No gloves ever?!?

[dizzyray822]

So I'm in my last rotation of nursing school and I followed a nurse in CVICU today. Well from the getgo he mentioned he's "old school" and that's fine with me. In fact I get excited when I hear that as I figure I'll learn a lot. Well... While this nurse let me do almost everything and I completely appreciate that experience, he didn't wear a pair of gloves the whole day. I watched him do peg meds, draw blood, suction, and clean a diarrhea bottom (touching testicles and all) WITHOUT gloves. I got excited at one point cause he pulled a pair of gloves out BUT THEN he handed them to me, none for him. In fact, when cleaning the poop he said "yeah, I know im being naughty." So, I thought that if he doesn't use gloves then he must scrub his hands. Nope, 5 second rinse, no lather...that's it. I was shocked....

Needless to say...didn't shake his hand at the end of the day.

[CrunchRN, ADN, RN]

Wow. How sad.

I would just be glad he was so great about showing me stuff and let him deal with his own behavior and any fall out.

Not everything in the world is a freaking huge disaster and must be reported.

I promise you that in the years to come that if you help a newbie like he did you and then you get burned you will become one of those "eat your young" nurses yourself.

I understand you are trying to do the right thing, but when you are new it is better just to learn all you can and when you notice things like that just swear to yourself never to become that way. A little discretion and common sense will go a long, long way.

I am not in any way say what he does/doesn't do is right. It isn't. I am just trying to give you a real world way of dealing with these types of things so you don't end up being the one that gets burned by the flames.

[coolpeach]

I have seen nurses wear gloves to listen to breath sounds...crazy. I believe patients need to be touched by human hands and not gloved ones all the time. That being said, I do my assessment without gloves unless the patient has contact precautions or open wounds etc.

If I am dealing with body fluids in any way I WEAR GLOVES. This includes drawing blood, starting IV's, hanging Fluids, Peg tubes, cleaning bottoms, Foleys, suction, dressing changes etc.

Its not only about the nurse being safe its about patient safety too. What if I were doing a dressing change, but got germs into the area from not wearing gloves? Then the patient has an infection to worry about too.

I have had trouble with the washing hands policy. I developed eczema since graduating and my hands will literally break open and bleed if I am not careful (which is dangerous for not only me, but the patient too).

I cannot use the hand foam at all. I wash my hands with soap and water inside the room, but this really upsets management. They send people around to watch and see who is using the foam when entering and leaving each room (its on the outside of each door) and I am always on the naughty list. I explained I am allergic and use soap and water, but they can't see that as they do not go inside the room. I have prescription medication for my hands and can get a Drs not if need be, but they still aren't happy about it.

[Ruby Vee, BSN]

as a student i must be careful what i say, hence discussing it with my instructor and not him. with due respect my age has nothing to do with this and i never claimed to know it all. i'm learning day in and day out of this program, and will always be learning something new in nursing. you also are making assumptions without knowing the entire story though. however, thanks for trying to provide another perspective but honestly this nurse is not someone i wish to learn from which is my personal choice.

you're right. i don't know the whole story. i only know what you've chosen to share.

if you feel that, as a student, you cannot discuss the nurse's handwashing technique (or lack thereof) with him, you ought not to even consider "reporting" him. besides -- do you honestly believe that you're the first person to have noticed this? i'm sure his colleagues know.

[dizzyray822]

you're right. i don't know the whole story. i only know what you've chosen to share.

if you feel that, as a student, you cannot discuss the nurse's handwashing technique (or lack thereof) with him, you ought not to even consider "reporting" him. besides -- do you honestly believe that you're the first person to have noticed this? i'm sure his colleagues know.

its not just handwashing i'm talking about. it's further than that...way further as my different posts have gone into further detail. i wouldn't feel comfortable as a student going up to him about this without my instructor knowing about it. i don't know my schools policy for reporting things like this. which is why my instructor is looking into how to go about it. also, she likes to know the type of nurses we are with so that she knows whether to assign us to them again in the future. i dont report nurses ever. thats not my place as a student.

i guess his colleagues know and if they are okay with him touching this patients dirty bottom and private areas and leaving and touching the doors/stockroom area with his dirty hands then the whole thing is more bizarre than i thought.

[Lovely_RN, MSN]

What's really crazy to me is that I've read many threads/posts about people being reported for using FB or their phones on the job. Some of the same posters who are going crazy about the student wanting to report something that actually may cause harm to a patient are the same ones who have posted in others threads about reporting silly things that have the zero potential to harm any patient.

I can’t understand it at all.

[CrunchRN, ADN, RN]

The point is not should he be reported or should someone intervene, but that as a student who is being treated well and learning a lot from this person (good and bad ) pick your battles.

There is a whole unit full of other people with a lot less to lose who should handle this.

[Lovely_RN, MSN]

Very true, we must always pick our battles. However, it seems as if other folks (colleagues) have passed the buck as well since the RN is presently doing this. I guess I’m just wondering why the student is being brow-beaten for handling the situation appropriately. Did she approach anyone on the floor? No. Did she go to a nurse manager? No. She talked about it in post-conference with her clinical instructor who decided the issue was relevant.

I understand that clinical spots are at a premium and that a student is a “guest” but I too wouldn't want to be taught by someone who purposely does the wrong things. It’s a trust issue…if you’re not teaching me how to do the simple things correctly how do I know you're teaching me how to do the more complicated things the right way?

I know as a nurse that we get picked on (many times undeservedly so) at times about things that non-nurses know nothing about but hand washing? Really? Is it that hard to do correctly? Is it such a burden to put on a pair of gloves and wash your hands the right way after you clean the feces?

The point is not should he be reported or should someone intervene, but that as a student who is being treated well and learning a lot from this person (good and bad ) pick your battles.

There is a whole unit full of other people with a lot less to lose who should handle this.

[CrunchRN, ADN, RN]

I don't disagree at all, but I just think that the students may end up being the losers ultimately. And if everyone else knows and nothing has happened then nothing will now either....so what was won and what was lost.

[country mom]

i wouldn't tell on the guy unless you're going to do the same when you see doctors and the higher ups do it also. then you'll see why it really doesn't matter, b/c nothing will be done to the docs and higher ups, but the nurse will get grief for it.

Sorry, can't let this one go. Your line of reasoning makes absolutely no sense whatsoever. So if the docs are doing it, that makes it okay? I think the student did the right thing in discussing the issue with her/his instructor. To ignore standard infection control practices is outright negligence and puts patient's lives at risk. HAI's are real, and they kill.

[heartflutter, ADN, BSN]

I think someone handed you a load when you were in school.

Glove/no glove will never be a defense in court if a patient was truly sexually abused. If you did peri-care on a female patient and wore a glove and put your fingers in their lady partsl area and had no medical reason/order for doing so...wearing a glove and claiming it was "peri-care" is not going to win anyone a defense.

I think it is horrible that instructors tell students things like that when there isn't a bit of truth to any of it.

Not your fault.

I'm not saying that it would work both ways, but since gloves are standard today, I feel they are a "professional barrier" between us and patients.

Also, laws vary state to state. My state may very well be different from yours.

[annister]

Sounds like its more an issue of being lazy than old school. From the view of a coworker, I believe that I'd simply approach him personally with this type of concern, but it's pretty obvious that he's already aware of what he is doing and isn't likely to have some profound change of heart based on my comment. As a student, I believe you were right in mentioning it to your instructor (rather than his supervisor, coworkers, etc.) If that is where the process stops I would probably just use it as a learning experience and continue to practice handwashing and glove up. If you feel the need to further intervene, I would suggest asking him about it directly, and I emphasize the word ASKING. I can't imagine anything good coming of a student calling out or accusing his/her preceptor of subpar care; however, inquiring about the reasons for such practice may provoke a more productive response. In any event, he is likely set in his ways (as nasty as those may be), and you are much more likely to suffer any consequences as a student for trying to change them. I promise you that, in spite of this bad habit, there are many things that you can learn from him as a preceptor. Try not to let this prevent you from doing so, as you will only be doing a disservice to yourself! Good luck and best wishes in your career.

[BabyLady, BSN, RN]

I'm not saying that it would work both ways, but since gloves are standard today, I feel they are a "professional barrier" between us and patients.

Also, laws vary state to state. My state may very well be different from yours.

I would call your instructor and ask her to send you a copy of the state code that says that if you touch a patient's private area without gloves, that you can be charged with sexual abuse.

I would bet you $1 that she can't find it.

Some nursing instructors like to "dazzle" students with these types of BS stories that have no actual foundation in reality to get the "wow" looks from the students and to boost their own sense of importance.

Just know that if it doesn't make common sense, it is probably not true.