old skills that we do not use anymore

[sassykitkatt]

hello,

I was wondering if you guys were doing anything different now than we did before? Like before when we would suction trach patients we would squirt NS down the trach but now after clinical study they say we don't have to that anymore because it does't work. So have you guys had any changes?

[Salty1]

How about alcohol drips for etoh withdrawals?

Zoiks.

Along the same lines, how about paraldehyde for prevention of DT's. I recall an ER nurse pouring some into a styrofoam cup with a resulting noxious permeation of the entire ER area when the paraldehyde ate a hole in the cup.

For those who have never experienced the smell of paraldehyde it might be considered an effective means of clearing the waiting room of frequent flyers.

I have also hung ETOH drips for treatment of wood alcohol poisoning. Probably still has merit in treatment.

[nurse_pam]

A very good answer.

[ADS RN]

Resterilizing urinary catheters (the head of central supply kept trying to culture something out of them but never succeeded. They finally went to disposable when it became more expensive to redo them than to replace them)

Clinitest (urine testing for glucose in diabetics), tricky because you were never sure if they emptied their bladder on the previous void, which was supposed to be 30 min I think before the test, and also because some people spill sugar when their blood glucose is normal and some don't when their BG is high.

We had a lady in LTC who we caught diluting her urine in the bathroom for her clinitest, guess who got to go to BGM!

[ADS RN]

In the "olden days", I could shake a mean thermometer, and take a brachial bp without a stethoscope.

I could too but now those glass thermometers are sooooooo hard to read- could I be getting old ?

[PJRNC2]

1.Putting the Mannitol Vial into hot wather to disolve the crystals - sometimes only to have them reform as you drew it up because a pt call out to you in a open ICU unit (only Curtains between Patients) and you went to see what he wanted- by the time you got back the vial had cooled too much. 2. Crushing morphine tab and disolving it to be able to give as an injection. Good old glass syringes could grind pretty good. 3. No air detector on a dialysis machine- just watch. 4. No heparin pumps on dialysis machines- just do clotting times --5. YOUTH. Young enough to work a double shift!

[PJRNC2]

Wather = water. No computers in the old days.

[Antikigirl, ASN, RN]

We used to use something called "common sense." Now, I wonder where it went. :chuckle

I was just speaking to my DON about this one! LOL! Now I am the newest of the nurses at my place, and I have more of this than the others there..which she said shocked her! She expected me to be worthless without a pulse ox, or the lastest in expensive dressing and wound care items...but nope, I am a common sense gal...where as my other nurses will use (experiment I say) with the latest trends in nursing and get so excited about it they forget the basic principles...well that and cost to the patient!

My DON and I are very close now, and she and I will have little "vent sessions" about the lack of common sense in the other nurses and patients alike! (many on patient side! My residents will freak out over a bleeding hangnail and demand immediate nursing services because it may get infected and kill them..I kid you NOT!...So one day I simply told my resident who had this "what did you do when you weren't in here? What did you do if your kids had one?" They said clean and bandage" and I went "bingo and you just paid a nurse to tell you that!!!!!"...LOL!!!!).

I would love to see common sense return!!!!! I went to an assignment for a volunteer medical deal, and a nurse freaked out and was worthless because a patient who was unconscious (took extacy) was being examined and we didn't have a pulse ox and she didn't know what to do! I told her..hmmmmm didn't anyone ever tell you to look at your patient, not the machines? So I went over what to look for...she was very appreciative (couldn't believe it either..and a BSN! OH boy how did she graduate???).

Then we really got her later on (now remember..this is a volunteer medical thing, and we were doing actually a RAVE, so there were more paramedics and fire fighters than nurses...so you get a pic of the humor level and type here! LOL!)...one of the staff faked unconsciousness and we hooked him up to an EKG (which we did have) and made sure it was asystole by not attaching things...she freaked out and was about to do CPR when we reminded her..one, check your leads ALWAYS on asystole, and try taking a manual pulse! Okay she got it and I see her from time to time..she still laughs and says she teaches that to others now! LOL!!! COMMON SENSE!!!!!

The rest of these are so hillarious!!!!! The old alcohol deal with fevers, glass iv bottles for all iv's, sterilizing used caths...OMGosh...it wasn't that long ago was it??? OR am I just getting old! LOL!!!!:rotfl:

[Mermaid4]

Well I don't know if they still do this or not but I can remember giving barium enema preps with the first thousand ccs on one side ( tip held in by a baloon we injected to keep the whole thing in the rectum), thousand ccs on their back and thousand ccs on the other side. So many times these little old men and ladies would go into chf and the docs would wonder why..And I really do NOT miss giving kay exalate enemas for high potassiums..And we NO longer, thank goodness, give enemas to laboring people.

[greyhair]

In the late 70's on EMERGENCY! John Gage used rotating tourniquets on a guy having a heart attack!! He used belts, neck ties and a scarf. He put them on the man's arms and legs. That show was an accurate protrayal of what was modern at the time.

I didn't know that they were also used for CHF. Hummm, I love learning new things!!

What about shaking a choking child? That was common practice in the 70's too. You turned them upside down in hopes that gravity would for the foreign body out!!

Watched EMERGENCY every week, loved it. I think the best one was after John had been bitten by a snake while they were out fighting a fire in an orchard he started his own IV while he was riding on the top of the pumper truck, racing down a dirt road as fast as it could go so it could get him to the hospital. I have done a lot of IV's but that was pushing it. I wonder how their consultants could approve that one.

[bobnurse]

I remember just 12 years ago, we used to shock asystole........And we would code asystole patients for hours.

It was not long ago when defibrillation was just a physican procedure....Now the janitors are doing it.

[Mommy2Katiebaby]

How about starting IV's without gloves on? I remember doing that. Also plain old hydration IV's were NEVER run on a pump - you marked your bag with your tape and your Sharpie and hoped you got your drip factor right and that the IV wasn't positional.

[JustaMaleRN]

Okay, here's some stuff I remember from days gone by:

Doing ekgs with the little suction cup thingie for the chest leads. Cutting them out with the little metal template and stylus. We actually even had needle electrodes for those patients who were too sweaty for monitor leads. It's just what it sounds like. That wasn't very nice.

Okay, I could go on and on, but I guess this is a long enough trip down memory lane.

Oh, in many, many ways nursing was much more satisfying and respected in the old days. Even when we got up to give our chairs to the docs. Go figure.

You forgot about the ashtrays in nurses station. I remember being able to smoke in the hospital. Nurses smoking with their patients, some of them passing medications with a cigarette hanging out of their mouths.

I will say that I am glad we don't give up our seats anymore to the docs. Most of these new kids havn't earned my respect to get the time of day, let alone my chair. (Sounds harsher than I meant it, but you get the gist...)