Do you actually wear gloves/gowns/masks ?

Nurses General Nursing

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I am a second-semester nursing student, and just finished my first clinical rotation at a local hopsital. I know that nursing school is different from the real world, and that working nurses will do things differently from what we were taught in school. But I am just wondering if you guys actually use your gloves/gowns/masks when a patient is on special precautions. At the hospital where I was assigned, I had patients with VRE, MRSA and C-diff. All of them were on contact precuations and one also had droplet precautions. NONE of the nurses caring for these patients wore anything besides gloves. My friends that were assigned to a different hospital said that they encountered the same thing, except that alot of the nurses there didn't even wear gloves. Is this pretty common in the real world? I know that Medicaid and/or Medicare has decided that they will no longer reimburse for treatment of hospital-acquired infections, so it seems like everybody would really be using their PPE. I personally have two small children and the last thing I need is to expose them to any of this stuff, so I used the gowns and masks. Do you just quit being afraid after awhile, or are there just alot of careless nurses where I live? Please don't flame me, I'm just asking for an honest answer.

Thanks!

I worked in Oncology and I needed to protect my pts from ME as many were neutropenic. I wore gloves EVERY time I went into the room!

I would hear them explaining why they needed more, as if somebody might be getting on to them for having the nerve to ask for more supplies.

It's ALWAYS a battle getting restocked. And then getting them from the box to somewhere near the rooms. When you think, you've got say a cart for 3 rooms, and you can only fit a couple packs on the cart, and then you think of all the people going in the room, then I'm supposed to wear them for my hourly rounds, you run out hourly! Heck, let the MD with their posse of residents and students go in, that's 2 packs of gowns there!

Our hospital has asked with H1N1 being the hot diagnosis to limit people in the rooms. So residents and students are supposed to be limited. But when EVERYONE is on precautions, (and being on a germy floor, pretty much everyone is), well that's not working.

Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.
I do the same, taking off my scrubs in the garage and they go into the washer as mine has a "sanitizer" mode (most newer washers as I bought this one specifically due to the sanitize mode) and into the shower myself before I do anything else. Water is heated much hotter than what my tap can do. I also take my shoes off at work, bag them and they are left in the garage until my next shift. I wear crock brand shoes so it's easy to stick them in a 10% bleach solution also when a blood spill occurs. I've worked in Burn ICU and Dialysis of which strict PPE is utilized - gown, gloves, mask, etc. Even with all the PPE I still would do my end day routine. If CMS came in and you arent following the appropriate guidelines the facility would be heavily cited.

My shoes go right in the washer (rubber clogs, NO HOLES IN THE TOP OF THE FEET--the thought of blood getting all over them...ew)on sanitizer mode.

People don't realize these precautions are truly, truly important.

And don't ONE dare to walk into a transplant unit (CVI, SI) without putting on the PPE. Not only cited, but probably BEAT up by Nurse Ratched of Infection Control.

Specializes in Pediatrics, Ob/Gyn.

Always wear PPE when needed. Contact, droplet, and airborne precautions are not just to protect you, but they are put in place to protect the other patients that are not infected. It is so easy to transmit microorganisms to other patients and to other parts of the hospital. You also mentioned that you have children; the last thing that you want to do is to transmit something to them. So PLEASE always use PPE and wash your hands before and after patient contact.

You are asking for an honest answer, I want to know how many of you wear PPE in the grocery store, or to the gym or send your children to school with PPE? These people do come from the community, and they do return to the community with MRSA, VRE, etc. I'm not condoning entering rooms without PPE, however, there has got to be a time that you have entered a room without a gown on. I worked in a hospital for 4 years, and have been tested (both swabbed and blood cultured) for all of the "bugs" and have never come back positive, and I lived by common sense. I always put gloves on when coming into contact with an isolation patient, and gowned when getting personal with them in terms of assessment, peroneal care, etc. Most of the times their isolation was contained though, if they were c-diff, they had an FMS, if it was in their urine, they had a foley, a wound, it was dressed; etc. I now work in homecare, and I know that I come in contact all the time with patients who would be on isolation, and do not gown up when entering their home, because I wouldn't gown if I encountered them in the community. I wouldn't even know, and neither would anyone else unless it was tattooed on their forehead! Furthermore, it is the policy of the facility that I was employeed at (one of the largest, and most well known in the country), that when transporting an isolation patient, that no PPE is to be worn in the hallways, so if we aren't to be wearing it in the hallways, then really how important is it to wear it into the patients room if you are only going in there to speak to the patient and not touch them, or check and IV pump? Just being honest...

So to the people that ALWAYS wear their gowns and gloves EVERY SINGLE TIME they walk into a room, how many patients do you have in one day on precautions? And how often during the shift do you go in and out of each room? I'm just thinking, getting the gown out, putting it on, put the mask on, put the gloves on. Even if I'm moving fast with that and manage it in 2 minutes (assuming everything is actually at the door rather than having to hunt a new pack of gowns or masks or gloves.) Then taking it off, another minute. I frequently have days with EVERY ONE of my patients on contact or contact-droplet. And you know patients/families never give all their needs at one time. So get dressed, go in, do your thing, they ask for ice, you ask if there's ANYTHING ELSE, of course not, you go for ice (after taking off all the garb), come back, put on all the garb (because you MIGHT touch something else in the room as if we're incapable of knowing we're in a precautions room without our gown) take the ice, oh yeah, I need more towels, so take it all off, go get the towels, put it all on, take the towels, take it all off. Lather rinse repeat for all your patients. Checking on them at least hourly. There's not even time to assess or give meds once you do all the gowning and ungowning and gowning and ungowning.

I challenge any IC nurse to actually come and work the floor following the rules to the letter. I'm capable of walking in a room and not touching anything. And if I need to touch something, I'll get gloves, get gown, get what I need. But the time wasted putting it ALL on every single time because I just MIGHT lost control of my appendages and touch something could be better spent peeking in the rooms an extra few times per shift to do a quick visual assessment and make sure nothing's going wrong that needs an intervention. The nurses that I see that are most "compliant" with the letter of the law are the ones that look in on their patient just a couple times per shift. I'd rather risk a tongue lashing from the IC patrol than miss a change in patient status, especially since I'm perfectly capable of controlling my limbs when I walk in a room.

Furthermore, it is the policy of the facility that I was employeed at (one of the largest, and most well known in the country), that when transporting an isolation patient, that no PPE is to be worn in the hallways, so if we aren't to be wearing it in the hallways, then really how important is it to wear it into the patients room if you are only going in there to speak to the patient and not touch them, or check and IV pump? Just being honest...

It's vitally important, because the germs know when they're in the patient's room and when they're in the hallway. They only jump off the bed when it's in a room. They immediately go dormant when you're pushing the bed down the hall ungowned.:)

Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.
If the patient is in contact precautions, you must wear a GOWN and GLOVES (no exceptions)! What docs do is there business, and I do correct them without hesitation. Just FYI, I had a co-worker that was fired when an infection control RN caught her giving a cup of pills to a patient without a gown on... People are watching!

I had a surgeon scream bloody murder at me once for telling him to gown up before going in to see a patient. He was NOT going to do it.

I blocked him from going in..he tried the "I'm going to your NM, administration." line, and I told him, "Go ahead. You're still not going in this room without a gown."

Eventually, he caved....

I think it was more of a "woman-telling-a-man-what-to-do-thing" I must've reminded him of his wife....(ugh)....

Specializes in Haematology, stroke.

In Sweden we rarely use masks. Nowadays with the "new flu" scare people are a bit more paranoid though.

Gowns and gloves must be used when handling "dirty" stuff (making a bed, changing and such), not for just entering a room with a "normal" patient. If the patient is isolated (unknown diarrhoea, c.diff, MRSA etc) gloves and gowns must be used at all times.

Hands desinfected prior to and after each patient. Handwashing is not recommended generally because it dries out your hands. The handdesinfectant is moisturizing.

Work clothes are supplied by the hospital and must not be used outside the hospital compound. I can't imagine getting into my care or the subway with my "filthy" work clothes. Yikes. Shoes are not hospital issue, but cannot be used outside the hospital either.

I had a surgeon scream bloody murder at me once for telling him to gown up before going in to see a patient. He was NOT going to do it.

I blocked him from going in..he tried the "I'm going to your NM, administration." line, and I told him, "Go ahead. You're still not going in this room without a gown."

Eventually, he caved....

I think it was more of a "woman-telling-a-man-what-to-do-thing" I must've reminded him of his wife....(ugh)....

I remember early on as a student having a pt who had a horrible infection following a compound fracture of his leg. His orthopod rounded on him between OR cases-no gown, bare hands, in his scrubs...AAAHHH!

Specializes in CTICU.
You are asking for an honest answer, I want to know how many of you wear PPE in the grocery store, or to the gym or send your children to school with PPE? These people do come from the community, and they do return to the community with MRSA, VRE, etc. I'm not condoning entering rooms without PPE, however, there has got to be a time that you have entered a room without a gown on. I worked in a hospital for 4 years, and have been tested (both swabbed and blood cultured) for all of the "bugs" and have never come back positive, and I lived by common sense. I always put gloves on when coming into contact with an isolation patient, and gowned when getting personal with them in terms of assessment, peroneal care, etc. Most of the times their isolation was contained though, if they were c-diff, they had an FMS, if it was in their urine, they had a foley, a wound, it was dressed; etc. I now work in homecare, and I know that I come in contact all the time with patients who would be on isolation, and do not gown up when entering their home, because I wouldn't gown if I encountered them in the community. I wouldn't even know, and neither would anyone else unless it was tattooed on their forehead! Furthermore, it is the policy of the facility that I was employeed at (one of the largest, and most well known in the country), that when transporting an isolation patient, that no PPE is to be worn in the hallways, so if we aren't to be wearing it in the hallways, then really how important is it to wear it into the patients room if you are only going in there to speak to the patient and not touch them, or check and IV pump? Just being honest...

When I'm at the grocery store, I don't stop off to visit several immunocompromised patients on the way home. PPE is to protect your PATIENTS from YOU and having infections spread to your other patients (as well as to protect you). Most of my work is in ICU and transplant floor - there's no way I would want to think that I was responsible for giving one of my vulnerable patients VRE, acinetobacter, C. diff. etc.

Those who make the informed decision NOT to glove/gown, well you can take the consequences. But don't use "common sense" as a rationale - of course we aren't eradicating every pathogen, but it's a hell of a lot better than doing nothing due to whatever slacker reason.

Specializes in PICU/Pedi.
Honestly, if I am going in there real quick to ask something and its a contact room, I am not going to gown up. The doctors don't do it, why should I? :D

if its airborne its a different story. Then yeah I do all of it. But for contact unless I am going in there to mess with the patient then yes I will. :D

This I understand, and have done the same. But I am talking about someone who has MRSA and is on contact AND droplet precautions (pt. had pneumonia), and when I first encountered this patient, the nurses were giving a bath with gloves only.

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