Gah! too many threads beating dead horses on this forum right now.(cough...nety...cough)..
So, i am going to beat a FUN dead horse! Lets get started!
Tips/ Tricks/Hacks for getting through your nursing shift... (hint: I never would have thought of that...)
1. Shaving cream for stinky areas that refuse to be clean (works for PANNI as well)
2. Flush and irrigate your fms to get rid of the chunks in the tubing that impede the flow (some people only irrigate and the chunks stay constant in the tubing)
3. when switching over lines with pressors, INCREASE the rate for a couple of seconds so that you do not have bottomed out pressures while you wait for the pressor to prime the new catheter hub/line(do not forget to change it back to the right titrated dose)
4. pesky radial A-lines? have pt hold a folder up towel/abd pads and it helps to keep the waveform constant while you track down the fellow to either rewire or give you an order to titrate via Nibp.
Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.
Wow! I'm totally hogging this thread but I just remembered a really good one:
TED hose application made easy:
Get a small plastic trash can liner. Place over patient's leg. Apply TED hose over the bag. Once they are applied, pull bag out through the hole in the toe. The bag provides a slippery surface for the TEDS to glide over.
If you don't have access to a plastic bag, you can use the bag the TEDS come in, just cut across the top and bottom and slide it up the leg in synch with the TED hose. Remove the plastic bag from the top of the TEDS.
Makes things so much easier for nurse and patient!
I use a different approach for TED hose -- yank the hose up as far as you can like putting on a sock. Then, grab the toe hole and pull that end up and over the foot and heel towards the knee (doubling the sock back on itself).
Once you're over the heel, you can reverse direction and bring the toe hole back down by the toes where it belongs, and then you can pull up on the knee end to get rid of any wrinkles.
This gets the middle of the hose up and "over the hump" of the heel (the thickest part to negotiate) without having to wrestle with it too much.
Just make sure you line your heel section up properly before you get started... turning TED hose to one side or the other to fit the heel into the heel section is a complete pain!
Specializes in Med nurse in med-surg., float, HH, and PDN.
Sugarcoma,
When I worked doing home health visits on the week-ends, I also developed the habit of building the new dsg upside down so that when I got the old one removed and the area cleaned, all I had to do was pick up the dsg standing by and place it. Easy-peasy! The primary nurses would say "What did you do to my patient that made him/her want you full time?"
Specializes in Emergency/Trauma/Critical Care Nursing.
I work in the ED and we have these bedside carts that hold all the IV and phlebotomy supplies. However its inconvenient to keep reaching over for supplies so I make my own little supply kit in an emesis basin that includes the tegaderm, angiocath, tourniquet, vacutainer w/adapter, lab tubes, gauze, and tape. This way I have all my supplies in one spot and can put it within easy reach, plus I put the filled lab tubes in there so they won't get lost in the pt's bedding.
Specializes in Med Surg, Perinatal, Endoscopy, IVF Lab.
1. I like to tuck pillowcases under breasts and pannis that get moist and excoriated easily.
2. With famale catheters I swipe down with betadine and tuck the cotton ball just into the lady parts enough to hold it, then I ask the pt to cough and the urethra winks at you so you can easily visualize where you're going.
3. With IV's, it really helps me to hang the arm below heart level and use a warm washcloth if I have a hard stick.
4. For squirrelly babies, I tie hands down onto the diaper with diaper tabs to get IV's and such.
For bedridden patients who are don't want to get out of bed or are too hemodynamically unstable to get out of bed, you can get their hair and scalps clean with Seabreeze astringent. It works like a dry shampoo and eliminates funky odors. It also works to dry up the moist yeasty abdominal folds.
I am HORRIBLE at IV's! Like embarrassingly so. New grads on their 3rd IV start are better than me. I keep plugging away but after 5 years of effort and instruction from nurses with stellar IV skills, I just resigned myself to the fact that I would NEVER be any good at it.
I recently received a tip from a coworker who is amazing at IV's. He is the type who could start a 16 gauge on the coding, 20 year IVDA HX, dialysis patient! Pick your spot, uncap the catheter, pull it out about 1/4 of the way, then push the catheter against the cap bending the needle just a tiny amount, like maybe 5-10 degrees, then uncap and proceed with the IV. I am not sure why this works but in the last 2 shifts I have managed to start 4 IV's using this method, which is amazing for me.
I, too, am IV challenged...
I bolded the part I had a question about. I'm not in acute care anymore, but I was still curious. So, when you say uncap the catheter, you mean just slide it out of the cap 1/4 of the way, correct? You don't completely remove the cap until after you've bent the needle a little? So, where should the bend be, in relation to the bevel? I'm mad, I wish I had a chance to try this! LOL
I bolded the part I had a question about. I'm not in acute care anymore, but I was still curious. So, when you say uncap the catheter, you mean just slide it out of the cap 1/4 of the way, correct? You don't completely remove the cap until after you've bent the needle a little? So, where should the bend be, in relation to the bevel? I'm mad, I wish I had a chance to try this! LOL
I didn't quite understand either. Bending the needle or the actual catheter? Up or down?
Specializes in Peds Urology,primary care, hem/onc.
The infant cath kits that have the catheter that goes directly into a little specimen tube.....those tubes can sometimes create a vacuum where the urine will not flow in even when you are in the bladder.....if you loosen the cap, JUST A LITTLE (you do not want it to leak) urine should drain fine once the catheter hits the bladder so you can get your specimen.
For young kids that cannot swallow pills (and the meds they need do not come in liquid) they can practice with M&M's or Tic Tac's before trying to swallow the pill. Or put the pill in a tablespoon of pudding/yogurt and have them swallow that way.
When cathing a male patient, if you get stuck at the sphincter...hold gentle, steady pressure and you should be able to get the cath to go through. Repeatedly pulling catheter back and forth against a tight sphincter makes it even tighter.
brillohead, ADN, RN
1,781 Posts
I use a different approach for TED hose -- yank the hose up as far as you can like putting on a sock. Then, grab the toe hole and pull that end up and over the foot and heel towards the knee (doubling the sock back on itself).
Once you're over the heel, you can reverse direction and bring the toe hole back down by the toes where it belongs, and then you can pull up on the knee end to get rid of any wrinkles.
This gets the middle of the hose up and "over the hump" of the heel (the thickest part to negotiate) without having to wrestle with it too much.
Just make sure you line your heel section up properly before you get started... turning TED hose to one side or the other to fit the heel into the heel section is a complete pain!