Urgent Step 2 CS Question about washing hands

[humd2010]

Can you wash your hands immediately you enter the room so that you don't have to do it b4 the physical exam. I'm afraid I'll forget to to so if i wait till the physical exam since i always practiced washing them immediately i entered the exam room..

Has anyone done it this way without any drawbacks?

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[Golding]

I don't see why not, though if it's not all that seamless you might be making your introduction awkward (which sets the tone for the entire encounter) and you might be wasting time while washing your hands (compared to before the PE, where you could throw in a few additional questions or comments while you wash).

And what if you get the dreaded difficult patient? You wouldn't just walk in the room and wash while your patient makes a scene.

I forgot about handwashing all the time when practicing in school. It's an understandable fear. But you can give yourself reminders like writing "WASH" on the top of your notes before you enter, or (like I did) inform your patient - and yourself - that you will be doing a physical exam by saying "Now I'm going to wash my hands and do a quick physical exam".

 

[Depakote]

The first thing I did when entering the room for every patient was put gloves on (this counts as hand washing and is faster) and drape the patient.

Quick and easy to integrate into the routine. I passed, so I guess it works.

 

[CyberKnife19]

The first thing I did when entering the room for every patient was put gloves on (this counts as hand washing and is faster) and drape the patient.

Quick and easy to integrate into the routine. I passed, so I guess it works.

I couldn't agree more as I did the same thing. Good luck. 🙂

 

[Tusk]

The first thing I did when entering the room for every patient was put gloves on (this counts as hand washing and is faster) and drape the patient.

Quick and easy to integrate into the routine. I passed, so I guess it works.

I did this as well. You know you get the points and it's a lot faster than washing your hands every time.

 

[kdburton]

Just put on gloves for every encounter. You'll get credit for the whole handwashing/gloves ordeal and it takes less time. Plus while you're gloving up you can make small talk with the patient... If you choose to wash your hands you gotta crane your neck around 180 degrees during the washing process to ask them about their day, etc.

 

[humd2010]

Thanks so much for the replies...

One (elderly) SP at my school tried to give me a hard time: I entered the room once exchanging pleasantries and extended my hand to shake his, but then he refused saying i hadn't washed my hands and he didn't know where they'd been.🙁 That was an isolated incident though, and he told me later on during feedback that he was just trying to throw me off...

About gloves, I wonder if they might limit your speed when taking down facts during the history part...

 

[kdburton]

About gloves, I wonder if they might limit your speed when taking down facts during the history part...

Just put the gloves on when you're about to begin your physical exam. Have a system. As you see on the video on the website there will be a drape on the stool in the room. Go in and introduce yourself to the patient and shake their hand. I asked each patient if it was okay if I sat on the stool during the interview (and I doubt anyone would have a problem with it), and when you're about to sit down you have to move the drape so the next best step is to put it on the patient's lap well in advance of the physical exam. Then I always asked permission to take notes during the encounter whether or not that mattered and again no one is going to have a problem with this but it was just for rapport points. When you get up to do the physical just ALWAYS put on gloves first. When you have a system like that for each patient you won't forget because you have to do it on anyone. Similarly you should have a system where you write down your mnemonic prior to entering the room in each encounter. I'm about to enter the room --> write out mnemonic. I'm about to sit down --> introduce myself/shake hands, drape, etc. I'm about to stand up to do my PE --> gloves. Just have a system like that and you won't forget anything.

 

[Golding]

I guess I'm the only one who washed their hands. 😀

 

[jtlc2345]

I washed my hands - gave me 30 seconds or so to think about what I had gathered from the history.

Jonathan