nails

Dixiecup · Jul 15, 2007

I am the ADON at a LTC facility. I have worn overlay nails for years and still do. Probably 75% of our employees wear fake nails including the DON.

It's not really an issue here. AS someone else stated. Gloves are worn religiously.

shellsincanada · Jul 15, 2007

It's not really an issue here. AS someone else stated. Gloves are worn religiously.

I suspect that gloves were worn more religiously in the nicu where the nails were a factor in the deaths of the 16 infants. Gloves make no difference. It's probably not an issue because of the population of your facility( ltc) where deaths are more expected and not looked at in terms of a pattern like it was in the nicu in Oklahoma. I think your facility is probably playing with fire , imo.

suzanne4, RN · Jul 15, 2007

Oh yeah...you name it, I've taken it. Geletin tablets, every conceivable vitamen, even the prenatals didn't work. I even used to only wash my hands with water when dirty, but when I took baths and showers, I would put on rubber gloves, tape the ends, so the water wouldn't soak into my nails. I once even spent $104 on a single bottle of a product that supposedly had enzymes in it that would harden nails over time...didn't work...it was something I found over in Europe.
My nails are so thin, I even have to pay extra before they put on artificial nails...to not use the electric filing bits, but to prep them by hand b/c it would make them so thin, I couldn't finish the process.
I will probably have to address this with my nursing school. I may have to carry a nail brush in my pocket or have the clinical instructor to check my nails for uplifting, etc. I don't have any issues with them lifting when I went to having them done every 7 days instead of every 14. I keep them manicured so well and have them buffed thin to wear most people can't tell the difference without extremely close scrutiny.
I just can't imagine spending a career in nursing with what I consider to be, a handicap that is easily corrected. With the frequent handwashing, there is no way, that once my nails grew out a little, I would survive a day before they ripped on something, and that can't be good either with all of the bacteria around.
I am obviously not trained in infection control...but still don't see how this is a risk to the patients. Gloves are worn for virtually all patient contact that involves your hands except for taking vitals. I would think the door knobs to the rooms would be more of an issue than artificial nails.
PS: I'm wondering if the issue is the acrylic rather than the artificial part. Does anyone have information on other types of nails such as silk, porcelin, fiberglass, etc.

Sorry, but you are going to have to deal with the federal laws that cover the healthcare workplace, and that is no individual directly caring for patients may have acrylic or artificial nails. Does not matter what your nursing instructors are doing, but have you even bother to run in by the facilities that are you are doing your training at? Unfortunately, you are putting them at risk as well. If JCAHO or one of the state groups make a surprise visit at the facility, they will charge the facility with a $10,000 fine.

The issue is with any type of overlay, does not matter what it is. Suggest that you may wish to check further into this before completing your degree. And yes, things like this happen to others, there have been people that have become allergic to latex such as surgeons and have had to make changes in their career. You are going to be expected to be washing your hands frequently all day, and if you are having issues where you are getting open wounds on your fingers from this, then maybe you need to select another career. Or a different aspect of nursing where you will not be at the bedside. To jeopardize a patient because you have problems with water/soap and your hands is just not going to be an acceptable reason. And now you are required to wash your hands more than ever.

Any bit of acrylic is easily picked up on, don't try to fool yourself that it is not. And gloves are not worn 100% when you are in a patient's room. And you are forgetting that you must wash your hands when you remove gloves, and cannot go into another patient's room even with just a new set of gloves on. Sounds more like you have not started any of your clinicals as of yet, this is something that you are going to need to look into. And your instructor has no permission to grant you any special treatment at a facility. They can not change federally mandated laws so that you can train.

Heaven forbid that I was a patient in a facility, but I can promise you one thing that no nurse with any type of overlay on their nails would be carrying for me, or any family member of mine. This is not to pick on you but explain how things how, and how infection control practices are set ip at facilities.

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And yes, I wore acrylic nails for years, but when the law came out that we could not wear them, they were removed and never placed again. And that was even in the OR at the time, and we always wore gloves there. And that has been more than five years now, and it is just not an issue.

suzanne4, RN · Jul 15, 2007

I am the ADON at a LTC facility. I have worn overlay nails for years and still do. Probably 75% of our employees wear fake nails including the DON.
It's not really an issue here. AS someone else stated. Gloves are worn religiously.

Sorry, but your facility is subject to a mega-money fine by the state, as well as federal law. This is not something that you are immune from.

As a DON, or ADON, you are not usually involved in direct patient care, so you could be exempt from that policy. However, I do not believe that the owners of your facility would back you up if the state made a surprise visit and fined them for every nurse or employee that was doing direct patient care and you allowed it.

This is not something to be proud of, wonder what the MRSA rate is at your facility, or any other communicable disease. Gloves alone does not prevent it from spreading.

Suggest that you may with to attend some infection control seminars to see why it has been mandated by the federal government and not up to you to make these decisions.

iluvmynavyman · Jul 17, 2007

maybe you can work in a different setting ? not in a hospital so you can still wear your fake nail

but what setting can allow it ?

NursingAgainstdaOdds · Jul 17, 2007

I am the ADON at a LTC facility. I have worn overlay nails for years and still do. Probably 75% of our employees wear fake nails including the DON.
It's not really an issue here. AS someone else stated. Gloves are worn religiously.

Ew, ew, double ew.

A) Gloves have a high failure rate.

B) I suspect that failure rate gets higher when you are wearing them over acrylic nails.

SmilingBluEyes · Jul 17, 2007

If you have very weak nailbeds subject to infection, and feel the need to wear acrylics/fakes, you would really do well to consider working in a non-clinical area of nursing. You are obligated to protect yourself and your vulnerable patient and/or resident population. I think that is the bottom line.

CRNI-ICU20 · Jul 17, 2007

what troubles me about the constant mantra about the "two nurses" in the nicu is that one had regular native nails and one had artificial nails....both harbored staph and gram neg. organisms under the ends of their nails.....but this was blamed on all artificial nails!

in addition, in nearly every evidenced based study, even with hand washing both with alcohol based products and without, whether with artificial nails or without, bacteria still was cultured out off study subjects' hands.....

i don't think a person should be discouraged from entering a nursing program because of this....

in the case of the op, her genetic condition inhibits her from having normal nail beds; this is no different that if she was born with one leg shorter than another; we accommodate people in wheel chairs, why can't we as nurses accommodate someone with malformed natural nail beds? there are so many other avenues of nursing that the op could contribute to that would benefit many; direct patient care isn't the only thing that she could be a nurse in....

for instance, what about phone triage? or informatics? or medical writing and library research? i think telling someone such as this op "to think about a different career" is a bit harsh and narrow.....what if someone were to tell all the people who have long hair below their shoulders that unless they cut their hair, they would have to think about a different career? since we are talking "infectious disease" here....how many of you see long haired nurses constantly rubbing their fingers through their hair and then trotting into a patient's room thereafter???? hmmm???? and since we are on the germaphobe train, why not spank every doctor, resp. therapist, and family member who fail/refuse to put on a pair of gloves or gown in contact isolation rooms????hmmm?? and what about all those docs who wear long ties that dangle down into someones spittle, urine, poo,or blood??? (how would you like to be wearin' that thing around your neck all day long??)

the point being, that the number one way to protect your patient is to wash your hands....vigorously, with soap and water.....before and after interventions.....and barrier yourself and them with gloves when coming into contact with body fluids, iv lines, or skin....

here's an article from medscape....

ask the experts about primary care for advanced practice nurses

from medscape nurses

what are the current guidelines about wearing artificial nails and nail polish in the healthcare setting?

question i have a colleague who still wears artificial nails at work. what is the latest evidence about wearing artificial nails and nail polish in the healthcare setting?

hs-rothrock.jane.jpg response from jane c. rothrock, dnsc, msn, bsn,cnor, faan

professor and director, perioperative programs, delaware county community college, media, pennsylvania

your question is timely in light of a number of ongoing initiatives to decrease healthcare-associated infections (hcais). as early as 2002, the centers for disease control and prevention (cdc) published a guideline for hand hygiene in health-care settings, which recommended that healthcare workers "not wear artificial fingernails or extenders when having direct contact with patients at high risk" (eg, those in intensive care units, transplant units, or operating rooms).[1] this recommendation is considered a category ia, which is defined as "strongly recommended for implementation and strongly supported by well-designed experimental, clinical or epidemiological studies." the cdc further advises nurses to check their facility's policy regarding artificial nails, which may be stricter.

in 2003, the cdc launched its campaign to prevent antimicrobial resistance in healthcare settings, including "12 steps to prevent antimicrobial resistance among surgical patients." step 12, which covers hand hygiene, includes the directive "do not operate with artificial nails."[2]

bacteria found on fingernails and artificial nails

studies have documented that subungual areas of the hand harbor high concentrations of bacteria, most frequently coagulase-negative staphylococci, gram-negative rods (including pseudomonas), corynebacterium, and yeasts.[1] freshly applied nail polish does not increase the number of bacteria recovered from periungual skin, but chipped nail polish may support the growth of larger numbers of organisms on fingernails. even after careful hand washing or the use of surgical scrubs or hand rubs, personnel often harbor substantial numbers of potential pathogens in the subungual spaces.

whether artificial nails contribute to transmission of healthcare-associated infections is unknown. however, individuals who wear artificial nails are more likely to harbor gram-negative pathogens on their fingertips than are those who have natural nails, both before and after hand washing. the effect of length of natural or artificial nails on infection risk is also unknown, because the majority of bacterial growth occurs along the proximal 1 mm of the nail adjacent to subungual skin.

an outbreak of p aeruginosa in a neonatal intensive care unit was attributed to 2 nurses (one with long natural nails and one with long artificial nails) who carried the implicated strains of pseudomonas on their hands.[3] the infected neonatal patients were substantially more likely than controls to have been cared for by the 2 nurses during the exposure period, indicating that colonization of long or artificial nails with pseudomonas may have contributed to causing the outbreak. personnel wearing artificial nails also have been epidemiologically linked to several other outbreaks of infection caused by gram-negative bacilli and yeast. these studies provide evidence that wearing artificial nails may increase the likelihood that harmful bacteria may be transmitted to patients, posing an infection control risk.[4]

please note: the article says "may increase" the likelihood......

as for me and my house....i wear my real nails....but when i go on vacation....i glam up... crni

justme1972 · Jul 18, 2007

Chipped nail polish has ragged edges that collect bacteria.
We had a nurse with artificial nails get a horrible MRSA infection under her nail. She was fired because artificial nails are forbidden at our facility.
Since that incident infection control spot checks on days/nights to see if anyone has artificial nails on. If you do you get fired on the spot. Only two persons have been fired - because it is obvious that the hospital means business.
For the poster with the really thin nails - that would be horrible to go through. I worry that you could get a nasty infection with OR without the overlay.

The only infections I have ever had with my nails (and I haven't had one in about 7 years once I figured out what caused them) is when I would go too long between fill-ins, and once I made that connection, I never got another one. I go every 7 days vs the standard 14.

Well over 98% of women wear acrylic nails and I am wondering if other types of nails such as silk wrap or porcelin...which do not contain acrylic products (b/c they were designed for women who were allergic to acrylic) do the same thing?

These products are substantially more expensive, which is the reason most women don't get them.

justme1972 · Jul 18, 2007

Sorry, but you are going to have to deal with the federal laws that cover the healthcare workplace, and that is no individual directly caring for patients may have acrylic or artificial nails. Does not matter what your nursing instructors are doing, but have you even bother to run in by the facilities that are you are doing your training at? Unfortunately, you are putting them at risk as well. If JCAHO or one of the state groups make a surprise visit at the facility, they will charge the facility with a $10,000 fine.
The issue is with any type of overlay, does not matter what it is. Suggest that you may wish to check further into this before completing your degree. And yes, things like this happen to others, there have been people that have become allergic to latex such as surgeons and have had to make changes in their career. You are going to be expected to be washing your hands frequently all day, and if you are having issues where you are getting open wounds on your fingers from this, then maybe you need to select another career. Or a different aspect of nursing where you will not be at the bedside. To jeopardize a patient because you have problems with water/soap and your hands is just not going to be an acceptable reason. And now you are required to wash your hands more than ever.
Any bit of acrylic is easily picked up on, don't try to fool yourself that it is not. And gloves are not worn 100% when you are in a patient's room. And you are forgetting that you must wash your hands when you remove gloves, and cannot go into another patient's room even with just a new set of gloves on. Sounds more like you have not started any of your clinicals as of yet, this is something that you are going to need to look into. And your instructor has no permission to grant you any special treatment at a facility. They can not change federally mandated laws so that you can train.
Heaven forbid that I was a patient in a facility, but I can promise you one thing that no nurse with any type of overlay on their nails would be carrying for me, or any family member of mine. This is not to pick on you but explain how things how, and how infection control practices are set ip at facilities.
-------------------------
And yes, I wore acrylic nails for years, but when the law came out that we could not wear them, they were removed and never placed again. And that was even in the OR at the time, and we always wore gloves there. And that has been more than five years now, and it is just not an issue.

Suzanne4...I just wanted to state that I didn't suggest (nor would) not to wash ones hands...this was a practice that I engaged in at home BEFORE I started getting artificial nails and this was only when I had prolonged exposure to water such as washing dishes, bathing the dog, taking a bath or shower that I "sealed" my hands. Like anyone else, I washed my hands before cooking, using the bathroom, etc...but I made sure that I dried my hands thoroughly before the water penetrated my nail beds.

PS: When my twins were in the NICU (and this was before I thought about being a nurse or knowing about the nail-studies), I did ask if my nails were a problem b/c I was going to remove them while they were in the hospital...the Neonatologist was the one that told me, "As long as you do the 2 minute wash when you come in, you are fine."...I'm not questioning you...but that is the God's honest truth of what he told me.

classicdame, MSN, EdD · Jul 18, 2007

Just this week I conducted a handwashing exercise with CNA's, using the glow-lotion and black light. None had artificial nails. But those with longer-than-fingertip nails "flunked" the exercise. They were amazed how much was retained on top of and under the nail and along the cuticle line. This is yucky stuff you take home and give to loved ones.

TheCommuter, BSN, RN · Jul 18, 2007

i was told that nurses cant wear fake nails or nail polish is that true?

I work at a LTCF (long term care facility), and the staff nurses are permitted to wear false fingernails and nail polish without any notable restrictions. Even though fake fingernails and nail polish are allowed on nurses at my workplace, these practices still are not the most prudent things to do. Personally, I have not worn acrylic fingernails in over three years!