Question on skin to skin touching

[germsjackson]

I noticed that the nurses I worked with while in school would routinely touch the patient with their bare hands, while I felt much more comfortable wearing my gloves.

What are your thoughts on this, while doing an ed assessment, gloves? It just seems much safer and cleaner to me.

[lrobinson5]

After seeing the cord to the BP cuff/thermometer/pulse ox fall into the commode, or mingle with feces on the patients bed, and sometimes puked on, all to be wiped "clean" with a washcloth... no thanks, I'm wearing my gloves for all of these 'uncomplicated' procedures, thank you very much.

[itsmejuli]

One of the days I'm going to remember to put on gloves before I touch the curtains in any patient's room.

[Kayla.J.RN]

After seeing the cord to the BP cuff/thermometer/pulse ox fall into the commode, or mingle with feces on the patients bed, and sometimes puked on, all to be wiped "clean" with a washcloth... no thanks, I'm wearing my gloves for all of these 'uncomplicated' procedures, thank you very much.

I can definitely understand why you would question the cleanliness of the vital signs equipment. As a patient care tech on L&D, I come across some pretty gross BP cuffs, pulse ox, and ultrasound/tocos. I've gone to place a patient on the fetal monitor and grabbed a bloody ultrasound with gel still on it. All of the nurses are supposed to wipe the equipment down with Cavacide wipes once the patient is transferred to postpartum... but I find that many of the nurses don't do this. So the first thing I always do when I get on the unit, is go to each empty room and bag and tag everything to show that it is clean.

But I agree with most people who are saying that it is not necessary to wear gloves unless there is a high likelihood of coming in contact with bodily fluids. I think skin with the patient increases their comfort level and shows that you care.

[brainkandy87]

I think it's kind of ridiculous to put on gloves to put a blood pressure cuff or pulse ox on someone if they're not bleeding or covered in bodily fluids (the only exception is when I get an EMS, I always wear gloves to triage them in). You're exposing yourself to more germs by pushing around a cart at Wal-Mart than you are putting on a BP cuff gloveless. I always wear gloves for any procedure, obviously. I do wear gloves when sliding someone up in bed or moving them in bed, just because you never know when the last time someone cleaned their armpits. :)

[rn/writer, RN]

I do not wear gloves for taking vitals. I do wear them for anything that involves bodily fluids or other obviously yucky stuff. If I wear gloves for routine matters that don't normally involve exposure hazards, it's because my hands are chapped or I have small cuts, but I mention that to the patient.

Touch is such an important factor in caring for people. We don't have to return to the early AIDS/HIV days when some felt that wearing gloves would communicate disgust or rejection. But neither do we need to go to the opposite extreme of insulating ourselves to the point where we roll ourselves in bubble wrap and never make skin to skin contact at all.

Some patients, especially those who have been in a facility for a lengthy time, become terrible skin hungry. We're programmed to crave that kind of contact from birth to wrinkly old age. Staff members who can go home to a family or a pet may not realize how important a few seconds of skin contact can be for a person who has no one to touch. That's one of the reasons service animals who visit patients in hospitals or nursing homes are so popular.

Touch is also a valuable assessment tool. You can tell whether skin is warm or smooth, supple or hard in a way that just isn't possible with gloves on. I'd hate to lose access to this kind of knowledge.

If you can't get beyond the "ick factor," I suppose it's better to wear gloves unnecessarily than to make pruney faces while putting bare hands on your patients, but it's a trade-off. Faithful and vigorous handwashing along with our own lively immune systems can take on a wealth of beasties that lurk on ordinary, unbroken skin.

[gcriado]

I say use your best judgement...be safe.

[hiddencatRN, BSN, RN]

I only wear gloves if exposure is likely. Most of my assessments I do with bare hands. If I discover an issue during assessment I pause and put gloves on.

[Been there,done that, ASN, RN]

Per Merlee>"And there is an incredible loss of intimacy when there is no skin to skin contact. Would you wrap yourself in plastic to hold your children or grandchildren? Where does this end?"

I wasn't referring to possible pathogens from children. There is no comparison with holding your grandchildren and providing care to strangers in the ER , regarding intimate contact.

[lovedijah]

What's funny to me is the argument that there are more germs on grocery carts. I always smile when I see mom's who have the shopping cart covers. I always wonder if they wash the cover or if it just stays in their car until the kid is too big for the cart. Regardless of what you do, your child is still going to come into contact with germs. YET, if people sleep people better at night by wearing gloves, or using hand sanitizer, or using shopping cart covers, or sanitizing their phone? What does it matter? Kudos to them.

Wear gloves or don't. Just take care of your patients people.

[Anna Flaxis, BSN, RN]

Hygiene hypothesis, people!

[NayRN]

Actually...The shopping cart covers are padded, so they are more comfy for the baby. They also have toys attached to keep baby entertained, and they are harder to wiggle out of than plain old shopping cart straps. But that's beside the point. Yeah they are germy, but so is everything else...Acquired immunity, baby!

[mystcnurse, MSN, APRN, NP]

After seeing the cord to the BP cuff/thermometer/pulse ox fall into the commode, or mingle with feces on the patients bed, and sometimes puked on, all to be wiped "clean" with a washcloth... no thanks, I'm wearing my gloves for all of these 'uncomplicated' procedures, thank you very much.

I think that it is the nurse's job to make sure there are no feces on the patient's bed, and all of those cords and other items should be clean enough for the patient, that you have no problem touching them. The first thing that I always do while I'm introducing myself to the patient and doing basic assessment, is clean the room with anti-bacterial wipes... anything that the patient or I will touch, including the door knobs. If it isn't clean enough for me to touch, then probably, it isn't conducive to healing for the patient either. I know Flo would agree.