I like my job. I really do. I work in critical care at a large, well-known, awesome hospital. This is my first job out of nursing school and I have been working there for about 16 months. Unfortunately, I have pretty bad allergic contact dermatitis at my job. I have gone to a dermatologist that specializes in this and have figured out what I am allergic to. I started using new gloves and different soap, and while it worked for maybe a month, my hands are right back to where they were at the end of a shift: red, chapped, cracked, and they BURN so bad. And unfortunately, it doesn't just go away overnight. No lotion, cream, soap, glove, nothing seems to work to prevent this anymore.
The last thing I would want to do is leave my job, but I am at a point where this is really affecting my quality of life. I know this field is so diverse and there are areas of nursing that do not require so much hand washing and glove use as bedside nursing does, but with only being a nurse for 16 months, what are my options?
Your advice and just listening to me rant are kindly appreciated. Truly! Thank you.
If your issue is with the soap, there's a couple of things you could try. One is baby shampoo/wash that you keep in your scrub pocket. You could even try some organic varieties.
Another is unscented/dye free/sulfate free soap bars. That you keep in one of those travel soap cases in your pocket.
Sometimes, it is a matter of sulfa allergies gone wild. There are many products that have sulfates in them--Including shampoos--so it could be what you are using at home, exacerbated by what you are using at work. Also, laundry detergents from your clothes, etc.
Thinking totally outside of the box, is your pediatrician that saw you throughout your childhood still in practice? I have had the very best thoughts and remedies from some old school docs--especially ones who have seen me since I was a kid. Plus a pediatric allergist who is used to dermatitis that is prevalent in children and will "resolve" itself as one becomes an adult. Ask them what they suggest. And your pharmacist is also an amazing resource. Even one that compounds can make you a concoction that could work. I had a friend who had to use a dish detergent that was "free and clear" that worked.
Specializes in Psych, Addictions, SOL (Student of Life).
You do not in fact have to use an antibacterial hand soap - I am not allergic but I simply refuse to add to the problem of multi-drug resistant organism's. I have had a couple of conversations with infectious disease docs who agree that we do not need to do such aggressive disinfection in non-surgical areas. I actually stopped using alcohol based hand gels when I was in the diversion program as it absorbs through your skin and is excreted by the kidneys resulting in positive drug tests. buy a simple fragrance free soap that lathers well. The surfactant action of the suds removes microbes and send them down the drain. My mom had contact dermatitis on her hands and she would coat them in petroleum jelly and don white cotton gloves before going to bed it formed a nice moisture barrier.
I know a few folks from the OR who had good results washing with plain old hibiclens ...the plain, sudsy variety by that brand name. We also used it as surgical skin prep on sensitive individuals and many peds; even oh so sensitive myelomeningocele repairs.
And I concur with the other statements - it's the surfactant and friction that gets rid of the microbes. I have pretty sensitive skin. Nothing like what you are experiencing though. I have more problems when I have to frequently soap/water wash. I do well with our foaming hand sanitizer. As long as I can just soap/water wash for bathroom breaks, before eating, and when taking my gloves off from leaving a contact room, I seem to do better. I also found a glycerine based hand lotion I really like. After one reaction I switched to only using cetaphil for a while; I had to to let everything calm down for long enough that I wasn't just compounding it day after day, getting to that place where *any* exposure made it worse. Good luck to you!
Very interesting! Thank you for your help. I do not believe my pediatrician is in practice, but if I do some digging maybe I could find him. I never had any dermatologic issues until the end of nursing school and of course my nursing career.
jadelpn, LPN, EMT-B
9 Articles; 4,800 Posts
Kind of a weird thought, however
If your issue is with the soap, there's a couple of things you could try. One is baby shampoo/wash that you keep in your scrub pocket. You could even try some organic varieties.
Another is unscented/dye free/sulfate free soap bars. That you keep in one of those travel soap cases in your pocket.
Sometimes, it is a matter of sulfa allergies gone wild. There are many products that have sulfates in them--Including shampoos--so it could be what you are using at home, exacerbated by what you are using at work. Also, laundry detergents from your clothes, etc.
Thinking totally outside of the box, is your pediatrician that saw you throughout your childhood still in practice? I have had the very best thoughts and remedies from some old school docs--especially ones who have seen me since I was a kid. Plus a pediatric allergist who is used to dermatitis that is prevalent in children and will "resolve" itself as one becomes an adult. Ask them what they suggest. And your pharmacist is also an amazing resource. Even one that compounds can make you a concoction that could work. I had a friend who had to use a dish detergent that was "free and clear" that worked.
Best wishes!