Progressive Care Nursing Certification (PCCN) Practice Exam

If a nurse observes a colleague instilling saline in a patient's endotracheal tube prior to suctioning, what is the best response?

1. Report the colleague to the charge nurse

2. Document the practice for consistency

3. Request a review of suctioning policy by the physician

4. Collaborate with the colleague to review the evidence

The correct answer is: Collaborate with the colleague to review the evidence

Instilling saline into an endotracheal tube prior to suctioning, often referred to as "normal saline instillation," has been a subject of debate in clinical practice. The best response in this scenario is to collaborate with the colleague to review the evidence. This approach fosters a supportive working environment and promotes professional dialogue about the best practices based on current research. By collaborating, the nurse can discuss the rationale behind the practice, as some studies suggest that saline instillation may not improve outcomes and can potentially lead to complications such as decreased oxygenation or infection. Engaging in a discussion allows both nurses to review current guidelines, policies, and evidence regarding suctioning procedures, ultimately leading to improved care protocols and practices within the unit. This method not only enhances understanding but also helps to ensure that patient care is grounded in the latest evidence-based practices. Furthermore, it builds a culture of collaboration and learning among healthcare professionals, which is essential in a progressive care setting.