alot of our rituals.

Alot of med administration times can be ritualistic. BID may fit the nurses needs more than the clients.