Have you ever asked one of your nursing colleagues for an explanation regarding the rationale for performing a procedure or administering a medication in a specific way and heard the response, “that is just the way we do it”? Have you been informed by one of the senior nursing staff, “because that is how the doctor has ordered it”? Having heard those answers multiple times during my nursing career, I now like to designate those types of query responses as “nursing myths.” A myth is defined as “an ill-founded belief held uncritically by an interested group” in Webster’s dictionary.1 In other words, a myth is using an approach in the delivery of patient care that is unsupported by evidence-based practice. In a previous column published in the Journal of Vascular Nursing, it was noted that evidence-based practice uses external confirmation as the guide for deciding whether to support nursing decisions in delivering individualized patient care.2 Although research is typically the method used to validate a particular nursing practice, it is not the only way. As a Critical Care Clinical Nurse Specialist developing practice guidelines for my institution, I have attempted to use research findings as the springboard from which to derive educational materials, protocols, and algorithms. The use of research findings provides a basis for critical thinking—not uncritical thinking and not myths. Delving into these various studies during the development of the protocols increased my interest in the research process and led me to begin the pursuit of a doctorate in nursing. One of the nursing guidelines being developed involved the postoperative care of the patient after lower extremity peripheral artery revascularization. Recent statistics indicate that in 1996, approximately 95,000 lower extremity peripheral arterial revascularization procedures were performed in the United States to restore circulation to the ischemic limb.3 After surgery, the maintenance of blood flow and tissue oxygenation to the revascularized limb was a nursing responsibility. Furthermore, extremity positioning was the usual method to promote optimal circulation. My question was, what is considered the best position in which to place the revascularized extremity? While writing the nursing guidelines for my institution, I found different recommendations in various nursing references. Smeltzer and Bare,4 Lewis,5 and Gulanick et al6 advocated extremity elevation as a standard. Fahey and McCarthy7 and Herbert8 recommended limb elevation when postoperative edema is present. Urban et al9 and Maxwell-Thompson and Yuan10 did not address the postoperative peripheral vascular surgery limb position. These differing recommendations, or lack of recommendation, led to further questions. Was there an optimal limb position that would maintain tissue perfusion in the revascularized extremity? Were these examples of nursing myths? Was there research that measured the lower extremity response to position changes after arterial revascularization surgery? These studies would provide the quantitative data or evidence to support the nursing practice. A literature search was initiated in an attempt to resolve these questions. I have been enamored with technology and its ability to help incorporate findings in a plan of care since my first staff nurse position in a combined intensive care unit/coronary care unit/cardiovascular unit. Consequently, my focus became twofold. The first purpose was to uncover studies that provided an answer to the question of optimal limb position after peripheral vascular surgery. The second purpose was to identify a physiologic instrument used during these analyses that easily and noninvasively measured the revascularized lower extremity tissue perfusion. Through these findings, I hoped to clarify the research questions that could answer this issue and that would be further pursued during my doctoral nursing work. Results of the literature review revealed several items. First, there was a paucity of research regarding extremity positioning in the patient after peripheral arterial vascular surgery. Second, a number of these studies used the technique of transcutaneous oxygen measurements (also known as TcPO2 or TCOMs) to noninvasively ascertain the underlying tissue perfusion. This method uses a heated electrode that is placed on the skin. Simplistically, the epidermal warming “arterializes” the underlying dermal capillary blood flow through arteriolar vasodilation, decreased dermal capillary resistance, improved diffusion, and a shift in the oxyhemoglobin dissociation curve.11,12 Reliability and validity of the TcPO2 measurements had been established by multiple researchers.13-15 If a patient had lower extremity periphKathleen Rich, MS, RN, CCNS, is a Critical Care Clinical Specialist for the Methodist Hospitals, Inc, Gary, Indiana.