jewelry in the labor suite?

[oramar]

My daughter handed me a picture of her newborn being cleaned up minutes after delivery. I can't see the persons face but the person cleaning my just born grand baby has three large clunky gold bracelets on her right arm. The person is wearing gloves and green scrubs so I know it is staff. It does not seem very sanitary, going from infant to infant with those bracelets dragging in the gunk. What do you labor and delivery nurses think? I remember being a student and not even be permitted to wear a wedding band.

[Jolie, BSN]

When I did my clinical in OB one of the nurses had very long ARTIFICIAL nails. I guess she saw me staring at them because she said "I know I shouldn't have these but I got them for a wedding". She had them the two weeks I was there, even during the delivery of a 26 weeker. She pulled them off my last day.... AT THE NURSES DESK; pieces went everywhere.

Artificial nails have been linked to deadly pseudomonas infections in the NICU setting. She should not have been allowed to work with them.

Article:What Are the Current Guidelines About Wearing Artificial Nails and Nail Polish in the Healthcare Setting?

http://www.medscape.com/viewarticle/547793

[Jolie, BSN]

I'll take the devils advocate and say that humans have been delivering babies for millions of years in areas less sterile than a modern day delivery room. Newborns and mothers that go normal spontaneous without complications are pretty much ready to take on the world.

Of course it is not ideal, dangling jewelry, etc., but most of the world still delivers at home, cuts own cords, performs placenta rituals, etc. ... Just sayin', I have no axe to grind here on this topic.

You are right that births take place in less than sanitary situations all over the world. But it is one thing for a newborn to be exposed to "native" germs in its own environment versus hospital-acquired superbugs. A newborn born in a hut in a 3rd world country will get immunity from its mother's milk to "native" microbes. A newborn exposed to MRSA or pseudomonas in the "sterile" hospital environment may get very sick, since neither he nor his mother will likely have any immunity.

Our own germs are usually less threatening than someone else's.

[Jolie, BSN]

Hey, oramar,

Congratulations! I'm embarrassed that it's taken me 3 posts to say that :)

[woknblues]

I knew my comments would bring out some ire, like I said, devils advocate and all that. I don't know what the neonate mortality rate is, but I do know that the US is far from the leader in the fight.

Oh, and a belated congrats.

[HappyBunnyNurse]

Artificial nails have been linked to deadly pseudomonas infections in the NICU setting. She should not have been allowed to work with them.

Article:What Are the Current Guidelines About Wearing Artificial Nails and Nail Polish in the Healthcare Setting?

http://www.medscape.com/viewarticle/547793

I think what bothered me the most was that none of her coworkers ever said anything to her. This was my first clinical experience so I didn't feel confident enough to say anything or report to the manager. She had this whole "I'm gonna show the stupid student the real world" attitude. At least she's no longer in L&D; I heard she moved to ICU. Maybe they are keeping a closer eye on her. Thanks for the link!-

[nkochrn, RN]

I don't wear any jewelry other than my wedding ring and when I picked it out I specifically looked for one that would not be a problem to wear underneath of gloves.

I am wondering what you all wear for watches if you are in L&D??? In my hospital we don't usually have more than 1 birth in a day, since we don't usually have but 3 or 4 a month. We are often going from taking care of very sick patients on the floor to L&D. I actually don't ever wear a watch because I'm not a jewelry person and never remember to put it on. I use the Apgar timer when I'm in L&D.

[erjunkie8]

You are right that births take place in less than sanitary situations all over the world. But it is one thing for a newborn to be exposed to "native" germs in its own environment versus hospital-acquired superbugs. A newborn born in a hut in a 3rd world country will get immunity from its mother's milk to "native" microbes. A newborn exposed to MRSA or pseudomonas in the "sterile" hospital environment may get very sick, since neither he nor his mother will likely have any immunity.

Our own germs are usually less threatening than someone else's.

I just wonder if being that births take place all over the world in all different kind of places comment would be something acceptable in your mind as you were delivering a child... I always pretend how that policy and procedure would apply to me and my family and would I be okay if another nurse violated it just because she went to a wedding. At my work you would be sent home immediatley, no questions asked and not to return until corrected. I think it should be that way.. no exceptions with infection control. NICU babies can die from a paper scratch that gets infected!

[prmenrs, RN]

I fixed the title, Oramar, hope that was OK....

:ancong!:

[Elvish, BSN, DNP, RN, NP]

I just wonder if being that births take place all over the world in all different kind of places comment would be something acceptable in your mind as you were delivering a child... I always pretend how that policy and procedure would apply to me and my family and would I be okay if another nurse violated it just because she went to a wedding. At my work you would be sent home immediatley, no questions asked and not to return until corrected. I think it should be that way.. no exceptions with infection control. NICU babies can die from a paper scratch that gets infected!

Jolie is a NICU nurse herself and knows that quite well. What she is saying is that in a hospital the bugs are so much worse than in the community, by and large...and I agree. If my baby is being born at home into germs I've already been exposed to (and hence, so has he), it is a far different story than if he is being born into icky hospital bugs carried on someone's scrubs, jewelry, face, or whatever. I think you and Jolie are agreeing here. And I am agreeing with both of you.

[CEG]

How many women and infants are dying in these countries due to infection?

Actually neonatal and maternal mortality became substantially WORSE when birth in the U.S. moved to the hospital. Why? Infection. It only improved again when penicillin became available.

If I deliver at home I have one midwife who is seeing only me. Fewer vag exams, no AROM, internal monitor, etc. In the hospital I have providers going from pt to pt spreading each patient's germs to the other and performing invasive procedures. Puerperal fever occurs in nature but majority of cases are due to iatrogenic causes. At home one can be relatively sure there was no MRSA, staph, etc unless it was already part of the environment in which case baby will get immunity from the mother and be much less likely to become ill.

[nursejohio, ASN, RN]

And for millions or years, as well as now, infant and maternal mortality rates were and are extremely high in those less than sanitary conditions.

But our perinatal mortality rate is one of the worst when ranked with other developed nations, we're actually worse than some of the places you'd expect to find the "less than sanitary conditions".