Health Care Is Constantly Evolving
It's hard to imagine that this could be an issue today, but there are nurses who believe that things don't change that much and that a technique they learned will always be correct. Never expect that what you learned in school will always be correct.
Take for example, newborns' and infants' sleeping positions. About twenty years ago, the theory was to place infants on their side or abdomen to sleep and to never place them on their backs. In this way, you would avoid any possibilities of aspiration. This was thought to avoid sudden problems such as Sudden Infant Death Syndrome (SIDS).
Recently, this whole theory underwent a drastic change, and now infants should only sleep on their backs, to avoid the dangers of suffocation. Now you never place them on their abdomen or side.
Nurses with many years of successful experience placing infants on their sides because of fears drummed into their heads that a newborn lying on his back might aspirate, may have great difficulty incorporating this new theory into their practice. Unless an edict from administration demands compliance, some nurses may avoid following new practices because they are uncomfortable with the findings.
Nancy is an LPN who received her training in the early 1940s. She is very confident about her skills and extremely knowledgeable. She has worked privately for patients for many years now, but has decided to return to per diem hospital work two days a week. Dr. Jules is leading rounds with a group of brand new interns when he finds that Nancy is about to inject a patient with an IM antibiotic. He jumps at the chance to have his students observe. However, he is appalled to watch as Nancy injects the patient in the lower right quadrant of her buttocks.
Nancy is indignant when Dr. Jules confronts her; she states that “is how she was instructed to give an IM medication and has always done so.” (How many patients have been subjected to painful sciatica as a result?) Apparently she has worked all these years for private patients and not been subjected to any skill checks. Her continuing education efforts have been focused on diseases and other aspects of care because she never questioned her skills. This is a rare but unfortunately true example, which nonetheless illustrates the point that techniques do change. Nurses need to keep pace with advances in techniques and procedures.
