What did you see at clinicals that shocked you (re/the nurses and doctors)

[Mandylpn]

Hello: I just finished my last two clinicals. I hope some of the things I saw are not the norm in the working world. Okay, here's a few things: doctors who did not wash their hands, even after touching a baby's bottom, and then go on to the next patient, nurses who changed peri pads without gloves, the funniest - nurses who wore patterned underwear (way too small) with their see-through white pants. Nurse helping a new mom breast-feed and to latch on, did not wash her hands before and then even put her fingers in the baby's mouth to check suck reflex. :uhoh21:

[NurseFirst]

Actually, wearing gloves isn't always a choice in any situation especially if the patient is immunocompromised. But I agree there are times when its redundant like when passing oral meds in cups. Its up to us to use good judgment about this.

I had a nursing instructor once tell our clinical group that we were wasting the gloves because we wash hands and immediately put them on after entering the pt's room, even if we're not going to do any pt care that requires gloving. On the other hand, the theory instructor told the class that we should always wash hands and put gloves on when we enter a pt's room anyway because there are so many germs about that can be transferred both ways.

Well...as a former medic in the late 70s, we never, ever used gloves. (Now, I never did do a delivery, and don't remember what field OB kits had in them...maybe THEY had gloves in them. The ambulance company I worked for actually was considering having us wear helmets (!)...but never really heard much about gloves.) What brought about the GLOVE revolution was the AIDS epidemic. Now, just an exercise in logic here: needlestick injuries where the needle was used on an AIDS pt--the reported rate of AIDS infection is something like .3 to .4%. Granted, hep C, having no vaccine, is more of a concern--especially since it lives longer outside the body than does the AIDS virus--I don't have a statistic for hep C needlestick injuries.

As for germs that can be transferred both ways...well, handwashing is quite effective. And frankly, I get a bit concerned about all the medical waste...(okay, let's think about this...remember plastics? remember oil? Plastics are long-chain hydrocarbons--they come from oil. Ask any organic chemistry instructor!)

There is something to be said for the nonverbal message being sent the patient if, every time you touch them, you have to put gloves on. Human touch is very, very powerful. One of my previous clinical instructors stated, and I agree, that she wouldn't want to do a bedbath with gloves on for the entire bath--only for "peri" care (does peri include anal? If not, include anal)--and, obviously, anywhere else you might come in contact with bodily fluids, especially those of open and/or weeping wounds.

NurseFirst

Your immune system IS good for something...

[mitchsmom]

I am in LTC this semester and I haven't seen anything too awful, but yesterday I had a lady that I was getting out of bed and into her wheelchair, she had a mat(sp?) in her hair so big and bad that I thought it would need to be cut out. There is no excuse for that. Her palate was also very excoriated... I'm not sure how easily that happens but I suspect she wasn't getting enough mouth care either.

After finally working with patients, I agree that there are times when real skin to skin touch is the best. And before I started clinicals I always thought I'd want to wear gloves 100% of the time.