What they did not teach in nursing school.

Heather27 · Nov 28, 1999

How about these...(just some things I have noticed since moving my employment to a more acute setting with "newer" nurses on staff)

The plastic graph on Tegaderm or OpSite is to be REMOVED once it is on the patient...(leaves a nice sharp edge...)

There is a REASON for the blue line on ABD dressing pads...lets you know which is the "Up" side...

When working the ER, and an obviously intoxicated patient comes in with, say, a laceration, it isn't a good idea to put him in a wheelchair, in an examining room, with a compress on the cut, and tell him that the EP will be with him in a minute. He will a) become very agitated, b) end up UNDER the examining table, or c) pass out, thus blocking the door to the TEENSY little exam room.

And my favourite from the other week:

"Breakthrough pain" analgesia such as Morphine is intended to be a ONE DOSE thing. If pt. is still exhibiting pain behaviours such as thrashing around, talking incoherently etc. he is probably HALLUCINATING from the three extra doses you gave him in two hours...(That one WASN'T a new grad..she has been a nurse for 8 years...Scary!!)

Hope those were somewhat of what you were looking for!!

Heather

TRN · May 18, 2000

What a great idea!!! I'll keep checking your site for updates since I am a student nurse.

iodine · May 20, 2000

Always hold a bed pan toward the toilet, not flat---it tends to come back on you.when you are cleaning it out.

Don't keep looking for that left leg amputee's other house slipper.(I was a freshman)

Keep up with patient's belongings: get someone to co-sign for what looks expensive: always describe as "ring with clear stone, or red stone" or what ever, patient,or familey can say rings, etc,, were switched by staff.

Never continue on 11-7AM , as charge, in major trauma ER, when all the other nurses call in sick . Especially when the supv. says they will help or send "help"/ (worst night of my 35+ year career.

Before pulling a bra off a patient during a code, check to see how many dollar bills are stored there(they went flying all over the room)

Don't ever assume the MD knows what he's doing: surgeon put chest tube in wrong side when I turned my back(he was sleepwalking and only woke up when I shook his shoulder)

And I loved it when the residents would call for the "Harvey team"(resusitation team) in the ER: I just responded"Dr., you are the Harvey Team in this ER" Quite a wake up call for them.

Oh, yeah, and you don't have to worry about hurting a patient with a gluteal injection---if he is para or quad(I was brand new USAF flight nurse, at 40.000 feet on the way back from Nam)

I'm sure ;you other nurses have a lot of stories to add to this.

Good luck to all.

------------------

iodine

JillR · May 31, 2000

If you have a post-surgical patient with an NG tube that is experiencing nausea and vomiting. After making sure the NG is in the right place and patent. Keep the suction on and take it apart. I found that there can somtimes be an airlock in them and the NG will suddenly stop suctioning as much stomach contents as it should be. If you do this the NG will begin to suction the stomach contents again and the N/V will disappear.

This may be a no-brainer too all of you but as a new grad I was very happy to have a seasoned RN there to give me this piece of advise. I either never learned this in school, or it was one of the things I forgot.

leia · May 31, 2000

Never try to take a patient to the bathroom if he/she says I'm dizzy without checking the RR,they might be telling the truth instead of being lazy-I learned the hard way, the patient fainted in the wheelchair and took a weez on my leg with which I was holding her up,she paid me back big times*lol*

xrn · Jun 6, 2000

I found a not-new rn (new to rehab nursing, though) placing an incontinence pad on a rather large, dysphasic, severely hemiplegic catheterized stroke victim ... and she had the catheter tube wrapped twice through the legs of the mash pants ... succeeded in pulling out the catheter - 20ml balloon and all ... patient wasn't the only one with tears in her eyes!! And I copped a mouthful for not being respectful to the nurse!

BJRN76 · Jun 8, 2000

Here are a few pearls of wisdom that I have learned (some of the learning experiences have been more painful than others)....

Shaving cream used in place of soap during a bath will take care of most noxious odors. When caring for a trach patient always be prepared to bob and weave when they cough out a goober...they have been known to take a sharp right turn and hit an unsuspecting nurse in the face (that I learned from a year worked on a pulmonary floor). When interviewing a impending DT patient you must do the alcoholic to nurse translation...a few beers = six pack, I just quit = I had my last beer as I pulled into the ER parking lot, I only drink on the weekend = if the weekend starts thursday and ends tuesday. And most important never let a doctor use you as a whipping post as a new nurse I accepted being treated badly by obnoxious doctors who didn't like me calling them in the night or questioning their orders. I just sat back and took it until I watched a senior nurse one night who called a doctor on a patient with unrelieved chest pain , this doctor went into a tirade as he is known to do and this nurse told him that she was not going to listen to him and that he should call back when he could speak to her politely and she hung up!! And in five minutes he called back very sheepishly and was sweet as pie... that was one of the most important lessons I ever learned. You have to stick up for yourself and you deserve to be treated like the professional you are.

espressoqueen · Jun 17, 2000

Shaving cream used in place of soap during a bath will take care of most noxious odors. DO NOT USE THE MENTHOLATED SHAVING CREAM ON THE PERI-AREA!!!

justanurse · Jun 18, 2000

If your patient that needs to use a bedpan has limited mobility or is large patient, put LOTION ON THE BEDPAN. Found that out the hard way. It slides in and out so much easier when you can't find the helping hands to help you get them off of it. It prevents the bedpan from sticking to skin and removing a piece of that along with the bedpan. Some people prefer powder, but I feel like that gets gummy much of the time. That's the first thing I found out that I didn't get taught in nursing school. There has been so much since, but that was my worst lesson.