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Since nursing is a dynamic and evolving profession, many old nursing practices we used to do have now gone obsolete. Advance research studies have proven that some patient care routines are not as effective as thought to be. This resulted in a more quality nursing care with improved skills.

Take a look back at some of the nursing skills that have been in practice.

Resterilizing urinary catheters and syringes. The different disposable medical types of equipment we use today were made to be reusable many decades ago. After each use, nurses have to re-sterilize this equipment. Since these were made from glass, re-sterilization required boiling or disinfecting.

Use of rotating tourniquets. This was used before for the management of pulmonary edema secondary to left heart failure. With the development of more potent cardiac drugs, the practice is no longer recommended for nurses who use this skill decades ago.

Narrative charting with color-coded inks. Before, nurses documented the nursing care they rendered by using different colors of ink. Nurses piled up charts at the end of their shift so they could finish narrative chartings. But now, charting and record of patient care are made easier with new computers and gadgets.

Getting blood pressure reading through palpitation. During those days when hospitals were still using mercurial BP apps, nurses could get blood pressure readings without using a stethoscope through palpitation.

Bathing feverish children with alcohol. It was believed that alcohol helped in lowering body temperature faster that is why nurses give pediatric patients with fever received sponge baths with a solution of lukewarm water and alcohol. But the practice was stopped when it was proven water alone is more effective in lowering down fever.

Shaking mercurial thermometers. Before digitals were born, mercurial thermometers made out of glass were used by nurses when taking the patient’s temperatures. Soaked in containers filled with alcohol and cotton, nurses shakes mercurial thermometers to lower the line up to a certain point.

Shaving before surgery. Shaving is included in preoperative preparations for surgery patients before. Now, hair clipping is recommended for skin preparations before surgery since studies have shown that shaving increases the risk of surgical site infection.

Manual regulation of IV fluids. When infusion pumps were not yet invented, nurses manually counted and calculated IV drip rates of each patient. Since their invention, the use of infusion pumps makes IV fluid regulation easier for nurses. Syringe pumps also help nurses regulate easily large preparations of IV medications.

Use of Trilene/Penthrane inhalers for labor pain. These inhalers were frequently used as a PRN medication whenever the patient could not stand the pain of labor. But it was later discontinued as patients may accidentally inhale too much which can cause adverse effects to the unborn baby.

Use of Dakin’s solution for wounds. First used during World War I, this wound antiseptic was frequently used for bed sores and infected surgical wounds. Nowadays, nurses rarely prepare Dakin’s solution as more topical antiseptic medications have become available especially for infected surgical wounds.

Coca-Cola to unclog nasogastric tubes. Coca-cola (or any carbonated soda) is a notorious unclogger for feeding tubes. The acidity in cola is believed help unclog the tube.

We fling open the doors of America’s emergency departments to help those who can’t afford health care. We have legislated this protection: No person can be turned away for financial reasons. This is very compassionate and represents the higher angels of our culture. Alas, it also is emblematic of the stupider demons of government. You see, the ER demonstrates the inverted priorities of American society.

In the ER, expensive tattoos abound. Piercing is ubiquitous. Almost every adult and child has a smartphone, it seems. All too many spend the duration of their ER visit glaring at the screen of said phone; barely looking up at the physician who is attempting to engage them in meaningful conversation about the reason they came for care.

Cigarettes populate purses and drug screens are notoriously positive for at least chronic narcotic pain medications, but often other substances, among them marijuana and amphetamines.

Dental care? It is regularly ignored because, in the words of my patients, “I don’t have dental insurance.” Guess what. Neither do I, and I pay a lot for insurance. Dental care has typically been a cash business. That’s why dentists, crafty guys and gals that they are, spend their time mucking around the human mouth. Floss and toothpaste? Seems a bit excessive compared to a nice new tattoo.

But, on the southern end of things, carefully groomed pubic hair is not at all out of the question. The teeth may fall out; the nether regions will be carefully tended.

It’s all about priorities: those of individuals and those of leaders. Our leaders, ever convinced that we must give medical care to those perceived to be in need, often forget that modern definitions of poverty and need may be a bit different from need throughout human history. And that if a family has an expensive cell plan, new truck and big-screen TV with satellite, it might not be unreasonable to ask them to put up a little money for their own health care.

A woman told me, recently, that her daughter (at birth) had a minor congenital abnormality that required daily application of a cream. “And I had to spend $200 of my own money!” She was aghast. As are all of those who will gladly pay anything for Oxycontin (legal or otherwise), but who are offended and downtrodden when their antibiotic isn’t free at the local pharmacy.

We can’t keep this up. We’ve created a monstrosity of entitlement. I care for the poor; I love the poor and have always tried my best to help those in genuine need. Those truly hurting.

But when cosmetics, vices and electronics are considered reasonable expenditures while the rest of us pay for necessities like prescriptions (or over the counter Tylenol and Motrin as I’m often asked to prescribe for Medicaid), then we are entering the death spiral.

Hate me if you want. The truth is unpleasant.

But it is clean-shaven.

Green Bay, WI- In a stunning turn of events, entire OR teams including anesthesia kneeled today during all surgical timeouts today at Bellin Hospital. The shocking display of unity against the hospital administrators has sharply divided the medical community across the globe.

The impetus of the mass genuflection was a lone General Surgeon, Dr. Bessie Jandle, who refused to comply with the mandate from Joint Commission that all OR staff wear bouffant scrub caps. Dr. Jandle started kneeling during timeouts in protest over a year ago, but no one paid much attention to it even after his contract with Bellin Health was not renewed.

This summer, several other isolated surgeons started kneeling during their own timeouts which caught the attention of Bellin Health Hospital Administrator Timofy Weeber MPH, MHA, GED, POS. Mr. Weeber demanded that all departments fire any and all surgeons who refused to stand for timeouts. Weeber’s demands, which he didn’t have the authority, ability or spine to enforce, actually served to galvanize and unite the entirety of the OR staff.

In OR 2, every person in the OR including the patient dropped down to a knee arms inter-linked for the timeout. Numerous other OR’s had similar happenings with 75% of all OR teams dropping to a knee or sitting down for the timeout. When word started to spread of the protests, several anesthesiologists claimed that they have been sitting down during timeouts and even entire cases for years.

Meanwhile in OR 4, Ortho also took a knee and replaced it with a better one.

1. You still have to work nights, but at least you get to spend it on your back.

2. No charting!

3. You only have to keep them alive for 30 minutes- not 12 hours.

4. Pillow therapy means something completely different.

5. The only person to micromanage you is your pimp

6. You only have to service one person at a time

7. Evidence-based practice? They “finish.”

8. The only thing better than wearing scrubs to work, is wearing nothing to work. .

9. If someone pees on you, you can charge extra.

10. Groin management is welcomed and not feared.

11. If you get hit as a prostitute, you can press charges.

12. Patient satisfaction? No surveys!! (See #7.)

13. Frequent fliers mean you’re doing a good job, not a bad one.

Dear God,

I write to you today, tired and wondering when I’m going to catch a break. Test after test, clinical after clinical — I feel like I can’t catch my breath. The hours upon hours of studying and paperwork during the late nights and early mornings are breaking me down. I have never been so physically, mentally, and spiritually drained in my life. But let me stop complaining, because this is just a season. Some days, I try to compare myself to a tree. They look as if they won’t live during the winter, but just look at them during the spring. They have blossomed, matured, and have become what they are meant to look like. This is our winter but our spring (graduation) is coming. You know just what we have to go through, how long it will take, and how hard it will be on us, but you also know that it will help us to stand taller and become stronger. Trees go through the same thing and if they can handle it, then so can I.

Thank you for this opportunity to be in college so that I may earn an education. Thank you for the future you already have planned out for me. I may feel as if things don’t look good now but I know that you have not brought me this far to leave me here alone. But I need you more than I’ve ever needed you, because I’m not able to do this on my own. I apologize for the times I’ve turned to my Med-Surge book rather than my Bible. I’m sorry for replacing the opportunities I’ve had to pray with thoughts of worry about my next Maternal Health test. Please, help me to always remember to put you first and then after I do that, everything else will fall into place. You have instilled a desire within me to take care of your children, I just ask that you would make me capable. As I learn, let the concepts enter my mind, register, and stay there. I am amazed more and more everyday at your creation of the human body. Every bit and piece of us is so intricate and delicate. Help me to understand what our bodies are supposed to do and what to do to help a person whose body isn’t working like it should.

I want to be a source of your light in my patients’ dark time. Nobody wants to be in the hospital but let your spirit work through me to instill hope in them. When they say that they want to give up, remind me to tell them to keep pushing through, just as I hear you saying those same words to me during this time. I pray that there is meaning behind what I am doing, don’t let it be for nothing, send me confirmations and encouragement along the rest of the way.

I thank you for sending your son and the shedding of his blood, because of that, the veil was torn and I’m able to write this letter to you.

Love Always,

Your Daughter

The eNLC will be implemented on January 19, 2018 – visit the Board of Nursing website for future updates about the enhanced Nurse Licensure Compact.

Florida RNs and LPNs will be able to start applying on January 19th to convert to a multi-state license.

Aug. 16, 2017

Implementation Date Set for Enhanced NLC

Enhanced Nurse Licensure Compact (eNLC) Commission members have set Friday, Jan. 19, 2018, as the implementation date for the eNLC. There are 26 states in the eNLC.*

The original NLC will remain in effect with Colorado, New Mexico, Rhode Island and Wisconsin as members until each enacts eNLC legislation. As of the implementation date, the multistate license held by nurses residing in these four states will only be valid in those states. They will not have the authority to practice in the 26 eNLC states without applying for a single-state license in those states, unless the original NLC states join the eNLC by the implementation date.

Likewise, nurses with an eNLC multistate license residing in eNLC states will not have the authority to practice in the four states that are still in the original NLC without applying for a single-state license in those states, unless the states join the eNLC by that date.

Additional information about eNLC implementation can be found here and at www.nursecompact.com. For the latest information, follow the eNLC on Twitter or Facebook.

*eNLC states include: Arizona, Arkansas, Delaware, Florida, Georgia, Idaho, Iowa, Kentucky, Maine, Maryland, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia and Wyoming.

When I started nursing school, I knew it would be difficult. I wasn’t naïve. I heard the stories. I knew what I was getting into…to a certain degree.

It was everything I thought it would be and more. The highs were higher and the lows were lower. The thing you realize quickly in nursing is that it’s not something you can achieve on your own. You have to have a support system. It’s how you survive. It can feel like you’re on your own because you have to perform the skills and make the grades, but really, there are so many friends standing behind you pushing you through.

I’ve seen it over and over again. I’ve been a part of it, witnessed it and had help myself. The truth is, even the most intelligent students need help in some sort of way. It might be hard to realize it when you’re so inwardly focused, but when you look around you, everyone is walking the same path. They just have different strengths and weaknesses. It’s an incredible thing when others use their personal strengths to offset your weaknesses. Nursing friends see in you what you don’t see in yourself. Nursing friends share your passions, sleepless nights, early mornings, stress, panic attacks, victories and failures. Nursing friends are your own personal cheerleaders.

It’s no secret that we deal with some pretty gross stuff. Who else can you count on when you’re walking down the unit trying to find an extra pair of hands to help you change the clothes of a morbidly obese patient who’s covered from shoulders to ankles in their stool? Your nursing buds.

What about when your patient goes into v-fib (ventricular fibrillation), and you need someone to relief on chest compressions? Your rock star nurse friends are there to lend a hand or two.

Or what about when you are scrubbing into a C-Section for the first time and you’re kind of, sort of, secretly concerned you might get queasy or faint? Your nursing squad will remind you how tough you are. They’ll assist you as quickly as possible and when you are finished washing your hands a thousand times, they’ll make you laugh or smile. They’ll always be there to help you with dignity, support, love and encouragement.

Your nursing friends know which supply closet you go hide in when you are about to lose it or when class is so long it’s giving you a headache so they pass you some Tylenol. Nursing friends are the backbone of your nursing school experience. I always love it that, whenever I need hand sanitizer, Tylenol/Advil/Motrin or even a Band-Aid, someone always has it.

Even if you don’t talk every day, or you take different class times, there is always someone waving hello or asking how you’re holding up. You are all so different, but at the same time, you feel like you’re surrounded by so many who are just like you. They care as much as you do. They love as much as you do. And the best part: they just love you. Even on your worst days. There will be times when you trip up on the easy stuff you know that you know, but they’ll be there with open arms telling you about when they were in the same place. They are the ones who “fight in the trenches” with you. They’ll carry you when you can’t keep going, and you’ll do the same. No woman or man left behind.

Nursing friends are incredible lifelong blessings. So, remember to thank them every once in while. Keep cheering each other on, keep fighting together and keep reminding each other that the end goal is closer than it seems.

According to a recent poll of nearly 20,000 health care professionals jointly conducted by the American Academy of Physician Assistants (AAPA), American Medical Association (AMA) and the American Nurses Association (ANA), 99.8% of health care professionals say their ability to wear scrubs, also known as work pajamas, is the one thing keeping them from quitting their professions entirely.

“Am I surprised by the findings? No,” said AAPA President Jeffrey Katz. He is wearing matching light green scrubs. “I mean, come on? Forget patient care and making a difference. What other professions allow you to dress like this? For that reason alone, we are incredibly privileged. In fact, it is amazeballs.”

“What was most surprising about this survey was that wearing scrubs wasn’t even one of the choices,” explained ANA President Pamela Cipriano, who is looking dapper in her dark blue scrubs today. “Everyone wrote in ‘wearing scrubs‘ in the choice marked ‘Other.’ This is clearly very important to the survival of our work force. Take away scrubs and you take away their reason for showing up everyday.”

“Taking care of patients has never been harder,” said AMA President Andrew Gurman, speaking with a somber tone to match his jet black scrubs. “Patients are sicker than ever. EHRs are the bane of every health care professional’s existence. Doctors, nurses, ancillary staff seem perpetually short-staffed yet we keep hiring administrators. The rates of burnout are higher and higher with each passing year. Suicide rates are higher than any other profession. There’s no art of medicine any more since patients, families, administrators, and the Joint Commission just tell us what to do. Other than call lights with lockout intervals, wearing comfortable scrubs to work is all that we’ve got.”

Experts also point out that scrubs are soft and soothing, allowing burned out staff to wipe away their tears repeatedly with minimal irritation to their eyes.

Cipriano, Gurman, and Katz went on to say that if scrubs were ever eliminated as attire, it is with “100% certainty” every person who wears scrubs in the health care setting would turn in their resignation letters.

Article originally appeared on Gomer Blog.