Perpetuating the myths

Nurses General Nursing

Published

I was just thinking about some rumors/false information that we hear before, during, or after nursing school that we believe only to find out our beliefs were wrong. I'll give a couple examples:

1. I thought that if you get retested for TB too soon, the 2nd test will come up positive.

2. I also thought some NCLEX-RN test takers are randomly selected to take all 265 questions.

What about y'all? When did you fall for the hype?

Specializes in ICU/ER.
o goodie...I get to bust the myth

http://www.nsna.org/pubs/imprint/jan05/jan_NCLEX.PDF

go to page 40 (p. 3 of the PDF); left column under: "Are some candidates chosen at random to answer 265 questions?"

btw...NSNA is the National Student Nurses' Association, so I consider them a good resource.

WOW---My nurse as a profession teacher, the one who gets us ready for Nclex told us the "random 265" theory..I really belived it and had my self convinced when I took Nclex if it went to 265 then it meant I was one of the random ones picked....

Thanks for pointing out the truth--I have spread that rumor myself as I thought it was true....

Specializes in Cardiothoracic Transplant Telemetry.
I was told that once a person receives a positive PPD reading, that they can NEVER, EVER have another one in life. But, I see it done often, because now, I'm learning that the BCG vaccination is not life-long as originally thought, for one, and that also, it depends on who did the reading...if an unexperienced person read the redness rather than the induration, it may have been documented as positive, when, in fact it was not. Because of this, many physicians probably prefer to obtain their own for their personal records.

You can NEVER administer Azactam (not sure if I spelled it correctly) if a person has allergies to penicillins. Now, I am reading that it is considered safe to give, but monitor the person.

You can NEVER give a cephalosporin to a person who has penicillin allergies...now, I am reading that 3rd generation cephalosporins may have less of a cross sensitivity than the 1st and 2nd ones.

Some days, I walk away totally confused...

There must have been something going around the medical community in 2000-2001, because all of a sudden docs started really questioning me about my PCN allergy.

How did I know I was allergic? Had I ever tried to take the medication as an adult?

The answer to the question is that I was apparently tested for PCN allergy as a baby- and my parents were told that a full dose would cause anaphylaxis. As to the second question- would YOU take a dose if you had been told that all of your life?

Anyhoo- I had all of these docs questioning my allergy- then I cut my foot and was prescribed Keflex. They acted surprised that I had never taken it and swore up and down that even if I DID have a PCN allergy that there was only about a 1% chance of a cross reaction. (granted I know that you were talking about 3rd generation)

Can you see where this post is going? You got it right. After the second dose I noticed some facial swelling, and by the third dose I had full blown angioedema that had me taking Benadryl for a week to reduce the swelling. I am betting that if I had taken the fourth or fifth doses that I would have had some serious anaphylaxis.

Sooooo... I can now say with relative certainty that regardless of how the docs came up with what they told my parents (and I have to wonder if there was a serious problem when I was a burn patient at 13 months) that they were right. If I had such a serious reaction to a cephalosporin then the PCN allergy was probably correct

Myth: That the Trendelenburg position should be used in hypotensive patients:

"The Trendelenburg position is taught in schools and on the

wards as an initial treatment for hypotension. Its use has

been linked to adverse effects on pulmonary function and

intracranial pressure. Recognizing that the quality of the

research is poor, that failure to prove benefit does not

prove absence of benefit, and that the definitive study examining

the role of the Trendelenburg position has yet to

be done, evidence to date does not support the use of this

time-honoured technique in cases of clinical shock, and

limited data suggest it may be harmful. Despite this, the

ritual use of the Trendelenburg position by prehospital and

hospital staff is difficult to reverse, qualifying this as one

of the many literature resistant myths in medicine."

Canadian Journal of Emergency Medicine. January 2004.

Thank you, thank you, thank you for this one. :bowingpur

If I had to count the number of times I've seen a CHF patient with a crashing BP literally stood on their head (and drowning from it) by die-hards of this practice..I could retire a rich woman of leisure:yeah:

Specializes in ER/Nuero/PHN/LTC/Skilled/Alzheimer's.

I fell for the story that if you explain rationales to a patient when coming up with interventions they would be more likely to agree to try them.

*snort* :lol2:. Whatever. Most of the time I don't get two words out when the patient asks why we are doing such-and-such and then they are screaming that I will do what they want me to do. *Sigh*.

I was also told that if someone is allergic to aspirin then they are allergic to all NSAIDs. Not true. I swell up with aspirin, but do great with ibuprofen and toradol.

I was told as a new nurse about the "full moon" craziness and so far that one has been spot-on. :bugeyes:

Specializes in Telemetry.

I still think that 265 happens randomly. Until I see something from the NCLEX people themselves I'm hanging on to it!! lol

Specializes in Med/Surg, Home Health.

Yep, nights of a full moon are full of excitement. When I worked nights, we could tell before ever going outside for a smoke-break if it was a full moon or not.

And I dont believe that people are randomly chosen to have the full 265 questions. Once you either pass/fail enough questions, your test is over. For some, its borderline throughout the test, therefore 265 questions are given.

Specializes in Med/Surg, Home Health.

Oh, before I went to nursing school, I thought that air in the IV line would kill you. You wouldnt believe how many patients Ive had who freaked out to see an air bubble in their IV line, only for me to explain it wouldnt.

Oh, before I went to nursing school, I thought that air in the IV line would kill you. You wouldnt believe how many patients Ive had who freaked out to see an air bubble in their IV line, only for me to explain it wouldnt.

excellent one...it would take nearly a full line of air to cause damage

I guess I could add this one...I thought that if you had a stroke and actually survived, life was pretty much over. Little did I know, recovery is possible, although not a sure thing even with the most aggressive of treatments

I'll never forget one individual...pt. was pretty much paralyzed on one side for a few days, then, as a fairly new grad. I made a major error of leaving a hep drip running at an increased rate because lab didn't draw the PTT and I didn't check up on them. Anywho, the next day, that side was moving and the pt. continued to progress. So it was a lesson learned on many fronts.

-Oxygen is harmful to patients with a hypoxic drive, we should hold off on giving oxygen to these patients.

-MONA should greet every MI patient at the door.

-We need to give fluids to our trauma patient until he has a normal blood pressure.

-My trauma patient is hypothermic, oh well, hypothermia will slow things down and help.

-It is critical that we give every CHF patient lasix ASAP.

-He is satting 90 percent, he is doing fine.

-We always calculate tidal volume at 15 ml/kg.

My favorite

-He said he only had two bottles of beer tonight.

Specializes in Emergency & Trauma/Adult ICU.
I still think that 265 happens randomly. Until I see something from the NCLEX people themselves I'm hanging on to it!! lol

Here you go then ... from "the NCLEX people"

https://www.ncsbn.org/1230.htm

(that would be the National Council of State Boards of Nursing - NCSBN)

Everything you ever wanted to know about NCLEX ...

Don't school instructors/advisers direct you to legitimate sources of information such as NCSBN, your state BON, PearsonVue, etc.?? :confused:

Specializes in Emergency & Trauma/Adult ICU.
honestly, i don't think that many students can grasp or appreciate the full implications of "critical thinking" until later in their schooling.

so if they're just starting out, i cut them a lot of slack.:)

leslie

My concern is that "critical thinking" is not just applicable to nursing ... we can probably all agree that critical thinking r/t the nursing process and developing that "sixth sense" about patients comes with experience.

But "critical thinking" in the more generic sense -- the ability to evaluate the legitimacy of information received by considering the source of the information, synthesizing the information with what is already known, etc. -- this is what I see lacking often and it bothers me.

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