Looking for opinions here on an *older* RN's habits

[GeminiTwinRN, BSN]

OK. I am a new nurse, and last night I was precepted by an *older* RN, who has many years of experience. I took 2 pts, and she took 2, then we admitted a transfer from CCU. (I work ICU step down). Anyway, she asked me to assist her in bathing a VERY LARGE woman before I even had a chance to assess my 2 pts. I agreed, because hey, I'm the new RN, and she needed my help. While bathing this woman (450 lbs), the older RN wasn't wearing gloves. I was. During the bath, the RN told me that *she* never wears gloves during pt. care because she believes it is de-humanizing to our pts. She said she came up during a time when gloves were considered a no-no. I wouldn't have minded her explaining herself, except that we were in the middle of the bath, and I felt like the pt. might think I was being de-humanizing to her because I had gloves on. Course, I didn't worry enough to take my gloves off, lol.

Thru the night, I swear, I never saw the RN wash her hands. Not even once. One of my pts. required trach care. We didn't have the appropriate shiley inner cannula in stock, so I donned my sterile gloves and proceeded to do the 1/2 saline, 1/2 peroxide scrub, and rinse in saline. After scrubbing, the RN said "here, let me show you my technique when inserting the cannula". I held out the cannula in my sterile gloves, and she took it from me in her bare hand, and inserted it. I was shocked. Remember, I have never seen her wash her hands! And I was looking. I watched her closely, just to make sure that she wasn't doing it when I wasn't looking, like in a pts. bathroom or something. She certainly didn't do it the entire 12 hr shift out in the sinks on the unit.

Now, if this lady wants to use her bare hands to wash a hoo-hoo, that's for her to decide. But I am looking for opinions here. I just can't imagine that in this day and age of super bacteria, that an RN wouldn't be careful of transmission from one pt to another with this practice. If she washed between pts. and used sterile gloves when appropriate, I would just shrug and think she's only endangering herself. BUT .... :trout:

Am I over-reacting here? Does it matter?

Keep in mind this RN was charge for the night, and is well-respected on the unit, loved by the pts, and I certainly have nothing negative to say about her other than this one issue! She was a wonderful, patient, considerate preceptor. I learned a lot from her. I don't want to sound like a know-it-all new grad, I'm honestly looking for opinions here.

[CHATSDALE]

i never heard of this whatever the age of the nurse, i don't think that her age had anything to do with it

this is dangerous to anyone she comes in contact with including herself and all the patients

your decision now is on the line...before i report her i would talk with her and ask her to wear gloves..ask her if she is allergic and if so she can be provided with allergy-free gloves but this cannot continue

[PANurseRN1]

Perhaps this should be discussed as one nurse's bad habits, and not picking on "older" nurses. Just as you would take umbrage if the bad actions of one "new" nurse were then used to categorize the whole, I take great offense at the same being done to older nurses. It happens here repeatedly, and it is sickening.

[GeminiTwinRN, BSN]

Just to clarify, the only reason I even mentioned that she is an older RN is because I have read on this very site that in previous times, it was considered disrespectful of health care workers to wear gloves when doing pt. care. I certaintly wasn't disparaging her age.. :) Her experience comes from a time when this must have been the case.

And I am not even considering reporting her. I am just looking for opinions. I would never dream of reporting a more experienced RN on a unit I have worked on for barely 2 months, and being a new grad and all.

When I went to get my size sterile gloves for the procedure, I asked what size she needed. Her response was "oh, I just wear whatever size is around". There was a pair of 6 1/2's in the room, I just figured she meant she would wear that pair..

[TazziRN, RN]

"wash a hoo-hoo".....?

Sorry, never heard that term before!!!

The part about not wearing gloves I can understand, it took me a loooong time to get used to doing some things with gloves on (washing a hoo-hoo was not one of them, though!), but not washing her hands? That's something that even older nurses were taught! Florence Nightengale, remember?

[PANurseRN1]

I've been an RN for 22y and never has this been considered acceptable in my experience.

[Myxel67]

long-time nurse or not, what she is doing is not good nursing practice and violates hospital infection control rules. she's not setting a good example for those she precepts. does your manager not know of her bad habits?

at home when pt and or family members do trach care or straight cath,

these are clean procedures. but in a hospital....this nurse is puting her patients at risk.

[Myxel67]

Why not just ask her why she doesn't use sterile gloves for trach care? Or why she doesn't wash her hands "more often"

[Lacie, BSN, RN]

I'm a long time nurse of 25 years and it has nothing to do with her being on "older" nurse. It's more just simple laziness and ignorance. Back in the day yes we didnt always wear gloves during baths or even starting IV's. We did always wash our hands before care and after care also. I never changed out or did trach care without use of sterile technique either even 20 years ago. Most of the time unless it was something just horrid we didnt but times have changed! We now know much more in relation to infection control and nosicomial risks. What this RN is doing is outright dangerous and with neglect in my opinion. Also next time she ask you to assist with a bath, you need to assess your own patients first and if you have the time when your work is caught up then give this type of assistance...with gloves I may add lol.

[GeminiTwinRN, BSN]

At home when pt and or family members do trach care or straight cath,

these are clean procedures. But in a hospital....this nurse is puting her patients at risk.

Thank you! I had completely forgotten about the fact that trach care and/or straight cath procedures are done "clean" and not sterile when in a home setting. Even dressing changes that we do "sterile" are done "clean" when done in a home setting. This is exactly the kind of response I was looking for. You're right of course, that when in the hospital (and especially with a new trach I would guess) we do things differently than at home. I hadn't even considered this POV. :) Of course, you're right when you say that we weren't in the home setting, we were in the hospital, where those types of procedures are done with sterility.

Thank you for the replies so far. They really help!

As to whether or not the NM knows of this RN's practices, I'm sure she does. It's not a new thing for her. A couple of the other RN's working last night warned me to watch my food closely. I was told that she has a habit of putting her hands in other's food (ie, popcorn), and then suddenly she has the rest of whatever she put her hands in as her habit is well-known to others. :uhoh21:

[P_RN, ADN, RN]

That's a fact, before AIDS swooped in people like ostomy and wound care nurses taught classes about how dehumanizing it is to put a barrier (glove) between you and the subject. Stomas cleaned and bags removed and reapplied bare handed.

That changed quickly when it became obvious there was heck to pay in the super-bug supply.

In the olden days of trachs I saw a chief resident pick up a patient's obturator from the floor wipe it on his handkerchief then wet it from the tap. He said that's how he was taught. (Not a discardable one).

But as far as Ms Dirty hand you need to push this up the food chain. What if she leaves cooties on something you use next? She needs hand hygiene training.

[GeminiTwinRN, BSN]

Why not just ask her why she doesn't use sterile gloves for trach care? Or why she doesn't wash her hands "more often"

Mostly because I don't want to look like a smartie-pants as a new grad, I guess. She obviously has waaaay more experience than I do, and frankly, I am in the learning process, and I don't want to appear like I'm second guessing her, or criticizing her practices. I am trying to absorb, certainly not wanting to look like a nit-picker.