Best Practices: change is hard for those who "Do"

 I'm in nursing school. I also think a lot about "best practices." 

Best Practices is the idea that there are ways of doing tasks or skills that are "better" than others. It doesn't usually mean that there is ONE best way, but that ways we thought were best may be superseded by a way we had never learned nor considered.

Let's take a daily task like brushing one's teeth for example. At what point did we learn that, 1) brushing for 2 minutes is best and 2) that brushing the gums is essential? '

Filing your nails? Best practices says to file in only one direction, rather than back-and-forth that we often see (even in salons.) 

So when I'm in nursing school and at clinicals, I hear a common refrain: that there is book nursing, then there is the real world. And I'm highly skeptical.

Skeptical with this caveat: part of our initial education told us that, as a novice nurse, we will want to do things "by the book," but that when we become a seasoned veteran, we will know that there may be methods, procedures, or processes that we have customized through trial-and-error. 

My skepticism is this: there is an accumulation of knowledge from all of these seasoned nurses who learn things by this trial-and-error that work better than the way they were taught in school. Some of these nurses take that knowledge, do studies, publish those, which are then put into books that teach the new wave of nurses. 

In other words, shouldn't these seasoned vet nurses consider that there may be thousands of other seasoned vets who have figured out a hack to various daily nursing challenges that can be incorporated for the benefit of the patient, the nurse, and the facility? I have to think so. 

However, when in class, I brought up something that I'd learned in my book that wasn't introduced in our lab. The professor said that she only used that method for a specific instance that didn't come up very often. However, the book cited a nursing research paper that said that their studies (reports from nurses) showed significant reduction in pain for patients when using a certain injection method every time this process was done. Now, I'm not a nurse, but why isn't this thing (that's in the book that they're using to teach us) something that they know about?

Furthermore, when I've been in the clinical setting, I'm not seeing it done. It's something that we should be seeing (or feeling) when we get our COVID vaccinations. Yet, the pharmacists who have given me the shots are not doing this. 

We learn that brushing our teeth for 2 minutes has significant benefits. Washing our hands for 20 seconds has significant benefits. 

Being me, I also think about the number of things that we do during the day for which there are updated "best practices" and there's no way to keep up with all of them. Sigh.