New Nurse Completely Surprised!!!

[LPNlisaD]

Hello All,

New to allnurses, and just wanted to get some opinions. I am a new nurse (LPN), started my first week at a long term care facility. I have observed many nurses not wearing gloves while doing patient care. The nurses and aides were not wearing gloves when taking residents to the bathroom, and when drawing blood, and fingersticks. Just wondering if this was the norm where any of you work??

[Crux1024]

If you're taking (as in walking) someone to the bathroom, then why wear gloves? I dont don gloves to do something simple like assess unless Im about to touch something wet with God knows what. Sometimes Ive been surprised, but that's what soap is for.

Gloves should be worn when expecting to come in contact with bodily fluids. There are some other circumstances, but thats the general rule.

[LPNlisaD]

Let me clarify, I have been in the room with these nurses while they are actively wiping a resident's hiney, and another today who informed me that she knows she should put on gloves while taking blood, but she doesn't because they get in the way. It seems to be common practice at this facility (especially with older nurses). I still think that wearing gloves is to protect me, but to also protect my patients. Am I crazy for thinking this??? My co-workers look at me like I'm crazy when they see me putting on gloves!

[delvenia]

Absolutely not!! Dont worry about how they look at you. I work on a busy Med/Surg floor and even when i did home health, i always wear gloves. I even wear them when i assess a patient. The reason i do this is because you never know what someone may have. you may go to remove a sock even and not even realize that there is blood or puss about to start seeping through. You are to use YOUR best judgment in patient care...

[Rachel, RN]

Dear "New" Nurse,

I don't think that you are crazy for wanting to protect yourself and your patients, however, some of those "older" nurses and CNA's were probably around when there were not any gloves to be used. It shouldn't be common practice, but there are those times when there is an unexpected moment or a Patient needs something now and not 2 mins after I get gloves and put them on. You should use your judgement with each situation. Should you use gloves, Certainly, without a doubt. However, I would like to hear from you in about 2 years to see if you do and feel the same way. Just curiosity. You will weigh your moments and your time.

[nitenurse02]

You are correct. Gloves are worn to protect you AND the patient. That said, I must admit that I have often been lax on this myself. Older nurses are the worst offenders. Esp when drawing blood or starting IVs. Bad habits are easily learned. I have cleaned patients and even done full baths sans gloves. As the above poster mentioned, we do have soap.

However, this is not the best practice and you are better off letting your coworkers think you are crazy and continue to wear gloves when needed.

[nitenurse02]

Sorry

[PedsDrNurseTheo, ADN, BSN, MSN, DNP, RN, EMT-P, NP]

Universal precautions mean just that: a set of standard precautions used every time, on every patient. At minimum, that is hand hygiene before and after contact, sharps discipline, aseptic technique, and barrier protection when indicated. However, feces, nasal secretions, urine, vomitus, perspiration, sputum, and saliva do not automatically require barrier precautions unless contaminated with blood or otherwise determined infectious.

That being said, I wear gloves with every patient, every time. It's just good practice, IMO.

[cb_rn]

I remember being astounded at my first pre-employment physical where the NP had posted a sign at her desk stating CDC guidelines do not require gloves for flu shot injections. I sniffed in disdain, thinking I'd never not use gloves. Now I sometimes find myself giving injections with insulin pens and not gloving up.

[annacnatorn]

New Nurse:

Your first line of defense is to wear gloves. Universal precautions are key to preventing the spread of disease. The nurses that you see that don't wear gloves should be reminded about universal precautions and how important that "in the way" line if defense is. You NEVER ever assume that just because you have their chart, hx etc, you have all of the info you need.

For instance, I was working in a SNF, LTC (same thing) and seen a fellow CNA do a blood check on a male patient who so happened to be on isolation..no gloves, no gown, no mask..nothing. I asked her, hay do you know everything about this patient, she said not really, but he looks ok and seems fine. I told her you are very correct, he does look good, talks wonderfully Oriented to time/date/place, able to take care of personal needs, but he has full blown AIDS..can you see Aids? Can you see HIV? Can you see MRSA?..she immediately ran to the bathroom, then the shower, took a shower, then asked to go home. Gloves is and are the first line of defense we Nurses, regardless of level, have to protect ourselves, our patients, our Families.

[mustlovepoodles, RN]

Handwashing and gloves are a sticking point with me. It really makes me crazy when I see nurses not gloving up when they're handling trash, cleaning up blood or body fluids, or "forgetting" to wash hands. And I *am* an old nurse. I remember a time when we were told NOT to use gloves because it would make our patient feel bad. Back then we didn't have a box of gloves on every flat surface and antibacterial squirt foam. You had to go into the patient's bathroom and wash up in there before and after you touched them. and you can imagine just how often that actually happend. When AIDS hit the scene and suddenly hospitals had to have TONS of gloves, there were shortages in many places. And forget nitrile or vinyl gloves. You wore latex, no matter what. Your hands break out and you lips swell up? Too bad. Wear your gloves and then wash your hands & face. (the old "rub some dirt in it and walk it off" approach)

There is no excuse today to not use gloves appropriately. I was in the ER 2 weeks ago with my DD17 having a small lac sutured after an MVA. There was a moderate amount of blood, but nothing gushing. The nurse came over, no gloves in sight, and started cleaning the bloody arm. I even stopped her and said,"You might want to put on gloves for this." You know what she said? "Oh, it's okay. this is nothing compared to what i see every night." That may be, but God knows what you have on your hands and this is my only daughter. Thankfully, the doctor stepped up, fully gloved, and took over from there.

[txsummerRN]

For instance, I was working in a SNF, LTC (same thing) and seen a fellow CNA do a blood check on a male patient who so happened to be on isolation..no gloves, no gown, no mask..nothing. I asked her, hay do you know everything about this patient, she said not really, but he looks ok and seems fine. I told her you are very correct, he does look good, talks wonderfully Oriented to time/date/place, able to take care of personal needs, but he has full blown AIDS..can you see Aids? Can you see HIV? Can you see MRSA?..she immediately ran to the bathroom, then the shower, took a shower, then asked to go home.

Dear Annacnatorn,

While you were correct in advising your colleague to check a patient's hx more carefully before deciding not to wear gloves, I hope you also told her that AIDS cannot be transmitted just by touching someone. Hopefully you also told her that the patient was probably on isolation to protect HIM from the staff, not the other way around!

:redbeathe