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.
Specializes in cardiology, med/surg, endo/day surgery.
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!
Bladder spasms. You need to clamp and I remember the number was different back in my day. I believe we were to clamp before that and then come back and open for more. I would have to check resources, but it was for comfort. If someone is retaining that much urine and you dump it...that bladder is going to spasm!
Specializes in cardiology, med/surg, endo/day surgery.
has anyone mentioned putting a few packets of sugar in juice vs plain old juice for a diabetic with hypoglycemia??? NOW...back in my day...lol...OK, 16 years ago a nurse stuck a couple of packets in OJ and gave it. The sugar was up before ya knew it. Today it is frowned upon because it is not a safe practice. I have seen a few nurses still do it under the table because it was so commonly done.
On another whacky and bad note, there was an old travel nurse fired about 6 years ago from our unit when she used a 10 cc flush for her 4-5 patients!!! OH the horror! Yes, this old nurse (in her 50's) claimed this was a common practice for her over her years as a nurse! I have seen this one pop up in the news from time to time. I read an article that in the southern states one of these cases just happened in a nursing home and about 8 people were exposed and some got hepatitis (with a few deaths). So bad!!!!
How about the use of Coumadin, or not after joint replacement. I was at an inservice given by an ortho. He said there is evidence that it is not needed, but most doc's still order it. (I see it used a lot)
My instructor was teaching us about coke in the feeding tube to break up a clog. Im not sure if this is good nursing practice so I let it go in one ear and out the other:confused:
I have a pt with a long term J-tube that frequently clogs. We have used coke, warm water and/or meat tenderizer with varying degrees of success. If it is a particularly bag clog the meat tenderizer seems to work the best. Just personal experience but I haven't got the coke trick to work yet.
I was actually told the other day that keeping a COPD pt at only 2 liters is old school. Is that correct?
Correct you are. My facility still has a 2LPM protocol unless MD orders specify otherwise, but now I am seeing more COPD patients with orders ranging from 2-6 LPM, and in one case 8 LPM. None of them have suffered any adverse effect from increased O2 flow.
Actually there was a very lengthy thread recently where it was proved that filter needles are necessary to keep the miniscule shards of glass out of the syringe.
Although I do LOVE that my post is sparking such interest and getting people talking, remember that in my case, I need to be able to find evidence-based nursing journal articles and write a paper on the subject. I don't mind if you continue to discuss all of the various questionable actions you've seen, but if you're trying to answer my question, it needs to be something that somebody might have actually researched and written about, and I can write a 6-page paper on.
Thanks guys! Keep up the discussion!
I haven't gotten through the whole thread yet but I was wondering if you found anything you could use yet. If it isn't too late for your paper, maybe you could look at wound care. In the olden days, we used to clean many wounds with hydrogen peroxide but research showed that peroxide was cytotoxic. Maybe a CINAHL or Google Scholar search for wound care or peroxide would help you.
Specializes in pediatrics, palliative, pain management.
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
The morphine/ Demerol one would be a good paper. There is +++ research out there about the problems with Demerol and the fact that it really has no different effects on the Sphincter of Oddi than any of the other opioids. Also the history behind Demerol (why and when it became the "it" drug and still continues even though it is unsafe!), is very interesting.
It intresting that USA nurses report using Demerol often. its known as pethidine in the UK and in my hospital only used in labor, mainly due to its effect on the kidneys. however laboring mothers generally have better kidney fuction that olders adults. Oh Hydromorphone(dluiad) is only used in pallative care pain relied is morphine or oxycodone i/r as a rule here and we perfer sub/cut.
Not bathing a patient every day just feels wrong. I was taught that a pt never died for not having a wash which is true. however any pt frail, acutely unwell, incontient needs a wash to check skin and protect it.
Tina73RN
44 Posts
Bladder spasms. You need to clamp and I remember the number was different back in my day. I believe we were to clamp before that and then come back and open for more. I would have to check resources, but it was for comfort. If someone is retaining that much urine and you dump it...that bladder is going to spasm!