So, you’ve had quite a crazy day on the floor with several nursing mountains to climb and you’re exhausted. We get it! There are some things in nursing that you have to fall on your rear end to learn, because they don’t tell you in the books what really happens out there. Enjoy these helpful Nursing Hacks!
1. Getting A Nasogastric Tube to The Right Place
It’s your third attempt and the tube hasn’t gone down yet. You check placement and nothing is coming back. Ng tubes can be tough to work with and need to stay very straight when they hit the back of the throat to get into the esophagus correctly. One little bend and it will either curl up in the throat or take a wrong turn into the trachea.
Solution: Ng tube placement isn’t a sterile procedure, so just open your package of tubing and toss it in a bath bucket with some ice to chill. This will help keep your tubing straight going down and you will find placement a lot easier.
2. That Wound Vac Alarm Won’t Stay Quiet!
Wound vac placement in small spaces and near creases on the body can be tricky to get a good seal. Every five minutes you find yourself going in to the patient’s room to troubleshoot that “low vacuum” alarm. This can take up a good part of your day.
Solution: With wound vacs, less is more. The more surface area on your wound vac drape, the more suction it will take to get a good seal. If you have a wound in a hard to reach area, trim your drape to no more than ½ inch outside of the wound bed. The less the machine has to suction the better seal you will get.
3. Non-Stop Occlusion Alarms On an IV Line
When you get a patient that needs an IV line and refuses to use an arm board, things can get tricky when they keep bending their arm. They may not even be consciously doing it. If you are unable to do a site change or the patient refuses, there is an easy fix that may work.
Solution: Grab some dressing tape, preferably a pretty wide piece and not paper if the patient can tolerate it. Have the patient straighten their arm totally flat. Take a good length of tape to reach an inch above the elbow and about an inch below. Attach it above the elbow and give it a little pull as you attach it to below the elbow. It doesn’t completely restrain the arm, but helps prevent too much bending.
4. COPD Patients and Shortness of Breath
If you have a patient with any kind of respiratory illness or disease and their oxygen saturations are within range, you of course call the doctor first. It may just be a common symptom of respiratory disease and illness called, “air hunger.”
Solution: If everything checks out okay you can place a fan in the room to circulate the air. This will help reduce the feeling of “air hunger,” that is common in patients with respiratory illness.
5. What Is Going On Here?
Your patient doesn’t understand why they are being awakened at 5 a.m. to go down for an MRI. They complain a few hours later that the physical therapist woke them up again, and the lab did a blood draw after that. They say there are too many people coming in and out of their room and they just don’t understand why. Whether they are genuinely confused or even alert and oriented, your patient is not happy with you in the morning.
Solution: Even if you are embarking on your own busy schedule and need to get things done, make sure you take the time during assessments to let patients know what the plan-of-care is for the day. They will at least be prepared for interruptions to their sleep.
6. Protocols and Standing Orders
It’s 3 a.m. and you’re tired. Your patient hasn’t pooped in 3 days or has a headache. What do you do? Call the doctor for an order? If so, you best hold the phone way out when he or she hears why you are calling at this ungodly hour. We get it. We have all been new nurses on a floor somewhere at some time and made this grave mistake. It not only hurts your ear, but your pride.
Solution: Yes, you want to be the “rock star” nurse and it is totally understandable you want to do things by the book. You should be! But, whenever you hit that floor running at the start of your shift you need to check for a few things first. Check your charts for “standing orders” for anything over-the-counter that may be given at your discretion. If they aren’t there, your floor may have a “standard protocol” on file for any over-the-counter medications. For example; labor and delivery units usually have a standard protocol for stool softeners after delivery. Whatever it is you give, make sure you see that order somewhere before you do it and only call the doctor as a last resort because you couldn’t find the order!
7. Nurses’ Helpers
Are you busy with your charting and your confused patients are wandering the halls? They don’t always need to be confined to their room or their bed. Besides getting an order to restrain a patient can be tough and not always the best thing. There is a quick trick that can keep them busy for hours.
Solution: Get a regular laundry basket and fill it with baby clothes, towels, and washcloths. Place it in the activity room and have them “fold the laundry” for you. This has proven to be an effective activity for patients who are confused and good for them too!
8. The Inevitable Will Happen
Whether it is a “code brown,” a blood splash, or any other leakage of some sort, you will inevitably need to change your scrubs at some point in your nursing career. The OR isn’t always able to “loan” scrubs in this event and you can’t walk around looking like you were part of a massacre either.
Solution: Keep an extra pair of scrubs in your locker or car for these unforeseen emergencies. You may think it will never happen to you, but it will. If staffing is tight, you may not be able to leave the hospital property to go home and change.
So many things can happen in a day and it only happens once you are fully licensed and on the floor working. It is the law of the universe. Nursing hacks can help you be prepared for those unexpected moments that slow down your day! Visit our nursing resources to help you master nursing even more!