old skills that we do not use anymore

RNKPCE · Sep 26, 2004

Palplate the radial or brachial pulses, then pump up sphynommeter(sp), when you first feel pulse again that is your systolic. You won't get a diastolic. So it will be 80/p p=palpable

I've just gotta know... since it was mentioned so much... how exactly DO you take a blood pressure without a stethoscope?
-Indy

snowfreeze, BSN, RN · Sep 26, 2004

How about glass dome arterial pressure systems. Squirt some saline in the glass dome and recalibrate every 2 hours. And mercury tube ICP setup, I used only one of those.

snowfreeze, BSN, RN · Sep 26, 2004

Paralytics for post op CABG patients when they shivered. Extubate 24 hours post-op on CABG patients. Now they arrive extubated and awake from OR. I was still doing some CABG when fast track started. We were very nervous about getting em out of bed the next day, **** they used to be just waking up.

gsd4me · Sep 27, 2004

LOL...I'm loving this thread. I usually just lurk but I couldn't resist...how about this one...

I remember being taught in nursing school to NEVER wear gloves when doing colostomy care. The reason was that the patient would feel "dirty" if the nurse wore gloves.

Jamesdotter · Sep 28, 2004

LOL...I'm loving this thread. I usually just lurk but I couldn't resist...how about this one...
I remember being taught in nursing school to NEVER wear gloves when doing colostomy care. The reason was that the patient would feel "dirty" if the nurse wore gloves.

We must have had the same instructors! And wasn't it hard at first to get used to wearing gloves for everything?

Shotzie · Sep 28, 2004

I hate that I am old enough to remember almost all this stuff!

And I have to admit I am amazed that palpating a B/P is not widely known among "the younger nurses" (ooohh, I hate using that term too! :chuckle)

That one about not wearing gloves really made me think about how it was when I was first out of nursing school. I remember starting IVs and drawing blood without gloves. Sometimes you would get blood on your fingers and it would run under the cuticle of the nail and be very hard to wash off. I remember suctioning without gloves and using my thumb on the airflow valve that regulated the suction. Of course the mucus was sucked right past that open valve and a nurse friend of mine got a terrible bacterial infection on that thumb. She was out of work for 9 months and in and out of the hospital. She eventually healed but lost a lot of tissue and mobility in that thumb because of it.

I remember changing adult diapers, doing colostomy care and cleaning up "the poopies" in bedbound patients without gloves. I am a very "clean" person and no matter how hard I tried I always ended up getting stool on my hands. :uhoh3: I would wash and wash and wash my hands afterwards and would still feel dirty. Eeeeuuueeek!!!

I also graduated from nursing school right as AIDS/HIV was being identified. I was on a special team that took care of these patients in the ICU. All we knew at that time was that it was a "gay disease". In the beginning, we did all the care on the open floor with no protective equipment, not even gloves while we did procedures (see paragraphs above) and care.

Six months later these patients were locked in the isolation rooms and we used full protective gear even including respirator hoods :rotfl: for a couple of months.

I look back on that now and wonder why in the world I didn't end up with some kind of hepatitis!!!

sassykitkatt · Sep 28, 2004

i still find it hard to wear gloves, especially when I used to give bed baths. And now that I am dialysis I have to think to put on gloves, because we deal in blood all the time and it cen get out of hand sometimes and all the nurses and one nephologist will tell me repeatedly to put on gloves, cuz i'm used to not wearing all the time, but with aids and hep B I have to be more conscious.

We must have had the same instructors! And wasn't it hard at first to get used to wearing gloves for everything?

MARY HOPPER · Oct 5, 2004

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.

I have worked in pediatric private duty nursing for over 15 years in Tennessee and it is still our practice to use saline when suctioning trachs or et tubes.Mucus plugs are a very dangerous situation that occurs without the use of saline.

talaxandra · Oct 5, 2004

I trained when the hospital introduced BABS (blood and body substances) precautions. Far from suctioning without gloves, I remember learning to suction using sterile technique - tucking the suction catheter packet under one arm, and using one sterile and one non-sterile glove. Even now, a good six years after we introduced 'clean' suctioning, if I'm not thinking I sometimes tuck the packet under my arm.

How can I possibly have been nursing long enough to know obsolete techniques? This is very distressing :)

apaisRN, RN, CRNA · Oct 5, 2004

I remember being taught in nursing school to NEVER wear gloves when doing colostomy care. The reason was that the patient would feel "dirty" if the nurse wore gloves.

This is so strange to me. We've known for a long time that stool had germs, right? If not hepatitis or worse, we at least knew about E. coli and other pleasant things. Seems like gloves would have been smart even then.

Did hospitals not routinely stock gloves before the AIDS/ hepatitis thing?

mscsrjhm · Oct 5, 2004

Remember adding the meds to the IVs, and those red labels that we had to fill out??

Bicarb every 5 minutes in a code!!!

Calibrating IV drips, unfortunately, many were positional, so IVs were very "iffy".

Smoking at the nurses station. Hallways filled with smoke.

Vest and posey restraints. (pre veil beds)

Picking up all the trash at the end of your shift. dropping the trash bag beside the door to let the others know that room was done.

Back rub list.

Everyone took report together, none of this "it's not my patient"

Letting confused patients fold towels and washcloths. Kept them happy and busy. Now that would be considered "work". Then it was "work therapy"

Team work.

lpndori · Oct 6, 2004

I am so enjoying this. I am sorry to say that I've not been a nurse long enough to remember many of these practices, but my aunt remembers a lot of these. Keep 'em coming!