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!

[hiddencatRN, BSN, 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.

I work in general Peds with a large sickle cell population and we routinely give transfusions to bigger kids in 24g IVs too. We just make sure to ask for the smaller RBCs ;-)

[Christy1019, ASN, RN]

Way back when - when someone came in with GI ulcerative disorders, automatically a strict SIPPY diet.

Don't know if they do that kind of stuff anymore in hospitals anymore. I mean I can understand avoiding spicy chili but those SIPPYs...

What in the world is a SIPPY diet?

[Esme12, ASN, BSN, RN]

What in the world is a SIPPY diet?

It is an old an obsolete diet formerly used in the initial stages of treatment of peptic ulcer, beginning with milk and cream every hour or two to keep gastric acid neutralized, gradually increasing to include cereal, eggs, and crackers (sippy two) after 3 days, with pureed vegetables later (sippy three).

[Esme12, ASN, BSN, RN]

or the Sippy one Sippy 2 meant the hour interval between the milk and cream

[Christy1019, ASN, RN]

It is an old an obsolete diet formerly used in the initial stages of treatment of peptic ulcer, beginning with milk and cream every hour or two to keep gastric acid neutralized, gradually increasing to include cereal, eggs, and crackers (sippy two) after 3 days, with pureed vegetables later (sippy three).

Ewww, cream and pureed veggies? Ill take a gastrectomy instead lol

[Emergent, RN]

I remember when I had my first child, 36+ years ago, parents had to fight with hospital to stay with their hospitalized child overnight. The old school of thought was that it was best for the child to separate from the parent, and bond with the nurses. I would read in parenting magazines how parents were limited to visiting hours.

Now, if the parent doesn't stay with the child the nursing staff is aghast, and the parent is suspect of being negligent.

Back when I was a child in the 1960s, no child under 12 years old could visit a person in the hospital. Visitor hours and rules were strictly enforced.

Now it's a free for all, people crowd into rooms with take out food, visitors try to lord over nursing staff, visiting hours seem to be a thing of the past. Only if a visitor is totally unruly will be expelled from the hospital.

[Cuddleswithpuddles]

Oh, I just remembered this: Do not use Vaseline around the nose of a patient using oxygen lest they burst into flames.

[Cuddleswithpuddles]

Oh, I was told my my older coworkers that mothers were in the hospital for several days after a postpartum delivery. Nowadays, it is not uncommon for such mothers to be discharged within 24 hrs. Since I do not know what a multiple day stay was like back then, obviously there has been a change in thinking as to what is necessary for the mother's health and safety.

Anyone care to elaborate?

[applewhitern, BSN, RN]

Cuddles, way back in the dark ages, mothers who just gave birth did stay in the hospital for several days. They were on bedrest, didn't even get to ambulate! Today, we know to worry about blood clots, etc. I remember they wouldn't even let me get up to the bathroom; gave me a BEDPAN and expected me to poop in it (I didn't!) and they wouldn't discharge mothers home until they had a bowel movement. The reason women have such short stays today mostly has to do with insurance.

[Esme12, ASN, BSN, RN]

Oh, I just remembered this: Do not use Vaseline around the nose of a patient using oxygen lest they burst into flames.

They acted like the patient would burst into flames...... however using vasoline will support the fire so it is still not recommended

[Esme12, ASN, BSN, RN]

Oh, I was told my my older coworkers that mothers were in the hospital for several days after a postpartum delivery. Nowadays, it is not uncommon for such mothers to be discharged within 24 hrs. Since I do not know what a multiple day stay was like back then, obviously there has been a change in thinking as to what is necessary for the mother's health and safety.

Anyone care to elaborate?

My Mom says she was kept in the hospital post delivery for 3 weeks because she had hemorrhoids

[Esme12, ASN, BSN, RN]

I remember waking up open hearts to see that they moved all their arms and legs them we snowed them for 10 days to "allow the heart to rest and heal".