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New Grad NP

Repurposing Treatments

Published August 23, 2012 9:35 AM by Beverly Clayton

Costs for healthcare are rising. There is not a revelation in this statement, but as providers, we have to be mindful of the dollars we use because it affects raises. My former mentor would drive that home for me. When I would order a test, she would ask, "Will that test change your treatment plan?" And if I responded with "no" then she would state, "Don't waste the dollars."

She would follow with, "I am trying to get a CT machine for the facility." It would be nice, but it will never happen. Diagnostic imaging (CXR) has been sufficient and if advance imaging was recommended from the radiologist, the individual would go to our area hospital for further testing. But again, if the treatment plan is the same most likely the individual is not going anywhere. Do you ever feel like you are part MacGyver, Houdini, and Professor Gadget?

 I have said all this to describe a thought I had while caring for an individual who had used toilet paper to clean his ears, and now cannot hear. He admitted to cleaning his ears with toilet paper and the end of a pencil stating, "I think the toilet paper is stuck in there." Without an otoscope, I could see the foreign body in both ears and it was hard as a rock! So I decided to make a mixture of liquid Colace and Debrox and instilled into his ear canals and let him sit for 30 minutes.

After the time had elapsed, I flushed his ears with warm water and hydrogen peroxide. I thought of all the creative things we as nurses, NPs and PAs have used to save on cost, time and just to downright get the job done. For Example, Colace, the stool softener, really works to not only soften fecal material, but cerumen, paper, and erasers from pencils. I have used Metamucil for not only a fiber supplement to bulk one's bowel movements, but I have also given it to my patients as a gentle facial scrub for those individuals with acne.

Selsun Blue, the shampoo, is a wonderful mild body wash for individuals with dermatologic issues. Toothpaste has been used for acne pustules. The condiment mayonnaise was used recently for a lice outbreak we had in the pregnant population. Calcium carbonate/Tums has been used for a vitamin supplement in those who do not drink milk, and in this population they are indoors and they do not get any sun exposure. Tongue depressors are used for splinting fingers, and topiramate for weight loss and when the individual states they have migraine headaches.

Even though I do not condone this behavior, individuals have used the end of a pencil eraser for ear plugs, hence the problem at the beginning of my blog. I have even used suture material to lace a cracked plastic slipper; they were not on suicide watch. If there is anything you used in the clinical setting where you repurposed a treatment or item to help with costs, will you share it with me please? I love MacGyver!


Nice!!,.. Hey Amanda, I just thought about something I have had to do, we do not have pillows so when I suture I make a pillow out of wrapping blue chux around  2-3 mayo stand cover packages. The inmates love it!


Beverly August 24, 2012 4:04 PM

Pediatric ostomy bags over leaky paracentesis sites!

Amanda Henderson, Emergency Medicine - RN August 23, 2012 3:39 PM
Pittsburgh PA

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