Wearing gloves with HIV positive patients

[Leekri]

(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.

[Guest219794]

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.

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.

That's your right and I disagree.

From the OP:

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 primary nurse who told me to put on the gloves pointed to his chart and was pretty clear that the gloves were because of the HIV+.

I mentioned earlier that it appeared that you might not have read the post.

The student was pulled out of a non-contact encounter and instructed to wear gloves, not as a universal precaution, but to protect herself from HIV.

[xoemmylouox, ASN, RN]

When I am in the hospital setting I do tend to wear gloves more often than are probably needed. This being said it is often dependent on the patient and situation. One example is if the patient is known to be inappropriate with their waste (smearing stool on surfaces, urinating on floors/side rails/etc, or if I have witnessed them not performing hand hygiene post bathroom - I wear gloves before touching most of the objects in their room that they commonly touch. The surface may appear to be clean, but could have dried urine or something else on it.

I know I'm exposed to these same germs out in the public, I just tend to think about it more while I am at work.

[guest769224]

I mentioned earlier that it appeared that you might not have read the post.

The student was pulled out of a non-contact encounter and instructed to wear gloves, not as a universal precaution, but to protect herself from HIV.

The OP didn't state that until after I made my comments. Then, later in the day, the OP returned and posted the following:

The primary nurse who told me to put on the gloves pointed to his chart and was pretty clear that the gloves were because of the HIV+.

If that's the case, then yes I agree.

At the end of the day, it doesn't matter if posters on AN agree with what is said. Using gloves is never a bad thing.

[TriciaJ, RN]

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 don't wear gloves for injections, either. Applying counter-pressure to the injection site with the alcohol swab before removing the needle seals it up fairly well. I think gloves are over-used and often used as substitutes for handwashing, which they shouldn't be.

[audreysmagic, RN]

I think gloves are over-used and often used as substitutes for handwashing, which they shouldn't be.

^ This! While doing infection control, I do preach about (APPROPRIATE) glove use, but I have to stress to so many people that it is not, never has been, and never will be a substitute for good ol' soap and water (plus hand sanitizer where appropriate, of course). Especially in my facility, because a lot of patients associate seeing staff put gloves on with behavioral emergency codes (as staff usually glove up when they arrive because of the likelihood that we'll be going hands-on and exposed to bodily fluids).

[/username, BSN, RN]

Your coworker is incorrect.

[rearviewmirror, BSN, RN]

What is wrong with wanting to wear gloves? When I was in the ED, there were lots of people from the hood, so there would be lots of scabies, lice, etc issues and that include their belongings. It appears that most here disagree with the preceptor because by wearing gloves, one way or another, you are "discriminating," which is a big no no now days, and hurting someone's feelings or what have you. Just narrowing down someone's desire to wear gloves whatever the situation be into either ignorance and fear seems pretty narrow-minded to me too.

I didn't study infectious disease or science of contagion or disease but at the end of the day, it's my safety and well-being and my family that is at stake. I am not denying the humanity of HIV patients, or any patients as I would treat them the same as someone with different disease, as I would wear gloves into all rooms. And if THAT offends yal...... oh well, I shrug and go on my day.

[OldDude]

I don't wear gloves for injections, either. Applying counter-pressure to the injection site with the alcohol swab before removing the needle seals it up fairly well. I think gloves are over-used and often used as substitutes for handwashing, which they shouldn't be.

Amen...plus I give most of my injections to infants and toddlers, vastus lateralus, I pin both knees to the bed with one hand and I inject, toss the syringe aside, and apply the bandaid with the other hand. Gloves are bulky, slippery, stick to the bandaid, and a general encumbrance.

[Elvish, BSN, DNP, RN, NP]

If you don't want to contract HIV from your patients, don't have sex with them, share tattoo or IV drug needles with them, or transfuse yourself with their blood. If you don't do those things, you will be fine.

Furthermore, the CDC's most recent statement suggests that if the pt's viral load is undetectable, then they really can't transmit HIV.

Years ago, when I was a brand new nurse, I had a pt whose AV fistula had abscessed. He was HIV+. His fistula ruptured on my shift, and I ran into his room and instinctively slammed my bare hand down on top of the artery shooting blood shooting out of his arm onto the walls and ceiling. He yelled at me to grab gloves, but I wasn't moving my hand, and at that point my hand was already covered in his blood.

If I didn't get HIV from that, there is no way you will get HIV from a pt interview. The nurse that told you to wear gloves is stupid and wrong, and reeks to me of the phobia we dealt with in the 80s.

[dudette10, MSN, RN]

Standard precautions should be observed for every patient interaction necessitating touch, which includes wearing gloves.

You misunderstood right here.

[TriciaJ, RN]

What is wrong with wanting to wear gloves? When I was in the ED, there were lots of people from the hood, so there would be lots of scabies, lice, etc issues and that include their belongings. It appears that most here disagree with the preceptor because by wearing gloves, one way or another, you are "discriminating," which is a big no no now days, and hurting someone's feelings or what have you. Just narrowing down someone's desire to wear gloves whatever the situation be into either ignorance and fear seems pretty narrow-minded to me too.

I didn't study infectious disease or science of contagion or disease but at the end of the day, it's my safety and well-being and my family that is at stake. I am not denying the humanity of HIV patients, or any patients as I would treat them the same as someone with different disease, as I would wear gloves into all rooms. And if THAT offends yal...... oh well, I shrug and go on my day.

If you're working in a busy ED where you never know what you're going to be exposed to, then it makes sense to just wear gloves as a matter of course. That's different from a regular nursing floor where you have a chance to know your patients and your interventions are generally planned.

[audreysmagic, RN]

If you don't want to contract HIV from your patients, don't have sex with them, share tattoo or IV drug needles with them, or transfuse yourself with their blood. If you don't do those things, you will be fine.

I'm going to start using this in my HIV trainings. :)