What's your best 'Nurse Hack'?

bgxyrnf, MSN, RN · Nov 20, 2017

Please don't do this, it increases irritation (think sharp little ridges from the plastic you just cut) inside the nose and raises the chances of a hospital acquired nasal infection. I worked in a Peds ED and we saw our nasal MRSA rates skyrocket and it took us a while to figure it out, turns out a nurse from another state brought this habit with her.

I beg to differ. When I cut them off, I actually make a "v cut" into the cannula itself... no sharp edges (seriously, who leaves sharp edges on things that can touch the skin?). I've done this at work without any issues and did it on my own kid for 9 months with nary a problem... after having been taught to do so by the NICU nurse discharging us (long before becoming a nurse).

If the choice is between the pt pulling out the cannula, being placed in restraints, or trimming off the prongs, I'll continue with my practice.

Kitiger, RN · Nov 20, 2017

Nursing hack?
Obese male needs a foley, but you can't find Waldo. The gopher isn't sticking his head up. You know it has to be in there somewhere, but you can't find it.
60 cc cath (not Luer) syringe. Remove plunger. Hook suction to small end of syringe. Place other end on the gopher hole. Apply suction. Grab that thing by the neck as soon as it sticks it's head up.

I about peed my pants laughing at your description! :roflmao:

Julius Seizure · Nov 20, 2017

3. When giving g- tube meds fill up your graduated cylinder, mark the volume and then when done note what's left- way easier than trying to keep track of I&O for all 20 0800 meds. (2nd on the coke for g tubes- and diet does not work as well)

I'm confused. Shouldn't "whats left" be nothing, since all the meds need to go in? What am I missing?

Julius Seizure · Nov 20, 2017

Please don't do this, it increases irritation (think sharp little ridges from the plastic you just cut) inside the nose and raises the chances of a hospital acquired nasal infection. I worked in a Peds ED and we saw our nasal MRSA rates skyrocket and it took us a while to figure it out, turns out a nurse from another state brought this habit with her.

Do you mean positive MRSA swabs IN the ED, or some time later in admission? Also, I wonder what was being used to cut the prongs with (if it was sterile, or clean but used).

fartjohnson · Nov 20, 2017

If you stain your otherwise-fresh white sheets with a little blood, grab a bleach wipe (the ones found in C.Diff rooms--not the CHG wipes that are more common) and rub it until that stain comes out. That'll save you from having to change the whole bed out

**canoehead, BSN, RN** · Nov 20, 2017

Please don't do this, it increases irritation (think sharp little ridges from the plastic you just cut) inside the nose and raises the chances of a hospital acquired nasal infection. I worked in a Peds ED and we saw our nasal MRSA rates skyrocket and it took us a while to figure it out, turns out a nurse from another state brought this habit with her.

For me, the point of cutting off the prongs is so they don't go in the nose, and the kid gets blow by. What do you do to keep O2 on if they don't tolerate the prongs as is, or a mask?

bgxyrnf, MSN, RN · Nov 20, 2017

Please don't do this, it increases irritation (think sharp little ridges from the plastic you just cut) inside the nose and raises the chances of a hospital acquired nasal infection. I worked in a Peds ED and we saw our nasal MRSA rates skyrocket and it took us a while to figure it out, turns out a nurse from another state brought this habit with her.

Do you mean positive MRSA swabs IN the ED, or some time later in admission? Also, I wonder what was being used to cut the prongs with (if it was sterile, or clean but used).

For me, the point of cutting off the prongs is so they don't go in the nose, and the kid gets blow by. What do you do to keep O2 on if they don't tolerate the prongs as is, or a mask?

Personally, when I do it I use a pair of sharp-point scissors from a suture-removal kit and cut a small V into the base of the prongs.

I can see how the problem PeakRN describes might develop if the prongs were trimmed perpendicular to their axes because that would leave sharp little nubs to rub the tender perinaritic tissue, especially in a child as found in Peak's peds ED. That sounds more like a case of a dunderhead nurse and poor execution than an issue with the fundamental approach.

smartassmommy · Nov 20, 2017

I love this thread. Seriously helpful hints! Lots to keep in mind when I graduate Lon school in 3 days! :yes:

bgxyrnf, MSN, RN · Nov 20, 2017

A wound (or eye) irrigation hack:

Surround the wound with one or more large adult diapers when you're starting to irrigate. You can generally soak up all of the irrigant with the diaper and makes clean-up a snap and keeps the patient from getting soaked.

AlwaysLearning247, BSN · Nov 20, 2017

If you have a confused patient trying to rip off their 02 probe from their finger, place it on their toe with a sock over it.

This may seem like common sense, but if you have a patient who is having multiple BM's place many pads underneath to avoid doing a full bed every time.

Not really a hack, but a tip, before doing a blood transfusion always make sure the patient has an appropriate and working IV. Things can get busy and this can be missed.

Delegate appropriately, don't think one person can do everything because you'll be staying late every day if you do that!

If you're inserting a foley on a male and meet resistance, keep the catheter in the same place for a like 10 seconds then proceed. One of the more experienced nurses showed me that trick after a few different nurses tried to put my patient's foley in with no success.

Always keep an IV drug compatability book/resource available. You can avoid making a patient get two IVs placed if their IV fluids are compatible with the antibiotic, etc. Get two separate pumps, the fluids will be directly connected to the patient and the ABX, etc can go into the Y port while running on the second pump. For example, we run zozyn over 4 hours but you don't wanna stop someone's fluids for 4 hours and don't wanna have them get another IV if they don't need it. Knowing what is compatible avoids meds being late.

Good luck!

Mandychelle79, ASN, RN · Nov 20, 2017

I work nights. I hate to wake people up unexpectedly. I combine as many of my med passes as I can at one time. When I'm doing my assessment I tell them about what times I will need to bug them. At the same time letting them know if they need something before that just to call.

So I may say Mr. Smith I will be back in about an hour with your bedtime pills and I will be in at 11 to empty your drain. Good news is that I then can leave you rest until 5 am when I have your antibiotic, and it's IV so if you make sure I can scan your band and access your iv site I barely have to bother you. if you need your pain meds or anything though please call out.

If there pain has been not well controlled I offer to wake someone when the PRN is avaible to try to get them to the point that they don't need the breakthrough medication.

HalfBoiled, BSN, RN · Nov 20, 2017

When my unit ran out of syringes to push crushed meds into a PEG tube,

I used the tubing from a continuous tube feeding bag to give the meds. Crushed finely.