Current and former sacred cows in nursing

5 Hi everyone,

The oldie but goodie thread got me thinking.

What are some former and current sacred cows in nursing?

By sacred cows, I mean facts, protocols, standards of practice etc. that were once bedrock but have been debunked over time through overwhelming evidence. This could either be stuff in the past that now seem so ridiculous, or stuff you still see nowadays that really should be stopped. Things like diethylstilbestrol for pregnant women, lidocaine and liberal doses of bicarb "just because" in codes, relying on auscultation only to check NG tube placement etc.

One of my big research articles for school was about the routine use of normal saline during endotracheal suctioning. Turns out its bunk. I, for one, was scared by my nursing school teachers into using it all the time. Otherwise, I will always scrape the trachea or leave the patient drowning in his own secretions. Really? Now, I have had chronic trach/vent-dependent patients who ask for NS for their own comfort and preference. I happily oblige but I no longer feel obligated to lavage every intubated and trached patient I have.

So, folks, share your nursing sacred cows!
Off the top of my head; 1. Trendelenberg for hypotension. Evidence-Based Practice Habits: Putting More Sacred Cows Out to Pasture2. Not aspirating with injections. http://ovidsp.tx.ovid.com.ezproxy.li...09ba3cc29cddb4I can think of some others given some time.

Quote from TiffyRNOff the top of my head; 1. Trendelenberg for hypotension. Evidence-Based Practice Habits: Putting More Sacred Cows Out to Pasture2. Not aspirating with injections. http://ovidsp.tx.ovid.com.ezproxy.li...09ba3cc29cddb4I can think of some others given some time.

Can't get to my computer right now to pull sources but I seem to remember vigorous debate (maybe on the CRNA boards) about how the theory of COPDers and hypoxic respiratory drive is merely theoretical and never been proven in a lab.

Quote from TiffyRNCan't get to my computer right now to pull sources but I seem to remember vigorous debate (maybe on the CRNA boards) about how the theory of COPDers and hypoxic respiratory drive is merely theoretical and never been proven in a lab.

That somehow RBCs would lyse if given through anything smaller than a 20g. Of course, we routinely give babies their transfusions through 24g catheters.

Quote from meanmaryjeanThat somehow RBCs would lyse if given through anything smaller than a 20g. Of course, we routinely give babies their transfusions through 24g catheters.

Would you believe at my current hospital, we have to obtain a doctor's order to infuse PRBC's thru a 22 g catheter. I have tried to educate nurses here about red cells being 4 microns, and the current trend on the use of Trendelenburg, but they prefer to do things the sacred-cow way!

To be fair about the blood, infusion rates in the neonate are so much slower one can justify smaller gauges. When your transfusion is 15mls over 2 hrs, it's all right to use a 24g.

I remember not allowing new MI patients couldn't have anything too hot or too cold. They felt it caused coronary spasm

immmobility and confined bed rest after lumbar disectomy or fussion (70's)

Quote from TiffyRN2. Not aspirating with injections. http://ovidsp.tx.ovid.com.ezproxy.li...09ba3cc29cddb4

I don't remember it personally, but my older co-workers told me they were taught not to use gloves when cleaning a patient after a code brown because it would shame and embarrass the patient.