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Hospital hand washing snitchs

Discussion in 'Anesthesiology' started by budmolotov, Jan 1, 2009.

  1. budmolotov

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    I have been ratted out by a faceless snitch. Our hospital has decided to implement a program of snitches reporting on staff. I have been written up for not washing my hands. I believe in washing my hands but especial in the winter time if I washed my hands a hundred times per day as required to please the snitches, my hand would be two bloody raw festering wounds. I have sensitive skin and am prone to getting eczema, so I try to minimize washing my hands and wear gloves almost every time I touch the patient, even so; I have a very difficult time in the winter months since my hands dry out and crack very easily.

    I hate that the hospital has decided to violate my right to face my accuser. I also feel that if I was to fully comply with the hand washing rules, I probably would need to not work during most of the winter months since I would be forced to stay home most days in order to let my hands heal. Now that I have been singled out by the snitch I will be under the microscope and thus will need to wash my hands raw to keep my job.
     
    #1 budmolotov, Jan 1, 2009
    Last edited: Jan 1, 2009
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  3. DRJJ1

    DRJJ1 New Member
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    you are kidding right,,,? If not you should seek help from a derm for your condition cause you seem a bit well,,scary
     
  4. jennyboo

    jennyboo Senior Member
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    Yeah, typical self-important nursing bureaucracy. This has actually happened to me too. The so-called "antibacterial" hospital soap is incredibly harsh and even those of us who aren't prone to exczema get dermatitis from it. And seems like it's only the old, bitter, ugly, big-arsed nurses who are watching like hawks and ready to attack on hand-washing and cal-stat. Nothing better to do I guess.
     
  5. jennyboo

    jennyboo Senior Member
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    So, ahh, are you spending 60-80 hours a week in the hospital as a medical student and washing your hands twenty times a day in the hospital?
     
  6. dfk

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    it's funny you disparage and unrelent the NURSES .. you are correct in the fact that washing hands several times completely ires the hands to say the least. i don't care who you are, but please don't tell me that you don't feel some sort of "ire" day in and day out washing the old hands with the 'prescribed soap.' i know i do.
     
  7. Bertelman

    Bertelman Maverick!
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    Violate your right to face your accuser? Have you been charged in a U.S. court of law? Heck, you're not even denying it here. You freely admit to washing your hands as little as possible.
     
  8. nap$ter

    nap$ter ASA Member
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    I have been ratted out by a faceless snitch. Our hospital has decided to implement a program of snitches reporting on staff. I have been written up for not washing my hands. I believe in washing my hands but especial in the winter time if I washed my hands a hundred times per day as required to please the snitches, my hand would be two bloody raw festering wounds. I have sensitive skin and am prone to getting eczema, so I try to minimize washing my hands and wear gloves almost every time I touch the patient, even so; I have a very difficult time in the winter months since my hands dry out and crack very easily.

    I hate that the hospital has decided to violate my right to face my accuser. I also feel that if I was to fully comply with the hand washing rules, I probably would need to not work during most of the winter months since I would be forced to stay home most days in order to let my hands heal. Now that I have been singled out by the snitch I will be under the microscope and thus will need to wash my hands raw to keep my job.

    Are you serious? You can't wash your hands? read The Cry and the Covenant. Singled out? maybe cuz you're the only one who hasn't read about a thing called GERM THEORY. Semmelweis knew this in 1847, and my momma taught me to wash my hands when I was five.

    If you can't wash your hands because of a medical condition, find a medicine, strategy, lotion, or alternative soap to adapt/treat, or TAKE YOUR DISABILITY. You should not be allowed to take care of patients, in my mind, if you cannot wash your hands.

    Can't believe you're complaining about washing your freakin hands, and can't believe you're complaining about a nurse doing the right thing - PUTTING THE PATIENTS FIRST.

    Stay away from my family. Hope this wasn't too harsh, but I'm like soap, dude.
     
  9. Lonestar

    Lonestar Senior Member
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    More headaches to come. If you are truly not washing your hands at all (very unbecoming), their either you are a moron or you are just dirty. I don't believe it for one second. I think what you say is true. There are always "soup nazis" hanging around.

    Next thing you know, they won't pay you if they find out you didn't wash your hand after a particular encounter.

    These hospital committes and joint commissions are a bunch of bull. I am sure there are a very small minority of people who maybe uncouth, but to blanket everyone with these rules is just ridiculous. Just another reason why you are not a physician anymore. You are just another "healthcare provider". WELCOME TO THE 21ST CENTURY.
     
  10. igotshoe

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    snitches die slow.
     
  11. leviathan

    leviathan Drinking from the hydrant
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    Washing hands is kinda important, ya know...something I think I learned in microbiology. If you're having trouble with the soap in the hospital, is there another solution (figuratively/literally) that you can use to meet their guidelines? If not, what can be done about reducing spread of infection? I don't necessarily blame the nurse/snitch for reporting you.
     
  12. Noyac

    Noyac ASA Member
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    Dude, wash your hands.

    I wash after every case. If you don't like the soap the use the antimicrobial squirt bottles. We even have ones with a skin conditioner in it.

    Its good hygene and can prevent spread of serious microbes. So check your ego and wash your hands. Its not about "who reported you".
     
  13. Arch Guillotti

    Arch Guillotti Senior Member
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    I get a squirt from the dispensers incessantly during the day.
     
  14. proman

    proman Member
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    We have Purell dispensers on our anesthesia carts, every 3 feet down the hallway, at every elevator, at the front of every PACU slot, in front of every ICU room, inside and outside of bathrooms, pretty much everywhere. The stuff is really benign, visibly soiled hands and C Diff are the only reasons I use soap now. Maybe you can solve your problem by having the hospital distribute a waterless gel antiseptic.
     
  15. leviathan

    leviathan Drinking from the hydrant
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    OP should read the chapter on handwashing in the book 'Better' by Atul Gawande.
     
  16. coprolalia

    coprolalia Bored Certified
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    You really want to fix them, budmolotov? Just go to the micro lab, swab your nose, streak it out on a blood agar plate, incubate at 35-37 celsius for about 24-48 hours, and tell them to report back to your supervisor what grows out. Next, tell them that you think everyone in your department to undergo the same test. Then, just call the local news outlet.

    I assure you no amount of handwashing is going to "cure" that problem.

    -copro

    P.S. You still should really wash your hands, though. You got busted. Deal with it.
     
  17. zippy2u

    zippy2u Senior Member
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    Do what masons do; petroleum jelly in AM and PM to protect their hands from the lime in the mortar mix. Don't let your state medical board get wind of this as they love to fine(steal) money from you any chance they get. Like your government, they stay awake 24/7 lookin' for ways to take your money. Regards, ---Zip
     
  18. Planktonmd

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    So do you agree or disagree with Jenny's statement??
     
  19. SleepIsGood

    SleepIsGood Support the ASA !
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    Hasnt happened to me yet.

    However, many residents that DO wash their hands HAVE gotten reported by these 'nursing hawks'. It's a power thing for the most part. I think it's ridiculous that the accuser is not shared with the person who is having the allegation against them. It's ridiculous because it is a 'serious' thing because there is 'documentation'. There's a paper trail. If someone wants to burn you down the road, they can say, "Dr. Y doesnt wash his hands, here is the proof". Whenever there is documentation, I think it should be substantiated with proof. If you cant stand by your accusation, you shouldnt make it...period.

    How about this. Nursing staff trying to regulate hospital scrub attire. They state that scrubs shouldnt be worn outside because of the transmission of MRSA,etc.

    Well, let's see. Has anyone gone to an ICU or a floor recently at the hospital? Those nurses come to work wearing their 'cute' scrubs and attire. They take care of MRSA patients (ie, bathe them, give meds, feed them, put IVs,etc). Basically more prolonged 'contact' with infected patients than physicians. Then they wear those same 'cute scrubs' back home to their family or can be seen walking around at the local grocery store,etc.

    What's the difference? Why isnt anything said about this? Well, the nursing adminstration is usually the ones creating the 'laws' of the hospitals. Conflict of interest...hmmm...

    Having said this. Keep in mind, I believe everyone should be washing their hands.
     
  20. dfk

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    agree wholeheartedly
     
  21. fakin' the funk

    fakin' the funk ASA Member
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    Seconded. Great book, great chapter.
     
  22. dhb

    dhb Member
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    Use soap for soiled hands and alcohol base solution/gel after each patient encounter.
    The OP stated using gloves which is an apropriate alternative.
     
  23. nutmegs

    nutmegs ASA Member
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    Not really. Skin flora (and whatever nasty MDR you picked up from some innocuous contact with the patient's gown, etc) go ape**** in the time they get to hang out in the warm, dark, sweaty environment under those gloves. Gloves also don't fully protect your hands from contamination. Thinking that wearing gloves instead of washing hands is OK is wrong... and probably doesn't help your dermatitis, either. Put barrier cream on your hands at the beginning of the day and use the allcare or other slimy foam.
     
  24. CambieMD

    CambieMD cambiemd
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    If you can't wash your hands because of skin problems, you should find another profession.
    Anesthesiologists wash their hands often.

    Cambie
     
  25. Dakota

    Dakota Senior Member
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    MSIII here, washing hands is critically important, but in all fairness this specific incident that was reported depends upon the circumstances of the infraction.

    Some premed students were volunteering in the ED here and were tasked with keeping track of staff handwashing as part of a "study." (I use the term loosely here, we're not talking publishable quality). Proper hand washing was defined as washing hands (or using alcohol) before and after each patient encounter. Seems reasonable enough. At the end of the "study" they reported a 45% proper handwashing rate. Holy smokes!

    What happened was often nurses, residents etc would finish seeing a patient, wash their hands, and immediately start seeing the patient in the next bed. This was counted as improper . . . because they would only count this as one hand washing event whereas two were required. You need to wash your hands once after seeing the last patient, and again before seeing the next, doesn't matter if the patients are in the same room in the ED, sharing the same darned sink.

    I can sympathize with hating silly regulations that don't make sense. But seriously . . . handwashing is important.
     
  26. budmolotov

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    I wash my hand more than anyone did when I was a resident. I far surpass Noyac's, standard of, washing hands after every case. To please the hospital hand washing snitches one would be required to endlessly perform the hand washing dance all day long. As SleepisGood and Dakota, point out the hospital hand washing snitches only report what they see, if you have just washed your hands in the Bathroom, PACU, day surgery or anywhere in between, you will be unjustly written up for not washing your hands. Since this snitching is done in an anonymous manner you are automatically guilty and do not have the right to confront your accuser and thus tell your side of the story. This report is placed in your file, to be used against you at a later date, a lawsuit, a medical board action, or the group wants to fire you, out comes the hospital hand washing snitch report.

    Below is the minimum number of times per case you need to wash your hands not to run afoul of the hospital hand washing snitches, for complete safety you probably should add couple of extra gratuitous hand washings, just to make sure the hospital hand washing snitches saw you. I count about 8 to 11 hand washing minimum per OR Case. See below.

    Case is over extubate patient, wash hands.
    Enter PACU with patient, wash hands.
    Use restroom, wash hands.
    Grab a sip of coffee in lounge, wash hands.
    Enter Day surgery ward to interview patient, wash hands.
    Perform procedure in day surgery, wash hands before procedure,
    Wash hands After procedure.
    Enter OR room to set up, wash hands.
    Leave room to get supplies in anesthesia closet re enter OR, wash hands.
    Patient enters room, start case intubate patient, wash hands.
    Place OG tube, wash hands.
    Case is over extubate patient, wash hands.
    Repeat 5 or more times per day until hands are raw.

    Does anyone wash their hand this often? I like Noyac, wash my hands after every case. I Probably average two hand washing between patients but not the 8 to 11 that would be the minimum required not to run afoul of the hospital hand washing snitches.
     
    #25 budmolotov, Jan 4, 2009
    Last edited: Jan 4, 2009
  27. rsgillmd

    rsgillmd ASA Member
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    The problem I have with these "snitches" is partly what they don't see, but also the fact they are not helping someone. What someone who cares about patient care would do is say, "Hey Dr. X, I noticed you were about to see Patient Y. Maybe I didn't notice, but did you wash your hands?" I would hope any intelligent physician would have the sense to recognize when a lapse of memory has occurred and wash their hands, or politely say, "Thank you, but I washed my hands around the corner." Something along those lines.

    But who cares about patient care these days, right? Power trips ("I just got Dr. X disciplined.") are more important.
     
  28. Consigliere

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    Snitches get stitches....
     
  29. coprolalia

    coprolalia Bored Certified
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    What they really need to do is give us a f**king break. Nurses are the worst offenders.

    I've regularly and repeatedly seen nurses on units go from patient to patient to patient without ever washing their hands, let alone touching the hand sanitizer.

    Oh, no. But, somehow the germs on the doctors are more sinister.

    We get blamed for everything, gang. It's doubly true as an anesthesiologist.

    -copro

    P.S. You still should wash your hands. I do this at least after every case, and I drill this into my med students when they're shadowing me. In between, I put so much hand sanitizer on it sometimes looks like I'm wearing gloves.
     
  30. rsgillmd

    rsgillmd ASA Member
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    We have Purel hand sanitizers in our hospital. In OB they are located outside each room. But they dry pretty quickly. What do you have at your hospital that leave your hands shiny? Just curious.
     
  31. DO4lifer

    DO4lifer Gold Member
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    did one of the Sopranos make it through med school?
     
  32. maceo

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    have you ever wanted to wash your hands and could not find a sink? or soap? or paper towels? this has happened to me more than a few times a month. I mean if jcaho wants everyone to wash hands often and thoroughly i think they should also be responsible for puttling endless amount of sinks everywhere.. This happens to me often when imlooking for somewhere to wash my hands only to find myself looking for a sink, or when i find a sink there is no soap or papertowels there. If they want to enforce the law they should make sure thereare adequate amount of handwashing stations. (have them all over the place) and appoint a handwashing czar to discipline offenders and make sure that every single handwashing station is attended to and a log kept of when they were serviced. But im sure that's too much work and its much easier to just single out people. thats how they deal with even more involved issues in healthcare. this is manisfest asthe current state of affairs.

    just another handwashing story: when i was an intern on the icu service we had this patient with mrsa. the icu attending was actually a critical care doc and the biggest ****ing ******* known to man. He just couldnt let things be he had to be a dick about everything. For example, if you didnt know a certain lab value while rounding on a patient he had to point out to everyone that you didnt know the lab valie . that type. He couldnt recognize the fact that maybe you were cross covering 70 patients the night before, put out a dozen fires and answered over 100 pages in a 12 hour period of time. anyway, one of the nurses snitched on one of the residents that he went in the room to listen to the mrsa guys lungs and left without washing his hands in the room. and called this attending and told him. SO *the attending) comes racing into the icu about 20 mins later and starts berating this resident came 2 inches from his face saying stuff like. cant you read? it says mrsa? do you have any idea what that means etc etc.. The resident just Decked him hard. right in the icu. I couldnt ****ing believe it. the attending went down. was brought to the emergency room. the resident was thrown out of the program. had some legal issues to deal with . I think he got back into medicine to be honest with you a few years later. . he had to pay the attendings medical bills. But that attending truly deserved it. And this all happened because of some nurse snitched because the guy washed his hands at the nursing station instead of in the room..
     
  33. SleepIsGood

    SleepIsGood Support the ASA !
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    wow

    I always wondered man. At times some attendings will get very confrontational like you stated. I'm surprised really that most residents can keep their cool while being berated.

    I personally believe that if you have a problem with someone, pull them to the side and discuss it, dont get in their face.
     
  34. KNC

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    If you are moving from patient to patient, please find some type of hand sanitizer that works.....There are sanitizers that have lotion in them as well. Now, that being said, when you put your hands south of the border while using the restroom...PLEASE, PLEASE, do not hesitate to wash your hands with soap and water!! I do not understand for the life of me why people do not wash their hands on a regular basis after using the restroom.....Thats just gross....
     
  35. AnesCoord

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    First, I'm not a doctor--or a nurse (but I have worked in the healthcare industry for more than 25 years).

    Although I agree that anonymous reporting often ends up a witch hunt, I think in this case that's not necessarily true.

    I remember during new resident orientation last summer the director said something to the effect of "...the OR nurses are really starting to be a pain about people bringing their coffee into the operating room..." and I almost fell out of my chair. You bring beverages into the OR???

    As a PATIENT, I respectfully request you wash your hands, or let me know the name of the hospital where I should not go for treatment. Sorry if that seems a little brash.
     
  36. Josh L.Ac.

    Josh L.Ac. MSA/LAc & BSN/RN --> AA-S
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    That anonymous doctor is my new hero.


    God, having a coffee in the OR would be utter fabulous.
     
  37. jetproppilot

    jetproppilot Turboprop Driver
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    I wash my hands.......uhhhhh.....I dunno......

    800 times a day?:laugh:

    Actually we're in wanna the only businesses where you need to wash your hands BEFORE you take a wizz.

    I do that too.
     
  38. Dakota

    Dakota Senior Member
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    Yup, just medicine and rail road workers using creosote soaked crossties.
     
  39. BobBarker

    BobBarker Member
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    I know a anesthesiologist that drinks copious amounts of dr. pepper and munches on heath bars all day long while manning his chair in the OR. When he gets extra hungry he warms up a cheese danish in the autoclave. He gives the circulator orders via megaphone. I'm not joking. He is loved by all in the hospital.
     
  40. QofQuimica

    QofQuimica Seriously, dude, I think you're overreacting....
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    Oh, no, you're forgetting another important group: chemists. I used to have a row of little holes in all of my work clothes from using acid and leaning up against the hood. You better believe I washed up before going to the bathroom!
     
  41. Bertelman

    Bertelman Maverick!
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    Don't forget microbiologists.
     
  42. dhb

    dhb Member
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    Can you point us to any evidence that patients outcome are modified if someone has a drink in the OR?
     
  43. AnesCoord

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    Nope, and I won't be be drawn into an argument about it either because that's not my point. But if you spilled your coffee into a patient's open abdomen, what might happen?
     
  44. anesonia

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    probably the same thing as if you were to drop a junior mint into an open abdomen
     
  45. dhb

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    :smack:
     
  46. killerleaf

    killerleaf beware, beyond there be dragons
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    why is the anesthesiologist looking at my open abdomen with his coffee cup in his hand? isn't he supposed to be somewhere up by my head or something?
     
  47. AnesCoord

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    Because he just came back from his bathroom break (and hopefully remembered to wash his hands).
     
  48. VA Hopeful Dr

    VA Hopeful Dr Senior Member
    Physician 10+ Year Member

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    What if isn't a game I see played often in the hospital.
     
  49. gman33

    Moderator Emeritus 10+ Year Member

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    the autoclave part had me laughing so hard I started crying.
     
  50. sevo85288

    sevo85288 Junior Member
    7+ Year Member

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    my routine:

    wash hands in AM before seeing pts.
    wash hands after intubation or coming in contact with secretions.
    wash hands after placing NGT.
    wash hands before starting IV
    wash hands before central line, aline, etc. (gown glove et)
    wash hands before leaving the OR after extubation(not to contaminate pacu areas)
    wash hands after dropping pt off in PACU before seeing next pt
    wash hands after bathroom, food, lounge etc.

    you get the picture. i wash my hands, alot. we have chlorohex gluc. in everyroom. and alcohol based cleaners in ORs.
     

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