What are some questionable/old-fashioned nursing interventions?

Nurses General Nursing

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Hello all,

What are some questionable/controversial/old-fashioned Nursing actions currently in use right now? I need to find a topic to write about. I don't have a lot of clinical experiences and really don't have the ability to tell if something is old or incorrect.

The examples that I was given to help direct my search are:

1. The use of chlorahexadine vs. betadine

2. Saline flushes vs. herparin for IV locks

3. The use of saline bullets for trach/ET suctioning

As you can see, the kind of topics I need are "this vs. that" or "do vs. do not". I'm having a very hard time with my private searching and thought I would ask more experienced nurses.

Thanks!

- Brad

Specializes in Certified Med/Surg tele, and other stuff.
Are there arguments against those? I know the rationales - inflating the balloon is to test if it works, and the draining thing is to prevent bladder spasms. Is there up and coming evidence against those? If there is, that would be an interesting subject.

I was always taught never to drain approx 700 or so off a bladder or you can drop b.p.

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Specializes in Certified Med/Surg tele, and other stuff.

I was actually told the other day that keeping a COPD pt at only 2 liters is old school. Is that correct?

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Specializes in Pediatric Pulmonology and Allergy.
nurses that take the air bubble out of the pre-filled Lovenox injectables...

On one of my first clinicals the instructor pushed out the air bubble and the patient's nurse (who was an LPN) said to me later, "You're not supposed to take out the air bubble but I wasn't gonna tell her anything!"

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Specializes in School Nurse, Maternal Newborn.
Why can't you drain more than 750 mls of urine from a foley. If the pt was peeing its not like they would be able to stop at 750 ccs and just hold the rest!

The theory, I believe, behind that one, is that it will help to maintain bladder tone. If the bladder is overdistended, the theory (OLD ONE) was that it may keep from reducing the bladder's tone by not emptying it all at once.

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how about

sterile vs non sterile gloves changing dressings?

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We recently had a "practice change" at my hospital and are not supposed to aspirate prior to giving vaccinations. Supposedly there is documented research to support this, but I haven't looked it up myself. Most nurses still do it, though...

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Your question regarding heparin flush vs. saline flush. You might want to consult the Infusion Nursing Standards of Practice, www.ins1.org

They publish standards of nursing practice for all types of infusion modalities.

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I had one instructor tell me we don't do Homan's any more to test for DVTs because if they have one, it may break it off. Another instructor does Homan's all the time, but if it is positive, it doesn't get repeated.

Today in class we were discussing pain meds for pancreatitis. Morphine vs Demerol. A recent change, as in from last edition of the text to this one says to use Morphine and doesn't mention Demerol at all. But all our previous classes said Morphine is a no-no, because it has negative effects on the sphincter of Oddi.

~Simmy

Demerol is not used where I work because it has proven to cause respiratory depression more often than not. Morphine can increase/cause spasms in the sphincter of Oddi. We always gave Dilaudid IV for pain, especially to our GI pt. population. However, there have been a couple sentinel events caused by Dilaudid, so now we pretty much have a choice of either Morphine or Fentanyl. Patients don't seem to get releif from the Fent. as it wears off too fast. So I guess that hospital policy and incidents play a large part in what type of pain meds are ordered--whether it be the most appropriate, or not.

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Specializes in Renal/Cardiac.
Demerol is not used where I work because it has proven to cause respiratory depression more often than not. Morphine can increase/cause spasms in the sphincter of Oddi. We always gave Dilaudid IV for pain, especially to our GI pt. population. However, there have been a couple sentinel events caused by Dilaudid, so now we pretty much have a choice of either Morphine or Fentanyl. Patients don't seem to get releif from the Fent. as it wears off too fast. So I guess that hospital policy and incidents play a large part in what type of pain meds are ordered--whether it be the most appropriate, or not.

IV Dlaudid is drug of choice where I work--but personally I do not like either one--and as far as heparin vs NS my facility is a heparin free facility so we are not allowed to flush anything except dialysis cath(theirs are not flushed but we deposit heparin in it) with heparin

And as far as the air bubble in the Lovenox I always leave it in dt the fact it keeps the med where it suppose to be same when I give a B12 shot I also use a air bubble in the syringe to keep the med in the correct place.

:nurse::heartbeat:clown:

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Specializes in ortho, urology, neurosurgery, plastics.
I was told to leave the little air bubble. What are others take on this?

Ostensibly leaving the air in not only clears the needle allowing the full dose to be delivered but to a degree it will also force the fluid into the tissue a bit more. The effect of this is when the needle is withdrawn, the fluid will not leak out the needle track from the swab suction that is created by the needle withdrawal. :)

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We used to tell gastric ulcer patients they could not drink milk or use dairy products. The joke is on us as we finally learned it was the heliobacter that caused the ulcer irregardless of your dairy intake.

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Inflating the foley balloon before inserting it...

Ouch! :eek:

:jester:

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