Current and former sacred cows in nursing

[Cuddleswithpuddles]

Hi everyone,

The oldie but goodie thread got me thinking.

What are some former and current sacred cows in nursing?

By sacred cows, I mean facts, protocols, standards of practice etc. that were once bedrock but have been debunked over time through overwhelming evidence. This could either be stuff in the past that now seem so ridiculous, or stuff you still see nowadays that really should be stopped. Things like diethylstilbestrol for pregnant women, lidocaine and liberal doses of bicarb "just because" in codes, relying on auscultation only to check NG tube placement etc.

One of my big research articles for school was about the routine use of normal saline during endotracheal suctioning. Turns out its bunk. I, for one, was scared by my nursing school teachers into using it all the time. Otherwise, I will always scrape the trachea or leave the patient drowning in his own secretions. Really? Now, I have had chronic trach/vent-dependent patients who ask for NS for their own comfort and preference. I happily oblige but I no longer feel obligated to lavage every intubated and trached patient I have.

So, folks, share your nursing sacred cows!

[littlehoneybee]

I don't remember it personally, but my older co-workers told me they were taught not to use gloves when cleaning a patient after a code brown because it would shame and embarrass the patient.

[TiffyRN, BSN, PhD]

Which article are you referring to? The link takes me to the OVID log in page.

Sorry!

I'm afraid the full article requires access to a research library.

Crawford, C.L. & Johnson, J.A. (2012). To aspirate or not: An integrative review of the evidence. Nursing2012 42(3), 20-25.

To aspirate or not: An integrative review of the evidence : Nursing2014 Critical Care

[HouTx, BSN, MSN, EdD]

I love this thread!!

I was taught not to use gloves 'back in the day'.

Betadine for foley care ---- arrggghhhhh. What were we thinking??

[malestunurse]

Sorry!

I'm afraid the full article requires access to a research library.

Crawford, C.L. & Johnson, J.A. (2012). To aspirate or not: An integrative review of the evidence. Nursing2012 42(3), 20-25.

To aspirate or not: An integrative review of the evidence : Nursing2014 Critical Care

Stink, my university doesn't subscribe to this journal.

[meanmaryjean, DNP, RN]

To be fair about the blood, infusion rates in the neonate are so much slower one can justify smaller gauges. When your transfusion is 15mls over 2 hrs, it's all right to use a 24g.

Actually, I've pushed 60 mL through a 24 in 5 minutes. Rate of infusion does not change the diameter of the cell.

[calivianya, BSN, RN]

I don't remember it personally, but my older co-workers told me they were taught not to use gloves when cleaning a patient after a code brown because it would shame and embarrass the patient.

That is terrifying. I would be more mortified if I was a patient by seeing my poop under someone else's fingernails than by seeing my nurse using gloves. So gross!

The physicians here are all big fans of Trendelenburg. At least some of the nurses know better. I have definitely seen nurses Trendelenburg patients while the physician is in the room and then lay them flat the second the physician leaves. It's pretty funny.

[Sunflowerinsc, ADN, RN]

I love this thread!!

I was taught not to use gloves 'back in the day'.

Betadine for foley care ---- arrggghhhhh. What were we thinking??

Way ,way back in the day ,we didn't have gloves at the bedside. The only gloves were sterile ones used in surgery. Yea, really

[NicuGal, MSN, RN]

When suctioning down an ETT, go until you hit resistance and then start sucking!

[NayRN]

I think complete bed rest for a DVT was going down the tubes when I was on the floor, too. I dunno. Kinda miss floor nursing sometimes. Sort of. Been away for 1.5 years now.

[applewhitern, BSN, RN]

I remember when a patient had a cholecystectomy, they were cut massively, all the way down the chest, and it was a big deal. Same with fem-pops; a million staples that leaked and bled. And yeah, the bedrest thing, too! And being forbidden to run red blood cells on a pump; free-flow only. I hung blood (25 yrs ago) and left the patient to go and get a tele monitor to place on him. When I got back in the room, after literally a minute, that bag of blood was gone!! I had the roller clamp too loose, and that blood just bolused itself right in! Thank goodness today we have pumps and/or dial-flows to regulate it. Back then you had to just watch it! Oh, the fem-pops were cut from the top of the thigh, all the way down.

[edmia, BSN, RN]

Way ,way back in the day ,we didn't have gloves at the bedside. The only gloves were sterile ones used in surgery. Yea, really

Oh no. That is terrifying! Gloves are my bubble of protection -- I can do anything if I have gloves. Anything.

My practice is not that old but I was taught to Trendelenberg (sp?). I was also introduced to Swanz-Ganz as the top of the line monitoring possible. And now I haven't seen one used in at least 5 years.

[TheGooch]

I remember when a patient had a cholecystectomy, they were cut massively, all the way down the chest, and it was a big deal.

My Mom had one in the late 70's and she had a huge scar on her abdomen.