12 Outdated Nursing Practices

Nursing advances because the practice changes. Techniques that were once standard get retired as better drugs, equipment, and evidence come along. Here are 12 interventions nurses used to perform that have largely disappeared, and why.

1. Rotating tourniquets

Also called congesting cuffs, these treated acute pulmonary edema from heart failure in the 1960s. The idea was to pool blood in the veins and reduce venous return, easing pulmonary congestion. Cuffs were placed on three extremities and inflated to 20 to 80 mmHg.

Why it disappeared: It was time consuming, diuretics and other potent drugs now do the job, and studies couldn't support its effectiveness.

2. The iron lung

The first widely used negative-pressure ventilator was developed by Drinker and Shaw in 1928. Often called the "Drinker respirator," it was invented by Philip Drinker (1894 to 1972) and Louis Agassiz Shaw Jr., professors of industrial hygiene at the Harvard School of Public Health. A handful are still in use in the US, and few nurses today know how to run them.

Why it disappeared: Modern and portable ventilators replaced it, and the polio eradication campaign removed its main use. The last case of naturally occurring polio in the US was in 1979.

3. Reusing catheters and syringes

Syringes were glass and catheters were metal, not the silicone used today. Because they were made of hard materials, they were heat sterilized and soaked in alcohol. Needles were reused and sharpened by hand.

Why it disappeared: Single-use disposable syringes became the standard after HIV and other blood-borne pathogens emerged. Reusable gear was replaced because disposables are safer, prevent cross contamination, and cost less than resterilizing.

4. Dakin's solution for wounds

Dakin's solution, sodium hypochlorite and baking soda, was developed during World War I and used widely afterward for bedsores and infected wounds.

Why it disappeared: It didn't entirely. Some institutions still use it, though many prefer antiseptics like povidone iodine.

5. Penthrane and Trilene inhalers for labor pain

Trichloroethylene (Trilene) and methoxyflurane (Penthrane) were popular obstetric analgesics in the 1900s, delivered through a calibrated, temperature-compensated vaporizer for PRN pain relief during labor.

Why it disappeared: They worked, but they caused maternal sedation and neonatal depression, plus vomiting and accumulation leading to renal damage. The adverse effects ended their use.

6. Sliding scale insulin from urine dipsticks

Before the glucometer, nurses collected a urine sample before meals to test for glucose and dosed insulin off the result.

Why it disappeared: Glucometers measure blood glucose far more accurately, so urine dipstick dosing is no longer recommended.

7. Antacid on pressure ulcers

Nurses once applied antacid to pressure ulcers, believing it sped healing.

Why it disappeared: Moist wound healing is now understood to be the ideal environment for faster healing.

8. Charcoal for foul wound odor

Nurses used to pack charcoal into gauze around an infected open wound to absorb the smell and supposedly speed healing.

Why it disappeared: Mostly it has. Some still use activated charcoal dressings, though infection risk is a concern in certain wounds.

9. Instilling saline during suctioning

Saline was thought to lubricate the suction catheter, loosen and dilute secretions, and trigger a cough.

Why it disappeared: Instillation was traumatic, and it didn't reliably elicit a cough, especially in patients with tetraplegia and limited diaphragm innervation. Studies showed it raises pneumonia risk by pushing bacteria deeper into the lungs. Mucolytics are now preferred for mobilizing secretions.

10. Cutting the Foley before removal

This involved snipping an indwelling Foley catheter to ease removal.

Why it disappeared: It's dangerous. The cut end can retract into the bladder under tension.

11. Milking chest tube drains

Squeezing, twisting, or kneading the chest tube to create bursts of suction and move clots.

Why it disappeared: It risks air leakage within the tube, causing irritation and tissue trauma around the insertion site.

12. Coca-Cola to unclog NG tubes

Carbonated soda was a well-known feeding tube unclogger. The acidity was believed to clear the blockage.

Why it disappeared: Acidic cola can damage the integrity of the NG tube and can worsen clogging by denaturing proteins in some enteral formulas. Water flushes or replacing the tube are recommended instead.

These practices are a reminder of the same lesson: keep improving, and give patients the best proven care available.