My pts (in a quad room) were all sleeping and I stepped into the entry way into their room to take a peak and check on them. This was not an infection control room.
The infection control nurse comes up from behind and asks if I washed my hands before leaving the room. I said no, I did not really go in to the room and I did not touch anything.
She says, well you just vioated policy. You are to wash your hands before leaving a patients room.
Now I know that bacteria are wiley, tricky, sneaky and devious organisms but I neever knew they could jump 30 ft and purposefully land on my hands.......
We do not have the hand sanitizer at every door. To wash we must use the sink, soap, paper towels the whole nine yards..........
Does this policy seem a little excessive? It doess to me......
I really do appreciate the replies, and you are right. The policy is the policy. It does not matter if the policy is scientifically grounded or not.....I am to follow the policy. I get that.
The reason no one is willing to discuss the actual means of infection transmission is that it would become obvious that a department of forestry water chopper is being used to extinquish a candle.......
Anyway, I will of course follow the policy. I just wonder why I just spent the last 4 years learning how to critically think........
A lot of people saying a lot of things, but not one shred of scientific rationale......
If I pop my head into a room to check on sleeping patients there is going to be no exchange of infectious organisms from them to my hands or my hands to them.......
Think about it folks.....
From many of your replies I find it hard to believe you even bothered to read the entire original post.......
have to agree with you, lots of persons didn't read or are reading into your original post.
good way to flunk NCLEX.
You need to suggest they put up hand sanitizers in the hall way, if not sinks.
then you can periodically wash/sanitize your hands quickly and obviously. Good luck.
Trying to apply logic in this profession doesn't always go well.
All facilities are different too. I work in a hospital that has hand sanitizers everywhere and lots of sinks to wash hands. It's easy to wash my hands just because there is always something to remind you like a pump or a sink that says "Use me!" Now the hospital I'm doing my clinical at is a whole different story. It is an older hospital that literally makes washing your hands an absolute task. There are no pumps on the outside hallway walls, sinks only in the patient's bathroom, and in each room they seem put the alcohol pump in a new place it seems like. When I'm at clinical, I'm literally going out of my way to make sure my hands are clean whereas at work its not even a second thought because access is all around me. Overall, I have noticed a better compliance at the hospital I work for and I think its because management has gone out of their way to provide ergonomic access for hand washing.
So I understand how the poster may be frustrated with the infection control nurse riding on them, especially if it is a facility that wants you to wash your hands but does nothing to help you do it. OP knew the patients were sleeping so the chance of them falling or some other hazard occurring was slim and probably interacted with the patients shortly before they slept because a student nurse has that kind of time to spend. It was a literal check but the unfortunate thing for the OP is that they are a student who got snagged at the wrong time in the wrong place. Let's just be honest.
On a side note, for the all the emphasis on hospital personnel maintaining hand hygiene there is one staggering group I have noticed that is lagging seriously behind in that department which are the doctors. It only takes one vector!
A lot of people saying a lot of things, but not one shred of scientific rationale......If I pop my head into a room to check on sleeping patients there is going to be no exchange of infectious organisms from them to my hands or my hands to them.......Think about it folks.....From many of your replies I find it hard to believe you even bothered to read the entire original post.......
It doesn't matter. It's the policy at your facility. Whether you think it's needed or not is totally irrelevant. Especially as a nursing student where you are a guest at the hospital and your actions reflect on your school. Follow the policy. Period.
My pts (in a quad room) were all sleeping and I stepped into the entry way into their room to take a peak and check on them. This was not an infection control room.
The infection control nurse comes up from behind and asks if I washed my hands before leaving the room. I said no, I did not really go in to the room and I did not touch anything.
She says, well you just vioated policy. You are to wash your hands before leaving a patients room.
Now I know that bacteria are wiley, tricky, sneaky and devious organisms but I neever knew they could jump 30 ft and purposefully land on my hands.......
We do not have the hand sanitizer at every door. To wash we must use the sink, soap, paper towels the whole nine yards..........
Does this policy seem a little excessive? It doess to me......
My answer deviates from many posts. I think the answer is yes and no. Yes, you broke a policy aimed at keeping people from getting illnesses and saving the hospital money. This is why you should scrub till the fingers bleed. However, just a peak into a room requiring handwashing is a bit much. But policy is policy and we adapt accordingly.
It reminds me of how you get stopped by the cop for going 2 mph over and tells you how speeding must be reduced. You could say (not that i do) he is passionate about saving lives and it will remind all to drive slower. You can't argue b/c he's right, but does it really have to be done? Nope. 2mph = peeking into room.
Also keep in mind how it might look to patients and their families. Or if the facility was having their annual evaluation and there were state inspectors there. No one knows what you did in that room. They only saw you walk out without washing your hands. I understand that your hands weren't dirty, but anyone who was observing doesn't know that. You don't want anyone complaining to the administration that a student nurse from X school isn't following infection control policy. Your school could lose its privileges at that facility and then it'd be tough to get a nice letter or recommendation from any of your instructors. It's good that you're thinking critically, but it can't hurt to squirt some sanitizer on your hands one extra time, even though you might not need it. Try to think about it less "scientifically" and more for show. Everyone in that hospital wants to see a nurse wash her hands when she walks in and out of a room. When they see one who doesn't, that's all it takes for someone to raise a stink. Imagine if someone in your room got MRSA... you'd be the first one to blame since you were observed not following infection control policy. So think about it more like general, expected professional behavior and do it every time, regardless if your hands are dirty or not.
Also keep in mind how it might look to patients and their families. Or if the facility was having their annual evaluation and there were state inspectors there. No one knows what you did in that room. They only saw you walk out without washing your hands. I understand that your hands weren't dirty, but anyone who was observing doesn't know that. You don't want anyone complaining to the administration that a student nurse from X school isn't following infection control policy. Your school could lose its privileges at that facility and then it'd be tough to get a nice letter or recommendation from any of your instructors. It's good that you're thinking critically, but it can't hurt to squirt some sanitizer on your hands one extra time, even though you might not need it. Try to think about it less "scientifically" and more for show. Everyone in that hospital wants to see a nurse wash her hands when she walks in and out of a room. When they see one who doesn't, that's all it takes for someone to raise a stink. Imagine if someone in your room got MRSA... you'd be the first one to blame since you were observed not following infection control policy. So think about it more like general, expected professional behavior and do it every time, regardless if your hands are dirty or not.
Hmmm...more for show than scientifically. Point taken and actually a good one.
A lot of people saying a lot of things, but not one shred of scientific rationale......
Because in this case it's not strictly a matter of science: it's also of money. Let's be honest, hospitals are not exactly the most benevolent of entities...they're looking to maximize profits and minimize costs wherever they can. Having to provide something for free just kills them.
Facilities will not receive reimbursement for any nosocomial infection that they treat: they have to eat that cost. So the best way to minimize nosocomial infection rates is...ta-da: infection control precautions. They enforce those, then there's no way insurers/Medicare can come back and say, "this is the hospital's fault because this nursing student (you) didn't wash his hands."
Even though you stated you just looked in, the infection control nurse didn't know what you did in that room, or what you did in the last room before you arrived here, so she's going to assume the worst...as the hospital is paying her to do.
The same thing happened with falls not too long ago: insurance companies and Medicare started telling facilities, "you could have prevented this fall, so you're not getting reimbursed for any treatment required because of the fall." Hence all the fall precautions to the point of what one may think is ridiculous.
I had a patient who had a slight limp and my charge nurse starts going on about whether this patient should be 1:1. Honestly, this patient wasn't that unstable on their feet...if anything, they were highly irritable from lack of sleep and being 5150ed, so having someone at arm's length 24/7 was IMO the very last thing they needed. But that gives you an idea of how seriously facilities take these issues...because if something happens that the facility could have prevented, the facility is throwing money away.
Are these precautions excessive? I'll admit that they can be.
Value your job or, in your case, your clinical site? Then smile, nod and wash up every time no matter what you think of these precautions. Otherwise take your chances of being fired from your job or failing your clinical.
Does every nurse/student follow them religiously? Do I? Honestly...no to both. But they--and I--are taking chances and so have to deal with anything that comes from that. If I'm out of a job because I didn't follow the facility's protocol, it's not the facility's fault for having such a strict P&P, but 100% my fault for not following it.
And that applies to you too: wash your hands, or choose not to--you're free to make your own decision. But you are a competent adult, and so you have to deal with the outcome.
The infection control nurse was doing her job. Don't question her on it or try to rationalize it. It is what it is. And you got buuuusted.
In my own little nursing world...
Do I make nighttime rounds with my handy-dandy pen light and wash my hands each time I exit a room if I've only just shined a light on the patient? No.
If the patient is awake and needs something without it being an emergency, do I wash my hands before assisting them? Yes.
If it's a real emergency--one in which someone yells "help" and we ALLLLL run--none of us have stopped to wash our hands prior. The last hand-washing after patient care will just have to suffice in that situation. I've even gone in bare-handed when a confused patient had managed to get out of bed in such a way that the bed alarm was delayed (I hate when they do that!), had ripped out every IV, and was about to topple over headfirst. After my co-workers were able to get their gloves on, they immediately relieved me and told me to go wash up and glove up.
I've lost count of the times I walked into a room intending to simply "take a peek" and check on a patient, only to hear the alarm beeping on the IV pump, or find the patient awake and wanting assistance to the bathroom, or complaining that their IV is leaking or some other similar problem. If you've used your sanitizer on the way in, you're good to address these unexpected events without having to stop and wash up. When you make it a habit, it comes automatically and you are ready to address any situation; and you won't get busted by the infection control nurse.
I agree with the original poster, but I have a little commentary of my own to add. If I go into a room where I expect direct patient contact, I wash my hands before entering, I foam with the antibacterial stuff after exiting, and I find the nearest sink and wash my hands ASAP (usually within one to two minutes of exiting the room). If, however, I am going to poke my head in the door and check on my patient, I do not wash my hands afterwards. I foam my hands with the antibacterial gel before poking my head in the door (just in case I need to go in and perform some kind of care), and I foam out afterwards. I do not, however, go to the sink and wash with soap and water after I've simply stuck my head in the door.
If I'm having a slow night at clinical, and not performing a lot of patient care, I ensure that I wash with soap and water at least once an hour regardless of what I've been doing, and I try to foam with the antibacterial stuff at least twice an hour. If I am busy during my shift, and have to do a lot of patient care, then of course I wash and foam a lot more.
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mindlor
1,341 Posts
I really do appreciate the replies, and you are right. The policy is the policy. It does not matter if the policy is scientifically grounded or not.....I am to follow the policy. I get that.
The reason no one is willing to discuss the actual means of infection transmission is that it would become obvious that a department of forestry water chopper is being used to extinquish a candle.......
Anyway, I will of course follow the policy. I just wonder why I just spent the last 4 years learning how to critically think........
But, yes, I will follow the policy.