If nothing else, 2020 taught the healthcare community to appreciate fact versus belief. Across the globe, we all faced the same challenge. A novel coronavirus first identified in 2019 was going to invade our countries, our towns, our homes, and our lungs. In more than 190 countries, healthcare providers, politicians, administrators, shop owners, clerks, and clergy all anticipated, planned, and prepared. In 190 different ways, they responded to COVID-19. Predictably, 190 different interventions were not equally effective. Some countries were devastated, whereas others were relatively spared.
In early 2020, people examined what meager evidence we had about COVID-19. They summarized the evidence and acted on the belief that they had the best plan. However, the virus did not care what they believed. Those who got it right had fewer infections and less death. For the most part, those who got it wrong incorporated new evidence and adjusted their plan. Moreover, the smartest medical teams, hospitals, towns, states, and countries that had the best results also adjusted their strategy based on new evidence. Across the planet, we incorporated each newly published piece of evidence. Slowly, the 190 different approaches to battling COVID-19 began to look more and more similar: physical distancing, masks, hand hygiene, proning, testing, tracing, monitoring, convalescent plasma, and so forth. The accumulation of evidence steadily forces us to change what we had once believed true and adopt new beliefs.
It is the weight of overwhelming evidence that gives me hope for neuroscience nursing. In 700 BC, early Romans were not wrong to believe that the earth was flat. In 650 AD, Vikings were not wrong to believe that animal sacrifice would please Odin. In 1750, doctors were not wrong to believe that fever could be cured by bloodletting. In 1986, nurses were not wrong to believe that they did not need to wear gloves when placing an intravenous catheter. However, over time, the accumulation of evidence forced us to abandon these beliefs. In 2020, we know the earth is not flat, animal sacrifice does not work, blood is important to carry oxygen, and gloves reduce infection risks.
Having learned my lesson that even disco cannot survive the test of time, it comes as no surprise that much of what we believe today will likely be abandoned. Here are 7 of my predictions for beliefs that we will be abandoned by the year 2100: (1) Staffing should be 2:1 for critical care and 5:1 for regular wards, (2) nurses should work 12-hour shifts, (3) stroke patients must stay in bed for 24 hours, (4) coma cannot be cured, (5) documenting a Glasgow Coma Scale score for a post-open-heart patient counts as a neurologic examination, (6) the electronic medical record is a good source for research data, and, my personal favorite, (7) draining cerebrospinal fluid is a good idea.
What do you think? What evidence-based practices from today should we examine or reexamine next? What evidence do you have to share? The Journal of Neuroscience Nursing is an open platform for you to convince the world that we can do better. Prove me wrong or prove me right, but either way, share your evidence.
Dr Olson declares that he is the editor of the Journal of Neuroscience Nursing.