Fingernail length

[cartoondoc]

I'm a female physician and I generally don't keep my fingernails super short. Lately I've been cutting them shorter because I have a baby and I'm worried about scratching her, but this has been a topic that I've gone back and forth on. Today I saw a female physician at work with immaculate but longish nails, and I'm wondering what is an appropriate length for nails.

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[Valadi]

I have no insight into this, but I wanted to add that I LOVE your blog and have been following it for awhile. Never knew you were on SDN. Keep up the great work!

 

[Law2Doc]

I'm a female physician and I generally don't keep my fingernails super short. Lately I've been cutting them shorter because I have a baby and I'm worried about scratching her, but this has been a topic that I've gone back and forth on. Today I saw a female physician at work with immaculate but longish nails, and I'm wondering what is an appropriate length for nails.

I'm not sure the scratching patients issue is the biggest risk. The big risks are (1) long fingernails often puncture gloves, and render them useless, and (2) the bigger your nails, the more space there is under them for stuff to hide and not get killed by the alcohol wash used in hospitals. Meaning you will recolonize MRSA far faster if you give it a place to hide under long nails.

 

[cartoondoc]

Valadi: Thanks!

Law2Doc: I agree with you that MRSA etc is the greater risk, but I wonder if the chances of getting MRSA under my nails is so much greater if my nails are a couple of milimeters longer. I would think if you have nails at all, there is a risk. And most doctors don't cut their nails down to nubs.

 

[Law2Doc]

Law2Doc: ... but I wonder if the chances of getting MRSA under my nails is so much greater if my nails are a couple of milimeters longer.

To a microscopic organism, a couple of millimeters is a universe. The point is that with short nails there's a chance that alcohol, soap etc gets under there. A mm longer and you create a nice safe haven.

 

[Buzz Me]

Hmmm...a little different in my world (surgery) where everyone keeps their nails short in order to be able to effectively scrub.

Are there actual written policies outside of the OR for people's nails (other than the usual "keep them clean")?

 

[gutonc]

Hmmm...a little different in my world (surgery) where everyone keeps their nails short in order to be able to effectively scrub.

Are there actual written policies outside of the OR for people's nails (other than the usual "keep them clean")?

Oftentimes, yes. Our hospital just updated its dress code and the kind of stuff that's in it is pretty ridonkulous. It includes nail length and acceptable colors as well as rules about visible tats and piercings too.

 

[BADMD]

Hmmm...a little different in my world (surgery) where everyone keeps their nails short in order to be able to effectively scrub.

Are there actual written policies outside of the OR for people's nails (other than the usual "keep them clean")?

Yes. Most require them to be kept short (for the same reason) and absolutely forbid acrylic nails.

 

[perpetual labor]

Last edited by J-Rad; Today at 05:36 PM. Reason: You're only allowed one link to your blog in your sig, not again in your text

J-Rad was wrong about this one--your blog is wonderful. Post a thousand links to it. Especially since you wrote about fingernail etiquette in your blog.

-P

 

[DrMom]

J-Rad was wrong about this one--your blog is wonderful. Post a thousand links to it. Especially since you wrote about fingernail etiquette in your blog.

-P

This is an SDN policy and repeat violation of it leads to being banned from SDN, so I'm not so sure you're giving sound advice to the OP.

 

[perpetual labor]

This is an SDN policy and repeat violation of it leads to being banned from SDN, so I'm not so sure you're giving sound advice to the OP.

Re-reading my post I guess it wasn't that clear. I understood the edit and the reasoning behind it. I was just complimenting the OPs blog.

OP--> Don't post multiple links to your blog, just know that I enjoy it.

Everyone else--> Check out the BLOG.

-P 🙂

 

[cartoondoc]

Thanks, Perpetual 🙂

I understand the reason for the SDN policy and that I violated it. My bad. Except I think the photo of my nails is relevant to the discussion and now I can't show it for fear of being banned. Unless of course I wanted to upload it here, which is simply way too much trouble. Oh well. Just as well, considering the original discussion resulted in people dissing on my nails.

 

[J-Rad]

Just experimenting. That took me less than ten seconds. The longest part was writing the words.

 

[45408]

Thanks, Perpetual 🙂

I understand the reason for the SDN policy and that I violated it. My bad. Except I think the photo of my nails is relevant to the discussion and now I can't show it for fear of being banned. Unless of course I wanted to upload it here, which is simply way too much trouble. Oh well. Just as well, considering the original discussion resulted in people dissing on my nails.

Get the Imgur plug-in for Firefox.

took about 10 seconds to re-host it. Right-click - Quick upload - copy vB code and paste

 

[Groove]

I....have no idea what the proper finger nail length is for physicians with children.

I keep mine short...because having them long as a man tends to look a little odd.

My 2 cents which can be gladly thrown into any nearest fountain.

 

[justaregularmed]

look at the palm of your hand, if you can see the nails over the tops of your fingers they are too long.

Done and Done.

 

[PMPMD]

Too long.

 

[Buzz Me]

look at the palm of your hand, if you can see the nails over the tops of your fingers they are too long.

Done and Done.

Agreed.

 

[Samoa]

As long as you use the fingernail scraper things when you scrub, there's no particular need to cut nails super-short (apart from someone with authority over you thinking otherwise, in which case just cut them). The thing is, I've watched, and most people skip that step of the scrub. I always do it though.

 

[Law2Doc]

As long as you use the fingernail scraper things when you scrub, there's no particular need to cut nails super-short (apart from someone with authority over you thinking otherwise, in which case just cut them). The thing is, I've watched, and most people skip that step of the scrub. I always do it though.

With longer nails you are never going to get all the real estate under the nail clean, even with that pick. That only really works to help dislodge dirt, not really get the povidine in there.

 

[Samoa]

With longer nails you are never going to get all the real estate under the nail clean, even with that pick. That only really works to help dislodge dirt, not really get the povidine in there.

This is your opinion, though it would seem to make sense. That said, plenty of things in medicine seem to make sense until studies find them to be incorrect.

I've looked, and the only study involving fingernail length showed no difference in the effectiveness of the surgical scrub. It also showed no effect from fresh, unchipped nail polish (<4 days old). Chipped and older polish showed increased bacterial carriage rates.

With regard to regular handwashing, the closest I've found is a study of fingernail length (>2mm) on S. aureus carriage in an unspecified group of healthcare workers in Norway. This study also found a significant a significant increase in bacterial colonization from wearing a wristwatch or a wedding ring, two practices that are not prohibited or disapproved of in any way. There was another study of critical care nurses, where these same factors were identified.

So I think if you're going to prohibit fingernails >2mm (not to mention nail polish), you should, at least for appearance's sake if not for correctness, also prohibit watches and wedding bands.

 

[Law2Doc]

...

With regard to regular handwashing, the closest I've found is a study of fingernail length (>2mm) on S. aureus carriage in an unspecified group of healthcare workers in Norway. This study also found a significant a significant increase in bacterial colonization from wearing a wristwatch or a wedding ring, two practices that are not prohibited or disapproved of in any way. There was another study of critical care nurses, where these same factors were identified.

So I think if you're going to prohibit fingernails >2mm (not to mention nail polish), you should, at least for appearance's sake if not for correctness, also prohibit watches and wedding bands.

Actually wrist watches and wedding bans are often banned on hands in ORs. Neckties and white coats are the real problem on the wards in terms of spreading infection. There has been a few studies but minimal movement on each of these. FWIW, there are likely no bugs in Norway as aggressive as the form of MRSA cultivated in the US hospitals.

 

[Buzz Me]

So I think if you're going to prohibit fingernails >2mm (not to mention nail polish), you should, at least for appearance's sake if not for correctness, also prohibit watches and wedding bands.

But you don't wear these when you scrub. 😕

 

[45408]

But you don't wear these when you scrub. 😕

No kidding. Otherwise the surgery techs and OR nurses won't hit on me.

 

[asap6]

so at our hospital theres a rule, you should not see your nails when you turn your hand over, so nothing above the finger itself.

 

[countingdays]

Too long.

Why do I suddenly want to watch Jurassic park again?

 

[CambieMD]

Oftentimes, yes. Our hospital just updated its dress code and the kind of stuff that's in it is pretty ridonkulous. It includes nail length and acceptable colors as well as rules about visible tats and piercings too.

Dress codes have to be in place because of the times in which we live. Some piercings and tats may be considered as being offensive by other staff and patients. Body art should be covered up. Long finger nails have no place at least in the OR. The obvious is not always evident to all involved. Written policies must be in place to prevent misunderstandings and needless distractions.

Cambie

 

[Janedoedoctor]

At my place, the rules are:
- no watches, bracelets or rings for anyone with patient contact (not just the OR)
- short nails (not defined further) without nail polish for anyone with patient contact
- Stick-on nails are apparently a pseudomonas heaven and are verboten for everyone, secretaries included

Is my hosptial the only one with such strict rules?

 

[Miss Alyssa]

At my place, the rules are:
- no watches, bracelets or rings for anyone with patient contact (not just the OR)
- short nails (not defined further) without nail polish for anyone with patient contact
- Stick-on nails are apparently a pseudomonas heaven and are verboten for everyone, secretaries included

Is my hosptial the only one with such strict rules?

wedding rings included?

 

[shopsteward]

wedding rings included?

A research opportunity: find out whether bacteria know the difference between a ring and a wedding ring.

 

[410322]

At my place, the rules are:
- no watches, bracelets or rings for anyone with patient contact (not just the OR)
- short nails (not defined further) without nail polish for anyone with patient contact
- Stick-on nails are apparently a pseudomonas heaven and are verboten for everyone, secretaries included

Is my hosptial the only one with such strict rules?

The nails are spot on with what I've seen elsewhere.

The rings and watches thing definitely isn't. I've never heard a hospital make a stink over wearing rings...

Does this place make every doc wear scrubs every day, too?

wedding rings included?

A research opportunity: find out whether bacteria know the difference between a ring and a wedding ring.

I lol'd.

 

[Miss Alyssa]

A research opportunity: find out whether bacteria know the difference between a ring and a wedding ring.

I know someone would have such a reply. But since wedding rings are some times excluded from such policies, I'm still curious to know the position of Janedoe's hospital.

 

[Law2Doc]

I know someone would have such a reply. But since wedding rings are some times excluded from such policies, I'm still curious to know the position of Janedoe's hospital.

You aren't married when in the hospital. It's like Vegas.

 

[Janedoedoctor]

You aren't married when in the hospital. It's like Vegas.

All rings are banned, no exceptions for a wedding ring. They used to have rule that said we could wear a 'smooth' wedding band. This lead to a slippery slope of endless discussions about how much frills/ridges/inlaid diamonds were too much, so it ended up with a total ban. Which is a pity.

There is an appointed 'hygiene nurse' on every service whose job it is to police this. They do their job with rottweiler zeal.

I think it looks ridiculous to have my engagement and wedding rings on a chain around my neck every day, so I just leave them at home.

When we got married, we selected a very simple ring design with this type of rule in mind. As I still only get to wear it during my time off, I retrospectively would have gone for a different ring. But hey, I'm happy with the husband, that's what counts 😉