Should I have worn gloves?

[noyesno]

I am a nursing student. In clinical this past week I applied lotion to a 65 year old woman's back without wearing gloves. Her skin was intact so I thought it would be okay for me to rub in the lotion with my bare hands (I washed with hot soapy water before and afterwards).

Prior to doing this, I asked the RN I was following if she would wear gloves to rub in lotion and she said yes. She made it seem like it was not a requirement but rather her preference, so, I went ahead gloveless because I thought it would be more personal for this patient.

Afterwards, I asked a fellow nursing student what she would have done and she said she would have wore gloves.

Now, I am a little paranoid...

What would you have done?

[matchsticktgt, LPN]

sorry, but if I'm touching the patient's skin then I'm wearing gloves....I find it easier to be in the habit of wearing gloves for everything, than stopping to think if I need to don them or not. If I "knew" the patient, medical history, etc...I might feel differently, but with the unknown factors in this day and time I can't be too safe. And I wear gloves with all fingers intact to draw blood or give injections.

[HappydayRn]

I think it's important for us to remember that human touch is very healing in and of itself. I would not have worn gloves if the skin was intact. While infection control is important standard precautions do not dictate it in this case. It's every nurses preference however but your rational was sound so don't beat yourself up!

[noyesno, MSN, APRN, NP]

Thank you everyone for such great responses! :) I've been reading threads on allnurses for a few weeks now and the first thread start for me.

Some more info on the patient:

She was a cancer patient in a cancer hospital, in for a therapeutic thoracentesis and possibly chemotherapy. She was my only assigned patient (we assume both the PCT and RN duties for them) and I had her for two back-to-back clinicals (a total of 12 hours). On our first day of clinical we are suppose to research our patient's charts for the first hour and a half of the clinical and know all about them. At the time of the lotion massage, I had already done that research, in addition to, two head to toe assessments on her, so, I was familiar with her skin and wasn't anticipating any surprises. I had just changed her linens too so I knew they were clean to stand up against. She was pretty healthy and upbeat compared to the other inpatient patients (who are basically at the end of life) and we became very close. She was also a nurse and gave me tips on nursing and told me stories from her days in school.

So... if she is there next week and I am faced with the decision to don or not to don... I will go gloveless during lotion application for this patient. As controversial as this may be, I'm with rebstudent in New Zealand! :)

[Kooky Korky, BSN, RN]

These days, gloves are used for everything.

I would have worn them in your case. And I think you should have worn them.

Check your facility policy and procedure manual. Always follow it. If you don't, and get injured, you might very well be out of luck as far as facing any possible disciplinary action or winning a lawsuit against the employer.

[Kooky Korky, BSN, RN]

Thank you everyone for such great responses! :) I've been reading threads on allnurses for a few weeks now and the first thread start for me.

Some more info on the patient:

She was a cancer patient in a cancer hospital, in for a therapeutic thoracentesis and possibly chemotherapy. She was my only assigned patient (we assume both the PCT and RN duties for them) and I had her for two back-to-back clinicals (a total of 12 hours). On our first day of clinical we are suppose to research our patient's charts for the first hour and a half of the clinical and know all about them. At the time of the lotion massage, I had already done that research, in addition to, two head to toe assessments on her, so, I was familiar with her skin and wasn't anticipating any surprises. I had just changed her linens too so I knew they were clean to stand up against. She was pretty healthy and upbeat compared to the other inpatient patients (who are basically at the end of life) and we became very close. She was also a nurse and gave me tips on nursing and told me stories from her days in school.

So... if she is there next week and I am faced with the decision to don or not to don... I will go gloveless during lotion application for this patient. As controversial as this may be, I'm with rebstudent in New Zealand! :)

If you already know what you will do, why did you ask?

[leslie :-D]

If you already know what you will do, why did you ask?

she was asking for general feedback.

after reading some responses that support her personal views, it sounds like it gave her the confidence to go forward.:)

leslie

[Kooky Korky, BSN, RN]

thats a hard one. In the hospital we think gloves gloves gloves. But if you are getting a massage.... and have intact skin.... they don't wear gloves. when you hold a patients hand because they are upset...you don't wear gloves.

Open sores, yes...but then again, you wouldnt' give a routine back rub to someone with open sores on their back.

If you wear gloves in a routine back rub....which is meant to comfort the patient..... how are they going to feel? here....I want you to relax, settle down....but yuk! I can't touch you! yea, it's not that bad, but gloves do convey something to a patient.

Here is another one somewhat related to that. think about it. It may happen to you....has happend to me.

You have an old geezer in the hospital....he needs to use the urnal...can't quite get it right, so you help him. You don gloves, and assist him.

Now. different situation. Your (insert one) Father, significant other, brother, best friend....... same situation...is in the hospital, needs to use the urnal, for whatever reason (pain, TIA, etc) can't quite get it right, so you help him. Not on duty in the hospital..... do you don gloves?

awkward situation.... My dad came to the ED. TIA. Urnal on the stand.... needed to use it.... I was looking for gloves, my Mom picked up the urnal and helped him before he had an accident.

ok, a bit off topic.

A wife helping her husband is totally different than a student learning professional nursing, even if, as she states in a post farther down, the patient was a nurse and she already had assessed her skin twice that day.

I don't think a person getting a massage would necessarily even know if gloves were on or off. They'd be on their abdomen, face down, probably eyes closed, would be feeling the lotion, wouldn't they?

What if the patient is perspired? I have gotten totally hinky about touching anything in recent years, so wear gloves for just about everything. Who needs the surprises? And if a patient doesn't like it, well, I'm sorry, we just really don't have to do any massage. Not to be mean, but who's going to massage me when I'm struck down by herpetic whitlows I picked up while doing bare massage (prodromal phase)?

[smarti15]

Contact precautions aside, my general rule of thumb is "if it's warm, wet, and not yours, wear gloves". To the OP: I commend that you took the time to give a back rub. I am in my last few weeks of nursing school, and very few of my fellow nursing students have ever given a back rub. It's nice to see that you care enough to give that personal skin to skin contact.

[jolly_tamale]

I give a back rub every day to one of my residents that is undergoing very tough chemotherapy. The rub helps her with her nausea she says. I always wear gloves. Not just to protect myself, but because her immune system is already compromised so much I don't want to risk anything with her. I would definitely follow the facilty and your school's procedure for whatever their protocol is.

[Otessa, BSN, RN]

i give lotioned/creamed foot rubs often...

and don't wear gloves.

my pts appreciate the massage and the tactile warmth of a human hand.

of course this only applies to intact skin.

leslie

The thing that stopped me from NOT wearing gloves while lotioning backs and feet is that I got warts on my hands from a patient's feet. Worried about other skin issues I could acquire-I am with the better safe than sorry camp.........

[leslie :-D]

The thing that stopped me from NOT wearing gloves while lotioning backs and feet is that I got warts on my hands from a patient's feet. Worried about other skin issues I could acquire-I am with the better safe than sorry camp.........

that's an excellent reason to wear them.

if i ever saw warts, i would have worn them, too.

you also have to keep in mind, my pts are all dying.

my heart has been known to overrule some otherwise, prudent decisions.

still, have never had regrets.

leslie

[Otessa, BSN, RN]

that's an excellent reason to wear them.

if i ever saw warts, i would have worn them, too.

The problem is-the warts didn't show their ugly 'heads' until a couple days later-on the patient's :crying2:feet and my hands.....