Out, Out, Damned Spot!

**VivaLasViejas**, ASN, RN

Although I came into this profession relatively late in life, I have been around healthcare long enough now to yearn for the "good old days", when nursing homes looked like hospitals and hospitals (and other care facilities) had squeaky-clean, shiny floors. I used to love walking down a hall where the tiles gleamed like pearls and no ugly stains could be seen to remind one of what sort of substances hit the deck on a regular basis. I miss the crisp, efficient sounds of rubber-soled shoes on freshly-waxed linoleum and the faint antiseptic smell of a well-scrubbed room. And while I'm sure walking on hard floors shortened my bedside-nursing career by several years due to the stress on my knees and back, it was certainly easier to push an occupied bed down to the ICU over a smooth surface than wall-to-wall carpeting.

The use of floor coverings in healthcare facilities---for all its cozy charm---has to be one of the worst trends ever invented. The stuff is everywhere now......in acute-care and skilled nursing facilities, clinics, doctors' offices, even long-term care. Yes, it makes the building seem more welcoming; yes, it's more "homey" than chilly, sterile tile. But I have to wonder what the powers that be were thinking when they decided to put carpeting in places where patients are incontinent of every possible bodily fluid, and where they drop food and liquids which produce stains that even the toughest industrial cleansers can't get out.......at least, not for long.

I didn't always loathe carpet in healthcare settings; in fact, for years I advocated it as an antidote to the cold and clinical appearance of most facilities. But the realities of working it are a "whole 'nother" matter entirely.

Take the one night when my son, the CNA, and I were working together on the LTC unit of a local nursing home. I'd gotten my med pass done and was charting my treatments when he came down the newly-carpeted hall with a resident perched on a shower chair, and he was hollering "MOM! I need you to come look at this!" Of course, I broke into a run because I thought someone had gotten hurt........but no, it was one of our two MR/DD residents, with poop trailing fifty feet behind her and the crowning achievement, a soft, extra-large BM, sitting right in the middle of the carpet like a comet with a long tail.

He did the best he could to pick up the mess, but after valiantly fighting his gag reflex for several minutes, he succumbed and gave it up, tossing his cookies unceremoniously in the nurses' station sink while both the resident and the rest of the staff howled with laughter. It would have been SO much simpler just to wipe things up with gloves and a few paper towels (well, OK, a lot of paper towels) and then mop the floor; but no........we've got to make things complicated and try to pick it out of carpeting with the texture of Astroturf.

Then there's the stain factor. Why is it that when something lands on a carpet in a healthcare facility, it keeps coming back to haunt you forever? Case in point: last winter, our company yanked out all the nice deep-maroon carpet that hid a multitude of sins and replaced it with a rough-napped, greenish-tan material that shows absolutely everything that's spilled, voided, evacuated, or otherwise deposited upon it. The maintenance staff extracts and shampoos it twice monthly, as well as spot-cleaning it PRN---which is sometimes every couple of hours---but those stains keep turning up like bad pennies. Housekeeping does the best they can; care staff tries to catch dribbles during meals; even the administrator has been seen standing over repeat offenders with a squirt bottle, muttering "Out, out, damned spot!"

When you're standing on the second-floor balcony overlooking the dining room, you can see every sip of soup, every spoonful of mashed beets, every overfilled glass of cranberry juice that's wound up on that carpet since it was installed.....from up there, it looks like a bad map of L.A.

Which is sooooo not-impressive when a prospective resident comes in to check out the facility. I'd been unaware of how bad the carpet really looked until a few weeks ago, when a tour came in and both my boss and the marketing rep were at some Chamber of Commerce deal. Since I was the only manager on duty, I was elected by default, which didn't thrill me because I'm a nurse, NOT a salesperson, and I couldn't sell a space heater to an Eskimo. But I digress.

I've always loved that upper-story view of the dining room with its lush appointments, its elegant chandeliers, and its generously proportioned picture windows; it's a gorgeous sight, and on the rare occasion when I do give a tour, I show it off, and most people comment very favorably on it. Unfortunately, this potential customer just happened to be a prominent state representative who was looking for a place for his mother......I still blame that stinking carpet for losing the "sale" to another assisted-living facility, which presumably made better choices when it came to flooring. Feh.

Now, if we had nice wood-grain floors, like another facility I worked for a couple of years ago, we'd have both form AND function---what a concept. So when the topic of changing the carpet came up last fall, I suggested this practical and attractive alternative....only to meet with utter disapproval on the part of Corporate. Actually, they pretty much laughed me out of the room when I mentioned it. "Our residents want a homelike environment," the "experts" reminded me. "Nobody wants bare floors and bleach smells in their home."

Ho-kaaay, well, it's hard for me to believe they want floor covering that looks (and smells) like 80 toddlers peed, drooled, and smooshed their strained carrots on it, either, but far be it from me to question marketing people!

I don't mind the carpet in the lobby and the hallways. It does make the building appear warmer and friendlier, and it muffles the institutional sounds of walker wheels and orthopedic shoes. I'm not as big a fan of carpet in the residents' apartments for the obvious sanitary reasons, but the rooms are their homes; and if they'd rather do their frequent face-plants on a nice cushioned rug than a hard floor that doesn't 'give', I'm all for it.

It's those ugly patches of black and brown stains that stretch from the med room to the mailboxes, the break room to the kitchen, the dining room to the patio out back that alternately fascinate and repel me. I wonder what, exactly, created those stains and what, if any, diseases they contain; and I avoid walking on them, thinking (as nurses are prone to do) that I don't want to take any of it home to my family and pets. If I start feeling nauseated, I automatically ask myself if I might have stepped in the area where RuthAnn horked up a plateful of chicken a la king earlier in the week; and when one of the staff tells me that Bobbie's catheter sprang a leak during lunch, I'll raise the maintenance man on the walkie-talkie and get him down there with the extractor before the yellow peril has a chance to do its damage.

Bottom line: The "eew" factor is very prominent in these misadventures, and to my mind carpeting serves mainly to reinforce the theory that the world is literally teeming with pestilence. But I have to confess that while I've been a germophobe by trade for many years, it's gratifying to hear residents and staff alike admit that they used to go by the 5-second rule for food and meds dropped on the floor, and now that they're here, they don't do it anymore. Hmm.......can't imagine why.

Out, Out, Damned Spot!

About VivaLasViejas, ASN, RN

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