The Clinical Hack Link Pack

One of the things I like most about my job as a nurse practitioner is continuing to learn. Given that I am a more experienced NP at this point, it seems that my life in the emergency department has become more routine, with significantly less day to day learning. While it's comfortable to be confident in my skills, and capable of caring for higher acuity patients, I still relish 'aha!' moments. If you're in the market for learning a few new clinical tips, tricks, and pearls, check out the following clinical hack link pack for our favorites. 

1. Kissing Trick for Nasal Foreign Body Removal

There are many ways to remove a pesky foreign body from a child's nose. Using hemostats, alligator forceps, or specialized ENT instruments is appropriate in many situations. In others, suction may be effective. But, in my experience in the emergency department, one trick has proven easier and less traumatic than the rest. I'm referring to the kissing technique or, if you prefer to be technical, the use of positive-pressure. Check out this post for details and a video demo'ing the skill. 

2. The Ring String Trick

Understandably, most patients prefer to salvage their stuck-on jewelry whenever possible. So, before cutting off a ring in a swollen-finger situation, try the ring string trick. Using a piece of dental floss or string and a little bit of skill, you can successfully remove a ring from a finger without damaging the ring itself. This video will show you how. 

3. Foreign Body Freakout! How to Remove an Insect from the Ear

Have you ever treated a patient presenting with a case of insect-in-the-ear? Understandably, the situation is quite distressing for the patient. Spiders, cockroaches, and other creepy-crawlies entering the ear canal, particularly during sleep, occurs more commonly than you might think. While this isn't a problem I treat on a daily basis as a nurse practitioner in the emergency department, it happens from time to time. What is the best approach for removing an insect from the ear? Here are the 4 steps, and a video to demonstrate. 

4. Tricks of the Trade - Epistaxis Management

Raise your hand if you hate treating nose bleeds! Whenever I see 'epistaxis' pop up as a chief complaint on my computer in the emergency department, I head straight for the restroom...maybe by the time I return, another provider will have picked up the chart... Some nose bleeds resolve quickly with just a few sprays of Afrin, but those that don't can be tricky to treat. Not to mention, patients generally don't appreciate having tampon-like devices shoved up their nares. Here are a few tips and tricks for treating epistaxis in your practice.

5. Subungual Hematoma Drainage Two Ways

One of my favorite procedures to perform in the emergency department is subungual hematoma decompression. The procedure is quick, easy, nearly painless for the patient, and provides instant relief. Not to mention, using a cautery tool is just plain fun. While draining a subungual hematoma is simple, there are complications and considerations nurse practitioners must take into account with the procedure. Here's what nurse practitioners need to know about subungual hematoma decompression. 

6. What is a Rust Ring and How Do You Remove It?

Have I mentioned before that I hate treating ophthalmology problems? Well, that and testicular diagnoses. When it comes to eye health, it's important that we as nurse practitioners and physician assistants have a solid foundation in our diagnostic and exam skills. Eye problems can range from simple infections and irritation to vision-threatening complications. So, let's talk corneal foreign bodies and rust rings. 

7. Clinical Pearls for Ear Foreign Body Removal 

Whether it's a bead, or a pea that makes its way into a patient's ear canal, as a nurse practitioner you may find yourself removing otic foreign bodies from time to time. While the procedure is usually quite simple, if done improperly serious complications can result. Here are a few clinical pearls to keep in mind when removing foreign bodies from the ear. 

8. Eye Injuries Caused by Superglue...Yeah, It Happens

The first time I saw a patient in the emergency department who had mistaken a superglue bottle for Visine, it seemed like a once in a lifetime situation. I mean, who keeps hard core adhesive on their nightstand? Then, it happened again. And again. Fortunately, a superglue to the eye situation is an easy one to fix. Let's look at the various ocular injuries caused by superglue and their treatment. 

9. Charting Hacks for Nurse Practitioners

Some days I swear that if I have to document one more visit for back pain, I'll walk right out of the hospital doors never to return. Other days, I vow I will quit charting for the remainder of my shift arriving early to work the following day to catch up. I never end up doing either of these things (OK, maybe the latter), but charting takes up much of my work day and can be a serious drain on enthusiasm for my job as a nurse practitioner. So, I use a few documentation hacks to help alleviate the burden. 

 

What are your favorite clinical hacks for nurse practitioners?