Here are 5 Nursing Myths or Sacred Cows that are not evidence-based but still persist in some pockets of nursing.
Inflating foley balloon to test it prior to insertion
Inflating the balloon can cause micro trauma from creasing of the silicone balloon. The manufacturer has QA processes in place. The product works, we really don’t need to test them. Don’t do it, even though it’s hard to resist.
Two doctors signing emergency consent
If the patient is unable to give informed consent, for example, if they are unresponsive or confused, and there are no surrogate decision makers present, the provider need only document that it is an emergency. If the procedure is needed to prevent death, alleviate severe pain, or prevent permanent disability, the provider must document a note, but a consent is not signed.
Ordering a stat glucose to verify hypoglycemia
Some nurses want to “verify” abnormally low glucometer results by ordering a stat lab glucose. But if your patient is symptomatic, you will follow your hospital protocol, and immediately administer oral carbs, or push D50. By the time Lab arrives to draw a Stat Lab, your patient has been treated. Whatever their blood sugar is now, it can’t be used to “verify” your previous result. (Some protocols include performing a second fingerstick to compare to the first reading.)
If the rationale is to “verify” glucometer readings before treating a patient, then the underlying assumption is that the machine is inaccurate. In which case why are we using it? The opposite assumption is actually the correct one. Point of care glucometer testing is accurate unless proven otherwise.
Sand bags to femoral artery after sheath pull
Evidence does not support the use of sandbags as a compression method to decrease vascular complications or discomfort. A sandbag exerts diffuse pressure and will definitely not stop an arterial bleed!
Some MDs order sandbags to be applied after hemostasis, and it won’t hurt anything, but it should not give you a false sense of security. They also interfere with visualizing the puncture site. There is a plus- it may remind your patient not to flex their affected extremity.
Trendelenburg for hypotension
Weak evidence exists for this time-honored intervention, and you may panic trying to remember how to put a bed quickly in Trendelenburg! Current data to support the use of the Trendelenburg position during shock are limited and do not reveal any beneficial or sustained changes in systolic blood pressure or cardiac output. Some deleterious effects have been documented.
Please be sure to check and follow your own facility’s policies and procedures. Requirements may vary by state.
Until next time friend,
Come visit me at Ask Nurse Beth career column at allnurses.com for all kinds of entertaining and informative career questions and answers, and to submit your own question
Guthrie, K. 2014. http://lifeinthefastlane.com/trendelenburg-position-for-the-hypotensive-patient-friend-or-foe/ obtained 12.05.2014
Makick, M. et al, 2011. http://www.aacn.org/WD/CETests/Media/C1123.pdf obtained 12.01.2014
Sabo, J. Savik, K. 2005. http://www.ncbi.nlm.nih.gov/pubmed/16317360 obtained 12.04.2014