Hit or myth message
I take a sharp intake of breath when I hear on the news that ‘research has been done…’
Scare stories about vaccination can have public health implications
Media health coverage can leave us wondering if tea, coffee, red wine or chocolate are good for you, bad for you, promote longevity or accelerate death.
Scaremongering has meant pockets of preventable childhood infectious diseases in some parts of the country because parents have been fearful of vaccinations. Some women, wary of developing thrombosis, have stopped taking their contraceptive pill, resulting in an unwanted pregnancy.
Social media also promotes confusion with the sharing of pithy ‘memes’ and cute animal pictures to advocate eating blueberries, or scaring people into only drinking bottled water instead of tap. The list is endless.
Although nurses are now more aware of the need for evidence-based practice, routines persist, and we seem to hang on to the traditions that appear to define us.
Take two-hourly turns. Where did this non evidenced-based practice start? It appears to originate from the first world war when orderlies were employed to change the position of patients. It took two hours to work through the entire ward, hence ‘two-hourly turns’ were born, which still persist today.
Nurses are reluctant to change this regimen in case a patient develops pressure ulcers. Fearing liability, their professional accountability makes them practice defensively and cling to clunky documentation tools that appear to promise a safe harbour in case of problems.
Another example is electroconvulsive therapy (ECT). The jury is still out on whether or not this works, but the Cochrane Collaboration – one of the last bastions of discovering gold standard evidence in health care – takes a guarded response in the systematic reviews of efficacy in older patients, or those with severe depression and schizophrenia.
Balance this against the plethora of anecdotal evidence that demonstrates how effective both patients and professionals find this form of therapy, and a multitude of crowds gather at each end of the spectrum of ‘for’ and ‘against’ arguments, with service survivor groups pitted against positive anecdotal evidence of the efficacy of ECT.
In his 2008 book Bad Science, doctor Ben Goldacre highlighted the medical quackery and suspect claims and counter claims about wonder drugs and superfoods. A short course in statistics is all it would take for the uninitiated to learn that we are often labouring under a delusion in many areas of health care.
Empowering ourselves with the tools and skills to analyse such information will improve the quality of care we deliver. When presented with yet another piece of nonsensical documentation that will take me away from caring, I simply ask to be shown the evidence for it, hoping the impregnable tower of Babel will collapse like the walls of Jericho.
But this is not easy, and we have a long road to travel before we can stand firm against tradition, routines and myths. We are at the beginning of an exciting journey. By becoming involved in research, having an open, inquiring mind and critically analysing our findings, we can empower ourselves as individuals and as a profession to find the best quality evidence for our patients.