Wear gloves during assessment?

RNsRWe, ASN, RN · Mar 2, 2015

Your question made me think of a clinical instructor I had when I was in school, who would read you the RIOT act if you gloved up just to do vitals and a simple assessment. She was of the opinion (and I loved this about her!) that a patient's dignity did matter. If there was no reason to assume that this patient who was visibly clean and kempt, had something wet/wild/weird on the surface of their skin, gloving up was insulting.

Now, if there was ANY reason to assume that there MIGHT be something funky going on, by all means OF COURSE put on gloves. But for routine vitals? No.

Bedbound patient who needed full skin assessment...yep, gloves, as it is more likely you'll encounter one of the aforementioned "wet/wild/weird" situations. Homeless....demented....anything that clues you in that there's going to be more than you bargained for? Yes indeedy do.

Most 'typical' people prefer the human touch to a glove, and if there's no valid reason to think there's a reason to glove....I don't. While I don't work the floor anymore, I DO do direct patient care, and only glove if I'm going to be touching something that started with the query "Hey, what do you think this is??"

Wash your hands. Use sanitizer. And gloves are always right there if you do need them!

RNsRWe, ASN, RN · Mar 2, 2015

I wear gloves all the time. There's been plenty of times I would come back to work and find a patient now on contact precautions for MRSA and VRE

Yes, except that very same patient (and his/her family) had already been at the nursing station, elevator, lobby....Walmart....Shoprite....basically anywhere and everywhere. Gloving up when you have the guy admitted didn't protect you from everything he touched (and everything that touched him!) before you met him.

trinitymaster · Mar 2, 2015

Yes, you should glove-up every time. It is for the patient's protection just as much as it is for yours.

I am strong and healthy so I overlook it when the doctor does not wear gloves.

Your patients are vulnerable, they are counting on you not to make their condition worse by spreading disease from one patient to the next.

It amazes me that nurses would be so inconsiderate as to not protect their patients.

Wrench Party · Mar 2, 2015

When working with potential body fluids; always. When doing paperwork and routine VS in post-op, not likely. Not unless the patient

is vomiting or nauseous. I do wash my hands a lot though and use hand sanitizer. Haven't gotten sick yet this year.

Here.I.Stand, BSN, RN · Mar 2, 2015

I wear gloves more often than not, especially when I'm taking that first look under the sheets. Esp. if it's a multiple trauma pt or someone w/ necrotizing fasciitis who can ooze a lot of fluids.

That said, for most people, if there's no wounds in the vicinity of their arm, I think gloving to put on a BP cuff is overkill. Likewise if I've already inspected and don't see any dampness, putting gloves on to hold a stethoscope to the pt is overkill. Honestly I don't even sweat sweat (unless they're on chemo precautions of course.) It's insulting to the patient, and we have a perfectly good sink w/ soap in every pt room--separate from the toilet area.

In those situations where holding their hand is appropriate, if no fluids present I would certainly not glove.

ETA: regarding protection for the pt. Of course if they're neutropenic, or if I'm floating to the burn unit, gloves are part of the required PPE. But otherwise, I wash my own hands before touching them, after "dirty" procedures, and after touching my own face. I'm very conscious of pt safety. :yes:

danielle2000, MSN, RN · Mar 2, 2015

I only wear gloves when I am going to assess an orifice of some kind or there is a lesion. I understand infection control is a major concern but human touch never goes out of style when it is appropriate. Common sense anything leaking from a patient is a given!!!!

anon456, BSN, RN · Mar 2, 2015

I almost always wear gloves. First of all 75% of my patients are on isolation. Secondly, even though I wash my hands before entering the room, gloves add another layer of protection for my fragile pediatric patients. It also makes the parents feel better about me touching their child. I only take gloves off if there is a very good reason to, and in my line of work I can't think of many.

ETA: there have been several times I am glad I routinely wear gloves. My favorite story is when I had given some oral meds to a patient and was counting caps of those oral syringed and found I was missing a cap. Before I had given the meds I had done a full assessment of this patient, and the diaper was clean (it was a bigger diapered patient). Well in the hunt for the missing cap, which I found had rolled uner the patient's bottom, I also found that the patient had just had a huge amount of liquid diarrhea that had leaked out of their diaper and had covered my gloved hands.

MedChica · Mar 2, 2015

I do.

...'specially, if it's a new admit. I mean - you're touching their face, limbs, abd, etc... Palpating for a pulse. (briefly) looking at their mouth/gums and whatnot. Handling their feet and such.

I don't like to touch anyone's face with an un-gloved hand. I wouldn't like anyone touching my face with their bare hands, either.

A fair amount of people don't even wash their hands properly, if at all.

It's a good rule to keep gloves on your scrub uniform, though.

Editorial Team / Admin · Mar 2, 2015

Yes, you should glove-up every time. It is for the patient's protection just as much as it is for yours.
I am strong and healthy so I overlook it when the doctor does not wear gloves.
Your patients are vulnerable, they are counting on you not to make their condition worse by spreading disease from one patient to the next.
It amazes me that nurses would be so inconsiderate as to not protect their patients.

Not everyone who reaches into a box of gloves has washed their hands. The gloves are not sterile and have been exposed to who knows what. The whole purpose of wearing gloves is to protect the nurse- those gloves aren't going to do much of anything in protecting patients; patients are protected by proper hand washing.

Personally, I do not wear gloves unless expecting to come into contact with bodily fluids.

lasair · Mar 2, 2015

As long as you remember to ALWAYS wash you hands, gloves or no gloves

KelRN215, BSN, RN · Mar 2, 2015

Yes, you should glove-up every time. It is for the patient's protection just as much as it is for yours.
I am strong and healthy so I overlook it when the doctor does not wear gloves.
Your patients are vulnerable, they are counting on you not to make their condition worse by spreading disease from one patient to the next.
It amazes me that nurses would be so inconsiderate as to not protect their patients.

Proper hand hygiene is sufficient for that and standard precautions do not include wearing gloves for all patient contact. I wear gloves when drawing labs, giving chemo or giving shots but I certainly don't for doing an assessment.

The idea of wearing gloves because "well what if the patient gets diagnosed with MRSA before my next shift" really doesn't make sense. First, MRSA requires contact precautions so gloves alone would be insufficient to protect anyone and, second, if the patient is suspected of MRSA, he should already be on contact precautions.

CT Pixie, BSN, RN · Mar 2, 2015

Generally I don't wear glove for VS. For an assesment I normally will. My hands are a mess from the constant hand washing and an allergy to the gloves and add in a case of eczema. My hands are split open, raw and itchy as all hell. I am doing it both for me (open areas all over my hands and at times they crack bad enough that there can be some scant bleeding and ) as well as my patients. I dont want there bodily fluids on me and I don't want to have my blood get on them.

I know some of my patients are taken back when they see me glove up for some things. I tend to explain my hands are a mess and that have some areas that can tend to bleed without warning. I say the gloves are more for YOUR protection from my me than protecting me from you with a smile. I will show them and they are normally thankful that I did.