Do you actually wear gloves/gowns/masks ?

Nurses General Nursing

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I am a second-semester nursing student, and just finished my first clinical rotation at a local hopsital. I know that nursing school is different from the real world, and that working nurses will do things differently from what we were taught in school. But I am just wondering if you guys actually use your gloves/gowns/masks when a patient is on special precautions. At the hospital where I was assigned, I had patients with VRE, MRSA and C-diff. All of them were on contact precuations and one also had droplet precautions. NONE of the nurses caring for these patients wore anything besides gloves. My friends that were assigned to a different hospital said that they encountered the same thing, except that alot of the nurses there didn't even wear gloves. Is this pretty common in the real world? I know that Medicaid and/or Medicare has decided that they will no longer reimburse for treatment of hospital-acquired infections, so it seems like everybody would really be using their PPE. I personally have two small children and the last thing I need is to expose them to any of this stuff, so I used the gowns and masks. Do you just quit being afraid after awhile, or are there just alot of careless nurses where I live? Please don't flame me, I'm just asking for an honest answer.

Thanks!

Specializes in Pediatrics, Ob/Gyn.

Personally and honestly, I always wear the apropriate PPE when I am at work because I do not want to transmit microorganisms to the other patients in the ER that I work in. Besides I am protecting myself and my family. Just because something doesn't affect me, whose to say that I children won't be affected.

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Specializes in Too many to list.

We had a Noro outbreak, and I was told that contact plus standard was enough. I also used my N95 and went in with splatter protection. Of all the "dirty nurses" who worked the outbreak, I alone didn't get sick, so my "extra PPE" that our infection control nurse said wasn't necessary....apparently was.

I believe you. I didn't use a mask the last time I was in a room with two nursing home patients that had it. Less than 48 hr later, I was sick too even though I had been super careful with gloves, and handwashing. Apparently, it was not enough...

http://microbiology.mtsinai.on.ca/faq/norwalkfaq.shtml

Norwalk and Noroviruses are transmitted primarily by the fecal-oral route. Having direct contact with vomit or feces from an infected person and then transferring the virus to the mouth from the hands primarily spreads the viruses. Secondary person-to-person transmission through sharing food, water, and/or utensils, or contact with the contaminated environment is also possible. Touching a contaminated door knob and/or stair railing and then touching your mouth is a possible method of transmission. In some outbreaks, there is evidence that the virus may be spread by the airborne route. These viruses are very contagious and only a few are needed to cause an illness.

The disease is transmitted through ingestion of contaminated foods and drinks, or by contact with an infected individual. Shellfish from waters exposed to raw sewage will concentrate virus particles from the water since they are filter feeders. Contaminated water can also introduce the virus to beverages, ice, eggs, fruits, and salad ingredients. Cooked foods may also be contaminated though handling by an infected individual. The virus can also be transmitted through close contact with an infected individual and/or touching contaminated surfaces.

http://www.cdc.gov/nceh/ehs/Docs/Evidence_for_Airborne_Transmission_of_Norwalk-like_Virus.pdf

An outbreak of gastroenteritis followed a meal in a large hotel during which one of the diners vomited. The clinical features of the illness suggested Norwalk-like virus (NLV, small round structured virus) infection, and this was confirmed by electron microscopy and reverse transcriptase polymerase chain reaction (RT-PCR) of stool samples. Further characterization of the virus by nucleotide sequence analysis of the PCR amplicons revealed identical strains in all the affected individuals. The foods served at the meal could not be demonstrated to be the cause of the outbreak. Analysis of attack rates by dining table showed an inverse relationship with the distance from the person who vomited. No one eating in a separate restaurant reported illness. Transmission from person-to-person or direct contamination of food seems unlikely in this outbreak. However, the findings are consistent with airborne spread of NLV with infection by inhalation with subsequent ingestion of virus particles.

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If there are precautions to be taken, then they should be taken. You are correct in that hired nurses do not usually follow the precaution standards and it usually does take either a student or a family member to point it out. Then, if you're lucky, they might roll their eyes and either follow the policy or they may just tell you "Yeah, that's what they teach you but it's different in the real world." Regardless, set the example and follow the rules. It's protecting everybody and isn't that one of the things that nursing is all about?

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For what it is worth - Follow your training, disciplinary action by the hospital or your board will not consider the actions of others, only your action - same logic as all practices, would you risk patient, visitor, or your own health by non compliance of other basic practices? If supplies are an issue call your infection control nurse, as far as the compliance of others - do not even go there- not your issue unless you are charge or infection control..

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Specializes in OR, public health, dialysis, geriatrics.

Absolutely! and if the nurses are not your clinical instructor needs to be talking to their supervisor. Just think about it--who wants that "stuff" on their skin, their clothes, on their faces (ick!) to take home to your loved ones or even just roommates--double ick!

It is a matter of protecting yourself and being a responsible practitioner!

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Absolutely. At our facility we do spot checks for PPE

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Specializes in OR, public health, dialysis, geriatrics.

Being a surgeon makes you immune to most bugs and being an orthopod makes you really, really immune--I don't know if this will ever change. ugh.

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I'm with you. I have 2 children at home and there is NO WAY I'm bringing anything home to them that I have the power to control. Shame on the nurses being so careless. I work the night shift -- yes, there are times I am soooo tired I don't want to gown up, put on a mask or get another box if we're out -- double glove, etc. BUT it's my responsibility to myself, my family and the other patients I care for to not be an idiot. 'Nuff said!

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Specializes in Med Surg, Parish Nurse, Hospice.

I would have to say that I wear ppe 99% of the time. If I need to stick my head in the room to ask a question, I may not gown up. Otherwise if I'm going to provide any type of hands on care I wear ppe. Many pts will say to me, you are the only one that does that. I tell them I follow the rules and do what I'm supposed to do. As an experienced nurse I feel that I must set a good example to other staff members and visitors and I am aware of too many nurses that have ended up with mrsa in their own wounds or with c diff. I agree with a previous writer, that it is disheartening when a pt that you have cared for for days, all of a sudden has mrsa in their nares or sputum. Keep following the rules to protect yourselves as well as other pts.

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That is aweful! We definitely use gown, gloves, and maskehen the isolation requires!! I work in the ICU (neo and pees) and many have suppressed immune system, if we are not careful, they can get really sick! Plus, don't want to bring anything home to my kids!!

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It is different when u r actually working as a nurse. Anyone who has MRSA, VRE, etc are on at least contact precautions. But once u work for a while and u know what type and where, u just use ur own judgement. Depends on what u r going in the room 2 do w/ the patient as 2 what u have 2 wear. If u just walk in the room w/ someone that has C-Diff and put everything on just 2 check the IV bag, or something 2 that nature for example??? No, there is no point b/c u know there is no contact w/ it. Just remember ur basic handwashing precations. U learn 2 pick and choose what ur gonna take the time 4.

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Specializes in ER.

absolutely wear it - I know nurses who don't use PPE for a variety of things, which is just stupid. It's about being responsible for yourself and OTHERS.

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