10 Old-School Nursing Skills You Don’t See Anymore


Nursing, along with the rest of the medical field, is constantly evolving to ensure better patient outcomes. Nursing skills, in particular, have changed quite a bit over the last several decades. Some skills have even been discarded completely for the sake of safety or efficiency. Here are 10 interesting examples of old-school nursing skills that have either drastically changed or are no longer practiced:

  1. Reusing syringes and urinary catheters

Believe it or not, new nurses, many of today’s disposable medical items, like urinary catheters and syringes, were made to be reused in the not-too-distant past. These items were sterilized between uses, a process that was eventually deemed too costly as disposable items became more common.

  1. Charting patient care on paper

While it’s still possible to find rural and small-scale clinics that utilize paper charting, the majority of health-care facilities these days chart electronically. In addition to providing all members of the health-care team with easier access to patients’ charts, electronic charting is typically more efficient and more accurate.

  1. Using urine dipsticks with sliding-scale insulin

Sliding-scale insulin has been in use longer than glucose meters. Before these meters were used to determine how much, if any, insulin to administer to a diabetic patient, nurses had to rely on urine dipsticks. Urine-dipstick results aren’t as accurate as those provided by glucose meters, so it’s no surprise that they aren’t used in this manner anymore.

  1. Regulating IV fluids manually

Before infusion pumps were invented, it was necessary to manually regulate IV fluids. To do this, nurses had to count drops and calculate drip rates for each and every patient receiving IV fluids. Now, thanks to infusion pumps, administering IV fluids is easier, more accurate, and much faster.

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  1. Palpating for blood pressure

The vast majority of health-care facilities throughout the United States take patients’ blood-pressure measurements automatically, but this wasn’t always the case. Nurses used to rely on palpation to obtain blood-pressure measurements. To obtain a patient’s blood pressure in this manner, nurses would inflate and deflate a compression cuff while feeling for the disappearance and reemergence of the radial pulse.

  1. Shaving patients prior to surgery

Up until fairly recently, hairy patients had their incision sites shaved prior to surgery. New evidence suggests that this leads to an increased risk of infection, and many hospitals have eliminated this practice. Now, instead of using a razor, nurses use clippers to cut away excessive hair as a part of their preoperative preparations.

  1. Shaking mercury thermometers

Now that digital thermometers are used to obtain patients’ temperatures, the sight of a nurse shaking a mercury thermometer is extremely rare. In the past, however, nurses could be seen shaking mercury thermometers in hospitals on a daily basis. The reason that these old-school thermometers were shaken is that the mercury would often cling to the inner sides of the thermometer. Prior to taking a new temperature reading, bringing the majority of the mercury back down into the bulb by shaking the thermometer was the best way to ensure accuracy.

  1. Cutting urinary catheters during removal

While cutting urinary catheters during removal is not recommended, some nurses and doctors still utilize this practice. It’s considered unsafe for two reasons primarily. Firstly, traction on the catheter could cause it to retract into the bladder if it’s cut. Secondly, the balloon might not deflate, which turns a simple catheter removal into something much more difficult and costly.

  1. Irrigating NG tubes with Coca-Cola

Many old-school nurses swear by Coca-Cola for NG tube flushing. In theory, this is due to the coke’s acidity. Regardless of the reason behind this method’s supposed effectiveness, it’s not recommended as it can affect the plastic tubing. Before using coke, juice, or something similar to flush an NG tube, refer to your facility’s guidelines. More likely than not, using water when flushing an NG tube will be the preferred method.

  1. Treating congestive heart failure (CHF) with rotating tourniquets

CHF patients used to be treated with rotating tourniquets. Essentially, these tourniquets were applied to the lower limbs to diminish venous return. These days, however, we have a wide variety of effective diuretics that can be used to help decrease the strain that excess fluid volume puts on the heart. Not only is this treatment more comfortable for patients than applying tourniquets, it’s much more effective.

Are there any old-school nurses working with you on your unit? If so, do they still practice a few of the skills mentioned in this article? Leave a comment below and let us know!

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25 Responses to 10 Old-School Nursing Skills You Don’t See Anymore

  1. kimmik

    Massage is missing from the list.. I became a massage therapist after nursing school. I thought it was a good combination for homecare nursing and it’s serve me well.

    • Sweetnurse64

      We didnt give massages but every turn ( to other side) we rubbed lotion on their backs.

  2. CMcD1

    Yep done all of these since I graduated in 1978

  3. tinathecma

    I love reading about nursing and how it wasb ack in the day – thx for sharing♥

  4. debbiethenurse

    This article points out a very real concern I have. Since graduating nursing school in 1977, I have done my best to keep up with the changes to best practice, but given the incredible amount of information, it wouldn’t be surprising if I missed some. My remedy for that is to research anything I haven’t done in 5 years and to mentor student nurses. Why would having a student nurse update my skills? Because I can ask them what they have been taught. This gives them a chance to flip the teacher/ learner roles and even if they don’t know, we can learn together. Nursing is lifelong learning.

  5. SisterB

    I remember most of these very well except the Coca-Cola in the Ng tube and tourniquets for CCF as it was labelled in Australia. Shaking down those b!@$$/y thermometers has left me with a weak and painful wrist! I still take blood pressures manually at times when the patient is either too thin or too large and the automatic one doesn’t want to work!

    • Wisebug

      Not only do I remember using Coke to flush a clogged NG tube, I remember using Adolf’s meat tenderizer mixed with warm water.

  6. Wisebug

    I remember inspecting the bevels of needles to make sure there were no burrs. If there was a bur, we would essentially scrape the bevel against a type of sandpaper to “smooth it out” prior to use. This was when I was in nursing school, I never actually had to do this as a RN. I too remember when back massage was a routine part of PM care. And-remember when the latest/greatest treatment for shock was the placement of MAST pants? Haven’t seen those in years either!

  7. Wisebug

    We were also taught that when making a bed, the pillow case opening ALWAYS pointed away from the door and that the seams or hems of the sheets were placed seam side up so as to not irritate a patient’s skin. How many of you remember making a post-op bed with the blankets and sheets folded like an accordion to the center and one side of the bed so that you could immediately pull them over the patient so they did not chill?

  8. mbyquah

    I love reading your articles a lot, but on this particular one, most of those practices are still being done where I work. Advancement in technology hasn’t really gotten to most of Africa.

  9. Catthenurse

    I used all of these . I graduated in 1970. I did massages every evening at 7pm to relax patients before sleep. Some pain melds came in pill form and had to be mixed with sterile water to be given by injection. There is so much that has changed.

  10. taughtmany

    Bedbaths using 110 degree tested water Dissolving morphine pills in sterile water over a burner to make a solution for injection. Taking the reusible,resterilized,glass syringes out of a miter box with sterile forceps and putting the reusible sterilized needle on the hub ,checking for burrs,before filling the syringe.

  11. maqsix

    Hypodermoclysis for rehydration in adults. Collodion at the site of insertion of a metal I.V. needle to stop leakage. Carminiative enemas for nutritional reasons. HHH enemas (high, hot and hell of a lot) It was often ordered by the M.D. PTA bath (p…st, tits and as…. bath. I.e a minimal bath.)

    Changing the water in the pressure cooker in the Emerson ventilator.
    Cleaning, blowing, powdering, folding and autoclaving gloves. Sharpening needles.
    Turning hydrogenated babies with 20 pound heads oh so carefully every hours. Turning patients on the Stryker bed or the Circoelectric bed.

  12. Sop832

    How about retention sutures and Montgomery straps? I was the fastest Montgomery strap maker in the OR.

  13. troutynz

    So much has changed, and, in my opinion, not always for the best. Watching the nurses these days, one wonders why they seem to have patients all over the ward, rather than in one or two rooms. We used to be given four rooms (2 fours and 2 singles) and those were ‘your’ patients. A lot less walking, and a lot less complaining about how busy we were in comparison. I have a TON of stories about the ‘old days’ I could share….

  14. Ginncat

    In house lab test with actual chemical- I grew up with constant ph testing, urine glucose testing with actual test tube and chemical tablet then color matching.
    Wound site instillation with antibiotic for treatment then draining to gravity. Nurses did this all the time and now some Doctors are starting to bring it back.

  15. Littlekid

    Sharpening pencils.

  16. rnsurgery

    Charting with blue ink 7 to 3, green ink 3 to 11 and red ink 11 to 8 shifts.

  17. Medley99RN

    Urinals and bedpans used to be made of metal and were reused after being sanitized.

  18. agus_andika

    In my country Indonesia, point number 4,6,7,8 still often nurses do. How late the nursing growth in my nation.

  19. kekpnp@gmail.com

    A lot of these practices aren’t truly all that “ancient”. I try to make sure my nursing students at least get an idea of how spoiled we truly are in the states in case they ever do go on medical missions or do travel nursing elsewhere. I’ve been to places where IV pumps are reserved for inotropes and antibiotics are limited to whatever is on hand that week/ month. Sometimes we need to go back to those “old school practices” so it comes in handy to know them!

  20. Bnancyderm2002

    I remember almost all of these procedures except sterilization of needles. When I graduated in 1980, our hospitals used disposable syringes. I had to chuckle at alot of the ones I forgot about!

  21. Mroyer

    I remember pouring cocktails, wine and beer for patients at 4 o’clock (ordered by the MD) this was to stimulate the appetite. Patients were allowed to smoke in bed and staff could smoke at the nurses’ station.
    We thought nothing of putting our lunches in the refrigerator with the urine specimens (ewe, I know!). It was not uncommon to hang alcohol drips on patients to prevent DTs. We would pack large open wounds with granulated sugar and treated decubitus with Maalox and heat lamps. Yes, I am well aware I am older than dirt.