Wearing gloves with HIV positive patients

kaylee. · Mar 30, 2018

Thank you for attempting to correct me but no I did not misunderstand.
There is nothing to lose by wearing gloves. I use them for almost all patient interactions, even without contact of bodily fluid and that is perfectly fine and an added safety barrier.

You ask how you misunderstand standard precautions? Well you have described the precautions you take and they are not the "standard".

Do you wear an N95 mask when entering all patient rooms in the chance that they are tb+?

Im not saying your gloving practice is extreme or super wierd, just suggesting that it is not the standard.

You wear for all care, even when statistically an interaction has a zero chance of fluid exposure. This is not a scientifically safer approach, it just makes you feel safer. So while its fine, its not scientifically "safer".

You think there is nothing to lose wearing gloves, fine... But in many cases there is nothing gained by wearing them.

You are not safer with gloves shaking an hiv pt hand than an ungloved hand.

Guest219794 · Mar 30, 2018

Thank you for attempting to correct me but no I did not misunderstand.
There is nothing to lose by wearing gloves. I use them for almost all patient interactions, even without contact of bodily fluid and that is perfectly fine and an added safety barrier.

The OP is not about using standard precautions.

The OP was specifically instructed to base PPE on hiv status.

Treating two pts differently, based on your beliefs about their hiv status, would not be "standard".

By definition, "standard" would mean the precautions are applied universally.

Otherwise, they might be called "Random Standards". Or "Arbitrary Standards". Separate standards based on hiv status would be called "Ignorant Standards", and should not be taught.

If you choose to don gloves while speaking with all pts, that is certainly your choice.

If you are in a mentoring position, you should probably explain to your student that this is an unusual practice.

If, like the OP stated, a mentor chooses to interview non-hiv pts without gloves, but dons gloves to speak with hiv pts, that person should not be in a mentorship position.

klone, MSN, RN · Mar 30, 2018

Wearing gloves will not make a patient "feel like crap" or feel bad about themselves. It is an everyday common practice in the hospital.
Standard precautions should be observed for every patient interaction necessitating touch, which includes wearing gloves.
Instructing a student to wear gloves does not make the nurse paranoid or ignorant.

Normally I am in agreement with things you post, ICUman, but I have to say, I think you're way off base with this post.

klone, MSN, RN · Mar 30, 2018

The OP is not about using standard precautions.
The OP was specifically instructed to base PPE on hiv status.
Treating two pts differently, based on your beliefs about their hiv status, would not be "standard".
By definition, "standard" would mean the precautions are applied universally.
Otherwise, they might be called "Random Standards". Or "Arbitrary Standards". Separate standards based on hiv status would be called "Ignorant Standards", and should not be taught.
If you choose to don gloves while speaking with all pts, that is certainly your choice.
If you are in a mentoring position, you should probably explain to your student that this is an unusual practice.
If, like the OP stated, a mentor chooses to interview non-hiv pts without gloves, but dons gloves to speak with hiv pts, that person should not be in a mentorship position.

If I could like this more than once, I could. Particularly the bolded parts.

OldDude · Mar 30, 2018

I think we are overdoing gloves these days. It's a waste of resources, for one. And, you find out a lot through human touch. Skin temperament, palpating a pulse, etc. And, nothing replaces the human touch.
Yes, there is too much paranoia these days. Commonsense has gone out the window.

Totally agree...if such "standards" existed as described above, we'd all have to wear gloves to go to the restroom; you know, to protect our self from our self...you never know. :whistling:

I'm sure this is gonna bring a scolding, but I don't wear gloves when giving injections... :woot:

audreysmagic, RN · Mar 30, 2018

Yeah, that's a great way to make the patient feel like ****.
You could hug and kiss the patient on the mouth and you still don't need to wear gloves (I don't recommend that from a professionalism standpoint). This nurse is practicing in the 1980s, and it frankly makes me quite angry.

Same, klone. I work in an area that has a lot of HIV positive patients, and I get so frustrated with health care workers - some nurses! - who are like "oh, I don't think that's right" when I educate them on the ways you CANNOT contract HIV. Some people just seem to enjoy their ignorance and fear.

bebbercorn · Mar 30, 2018

You are right. Your preceptor was wrong. I work with marginalized populations and I make it a point to shake hands, touch skin, make them feel welcome and not like a leper. Drawing blood? Gloves. Shaking hands? No. I had a brother with HIV, and we shared drinks, hugged, and went on as normal. My status is negative. As far as how it is transmitted, the most likely way to get it is intercourse (especially anal) or through blood (shared needles, potentially an accidental needle stick). Not by "touching things in his environment."

And I agree with hherrn about their point regarding standards... I would like to refer to them as "fake standards."

Have Nurse, ADN, RN · Mar 30, 2018

(First time writing here)
Yesterday during my clinical, I was interviewing a HIV positive patient. Half way through, the primary nurse asked me to talk with her in the hall, and when we spoke she told me to wear gloves whenever I was with the patient or touching things in his environment.
The patient didnt have any open open cuts or bodily fluids out, and I didn't have any cuts and was just talking with the patient. There weren't any signs saying to use any special precautions either...
I personally don't think that situation neccesitated the need for gloves, but I was hoping to get someone else's opinion on this. :)
Also I'm a student, and the nurse was really adamant on the gloves so I didn't really ask questions.

Unless there's something like what you've mentioned (Handling body waste,cuts or leaking body fluids,) there is no need to wear gloves while in the person's room.

Sounds like your colleague needs to brush up on how this illness is spread.

(I work in the Infection Control Dept. of my facility.) Good question!

Have Nurse, ADN, RN · Mar 30, 2018

Totally agree...if such "standards" existed as described above, we'd all have to wear gloves to go to the restroom; you know, to protect our self from our self...you never know.
I'm sure this is gonna bring a scolding, but I don't wear gloves when giving injections...

I must admit, one has a better grip on a syringe without them. Me? I do glove the hand that handles the alcohol wipe as my skin is sensitive to it now. Also, if the patient happens to have a bit of capillary blood oozing from the needle site, it's best to be protected as you apply the band aid.

It doesn't always happen of course, but it's nice to be prepared.

guest769224 · Mar 30, 2018

You ask how you misunderstand standard precautions? Well you have described the precautions you take and they are not the "standard".
You wear for all care, even when statistically an interaction has a zero chance of fluid exposure. This is not a scientifically safer approach, it just makes you feel safer. So while its fine, its not scientifically "safer". .
You are not safer with gloves shaking an hiv pt hand than an ungloved hand.

I stand by that all patient care where a worker is touching the patient or certain equipment or surfaces in the room, should be done with standard precautions. Which means utilization of hand hygiene and gloves., etc. Doing so reduces transmission risk of any unknown contaminated surfaces. There is no harm in doing so.

The OP is not about using standard precautions.
The OP was specifically instructed to base PPE on hiv status.
Treating two pts differently, based on your beliefs about their hiv status, would not be "standard".

I didn't see anywhere in the posts by OP that the nurse specifically stated to the student, "You must wear gloves before touching this patient because they are HIV positive." What I did read, was the nurse saying to don gloves before patient care. Which is acceptable and an expected practice. If the nurse had told them to glove for that specific reason only, then no, I would not agree with her. And I agree that one could provide care to this patient without using gloves and be at no risk of contracting the disease.

What I specifically stated, was gloves should be used for any patient care interaction with the possibility of direct touch, or contaminated surfaces. Not just because they are HIV. That would be ridiculous.

Normally I am in agreement with things you post, ICUman, but I have to say, I think you're way off base with this post.

That's your right and I disagree.

Khow89 · Mar 30, 2018

It might be because you're a student that the staffs or preceptors are overly cautious.

Emergent, RN · Mar 30, 2018

I just want to add, when you're a student, do it your instructor or preceptor's way, in a case like this. Don't debate. If someone wants to go overboard with gloves, so be it.

As you can see from this thread there's no changing people's minds...