Do you actually wear gloves/gowns/masks ?

[Nepenthe Sea]

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!

[RedhairedNurse, BSN, RN]

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...

perfectly said!! Common sense!!!

[JJGRN]

Well if you're in nursing long enough you're gonna be "colonized" with MRSA... Especially in the nares. If I just go into spike an IV I don't get all dressed ready for the Ebola virus! Staph aureus or just plain Staph is a bacteria found on the skin of everybody.

Michael

Michael,

When we first started swabbing all of our ICU admissions, we also swabbed 50 ICU nurses because we heard the same excuses from them about not needing to wear PPE "because we were all positive anyway." We only had 1 come back positive. While staph is found on skin, resistant staph is not. Why would you want to expose yourself, your other patients, and your family to this MDRO?

[pj4854]

I'm just curious, what do you consider "immediate" environment? I think if there's a rule, follow it everytime with everyone.

[pj4854]

I'm with you on that one - save the "U" learn "2" . . . "ur" for texting your kids.

[merrywhiterose]

It depends. If the person hasn't had a positive test lately, no. Sometimes the doctor doesn't verify it even though tests do, that it's negative. If the person is positive, I sure wouldn't take the chance of NOT wearing protective equipment, and bringing home something to my family!

[landesmummy]

Yes every single time...so many of my pts are positive for everything and i'm not bringing unwanted visitors home to my hubby & kidlets...i don't even take vital signs w/o gloves...and yes, everything keeps coming back negative so i'm doing something right unlike half of my classmates who keep getting sick and won't wear gloves or they rationalize well, i'm just clearing a pump or i don't need gloves, yeah right...when i pick the children up from school, the rules are: absolutely NO touching until after i shower, uniform sprayed before i get into the car as are clogs which then live on my front porch, uniform washed STAT in sterilize cycle & me out of the shower looking like a lobster!!once dressed, then its time for cuddles!

[JohnR,RN,CMSRN]

in my state, the hot water temp for residential use is too low to be of any use....and in all likelyhood would not ammount to much dif. sunlight may be more helpful.....and do you have washable shoes or do you leave them at work?

Water temp has NOTHING to do with antiseptic hand washing as per the CD ...it ALL has to do with the soap and TIME you actually wash your hands...just FYI

[futoi mia]

i am a forth-semester nursing students. my lecturers and clinical instructors always stress on how important PPE. i always practise them to protect myself and my family, just like what others said. we can't do anything if others don't practise PPE, you can ask them "do you need gloves", if they don't then you wear it yourself. you have remind them but they still prefer working unprotected, then you can't do anything else, don't you?

[czarabian]

I was a nurse for over 30 years. I remember the days when we didn't wear gloves to do "routine" things like empty bedpans, give oral care and suction patients. UGH!!!! I can't believe I wasn't always sick although I did always wash my hands. I followed ALL precautions when working with patients in isolation (just like I was taught in school) even when others did not. When AIDs came along and we started wearing gloves for IV's etc. I was a real stickler for that too. I helped train paramedics for awhile and I told them that if I ever caught them starting or DCing an IV or drawing blood without gloves that I would kick them out of the program! It is not just YOU that you are protecting. It is every person you come into contact with and every person that person comes into contact with! What possible reason would you have for risking anyone's heath, or life for that matter???? It takes too much time to put on all that stuff? I'll just run in really quick and I won't breathe? I won't touch the patient? Give me a break. It only takes one little germ/virus carried to the person unable to fight it that will cause unknown harm. Do you really want to be the person responsible for that? How can anyone in the health care (read the CARE part again) be so arrogant or ignorant?

[JennNJ83]

Good question, I've seen nurses who do and don't, among other things and its confusing when we are taught one way and we see the complete opposite in the clinical setting!

[JennRN65]

I wear all of the appropriate items required for isolation, whether it is a rule out or known case. I have been a nurse for 16 years. There are some shortcuts that are not worth it - it doesn't take a long time to put on a gown/gloves/mask.

[JJGRN]

Good question, I've seen nurses who do and don't, among other things and its confusing when we are taught one way and we see the complete opposite in the clinical setting!

Well said. Imagine how confused our patients and families must be, seeing different caregivers coming in to the room with or without PPE. I've actually heard one patient remind her doctor that he needs to wear a gown and gloves when entering her room. It was great!