Nursing the old fashioned way - page 4
by Scarlette Wings, BSN, RN | 14,824 Views | 67 Comments
hi all, i just read a thread asking about older nursing interventions and it made me think of the older techniques that we really did use before so many modern meds and procedures. for a lower gi bleed we used to do strong... Read More
- 1Dec 4, '10 by Esme12, BSN, RN Senior ModeratorQuote from j621dNo ice for cardiac patients
Cardiac level #1 May assist with bath and read holding book below the level of the heart.
No Ice or hot and cold liquids.
Too funny now.......they also thought that the extreme temperatures down the irritated the heart and could cause arrythmias and/or spasm.
We had a cardiologist that placed all MI's on a lido gtt to prevent cardiac arrythmias to "decrease the hearts irritation" after an MI. Lido 4:1 at 1mg we called them "Chip drips" after the cardiologist. I remember isuprel gtt's for bradycardia with MI's........... no wonder we had a lot of VT.
I forgot all about breaking those thermometers and playing with the mercury. I remember Dr Clancys butt ointment and alcohol baths for temps. I hated those chest tube bottles taped to the floor! How about iced levages until clear for GI bleeds and actually counting gtts to time your IV's.
The vent was a MA1 and we kept open hearts snowed and vented for weeks.
White uniform, white or blue sweaters only and clean white shoes. Hair off the collar! HS care included "tidying the patients room and emptying the garbage" Posey vests and "all side rails up" was a saftey measure. OH! alcohol gtts for DT's!
There are so many posts that become negative......This is really refreshing!Last edit by Esme12 on Dec 4, '10
- 7Dec 4, '10 by RuthiegalQuote from LiquidiamondMetal bed pans are great for emergencies, if you can't reach the call light, or yell loud enuff, toss one in the hallway.... see how fast people come running.... :-)Maybe we're old fashioned at my hospital, but we still have metal bedpans and gerichairs :S
- 4Dec 4, '10 by Scarlette Wingslord yes, i did the alcohol drips as well to prevent dt's. lol. specially if they were a cardiac patient because dt's "would kill them." the butt ointment reminded me of the numerous mixtures we used on ladies who had under the breast or the belly yeast skin infections ..every doctor had their own mix-it-yourself recipe...and the heat lamps used on the wounds to dry them. (can you imagine how we not only dried them with heat lamps but betadine solution as well) i have made many a little tent over the lower parts of a patient using the 4 side rails up "for safety" and then put the light on so it would shine on the wound/bedsore areas.
..and there was also a spray in a can to prevent bedsores. honest. the slogan was "think pink"
there was a push to "think pink" and the salesmen would give all the nurses a stick-on pink ribbon so we would use their product and spray the skin on a pressure point "at the first sign of pink."
bedsores and contractures were highly prevalent back then. and every nursing home patient got a foley catheter if they were incontinent in our area. so sad now.
hippa did not exist and you could have most anyone call to check up on "aunt sally". children were not allowed on the units period (except if the patient was dying). doctors would often snow any terminal patients so they would not suffer and i wonder how many we sedated to the other world that may could have had some quality time with their families? there was no hospice then in my neck of the woods.
hair on the collar was an absolute no-no, jewlery was forbidden, only a wedding band and a watch. shoes were kept clean and if they were soiled with blood or other brown things you ran in the bathroom and cleaned them right then and there.
cardiacs, i remember teaching them to never cross their legs or rest one leg over the other or they would get blood clots from compressing the circulation. there was no anti-thrombolitic therapy after heart attcks or surgery. (shiver)
pre-cordial thumps were "in" if you could "see" the v-tach and whether they are supposed to work or not....i saw them actually work many a time. cvp readings were all manual, put the bed in "x" position,put the patient on "y" position, turn the knob to allow the fluid to slowly fill the glass tube and watch for it to level off.
i also did many a feeding with a 60 cc syringe for the elderly patient after mashing the food and mixing it with either their milk or juice because it would take the kitchen forever to put it all in a blender and puree it. shoot i remember the first heplock i ever saw and i thought that was the neatest thing.
oh and rib belts for rib fractures..... and teach them to deep breath ......and abdominal binders after any surgery to the abdomen so they would not 'split back open.'
potassium was kept on the floor and most all iv fluids were in glass bottles and you mixed it and counted the drops. lord how many times i would count and recount to make sure i was right. all piggy backs were mixed when you were ready to use them and they were mixed from scratch, not the pop the top and shake the bag kind we use now... and come to think of it, most antibiotics were done by deep im injections. ouch. rotated injection sites every few hours...only a few actually got the antibiotics iv.
anyone remember the "banana bag" iv that all alcoholic patients got?
and yes i recall unit secretaries...love them and the aides.
i would always have someone else calculate med mixtures behind me on cardiac drugs and such just in case i was wrong. half the time the night shift charge nurses covered the house and did all the pharmacy detail after 5pm. nurses worked with the aides and together they did all the baths.
not all of it was so bad. you knew your patients much better and had a lot less paper work!Last edit by Scarlette Wings on Dec 4, '10 : Reason: correction
- 6Dec 4, '10 by sevensonnetsOh yes the precordial thump!! We had this guy once that kept going into vtach and got thumped 3 times. I was the one that had to do it the last time. He looked up at me and said, "Lady, what the devil do you keep hittin' me for?"
- 1Dec 5, '10 by Esme12, BSN, RN Senior ModeratorOh that spray......smelled like bubble gum! It was supposed to help with granulacytosis! I remember trying the bedsheet to the bed in an attempt to keep confused naked patients cevered. I had a nurse manager who carried shoe polish in her pocket and would pull it out and give it to you to clean your shoes. Some ED's still do a banana bag x1 for heavily intoxicated patients. How about those hand mitts with wrist restraints for that creative escape artist!
Awe.....the days of the precordial thump! I have actually seen it work a few times. I remember one night after work we all went out (in white head to toe!) we walked into this local bar and a guy grabbed his chest and fell off the bar stool. A nurse I was with jumped on him and gave him a precordial thump to which he replied "OUCH" and sat up.......she promptly puched him in the face I'll bet he never pulled that stunt again! Remember the first ACLS..........what a torture! One and two man perfect strip was required and mega code was going before the Spanish inqusition!
I remember having to manually zero and calibrate with a mercury sphymomanometer! I remember cardiac outputs took at least 2 people and ICED! saline and .doing the calculations without the benefit of a calculator let alone no computers. Unit secretaries we angels! and everything was their job. I remember "slow codes" because there was no such thing as DNR. We mixed everything ourselves.
I also remember blue green urine from too much methylene blue in the tube feedings.
AWE the good ole days.............but we really knew our patients.
- 6Dec 5, '10 by Old.TimerThis is a fun read!
Does anyone remember monitoring IV infusions by placing a sticky label along the length of the glass IV bottle marking hourly times to correspond with the amount of fluid that should be infused by that specific time?
- 1Dec 5, '10 by Scarlette WingsQuote from old.timerlol. oh my heavens yes. and i remember having to lay on the floor on my belly to look at the chest tube bottles and be able to read them accurately for output. same piece of tape with the times and all used there as on the iv bottles.this is a fun read!
does anyone remember monitoring iv infusions by placing a sticky label along the length of the glass iv bottle marking hourly times to correspond with the amount of fluid that should be infused by that specific time?
blue urine? yep. i remember no one was ever allowed red jello in case they vomited so you "could see if it was blood or not." of course the jello was so tough and gummy you could have bounced it off the floor.
we used to clear blocked ng tubes with everything from coke-cola to my favorite mixture, that was half hot coffee and half cranberry juice. speaking of cranberry juice, everyone with foleys or tube feeds got a glass of that daily for their bladders to keep down infections. i personally think it really did help.
esme12, lord what i would have given to see that guy in the floor that yelled chest pain and fell out. rotflmao.
i have precordial thumped a few to hear them holler at me for it too. think one of the weirdest things i have done was when a doc ordered us to use a dental contraption to do irrigations with pressure on a decub that needed "pressure washing for debridement."
insulin was simple back then, you had regular and long acting, period. can't remember the name of the long acting one now. i do remember that anyone having any surgery was in patient for up to 2 weeks and then they didn't have pt come work with them, nurses got them up and walked them. imagine after being flat in the bed for 2 weeks? geesh. then the doctor had to order when the patient could get out of bed. first day let them sit up. second day dangle on the side of the bed. day 3 advance to standing and so on.
lol. all vaginal births were in patient 3-5 days and c sections about 2 weeks. wrapped the breasts tight with a binder to keep the milk from coming in. darn that had to be uncomfortable!Last edit by Scarlette Wings on Dec 5, '10
- 2Dec 5, '10 by michelle126Love this thread! I've only been an nurse since 96 and oh how things have changed in LTC.
Most of the residents had demtian, contractures, restraints, full side rails, bed sores, foley or were inct, impactions were very common.....
Now LTCs have younger, sicker folks, no restraints, no side rails, very few foleys or decubs and rarely a contracture. IVs galore...TPN, central lines and pics with ton's of IV abtx, cardiac rehab, complex wound care, pain management......More diabetics and obesity too.