Gloves: It All Started With a Doctor/Nurse Love Affair

FJN

Our Love/Hate Relationship with Gloves Began ... with Love

In the Summer of 1982, I began working the night shift as a new graduate nurse in the Emergency Department (ED) at my local, regional medical center. Since we started a lot of IVs, I soon became proficient at what is a routine skill among ED nurses.

One night a co-worker stopped me as I prepared to insert an IV catheter, "You gotta put on gloves.”

"Why? He's an easy stick, and I'm not going to get any blood on me. Besides, I washed my hands.”

"Hospital policy because of HIV,” she replied.

HIV, for Us Old Dogs in Healthcare, was Our Pandemic

Like COVID, there was much initial confusion. Can I get AIDS from a mosquito that bit an HIV-infected patient? Can I get it from a needle stick after giving an injection to an AIDS patient? What if a patient spits in my face? (Not unheard of in the ED.) If I get emesis from someone infected with HIV on my dry, chapped hands, will I get AIDS? On and on.

So, it began. The aggravation of a new learning curve as I struggled to palpate deep veins on "fluffy" or dehydrated or shocky patients while wearing latex gloves that greatly reduced the sensitivity of my fingertips.

Yes, Believe it or Not, the Routine Use of Gloves by Healthcare Workers was Once a New Thing!

In the 1980's, we started using latex gloves, and it became so ubiquitous that the percentage of healthcare workers developing latex allergies was concerning. Plus, there were increasing cases of allergic reactions among patients who had pre-existing latex allergies. Some of the early latex gloves were powdered (now banned), which increased the potential for allergic reactions by creating airborne exposure. In addition to latex, gloves are now made from nitrile, polyvinyl, or neoprene, avoiding latex exposure.

It is important to follow your institution's protocol for donning gloves and to examine them carefully when putting them on, checking for rips and tears. Remember, you're probably using a product from the lowest bidder. Protect yourself and your patient. If your institution doesn't have protocols, you can follow CDC Guidelines .

As late as October of 2021, CNN reported that a supplier in the US had received visibly soiled "new" gloves from an offshore company. The company had washed, dried, and dyed soiled gloves to make them look new. Months later, the offshore company was still shipping millions of gloves into the US.

The History of the Use of Gloves by Healthcare Workers is Interesting

Surgeons have been using gloves routinely since the late 1800's. Actually, as early as 1758, the gynecologist Johann Walbaum had used the tissue from the cecum of sheep to cover his fingers!

During the Civil War, battlefield surgeons wore street clothes with perhaps an apron to protect their clothes from the blood and gore. There was no sterilization of instruments, essentially no handwashing, and no gloves. The infection rate could be as high as 50%!

Now, for the Love Affair

One of the prominent change agents was Dr. William Halsted, a surgeon at Johns Hopkins Hospital who had embraced the concept of germs and began sterilizing surgical instruments. However, not only instruments but anyone involved in the operation had to:

Wash their hands with soap
Dip their hands in potassium permanganate
Bath their hands in hot oxalic acid
Finally, wash their hands with a mercury-chloride compound

During this time, Caroline Hampton took on the job of chief surgical nurse. She also became Dr. Halsted's chief object of affection.

After a period of time, Nurse Hampton informed Dr. Halsted that she had to quit. Having a history of sensitive skin, she could no longer endure the pain of the "sterilization" process on her hands. Dr. Halsted, with great concern, contacted Goodyear and had them make a pair of reusable rubber gloves especially fitted for Nurse Hampton. Fortunately, it worked! Dr. Halsted and Nurse Hampton continued their work side by side. Eventually, they married.

One has to wonder what would have happened had it been anyone other than Nurse Hampton who complained. Would he have simply replaced them?

Shortly thereafter, Dr. Halsted took an extended leave of absence due to a cocaine addiction. Dr. Joseph Bloodgood took over and, because the other staff was envious of Nurse Hampton's new gloves and pain relief, he ordered more gloves for the staff.

When Dr. Halsted returned months later, an interesting observation was made. Post-op sepsis had dropped dramatically! Sepsis without gloves among post-op hernia patients was 17% compared to 2% with gloves.

Initially, there was resistance among surgeons, but by the early 1900's, about 50% were wearing gloves. The main complaint was the inability to feel tissues, reducing the ability to differentiate organs and diseased tissue when elbow deep in pelvic, abdominal or thoracic cavities. Change was slow, but it brought us to where we are today.

If Dr. Halsted had not been in love with Nurse Hampton, how long would it have taken for the discovery of the impact gloves would have on the reduction of post-operative sepsis?

How many lives were saved because of a love affair?

References/Resources

COVID-19-Personal Protective Equipment: Questions and Answers: CDC

CNN Investigation: Tens of millions of filthy, used medical gloves imported into the US: Cable News Network

Medical Gloves: U.S. Food & Drug Administration (FDA)

History of Medical Gloves That Saved Millions: Gloves Mag

Rubber Gloves: "Born" - and Now Banished - At Johns Hopkins: Johns Hopkins Medicine

The History of Surgical Gloves: Past Medical History

The Nurse Who Introduced Gloves to the Operating Room: Science History Institute