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?

[VivaLasViejas, ASN, RN]

Good grief........I've only been around nursing for 10 years, but some of what I learned is as obsolete as the enema bag! Speaking of which: when was the last time you did a Harris flush? Or put in a rectal tube (oh, how I long for the return of THAT practice whenever I have an incontinent patient with C. diff!)?

Then there's some of the things my grandmother used to do when she was a nurse.........like put mustard plasters on someone with a bad case of bronchitis, give soap-suds enemas for constipation (which she defined as going more than 24 hours without a BM), and slathering the patient from head to navel with Mentholatum for sinus and chest congestion.

What about putting babies to sleep on their backs?? We put generations of children to sleep on their tummies for fear they would spit up and aspirate; yet to do so now would be unthinkable. And I've noticed that parents are starting solids in the early months again, like their grandparents before them, instead of waiting until six months of age or even later like we were told to do. I used to get these nasty looks from the kids' pediatricians whenever I told them I'd been feeding my babies solid foods; for crying out loud, every one of 'em was upwards of eight pounds (the last one was almost 11), and they were drinking over a quart of formula a day and STILL hungry by the age of eight or nine weeks......as far as I was concerned, if the doctor didn't want me to feed them cereal, he was perfectly welcome to come to my house and listen to them howl all day & night.

Oh well, the more things change, the more they........change! :chuckle

[kwagner_51]

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!!

[sassykitkatt]

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

You I forgot about the shaking thermometer. Shake it so hard, could bearly see the mercury and i still can palpate or even eyeball a BP

[sassykitkatt]

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!!

Or how about when the child is choking, you pull their arms up over their head to stop them from choking. Upside down and arms over works. Old wives tells or not.

[LPN-n-2005]

I used to be a mean hand at scrubbing bed pans, changing water for the flowers, damp dusting surfaces prior to starting my shift, methoing the surfaces in the treatment, and pan rooms and not to forget changing the curtain ties..........

Maybe, not quite what you meant, but they were all nursing duties when I started nursing. Things have changed. Back then I actually had time to do this, I can't imagine having the time to do the 'extra duties' now.

Whew! Doing all of the above duties you described above sounded more like a maid service rather than nursing! Nursing has evolved a long way since then.

[live4today, RN]

........Nursing has evolved a long way since then.

Really now! Not where I usually end up working. MAID service is more popular than ever among "The Powers That Be" in the hospitals...giving patients AND family members whatever their hearts desire. Nurses today are being treated more and more like emotionless service workers.

[Ruby Vee, BSN]

Learning math that requires the use of ones brain would be a miracle today. What! No calculators to figure out the problem? :rotfl:

When I started in ICU, calculators were so expensive that no one had one. The hospital bought one for the pharmacy; everyone else did their math by hand. And we COULD!

[P_RN, ADN, RN]

Suction produced by a Wangensteen setup. Or suction by using a faucet wide open with a Y connector.

GLASS urinary catheters (i&o not foley)

Oxygen tents.

TPN/Hyperal done to gravity and calculated to run exactly 24h.

Calculating rates in general.

Mercury manometers and thermometers. If they broke you scooped the mercury up on a piece of paper and trashed it or washed it down the drain.

Incinerator chutes on every floor (flames shooting up sometimes when you opened it.)

Isolation wards.

Iron lungs- usually for polio....

and POLIO scares. No one went to the movies in the summer out of fear. My best friend got it when we were 10.

Call lights with a string for the patient to pull. A light went on over the door.

Meds charted within the narrative charting. Days blue, evenings green, nights red.

IM penicillin.

Doctors starting IVs...it was a secret or something.

Co-workers as "a second family."

Getting your cap after 6 months.

Putting the blue stripe for year 2 and the black stripe for year 3.

R E S P E C T for nurses.

Ahhhh, yes I remember it well.

[RainbowSkye]

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

Yup, the rotating tourniquets. We had three big abd pads with three fat tourniquets on our crash cart. You would put them on three out of the four limbs and then, well, rotate them very few minutes. I remember when we got an automatic rotating tourniquet machine. You put four big old bp cuffs attached to this machine which pumped up three at a time. Much easier.

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.

Irrigating gi bleeds with iced saline. That was a delight. You would do it for literally hours in hopes of stopping that upper gi bleed.

Blakemore tubes for esophageal varicies. We would put them in and attach them to a football helmet the patient had to wear to keep traction on the tube. Enjoyable for both nurse and patient.

Sippy diets. We would put folks with gi bleeds on this diet beginning in the icu. Cream every half hour or something like that graduating to soft boiled eggs.

Irrigating foley catheters routinely to keep them from, I don't know, clogging up I guess. We would sure vinegar mostly.

Nebulizer treatments done with ippb machines. IPPB machines used for ventilators (or more correctly, respirators) in ice.

A bunch of meds I don't even know if they exist anymore. Aramine drips for svt. Levophed drips for hypotension. SKKI - now what the heck was that?

When I was first a nurse we rarely gave iv antibiotics or pain medication. It was most common for someone to be getting penicillin injections im q 4 hours post-op and morphine sq for pain while they were npo getting iv fluids.

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.

[RNKPCE]

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"

[dianah, ASN]

I remember the hot packs, soaking in sub-boiling water. Open the lid of the metal box, take one out with the tongs, place it on a special pad (so the pt didn't get burned), and wrap it up. Put it on the owie. Check skin site under hot pack periodically so you don't burn the pt.

Milking chest tubes.

Yes, I do remember "Hyperalimentation," or Hyperal for short. :)

Drip IVs (I can still glance at a gravity IV and tell you how fast it's infusing -- 125ml/hr, 100ml, etc) -- don't even need to calculate 'em anymore.

I remember when Swan Ganz catheters were just becoming THE thing to use in the ICU.

I, too, remember mercury thermometers, and I can get a BP w/o a stethoscope (radial or brachial), as long as the pressure isn't too low. If I can feel a pedal pulse, the pressure is at least -- what, 90 syst???

Doing pericare around indwelling catheters q 8 hr (yuck): cleaning the area w/betadine swabs (top to bottom, one swipe per swab), then applying betadine ointment w/"cotton-tipped applicator" just at the meatus.

I did wear my hat the first 2 years after I got my RN. The patients loved seeing it (and remarked about it to me, many times), and since I was there for pt care, and they liked the hat, I wore it. :)

Nowadays it seems good infection control NOT to wear one. Same goes for MDs wearing ties (how often are THEY cleaned???), IMO.

Yes, I do remember the three colors of inks used for ams, pms and nocs charting! Ah, the days before care plans!!!!

Thanks for the memories!

[bam_bam]

heat lamps for episiotomy care