What is your no fail nursing tip - page 6
I was surfing the web and came across this web site It is mostly related to doctors but there are some good nursing tips... But I know that all of you experienced nurses have learned something... Read More
Jan 27, '07For covering IV sites when adults take a shower: Use glove or plastic bag with bottom cut open like a tube, depending on where the IV site is. Wrap/seal the ends of this stuff with foam micropore tape, the 2 inch wide stuff. It's a lot closer to waterproof than transpore and it doesn't yank all the hair off. Actually I think it absorbs the water and keeps it, so it comes off really easily after the shower, and you get dry IV sites! It is not insanely gummy so if you taped it over an IV line for a drip that you couldn't d/c for twenty minutes, you don't mess up your line or pull it out when untaping it.
If you have someone who happens to have long hair and hasn't washed in months, with umm, a giant mat of felt hanging off their head... oily products work as conditioner. Our facility stocks shampoo but not conditioner. Mayonnaise, baby oil... will work so they don't have to yank all their hair out after a wash.
Coca-Cola or grape juice take away the bad taste of mucomyst.
When we were in school most of the teachers wanted us to have things in our pockets, but there was one that made us go back to the store and buy a pair of hemostats. Never, EVER try to work without 'em. There's a million different ways things can get stuck so that you need a tiny little wrench or pliers to get 'em unstuck.
Check the wall suction before you turn it on with the NGT hooked up for the first time. Check to make sure it's not turned on as high as possible, and that it actually works. (Things we learn the hard way for $100, Alex...)
Don't assume your patient is fulla crap just because the things they tell you seem unbelievable and they happen to be in their eighties. Sometimes there's more truth than crap, and people can surprise you.
Involving the patient in their treatment and plan of care is a good idea except for when you're dealing with the manipulative psychotic. Of course, they don't all wear signs that say "Hi, anything you say will cause me to find a way to make you work harder for absolutely no reason other than my own pleasure!" but if you do see that happening, there are things you can do to regain your own sanity: Don't make the slightest suggestion that other people can do more for the patient, because you'll wind up having to call your supervisor. Don't make any reference to other things that may be wrong with the patient, because they'll suddenly be wrong. This only applies to very specific patients, and if you get one, you'll know what I mean. Also, if you get one, don't let it make you too upset; just because your communication skills may work against you with that patient doesn't mean you need to rethink everything.
Also, when dealing with people that easily lend themselves to being labeled, i.e., drug seeker, schizo, alcoholic, (insert label here), don't forget that even they have actual health problems and acute situations from time to time, and need actual drugs and/or TLC to get through the problem.
When giving tranxene protocol to a patient, remember to question not only the patient but also family if they are available, to find out how much they actually drink. The idea is not to give them all the tranxene we possibly can, and sometimes not all of the tranxene that is prescribed, either. I've had overmedicated alcoholics and that's not good.
When dealing with people who have terminal conditions, sweetness and light isn't always what the patient may want out of you. I once told a cancer patient some very morbid stories of some of my previous terminal patients, and I had no idea why I was even telling her those things... they certainly weren't "light conversation." She reached up and hugged me, and thanked me for sharing. It's certainly okay, sometimes, with adults, to be serious.
When someone hits a call light and says anything resembling "mess", "blood" or "whoa", grab the IV tray and some towels on the way to their room. Nine times out of ten you'll need it.
When a family member blurts out "mother has been in restraints before for psychotic episodes when she was in the hospital" just before running out of the room, take that as a prophetic warning.
Don't buy cheap shoes just because they are cute and on sale.
Jan 27, '07After d/cing a foley, if a person is having trouble urinating, have her sit on the toilet and give her a cup of water and a straw. Have her blow bubbles into the cup. It helps relax things. Also, a few whiffs of oil of peppermint can stimulate the urge to go.
If a patient is nauseus, wave a little alcohol pad under their nose. The smell of the alcohol can reduce nausea. (learned this one from a patient!)
Jan 27, '07Use either ginger ale or coke to unclog a gtube ps coke works better but ginger ale will work too
Jan 27, '07Outstanding tips in here. Took many notes.
(I used to work in P.T.)
Before getting anyone up, regardless of hearing "max assist" in report, try these two words:
"SIT UP," or "STAND UP," as the case may be. You may very well need to call an orderly and get 5 other people to get this person out of bed, but in my decade plus of experience, most nursing assessments of "max assist" are grossly over exaggerated. Granted, if the person is totally weak and flaccid, that's one thing. But tons of old hip fractures will do better than you think if you give them time to move on their own before having three people grab them and do the "1, 2, THREEEEEEEE" lunge that hurts the patient and your back as well. I have gone into "total assist" rooms and said, "Frank! Get up!!!" And proceeded to watch Frank crawl out of bed on his own. Give them a chance to move on their own before lugging.
One last request... NEVER grab a patient under the armpits (2 person assist standing from wheelchair) to lift to standing from a seated postion. puts enormous stress on already weak shoulder joints. and NEVER, EVER lift a CVA patient with a flaccid side from under the arms, even if it's just pulling up in bed. Shoulder subluxation happens with flaccidity, and pulling on a wet noodle of an arm will take you from subluxation to dislocation in a heartbeat.
Some solutions... When trying to get someone to standing, (assuming to have 2 people), stand on either side and put a hand under each buttock. better to pull from the stable meat than the limp noodle arm. If there's just one person, squat down and hug them, wrapping arms around lower waist and butt if possible. if you can pull them forward and have them lean on you, you can pivot anyone safely.
i am a 32 year old man, and i have the musculature of a 9 year old girl. but i can move 300+ pound CVA patients with total hemiplegia on my own (pivot transfer with spotters 'just in case') 9 times out of 10.
The PT side of me cringes when i see someone yanking a flaccid person by the weak extremity, as does the nurse side.
I hope these tips are totally repeat info for you all, but my experience in my hospital indicates there's lots of room for learning outside of lugging limp bodies around like sandbags.
I'll save my positioning and wound care rants for another day.
Great forum. Great tips in this thread. Good to see so many people so involved in providing quality care. Renews my faith in the line of work I stumbled into years ago.
Godspeed, ye fixers of the broken.