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Disgusting Icky Stickies: Nurse Protect Yourself

Updated | Published

Okay big bird. Yes, you in that yellow gown. Hello gorgeous! Thank you my dear, thank you for caring enough about the creepy crawlies to put on that personal protective gear. You my friend are a rock star! You are the ultimate nurse! You are THE WINNER!

Specializes in Med/Surg, Onc., Palliative/Hospice, CPU. Has 3 years experience.

Dear, dear friends. We all hate being "under the man". I get it. But goodness. Let's face it. Protective gear is a rule because it is so very necessary. If you are ever fearing a back spray, please, wear the gear to protect your ever-absorbing skin and EYES. We touch some of the most unruly things in our profession. In the longest run on sentence I would love to share with you some of my icky-stickiest: maggots in the feet, wounds to the bone, explosive clostridium difficile, excessive lice that took over a week to treat (HEAD TO TOE), tunneling wounds in the peri-area that exceeded 8 inches in depth, infected boils bigger than golf balls, dehisced abdominal surgical sites (staples flew across the room), goopy tracheostomies that hadn't been cleaned in so long they were almost cemented in place, shingles galore, meningitis with fevers of 104, tuberculosis with projectile sputum that was yellow/green, anything sputum (makes me cringe), explosive bloody diarrhea, Mount Vesuvius-like blood spurts when inserting an airway while in a code, removing feeding devices thus spurting bile, etc, etc, etc.

Did you turn a little green yet? If you're a nurse, I am sure the answer is no. For me, sputum always makes me a bit (more like a LOT) nauseated, and sometimes uncontrollably gaggy. Funny and so not funny all at the same time. It's kind of embarrassing. I'm always afraid it will make my patient feel bad (in any way shape or form). Moral of the story above is that PPE is not just a GREAT choice when dealing with our usual: MRSA, VRE, Cdiff, Meningitis, Tuberculosis, Shingles, etc. Any time you are coming into contact with flaking skin, excessive wound drainage, foot care, you name it, WEAR SOMETHING TO COVER YOURSELF.

We all know that Cdiff has legs. The spores have legs people. It attaches to things and it clings on for dear life. Do you not realize that this advanced bug has the ability to live on surfaces for extended periods of time unless it's given a proper clean? Seriously. If you can't imagine anything else, imagine these microscopic critters sticking to you, your hands, your clothes and shoes. Now think of what you touch. Your face, phone, private parts (you gotta pee at some point), say you pick your nose for that stubborn boogey, or capture a stray eyelash, or even chew a nail.. Yum yum, nom nom, right? Wrong. Disgusting. Hospitals are cesspools. May I remind you that everyone is sick? (That or asking for Aunt Dilaula, but that's a different issue).

It is OVERLY tedious to gown up, remove, gown up, remove, and go from room to room. I guarantee that your neutropenic patient who is crazy sick (or may even have cancer) greatly appreciates your attention to detail when washing your hands in between patients. It's easy to get cavalier when moving fast, rushing or just thinking that hand sanitizer will do the job. If I could give you a sad face/awkward frown, I totally would right now. The thing is that we all know this is necessary, an issue, and a PIA, but we have to do it. Personally, when I get home and hug my love, I don't want to pass someone else's poo to his lovely person. It's rude. And it's just down-right gross.

What do we do then? Comply comply comply. Wash your hands. Comply some more. We are a profession that washes our hands before and after using the bathroom. It's just the way we need to conduct ourselves. I personally don't want to go to the bathroom and take care of MY business after putting a suppository up someone else's end. Just saying. Your poo-poo platter doesn't need to be on my platter. Okay okay. Enough puns.

Things are becoming more and more resistant to antibiotics. When in doubt, don the yellow gown (or whatever color your hospital PPE is). When there are creepy crawling things that are jumping, break out the hazmat and have no shame. I've worn hazmat and I felt so so SOOOOOO blessed. I did NOT want to bring that ju-ju home with me. I love my job, but I don't have to love the bugs involved.

What can be a controlled infection can turn to sepsis quickly. Be aware and seriously, just wash your stinking hands! I will never forget how horrified I was when palpating an abdomen that I didn't know had a tunneled wound down to the patient's infected stomach appliance from bariatric surgery. Let's just say that warm puss from someone's insides on your bare hands is enough to make you want to autoclave your body for the rest of the shift.

Believe me when I say that I love wounds and wound care. I find it fascinating. But when I'm assisting on an Unna boot and physical therapy is blasting off dead skin with their crazy machine, I'm covered with PPE head to toe. Because as rewarding as it is to heal wounds and assist in curing the sick, I'd rather not have your skin flakes in my hair (thank you very much).

There have been times when a culture has come back and I wasn't sure if the patient needed contact precautions or not. The navigator for that is literally a phone call away. If night shift can't get ahold of someone who knows for sure then a 'cheat sheet' needs to be made. For you and your safety, always err on the side of caution.

Two last things to keep germs at bay... REMOVE your shoes before getting in the car. If I had a dollar for every time I stepped in poop, pee, vomit, spit, blood, or found those things clinging happily to my shoes, I would have paid for all of your school loans and probably paid off your mortgage (you're welcome). Leave those nasty buggers in the TRUNK of your car in a box. It is NOT necessary for those shoes to see the light of day besides fluorescent lights at your job, and then the brief walk to your car. You don't wear shoes in the house? Good for you. I don't either, but! Wearing work shoes home with first driving, then leaving them wherever you do and then driving the next day while (you're off) in your awesome civilian kicks, heading to a friends house and walking into their door... You're welcome. Whatever grime was on your work shoes, can make a lovely imprint on your car's pedals and excitedly await another shoe to make close friends with. It's truly that simple.

Lastly, my dear dear germ-ED family, our scrubs. Our scrubs. They need their own planet. If there was a laundromat in space, we'd need it for frequent use. Since that is not (yet) a possibility (let's go NASA!) we have to wash our scary things at home. Rule number one. I don't care how much you paid for those super cute/stylish/comfy Grey's Anatomy scrubs (they are my favorite too), if you get excessive bodily fluids on it. Trash it. End of story. Buh-bye! I had Cdiff pooped down my leg once. I bought the scrubs the DAY BEFORE. Guess where they went? BIOHAZARD. OR scrubs the rest of my shift, for the win! Rule number two. Scrubs need to be cleaned on HIGH heat and washed separately from the rest of your gear. Think about it.. Wash your washcloths with your scrubs. Later on, wash your face, bum, etc with that washcloth... I don't think I need to elaborate more. I make my own detergent and use essential oils for their antimicrobial properties in my fabric softener. Then I do an empty cycle behind my scrub laundry to clean out the machine. Do what you need to do friends, the bugs we deal with daily are serious.

Unfortunately, the germs we work with, deal with, fight with, all deserve respect beyond what we've been giving them. I'm sure we are all walking around carrying something or with some antibodies of some sort... But for me, I'd rather win than have to deal with MRSA boils, or Cdiff diarrhea.. Personally, I'd also like to refrain from nursing my own tuberculosis.

We need to have compassion for our patients. Not the germs.

I am selectively germ-phobic and am pretty lax about a few things, thanks for the reminder!

Donna Maheady

Specializes in Pediatrics, developmental disabilities. Has 38 years experience.

Great article! Such an important topic...we need constant reminders.

Using humor is very effective! Loved it!

xoemmylouox, ASN, RN

Has 13 years experience.

I don't worry about the germs as much now as I did before. If I deal with a nasty case of crud I bleach the heck out of the bottom of my shoes. I'm not as good about things as I should be, I can admit it. My immune system is a rockstar though so I suppose that is a good thing.

SeattleJess

Specializes in None yet..

AWESOME article! This is going to be one of my selections for the AN article award for summer 2015.

As for the caps, heck, if you wrote the entire article in caps I would understand. How can nurses and nursing students not get the importance of breaking the chain of transmission?

I'm still a student and somewhat shocked that the topic of shoe care hasn't come up at all in the first year of nursing school. I was told about taking off my shoes before driving and using bleach solution when I got my NAC license before nursing school. But even then, that didn't come from formal education but from the floor nurse at my first LTC clinical. Bless that nurse. Because of her, I see imaginary Mr. Yuck stains all over my hands and the workplace. I try to mop them all up. You're right, it's tedious and time-consuming and the pressure to save a few seconds when there aren't enough seconds on the shift to start with is strong. That's another reason why your article is so valuable. We all need help to remember.

And if we're not motivated by concern for our patients and coworkers, we could remember that DNA technology is at the level where infection sources can be traced back to the source. Maybe an increasing level of accountability is additional motivation.

Thank you for your service by writing this article. Or may I say, without insulting you, THANK YOU FOR YOUR SERVICE!

:chicken: of doing harm through microbes

Jacqueline.Damm

Specializes in Med/Surg, Onc., Palliative/Hospice, CPU. Has 3 years experience.

Thanks SeattleJess! Good luck in school. I'm glad you enjoyed the seriousness and the humor in my article. It was in clinical I learned about the shoes also! Amazing isn't it? ; ) Thank you for the read and kind words.

I've posted my end-of-shift ritual and scrub-washing methods before. Yes, I know we are all exposed to who-knows-what in our daily lives and travels, but I whole-heartedly agree with this article. Like x 100:yes:

This goes for LNAs/CNAs too! I'm always surprised when fellow LNAs say to me, "Oh, you gown up for this patient?" Well, yes, there's a whole precaution kit on the door for a reason. I know it's hot, I know it takes time, and I know it could alienate the patient - but I wonder why that awful gushing-liquid-diarrhea disease spread throughout the entire facility last winter. I generally assume there is poop on everything in the facility, because I've seen it on pretty much everything in the facility: curtains, shoes, wheelchairs, floors, walls, patient hands, etc., etc., etc. I pack my scrubs into a plastic bag and take a shower right away when I get home. But your article did teach me something new: deal with the shoes. I totally step on, kick aside, and brush against poop-sodden items on the floor as I go throughout my day. What about sitting on the car seat? Perhaps I'll use a towel to sit on when I drive home from work. Sometimes I feel I'm going overboard, but then again.... Your article makes me feel a little less alone. Thanks!

I love this whole thing! I am a student and I often get (nicely) teased about being a germaphobe by fellow students because I insist on wearing gloves and following hygiene protocols to a tee. But the germs are seriously something that needs to be considered - especially when they have the ability to affect those we love at home. I already keep my hospital shoes out of the house, but this article has pointed out how much better I could protect my home. I will definitely be doing the trunk thing from this point on. It only takes a second, after all, to change your shoes. I've also been thinking about getting some eye covers / goggles to go over my glasses for irrigations and dressing changes since there is always the possibility of splashback, especially when using the little saline flushes. In the OR, those are readily available and encouraged, but they seem to get a bad rap on the floor...

I bring my glasses in the shower with me when I get home and wash them thoroughly.

emtb2rn, BSN, RN, EMT-B

Specializes in Emergency. Has 21 years experience.

What about the visitors who walk on what we walked through?

Well for one, I thought your post was very humorous and not to mention: TRUE! (In the nursing world). I always leave my work shoes in the trunk of my car after a shift, god knows I don't want to transmit all those nasty germs to MY personal life.

Since I started nursing school, I washed washed washed and rewashed my hands! Yes I did use hand sanitizer, gel in and gel out, but I still took the time to wash my hands after a procedure. For my sake and my patients sake!!

Yet, I have seen nurses (because I helped assist) do pericare and go on to touch the patients sheets and call light, without changing gloves!!! I could not believe it.

Anyway, I agree with the special precautions we as nurses MUST do. To keep our patients, us, and our families safe!

YAY for using proper medical asepsis techniques; or go a little overboard :)

Ruby Vee, BSN

Specializes in CCU, SICU, CVSICU, Precepting & Teaching. Has 40 years experience.

Shoes last longer and are more supportive if you rotate shoes -- it takes more than 24 hours for a shoe to "recover" from your weight. So I rotate my shoes. Shoes left in the trunk of a car break down faster -- the glues melt, and shoes come apart. So the advice about leaving your shoes in the trunk of your car seems like an expensive proposition to me. And unnecessary. I've been nursing for 40 years, my shoes come home on my feet and go right upstairs to my closet.

My scrubs go into the laundry and get washed in a separate load from everything else, but I certainly don't disinfect my washer after I wash them. That seems like a waste of water.

The advice in the article seems like overkill. While the word on handwashing and use of personal protective gear is worth noting, the rest of it is probably just a good writing exercise.

brandy1017, ASN, RN

Specializes in Critical Care.

I prefer to wash my hands each time. I don't like the gel, plus I don't think it works for cdif. The downside is my hands get red and irritated each winter. We can do our part and do, but it is up to the hospital to their part as well. For instance there are UV disinfectant cleaners that can and should be used to clean each room between patients. I recently found out my hospital has them, but up until recently only used them in the OR and now only use them for some isolation rooms. They should be required to be used for every room no excuses, I think this would cut down on infections. My hospital changed to a disinfectant wipe that takes 3 minutes to be effective! Why? Why would you change to something that takes longer to actual clean! Makes no sense.

I like the idea about not wearing your shoes and keeping them in a box in the trunk. I don't wear mine in the house, just leave them by the door, outside if it's not going to rain. However your idea is even better.

Julie Reyes, DNP, RN

Specializes in pediatrics, occupational health. Has 6 years experience.

missmollie said:
I couldn't get past the tone of your article to even get to the end. All caps, italicized, underlined, and bolded words conveys hostility towards the reader.

I'm sure that's not what you intended. You may want to remove them if you are still able to edit.

Why are the readers on this awesome site always telling the authors how to write? Maybe the authors should start every article with a disclaimer or a warning?

something like, "You may not want to read this article if you are Debbie Downer".

This article rocked. There is VERY IMPORTANT LIFE SAVING INFORMATION in it, mixed in with humor to make the medicine go down a little easier.

Good job, Jacqueline!

Jacqueline.Damm

Specializes in Med/Surg, Onc., Palliative/Hospice, CPU. Has 3 years experience.

ChickaBoom said:
I've also been thinking about getting some eye covers / goggles to go over my glasses for irrigations and dressing changes since there is always the possibility of splashback, especially when using the little saline flushes. In the OR, those are readily available and encouraged, but they seem to get a bad rap on the floor...

I am SOOOO with you there! I was in a respiratory code the other morning with a VERY complicated intubation that was just not working.... You wouldn't believe the spurting things in that room.. All I could think of (besides the obvious!) was... please don't get into my eyes, please don't get on my face, please please please... ewww juicyyyyyy..

; )

mamagui

Specializes in Eventually Midwifery. Has 1+ years experience.

Excellent article!

Just want to add a probably worthless comment....I taught Spanish in high school for about 3-4 months and was sick almost the whole time. I was afraid that I would be the same when beginning my clinicals in the hospital. For 3 semesters straight I haven't gotten sick a single time, except for just after New Year, when the infection could not have come from clinicals. PPE is Awesome! Teachers should have it available LOL

Valcorie34

Specializes in Skilled Rehab Nursing. Has 3 years experience.

Oh My goodness! I never thought of my shoes! I am crazy about personal protection, I am a CNA and starting Nursing school. I deal with TB, Cdiff, Hepititis you name it but I never thought of shoes. Yuck. I feel like bleaching them already. lol Thanks!