What is your no fail nursing tip

nicola · Nov 14, 2001

In home care, when you call before the initial visit, confirm addy and directions. If it's a delicate dx (like HIV), ask the patient who knows what so you don't blow a confidence. I've had many patients who tell certain friends or family members that they have liver problems or CA instead of HIV.

The tips for cathing pts was great! I have a friend who went to do a cath on an elderly man and couldn't find the member! He wasn't that heavy, according to her. When she couldn't find it, she called a more experienced nurse who went in the room AND COUDN'T FIND IT EITHER!!! One would assume he had one, but it was hiding I guess. Sigh!

debbyed · Nov 14, 2001

When starting an IV on a frail elderly patient who's veins roll place a thin strip of clear tape on each side of the vein about 2" long. Use a BP cuff instead of a tourniquet. Leave the tape inplace and cover with op-site. Will help maintain patency of the catheter.

radnurse2001 · Nov 16, 2001

For injecting a child (placing an IV) use ethyl chloride to numb first, then divert their attention while you stick, when palcing a urinary catheter in a peds patient, use lidocaine jelly, wait 5 min, then cath using a 6-10 french neonatal feeding tube...of course this is tempoary, not an indwelling. If you need to pass a NG on a unresponsive patient, gently stroke thier throat to get the NG into the esophagus instead of the trachea. The pressure on the neck involkes a swallowing type action. These are oldies but goodies. OH, one more, when catheterizing someone and you are meeting resistance, have them take in a deep breath and blow it out slowly, it relaxes everything.

Anne

NCNocRN · Nov 16, 2001

Medication patches on a confused patient? Put it in between the shoulder blades, where they cannot be reached and pulled off.

LilgirlRN, ADN, RN · Nov 16, 2001

Originally posted by moonshadeau
I was surfing the web and came across this web site
http://nursing.about.com/gi/dynamic/offsite.htm?site=http%3A%2F%2Fwww.postgradmed.com%2Fpearls.htm

It is mostly related to doctors but there are some good nursing tips... But I know that all of you experienced nurses have learned something about some tip or trick that you didn't learn in nursing school but now is a no fail tip

I know that one tip I have is for blood. Check component, blood band, patient name, order, and check with patient if they have ever had a blood reaction before. This has saved me from having to call the doctor after I had the transfusion reaction. I just called before I gave the blood to get some prophalaxis.

Another one that I know works is to put powder on the bed pan.

any others out there

If you get a patient in who has a low temp (and its not cold out), check their blood sugar...can't tell you how many times I have done this and found out later that the patient has IDDM. To get them warm... blankets from the blanket warmer (every ER should be so lucky as to have one), be sure and cover the patients head. I usually get them to sit up and drape the blanket over their head and shoulders.

The blood pressure cuff as a tourniquet works very well, if the patient is not allergic to lidocaine I use it on everyone before I start an IV and on some just when drawing labs, depending on where I have to stick. When drawing labs via a just inserted angiocath, I use a syringe instead of the vaccutainer system, it hemolyzes blood less often. One 10 cc syringe can get you a CBC, any chemistry you need, PT, and blood bank, if you distribute it right.

O2 sat probes work well on ears when they wont work on digits.

Where foley catheters are concerned...sometimes having the woman lie on her side and bend one knee up works well if you don't have any help. I have been known to use the finger in the lady parts trick to keep the catheter from going there too.

Jenny P · Nov 17, 2001

When your fresh post-op OHS comes back from surgery and the chest tubes need banding, use Betadine swabs to lubricate the connectors and tubes so you can push the tubes on to the connectors easily, then band.

To hear a faint cuff pressure easier, pump up the BP cuff as usual, then elevate the arm to slightly above the heart level (just about 4 inches off bed if pt. lying down) and let the air out of the cuff normally. The sound is usually amplified by doing this.

Always tip the pts. head forward (chin towards chest) when inserting an NG to ensure the NG goes down the esophagus instead of the trachea. Stroking the throat while inserting the tube helps also.

When my husband says his feet are cold (he has neuropathy related to his MS and diabetes), we found that warm packs to the groin areas work better at warming his feet than heat to his feet-- no chance of burning himself this way. Haven't tried it yet on a pt. in the hospital; but I do use cold packs there for pts. with fevers (along with cold packs in axillas and behind neck and a cool cloth to forehead).

Re: Ativan, I use a large guage needle (#18 or #16) instead of diluting it in the Ativan vial because of having to keep track of the waste.

OC_An Khe · Nov 17, 2001

This is an interesting thread. We need to learn/teach from each other.

For expirienced RNs find a newby to mentor and share your pearls of wisdom. For the new RN find an expirenced RN you are comfortable with and develop a relationship so that she will pass on her pearls of wisdom.

codebluechic, ASN, RN · Nov 17, 2001

When I'm taking a "road trip" with my ICU patients (CT,MRI etc) I always have an amp of epi,atropine,and lido in my pocket. An elevator is a BAD place for a code!

VictoriaG · Nov 17, 2001

When giving am IM ingection that really stings, dip the needle in 1%Xylocaine first. When running IV meds that sting, first push a little lidocain to numb the vein. When inserting a foley cath, always lube the cath first with lidocain jelly.

shannonRN, BSN, RN · Dec 3, 2001

great tips...i'm always up for learning something new.

the tips i have concern bladder scanning. always ask the female patient if they have had a hyst. if they had the machine registers them as a male and the amount of urine reported will be different. taught a nurse at work this and the amount changed from 0cc to >999cc!!! :eek: it also helps if the head of the bed is down. :)

Sylvia · Dec 3, 2001

I have two tips for inserting catheters.

If you have trouble finding the female meatus, watch carefully as you swipe the Betadine swab - the meatus will actually "wink" at you. Works every time!

The second tip is the one most patients truly appreciate. Catheter kits usually only provide one package of K-Y. Try to obtain a second package of KY and use both to lubricate the catheter before insertion. It makes it so much easier and many patients have told me "That's the only time someone did that and it didn't hurt." Of course, the second package is likely to come from a supply room shelf and the outside of the package won't be sterile, so it makes it more difficult to maintain your sterile field, but it's worth it. If possible, have another nurse empty the second package onto your sterile field.

Sylvia

amdrn · Dec 4, 2001

Hello all,

When I'm starting an IV on a person who is "afraid" of needles(most people are, right?!?), I have them lay back as far as is comfortable for them. I ask them to close their eyes and think of the best thing of their lives, (I always tell people that they don't have to tell me what it is, you can't imagine what some people have chosen to share with me.)

Than I teach them good ole' fashioned relaxation breathing, in thru the nose out thru the mouth, slowly.

To allay their fears, I tell them absolutely everything I'm doing from opening the start kit to ripping tape.

After applying the touniquet, I ask them to open and close their hand until I ask them to stop.

99% of the time, we have a successful IV start and everyone involved is relatively calm.

Good Luck!