My humble answer: You are right to suction with reservation and to question any suction order. Yet if a patient absolutely needs to be suctioned, then you have no choice in the matter. I was taught a method that should always be followed when NT suctioning that makes the process easier for you and for the patient, and prevents trauma to tissues.
Follow the following technique and you shouldn't have to worry if the patient is a bleeder or not:
1. Always insert a nasal airway prior to NT suctioning. Nasal airways are soft and easy to insert. They actually make it easier to insert the suction catheter, and also prevent the catheter from nicking the nasal passages (you'll have to lubricate the suction catheter before inserting it).
2. Never go all the way down to the corina. Hitting the corina with the suction tubing can cause trauma, bleeding, and if done often enough it can cause necrotizing tissue.
I hope this helps
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