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!

[tyvin, 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?

72 hour stay was the norm and then the insurance companies said it wasn't necessary so it was reduced to the 24 hr (it came down to the almighty dollar). What happened was the new moms and babies suffered a very high relapse rate when switched to the 24 hour stay. Incidents of things started happening and after some research it was discovered that the new moms were being released before they were properly educated. The babies were being taken to the doc more often with infections, and things that should have been avoided were happening, lots of breast feeding concerns, incidents of jaundice went up, etc...

Now it is a choice as the insurance companies will let new moms stay for 72 hours if the new moms want. Remember, the insurance companies have their hands in everything.

When I had my last child, even though I was an experienced mom I opted to stay the 72 hours. I was a single mom with a 12 year old. I had driven myself to the hospital and parked my car in the ER parking lot. My water had broke and instead of alerting everyone I just drove to the hospital.

When it was time to leave the nurses escorted me down to the parking lot and to their absolute shock I went to my car and started putting my child in the car seat. They kept looking frantically around for anyone who was going to drive me. Then they started to realize that I was going to drive myself! The nurse came up to me and begged me not to do it and told me I can't drive myself home because I just had a baby (sacred cow!).

Anyway, you should have seen their faces as they discussed if they should go get their boss or alert security. I got in my car and drove away as they stood frozen in the parking lot unsure of how to proceed next.

Women have been having babies forever...I just have to laugh when people treat women who have just given birth as if they are going to break. It's all individual. I can still see those nurses in my rear view mirror standing in the middle of the parking lot with their mouths wide open...priceless.

[psu_213, BSN, RN]

immmobility and confined bed rest after lumbar disectomy or fussion (70's)

Or how about strict bed rest for someone with a DVT.

(Sorry, I didn't get through the other responses before I posted this.)

[psu_213, BSN, RN]

AHRQ WebM&M: Morbidity and Mortality Rounds on the Web

This article should be required reading for any nurse who regularly takes care of patients with COPD.