1) People are afraid to change, especially if they feel they have no vested interest in it. This includes nurses, MDs, anyone.
2) A field like OB is so fraught with lawsuits, many OBs are afraid that if they don't cater to what the patients want (social induction or scheduled c/s at 37 weeks, for example) they'll be sued.
3) Field that have little to do with nursing have some say over what nurses can & can't do. Example: Anesthesia
wants to keep laboring women NPO just in case
they have to have a c/s so they don't risk aspirating under general anesthesia. So nurses
have to follow the physician's
order to keep them NPO. Forget the fact that women tend to self-regulate their intake in labor, and have more strength when they've been allowed to eat. Forget the fact that a whomping majority of c/s use epidurals or spinals, not general. Forget the fact that someone could very easily come to triage in with a prolapsed cord needing a crash c/s, at which point you better be doing it without diddling & worrying about if she's eaten anything in the last 8 hours.