old skills that we do not use anymore

Editorial Team / Admin · Sep 18, 2004

Oh yeah, I did those, as well as PP sitz baths (and swabbing the sitz bath out w/disinfectant between pts)! And heat lamps for decub care.

BBnurse34 · Sep 18, 2004

I can remember needing to call a weather station to get an accurate, current barometric pressure so I could figure the tubing compliance on an old vent.

Gompers, BSN, RN · Sep 18, 2004

My coworkers like to talk about the "stimulation beds" they used to have for preemies to decrease apnea. I guess they went up and down in some kind of a shaky cycle, always keeping the baby moving. Poor kids! Thank goodness for CPAP and caffiene.

On our unit, the Filipino nurses are usually our best IV resources. They tell us it's because when they were in the Phillippines, there weren't very many IV needles, so if they missed on the first stick, they had to go resharpen and resterilize the one they used. They said they didn't have time for that kind of nonsense, since they would have 20-30 patients each. International urban legend or truth???

Lenap · Sep 18, 2004

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?

I work on a Head and neck CA floor and we still use NSS squirts before suctioning trach pts!!!!! And it does work!!!! Trust me! Nss helps pt to cough up all that mucus and makes it easier for me to get those thick and sticky mucus out when I do deep suctioning. This is also part of the teaching we give our pts.

I do want to mention that our hospital is known to be the best in the nation in this head and neck ca specialty for the past 8 yrs. So we must be doing something right here:coollook: . I would like to know where you got the idea that NSS should not be used? Let me know!

Some things are still practiced :rolleyes:

bookwormom · Sep 18, 2004

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 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"

barefootlady, ADN, RN · Sep 18, 2004

I have given many a dose of SSKI, used the approiate glass straw too. I remember when doing a dressing was a work of art. Can still palpate a BP too. Chest tubes attached to glass bottles taped to metal rings on the floor. Milking the tube every 4 hours and eventually working the way up to 8 hours just before removed. I have done an iced saline lavage for unexpected GI bleeding in the last year. The patient popped right after being put into the bed when returned from EGD, MD was inhouse, I lavaged while the room was reset. No one else knew what he was talking about but us 3 older ones. Stryker frames, halo braces, not used as much now. Could go on and on but I did feel more pride and enjoyment when nursing was a more respected career.

sjt9721, BSN, RN · Sep 18, 2004

i work on a head and neck ca floor and we still use nss squirts before suctioning trach pts!!!!! and it does work!!!! trust me! nss helps pt to cough up all that mucus and makes it easier for me to get those thick and sticky mucus out when i do deep suctioning. this is also part of the teaching we give our pts.
i do want to mention that our hospital is known to be the best in the nation in this head and neck ca specialty for the past 8 yrs. so we must be doing something right here:coollook: . i would like to know where you got the idea that nss should not be used? let me know!
some things are still practiced

i am sure your statements are supported by your years of excellent clinical experience; however, that does not equate to evidence-based practice, which has quickly become the standard across healthcare disciplines. the following is an excerpt from a journal article about endotracheal suctioning. i apologize for not being able to provide a direct link, but i did post the citation for your information. perhaps you can review recent literature and answer your own questions.

day,t., wainwright, s., & wilson-barnett, j. (2001). [color=#990000]an evaluation of a teaching intervention to improve the practice of endotracheal suctioning in intensive care units. journal of clinical nursing. 10(5), 682-696.

"the instillation of normal saline prior to suctioning has become common practice in many intensive care units (ackerman, 1993; ackerman et al., 1996). however, as bostick & wendelgass (1987) argue, this is an example of a widely practised intervention that is not supported by research. in fact there is considerable research evidence against its use (blackwood, 1999). theoretically, saline is used to loosen secretions. however, there is evidence that sputum and saline do not mix in vitro (ackerman, 1993; blackwood, 1999). the potential detrimental effects of saline instillation include a fall in pao2 (ackerman & gugerty, 1990), an increased risk of infection (rutala et al., 1984) and a failure to remove all saline during suctioning (hanley et al., 1978)."

phn92 · Sep 19, 2004

How about L&D and NICU nurses actually having to suck on DeLee catheter to clear the airways of meconium-stained newborns? Yeech! I know more than one nurse who got a mouthful of meconium.
I worked as an LPN in NB Nusery many years ago. I remember the RN's using the DeLee caths and the fear of sucking meconium in their mouths! It was the one time I was glad I was an LPN. What do they use now?
I am really feeling old after reading this thread. I can remember most of this stuff. MOM and the heat lamp for decubs was one we used a lot. Did anyone ever use Betadine and sugar to heal a decub? We had one doc who ordered that one alot! You guys are bringing back alot of memories!! :rotfl:

mattsmom81 · Sep 19, 2004

Everytime I take some preemployment test and they ask me 10 questions on calculating a drip rate by hand, I want to scream. Why do they keep testing us on stuff we haven't done in 25 yrs??? GRRR.

Thanks for the trip down memory lane guys...I also remember much of what has been shared here.

I can't just jump on the 'out with the old, in with the new' campaign for evidence based practice as the be all end all. Lots of the old ways worked too...in their own way, perhaps mostly because of the human caring and time we actually had to give our patients...patients who actually appreciated us!!

It was a happier time for me too. Now on many days I'm feeling like a high tech maid to consumers clients, machines and computer systems, stressed, underappreciated and held to a ridiculously high standard of care by the entire system. A system that seems to hold nurses accountable for most deficiencies it creates.

Lenap · Sep 19, 2004

day,t., wainwright, s., & wilson-barnett, j. (2001). [color=#990000]an evaluation of a teaching intervention to improve the practice of endotracheal suctioning in intensive care units. journal of clinical nursing. 10(5), 682-696.
"the instillation of normal saline prior to suctioning has become common practice in many intensive care units (ackerman, 1993; ackerman et al., 1996). however, as bostick & wendelgass (1987) argue, this is an example of a widely practised intervention that is not supported by research. in fact there is considerable research evidence against its use (blackwood, 1999). theoretically, saline is used to loosen secretions. however, there is evidence that sputum and saline do not mix in vitro (ackerman, 1993; blackwood, 1999). the potential detrimental effects of saline instillation include a fall in pao2 (ackerman & gugerty, 1990), an increased risk of infection (rutala et al., 1984) and a failure to remove all saline during suctioning (hanley et al., 1978)."

thanks for info. i don't work in icu so i don't know if they stopped this practice. i can see all of the above reasons why it's not the best to use nss on pt's that are in coma , paralized or just bed ridden. however most of our pts are ambulatory and most have trachs only temporary. i had never seen any of my pts drop in sao2 or pao2 levels after suctioning. only improvement. and unfortunatly i have seen pt develop mucus plugs when they weren't suctioned often enough or new nurses were forgeting to use nss squirts. trust me, not a pretty scene. from my experince and also from seeing successful outcomes of these patients, i will continue my practice they way it was established on our floor. our ent docs have a pathways for pts which says saline must be used.

mitchsmom · Sep 19, 2004

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'll have you know that my pharm math included apothacary just this spring!! #(*&%#(!??? :rolleyes:

imenid37 · Sep 19, 2004

Performing clinitest and acetests, EKG's w/ rubber straps, alcohol wipes and those ruber balls/metal suction cups and gel, using refractometer to do urine specific gravities. I was taught all of these wonderful skills as a nursing tech in the mid 1980's. I think of all of the"old nurses" I worked w/ then. They were ancient-pushing 40 like I am now and the most wonderful people EVER. I guess the very best things they taught me are intangible and never go out of vogue. :)