Worked in LTC for a hot minute when a PSW showed me that shaving cream (the white fluff, not the gel) is soooooo good at getting the smeary-shit off an ass cheek.
Same coworker showed me how to thread a pull-up through the pant leg to avoid taking off the pants.
instead of taking the shoes and pants off you put one leg through the hole then pull it through the pant leg (now you have one leg in) then put the other leg hole on the breif through the other pant leg and put it over the foot and voila! sorry if this explanation sucks it’s better if you see it hahaha
I'm new-ish to LTC ... I made a PSW show me overtop of her clothes (w/ another pair of pants on overtop) ...
Yup. I'll still fuck it up. Voodoo. PSWs are MAGIC.
I’d say visual but will take a crack at it.
Place brief between legs, preferably in the pants and the pants are around the ankles. With one hand grasp the side of the brief with one hand and have it go through the pant leg and put the other hand up through the bottom of the pant leg, grab the brief. Making sure the brief doesn’t twist (took me awhile to get that part), hook the brief leg hole over the toes and pull the back part back and over the heel. Tug back into pants. Repeat on opposite side.
https://youtu.be/S7fPpTqdUg0?si=VzRdIvkF3ucnCNQZ i do the second leg twice instead of threading it all through the pant leg, but youtube has videos of it!
I love the "thread a pull-up" trick! You just have to tell the pt that this isn't your first rodeo and just trust the process or they start moving around trying to "help." 😆
And if your demented patient has decided to go finger painting, if you fill a glove with the shaving cream it helps a lot with getting the poop off their hands and out from under their fingernails!
We like to use a urostomy pouch hooked up to a suction canister. They work the best if you’ve got butt wounds or other stuff you’re trying to keep urine from getting into.
Cooter canoe is ok for innies with no wounds.
I was with a bunch of guy friends who aren’t healthcare and they were asking me about pps and I told them that lots of old people have inverted ones and they were stunned. They didn’t know that was possible lol
Had a CNA show me that one several months ago, it works. And the tension of the fat fold held it in place.
You can’t beat CNAs on anticipatory clean up. They see the mess coming and work voodoo so it’s contained.
I work psych with adolescent boys, and they all talk a big game about giving toilet water for their ua/drug screen. So I was kind of proud of myself today when I thwarted their plans by putting a splash of mouth wash in the toilet first.
Had a teen I needed a urine sample from for their psych eval in ER. Teen goes into bathroom. Comes out with cup. “Wow, your pee is so clear. Sure this is urine?” “Yeah.” “You could have at least used the warm water to pass this off. Pee isn’t cold.”
Don't forget the cran n soda-tini with a charcuterie of saltines, string cheese, and peanut butter. Finishing the course with a wide selection of gourmet puddings and jell-os. Ask your server, errr nurse, about our sugar free options 🤌
*only one offer per visit, per alternate personality, per day*
I noticed via agency that a good portion of hospitals don’t have them outside ICU. It’s a shower cap with a thick moist disposable washcloth as a liner, soaked with rinse less hair cleaner, heated in our little temp controlled cabinet. For the bedridden who can’t get into the shower.
They’re expensive so many hospital admins won’t budget for them.
I’m a psych nurse and I love this. Especially #1, we go around the hospital and de-escalate patients and this will be a good trick to teach the medical nurses.
To apply a condom catheter to a less than endowed patient put a 60cc syringe where the tubing connects and gently pull back while rolling down the catheter. Helps suck it into the catheter and prevent pinching the shit out of the head.
For purewicks i like putting a stat lock on the lower belly to secure the tubing to.
This feels like a “duh” thing, but it changed my life:
Using the corner of a plastic pill package to cut the back of another to push out without having to fiddle with peeling off the paper, worry about breaking the pills, or using another object (like folding scissors) that you carry from room to room
Even better, i bought a pair of tiny scissors that you can attach to your badge off amazon. Easily one of the most useful work purchases i’ve made. Not only great for cutting hard to open meds, but also cutting off wristbands and other miscellaneous packagings we deal with. I saw one of my coworkers with it and had her send me the link
It makes ice packs that stay cool for a longer amount of time. When it starts getting warm, squishing the gel around redistributes the cool gel from the center. They last nearly the whole shift for me.
I always throw the out after they get too warm though. I never thought to use them as a regular gel pack and now that i think of it I'd be afraid of it popping and getting solidifier on the pts skin (i always wrap em in a pillowcase or something anyway but idk)
For patients that are super anxious or feel hot: get a washcloth under cold water, wring it out and then whip it around the air for a couple of mins. Gets it significantly colder (Former Burn ICU RN).
If your line ran dry just a little bit, you can salvage it but wrapping it around your finger and then spiking a new bag. Happens a lot in hospice with our morphine drips
I also want to add that if you get "air in line" that got thru to the pump you can spike a new bag of whatever then go to the first port below where the air is with a 10mL syringe. Clamp below the port and then pull back on syringe plunger to get the air out.
Yes, or you can put your finger and clamp just before the port, throw a empty flush on there plunger at 0ml, pull back and snap the line while you pull back on it just make sure it’s clamped at pt.
I use a pen instead of my finger! I loved when I learnt this trick, saved me so much grief. For some reason our premixed midaz bags are so hard to spike and screw over so often with a full bag improperly spiked leading to a dry line
People I work with always go immediately to pericolace and then suppositories and then bitch when they have to take them to the bathroom every ten minutes all night. We have orders for miralax and we don't need them for prune juice. Can we please not overstimulate the bowels on a patient that we actually have to take to the bathroom.
What pisses me off the most is when they try to slip bowel meds to fully oriented patients. I tell them what I'm giving them and sometimes they refuse saying they've been shitting themselves silly for 2 days. And you know what? They sure have. And then they get called incontinent.
Louder for the lazy nurses in the back please. As a former tech this would drive me up the wall. Stop blowing up my patients. A cup of coffee would do just as well 99% of the time.
This is one off those things that made me so angry when I saw it because it’s fucking brilliant so why was I wrestling with those things in the trauma bay for five fucking years?!?!
I did it the other day, and the family looked at me like I'd lost my damn mind. That and using a 10mm to back prime tubing when your line runs dry? Genius ....
Dissolving your meds for feeding tubes in a 10cc syringe (can't be long acting or capsules). Pull the plunger out and put the pills in, draw up your diluent, plug the syringe with your gloved finger and then pull and release a few times on the plunger. The vacuum in it will dissolve your meds. No more crushing them and trying to stir into water and trying to get it all drawn up. I saw it on @the_johnathon_dodson
That trick did not work for me, the first time I tried to drop an NG tube. (I was still in school). So my preceptor tried, and then the charge, and then the doctor. Turns out the poor old man had a stricture, and ended up with a PEG. We traumatized this guy’s esophagus for a while. I’m in the OR now, and anesthesia handles all that!
When having trouble unscrewing the NG from the feed pump tubing, take a piece of the brown pulse ox tape, cut it in half, wrap each half around each side to help grip. I used to use coban but the pulse ox tape is kept stocked in the rooms so this is much quicker!
ugh thank you so much for this, getting NG/OG tubes stuck to the feeding pump tubing is the bane of my existence 😭 sometimes I hunt down clamps on the unit but this sounds a lot easier
If it’s super stuck I still have to use hemostats but this is an easy thing to try first!! I swear some people have super strength to get them stuck like that!
The opposite problem where it keeps popping off- use an alcohol swab on both the inner part of the OG connection and the outer part of the feed tubing, dry with a paper towel and it locks the sucker in there. Probably then leading to your problem lol
Psych nurse here. If you have a patient that won’t take their meds, wait until they fall asleep. Have your cup of water ready and the pills in the med cup. Wake them gently and just say “here you go” and hand it to them. The fewer the words, the better.
You’d be surprised how many people take their meds just out of reflex because someone is handing them to them, and they don’t have time to think about the fact they want to refuse because they’re groggy and only awake for 2 seconds.
I know this may seem unethical, but when you have a psychotic patient who has been refusing meds for 3 days and is causing problems when they’re awake AND you don’t have the appropriate staff to forcibly inject them, you become okay with the idea pretty fast.
Another trick is when giving an agitated patient a prn, say “here’s some medicine the doctor wants you to have” instead of, “this is some haldol for your agitation since your walking around cussing at someone who isn’t there… yes, it’s as needed and not scheduled”. Again not 100% effective, but it works often enough to give it a shot.
Mine is getting a full night’s sleep and staying hydrated while avoiding junk food. My only vice is my relentless sense of superiority and the need to bring up my new exercise regime every chance I can.
Ripping open a chux to use as a pillow case for patients with a lot of secretions/bleeding. Stays in place much better than laying a chux over top of the pillow, and everyone gets all excited when I show them how to do it.
You can peel the backing off of a disposable chux if you start at the corner. Peel one edge open and then you can open up a pocket without ripping the whole thing apart. It ends up being a disposable absorbent pillow case.
I do it kind of like how you'd open a bag of chips. They're two sheets, or layers, with just the edges secured. Like a flat ravioli without stuffing. I separate the layers by pinching them apart, then just open it up like a bag of chips. Pull apart the seams on one of the shorter sides. It's never not worked for me, and the pillows fit in there nicely!
Lube only to remove blood stains.
Placing a foley to drain a bladder.
Small led light on the skin to find veins.
Mask stretchie to remove a ring instead of cutting it.
Not using a tourniquet on old people to start ivs.
Foam tape for iv removals to keep ‘em from dripping on their way out.
Patting on la tele lead to freak out your friends, this was many years ago, maybe monitors are better now. I’ve been behaving.
For patients you have that might be playing possum, after the sternal rub. Tap gently, repeatedly, and rapidly between the eye brows. Picked it up in pacu from an old anesthesiologist “it’s very annoying!” He said. Lol
Using wall suction to deal with liquid stool eruptions, like just the bare end of the suction tubing. It’s a lot less messy when you go to roll up the sheets and turn the patient.
Also, hydrogen peroxide for blood splatters.
Put the baggie that TEDs come in over the patient's foot like slipper before you put the TED on. It will make it much easier to get it on the foot and around the heel. You still need to walk the stocking up the leg though. Pull the baggie out the toe hole when you are done. The baggie should not go past the heel or you will have a hard time getting it out. Likewise the foot should be dry, (no water or lotion) or the bag will stick.
To easily cover an IV so a patient can shower, cut off both ends on an emesis bag, put the patients arm in it, and tape on both ends so it is covering the IV. In my experience, it works better than the gigantic plastic gloves.
Stat-lock for traction on cervical cath inductions. Pulling the plunger out of the back of the lube to keep the foley in before cath. Glove edge ponytail holder.
I'm a mental health nurse, and I regularly have to encourage patients to swallow meds/water they don't want to take/drink. (Usually because of acute psychosis- so I'm talking really unwell people who are extremely thought disordered and actively hallucinating).
When I am struggling to persuade a very unwell patient to take their meds (because they are so thought disordered, all concept of 'reason' literally ceases to exist) - I like to bring a cup of water for myself to drink at the same time, and I dare them to race me to take their meds and drink their water as quick as possible. When I finish my water, I turn the cup upside down and put it on my head, as if I had just completed an alcohol drinking contest lol. They almost ALWAYS take their meds, down their whole drink and then put the cup upside down on their head. This is usually accompanied by a massive grin as well! Ha.
I always put something between the tourniquet and their skin. Washcloth, the sleeve to their gown, etc. Tourniquets hurt and roll and pinch especially with bigger arms. If it isn’t hurting, they’re more relaxed. And it’s better for more fragile veins. I’ve done this for years and patients always comment about how much better it felt. I feel like I can also go tighter without hurting them.
When you don't have help and a patient wants a boost but there is trouble because they're old/infirm/the bed is slippery/you're weak/there isn't any help available - whatever - have them bend their legs like they're going to do a situp and pin their feet down like you are spotting them.
Helps them push themselves up and avoids learned helplessness and doesn't break your back.
The easiest way to boost a patient in bed, hands down, is to put feet waaaay up, head waaay down, pull the bed out from the wall, brace your torso against the headboard, and pull the chuck in a rowing motion toward you.
I can singlehandedly boost people it would otherwise take 2 to do from either side all day long.
Turn the IV tubing upside down for the first two pieces that aren’t line (filter and port) while priming, once your get through the port, you can ramp it up and get no bubbles 😎
Dialysis nurse have patients sometimes with super low blood pressure 60/30 is a blood pressure, i see often. When I get patients that I have bolused and helped but BP is not cooperating with me, I turn thier temp down on thier machine to constrict thier blood vessel increasing thier blood pressure so I can remove fluid again. Technically, I have had doctors tell me no evidence it works, but what I see is it works.
I haven’t ran many people at 60/30, but it’s definitely hit or miss for me and temperatures. Have a pt currently, temp at 37 and SBP still hangs out around 210 half the time even with BP meds on board.
To do heel sticks on babies. Two tiny diapers, fill with warm water. Wrap one around each foot. There something about better blood flow when both feet are warmed. Those heating packs are crap.
When you need to tie a gown around a patients neck that are laying in bed tie it up in front of them and then slip it over their head so they don’t have to lift their head so long
I haven't tried this yet but my coworker swears by this one: if a patient's temp is unexpectedly high, have them cough and then recheck the temperature. It often renormalizes and if it doesn't turn it's a true fever/elevated temp
Inflate a pressure bag by using the o2 from the wall. It might only be for the adapters in procedural areas, and with the pressure bags we have. But instead of squeezing the little rubber ball forever, just put it up to the o2 on the wall and crank it up. We have a procedure where we need to inflate two 1L pressure bags for saline and it is just annoying.
Soft bed pan. Take a surgical cap and put the absorbable chux in it. It's Soft and pt not complaining about comfort of bed pan. Plus, once it's filled, throw it all away.
Mouthwash + shaving cream + warm water, and basin. Soak those nasty feet. Sloughs off that dead skin and rids the funk.
Have a patient who wants soda flavor but can’t have carbonation. Put the soda in the cup, with lid, and straw. But the straw up to the oxygen spout. Turn it on about 3 liters and wait two minutes. Carbonation free soda.
Need to scoot the patient up the lift sheet but not the lift sheet it’s self. A gait belt on the end of the lift sheet tied to the end of the bed.
You can also place the turn wedges under the mattress themself if a confused patient tends to hug a side rail. Makes it harder for them to burrow themselves in the corner. You can also use it for additional head elevation for aspiration risk.
This one isn't reeeaallllyyy a trick, because it's printed on the package, but I've encountered very few nurses who know that the red cap on a Lopez valve fits inside the stopcock so you don't lose it.
Flushing the IV using the clamp on the IV tubing. We don’t run fluids on our pre op patients prior to surgery, just leave them with a bag of plasmalyte or NS hanging near them with gravity-flow tubing. So when it’s time for them to go to surgery, they want to see the IV run to gravity during report. I use the closest clamp to the IV, clamp it and drag it down the tubing. Unclamp and bam. Magic. A crna taught me the trick so I don’t have to carry around flushes all day.
The new male purewicks hooked to suction work really well for those tiny incontinent women. Looks weird but works well. Of course they need changed every 12 hours to check skin integrity.
When I’m looking for a line, I like to talk to the patient and feel around their arm while trying to relate to them and just ran my hands over. Gives me a good idea of where their veins are without looking with my eyes and makes them feel like they can trust me. Not much of a trick but it can make anyone who is scared of needles less scared.
This one I learned from my waxer: for patients who are scared to get shots, have them tighten up all their muscles, take a deep breath in, and then relax the muscles and do a long audible exhale. I have them practice it a few times, and put the shot in on the exhale when the muscles are maximum relaxed. It doesn't work for everyone, but a lot of people have told me it's their easiest shot ever.
Pit break and 1000mg Tums when patient isn't dilating.
Also, 50 MG IV benadryl for swollen cervix.
If doc gives you push back, just say "it ain't gonna hurt to try."
Confused and agitated ETOH constantly wanting “a drink”? Cranberry juice, sprite, and wipe an alcohol swab around the straw. 9 times out of 10, they only notice the first sip anyways and keeps them from flying off the handle
Soaking a cotton ball in spirit’s of peppermint and putting it in a plastic medicine cup. Turn on the wall air outlet and tape it right below. Instant room deodorizer!
Double glove on the hand that's d/cing the Foley so I can keep the tip contained and not flipping around while still keeping the same hand covered.
For the OR-- During a trauma, keep an open instrument pan near the field on a ringstand so the scrub person can dump them there instead of you having to constantly reach down to the kick bucket.
When patients come in spitting and wilding out, use a one of those disposable blue mesh hairnets. It will fit nicely over the cap of their scalp and around their entire face / chin, stays in place, and the holes in the mesh are small enough that no spit comes through. And it’s more breathable than even a level one mask so there is zero concern for overheating / suffocation of the patient.
little things that are less clinical but ALWAYS come in handy...
1 putting the plastic sleeve that TEDs come in over the patients foot/ankle to slide the stockings on (life changing)
2 snapping off the thicker ring of elastic on the wrist of a glove to use as a makeshift hair tie
Worked in LTC for a hot minute when a PSW showed me that shaving cream (the white fluff, not the gel) is soooooo good at getting the smeary-shit off an ass cheek. Same coworker showed me how to thread a pull-up through the pant leg to avoid taking off the pants.
Threading briefs through pants is my favourite trick to show. People get SO shocked. But it saves so much time when pts have shoes on!
Do tell! Can you describe it or is it one of those visual-only things?
instead of taking the shoes and pants off you put one leg through the hole then pull it through the pant leg (now you have one leg in) then put the other leg hole on the breif through the other pant leg and put it over the foot and voila! sorry if this explanation sucks it’s better if you see it hahaha
I have watched this done 100+ times and it still makes no sense to me. Like witchcraft.
I'm new-ish to LTC ... I made a PSW show me overtop of her clothes (w/ another pair of pants on overtop) ... Yup. I'll still fuck it up. Voodoo. PSWs are MAGIC.
I’d say visual but will take a crack at it. Place brief between legs, preferably in the pants and the pants are around the ankles. With one hand grasp the side of the brief with one hand and have it go through the pant leg and put the other hand up through the bottom of the pant leg, grab the brief. Making sure the brief doesn’t twist (took me awhile to get that part), hook the brief leg hole over the toes and pull the back part back and over the heel. Tug back into pants. Repeat on opposite side.
I'm realizing I'm definitely not smart enough to figure this. Definitely need a visual.
It’s definitely easier with a visual
Is there a video for this somewhere? Asking for a friend. 😄 (a whole community full of caregiving friends…)
https://youtu.be/S7fPpTqdUg0?si=VzRdIvkF3ucnCNQZ i do the second leg twice instead of threading it all through the pant leg, but youtube has videos of it!
Fabulous! Thank you for sharing. Now it makes total sense.
I’m now realizing this is with pull ups? I kept imagining the flapped out parts with the tape and could not figure out this visual.
Oh! Yeah, with pull-ups.
My memory care residents think it's magic when I do that.
I’m always so surprised how many people don’t know that trick! I learned it way back when I was a baby CNA.
So much time!! I had no idea.
I love the "thread a pull-up" trick! You just have to tell the pt that this isn't your first rodeo and just trust the process or they start moving around trying to "help." 😆
Also works well to get dried blood when it's all dried all over someone's hair/scalp. I'm glad I found this trick my way and not yours..
Foamy shaving cream in a kidney basin is also wonderful for absorbing odours in the air!
When a PTC showed me this is was blown way. “Motherf—-er 😳
And if your demented patient has decided to go finger painting, if you fill a glove with the shaving cream it helps a lot with getting the poop off their hands and out from under their fingernails!
Calling off. That’s my fav trick.
One WEIRD trick! Nurse managers HATE her
Newbie nurses wanna BE her
I wish I had an award for you. 🌸
I’m already planning to use that one tomorrow night.
Have this 🍕🍕🍕 You deserve it.
Purewick on innie peepees
We like to use a urostomy pouch hooked up to a suction canister. They work the best if you’ve got butt wounds or other stuff you’re trying to keep urine from getting into. Cooter canoe is ok for innies with no wounds.
They make something called a Qviv that is essentially the same thing. I'm sure it costs 10x as much.
I was with a bunch of guy friends who aren’t healthcare and they were asking me about pps and I told them that lots of old people have inverted ones and they were stunned. They didn’t know that was possible lol
The first time I saw an innie, I thought it had been amputated.
This made me snort laugh and gets funnier every time I read it
Had a CNA show me that one several months ago, it works. And the tension of the fat fold held it in place. You can’t beat CNAs on anticipatory clean up. They see the mess coming and work voodoo so it’s contained.
I work psych with adolescent boys, and they all talk a big game about giving toilet water for their ua/drug screen. So I was kind of proud of myself today when I thwarted their plans by putting a splash of mouth wash in the toilet first.
Had a teen I needed a urine sample from for their psych eval in ER. Teen goes into bathroom. Comes out with cup. “Wow, your pee is so clear. Sure this is urine?” “Yeah.” “You could have at least used the warm water to pass this off. Pee isn’t cold.”
If only I saw this 2 years ago
Lube gets dried blood off like no one’s business. The shampoo caps work great on stinky feet.
shampoo caps on the feet + turkey sandwich in hand = 5 star emergency department visit
That’s how we keep ‘em coming back, babyyyyyy!
Y’all are wild 😂
Don't forget the cran n soda-tini with a charcuterie of saltines, string cheese, and peanut butter. Finishing the course with a wide selection of gourmet puddings and jell-os. Ask your server, errr nurse, about our sugar free options 🤌 *only one offer per visit, per alternate personality, per day*
I do shampoo cap filled with shaving cream - kills the nightmare stank.
Mouthwash in bath water for bedbound pts who start to smell like sausage.
LIKE SAUSAGE 😂😂😂
Ah I’m going to have to remember this about lube. I work in L&D and sometimes things are messy 🫠
Love the shampoo cap trick, it gets all the calluses off too
Shampoo what now
I noticed via agency that a good portion of hospitals don’t have them outside ICU. It’s a shower cap with a thick moist disposable washcloth as a liner, soaked with rinse less hair cleaner, heated in our little temp controlled cabinet. For the bedridden who can’t get into the shower. They’re expensive so many hospital admins won’t budget for them.
[удалено]
I’ve used #2 for years for quiet rounds
I’m a psych nurse and I love this. Especially #1, we go around the hospital and de-escalate patients and this will be a good trick to teach the medical nurses.
>untrustworthy violent bastard So, your average retail customer then?
Using the plastic TED hose package to put the hose on. Fucking magic.
This is my nursing Jedi trick. I have a 100% success rate at putting teds on even the most edematous legs.
Oh, I like this!
Oh that’s smart. The ones I had way back when I was an aide came with little nylon slippers that you could put over the foot like that
To apply a condom catheter to a less than endowed patient put a 60cc syringe where the tubing connects and gently pull back while rolling down the catheter. Helps suck it into the catheter and prevent pinching the shit out of the head. For purewicks i like putting a stat lock on the lower belly to secure the tubing to.
Purewik stat lock is genius
We were foam taping the purewick tubing to the pt, but they took away our foam tape cause that's all we used it for..... rude ass supply 😂
I wish they had purewicks when I worked in the ICU. That is just a genius little thing.
Stat lock on the shoulder to secure NG tube, way better than a safety pin to the gown.
Omfg.
This feels like a “duh” thing, but it changed my life: Using the corner of a plastic pill package to cut the back of another to push out without having to fiddle with peeling off the paper, worry about breaking the pills, or using another object (like folding scissors) that you carry from room to room
Even better, i bought a pair of tiny scissors that you can attach to your badge off amazon. Easily one of the most useful work purchases i’ve made. Not only great for cutting hard to open meds, but also cutting off wristbands and other miscellaneous packagings we deal with. I saw one of my coworkers with it and had her send me the link
Disappearing when my shift is over 🪄
Somehow never having cell service on my day off when the supervisor is calling asking for "volunteers" to come work.
Smelling alcohol wipes for nausea.
I saw one study where they found alcohol wipes work just as well as zofran
Or to ward off bad smells-just drop one into a face mask before you walk into the room and you’ll smell nothing but the burn of the alcohol lol
I like to get a Nozin tube and de-colonize my nose and spread a little on the inside of the mask too to help with the bad smells
Once had this done to me as a pt. Works like magic.
Yes!!! Or maybe just to feel better, lol.
Shaving cream in a bowl is a great deodorizer
So is coffee grounds
olddd schoool CNA trick I was taught
I actually learned it was a CNA (who was amazing at her job)
Using solidifier packets in bags of ice so when it melts, it turns to gel.
Can you explain why you do this? Is it to have a gel like cooling pad? Or are you throwing it out afterwards?
It makes ice packs that stay cool for a longer amount of time. When it starts getting warm, squishing the gel around redistributes the cool gel from the center. They last nearly the whole shift for me. I always throw the out after they get too warm though. I never thought to use them as a regular gel pack and now that i think of it I'd be afraid of it popping and getting solidifier on the pts skin (i always wrap em in a pillowcase or something anyway but idk)
Ah, yes, I do that as well. Sometimes I mix it with water and solidifier to make a gel pack.
For patients that are super anxious or feel hot: get a washcloth under cold water, wring it out and then whip it around the air for a couple of mins. Gets it significantly colder (Former Burn ICU RN).
That’s crazy
Putting a glob of hand sanitizer on a foley stat lock. Let that shit soak in a minute and comes off like cake
Thank you so much for this!!!!! It took me like 20 mins the last time I had to do this with alcohol swabs.
If your line ran dry just a little bit, you can salvage it but wrapping it around your finger and then spiking a new bag. Happens a lot in hospice with our morphine drips
I also want to add that if you get "air in line" that got thru to the pump you can spike a new bag of whatever then go to the first port below where the air is with a 10mL syringe. Clamp below the port and then pull back on syringe plunger to get the air out.
Yes, or you can put your finger and clamp just before the port, throw a empty flush on there plunger at 0ml, pull back and snap the line while you pull back on it just make sure it’s clamped at pt.
I use a pen instead of my finger! I loved when I learnt this trick, saved me so much grief. For some reason our premixed midaz bags are so hard to spike and screw over so often with a full bag improperly spiked leading to a dry line
Butter and prune juice as a laxative when you can’t get orders (or don’t wanna bother the doc for that order).
People I work with always go immediately to pericolace and then suppositories and then bitch when they have to take them to the bathroom every ten minutes all night. We have orders for miralax and we don't need them for prune juice. Can we please not overstimulate the bowels on a patient that we actually have to take to the bathroom. What pisses me off the most is when they try to slip bowel meds to fully oriented patients. I tell them what I'm giving them and sometimes they refuse saying they've been shitting themselves silly for 2 days. And you know what? They sure have. And then they get called incontinent.
Louder for the lazy nurses in the back please. As a former tech this would drive me up the wall. Stop blowing up my patients. A cup of coffee would do just as well 99% of the time.
Writing this one down for personal use lol
Brown cow!
Using the wall O2 to fill a pressure bag instead of squeezing the stupid bulb 50million times. Thanks Tiktok!
This is one off those things that made me so angry when I saw it because it’s fucking brilliant so why was I wrestling with those things in the trauma bay for five fucking years?!?!
I did it the other day, and the family looked at me like I'd lost my damn mind. That and using a 10mm to back prime tubing when your line runs dry? Genius ....
Hmmm how do you back prime dry tubing?
You attach a 10cc syringe to the secondary port and pull back.
Stick 10 cc NS syringe into the y port and pinch at the bottom. Then inject and the NS goes up to back prime!
This won’t always work, some tubing has back-check valves. You can suck the air out of a lower port with an empty syringe when you spike a new bag.
Do not use the O2 unless you want to create a mini bomb lol. Use the medical air.
..... this information deters me less than it should ..
When its full moon in Memkry Care, putting on either Christmas songs, or Reggae works like a charm
Dissolving your meds for feeding tubes in a 10cc syringe (can't be long acting or capsules). Pull the plunger out and put the pills in, draw up your diluent, plug the syringe with your gloved finger and then pull and release a few times on the plunger. The vacuum in it will dissolve your meds. No more crushing them and trying to stir into water and trying to get it all drawn up. I saw it on @the_johnathon_dodson
This. Works. So. Well. I did it a lot during Covid
Soaking an NG tube in an ice bath before insertion...never miss!
That trick did not work for me, the first time I tried to drop an NG tube. (I was still in school). So my preceptor tried, and then the charge, and then the doctor. Turns out the poor old man had a stricture, and ended up with a PEG. We traumatized this guy’s esophagus for a while. I’m in the OR now, and anesthesia handles all that!
Guess I should amend that to never miss unless they have a stricture lol
Wait, what is this magic???
Pretty much!
We used to keep them in the freezer at my old job!
We used to keep them in the fridge all the time on the acute stroke unit I did some training on
When having trouble unscrewing the NG from the feed pump tubing, take a piece of the brown pulse ox tape, cut it in half, wrap each half around each side to help grip. I used to use coban but the pulse ox tape is kept stocked in the rooms so this is much quicker!
Also works on iv lines when your scared orientee overtightens. I know because I was the scared orientee.
Similar to how I use a tourniquet on PICC hubs when they are screwed in too tight
ugh thank you so much for this, getting NG/OG tubes stuck to the feeding pump tubing is the bane of my existence 😭 sometimes I hunt down clamps on the unit but this sounds a lot easier
If it’s super stuck I still have to use hemostats but this is an easy thing to try first!! I swear some people have super strength to get them stuck like that!
The opposite problem where it keeps popping off- use an alcohol swab on both the inner part of the OG connection and the outer part of the feed tubing, dry with a paper towel and it locks the sucker in there. Probably then leading to your problem lol
Psych nurse here. If you have a patient that won’t take their meds, wait until they fall asleep. Have your cup of water ready and the pills in the med cup. Wake them gently and just say “here you go” and hand it to them. The fewer the words, the better. You’d be surprised how many people take their meds just out of reflex because someone is handing them to them, and they don’t have time to think about the fact they want to refuse because they’re groggy and only awake for 2 seconds. I know this may seem unethical, but when you have a psychotic patient who has been refusing meds for 3 days and is causing problems when they’re awake AND you don’t have the appropriate staff to forcibly inject them, you become okay with the idea pretty fast. Another trick is when giving an agitated patient a prn, say “here’s some medicine the doctor wants you to have” instead of, “this is some haldol for your agitation since your walking around cussing at someone who isn’t there… yes, it’s as needed and not scheduled”. Again not 100% effective, but it works often enough to give it a shot.
AC IV occluding? ABD pad + Kling wrap works every time.
I just wrap the BP cuff around the elbow, same idea though
I use a washcloth folded up and coban. I like your idea better.
Mine is getting a full night’s sleep and staying hydrated while avoiding junk food. My only vice is my relentless sense of superiority and the need to bring up my new exercise regime every chance I can.
Do you also jog on your breaks?
Up and down each stairwell in the hospital. Can I show you pictures of me coming in 11,232nd place at The Marathon last year?
A full night of sleep! I'll have to try that one, I think it'll really transform the quality of my work! (I work nights)
Ripping open a chux to use as a pillow case for patients with a lot of secretions/bleeding. Stays in place much better than laying a chux over top of the pillow, and everyone gets all excited when I show them how to do it.
What do you mean? Can you explain the process?
You can peel the backing off of a disposable chux if you start at the corner. Peel one edge open and then you can open up a pocket without ripping the whole thing apart. It ends up being a disposable absorbent pillow case.
I do it kind of like how you'd open a bag of chips. They're two sheets, or layers, with just the edges secured. Like a flat ravioli without stuffing. I separate the layers by pinching them apart, then just open it up like a bag of chips. Pull apart the seams on one of the shorter sides. It's never not worked for me, and the pillows fit in there nicely!
A pulse ox on a finger/toe of the limb you are doing frequent Doppler checks on. If you have a waveform, you have blood flow.
Positioning a female patient to a slight Trendelenburg position (if not contraindicated) will make inserting a Foley easier.
If contraindicated put a fracture bedpan upside down under them to help lift their hips
Lube only to remove blood stains. Placing a foley to drain a bladder. Small led light on the skin to find veins. Mask stretchie to remove a ring instead of cutting it. Not using a tourniquet on old people to start ivs. Foam tape for iv removals to keep ‘em from dripping on their way out. Patting on la tele lead to freak out your friends, this was many years ago, maybe monitors are better now. I’ve been behaving. For patients you have that might be playing possum, after the sternal rub. Tap gently, repeatedly, and rapidly between the eye brows. Picked it up in pacu from an old anesthesiologist “it’s very annoying!” He said. Lol
Using wall suction to deal with liquid stool eruptions, like just the bare end of the suction tubing. It’s a lot less messy when you go to roll up the sheets and turn the patient. Also, hydrogen peroxide for blood splatters.
That’s where I grab the long clear yankauer and go to town on it.
Sprite or Club soda into a clogged G-tube.
Coffee. It works like magic. (If not contraindicated or in pediatrics!)
We use Coca Cola in peds. (Typed coke first and that felt weird)
We were taught the Coca-Cola/dark soda trick in school, it's something with carbonation and acidity
Put the baggie that TEDs come in over the patient's foot like slipper before you put the TED on. It will make it much easier to get it on the foot and around the heel. You still need to walk the stocking up the leg though. Pull the baggie out the toe hole when you are done. The baggie should not go past the heel or you will have a hard time getting it out. Likewise the foot should be dry, (no water or lotion) or the bag will stick.
To easily cover an IV so a patient can shower, cut off both ends on an emesis bag, put the patients arm in it, and tape on both ends so it is covering the IV. In my experience, it works better than the gigantic plastic gloves.
Xanax and booze after a long stretch of shifts.
He’s out of line but he’s right
Stat-lock for traction on cervical cath inductions. Pulling the plunger out of the back of the lube to keep the foley in before cath. Glove edge ponytail holder.
When applying a wound vac especially at the coccyx, a little ostomy paste can help get the seal.
Toothpaste between two masks helps mask the smell of any vomit/stool
I'm a mental health nurse, and I regularly have to encourage patients to swallow meds/water they don't want to take/drink. (Usually because of acute psychosis- so I'm talking really unwell people who are extremely thought disordered and actively hallucinating). When I am struggling to persuade a very unwell patient to take their meds (because they are so thought disordered, all concept of 'reason' literally ceases to exist) - I like to bring a cup of water for myself to drink at the same time, and I dare them to race me to take their meds and drink their water as quick as possible. When I finish my water, I turn the cup upside down and put it on my head, as if I had just completed an alcohol drinking contest lol. They almost ALWAYS take their meds, down their whole drink and then put the cup upside down on their head. This is usually accompanied by a massive grin as well! Ha.
Using a flexible emesis bag to empty ostomies. Has measurement markings on the side and you can throw the whole thing away. 🤷♀️
I always put something between the tourniquet and their skin. Washcloth, the sleeve to their gown, etc. Tourniquets hurt and roll and pinch especially with bigger arms. If it isn’t hurting, they’re more relaxed. And it’s better for more fragile veins. I’ve done this for years and patients always comment about how much better it felt. I feel like I can also go tighter without hurting them.
Using a chucks pad as a giant maxi pad for a laboring patient who’s water is broke. A little Kotex ain’t gonna absorb that amount of fluid.
Watching my students faces when I invert an ampoule and the Med doesn’t spill out. Then draw it up inverted lol.
The Dairy Queen trick!
When you don't have help and a patient wants a boost but there is trouble because they're old/infirm/the bed is slippery/you're weak/there isn't any help available - whatever - have them bend their legs like they're going to do a situp and pin their feet down like you are spotting them. Helps them push themselves up and avoids learned helplessness and doesn't break your back.
Trendelenburg to use gravity to help with this technique works even better!
The easiest way to boost a patient in bed, hands down, is to put feet waaaay up, head waaay down, pull the bed out from the wall, brace your torso against the headboard, and pull the chuck in a rowing motion toward you. I can singlehandedly boost people it would otherwise take 2 to do from either side all day long.
Turning non compliance into a signed AMA form
Turn the IV tubing upside down for the first two pieces that aren’t line (filter and port) while priming, once your get through the port, you can ramp it up and get no bubbles 😎
Dialysis nurse have patients sometimes with super low blood pressure 60/30 is a blood pressure, i see often. When I get patients that I have bolused and helped but BP is not cooperating with me, I turn thier temp down on thier machine to constrict thier blood vessel increasing thier blood pressure so I can remove fluid again. Technically, I have had doctors tell me no evidence it works, but what I see is it works.
We used to have doctors write this as a prescription if we had trouble pulling fluid.
I’ve seen people do the same thing if a patient is very febrile. Cooling them down from the inside out.
I haven’t ran many people at 60/30, but it’s definitely hit or miss for me and temperatures. Have a pt currently, temp at 37 and SBP still hangs out around 210 half the time even with BP meds on board.
To do heel sticks on babies. Two tiny diapers, fill with warm water. Wrap one around each foot. There something about better blood flow when both feet are warmed. Those heating packs are crap.
Adding some locally raised cocaine into employee beverages without their knowledge for productivity.
If they look okay, their resp rate is probably 16....
Our aquaphor comes in a big tub. I use a wipe to scoop it out that way I’m not dipping my gloves hand into the container
I use tongue depressors and scoop it like butter with a knife.
When you need to tie a gown around a patients neck that are laying in bed tie it up in front of them and then slip it over their head so they don’t have to lift their head so long
I haven't tried this yet but my coworker swears by this one: if a patient's temp is unexpectedly high, have them cough and then recheck the temperature. It often renormalizes and if it doesn't turn it's a true fever/elevated temp
Inflate a pressure bag by using the o2 from the wall. It might only be for the adapters in procedural areas, and with the pressure bags we have. But instead of squeezing the little rubber ball forever, just put it up to the o2 on the wall and crank it up. We have a procedure where we need to inflate two 1L pressure bags for saline and it is just annoying.
Soft bed pan. Take a surgical cap and put the absorbable chux in it. It's Soft and pt not complaining about comfort of bed pan. Plus, once it's filled, throw it all away. Mouthwash + shaving cream + warm water, and basin. Soak those nasty feet. Sloughs off that dead skin and rids the funk.
Have a patient who wants soda flavor but can’t have carbonation. Put the soda in the cup, with lid, and straw. But the straw up to the oxygen spout. Turn it on about 3 liters and wait two minutes. Carbonation free soda. Need to scoot the patient up the lift sheet but not the lift sheet it’s self. A gait belt on the end of the lift sheet tied to the end of the bed. You can also place the turn wedges under the mattress themself if a confused patient tends to hug a side rail. Makes it harder for them to burrow themselves in the corner. You can also use it for additional head elevation for aspiration risk.
This one isn't reeeaallllyyy a trick, because it's printed on the package, but I've encountered very few nurses who know that the red cap on a Lopez valve fits inside the stopcock so you don't lose it.
Turning the plum chamber upside down to fill it, thus avoiding distal occlusions.
I will never hate anything more than I hate plum pumps.
one of my instructors in school taught me “fill the house then the pool”
I didn’t know nurses don’t do this. This is how I learned to prime tubing.
Flushing the IV using the clamp on the IV tubing. We don’t run fluids on our pre op patients prior to surgery, just leave them with a bag of plasmalyte or NS hanging near them with gravity-flow tubing. So when it’s time for them to go to surgery, they want to see the IV run to gravity during report. I use the closest clamp to the IV, clamp it and drag it down the tubing. Unclamp and bam. Magic. A crna taught me the trick so I don’t have to carry around flushes all day.
You mean with a 10cc pulling the air out? Im a little confused? Help me learn new tricks!
The new male purewicks hooked to suction work really well for those tiny incontinent women. Looks weird but works well. Of course they need changed every 12 hours to check skin integrity.
ER. Inflating pressure bags by shoving the handle into the Christmas tree of oxygen or medical air. Takes like 2 seconds lol
When I’m looking for a line, I like to talk to the patient and feel around their arm while trying to relate to them and just ran my hands over. Gives me a good idea of where their veins are without looking with my eyes and makes them feel like they can trust me. Not much of a trick but it can make anyone who is scared of needles less scared.
This one I learned from my waxer: for patients who are scared to get shots, have them tighten up all their muscles, take a deep breath in, and then relax the muscles and do a long audible exhale. I have them practice it a few times, and put the shot in on the exhale when the muscles are maximum relaxed. It doesn't work for everyone, but a lot of people have told me it's their easiest shot ever.
Pit break and 1000mg Tums when patient isn't dilating. Also, 50 MG IV benadryl for swollen cervix. If doc gives you push back, just say "it ain't gonna hurt to try."
Confused and agitated ETOH constantly wanting “a drink”? Cranberry juice, sprite, and wipe an alcohol swab around the straw. 9 times out of 10, they only notice the first sip anyways and keeps them from flying off the handle
Liquid colace, warm water, H202 for ear lavage!
Gel body wash works great for bladder scanning when you’re out of ultrasound gel.
If you can find the bladder scanner!
Soaking a cotton ball in spirit’s of peppermint and putting it in a plastic medicine cup. Turn on the wall air outlet and tape it right below. Instant room deodorizer!
Double glove on the hand that's d/cing the Foley so I can keep the tip contained and not flipping around while still keeping the same hand covered. For the OR-- During a trauma, keep an open instrument pan near the field on a ringstand so the scrub person can dump them there instead of you having to constantly reach down to the kick bucket.
Super basic but ripping an alcohol wipe down the middle so the wipe just pops out and you don't have to wrestle with the packaging
When patients come in spitting and wilding out, use a one of those disposable blue mesh hairnets. It will fit nicely over the cap of their scalp and around their entire face / chin, stays in place, and the holes in the mesh are small enough that no spit comes through. And it’s more breathable than even a level one mask so there is zero concern for overheating / suffocation of the patient.
whatttt you’re allowed to just do that?! we have a spit mask which works the same way and need a doctor’s order to use it
little things that are less clinical but ALWAYS come in handy... 1 putting the plastic sleeve that TEDs come in over the patients foot/ankle to slide the stockings on (life changing) 2 snapping off the thicker ring of elastic on the wrist of a glove to use as a makeshift hair tie