Wearing scrubs in public...

[HappyNurse2005]

I was reading the paper this morning, and this topic was mentioned in teh "Ask Marilyn" column. The question and answer was this

"A question has been bothering me since I moved to a city that is home to some of the finest hospitals in the world. When I use public transportation, I see people wearing scrub suits to work. Is this acceptable? I had thought employees were supposed to change into scrubs provided at the hospital in order to leave outside germs at the door"-

and her answer

"You're right. I've noticed the same phenomenon in other cities, too. If those people are hospital employees they are endangering patients and should be reported to hospital authorities. Another growing problem is scrubs being stolen and word in other places, such as the subway, to convey an impression of respectability. Anyone seen wearing scrubs outside an appropriate environment should be regarded with caution"

What do you think?

WHen i was a student, so recently, we had to wear our scrubs into the hospital, we were told not to change at the hospital. Here I saw the OB nurses and OR nurses were the only ones who had uniforms provided to them to change into at the hospital.

[austin heart, BSN, RN]

My hospital only provides scrubs daily for the OR staff (we don't have and L&D dept). Once a year they give a free set of scrubs at your eval but the rest of them you must purchase from the hosapital as they have to have the hospital logo on them. I wear my scrubs to and fom work and I have been known to run an errand or two in them. Honestly, if I wore street clothes to work and then changed before and after my shift that would add another 20-30 minuets on to the 13 hours that I am already there. My time is my time and I don't think that it is worth it to do that. We don't ask doctors or visitors to change after patiant contact do we?

[markjrn]

You know who I look at with great caution? The store employees.

I firmly believe that the grocery-store worker who doesn't wash hands properly is spreading more germs than I possibly could.

Ever been to the cash register and have a cashier with a cold handle all of your food items, then give you change?

I agree.

"Would you like a little e coli with your pastrami?"

[pricklypear]

I don't usually rub my scrubs all over my patients at work. If I have a patient with a bad bug - like MRSA, I wear a gown over my scrubs. Otherwise, most of my patients are pretty clean.

When I go to the store after work, I don't usually rub my scrubs on things there, either. Except maybe the handle of the cart, which is already covered with 500 people's snot.

I have to admit, I have stolen scrubs to wear on the subway to "convey an impression of respectability." I'm beginning to wonder about Marilyn's actual intelligence.

[Salty1]

NOTHING will EVER stop that! The bakery lady once stopped me and asked me questions that should have been directed to her GYN doc.

I still love the response from an OB/GYN at a party once. He was there with his wife enjoying the evening and a woman approched him and started asking him medical questions. He suggested she remove her clothes, lay on the table (table with all the food spread out) and he would examine her.

HA! She was mortified. I was laughing so hard I thought I'd bust.

Any bets she'll never do that again?

For some strange reason, the public always seems to think it is okay to strike up a conversation with anyone wearing scrubs but who otherwise would not address the same person if they were in street clothing. On one occasion after finishing a tour in the ER I stopped at a diner in my scrubs, sat down at the counter for eggs and coffee. A wise guy total stanger in a booth called out loudly "Hey Doc! How many people did you kill tonight?" I replied just as loudly "Don't you remember me from last week when I treated you in the VD Clinic?"

The wise guy immediately got up, went to the register, paid his tab and hastily departed. The only other comment I received was from the waitress who said "Good for you!"

On the topic of wearing scrubs to and from work, note that attending physicians wearing suits travel from their office to see their patients in the hospital without changing clothing. Some don a lab coat, some don't.

[TennRN2004]

You know what came to mind first when I read the OP? I work in an ICU and we wear our own scrubs into work. I work nights, and I freqently dress in my scrubs when I get up in the afternoon and go out to run my errands in case I don't have time to change before work. How ridiculous is it for someone who sees me in Wal mart or at the bank to treat me with caution because I have my scrubs on getting ready to go to my job? I wouldn't look at someone in a tuxedo in the dollar store cautiously, and assume he stole the tux to look more important. I think the problem with the public and healthcare in general is that they do not understand what we do, at all.

[NurseFirst]

That's absolutely false. Handwashing is a proven way to prevent transmission of disease causing pathogens, so no one would advocate not doing that. Putting on your nice vest hasn't been shown to be an effective infection control measure (and again, if it were why would visitors not be required to change into a fresh outfit?). I work NICU and ALL parents have to gown over their clothes as an infection control measure, but you know what? Our ID doc says it's not necessary for most babies that can be held. We do it because we have always done it. That's probably the same reason for your school's vests. You'll find many nursing measures are not evidence based.

First of all, I don't fully agree with the idea of evidence-based practice. Scandalous, you say? Perhaps. But there isn't time nor money enough in the world to test everything--throw in a bit of "who paid for that research" (think of the cigarette companies) along with Mark Twain's very valid statement that there are "lies, d*** lies, and statistics," and you have some significant ammunition with which to question scientific studies. Further, I think "positive" proof is much more reliable than "negatie proof" (we know disease is transmitted thusly vs. we know that disease is NOT transmitted this way.) Scientific method is a useful tool, but there are limitations. Oh, and then, of course, you have to have a study that is significantly seminal to make a difference; otherwise, scientific studies can get bogged down in arguments about the experiment methodology, etc.

Sometimes we have to act on the PRINCIPLES that have been proven and then make logical conclusions from those.

Let's see:

Cas we agree that, if someone is in a classroom with people who have a cold, their chances of getting a cold are greater?

Hospitals are "supermarkets" of germs; you will find worse bugs in the hospital setting than in the general environment. ISTM that I heard the reason why nurses stopped wearing caps was because they were detected as being modes of transmission of bugs; and people have eyed physicians' ties as well. In fact, hospitals can be quite dangerous places for patients just because of the types of germs that live there--they are the worst of the worst.

You've only addressed one part of the equation: bringing bugs into patients. I don't think that's the worrisome part. The worrisome part to me is spreading germs that are more endemic to the hospital environment to others, outside.

But, if we take your original scenario, that of preventing spread of disease TO patients, I do know that Kaiser in my area had any patient coming in to the clinics who had a cough to wear a mask; and that I was told by my physician to not be around patients while I had a URI.

NurseFirst

PS Back in my undergrad days I did work with Electron Microscopy. To do some of the work, the staining and so forth, we needed to have triple-distilled water. We had the water, but at one point the water was "bad"--I don't recall the details--but I do know that it took them an awful long time to figure out what was wrong with "our" triple-distilled water--and these were Ph.D. scientists trying to figure it out. I guess that's another mythology about science--that we really have identified all the variables...

PPS FYI: I have a B.S. in Microbiology, specialty "med tech" (now CLS) option.

[Spidey's mom, ADN, BSN, RN]

We have a sign in our hospital and ER waiting room that says if you have an upper respiratory infection, please ask for a mask. :)

steph

[rach_nc_03]

this is idiotic.

on my current unit, i have a locker- I keep a change of scrubs in there (clean), just in case. if i get gross during the day and need to change, or have gotten semi-gross at work and need to run errands, I change scrubs. our lockers are so tiny you can hardly fit a purse and pair of shoes- god forbid it's wintertime and you need a coat.

on the unit where i'll be working as an rn, they have no lockers. it's an icu, and most nurses have their bag in a drawer under the room computer- there's barely enough room. we have a lot of problems with theft in our hospital, and i'm certainly not going to have my belongings stolen just because someone seeing me at the convenience store thinks i'm too stupid to change before i leave work if i have something hazardous on me.

[student4ever]

I don't usually rub my scrubs all over my patients at work. If I have a patient with a bad bug - like MRSA, I wear a gown over my scrubs. Otherwise, most of my patients are pretty clean.

When I go to the store after work, I don't usually rub my scrubs on things there, either. Except maybe the handle of the cart, which is already covered with 500 people's snot.

I have to admit, I have stolen scrubs to wear on the subway to "convey an impression of respectability." I'm beginning to wonder about Marilyn's actual intelligence.

Why must she (referring to whoever this bimbo Marylin is) assume that someone other than a nurse/medical professional/hospital employee have to have "stolen scrubs" in order to be wearing them?? Anyone can purchase scrubs online, or even at Wally World without having to show proof of a medical position. Not to mention that none of the docs in our ER wear scrubs 100% of the time; they're often wearing dress clothes, which I KNOW they don't change into/out of every time they enter or leave the hospital. One of the docs actually wears mocassins (sp?) as shoes, WITHOUT SOCKS!!! Until they make every patient and visitor scrub down in the decontamination room and wear masks, shave their heads to get rid of lice, and force every disgusting LTC facility in the area to notify the squad when a pt has MRSA/VRE so we don't treat them for two hours before finding out their MRSA/VRE status, I will continue to wear my scrubs (freshly laundered of course) and shoes (regularly scrubbed and sprayed with lysol) into and out of the hospital, and anywhere else I need to go before I have a chance to change. If people were really so germaphobic as to want nurses/other health professionals to spend approx 8 hours a day (on top of 12/13 hr work shifts) scrubbing away "germies" there would be no one outside of their houses running each other over with cars, hitting each other over the head with beer bottles, etc. Plus, if everyone carried around lysol and sprayed everything they touched, everyone would have such a weak immune system from not ever coming into contact with common bugs, we would all be dying from pneumonia and antibiotic resistant bugs because we all know that anymore, docs hand out a rx for abx for every sniffly nose, so we're all getting more and more resistant to abx treatment. Just my vent for the day.

[Fraggle]

Marilyn is a columnist with a really high IQ. She used to do only trivia and mind game type questions. Now she also does advice and other type of questions. Whenever she strays from mind and logic puzzles, it's pretty obvious that her high IQ doesn't always equal perspective or sense.

[RosesrReder, BSN, MSN, RN]

NurseFirst...

Nobody said that, they didn't even infer it. Actually, the topic hasn't even been discussed in this thread unless I missed it.

I think it's okay to give the nurses here just a *little* more credit than that.

I AGREE. EVER BEEN TO YOUR LOCAL SUPERMARKET'S DELI AND WATCH THEM USE THE SAME SLICER TO SLICE LETS SAY ........TURKEY TO CHEESE TO RARE ROAST BEEF TO HAM TO SALAMI TO BOLOGNA TO CHICKEN TO PASTRAMI AND BACK TO TURKEY......IT'S NASTY.

NEEDLESS TO SAY, MOST DO NOT EVEN WASH OR CHANGE THEIR PLASTIC GLOVES IN BETWEEN HANDLING RARE ROAST BEEF AND THEN TO YOUR AMERICAN CHEESE

ANYHOW, THAT IS HOW IT GOES....

[SteveNNP, MSN, NP]

Hey all,

Here's my 2 cents:

Why is everyone so paranoid about germs? Haven't most of us developed great immune systems from being around sick people all the time? I wash my hands frequently, and before and after my shift. I lysol my badge, stethoscope and pens before I go. I wear PPE including gowns when caring for iso pts. I shower and throw my scrubs in the wash as soon as I step in the door. My shoes stay in the foyer.

MD's often wear disgusting bloodstained shoes (OR, L&D) and they actually found that their neckties cultured out MRSA!! They also don't wash their hands!

I've had visitors walking around my floor BAREFOOT! Coughing and hacking, but "I still want to see Grandma"

I am one of the culprits who wears "stolen" OR scrubs. Aside from them being comfortable and in good supply if I get junk on my scrubs, I work about 4-5 12 hour days a week and can't keep enough scrubs clean all the time to wear to work. The day housekeeping, dietary and pharmacy stop wearing their unnecessary scrubs is the day people will realize who their actual care providers are, and OR will stop griping about seeing everone in "their" scrubs. Like they are better than other nurses!!

The End of My Rant