Do you wear gloves

Nurses General Nursing

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Sorry I have so many questions but you guys are so helpful. I was woundering do you wear gloves most of the time, like when taking blood, giving injections etc. I remeber being in a hospital and one of the nurses put some pill like thing up someones bum with no glove. surely this isn't normal practice. Also do you worry about catching something contagious or have you pricked your self with a needle after it's come in contract with someone else.

Thanks

I had an mrsi in my legs, mild but still a worry, got in through a nick when shaving my legs. Now I wax! Probably shaken off bed linens, I don't know, but now am maniacle about gloving and NO shaking out the bed linens. I glove to shower, to make beds, to take bed pans/urinals, to take BSL's, to do everything. I protect myself and my clients in this way. If a client objects I just tell them that it is for their own protection as well as my own.

I don't get paid enough to put my life at risk.

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I had an mrsi in my legs, mild but still a worry, got in through a nick when shaving my legs. Now I wax! Probably shaken off bed linens, I don't know, but now am maniacle about gloving and NO shaking out the bed linens. I glove to shower, to make beds, to take bed pans/urinals, to take BSL's, to do everything. I protect myself and my clients in this way. If a client objects I just tell them that it is for their protection as well as my own.

I don't get paid enough to put my life at risk.

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AussieNurse, when those bed linens you talked about got shook up, do you thihk you got any mirsa in your nasal cavity? Only one right answer.

a. yes

b. no

c. I don't know

d. mirsa can not colonize in your nose

You don't have to answer. No osmotic pressure from me. :-)

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I am a petite person and have very small hands and very few floors carry small gloves. The gloves are way too big for me and when I am doing a dressing, I often times have to remove my gloves because I have all of this extra finger space and they get caught in the tape and stuff. The sterile gloves fit better but if it's not a sterile procedure you get yelled at for wasting them. I keep meaning to get myself a box of small gloves, but I never do. Someone please yell at me.

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Please note: clean gloves are personal protective equipment (PPE) - they protect the wearer, not the patient. It is a bad idea to think clean gloves are any cleaner than the hands that put them on (or, come to think of it, any hands that reached into box before). Only sterile gloves (put on with sterile technique) protect the patient.

Just thought I'd clarify that.

Also, latex is highly allergenic, becoming a big health risk for nurses and other health care providers.

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Originally posted by abrenrn

they protect the wearer, not the patient. Only sterile gloves (put on with sterile technique) protect the patient.

whoa - if this is true, then what about all the people who said they want gloves on to protect themselves and their loved ones? Imagine going to a hospital or health care facility and wanting people to wear gloves to protect them from you? Why would you even be in the place? Being immuno-surpressed is one thing, but the only boy in the bubble i know is John Travola from a 70's made for TV movie. I'm sorry :-(

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Uh, Mario, you should be sorry. If you think I dropped a bomb, there is much more for you to learn.

When you go to a hospital, the nurses wear clean gloves to protect themselves from you and all other patients. Handwashing protects the patient - and you and your loved ones as well.

I started nursing school in 1985, just when HIV was scaring everyone, just as the CDC was implementing universal precautions. Before that time, it was rare to wear clean gloves to draw blood, etc. and it took patients a while to accept it. Good handwashing was all that was suggested. It remains suggested - since clean gloves are pulled out from a box, they will contain any microbes that are on your hands.

You may want to read up on personal protective equipment, how and especially why it is used.

BTW, I have also worked in Bone Marrow Transplantation and met a number of patients who lived, temporarily, in just such bubbles. None of the units I worked on had anyone with John Travolta's diagnosis in the movie (SCIDS - severe combined immunodeficiency syndrome is its name I believe - BMT was originally "invented" for this disease to get such people out of bubbles), but many had severely compromised immune systems until their graft took.

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Oh, regarding bone marrow transplantations. They are done two ways: completely sterile (put in bubbles, all contact through sterile technique, laminar air flow etc.) and very clean (private rooms, laminar air flow, gowns to protect patients from microbes on uniforms, etc. - tecniques vary). I have worked both.

Completely sterile is very hard on patients, for a number of reasons - bubble isolation, need to "sterilize" gut, skin, etc.. Very clean also hard but not as bad in terms of isolation, no "gut meds" - may need more antibiotics.

It's been a few years since I worked in this setting so I am not completely up to date with the directions it is taking though I've heard many places seem to be moving toward very clean.

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This is right out of my "Fundamental of Nursing" book, Mario:

"Gloves are Personal Protective Equipment. Gloves are worn for three reasons: first they protect the hands when the nurse is likely to handle any body substance . . . Second, gloves reduce the likelihood of nurses transmitting their own endogenous microorganisms to individuals receiving care. Third, gloves reduce the chance that the nurses' hands will transmit microorganism from one client or a fomite to another client."

Clean gloves (like sold in bulk in boxes) do NOT protect the patient. They can help reduce, but not protect the patient from pathogens. To protect the patient, you have to consider the 6 steps of the Chain of Infection:

1. the microorganism (pathogenicity, characteristics of the bacteria, etc.)

2. source of the microorganism

3. portal of exit (urinary tract, nose, skin, etc.)

4. method of transmission (airborne, contact, etc.)

5. portal of entry to the susceptible host

6. host.

Mario, any of the above steps in the Chain of Infection are can expose the patient (or the nurse) to nosocominal pathogens. Gloves just don't do it. They are there to protect the nurse and help reduce the chances that the nurse becomes a fomite. To believe that gloves alone protect the patient is really oversimplifying how infections are spread and the varieties and transmission of these nosocominal pathogens.

And yes, MRSA can colonize in your nose or anywhere else for that matter. But remember that colonization protects the colony. There will always be individual cells that will break away from the colony and can reinfect the host or be spread to another host.

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Just to add to what Youda said, handwashing remains the most effective means of protecting patients from caregivers (done immediately before putting on gloves) and caregivers from patients (done immediately after removing gloves). A caregiver so protected will be less likely to spread microbes from patient to patient or from work to home.

Specific techinques for "clean" handwashing (vs sterile scrubbing) are included in all basic nursing texts along with other infection control techniques.

What is now termed "standard precautions" was first called "universal precautions" which were implemented during early HIV days. The idea was to treat all patients as potentially infected - if not with HIV than something else. Before then only disease specific precautions were used.

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Im not afraid to ask a stupid question. What is the significance of washing your hands after you take the gloves off? Is it to wash off any fomite that existed within the latex glove you took off? And I never claimed to have all the answers, nor am I saying it's okay not to wear gloves. I am interested in this because I always "go there."

Surprised and concerned am I about specific examples of actual points vectors transmit from. I know about c-diff and mrsa and TB from the hospital, but what else,>(escherichia coli, enterococus, pseudomonas eruginosa, coagulase-negative staphlococcus aureus)

mario shut his fat mouth and opened fundamentals of nursing. it goes into it all. But after todays knock down intro-lecture on antibiotics, these new words are but a blur. I love to read abut infections now, but memorizing pharmocological names for antibiotics is killing me.

Anxiety r/t forced memorization AEB crying

I'm sorry :-(

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Mario, it's great that you do ask questions!

Washing hands after gloves are removed for two major reasons:

1. The gloves may have imperfections or have been damaged during use so that your hands have been exposed to allow microorganism entry.

2. Your hands may become contaminated as you remove the gloves.

Washing your hands before putting on gloves is for similar reasons. If the gloves have imperfections or are damaged during use, washing your hands before putting them on helps prevent microorganisms from transferring. Also, you can contaminate the gloves when you put them on.

As Anne said, the boxes of "clean gloves" must be considered contaminated as soon as the box is opened. Just a tiny speck of dust is enough to contaminate a box of gloves with pathogens. Many bacteria actually thrive and enjoy these environments. When a pathogen like pseudomonas can metabolize soaps, you need the friction of handwashing to remove these kinds of pathogens.

So why care? Because gloves protect YOU. Everytime a nurse doesn't do this, they take those pathogens to clean utility rooms, into surgical suites, to the nurses' station, to the phone! Ever wondered why everyone gets the flu or a cold at work about the same time? Because someone isn't wearing gloves and washing their hands.

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