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5 Nursing Myths Debunked

Sacred Cows in Nursing

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Sacred Cows

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.

 

Related links

Debunking Nursing Myths, Sacred Cows and Identifying Barriers to Evidence-Based Nursing Care 

and Debunking Reverse Isolation.

 

Please be sure to check and follow your own facility’s policies and procedures. Requirements may vary by state.

Until next time friend,

Beth

Author “Your Last Nursing Class: How to Land Your First Nursing Job..and your next!” 

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

About Beth Hawkes (144 Articles)
Nice to meet you! I'm a Nursing Professional Development Specialist in acute care, a writer, speaker and career columnist.

3 Comments on 5 Nursing Myths Debunked

  1. The blood glucose point isn’t necessarily true. In my hospital, there is a policy that all bedside Accuchecks must be repeated if they’re out of range. Yes, it might seem illogical, but the point is that nurses are still doing it in some places. Not because they want to, but because that’s policy.

    • I hear you! We went to the Clinical Practice Committee to get our illogical procedure changed. Another thing we did
      was to do away with double checking subq insulin.

    • Do you have a clinical practice committee where nursing practice can be discussed? Often we do things because “that’s the way we’ve always done it”

2 Trackbacks & Pingbacks

  1. Debunking Nursing Myths, Sacred Cows and Identifying Barriers to Evidence-Based Nursing Care - nursecode
  2. Debunking Reverse Isolation - nursecode

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