Because that's the way we've always done it around here

Nurses Relations

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This little parable may be familiar to some of you. It came around to me again recently and got me thinking about the nursing rituals we see in practice, the assumptions we see made so often about the dread NETY syndrome, and a host of other things that happen --or are assumed to happen, or are assumed that WILL happen-- without conscious or critical thought. Make of it what you will. What do you think?

"Start with a cage containing five monkeys. Inside the cage, hang a banana on a string and place a set of stairs under it. Before long, a monkey will go to the stairs and start to climb towards the banana.

"As soon as he touches the stairs, spray all the other monkeys with cold water. After a while another monkey makes the attempt with same result, all the other monkeys are

sprayed with cold water.

"Pretty soon when another monkey tries to climb the stairs, the other monkeys will try to prevent it.

"Now, put the cold water away. Remove one monkey from the cage and replace it with a new one. The new monkey sees the banana and wants to climb the stairs. To his surprise and horror, all of the other monkeys attack him. After another attempt and attack, he knows that if he tries to climb the stairs he will be assaulted.

"Next, remove another of the original five monkeys and replace it with a new one. The newcomer goes to the stairs and is attacked. The previous newcomer takes part in the punishment with enthusiasm. Likewise, replace a third original monkey with a new one, then a fourth, then the fifth. Every time the newest monkey takes to the stairs he is attacked. Most of the monkeys that are beating him have no idea why they were not permitted to climb the stairs or why they are participating in the beating of the newest monkey.

"After replacing all of the original monkeys, none of the remaining monkeys have ever been sprayed with cold water. Nevertheless, no monkey ever again approaches the stairs to try for the banana. Why not? Because as far as they know that is the way it has always been done around here."

Specializes in Oncology, LTC.

We are actually having a contest at the hospital I work at called "The Sacred Cow Contest". We are to think of things that we always do without any real evidence base, or something that we "have always done" and don't really know why (like taking vitals at midnight..it's something we have always done). Those whose ideas are chosen will be able to receive grant money to do research and see if we can make changes. It will be really interesting to see what comes forth!

...."have always done" and don't really know why (like taking vitals at midnight..it's something we have always done)

The reason given in my old hospital was that the policy on taking vitals on patients on our floor was q4h. Given that dayshift starts at 0700, if they take them at 0800, the next would be 1200, 1600, 2000, and then....2400. We all knew why we did it that way, it's because it was our protocol. And that was designed by the facility Medical Director.

Guess someone should consider waking HIM at midnight for v/s ;)

Nifty book to help with the Sacred Cow contest: Nursing and Ritualistic Practice, Virginia Walker.

It's 1967, but a true classic and available cheapcheap ($2 - $8) on Amazon right now. I'll tell ya, I read it as an undergraduate when I found it by accident in the stacks, and it ruined me for anything but evidence-based practice right then and there.

Nursing and ritualistic practice: Virginia H Walker: Amazon.com: Books

I've worked there!

Thank You for this!! :)

Specializes in Ambulatory Care.
GrnTea, thanks for the book suggestion!

Love this!! Thank you!!

THis poster made me think of this thread:

traditiondemotivator.jpg

Daliadreamer, what ever happened with that contest? Who "won"? (or lost, depending on how you think about these things)

To Tex - TY. Never saw it abbreviated. Again, TY.

I thought you were questioning this in jest!

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