Monday, October 13, 2014

Why I fear Ebola

I am heartbroken at the news of a nurse who has contracted the ebola virus.  But I have to say I saw it coming.

I have spent a bit of time in hospitals, for the births of my seven babies, and a few trips to the ER for stitches as those babies grew through childhood, and a few random surgeries for the kids over the years.  The things I observed in my time in hospitals have absolutely frightened me.

I am not a germ-a-phobe, but I do understand the basic principles of microbiology and infection control.  Most of what I have seen in hospitals runs counter to these basic truths of science.

My son had a minor nose surgery last winter, and because of some lingering nausea, we ended up spending the night at the hospital.  Over and over, my son would throw up, a gloved nurse would help him and clean him up, and then go over and type on a keyboard to document the event.  Yep, with the same gloves she used to drop that emesis bag into the trash can.

When I was in the ER six years ago for some sudden and severe abdominal pain, I had a nurse come in, glove up, touch about 20 things in the room, pick up a stool that I am sure had never been wiped down, and then proceed like she was going to get my IV started.  I asked her if she could please change her gloves.  She gave me the crustiest look I have ever seen in my life.  She took off her gloves, left the room, and I didn't see her again.  Apparently, that was unreasonable for a patient to think that gloves that had just touched everything in the room, including the bottom of a stool, should not be the same gloves that open sterilized IV tubing and then puncture my skin with a needle.

Each time I have stayed overnight in a hospital after giving birth, I was stunned as I watched the housekeeping staff come into my room.  They already had gloves on, which they used to open my door.  Then they emptied the trash, opened the dirty linen basket and removed bloody sheets, picked up the mop and "cleaned" the floor with the same water in the bucket used for the room just before mine, then went over to wipe down the toilet and sink area with the same cloth.  All with those original gloves on.  And then the housekeeper was off, pushing the cleaning cart with those same dirty gloves to "clean" another room.

It seems in the healthcare world, gloves are seen only as a barrier to keep the wearer protected from infection.  Yes, that is one major purpose to be sure.  But the bigger part of the picture is that gloves should be used as a disposable barrier for infection control.

To healthcare workers, I ask:  Go ahead and put those gloves on to take care of me but then immediately dispose of the gloves before touching ANYTHING else, including me, the bed, the keyboard, the doorknob, the curtain, or the new sheets you need to put on the bed.  If you have to change your gloves 8 times in 2 minutes, then do that.  Please, throw away your dirty gloves before you touch anything else.  Because although you are protected from the germy stuff, that bedpan you just emptied has contaminated your gloves, and when you touch the bedrails with those gloves on, you have just spread the contamination to the patient's bed.

I guess I am super sensitive to this because of my husband's job.  He is a dentist.  He wears gloves.  A lot of gloves.  How would you like it if you went to the dentist and he left the same gloves on all day? My husband might start a filling on you, and then decide he needs to get a different bit or polishing disc on his handpiece.  Does he leave his gloves on to open the drawers and look for what he needs?  No way!  He takes off his gloves, throws them away, and then finds what he needs, and re-gloves.  Probably at least six times per patient.  It's called basic infection control.

Anyway, I am sure when it comes down to it, we will discover that this poor nurse in Texas did absolutely everything right when caring for the Ebola patient (which is a whole other rant I could go on).  My guess is that is was another co-worker who used dirty gloves to touch something in that room--from the light-switch to the bed to the stack of clean diapers--because it would have been too much of a bother to change gloves one more time. My gut tells me that this poor nurse touched something that should reasonably have been expected to be sterile, and it wasn't.

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