old skills that we do not use anymore

SusanJean · Jan 5, 2005

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

Love those thermometers... IMO are the only way to get an accuate temp. Every time I see them in a pharmacy, I buy them out.

SJ

rebelmama7 · Jan 6, 2005

I remembering having the apothacary system on my first dosage and solution test in first semester of nursing school. About the only thing I remember is that V grains of tylenol is equal to 325mg. The new grads on our unit had never even heard the word "apothacary"

I'm getting ready to start Semester 2 in a week, so I LOVE this site (I lurk alot to see what is coming and to see if there is any light at the end of this tunnel). In Funds, for clinical calculations we had to know metric, apothecary and household measurements. Had to be able to convert gr to g, tsp to cc (oops, only using ml now), the whole bit. The best part was that our instructor told us that we would only really need to know gr V=325/350mg and gr X=650mg. Our book still includes drams, which we were told we probably wouldn't even be seeing! Also, one of our instructors told us that everything they were teaching us now would be out-dated or obsolete within 5-10 yrs. Scary.

gypsyangelrn · Jan 7, 2005

I know I am an old RN: I remember alot of things you have all brought back to my memory....using glass thermometers soaked in tincture of benzoin, routinely doing urine specific gravity, testing urine for insulin coverage, using buritrols and mixing our own IV antibiotics and potassium in IVs along with taping and calculating drip rates. Med trays with tiny cards and bottles of pills and all meds given by the med nurse..(we used to check pulses for dig and beta blocker or calcium channel blockers didn't exist. All flat sheets that were mitered at the corners...and the instructors expected the sheets to be tight!! Let's not forget cranks at the foot of the bed to adjust the head and foot. Metal bedpans, emesis basins and enema containers. Metal procedure equipment that was sent back to Central Supply to be autoclaved and reused.

Dressing trays made up with sterile towels, using forceps to place gauze dressings on them.

During my CCU and ICU days Keflex and Bertyllium were new drugs. CVP lines were attached to a manometer and hung on an IV pole and the patient's bed had to be at the right height to assess CHF. How about Lidocaine drips for every pt. with more than a couple of PVCs. MA I ventilators with knobs and the adustable bellows. If a patient needed an emergency pacemaker the doctor threaded the wires into the heart at the bedside, and a box with adjustable settings attached and placed at the bedside. If a pt. was having a MI you gave nitro and morphine and prayed....heart caths were a special procedure. Betadine used liberally for everything. Percussion and drainage for pulmonary pts.

I never wore gloves the 4 years I worked as a Red Cross bloodmobile nurse, or anytime, except for sterile procedures until at least the mid to late 1980s.

actioncat · Jan 7, 2005

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:

What you call "common sense!!!!!!!!" others might call "basic assessment skills". Try not to be so hard on new nurses.

coocooclown · Jan 13, 2005

These are some very interesting stories. Out in the field, we still use a lot of the old techniques, such as eyeballing and palpating b/p's. I love the stories about the tourniquets for chf and MI's :rotfl: ....I've heard of the suction cup electrodes, but needles?!?!?!?! Fortunately the trend toward painless treatment seems to be taking hold. And EMS will follow...oh maybe ten years behind nursing.

dknunges · Jan 13, 2005

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?

Heres a few oldies but goodies

MOM and Ivory Soap Flakes or Regular Insulin followed by Heat Lamp for decubs.

Asking patients if they wanted a smoking or non-smoking room when admitted

Setting up all your meds for the day, based on hand written colored coded cards in little white pill cups.

Prior to introduction of PPE and Safety initiatives: Recapping all needles, sticking needles from IV starts into mattress. No gloves unless you were in speciality areas.

Doing PM care for patient that included offering them a backrub, brushing teeth etc.

Before blanket warmers, for patient with post-op gas pains, heating blankets

in microwaves

Enemas and shaving for labor patients and Fathers waiting rooms! Big viewing nurseries where the families gathered to catch the first look at the newest addition to the families

Oh the good old days! :)

jeepgirl, LPN, NP · Jan 13, 2005

Amazingly, I still teach the apothecary system as a nursing instructor. It is still in the Math Med texts. I wanted to give it up, but a recent grad told me there was an apothecary question on her NCLEX. Could this be true? I do know that not too many years ago, doctors were still ordering cough medicine in drams at the hospital where the students do their first med-surg clinical.

i didn't have any math on my NCLEX... however, our surgeons still write apothecary. so i am glad that my instructors taught it to me also!

Quickbeam, BSN, RN · Jan 13, 2005

Jamesdotter said:

Clinitest (urine testing for glucose in diabetics),

I am the nurse for a state DOT and oversee medical issues for drivers. We monitor thousands of people with diabetes who have had problems behind the wheel r/t their disease. We ask for routine medical information....A1C level, blood glucose readings, etc.

There is one MD in this state who STILL does not have his patients with diabetes checking their blood sugar...urine testing only! I couldn't believe it so I called him and yep, its true. Yikes.

On the apothecary front....just yesterday one of our staff brought me a medical form and said "what on earth is that symbol?" ...it was the apothecary "ounce" sign.

CseMgr1, ASN, RN · Jan 13, 2005

I was an aide back in 1970 and 1971 and worked the night shift...when the protocol for BE preps was "Enemas Until Clear"...which meant exactly that in those days. One night, when I was the only aide working on our unit, I had 12 of those to give. Needless to say, I smelled and looked like you-know-what, by the time I went home the next morning! :eek:

CCL"Babe", BSN, RN · Jan 14, 2005

Calibrating art lines (The ones taped to the IV pole) with a screw driver. Still have mine.

HazeK · Jan 23, 2005

I remember days gone by in nursing when blood pressure cuffs on the wall above patients beds actually worked.
********** ours were wall decorations x 10 years before someone finally took them down!
I remember when nurses had autonomy, and could actually go to bat for their patients and be respected for doing so.
**********still do, in L&D where I work
I remember when there wasn't a shortage of dinemap machines on the floor, and didn't have to steal one from the other floors.
***********thank goodness BP machines are finally integrated with each and every monitor in L&D!
I remember when nurses had time to actually spend with each patient, teaching patients and their family members about things they needed to learn in order to perform their own dressing changes at home, etc.
**********"time to spend with each patient teaching patients and their familys...." Hmmmm haven't had this for a while now!
I remember when WHAT we wore had some degree of respect attached to it.
******** I wish we all went back to 'white' instead of wearing PJs, for the sake of professional appearances and credibility. Hard for patients to tell the difference between RNs and housekeepers in my hospital!
I remember when it was perfectly acceptable to ask family members to exit the patients room when the nurse needed private time with the patients.
********still is acceptable, even somewhat mandatory, with HIPPA laws
I remember when patients were admitted to the hospital, I actually had time to fully admit them without fear of the "chart monitor" sneaking around checking off what PAPERS had not been signed within 24 hours.
*********the joys of "quality assurance" Sigh.
I remember when I LOVED being a nurse because the respect was there, the thankfulness of the patients and family were there, and no one watched every move I made and wrote down everything I did just in case they needed those notes for a lawsuit.
*********remember when you charted important things...instead of for the jury to review next year?
Come to think of it....does REAL NURSING exist anymore!!!

Yup! Come on down to L&D!

Haze

Gail-Anne · Jan 23, 2005

I love this site! Lots of memories. Ever spill that Paraldehyde on yourself, then get pulled over in a police check-stop on the way home?

In 1971, in first year, a classmate was shortening a drain with an R.N. (not instructor), she insisted that the sterile safety-pin had to be reattached with forceps! Guess she had never learned to use her hands in sterile gloves. We cut the fingers off gloves to use as "finger cots" for rectal checks. Guess using a whole glove was too costly.