Staff and artificial nails

Specialties LTC Directors

Published

More than half of my staff are wearing artificial nails with outlandish nail polish. This is not allowed per policy but the staff has gotten away with it for years. Not only is this against policy, but the risk of infection increases, not to mention the lack of professionalism. Any suggestions on how to enforce this?

Specializes in LTC, Hospice, Case Management.

A copy of the policy by the time clock to remind them. Make sure to list the reasons it is important to follow the policy, ie: infection control, injury prevention, etc - this sometimes makes people more compliant if they understand WHY the rule is being enforced. Give it a few days then give verbal reminders on a 1:1 basis...give it a few more days...then follow disciplinary procedure.

Specializes in acute care and geriatric.

This is a huge problems. Are you talking about nurses or CNA's (or both). Both categories should have been learned in training (nursing school or whatever courses they took) that this is not allowed for so many reasons (as you know) so it is just a matter of enforcing it. BTW the nails leave scratches and marks. Also- If you want to make an infection control inservice and send a swab of what is growing under those nails- it may be effective.

Nascar is right. It is a problem that they have been getting away with it for years. Perhaps you can say that the Board of Health is totally enforcing it so you have to- NO EXCEPTIONS. It depends on how respectful they are to your orders. You might have to send one or two home if they continue.

You can also give the recalcitrant ones the worst tasks under the guise of "with nails like that I cant let you...."

Good luck!

Specializes in LTC, assisted living, med-surg, psych.

I've always been pretty militant about the artificial nails---as we all know, they are a breeding-ground for bacteria, and most look atrocious to boot. (Would WE want a suppository given by a nurse or tech with two-inch long nails? OUCH!!)

Then when I took my current position, I walked into a literal culture of artificial nails. Maybe it's because I'm working in a big city now and women are expected to have them, but every time I bring up the subject, my staff all look at me like I just sprouted three heads. Lord knows how these girls afford them on the wages they earn, but even the older med aides wear them, along with glue-on rhinestones, decals, glitter---if it can be worn on a fingernail, they're wearing it.

So how do I get them to give up these things? I'm seriously considering asking Corporate to back me up on this and issue an edict, because even leading by example (I keep my nails relatively short and well-groomed, but wear trendy polishes and redo my manicure regularly) hasn't made a dent in the number of staff members with glittery talons for nails. And they wonder why we have so many UTIs in the building.......?

Specializes in acute care and geriatric.

I so agree with VivaL, I also wonder how they find room in their budgets for these nails, but I have learned that you cant argue with personal priorities and people have the money for that which they find important.

It is easier to deal with this when it is still a young problem and I think the only way of breaking it is an edict - if you are prepared for the battle that will ensue.

The more facilities in your area that join the edict, the better, so it might pay to call other facilities and do this en mass.

Specializes in LTC, ER, ICU, Psych, Med-surg...etc....

I was observing a med pass with a nurse who had nails on that I swear to you were three inches long and curled all under...they were artificial. Besides that, they were painted the loudest shade of neon reddish orange and each nail had these rinestone things all over them. She said "Oh I'm sorry about my nails, but I was in a wedding." Okay so this is Wednesday and when was the wedding? Last Saturday...hummmm... I know they must have paid a lot of money for those things, but they were so inappropriate and dangerous. However it appeared that she must have been used to them because she had no trouble popping those pills out of the packets with those daggers. I asked if she did treatments, and she said yes. How in heavens name could you not poke a hole in your gloves with those things and injure the resident? There is no regulation that says "you must not wear artificial or long dangerous curved all around daggers on your fingers..." but the facility had an infection control policy against it, so guess what happened? Normally I do not say anything about peoples nails, but in this case it was the most extreme thing I have ever seen.

Now that I think about it, how could you even get a glove on over those things? I should've observed her doing a treatment....

Specializes in LTC.
I was observing a med pass with a nurse who had nails on that I swear to you were three inches long and curled all under...they were artificial.....

Now thats inappropriate for work in any setting.

Specializes in acute care and geriatric.
Now thats inappropriate for work in any setting.

I have heard that argument used by some DNS's, the bottom line is to enforce the in house policies or close your eyes to it. You cant argue or appeal to the CNA's better judgment or common sense. This is the rule here, take it or leave it. You can try to soften it with some other 'reward'

I really cringe when I see a nurse insert a suppository with artificial nails and scrape up against a res. skin with them while providing care. I think an in-service and giving the staff 30 days to correct the problem as in having them removed then not allowing someone to show up on their first day of work with them on and sending them home will solve the problem.

Could do what our DON did. We don't have a policy against artificial nails only on the length of the nail (artifical or natural). She "gently" reminded each and every person that nails were only to be X long and that as that coming Monday everyone's nails would be checked she also stated that this was their "oral warning" next would be written. She was giving quite a bit of time for people to A) have nails removed or B) have then trimmed back. If during the check nails were NOT at policy length they would be cut by the staff themself OR be formally written up AND sent home without pay until such time they were trimmed back to policy length.

Monday came and I noticed quite a few of my team with the same long nails, I warned them at the start of shift cut them down now before she comes. They laughed me off. Well the DON marched up to the unit (toenail clippers in hand..did you ever try to cut acrylic nails with a nail clipper?? doesn't work..you need the big toenail clippers and even then its difficult). She did the nail check..and found that each and every person who she warned prior STILL had the same length nails. she said cut them right now or you're getting formally written up and you are being sent home without pay until the nails are cut!

Amazing, nails were flying left and right, nails being filed so they weren't like blades..it was like a nail salon gone crazy.

That lasted quite a while, nails were never longer than what policy dictated. Until, sadly, that DON left for greener pastures..then the nails were back..grrr!

Specializes in everywhere.

There is no regulation that says "you must not wear artificial or long dangerous curved all around daggers on your fingers..." but the facility had an infection control policy against it, so guess what happened? quoted from previous post

As a surveyor, there may not be a Federal regulation about fingernails, but CMS also states that facilities must follow state and/or local laws "whichever is more stringent". Go to the CDC website and follow their mandate on fake fingernails. Because tags can be written per the CDC guidelines.

Also, as a general rule of thumb, facilties policy and procedures are more stringent than the CMS regs. If the facility has a policy and procedure prohibiting fake fingernails or finger nail length, polish, etc......time to enforce it.

More than half of my staff are wearing artificial nails with outlandish nail polish. This is not allowed per policy but the staff has gotten away with it for years. Not only is this against policy, but the risk of infection increases, not to mention the lack of professionalism. Any suggestions on how to enforce this?

I'd take a multi-step approach but set myself a 30 day deadline for compliance.

Start by posting the policy prominently by the time clock with a notation that it is an existing policy that will be enforced and that compliance needs to be achieved by x date.

Incorporate discussion of the policy and the deadline into staff meetings, have each employee sign a copy of the policy and an attached memo that includes a deadline for compliance and the progressive discipline). Track down every employee who dodges the meeting, inservice 1:1 and obtain their signature.

This is a great opportunity to give everyone a brand new copy of the employee handbook (even better if it also includes the policy barring artificial nails on clinical staff) and have them sign an acknowledgment that they have received and read it.

On day 30 start sending people home, failure to comply by their next scheduled shift is grounds for termination.

Following a consistent and systematic process should establish progressive discipline.

There is a certain crowd that you're going to be unpopular with but infection control policies aren't optional, if they want to quit over having to remove their nails so be it, wish them well in their future endeavors.

Going forward include a seperate copy of the policy to be signed as part of every orientation packet (at least for the next year or so).

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