No gloves ever?!?

[dizzyray822]

So I'm in my last rotation of nursing school and I followed a nurse in CVICU today. Well from the getgo he mentioned he's "old school" and that's fine with me. In fact I get excited when I hear that as I figure I'll learn a lot. Well... While this nurse let me do almost everything and I completely appreciate that experience, he didn't wear a pair of gloves the whole day. I watched him do peg meds, draw blood, suction, and clean a diarrhea bottom (touching testicles and all) WITHOUT gloves. I got excited at one point cause he pulled a pair of gloves out BUT THEN he handed them to me, none for him. In fact, when cleaning the poop he said "yeah, I know im being naughty." So, I thought that if he doesn't use gloves then he must scrub his hands. Nope, 5 second rinse, no lather...that's it. I was shocked....

Needless to say...didn't shake his hand at the end of the day.

[Lovely_RN, MSN]

It wasn't too uncommon at my previous job for a new resident to be diagnosed with things like scabies, herpes, or shingles after being admitted for a few days or weeks. Just because a person's genitals or other parts look fine initially doesn't mean that some newly caught infection isn't brewing and just waiting to manifest itself. Fine, call me paranoid but I can't see why a person would want to take the chance. Is that some sort of super nurse thing?

[nursel56]

I'm not saying that it would work both ways, but since gloves are standard today, I feel they are a "professional barrier" between us and patients.

Also, laws vary state to state. My state may very well be different from yours.

Things being what they are today as opposed to 25 years ago, I agree with you. Whether it is actually written down or not, the thought of STDs, superbugs like MRSA, the widespread news stories about professional people (teachers, coaches, priests, etc) and heightened level of awareness has changed the psychology of most people. Just like kindergarten teachers think twice before hugging a child nowadays. I don't think there is an actual law against it, but it makes you think twice, for sure.

Just wanted to let everybody know that when bottoms were cleaned in the pre-glove era there would normally be a nice thick washcloth in between your bare hands and the poop, and a folding process that minimized re-wiping areas and hand to poop contact. I don't think I've ever seen someone clean a bottom by just scooping it up. Picking up a scrotum with bare hands is unusual.

[heartflutter, ADN, BSN]

I would call your instructor and ask her to send you a copy of the state code that says that if you touch a patient's private area without gloves, that you can be charged with sexual abuse.

I would bet you $1 that she can't find it.

Some nursing instructors like to "dazzle" students with these types of BS stories that have no actual foundation in reality to get the "wow" looks from the students and to boost their own sense of importance.

Just know that if it doesn't make common sense, it is probably not true.

I am awaiting an answer from the DOH on this in my state, but if we define sexual abuse as "unwanted sexual contact" and a patient is OK with a nurse doing peri-care with gloves, but not without gloves on, I would assume such an act would fall under "unwanted sexual contact".

Regardless, old fashioned is not an excuse for stupidity and gloves should be worn at all times during such tasks.

[BabyLady, BSN, RN]

I am awaiting an answer from the DOH on this in my state, but if we define sexual abuse as "unwanted sexual contact" and a patient is OK with a nurse doing peri-care with gloves, but not without gloves on, I would assume such an act would fall under "unwanted sexual contact".

Regardless, old fashioned is not an excuse for stupidity and gloves should be worn at all times during such tasks.

Good Gosh..are you serious?

Do you really think that a glove vs no glove can make a difference of sexual contact?

So if a healthcare worker wanted to molest a patient with their hand, all they have to do is don a glove and call it peri-care and they are scot free?

Please let those on the abuse registry know where they went wrong.

Unwanted sexual contact is LEGALLY DEFINED as contact of any kind...glove or no glove!!!!!

I guess if you wear a condom, you are not guilty of rape either because technically, you didn't touch them.

[heartflutter, ADN, BSN]

Good Gosh..are you serious?

Do you really think that a glove vs no glove can make a difference of sexual contact?

So if a healthcare worker wanted to molest a patient with their hand, all they have to do is don a glove and call it peri-care and they are scot free?

Please let those on the abuse registry know where they went wrong.

Unwanted sexual contact is LEGALLY DEFINED as contact of any kind...glove or no glove!!!!!

I guess if you wear a condom, you are not guilty of rape either because technically, you didn't touch them.

You're making sweeping generalizations that I don't appreciate. I don't think you got my point so I'll just back down since I don't feel like hijacking the OP's discussion further with this topic.

[iluvivt, BSN, RN]

Now......... I DID NOT say go and call the guy an idiot. What I usually do for the record is pull a nurse aside and tell them what I saw that was unacceptable and believe me I see a lot b/c of my position. How I deal with it next depends upon the response that I receive. Some things that I have seen are so egregious that I decide to go to the supervisor immediately. Once I witnessed a very stressed male RN hit a elderly mean b/c he had soiled the bed and then the poor pt was so confused had put his hand in it. I immediately stopped the abuse and never gave that nurse a chance to correct anything. I called the house supervisor and shortly thereafter he was escorted out of the building.

In this case you can bet that nurse knows better. It is posted everywhere in hospitals..hand gel everywhere..hand foam everywhere...sinks everywhere....Joint Commission NPSGs everywhere...in staff meeting...in every nursing policy and procedure manual...NO so I do not buy it that it was just a slight little error The truth and reality of the situation is that nurse can KILL someones mother..father...brother.....son...daughter...SOMEONES LOVED ONE. All he as to do is not wash his hands and then touch a central line and oops the pt dies from overwhelming sepsis. So no I have no problem calling someone this careless with another life an idiot. Now if he was an idiot I had to deal with,,YES I would approach him..and then continue to watch him and if no changes I would then go to his supervisor. I would also write up an incident report. This student had very few options as I see it...do you really think that supposedly seasoned nurse would have listened to the student nurse? I would not care about anything that nurse had to teach me or anyone if he can not follow the most basic of nursing care standards.....As I am sure you know hand hygiene is the SINGLE MOST IMPORTANT thing a health care professional can do to prevent infection.

[llerkl, ADN]

While rounding recently on a surgical floor, I saw a medical student remove a patient's abdominal dressing WITHOUT gloves on! I was horrified! I looked for her when I was finished seeing the patient, but she was gone. I remain stunned and will talk to her about it if I see her.

[SkiMama]

I realize that I have a lot to learn. I am about to enter nursing school. I recall something called nosocomial infections being stressed in my micro class... um yikes!?!

No matter how little one minds personally contaminating themself with pathogens... are we not legally obligated to do our best to prevent passing them around to all of the other pts in the facility?

I suppose the lax viewpoint is why there had been such a rise in this type of infection in recent years. Holy cow.

[tdmaher]

I can totally relate to the OP. I did my first rotation in LTC, and not one pair of gloves... and no hand washing between residents either. (this includes stool) And we were given the line, "some people take short cuts... YOU are to follow protocols when you are caring for the resident". There were a lot of things I saw there that I did not agree with, and struck me as upsetting.

[noreenl]

Now I'm gossiping!! As a STUDENT we tell our experience at our post conference and how we felt about it. That's not gossiping. I have very strong gut feelings that what happened yesterday was completely wrong. COMPLETELY, no question about it. I didn't feel comfortable learning much from this nurse because of it. This feeling has never happened to me before but as far as I'm concerned I did that right thing by reporting to my instructor.

You absolutely did teh right thing and it was not gossiping if it was said in the context of post conference. That's where the good the bad and the ugly is discussed! just be sure that everyone remembers confidentiality of the patient and does not discuss teh details of post conference in the elevator or anywhere else!!!

[Rob72, ASN, RN]

Good Gosh..are you serious?

Do you really think that a glove vs no glove can make a difference of sexual contact?

So if a healthcare worker wanted to molest a patient with their hand, all they have to do is don a glove and call it peri-care and they are scot free?

Please let those on the abuse registry know where they went wrong.

Unwanted sexual contact is LEGALLY DEFINED as contact of any kind...glove or no glove!!!!!

I guess if you wear a condom, you are not guilty of rape either because technically, you didn't touch them.

As the use of gloves is "standard of care", touching the genitalia w/o gloves could specifically be construed as sexually oriented, and therefore sexual battery or assault. This would be without regard to patient consent, LOC, etc.. Some male OB/GYNs have been prosecuted for "unnecessary" and bare-handed exams, that while w/in standard of technique were determined to be overly frequent, or in the case of bare-handed, specifically sexually gratifying to the doc.

[RW23RN, BSN, RN]

Sometimes when we have been on the job awhile, we get a little bit lackadaisical about policies and standards. There are times that I run into an insolation patients room quickly to stop a pump without gown and gloves, and I shouldn't. Although I have gotten more comfortable doing assessments and such without gloves, working in an oncology unit has made me more diligent about good handwashing. However, gloves for things like bodily fluid or mucous membrane contact is a standard of care for a reason. The OP is right to be questioning this nurse's practice and if I were a clinical instructor I would think twice about having that nurse precept any more of my students. It is not ok. People do die from hospital (read "health care worker") acquired infections. And remember, as much as new grads and students learn from those of us that have been practicing awhile, we learn from them too. They are good reminders to us about the way things should be! Alot of hospitals are also encouraging their patients to be on the lookout for staff hand hygiene and to speak up when they don't see it. Its a growing focus and I think its only going to get more stringent in coming days.