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?

[nursenatalie, ADN, RN]

I used a rectal tube the other day, and we do have large volume enema bags. I can remember working as a CNA and taking a patient with multiple decubitus ulcers to the shower daily to "scrub sores with dial soap until they bleed" as ordered by MD. I know we werent doing what was right but in this situation his sores improved

[Salty1]

Wow I never heard of that. When was that used?

This one girl told me about the Iron Lung that was for pneumonia patients. She said they used that up until the late 70's. But a rotating tourniquet, that would have been something to see and to use. thanx!!!!!!

I last recall using the Rotating Tourniquet Machine around 1976. It had four tourniquets attached-one for each extremity-and worked automatically with one of the tourniquets always being deflated. For example, the two lower extremities and left arm would be inflated while the right warm would be deflated. The machine would then cycle with the right arm cuff being inflated with one of the lower extemities being deflated, and so on.

I have seen iron lungs in storage and recall pix of same with patients inside which were used for polio or as it was called then "infantile paralysis".

Reading many of the posts evoked memories of treatment modalities long since forgotten. No one mentioned turpentine stupes which were used to "break up chest congestion". I also recall hearing about rural at home treatments for "chest congestion" in the form of a "cow flop stupe". If such a treatment was applied to me I'm sure it would result in a miraculous cure as I would immediately jump out of bed and run for my life.

Salty

[babynursewannab]

I recall using a rotating tourniquet machine as part of the protocol in the treatment of pulmonary edema. Of course, that was accompanied by IV Lasix. Apparently studies revealed that rotating tourniquets were totally ineffective in the management of CHF/Pulmonary Edema.

I was just practicing NCLEX questions this morning and 4 were about the rotating tourniquet for CHF pt. I had no clue what they were talking about...so I guessed.

[mattsmom81]

Some of the old ways had their way of working. Rolling a pt far to his side and putting heat lamp on sacral decubs for instance... kept the pt off his ulcers primarily. Probably kept urine and stool out of the wound awhile, always helpful.

Rotating tournequets were an attempt to reduce preload...now we use meds to do that, much more efficiently I'm sure but the meds weren't around then!.

A little aggravation to the lungs stimulates pulmonary toilet...LOL! Now we have better ways than turpentine and cowpoop.

Folks used to throw alchol into a wound...killed germs and bet they got up moving and that reduced prevented DVT/complications of immobility.

Yes we have evolved but lets keep perspective rather than some here who totally disdain all old ways and nurses who haven't totally abandoned them all.. I loved Imened's comment about the 'intangibles' in nursing...it ain't all about science IMO.

And no my post here is not 100% serious for those who wonder.

[apaisRN, RN, CRNA]

My understanding about the NS thing is that the chilly/room temp saline can cause bronchospasm. In MICU we use it occasionally for plugs but not routinely.

I placed a rectal tube yesterday! The patient has a huge wound to her inner thigh, bordering the perineum. It has a wound wac and stool kept getting under the plastic wound vac dressing.

We do use Blakemore tubes when all else fails.

I was taught drip rates in school (BSN '02) but not apothecary. I use drip rates almost never, everything is on a pump. The pump also has multiple modes to calculate mcg/min, mcg/kg/min, etc, so I don't practice that math as much as I should.

I love these stories.

[ldkrn]

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

Here is an article concerning this practice, which hasn't been recommended for many years although still is routinely used in many settings. Lots of good references as well.

http://www.aacn.org/AACN/jrnlajcc.nsf/GetArticle/ArticleThree74?OpenDocument

[Melissa H]

I have worked at my current hospitals endoscopy unit for 2 years and have done a blakemor tube 3 times!!! I remember iced saline lavages for gi bleeders. I remember using dakens solution for bedsores. I also recall cantor tubes suction EKG leads, when PEA was called EMD. MAN IM GETTIN OLD!!!!!!!!!!!!!!!!!

[tinnekke]

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"

Wow, my instructors must have been weird or something. I've only been out of school a little more than a year, but we had to learn 3 measurement standards and the conversions between them: Metric, Apothecary, and household. I can convert grains to milligrams, ml to teaspoons and drams and reverse them... some of my patients go to doctors who regularly prescribe using apothecary or household doses.

[KarafromPhilly]

Uh, what's wrong with iced saline lavages for GI bleeders and Dakin's solution for decubs--are these practices now considered obsolete?

[redheadRN]

Well I work in LTC and things always move slower for us! We still use Dakins for decubes(but there are MANY other, newer txs. we use also), we use saline for trach care, and have even been known to have our Stage 1s and Altered Skins treated with Desitin and Crisco. And if a resident needs a little, ahem, odor control for their peri area we still use Barbasol. As an aside, do any nurses who work L & D still use Sitz baths? My local hospital does (I had my daughter 7 months ago), but when I was in clinical a few years ago, the nurses at a larger hospital with a bigger OB unit didn't know what I was talking about!

[boggle, ASN, RN]

Long before incentive spirometers we used blow-bottles. I don't know how effective they were for encouraging deep breathing, but the sound and visual of water flowing from one chamber into another as the patient blew sure encouraged urination! So we had lots of congested lungs and empty bladders.

I still use drip rate calculations to run medicated bladder irrigation drips. No pumps around for for that.

Did anyone else ever have to use those cloth OR leggings? They looked like giant,white Christmas stockings. Every patient who went to OR had to have them on their legs.

How about one medication nurse for the whole floor? Each med order was written on a little card, different color cards for different frequency of medication. You would pour the whole shift's worth of meds for the entire floor at the start of each shift. The 8am , 10 am, noon and 2 pm doses were each in little paper cups, nested one on top of the other. The entire floor's stacks of cups were nestled in a carrying tray, and you carried it from room to room. How did we ever get the right pills into the right patient? And what ever you do, don't drop the tray!!!!!

We did so much with much less depth of understanding why back then. Nurses understanding of science has grown, but then so has medicine in general.

[Uptoherern, RN]

glass thermometers in jars of alcohol..........(and playing with the mercury when they broke!)