Seasoned Nurses - This one is for you

[tnbutterfly - Mary]

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Seasoned nurses are special, not only because of the knowledge they possess and the skills they have mastered, but also for the many changes and advances in medical technology they have seen over the years.

I need your help. As we are preparing the next issue of the allnurses magazine which will be published in January, I would love to get input from you seasoned nurses as soon as possible.

What are some of the biggest changes you have seen in nursing and medical technology, for better or worse?

What are some of the newest and latest pieces of equipment, treatments...the newest shiniest objects?

What are some of the newest trends that might have you raising your eyebrows or increasing your nursing curiosity and wanting to learn more? (some of the less seasoned nurses can join in this one) I would really like to see posts about new advances as we look toward the future.

I would love to get LOTS of posts because I want to share some of your insights and comments contrasting the past with the future in a section of the upcoming magazine. I know this is a particularly busy time of year, but please take a few moments to post some thoughtful comments as soon as you can.

Thanks in advance for your help.

[canoehead, BSN, RN]

I worry that there will be no one left that remembers how to do things without a computer. How to organize all the paper, how to communicate between floors. It's a skill we should maintain, but unless we're doing it daily, its going to be lost. That's too bad.

The patient satisfaction push. Yes we needed to be more responsive to patient input and keep them as part of the health team, but once they choose to endanger their own health, we shouldn't be a party to it. Yes, I want to control pain, but I want the patient to be able to do PT. Yes I want to encourage patient's making their own choices, but that fifth tub of ice cream...they need to walk to the kitchen and get it themselves. I' know my fellow nurses get this, but the suits seem oblivious.

[Leader25, ASN, BSN, RN]

Suffocated by visitors,abused by visitors,tormented by too loud constant ding ding dang!Having to carry an ipod which battery is always low,a wireless phone that is set to call everyone for everything,like pharmacy calling on it,hard to hear due to loud alarms that ring when you breathe, and don't ring when iv infiltrated,carry a label maker /scanner,scan patient,meds /food/.No real upkeep on programs in computers,needs upgrades desperately.The worst offense I heard about was administration ruling that only BSN people could do fingerstick for glucose level.No valid explanation,only finger pointing,no plan to buy newer machines that were safe for all to use.So you ended up doing glucose on many patients besides your own busy assignment.Sure we do plenty of handwashing but we let in every kind of viral/bacterial feverish coughing visitors all the time,they slap a mask on and that's it,they wander about with the mask hanging off their chin and you can not say anything.Heaven help you if your named in any type of complaint by some deranged visitor,it is all your fault,you are wrong ,it will be in your evaluation.Too many classes on empathy,diversity forced down our throats and not enough on disease prevention,contagion,medications.

I could continue but what is the use.

[Kallie3006, ADN]

EMR- love /hate relationship, older programs with redundant, outdated systems, or lack of physician compliance- ease of access and patient safety check a plus, not having to play guess that word as much for written orders

Pyxis- wonders over a med cart

Medical information access- easier to find relevant patient education information but also harder for patient care whe. Dr. Google diagnosis a cancer not there

Work phones- direct number to be reach for needs or paging doctor: awful when also ringing for random crud all shift long

Insulin pumps and glucose monitoring systems

Cardiac devices that monitor pt in outpt setting sending data to phone program or dr office

Internet forums for advice, education, social interaction, and venting

[iluvivt, BSN, RN]

I love all the new technologies in IV Therapy.The use of Tip Confirmation Sytems to verify tip PICC placement lessens treatment delays and saves nursing time and money.Also the use of Ultrasound to get that PICC well above the ACF in the Basilic or Brachial vein.The use of Ultrasound to start a PIV is a different matter.While still good, it's not as easy as many portray it to be and they have a much greater propensity to infiltrate than the standard method to start an IV.Do I use it.....yes...but only if I have toif other options do not exist.It does buy some time though to get IV therapies started while you work on central line access.It's also annoying that nurses fail to lrearn how to start an IV by palpation or visualization and want to go straight to technology.They pick these superficial veins with a vein light that last a few hours or fail multiple times with the US and fail to see or palpate the good veins right in front of them.I see this every day.Technology is only as good as the hands it is in .

[Nursedeb1989]

work ethic in newer nurses (not all) isnt the same. some of our aides try to hide to avoid work. some coworkers are slobs, reports are often not accurate or complete. staff reduction in key areas to save money but at the risk of patient safety. I've been a nurse for 30 years and its definitely getting worse. sad but true.

[Kitiger, RN]

In home care, the newer equipment is wonderful. I work with LTV 1150 and Trilogy vents now, vents that hook onto the back of the wheelchair. I can carry all of the equipment on the wheelchair!

That's one wheelchair to push, with everything I need.

Remember how LARGE some of the old vents were? I worked with the LP4, LP5, & LP6 vents in the 80's. They were something like a 2-foot square cube of metal that was very difficult to lift. One family bought a full-size grocery cart to hold the vent with its boat battery, the Hot Pot with its bag of sterile water, the heavy suction machine, the big Pulse Oximeter, his Go-Bag, and an E-tank.

That cart was FULL. And we still had to push the wheelchair with the child. A trip to see the doctor used to be such a huge affair that a trip to almost anywhere else was out of the question.

Now-a-days, we can go pretty much wherever we want, whenever we want. The world has opened up for these people.

[alucas75]

I wish there was a love this post option.

[alucas75]

Yes! the Provena incisional wound vac dressing is very cool for surgical patients. One of my surgeons once said about Aquacel (that can stay on for up to 7 days), that it is like leaving a patient in a wet diaper. Don't know the cost to benefit ratio but if it reduces SSIs, I'm sure it will be worth it.

[JBudd, MSN]

portable tele boxes, so patients aren't tied down

being able to call into a room when the call bell goes off, to see what they need, only make one trip (hopefully)

bladder scanners, instead of cathing for residual

individual incentive spirometry gadgets instead of having to hunt down the roll around one that everyone shared

plastic IV catheters instead of leaving the needle under the skin

[Hoosier_RN, MSN]

doing away with visiting hours in the name of patient satisfaction; actually the whole patient satisfaction is king concept. EMRs. Certifications for everything under the sun (some good, some bad). Doing away with minimum standards in some programs. Unethical programs (for profit) popping up all over the place. New medications for anything that ails you. For the good, continued research into holistic medicine, even though unfortunately, we seldom get to use, or teach, those methods due to time and financial constraints

[anewsns]

RN- 8 years. Moving from paper to electronic charting, cracking down on opiates. When I was in school, they said "the risk of becoming addicted is about 0.12%"- we used to hand them out like candy! The market seems to have changed in my career, I came through when it was flooded and hard to get a job but I think it's easier now as many nurses move away from bedside, it gives new grads more of a chance to get a hospital job. There are also more work from home/ remote telehealth jobs.

[caliotter3]

Recently had first introduction to electronic charting. Worse than my expectations. And not fast at all.