Here are a few of mine--they are things that no one who does them can explain the rationale for, other than justifying it with these 6 words, their mantra:
"We've always done it this way."
1. Putting down a "foot sheet" (usually a drape sheet; half or 3/4 sheet) before putting down the main drape (lap sheet, transverse lap sheet, split sheet or whatever--)
My question: WTF for? Do people not trust that the surgical drape companies have put time and money into researching just how thick the surgical drapes need to be to make them impervious to strikethrough or instrument penetration?
2. "Testing" the balloon on a Foley catheter before inserting it--
Again, what is the rationale? Do they somehow think that the balloon on a Foley is prone to failure to inflate--have they ever actually SEEN one not inflate?
When I put a Foley in, I insert it all the way to the hub, inflate the balloon with the full 10cc of H2O, then pull the catheter back--it stops on its own, proving the balloon is inflated.
Never once have I seen a Foley slip out because the balloon failed to inflate--and if it did, so what? Has any harm come to the patient? Of course not! Just get a new catheter and reinsert it.
I don't think that sterile items should be handled more than necessary--putting on gloves to "test" a Foley balloon, taking them off, doing another task, and then regloving to actually perform the catheterization--often announcing to whomever they think cares: "I tested the balloon earlier" is, to me, an unnecessary practice and one that can potentially contaminate the catheter and lead to a nosocomial UTI.
3. Double gloving for every single task--even patient transport
First off, I think it is a waste of gloves, but second--everybody keeps quoting "research" that says double gloving is "safer--" I even saw a recent AORN article that quoted someone as saying something to the effect that double gloving will reduce the likelihood of needlestick or other sharp object penetration by 50%--
Now, that sounds reasonable in theory, but is it actually true in PRACTICE? Has anyone actually SEEN this research, or is it anecdotal? Does this mean that if we triple glove, we wiil reduce the chance of sharp object penetration by 70%? Should we put on 4 pairs of gloves, thus reducing the chance of needlestick by 75%? Why not just wear 5 pairs, reducing the chance to... well, you get my point.
And, while we're at it, why not just put on 2 gowns and 2 masks--hey, if one is good, shouldn't 2 be better? Where do we stop and say, "Enough, already--this is just silly."
Again, I think that, just as with the example of the surgical drapes, the glove companies have a vested interest in making gloves that are strong and durable--why should they make a product that necessitates wearing two of for safety?
I have never double gloved, and I have only been stuck once in my career--by a sharp needle that would have penetrated 2, 3, or 4 pairs of gloves; double gloving would have served no purpose whatsoever--
If people feel the need for thicker gloves to make them feel "safe," ortho gloves serve that need just fine.
OK, I know I will get flamed especially for my double glove views, but I just think we need to use a little more common sense and not rely so much on outdated "policies" and practices that MAYBE made sense in the '50s--MAYBE--but maybe, even then, they were sacred cows--
Let's hear YOUR sacred cows!!! Bring 'em on!! Remember, there are student nurses out there reading this board who can learn from us; it will be nice to provoke critical thinking in the generation that will be providing our perioperative care, possibly sooner than we think---
