Only Crusty Old Bats will remember..

[Pepper The Cat]

So, I really need a fun thread right now. We've done similar things before and it's always fun.

so, things Crusty Old Bats(COB) remember that new nurses today will not.

1. The clunk your uniform makes when you drop it in the laundry hamper and you realize you came home with the narcotic keys.

2. The splat the over full paper chart makes when you drop it on the floor. Papers everywhere. 15 mins getting everything back together.

3. The smell of the smoking lounge .

4. Nurse and Docs smoking at the Nsg Station.

5. Trying to match the colour of the urine in the test tube to determine the sugar level.

+1? +2? Which one?

OK my fellow COBs. Jump in!

[quazar]

I was actually involved in the clinical trials of quite a few of the routine things we do on the unit today. It's really bizarre. I can still remember when the residents and research team started doing them, and thinking they were really weird (and some kind of barbaric and painful), but now they are routine and have reams of evidence backing them as truly the safest and most effective methods out there. Totally bizarre.

[pasdequoi]

Doing spin 'crits, collected using glass capillary tubes directly onto a finger stick or heel stick.

Docs and critical care nurses pacing the hall on the last day of the ACLS course, nervously awaiting their turn running the mega code. (ACLS courses used to be hardcore and very scary, but that changed sometime in the 90s).

Ativan taped to the headboards of seizure patients (yes, really!)

[Davey Do]

[meanmaryjean, DNP, RN]

I was actually involved in the clinical trials of quite a few of the routine things we do on the unit today. It's really bizarre. I can still remember when the residents and research team started doing them, and thinking they were really weird (and some kind of barbaric and painful), but now they are routine and have reams of evidence backing them as truly the safest and most effective methods out there. Totally bizarre.

I got to work on the trials for alprostadil (PGE1), artificial surfactant and some kid of blood substitute that ended up not working so well.

[Oedgar]

Graduated in 1992, and remember lots of these things. I guess this makes me a crusty old bat at a few-weeks-shy of 45!

[Spidey's mom, ADN, BSN, RN]

Nice full lady-scaping and enema for a laboring mom

Oh man . . . you reminded me of my first time laboring with my 1st kid. 33 years ago. That happened to me! It was awful. The other funny thing was a normal lady partsl delivery stayed 3 days in the hospital.

I had my 2nd kid two years later in a different state and I might have been on the cusp of changes in L&D policies. No full shave or enema! And I only stayed barely 24 hours.

Such a difference . . . especially for the itchy time to regrow hair. I'm obviously not a fan.

[Davey Do]

One thing that hasn't changed in over 30 years of nursing is that I still like to have fun with my colleagues.

This photo was taken circa 1986. My coworker is wearing my glasses and "nurses cap" with my pin on it and I'm wearing her glasses and stocking hat, giving my lobotomy look:

[BabyFood26]

4. Heat lamps applied to fresh postpartum bottoms

Sounds heavenly! Had baby #1 in 2008. Gotta "hot water bottle" and witch hazel pads. But woulda loved that lamp though!

[travduck, BSN, RN, CNM]

Giving backrub and foot rubs.

Menu choices instead of "standard fare for assigned diet"

Actually touching AND talking to your patient for longer than 30 seconds.

Putting patients first not money.

Nursing administration and management who were actually ecperienced nurses themselves.

Respect and ability to make change.

Nipride watch.

Actually sitting/staying with labouring patients

Teaching patients one to one.

Fire drills instead of gun fire drills.

Circumcisions wuthout strap down boards

Receiving verbal report post procedure, and giving report verbally preprocedure.

Heated blankets and sheets in the winter with bedwarmers.

Don't miss wires taped to hall floors which always seemed to magically appear on the way BACK down the hall wuth the crash cart.

"Diploma" nurses.

Coin drop testing of nonfitted sheets on plastic spraycovered mattress.

2weeks in bed postpartum.

Home follow up of new moms and babes by delivering staff.

[DoGoodThenGo]

I graduated in 2015. Not only did we learn how to calculate drip rates and set up IVs to gravity--we were checked off on these things too. This is despite the fact that all of our clinical sites were hospitals that used IV pumps. The instructors told us we would have plenty of practice with IV pumps at clinical (they were right!).

I will never forget my second semester instructor informing us that the roller clamp on the primary line is the "remote control" of the system, haha.

I filed this knowledge away in my memory bank. Never once used it in my first nursing job on a telemetry floor. But it sure came in handy last week at my new job in a pain management clinic, where IV pumps do not exist. (We just started performing procedures that require pre-procedure antibiotics and/or NS running at KVO).

My coworker did not know how to calculate the drip rate for the antibiotic, nor did she know how to hang the IVPB to gravity and make it "drip" at the correct rate--roller clamp was wide open and we could have bolused pt with Ancef--not a good plan especially since pt had never taken this med before.

Anyway, in that moment I was immensely thankful to my second semester instructor and her words of wisdom about drip rates and roller clamps!

Aside from the apothecary system and conversions (which also has largely gone by the wayside), probably one of the biggest mine fields for nursing students in past was volume/time IV drop rates. Saw grown women break down into tears after getting back test results with an "F" that meant failure of the course (ours was a half semester "Pass or Fail"). This of course meant your nursing education came to a halt as you couldn't go into Med/Surg II without passing med dose calc.

You can do it in either one or two steps but either way it requires no more math skills than low level algebra and probably is the most difficult as things get for "nursing math".

Math education in the USA has been declining for decades and that may be the sticking post (as Carmine Lupertazzi, Jr. would say). Everything one needs to know is written in the med order, the rest is simply setting things up and plugging in the numbers. You'd think with the advent and acceptance of calculators (my COB program forbade them, but that was decades ago)

You've got an order for 1000mL to be infused over 8 hours, the IV set is 15gtts/mL. Pick your method, set it up and go.

Things get (just) slightly more complicated when dealing with continuous infusion rates where you are infusing something that comes as mg or mcg in a solution measured in cubic centimeters.

This brings up another point; recall reading several years ago that the federal government (IIRC) did a study regarding nurses and the preparation of reconstituted meds. Several hospitals were included in the study and a large number if not majority of nurses made substantial if not serious errors in their calculations. Upshot was the recommendation that such meds be prepared by the pharmacy... Now that is just sad.

It took the work of Florence Nightingale and others to get nurses preparing the medications they would administer. Indeed the old school model taught that a professional nurse should never administer anything she (or he) did not prepare themselves.

Unit dosage, Pyxis and the rest are wonderful inventions and so forth; but one must never lose sight of the fact responsibility for medication administered still rests mostly on the one who gives. Computers, calculators, phones and the lot are all useful tools, but they can only give answers based upon what is input; garbage in still will get you garbage out. Worse over reliance upon devices can result in nurses losing (or not even developing) the knowledge/skills that comes from being intimately familiar with nursing math.

Am sure many remember the rash of infant deaths/adverse reactions not that long ago due to med errors involving heparin.

[sallyrnrrt, ADN, RN]

Oh yea I remember all....... The one convient time I herd the clung of narc keys, my apt. In wash DC was only across a parking lot, less than a block from GWU hosp. cCU

[sallyrnrrt, ADN, RN]

I'm surprised no one has mentioned glass IV bottles.

Having to adjust IV flow rates using a roller clamp & your watch.

Oh, arranging glass bottle, multiple sets for chest tubes, Monaghan ventilators, wag stein intermittent suction machine...for sump tubes, all hole pristine managing those white clinic shoes