The fingernail police!!

Gompers, BSN, RN · Jul 17, 2004

Five years ago our infectious disease department really cracked down on acrylic nails - for all healthcare and foodservice providers working in our hospital. Our NICU was one of the most hounded areas, and for good reason. Our sepsis rate was alarmingly high, especially for things like pseudomonas, e.coli, and coag negative staph infections. But the most alarming was a slew of babies over several years who had positive blood cultures for pachydermatis (I believe that's it) - something often found in the floppy ear flaps of dogs. These kids were SICK SICK SICK. Several died. Many staff members have dogs, probably about 50% of the unit. Since cracking down on the acrylics, we haven't had a single case of pachydermatis in five years. We still have the other buggies I mentioned, but our sepsis rate has drastically increased.

Parents and staff all have to do a 3 minute surgical scrub each day upon entering the unit. We recommend to moms that they remove their acrylics - we do see the babies with moms that refuse to remove the nails tend to have never-ending infections. But the healthcare staff is touching multiple babies and the parents are only touching their own, so we can't force them to lose the nails. And it's not like the parents are accessing their babies' central lines, ETTs, or having any real invasive contact like we do.

On our unit the rules state that we are not to wear wrist watches or bracelets, no rings except for a completely smooth, plain wedding band that is worn during the surgical scrub, and no nail polish. Of couse not everyone adheres to these rules, and that drives me crazy. I hate seeing people with peeling purple polish, huge diamond rings with lots of crevices, and old wrist watches that get wet everytime they wash their hands. But we're trying, slowly making progress on that, and like I said there still has been a dramatic decrease in infections since the fake nail issue.

Energizer Bunny · Jul 17, 2004

THere are so many other nice things you can do for yourself that don't have the possiblity of harming others. I agree with Kyboryn about the nails. They look tacky to me too and I don't see the need for them.

angel337, MSN, RN · Jul 17, 2004

i know a former nurse that left nursing because she did not wnat to comply with the rules of short nails, hair up, no perfume etc... When you are in nursing school you learn all of these things for a reason. she worked nursing for one year and now works in a lawyers office where she can "look good". i disagree that you can't look good in nursing. there are other creative ways to look nice without sacrificing patient care. when i worked in a bank i had the fake nails, perfume, jewlery. it was appropriate for that setting. it is inappropriate for healthcare. something people should consider before becoming a nurse.

kyboyrn · Jul 17, 2004

I have to say I see all your points. I can understand everything you guys say. I guess it's just hard for a male to relate in these kind of topics. I should probably just stay out of topics dealing with nails, hair, etc. Anyway, sorry if I offended anyone. Have a great day!

LydiaNN · Jul 17, 2004

(Why are ppl mentioning their years in this profession, like it's going to make a difference in the proven fact of what's dirtier?)

I'm guessing that the implication is supposed to be that they haven't infected anyone yet (*** that they know of!!!***), so they are just going to continue

to risk their patient's health. I had no idea that there were still hospitals that allowed acrylic nails, I haven't worked in a hospital in nearly 13 years and I never worked in one that allowed acrylics! There is just no reasoning with some people, I guess.

GNik · Jul 19, 2004

For any nurse to say they don't care what the studies say or they will do what they want to do regardless, is just an example of how our profession is slowly losing it's focus of the patient. To you nurses who don't care, I say don't let the door hit you in the butt as you leave. :angryfire

Infection control is a serious issue in patient safety. If I could trace an infection to a nurse wearing fake nails or not washing hands properly or in someway contributing to the infection I'd cite that facility and the nurse and report her/him to their respective Boards.

Follow the rules or leave the profession. We need nurses who truly care about the job they do, not how the look for that 40 hours. I've been a nurse for 28 years and it is sad to see such lack of concern for our patients for the saske of vanity. P.S. Grow up and stop biting your nails.

rn-medic · Jul 19, 2004

i have short acrylic nails..and i can tell you i wash my hands all the time to prevent infection. fyi- i also have a few tattoos that are seen, 3 earrings in a ear and 4 in the other, and i wear my pentacle ALL the time....so when some a__ tells me some item on me has to go..(i'm like hoolahan) i'll be more than glad to say..all of me is going!!!!

...now let's see them find someone to work all those extra nites........hehehehe

robin

Hellllllo Nurse, BSN, RN · Jul 19, 2004

Long nails also subject patients to skin tears and scratches when performing procedures. Outlawed where I work. Do what you please on your days off, but when you come to work, have clean short nails, minimum jewelry...oh, and lay off the brow rings, nose rings, lip rings, tongue rings, etc. And pull your hair up! lol

I agree!

The messy and/or long hair thing bugs me a lot, too.

I have VERY long hair, down to my behind. However, it is up in a neat bun when I'm at work.

Hellllllo Nurse, BSN, RN · Jul 19, 2004

I wonder if some who defend fake nail on nurses turn around and condemn other nurses for smoking?

GNik · Jul 19, 2004

i have short acrylic nails..and i can tell you i wash my hands all the time to prevent infection. fyi- i also have a few tattoos that are seen, 3 earrings in a ear and 4 in the other, and i wear my pentacle ALL the time....so when some a__ tells me some item on me has to go..(i'm like hoolahan) i'll be more than glad to say..all of me is going!!!!
...now let's see them find someone to work all those extra nites........hehehehe
robin

You make my point. You care more for yourself than your patients. I have no problems with anything else you chose to wear. But to callously disregard those you care for in a hospital or nursing home is just downright unprofessional. Nursing can do without you. There are others to work those shifts. Attitude means alot and your actions speak loads about your attitude.

:crying2:

Mandarella · Jul 19, 2004

It is proven. It's fact. It's not an urban lgend...certain ingredients that make up artificial nails promote bacterial growth period. If I can find the links I will post it. I believe they already have been posted though. Wash as much as you like, it doesn't matter. And the small tears in the nails...guess what, they are warm dark incubators for bacteria. You can't get a good wash under there. People/newborns have been proven to have died from nurses wearing fake nails. What more needs to be done??? If you have a job without patient contact, go for it. If not please don't be irresponsible. This was such a big issue where I used to work, ID came in with studies, videos and hard facts, then some started to feel bad about being so hardcore about keeping their nails. Simply put if you were still wearing nails and you had not taken them off you were let go after 3 warnings. I don't understand why it is such an issue. :eek: Where I work now nails are prevelent...and I am disgusted whenever I see them. Believe it or not that is the FIRST thing I notice about a nurse now...is whether or not they are wearing any type of artificial nails.

You make my point. You care more for yourself than your patients. I have no problems with anything else you chose to wear. But to callously disregard those you care for in a hospital or nursing home is just downright unprofessional. Nursing can do without you. There are others to work those shifts. Attitude means alot and your actions speak loads about your attitude.

ceceliajane2003 · Jul 19, 2004

:balloons: :) I agree that , of course the nails harbor bacteria, and its the front line when your caring for people.....its totally different than an earing, you dont lay an ear on someone's shoulder in passing to give a fleeting reassuring touch. But, some bleach and a tooth brush several times a shift should fix that! thats what I do.......or you can use H2 O2 also. I dont think it should be against rules, but "clean" should apply.

Lisa

I knew it was coming,but...the hospitals around here
are "outlawing" fake nails and/or overlays. I can see their issue with bacteria, etc..under the nails..
but it bothers me that they are dictating what I can or cant have on my own body. For instance, if nails are dirty - what about jewelry, earrings, etc.,where do you draw the line? Does it not make sense that anyone who goes to the trouble of having nice nails would also take the time to wash under those nails. Im not talking about 6" long tiger nails - but any length, nomatter how short,isnt allowed. I am a nail biter - if I dont have overlays, I will be biting my nails all day - how sanitary is that? I was just wondering if this was a local thing or country wide.