Top 10 Nursing Practices That Are No Longer Approved
(A nostalgic, slightly alarming walk down memory lane)
I jokingly say I was practicing nursing when the dinosaurs roamed the earth but here are some things we did that we no longer do. I am sure you have some examples on your own.
1. Unclogging G-Tubes with Coca-Cola For years, Coca-Cola was treated like a medical device hiding in plain sight. If a G-tube clogged, nurses reached for a can, confident that carbonation and acidity would save the day. While this was historically common, evidence now shows that carbonated beverages and juices are inferior to warm water and can actually make clogs worse by curdling proteins in formula. The vending machine has officially been removed from enteral therapy.
2. Using Saline for Suctioning Instilling saline directly into a tracheostomy or endotracheal tube before suctioning was once thought to loosen secretions and make suctioning more effective. Research later revealed that this practice can cause hypoxia, increase infection risk, and add unnecessary discomfort. What felt helpful turned out to be harmful, and routine saline instillation is now firmly discouraged.
3. Shaving Pre-Operative Patients Routine shaving of surgical sites used to be standard pre-op care. The cleaner the skin looked, the safer the surgery—or so we thought. Evidence showed that shaving creates micro-abrasions that increase surgical site infections. Clipping, not shaving, is now the preferred method, and razors have been officially banished from pre-op prep.
4. Routine Gastric Residual Checks Checking gastric residuals on tube-fed patients was once considered essential for preventing aspiration. Nurses measured, documented, discarded, and worried. We now know that frequent residual checks do not reliably predict aspiration risk and can lead to clogged tubes and accidental dislodgement. Less poking, fewer problems.
5. Sliding Scale Insulin with Urine Dips Before glucometers became commonplace, urine dipsticks were used to estimate glucose levels, and insulin was adjusted accordingly. The problem? Urine glucose lags far behind blood glucose and is wildly inaccurate. Blood glucose monitoring has replaced this practice entirely, and urine dips have been retired to nursing history trivia.
6. “Milking” or Stripping Chest Tubes Stripping chest tube tubing was once taught as a way to prevent blockages and maintain drainage. Unfortunately, this practice can generate dangerously high negative
pressure, risking lung tissue damage. Current standards strongly discourage routine stripping, reserving it only for rare, provider-directed situations.
7. Routine Soaking of Feet for Diabetic Patients Warm foot soaks were once considered soothing and hygienic for patients with diabetes. We now know that soaking can macerate skin, increase infection risk, and cause injury in patients with neuropathy who may not feel heat or trauma. Modern diabetic foot care focuses on protection, inspection, and keeping skin dry and intact.
8. Reusing Needles, Catheters, and Other Instruments There was a time when supplies were reused after sterilization due to cost, availability, and necessity. Today, this practice is unthinkable. Reusing syringes, urinary catheters, or other single-use instruments carries an unacceptable infection risk and is strictly prohibited under modern infection-control standards.
9. Using Alcohol Rubs or Baths to Reduce Fever Alcohol rubs and baths were once used to bring down a patient’s temperature. While they appeared effective, alcohol causes vasoconstriction and shivering, which can actually raise core body temperature and increase discomfort. Evidence has fully retired alcohol from fever management.
10. Placing Antacids or Food Products on Pressure Ulcers At one time, antacids, sugar, honey, and other household substances were applied to pressure ulcers in hopes of promoting healing or controlling bacteria. These practices have been replaced by evidence-based wound care products designed specifically for tissue repair, moisture balance, and infection prevention.
None of these practices were done out of carelessness. They were done by nurses who were resourceful, committed, and working with the best knowledge available at the time. Nursing didn’t get safer because nurses were wrong—it got safer because nurses were willing to learn, adapt, and change. And that, arguably, is still the most important nursing skill of all.
