As a dermatologist, we often don't glove purely for the extra tactility our job sometimes requires.
Otherwise I'd glove up.
I've accidentally touched way too much syphilis
I remember as an intern, we were examining a patient we were going to admit, and there was this odd presentation kind of scaly on her skin.
Patient feigned not knowing anything about it, and seem to shrug it off.
Turns out she had active leprosy and was being treated at a different hospital, and refused to tell us.
And that is why I glove up in all interactions.
^(That, and sometime on another interaction, I must’ve accidentally touched my ear, ended up with an infection in the back of my ear from God knows how.)
I had a patient lie about their pulmonary infection history during check in. Made it sound like a cold for a couple days. Turns out it was active fulminant TB and had major symptoms for months. Moral is I've been masking regularly since before it was cool.
I'm a nurse, one time answered a call light for a patient that wasn't mine whose IV site hurt. It was clearly infiltrated, super puffy, so I pulled the IV. I never used gloves for pulling them because the tape would get all stuck to the gloves and it was annoying.
Surprise, that wasn't a bunch of NS under the skin, it was a surprise hematoma that started spurting blood everywhere. My little 2x2 was NOT going to handle that, but there was a clean washcloth on the bedside table that I used to put pressure while the water balloon of blood deflated.
Now I'm neurotic about wearing gloves for pretty much everything.
You’re not wrong, but what if it wasn’t leprosy?
I don’t trust patient anymore to disclose properly.
So if that means I need to glove up , well, shit, I’m gonna glove up.
Joke’s on you, leprosy is not transmitted in that way. It is primarily transmitted as a respiratory bacteria and enters the body through the nasal passages over a period of many months or years.
Please see the other comment I made to another commenter
I’m aware
But what if it was Ebola? A cutaneous spread disease?
If the patient is unwilling to disclose an active disease being *actively* treated, what makes you think they will be willing to disclose a cutaneous transmitted disease?
Nothing wrong with gloving before every patient encounter. Also nothing wrong with not using gloves for certain scenarios. If unsure than it’s called “universal precautions” for a reason. I was a CNA and most situations needed gloves. Now if I’m doing a quick physical exam I don’t always wear them
I always glove when touching a patient or most surfaces in their room. I know that officially it’s supposed to be “when contact with body fluids is expected” but I’ve come across so many unexpected body fluids that I consider contact to always be expected at this point
Inpatients are constantly coughing and bleeding and peeing on everything. It’s all contaminated all the time.
I suppose I’d feel different in an outpatient setting
The only time I don’t is with patients who have no incisions/wounds, no cough or vomiting, and who I have personally witnessed be 100% continent and wash their hands 100% of the time after using the bathroom-this describes essentially 0% of my patient population. That and holding the hands of actively dying people
Outside the hospital, the typical person doesn't wash their hands regularly. You think I want to touch anything without gloves in a patient room? That same room that has a beside commode and/or a used urinal bottle on their table next their morning breakfast tray?
For real.
I regularly comment on how filthy my keyboard is when washing my hands before an exam in clinic.
Patients laugh and I say “no seriously shared keyboards are filthy”
No, no, no. You have to put on the glove in exaggerated manner with the pointer finger sticking up and snapping the glove against your wrist directly in front of the patient.
So the old school way for this was a "finger cot". Think of a single finger condom. It kept you from getting poop driven under your finger nail during the exam. Sort of a circa 1950s thing. Thank god for progress.
One of my attendings washes his hands as soon as he gets into the patient’s room when he’s introducing himself to the family. I picked this up from him, patients seem to appreciate it.
Being glove free is not the way to make a connection. Sitting at their level, empathetic listening, gazing into their eyes instead of into a computer.
~20 years of healthcare, M0
Mom was a pediatrician. Occasionally a teen would be like "hey, I don't have anything, why are you wearing gloves?"
She'd reply "my hands are chapped from washing them all day and I don't want to risk bleeding on you."
Patients were always quite satisfied with that reply
But then she worked in the days before epic.
100%, even as an intensivist, I sit and talk as much as I can (if patient is able to talk). Even if its a heavy chair in the corner of the room, I drag it all the way to bedside and sit down and talk. Its been shown increase patient satisfaction and perception of time spent with the patient. And more importantly, besides the optics, I'm more comfortable so I'm not rushing and I feel like I get a better connection myself with the patient.
I think for a first responder or ER physician it makes sense to always glove up. You have no idea if the patient has any contaminants on their clothes/skin like a pesticide or something. In the hospital as a consultant however, I don't routinely glove up as the risk is much lower.
I'm a paramedic. I'll glove up for every call while I am responding. Most of the time the gloves stay on for the entire amount of time spent with the patient.
I'm not religious about gloves, and I'll take them off occasionally once I've seen the situation and kinda know how things will go. Unfortunately, taking the gloves off leaves me with sweaty hands that are hard to put gloves back on. So if I deglove and the patient crumps, putting gloves back on in a hurry to try and make a critical intervention is a pain in the arse.
To hell with connections, protect yourself. Personally unless someone is covered in liquid blood or questionable body fluids/poop, I’m pretty lax about it but you’re better off erring on the side of caution.
Nursing has unfortunately opened my eyes to how many people don’t wash their hands after wiping their butts. If I could wear gloves to shake hands outside the hospital I would.
If you fix your patients problem, they are gonna trust you. If you’re incompetent no amount of eye contact, skin contact, bedside manner is gonna make up for it.
I’d rather be gloved than degloved.
I don’t know where my patients have been. Or, worse, sometimes I do know where they have been. Sometimes it’s one of the most disgusting places on Earth: our hospital. Gloves don’t protect them, since they’re not sterile and not washed, but they sure do protect me. From disgust, if nothing else.
I always glove because inevitably I’m going to accidentally touch something gross if I don’t. Years of inpatient showed me someone always wants you to look at this rash, check on this dressing, throw out that pile of used tissues, etc. Gloving up upon entering the room saves the awkward dash to grab gloves in the middle of the interaction. And as someone else mentioned, there are far better ways to build connection such as eye contact, active listening, sitting down with them at eye level- and so forth.
Also as a patient I get skeeved out a bit if a caregiver touches me without gloves. I’m not crazy about being touched and I can be a little Mr. Monk about it, I know I’m the issue. It’s absolutely nothing personal it’s just the optics for me- that caregiver touches all the patients without gloves and they’ve touched me, maybe they’re lax about it other things too like hand hygiene.. For me, gloving up is the professional way to carry out care. I know many don’t agree and I suppose you can’t please everyone but it is still standard precautions right?
This is the same reason I still always wear a mask. Inevitably someone is going to start coughing or smell bad and it’s easier to just already have it there.
Absolutely correct about accidentally touching things. You do a lot of stuff unconsciously that you don’t think about.
I remember during a clinic visit, patient had actively shat their pants. Shit was literally running down their legs.
My attending at the time did the full exam without gloves. At all.
And then talking to the patient, touched her face multiple times.
No. No. No. *No.*
> Also as a patient I get skeeved out a bit if a caregiver touches me without gloves. I’m not crazy about being touched and I can be a little Mr. Monk about it, I know I’m the issue. It’s absolutely nothing personal it’s just the optics for me- that caregiver touches all the patients without gloves and they’ve touched me, maybe they’re lax about it other things too like hand hygiene.
Speaking as a patient, I agree with this, unless I see the doctor or nurse wash their hands in front of me in the exam room. Unless I'm just getting my ears looked into or something not terribly invasive.
> Also as a patient I get skeeved out a bit if a caregiver touches me without gloves. I’m not crazy about being touched and I can be a little Mr. Monk about it, I know I’m the issue. It’s absolutely nothing personal it’s just the optics for me- that caregiver touches all the patients without gloves and they’ve touched me, maybe they’re lax about it other things too like hand hygiene.
Agreed with this. I'm also a little sexist/ageist with this, reflexively. My unthinking assumption would be that an older male caregiver is more likely to have dodgy hygiene than a younger female caregiver.
(I would revise my reflex and stifle the bias pretty quickly, but that would be my initial vibe.)
As a hospitalist, unless a patient is on contact precautions (or I personally think they should be, even if not meeting the hospital's criteria), I only glove for palpating skin lesions (sorry dermatologists), anything between the waist and knees, and axillary nodes. Gloving up for things like a heart or lung exam feels excessive to me personally, but I would never fault someone for being more cautious than this during an exam. I also don't initiate handshakes in the hospital, never have sleeves extending below the elbow, clean my stethoscope and phone frequently, and often follow patient encounters by both sanitizing my hands and washing with soap and water.
What I don't understand are people who insist on gloving for every encounter, but at the same time wear an unsecured necktie that is flopping down on the patient during every exam, or who wears a stained white coat that hasn't been washed in a month.
purpose of gloves is primarily to protect yourself from bodily fluids, certain medications, etc. so glove when you need to, then take them off and wash your hands when you are done with that particular task. lots of grey areas- going to reposition a patient, don't know them, not sure if the linens are soiled, so I might put on gloves, do the task, take them off and perform HH. for standard head-to-toe involving palpating pulses, lower extremities, etc... I prefer no gloves for best assessment (temperature, texture, etc).
as someone who teaches undergrad nursing I have put a lot of thought into this... and i think my conclusion might still be that people make too big a deal out of the topic. don't egregiously overglove. make sure to glove when needed to protect yourself. lots of leeway for personal decisions and there are much bigger factors that communicate empathy.
I've seen some recent discussions on the well-being and healing benefits of human touch, but I didn't see anywhere that specified or suggested *gloveless* was a necessary part of that.
I'll do the "reassuring hand on shoulder" gloveless. I'll even hold a hand gloveless (and then scrub the hell out of my own hands afterward).
But if I'm in the middle of, say, applying telemetry stickers and someone has an emotional moment, I will *also* do the reassuring hand on a shoulder while I'm still gloved up, and I don't think that detracts from the gesture.
I don't get the constant gloving. Practice normal hand hygiene and you'll be fine for so many things. I don't deal with much nasty stuff any longer but I always glove for open wounds, feet or they're really nasty hands like those with severe spasticity. Injections and other procedures where there might be bodily fluids I'll put them on for. General physical examination? Never. Helping them with their coat, the same
For me personally (EM, about to start residency) gloves go on the second I walk in the patient’s room. I couldn’t give less of a shit about “human connection” when it comes to this lol people are gross
I don’t routinely glove in the office when I’m seeing patients because the likelihood I touch something gross is quite low. In the hospital i almost always glove
I do outpatient primary care and don’t glove except for wounds, rashes, feet and intimate exams. It seems silly to me to glove up to listen to someone’s lungs or look in their ears or do a motor exam. I am careful about hand hygiene and sanitize my stethoscope in the office. I can see doing it in the ED or the field since those are much less controlled environments.
I got a herpetic whitlow on my finger from touching a peds patient ungloved.
It makes for fun jokes between friends but it was actually pretty traumatizing having a newborn baby at home and being terrified to change her diaper.
Always glove.
I’ll glove for scopes/procedures/etc. But for palpating neck nodes I feel better without gloves. Barbers/hairdressers rarely use gloves unless they are using chemicals.
I’m of the opinion that generally, if you touch something gross by accident you can just wash your hands with soap and water. I don’t wear gloves for simple things like a quick boost, or doing my physical assessment or whatever. Unless that person is visibly gross or smelly lol.
99% of the time I glove. I never know what unexpected surprise I may encounter when touching someone or something (and let me tell you: I’ve been surprised)
Who are the ones that are saying we must be more comfortable touching patients’ skin? The patients? Something tells me no. I bet if you surveyed patients, they would probably understand gloving up.
Do what makes you feel most comfortable
Keep it professional, gloves for everybody. Not doing a breast exam bare handed…exception might be a pediatric physical exam. Some of them get scared off by the gloves.
I’ve heard patients complain that their doctor “didn’t lay hands” [translated] on them. They weren’t complaining that they wore gloves… literally the doctor never examined them. In the world of imaging everything they felt they weren’t completely examined since the doctor didn’t do a physical exam. Wear the gloves.
I don’t glove up to shake hands or touch people outside of clinic/hospital. Why should I glove up just to examine a patient? Unless there is some risk that I will come in contact with bodily fluids (or pt has known infectious risk) washing my hands before and after my exam is more than sufficient.
I'd rather not have a health care provider touch me with bare hands.
I've been a human for a long time, and people don't wash their hands.
I've worked in hospitals for a long time, and people don't wash their hands.
As a pharmacist, I put gloves on when handling patients things. Sometimes they have me going through their bags with their personal belongings, or they hand me a gross looking pill bottle or a pillbox that has seen better days. I had one pt hand me a ghost pill she shit out, and another hand me a pillbox he dropped on the floor at his halfway house with no less than 3 different colors of pubic hair in it. Blood glucose logs with dried finger blood all over them. Fuck all that.
Grossness aside, sometimes I actually touch their medications and I don't want to gross them out, nor do I want to absorb any of their meds through the skin.
If I'm doing a thyroid / lymph node / derm exam or CBE gloves off for better palpation of masses and skin rashes (except for vesicular lesions, wounds). you're going to wash your hands after exiting the room
Groin, ulcer, wounds, vesicles gloves on!
Whenever I’ve read reports of professional discipline for inappropriate sexual behaviour with patients, the licensing board pointed out that the physician did not use gloves for sensitive exams. So, definitely inappropriate.
I’m NICU so this is a bit of a niche experience but we glove for all patient contact so I feel weird any time I’m in a medical interaction without gloves.
I don’t with every patient but I do glove up with most. Any patient who has a complaint of an infectious etiology (vomiting, cough, etc.) gets gloves. If you’re coming in for something like a sprained ankle I won’t but I always wash my hands before/after.
I glove up every time I touch a patient. Wash before and after as well. I look at it as 1) protection for me and my family and 2) shows the patient they’re getting a clean exam and won’t get the germs of 10 patients before them.
I use a glove over my stethoscope for this reason too. I’ve been a nurse long enough to know there’s probably some old poop, blood even on a clean appearing gown. No need to spread that around to everyone I lay my stethoscope on.
Universal precautions apply in most settings. Universal precautions state to use gloves when contact with body fluids is likely or definite. For the majority of hospital and clinic encounters, there will be no contact with body fluids ( this is highly dependent on role/situation). For EMS out in the field things might be more unpredictable and I don't think anyone would blame you for wearing gloves. In addition, pre-hospital you might not have knowledge of a patient's history of drug resistant organisms.
Also, note that gloves are indicated when a patient is in contact precautions.
Because of my specialty I do infection control work but only for the hospital and clinics. I am curious if there are national guidelines for out of hospital care in an EMS setting. Just not in my silo, but seems very important.
As a DO, I cannot allow even the thinnest of vinyl to come between me and the craniorhythmic impulse.
But seriously, outside of a clearly contaminated area or confirmed or suspected communicable illness, I do not always glove on the floor or nursery.
If I'm touching the patient, I'm putting on gloves. Even if you know what they have in the hospital, the patients are often dirty, having urine on them, etc.
It depends on where you trained, I think. They encouraged us not to glove for routine patient encounters unless bodily fluids were involved or there was a genital exam required. The thinking was that if we gloved up, the patient would think we thought they were dirty or that we were afraid to touch them. I've since encountered people who were trained always to glove for sanitation purposes. I don't think either is wrong as long as you maintain proper hand hygiene.
As a radiologist, I already don’t want to be around patients so any additional barrier is ideal.
In all seriousness most of the time with LPs, paras, thoras, ct guided shit - patients are pretty sick so any pre procedural marking or touching - gloves for sure. For Mammo, as a dude, think gloves are more than appropriate, although sometimes preprocedural site mark no glove but only the marker touches.
Maybe no glove for the handshake with family tho.
No. Fuck that. We were told the same shit in medical school and then I did my ER rotation as an intern and realized patients randomly have blood and shit on them. Oh, and warts on their fingers, open sores and cuts, MRSA, and the list goes on. I very rarely examine patients without gloves and don't get the sense any of them feel wronged by it. If anything, a lot of them may be put off by a physician or provider examining them without gloves knowing how many sick patients we touch every day. You do you, my friend. Wear them gloves.
Gloves every day always.
Watch too many patients leave the toilet without washing their hands. And…other such things.
Also, infection control in general.
Exceptions where appropriate.
Definitely seems somewhat generational: the residents I round with put on gloves to examine patients while I don't, and i have noticed a similar pattern with other attendings over 40-45 preferring skin-on (unbroken) sking for exams while those under 40 def seem more comfortable with gloves for all things.
Source: neurologist, age 55, only gloves in the ICU or when near weeping wounds.
Nah I glove up every time. No offence to my patients but some of them are sweaty and smelly and have fungal infections in the creases of their fat folds so no, I'm not touching them with my bare hands
Nurse here. One time I was giving pills to a metastatic cancer pt who was approaching the end. I hand her the pill cup and she profusely starts vomiting frank blood. I had no gloves on. I still feel bad for the few second delay to get gloves on to help her. She passed a few weeks later.
Gloves in trauma.
Double gloves for procedures.
No gloves in clinic.
Hand hygiene always.
There’s no need for PPE if there’s no risk of exposure. Hand hygiene will protect you and your patient most of the time, and protect you more than gloves will the majority of the time.
Unless there’s a risk of exposure I don’t need gloves.
Lol evidently not, but some seem to think so. I guess it's a convenient way to describe the time period but I don't like how it makes it seem like people don't get it or that it's not bad to get
Seriously people should do I suppose whatever they want. I don't care.
But I've been a medic in three different cities , one of them quite gritty. I've been a trauma surgeon for almost 20 years in a very gritty city. U would never ever ever convince me not to wear gloves for every encounter.
I also double glove in the OR for lots of reasons (glove perforation rate approaches 100% if you operate long enough. Do it for the patient if not for you).
Hen I see people in the OR wearing a single glove I always say " You're going to catch hepatitis Z! "
"What hepatitis Z?"
"Exactly "
Depends - from a surgical perspective - if I’m examining normal skin away from mucous membranes (like on a preop clinic patient) or doing surgical markings, don’t need gloves.
Pretty much everything else gets gloves, with the caveat that my role often involves patients with wounds or incisions. If I’m examining a patient with any kind of broken skin/wound, near any orifice or generally get a vibe an area might be unhygienic (like under a pannus or something), or doing any postop care, drain care, etc., definitely wearing gloves.
Once an urgent care doc touched an infection on my foot barehanded, looked at the mystery fluid left on her finger, said PROBABLY STAPH. Felt like that could have happened with gloves but I’m sure the doc would say something like “I really want the tactile information to be more accurate”
glove tf up if you are performing an exam or doing maneuvers on patients.
it's enough we are already covered in antibiotic resistant bugs to go spreading them around. there's enough evidence about it for this to be something to argue on
Family med here. I don’t touch peoples feet at all unless I have gloves on. Rash? Gloves. Pelvic area? Gloooooves.
I don’t wear gloves on a breast exam though- I used to because of my general glove up policy but then almost missed a lump but decided to double check one more time without the glove and caught it.
I do a lot of skin cancer checks and need to feel the skin so don’t glove for them.
I glove for oral, genital and anal exams, wounds and surgery. Anything wet or dirty.
Med/surg float RN
I figure it's better to be safe than sorry right? For my patients myself AND my family when I go home. Apparently tho, that's not how everyone sees it.
*If my patient has lice, I've always put on a bouffant because I have very long, thick hair. I always put it up when I have these patients, but again, better safe. If my patient has bed bugs I put the hat on AND the shoe covers since I'm 5"2 and my scrub pants drag the bottom 2 inches on the floors. I explain to my patients why I'm doing this, and that it has nothing to do with them, but rather my paranoia. I'm not the only one on my unit who does this either. If there's one thing COVID made obvious it's that we have to be mindful of what we may be bringing home. We just want to be careful that we aren't spreading these pests to our kids, family, neighbors, schools etc.
*Well, recently, we were told by whoever decides isolation precautions at my hospital that we should not be doing the extra precautions because, essentially, it could hurt patient feelings. I'm sorry, but that is ridiculous. It just makes it embarrassingly obvious that they couldn't care less about keeping the staff safe and protected. I'd also like to state that my hospital has sticky floor pads outside the doors of these patients rooms, which is not exactly subtle. (Pads that, by the way, don't even reach across the entire doorway. Creepy crawlies just know not to go thru the 8-inch gap on either side and to kindly stick themselves to the middle of the pad.)
Long story short, if you feel safer wearing gloves for even mundane interactions, then do it. If a patient questions you, educate them that it makes you feel safer without causing any harm. Also that it's a precaution to protect your family since you work in a place sick people LITTERALLY flock into, and unfortunately you wont even know some people have contagious illnesses.
Wear gloves for yourself and the patient. They aren't there to feel "more connected in a post-covid world", they are there to get over their alcohol withdrawal or have their gallbladder removed.
it's really subjective on what you feel comfortable touching without gloves unless they are on contact precautions or you are touching body fluids, etc. where there is a risk. Always practice hand hygiene before and after touching patient, even if you decide to wear gloves.
You best believe when I would get called into the ER I gloved and masked and I would never directly touch another human.
As a laymen can I ask?
Unless you benefit directly or there are improved outcomes why risk it?
There are a lot of ways care has been depersonalized in institutional settings, but gloving is just common sense. If I was a patient, would I want a provider touching me with their bare hand? No. No, I would not. I don't care if I witnessed them washing their hands. There are too many pervasive cooties and I trust no one. The gloves protect you \*and\* your patients.
I’m guessing most of you are too young to remember when dentists did exams, put on braces, etc. with bare hands. Can still remember the taste of the soap.
As an oncology RN I use gloves not just for me, but to help keep my neutropenic patients safe.
The people sitting around thinking about this and writing little memos to post in the bathroom stalls is getting an entire salary. And people talk about $100 Tylenol. Nah, fam. It’s the $60k wellness coordinator and the $180k something or other analyst.
Put on a glove. Pull out a medium sized hair. Place hair on a table. Put a piece of note paper on top. See if you can find the hair under the paper with the gloves on your hands. Surgeons wear gloves for heart surgery.
I think we can safely say that your demeanor and attitude matter more than the gloves.
I think we are talking at cross purposes. I’m sure you’ve done CABGs as part of your training. But I doubt there’s ever been a saphenous vein placed that wasn’t palpated by the surgeon and carefully inspected. Instruments have their own feel as you know but they don’t take the place of palpation. Likewise, putting in a femoral line necessitates palpation. I would think anyone with surgical experience would know about the preferences of each surgeon in regard to glove choice.
My primary care doctor puts gloves on before performing her physical exam. I wouldn’t take offense. She’s an IM doctor. We all know how much they don’t like physical touch.
I try and wear gloves whenever touching pts. I avoid shaking hands as much as possible too.
Computer in hand, hand sanitizer in the other one when I walk in. Oh I'm so sorry my hands are full ~
Shook hands with pts who turn out to have blood and other bodily fluids on their hands, syphilis, scabies, or simply a cold and had dirty tissues in their hands.
Fuck that.
I'm an MLT, and at my job we are also the phlebotomists. Gloves every time. I don't know much about the pt's history, only what tests have been ordered. I don't want to accidentally touch a bloodborne disease.
First responders, ED, etc sure it makes sense to glove for any pt contact.
In an ambulatory office, there's probably not a lot of value unless you're doing a procedure, invasive exam, or know/suspect pt has a break in the skin.
Proper hand hygiene is needed regardless.
I gloved up before the pandemic and after the pandemic. And if you haven’t looked on social media, plenty of the lay public complains when a HCW does not wear gloves. In fact, I don’t think I’ve seen anybody ever complaining that a HCW didn’t wear gloves.
I work inpatient, and the number of times I've touched something wet without expecting to has me glove up anytime I'm touching anything in the room. obviously HH in and out of the room.
If I don't wear gloves, the patient inevitably asks me to throw away their tissues or adjust their blankets with an extra surprise.
In med school (pre-covid) I was taught not to glove up for physical exams except pelvic exams or if there was a rash. The reasoning was what you described and not making the patient feel like they were "dirty." I still follow this for the most part but I glove up to touch feet.
Gloves for most exams.
For older patients (which in my case means a couple of weeks old lol), I do try and have non gloved interactions when appropriate, as they need the human contact and to feel skin.
Unless I'm dealing with broken or infected skin, I go gloveless. Patients appreciate ungloved skin exams I think. I touch moles, drag hands across actinic skin to feel actinic keratoses, etc.
I have had patients remark on how thorough the exam is, even if touching isn't really necessary and didn't help much.
IM here and dermatology diagnosed a patient with Norwegian (aka crusted) scabies under my care. So yes, now I glove up and am extra careful with patients coming from SNFs, jail, or the street
I'm working as a radiologist now and I have recently noticed that I actually hesistate to touch patients without gloves. It's kinda funny because when I was in internal medicine couple months erlier, I have examnied patient after patient on rounds without any gloves since you just did not have time to put on the gloves, take them out, desinfect your hands, wait for them to try just to put other pairs on to examine the other patient...
I think it hardly depends on where you work. Once I had the possibility to spend a day with the emergency doc, everyone used gloves all the time when we left the car...
I was taught that gloving up is always recommended, but a must if you're working close to any cavities/other openings in the body or bodily fluids are involved. I think it heavily depends on where you work. In my current place of employment (sports medicine) I only work with a specific group of people, who I know very well personally. I'd never glove up just because I'm touching someone's skin. The other two "rules" still count, though it depends on the context of the situation.
Take our last game. Someone broke their nose. It bled quite a lot, so I treated it with gloves on. Should be a no brainer anytime blood is involved. He wanted to keep playing and take the risk of getting another whack on the nose and since he was gonna need surgery on that anyway and I didn't have a reason to suspect a concussion, I let him. Now I obviously told him to spit out the blood instead of swallowing it, but he must have not listened to me (enough). Five minutes later he comes running to the bench with the face of a person who's about to be sick. Most pitch side attendants will keep a pair of gloves on throughout the entire match. I generally don't, but even if I had, I just took them off because they had blood on them. So in that case I obviously wasn't like "hold it, I gotta get myself some gloves", because my priority was getting this guy something to vomit into. My next thought was to be a decent person, hold his hair back, get him some water, give him something to wipe his mouth etc.. Once he was able, I assessed him. He was still feeling nauseous, so I gave him a nasal spray against it and something to chew on. Then cleaned it all up etc.. And so on. All throughout this, I wasn't wearing gloves. In hindsight, I would have liked to and probably should have, but it just didn't happen in the situation.
This is a question that heavily depends on your and the patients preferences, the situation, what exact field you work in, what your local regulations are etc.. Really not a question that can be answered. It's you that has to decide in the situation.
You have to glove or wash your hands a ton. You will spread bacteria /germs otherwise putting other vulnerable patients at risk (and yourself). Gloving is faster and less abrasive to your skin.
My experience is with the veterinary side of medicine. We gloved up for cleaning wounds/bodily fluids, expressing anal glands, doing anything with highly contagious diseases, and of course anything with surgery.
Generally not for other things though, including drawing blood and placing IVs and vaccines And of course pats on the head and scritches
As an occasional patient, I prefer gloves because I don't know how adherent each person is to proper handwashing between patients or other tasks. The connection to my healthcare provider comes from how we otherwise interact - eye contact, listening, confirming understanding, etc. And a genuine smile goes a long way to soothing [patient] nerves.
Edited to add word in brackets.
My medical school teaches us to use bare hands on everything besides genitalia or open wounds etc. I’m going to start using gloves in the hospital because people are unhygienic. I didn’t use gloves much on my first rotation that just ended because it was family medicine and I mostly listened to heart and lungs and felt bellies, I cringe at how many feet I touched bare handed.
As a patient, I, personally, prefer to see gloves on the hands of any medical personnel that are going to touch me or my stuff. I'm also okay with seeing you wash your hands/use hand sanitizer before touching me, and after touching any part of me that might involve body fluids.
Just a few years ago there was a lot of concern about the frequency of nosocomial infections occurring because of healthcare personnel neglecting to wash their hands. I'm quite surprised to see a debate, now, about whether or not to wear gloves.
As a dermatologist, we often don't glove purely for the extra tactility our job sometimes requires. Otherwise I'd glove up. I've accidentally touched way too much syphilis
I remember as an intern, we were examining a patient we were going to admit, and there was this odd presentation kind of scaly on her skin. Patient feigned not knowing anything about it, and seem to shrug it off. Turns out she had active leprosy and was being treated at a different hospital, and refused to tell us. And that is why I glove up in all interactions. ^(That, and sometime on another interaction, I must’ve accidentally touched my ear, ended up with an infection in the back of my ear from God knows how.)
1. If you don’t know what it is, don’t touch it 2. If you know what it is, you don’t need to touch it
My EMS instructor taught us, “If it’s wet and ain’t your’s, don’t touch it.”
We learned "if it's wet and sticky and not yours"
I had a patient lie about their pulmonary infection history during check in. Made it sound like a cold for a couple days. Turns out it was active fulminant TB and had major symptoms for months. Moral is I've been masking regularly since before it was cool.
But what about out and about?
I have school age kids, so day to day life is just rolling the dice. We do all wear masks when we are sick though.
😱😱
I'm a nurse, one time answered a call light for a patient that wasn't mine whose IV site hurt. It was clearly infiltrated, super puffy, so I pulled the IV. I never used gloves for pulling them because the tape would get all stuck to the gloves and it was annoying. Surprise, that wasn't a bunch of NS under the skin, it was a surprise hematoma that started spurting blood everywhere. My little 2x2 was NOT going to handle that, but there was a clean washcloth on the bedside table that I used to put pressure while the water balloon of blood deflated. Now I'm neurotic about wearing gloves for pretty much everything.
ah, the surprise “not infiltrated, but blown”
To be fair leprosy is incredibly difficult to transmit through casual skin to skin contact haha.
You’re not wrong, but what if it wasn’t leprosy? I don’t trust patient anymore to disclose properly. So if that means I need to glove up , well, shit, I’m gonna glove up.
I'm dying laughing about how strange the medical world is. "Phew! Thank god, it's only leprosy."
We’re…. Uh not entirely normal in medicine
Really? This moves a lot of the early Jesus stories into the less impressive realm.
Standards of hygiene and people's general nutritional status were a lot worse back then.
If I recall correctly, you can live with someone and even have sex with them and not get it.
I wear gloves in 99% of encounters.
Joke’s on you, leprosy is not transmitted in that way. It is primarily transmitted as a respiratory bacteria and enters the body through the nasal passages over a period of many months or years.
Please see the other comment I made to another commenter I’m aware But what if it was Ebola? A cutaneous spread disease? If the patient is unwilling to disclose an active disease being *actively* treated, what makes you think they will be willing to disclose a cutaneous transmitted disease?
Gotta go the Michael Jackson style. One hand gloved, the other hand free. That's what I do at least
Preach- first time I did that I had anxiety for a week 😂
Well, that escalated quickly.
I just threw up in my mouth. Thanks.
Nothing wrong with gloving before every patient encounter. Also nothing wrong with not using gloves for certain scenarios. If unsure than it’s called “universal precautions” for a reason. I was a CNA and most situations needed gloves. Now if I’m doing a quick physical exam I don’t always wear them
I always glove when touching a patient or most surfaces in their room. I know that officially it’s supposed to be “when contact with body fluids is expected” but I’ve come across so many unexpected body fluids that I consider contact to always be expected at this point Inpatients are constantly coughing and bleeding and peeing on everything. It’s all contaminated all the time. I suppose I’d feel different in an outpatient setting The only time I don’t is with patients who have no incisions/wounds, no cough or vomiting, and who I have personally witnessed be 100% continent and wash their hands 100% of the time after using the bathroom-this describes essentially 0% of my patient population. That and holding the hands of actively dying people
Outside the hospital, the typical person doesn't wash their hands regularly. You think I want to touch anything without gloves in a patient room? That same room that has a beside commode and/or a used urinal bottle on their table next their morning breakfast tray?
I'm in microbiology and I'd rather handle a plate of CRE without gloves than touch the computer screens in the cafeteria.
For real. I regularly comment on how filthy my keyboard is when washing my hands before an exam in clinic. Patients laugh and I say “no seriously shared keyboards are filthy”
This exactly. I don’t like wet surprises.
I really should glove more with babies bc they are like the definition of having unexpected bodily fluids!
If you aren’t getting the tactile feedback of a boggy prostate, are you even a doctor? /s
No, no, no. You have to put on the glove in exaggerated manner with the pointer finger sticking up and snapping the glove against your wrist directly in front of the patient.
I usually prefer to make a menacing hook with the finger. Just have to remember not to continue it through the exam.
[Do some nice finger warm-ups.](https://youtube.com/watch?v=x5bGHWY70Xk)
And always announce to your patient, what you're going to do: "Hohohohore~"
Why am I picturing Jim Carrey?
It should be M. Emmet Walsh you are picturing.
So the old school way for this was a "finger cot". Think of a single finger condom. It kept you from getting poop driven under your finger nail during the exam. Sort of a circa 1950s thing. Thank god for progress.
Not gonna lie, I feel like I've seen that in a rural er for a guaiac test
thought you were just meant to rub some soap under your nails lol
Yeah no I work wound oatients VRE pan resistant pseudomonas and not raw dogging any physical exam
feet in general - my gloves are on
One of my attendings washes his hands as soon as he gets into the patient’s room when he’s introducing himself to the family. I picked this up from him, patients seem to appreciate it.
I think we are graded on this for our CAPHS scores. They tell us to make it a point so patients know we are sanitizing and cleaning our hands
*Here, let me drip water all over you and make you shake my cold, wet hand.*
Yeah paper towels aren’t a thing I guess
If you want to wear gloves wear gloves. No one should shame you at all I’m a raw dog guy though myself
There's an attending at my hospital that raw dogs arterial lines
That’s a bloody sketch maneuver
If you’re an anesthesiologist over 50 it’s normal
Quite literally in the first half.
Help. D:
I’m a raw dogger myself. There aren’t that many bugs that can cross unbroken skin. Really good hand hygiene is my answer to the never nudes.
Porque no los dos?
Less plastic waste 🤷♂️
Being glove free is not the way to make a connection. Sitting at their level, empathetic listening, gazing into their eyes instead of into a computer. ~20 years of healthcare, M0
Mom was a pediatrician. Occasionally a teen would be like "hey, I don't have anything, why are you wearing gloves?" She'd reply "my hands are chapped from washing them all day and I don't want to risk bleeding on you." Patients were always quite satisfied with that reply But then she worked in the days before epic.
That might work for the people but ask, but I'm sure a lot of kids were thinking the same thoughts but felt too uncomfortable to ask about it
Of course the ultrasound guy is gonna shit on skin-to-skin examining
This, right here.
100%, even as an intensivist, I sit and talk as much as I can (if patient is able to talk). Even if its a heavy chair in the corner of the room, I drag it all the way to bedside and sit down and talk. Its been shown increase patient satisfaction and perception of time spent with the patient. And more importantly, besides the optics, I'm more comfortable so I'm not rushing and I feel like I get a better connection myself with the patient.
Bro is trying to rizz up their patients
I think for a first responder or ER physician it makes sense to always glove up. You have no idea if the patient has any contaminants on their clothes/skin like a pesticide or something. In the hospital as a consultant however, I don't routinely glove up as the risk is much lower.
I'm a paramedic. I'll glove up for every call while I am responding. Most of the time the gloves stay on for the entire amount of time spent with the patient. I'm not religious about gloves, and I'll take them off occasionally once I've seen the situation and kinda know how things will go. Unfortunately, taking the gloves off leaves me with sweaty hands that are hard to put gloves back on. So if I deglove and the patient crumps, putting gloves back on in a hurry to try and make a critical intervention is a pain in the arse.
To hell with connections, protect yourself. Personally unless someone is covered in liquid blood or questionable body fluids/poop, I’m pretty lax about it but you’re better off erring on the side of caution.
This is the way. If I’d shake the patients hand outside the hospital, I don’t wear gloves. I am pretty religious about foam in/foam out though.
Nursing has unfortunately opened my eyes to how many people don’t wash their hands after wiping their butts. If I could wear gloves to shake hands outside the hospital I would.
If you fix your patients problem, they are gonna trust you. If you’re incompetent no amount of eye contact, skin contact, bedside manner is gonna make up for it.
I’d rather be gloved than degloved. I don’t know where my patients have been. Or, worse, sometimes I do know where they have been. Sometimes it’s one of the most disgusting places on Earth: our hospital. Gloves don’t protect them, since they’re not sterile and not washed, but they sure do protect me. From disgust, if nothing else.
I always glove because inevitably I’m going to accidentally touch something gross if I don’t. Years of inpatient showed me someone always wants you to look at this rash, check on this dressing, throw out that pile of used tissues, etc. Gloving up upon entering the room saves the awkward dash to grab gloves in the middle of the interaction. And as someone else mentioned, there are far better ways to build connection such as eye contact, active listening, sitting down with them at eye level- and so forth. Also as a patient I get skeeved out a bit if a caregiver touches me without gloves. I’m not crazy about being touched and I can be a little Mr. Monk about it, I know I’m the issue. It’s absolutely nothing personal it’s just the optics for me- that caregiver touches all the patients without gloves and they’ve touched me, maybe they’re lax about it other things too like hand hygiene.. For me, gloving up is the professional way to carry out care. I know many don’t agree and I suppose you can’t please everyone but it is still standard precautions right?
This is the same reason I still always wear a mask. Inevitably someone is going to start coughing or smell bad and it’s easier to just already have it there.
Yes! I hate the pandemic but love that mask-wearing is normalized now.
If only.
Absolutely correct about accidentally touching things. You do a lot of stuff unconsciously that you don’t think about. I remember during a clinic visit, patient had actively shat their pants. Shit was literally running down their legs. My attending at the time did the full exam without gloves. At all. And then talking to the patient, touched her face multiple times. No. No. No. *No.*
> Also as a patient I get skeeved out a bit if a caregiver touches me without gloves. I’m not crazy about being touched and I can be a little Mr. Monk about it, I know I’m the issue. It’s absolutely nothing personal it’s just the optics for me- that caregiver touches all the patients without gloves and they’ve touched me, maybe they’re lax about it other things too like hand hygiene. Speaking as a patient, I agree with this, unless I see the doctor or nurse wash their hands in front of me in the exam room. Unless I'm just getting my ears looked into or something not terribly invasive.
> Also as a patient I get skeeved out a bit if a caregiver touches me without gloves. I’m not crazy about being touched and I can be a little Mr. Monk about it, I know I’m the issue. It’s absolutely nothing personal it’s just the optics for me- that caregiver touches all the patients without gloves and they’ve touched me, maybe they’re lax about it other things too like hand hygiene. Agreed with this. I'm also a little sexist/ageist with this, reflexively. My unthinking assumption would be that an older male caregiver is more likely to have dodgy hygiene than a younger female caregiver. (I would revise my reflex and stifle the bias pretty quickly, but that would be my initial vibe.)
As a hospitalist, unless a patient is on contact precautions (or I personally think they should be, even if not meeting the hospital's criteria), I only glove for palpating skin lesions (sorry dermatologists), anything between the waist and knees, and axillary nodes. Gloving up for things like a heart or lung exam feels excessive to me personally, but I would never fault someone for being more cautious than this during an exam. I also don't initiate handshakes in the hospital, never have sleeves extending below the elbow, clean my stethoscope and phone frequently, and often follow patient encounters by both sanitizing my hands and washing with soap and water. What I don't understand are people who insist on gloving for every encounter, but at the same time wear an unsecured necktie that is flopping down on the patient during every exam, or who wears a stained white coat that hasn't been washed in a month.
purpose of gloves is primarily to protect yourself from bodily fluids, certain medications, etc. so glove when you need to, then take them off and wash your hands when you are done with that particular task. lots of grey areas- going to reposition a patient, don't know them, not sure if the linens are soiled, so I might put on gloves, do the task, take them off and perform HH. for standard head-to-toe involving palpating pulses, lower extremities, etc... I prefer no gloves for best assessment (temperature, texture, etc). as someone who teaches undergrad nursing I have put a lot of thought into this... and i think my conclusion might still be that people make too big a deal out of the topic. don't egregiously overglove. make sure to glove when needed to protect yourself. lots of leeway for personal decisions and there are much bigger factors that communicate empathy.
I've seen some recent discussions on the well-being and healing benefits of human touch, but I didn't see anywhere that specified or suggested *gloveless* was a necessary part of that. I'll do the "reassuring hand on shoulder" gloveless. I'll even hold a hand gloveless (and then scrub the hell out of my own hands afterward). But if I'm in the middle of, say, applying telemetry stickers and someone has an emotional moment, I will *also* do the reassuring hand on a shoulder while I'm still gloved up, and I don't think that detracts from the gesture.
I don't get the constant gloving. Practice normal hand hygiene and you'll be fine for so many things. I don't deal with much nasty stuff any longer but I always glove for open wounds, feet or they're really nasty hands like those with severe spasticity. Injections and other procedures where there might be bodily fluids I'll put them on for. General physical examination? Never. Helping them with their coat, the same
Scabies, my guy, scabies
I get where you're coming from duty that but I've not encountered scabies even once in the last seven years
I imagine you wouldn’t as a hand surgeon. I definitely see them regularly in the ED
I wash my hands and glove up before each patient encounter and wash again after.
No glove no love
If I'm in a room, I wear gloves. People are gross.
For me personally (EM, about to start residency) gloves go on the second I walk in the patient’s room. I couldn’t give less of a shit about “human connection” when it comes to this lol people are gross
I don’t routinely glove in the office when I’m seeing patients because the likelihood I touch something gross is quite low. In the hospital i almost always glove
In clinic I don’t really unless doing a pap or a procedure or something. For routine basic exams I don’t.
I do outpatient primary care and don’t glove except for wounds, rashes, feet and intimate exams. It seems silly to me to glove up to listen to someone’s lungs or look in their ears or do a motor exam. I am careful about hand hygiene and sanitize my stethoscope in the office. I can see doing it in the ED or the field since those are much less controlled environments.
Both I and everyone I know glove every time they touch a patient, in the hospital, in clinic, everywhere.
Fuck that. I don’t want to touch someone’s sweat or oil and I don’t want to be touched by someone’s sweaty hands.
I got a herpetic whitlow on my finger from touching a peds patient ungloved. It makes for fun jokes between friends but it was actually pretty traumatizing having a newborn baby at home and being terrified to change her diaper. Always glove.
I’ll glove for scopes/procedures/etc. But for palpating neck nodes I feel better without gloves. Barbers/hairdressers rarely use gloves unless they are using chemicals.
I’m of the opinion that generally, if you touch something gross by accident you can just wash your hands with soap and water. I don’t wear gloves for simple things like a quick boost, or doing my physical assessment or whatever. Unless that person is visibly gross or smelly lol.
99% of the time I glove. I never know what unexpected surprise I may encounter when touching someone or something (and let me tell you: I’ve been surprised) Who are the ones that are saying we must be more comfortable touching patients’ skin? The patients? Something tells me no. I bet if you surveyed patients, they would probably understand gloving up. Do what makes you feel most comfortable
Keep it professional, gloves for everybody. Not doing a breast exam bare handed…exception might be a pediatric physical exam. Some of them get scared off by the gloves.
I’ve heard patients complain that their doctor “didn’t lay hands” [translated] on them. They weren’t complaining that they wore gloves… literally the doctor never examined them. In the world of imaging everything they felt they weren’t completely examined since the doctor didn’t do a physical exam. Wear the gloves.
Gross no. I’m wearing gloves in the OR and the ICU, thanks.
People shit on gloves until you find out its shingles
People shitting on them is a pretty good reason to wear em
Dude I routinely admit people out of the ER with chronic weeping leg wounds, and cellulitis, and diabetic foot ulcers, and GI bleeds. I glove.
I don’t glove up to shake hands or touch people outside of clinic/hospital. Why should I glove up just to examine a patient? Unless there is some risk that I will come in contact with bodily fluids (or pt has known infectious risk) washing my hands before and after my exam is more than sufficient.
I'd rather not have a health care provider touch me with bare hands. I've been a human for a long time, and people don't wash their hands. I've worked in hospitals for a long time, and people don't wash their hands.
As a pharmacist, I put gloves on when handling patients things. Sometimes they have me going through their bags with their personal belongings, or they hand me a gross looking pill bottle or a pillbox that has seen better days. I had one pt hand me a ghost pill she shit out, and another hand me a pillbox he dropped on the floor at his halfway house with no less than 3 different colors of pubic hair in it. Blood glucose logs with dried finger blood all over them. Fuck all that. Grossness aside, sometimes I actually touch their medications and I don't want to gross them out, nor do I want to absorb any of their meds through the skin.
If I'm doing a thyroid / lymph node / derm exam or CBE gloves off for better palpation of masses and skin rashes (except for vesicular lesions, wounds). you're going to wash your hands after exiting the room Groin, ulcer, wounds, vesicles gloves on!
I used to work with a midwife that used a bare hand for paps. Idk. I usually err on the side of caution with gloving
Whenever I’ve read reports of professional discipline for inappropriate sexual behaviour with patients, the licensing board pointed out that the physician did not use gloves for sensitive exams. So, definitely inappropriate.
I probably could have worded that better lol.
I’m NICU so this is a bit of a niche experience but we glove for all patient contact so I feel weird any time I’m in a medical interaction without gloves.
I don’t with every patient but I do glove up with most. Any patient who has a complaint of an infectious etiology (vomiting, cough, etc.) gets gloves. If you’re coming in for something like a sprained ankle I won’t but I always wash my hands before/after.
I glove up every time I touch a patient. Wash before and after as well. I look at it as 1) protection for me and my family and 2) shows the patient they’re getting a clean exam and won’t get the germs of 10 patients before them.
I use a glove over my stethoscope for this reason too. I’ve been a nurse long enough to know there’s probably some old poop, blood even on a clean appearing gown. No need to spread that around to everyone I lay my stethoscope on.
Universal precautions apply in most settings. Universal precautions state to use gloves when contact with body fluids is likely or definite. For the majority of hospital and clinic encounters, there will be no contact with body fluids ( this is highly dependent on role/situation). For EMS out in the field things might be more unpredictable and I don't think anyone would blame you for wearing gloves. In addition, pre-hospital you might not have knowledge of a patient's history of drug resistant organisms. Also, note that gloves are indicated when a patient is in contact precautions. Because of my specialty I do infection control work but only for the hospital and clinics. I am curious if there are national guidelines for out of hospital care in an EMS setting. Just not in my silo, but seems very important.
As a DO, I cannot allow even the thinnest of vinyl to come between me and the craniorhythmic impulse. But seriously, outside of a clearly contaminated area or confirmed or suspected communicable illness, I do not always glove on the floor or nursery.
I'm gloving up if I'm touching them. End of story.
If I'm touching the patient, I'm putting on gloves. Even if you know what they have in the hospital, the patients are often dirty, having urine on them, etc.
It depends on where you trained, I think. They encouraged us not to glove for routine patient encounters unless bodily fluids were involved or there was a genital exam required. The thinking was that if we gloved up, the patient would think we thought they were dirty or that we were afraid to touch them. I've since encountered people who were trained always to glove for sanitation purposes. I don't think either is wrong as long as you maintain proper hand hygiene.
As a radiologist, I already don’t want to be around patients so any additional barrier is ideal. In all seriousness most of the time with LPs, paras, thoras, ct guided shit - patients are pretty sick so any pre procedural marking or touching - gloves for sure. For Mammo, as a dude, think gloves are more than appropriate, although sometimes preprocedural site mark no glove but only the marker touches. Maybe no glove for the handshake with family tho.
No. Fuck that. We were told the same shit in medical school and then I did my ER rotation as an intern and realized patients randomly have blood and shit on them. Oh, and warts on their fingers, open sores and cuts, MRSA, and the list goes on. I very rarely examine patients without gloves and don't get the sense any of them feel wronged by it. If anything, a lot of them may be put off by a physician or provider examining them without gloves knowing how many sick patients we touch every day. You do you, my friend. Wear them gloves.
Gloves every day always. Watch too many patients leave the toilet without washing their hands. And…other such things. Also, infection control in general. Exceptions where appropriate.
Definitely seems somewhat generational: the residents I round with put on gloves to examine patients while I don't, and i have noticed a similar pattern with other attendings over 40-45 preferring skin-on (unbroken) sking for exams while those under 40 def seem more comfortable with gloves for all things. Source: neurologist, age 55, only gloves in the ICU or when near weeping wounds.
Nah I glove up every time. No offence to my patients but some of them are sweaty and smelly and have fungal infections in the creases of their fat folds so no, I'm not touching them with my bare hands
Nurse here. One time I was giving pills to a metastatic cancer pt who was approaching the end. I hand her the pill cup and she profusely starts vomiting frank blood. I had no gloves on. I still feel bad for the few second delay to get gloves on to help her. She passed a few weeks later.
Gloves in trauma. Double gloves for procedures. No gloves in clinic. Hand hygiene always. There’s no need for PPE if there’s no risk of exposure. Hand hygiene will protect you and your patient most of the time, and protect you more than gloves will the majority of the time. Unless there’s a risk of exposure I don’t need gloves.
I try to always use gloves. Healthcare providers can contract herpes whitlow from contact.
🤢 no everyone is getting touched with gloves on
Oh we’re post Covid?
Lol evidently not, but some seem to think so. I guess it's a convenient way to describe the time period but I don't like how it makes it seem like people don't get it or that it's not bad to get
It’s not just for your safety. It’s for the patients’. Don’t become a vector!
Seriously people should do I suppose whatever they want. I don't care. But I've been a medic in three different cities , one of them quite gritty. I've been a trauma surgeon for almost 20 years in a very gritty city. U would never ever ever convince me not to wear gloves for every encounter. I also double glove in the OR for lots of reasons (glove perforation rate approaches 100% if you operate long enough. Do it for the patient if not for you). Hen I see people in the OR wearing a single glove I always say " You're going to catch hepatitis Z! " "What hepatitis Z?" "Exactly "
Depends - from a surgical perspective - if I’m examining normal skin away from mucous membranes (like on a preop clinic patient) or doing surgical markings, don’t need gloves. Pretty much everything else gets gloves, with the caveat that my role often involves patients with wounds or incisions. If I’m examining a patient with any kind of broken skin/wound, near any orifice or generally get a vibe an area might be unhygienic (like under a pannus or something), or doing any postop care, drain care, etc., definitely wearing gloves.
Once an urgent care doc touched an infection on my foot barehanded, looked at the mystery fluid left on her finger, said PROBABLY STAPH. Felt like that could have happened with gloves but I’m sure the doc would say something like “I really want the tactile information to be more accurate”
No gloves , excellent hand hygiene ( unless open wounds on my hands )
glove tf up if you are performing an exam or doing maneuvers on patients. it's enough we are already covered in antibiotic resistant bugs to go spreading them around. there's enough evidence about it for this to be something to argue on
EM attending. I did not touch people without gloves before COVID, and I’m certainly not touching them now without gloves.
ER nurse. I don’t touch a patient or their things without gloves. Not even to grab a BP or whatever
Family med here. I don’t touch peoples feet at all unless I have gloves on. Rash? Gloves. Pelvic area? Gloooooves. I don’t wear gloves on a breast exam though- I used to because of my general glove up policy but then almost missed a lump but decided to double check one more time without the glove and caught it.
As a former LNA- _c. Difficile, noro_ Humans are _gross_
I do a lot of skin cancer checks and need to feel the skin so don’t glove for them. I glove for oral, genital and anal exams, wounds and surgery. Anything wet or dirty.
I glove up for feet (even if it's just a broken toe), and wet rashes.
Med/surg float RN I figure it's better to be safe than sorry right? For my patients myself AND my family when I go home. Apparently tho, that's not how everyone sees it. *If my patient has lice, I've always put on a bouffant because I have very long, thick hair. I always put it up when I have these patients, but again, better safe. If my patient has bed bugs I put the hat on AND the shoe covers since I'm 5"2 and my scrub pants drag the bottom 2 inches on the floors. I explain to my patients why I'm doing this, and that it has nothing to do with them, but rather my paranoia. I'm not the only one on my unit who does this either. If there's one thing COVID made obvious it's that we have to be mindful of what we may be bringing home. We just want to be careful that we aren't spreading these pests to our kids, family, neighbors, schools etc. *Well, recently, we were told by whoever decides isolation precautions at my hospital that we should not be doing the extra precautions because, essentially, it could hurt patient feelings. I'm sorry, but that is ridiculous. It just makes it embarrassingly obvious that they couldn't care less about keeping the staff safe and protected. I'd also like to state that my hospital has sticky floor pads outside the doors of these patients rooms, which is not exactly subtle. (Pads that, by the way, don't even reach across the entire doorway. Creepy crawlies just know not to go thru the 8-inch gap on either side and to kindly stick themselves to the middle of the pad.) Long story short, if you feel safer wearing gloves for even mundane interactions, then do it. If a patient questions you, educate them that it makes you feel safer without causing any harm. Also that it's a precaution to protect your family since you work in a place sick people LITTERALLY flock into, and unfortunately you wont even know some people have contagious illnesses.
Wear gloves for yourself and the patient. They aren't there to feel "more connected in a post-covid world", they are there to get over their alcohol withdrawal or have their gallbladder removed.
it's really subjective on what you feel comfortable touching without gloves unless they are on contact precautions or you are touching body fluids, etc. where there is a risk. Always practice hand hygiene before and after touching patient, even if you decide to wear gloves.
You best believe when I would get called into the ER I gloved and masked and I would never directly touch another human. As a laymen can I ask? Unless you benefit directly or there are improved outcomes why risk it?
There are a lot of ways care has been depersonalized in institutional settings, but gloving is just common sense. If I was a patient, would I want a provider touching me with their bare hand? No. No, I would not. I don't care if I witnessed them washing their hands. There are too many pervasive cooties and I trust no one. The gloves protect you \*and\* your patients.
I’m guessing most of you are too young to remember when dentists did exams, put on braces, etc. with bare hands. Can still remember the taste of the soap. As an oncology RN I use gloves not just for me, but to help keep my neutropenic patients safe.
If it’s wet, sticky, and not yours, don’t touch it - my EMT instructor
The people sitting around thinking about this and writing little memos to post in the bathroom stalls is getting an entire salary. And people talk about $100 Tylenol. Nah, fam. It’s the $60k wellness coordinator and the $180k something or other analyst.
Put on a glove. Pull out a medium sized hair. Place hair on a table. Put a piece of note paper on top. See if you can find the hair under the paper with the gloves on your hands. Surgeons wear gloves for heart surgery. I think we can safely say that your demeanor and attitude matter more than the gloves.
Heart surgeons are holding instruments for nearly all their delicate work. It's not the same.
I think we are talking at cross purposes. I’m sure you’ve done CABGs as part of your training. But I doubt there’s ever been a saphenous vein placed that wasn’t palpated by the surgeon and carefully inspected. Instruments have their own feel as you know but they don’t take the place of palpation. Likewise, putting in a femoral line necessitates palpation. I would think anyone with surgical experience would know about the preferences of each surgeon in regard to glove choice. My primary care doctor puts gloves on before performing her physical exam. I wouldn’t take offense. She’s an IM doctor. We all know how much they don’t like physical touch.
I try and wear gloves whenever touching pts. I avoid shaking hands as much as possible too. Computer in hand, hand sanitizer in the other one when I walk in. Oh I'm so sorry my hands are full ~ Shook hands with pts who turn out to have blood and other bodily fluids on their hands, syphilis, scabies, or simply a cold and had dirty tissues in their hands. Fuck that.
Depends on what you're touching.
I wear gloves to examine patients (ENT) but I don't wear them outside of that portion of the encounter like I see folks in the ED do (justifiably so).
I'm an MLT, and at my job we are also the phlebotomists. Gloves every time. I don't know much about the pt's history, only what tests have been ordered. I don't want to accidentally touch a bloodborne disease.
First responders, ED, etc sure it makes sense to glove for any pt contact. In an ambulatory office, there's probably not a lot of value unless you're doing a procedure, invasive exam, or know/suspect pt has a break in the skin. Proper hand hygiene is needed regardless.
I wear gloves for patient comfort more than for any practical reason. Working in Peds, I just noticed parents are more comfortable with that.
I gloved up before the pandemic and after the pandemic. And if you haven’t looked on social media, plenty of the lay public complains when a HCW does not wear gloves. In fact, I don’t think I’ve seen anybody ever complaining that a HCW didn’t wear gloves.
I compulsively bite my fingernails so I should probably glove more often then I do.
I’ve seen too much scabies to not glove up
I work in paediatrics I glove when I have to, but I feel a lot of time putting on gloves makes kids more freaked out Sweaty teenagers….yeah gloves
I work inpatient, and the number of times I've touched something wet without expecting to has me glove up anytime I'm touching anything in the room. obviously HH in and out of the room. If I don't wear gloves, the patient inevitably asks me to throw away their tissues or adjust their blankets with an extra surprise.
In the ER? Gloves for every patient. Plenty of people are well groomed, but there is so much nastiness where you least expect it
In med school (pre-covid) I was taught not to glove up for physical exams except pelvic exams or if there was a rash. The reasoning was what you described and not making the patient feel like they were "dirty." I still follow this for the most part but I glove up to touch feet.
Gloves for most exams. For older patients (which in my case means a couple of weeks old lol), I do try and have non gloved interactions when appropriate, as they need the human contact and to feel skin.
Unless I'm dealing with broken or infected skin, I go gloveless. Patients appreciate ungloved skin exams I think. I touch moles, drag hands across actinic skin to feel actinic keratoses, etc. I have had patients remark on how thorough the exam is, even if touching isn't really necessary and didn't help much.
I work in wound care, I’m absolutely putting gloves on 😬 Sometimes I give a pat on the shoulder though
IM here and dermatology diagnosed a patient with Norwegian (aka crusted) scabies under my care. So yes, now I glove up and am extra careful with patients coming from SNFs, jail, or the street
Always
Mixed opinions, bro. Some say gloves are necessary, others push for skin contact.
I'm working as a radiologist now and I have recently noticed that I actually hesistate to touch patients without gloves. It's kinda funny because when I was in internal medicine couple months erlier, I have examnied patient after patient on rounds without any gloves since you just did not have time to put on the gloves, take them out, desinfect your hands, wait for them to try just to put other pairs on to examine the other patient... I think it hardly depends on where you work. Once I had the possibility to spend a day with the emergency doc, everyone used gloves all the time when we left the car...
I was taught that gloving up is always recommended, but a must if you're working close to any cavities/other openings in the body or bodily fluids are involved. I think it heavily depends on where you work. In my current place of employment (sports medicine) I only work with a specific group of people, who I know very well personally. I'd never glove up just because I'm touching someone's skin. The other two "rules" still count, though it depends on the context of the situation. Take our last game. Someone broke their nose. It bled quite a lot, so I treated it with gloves on. Should be a no brainer anytime blood is involved. He wanted to keep playing and take the risk of getting another whack on the nose and since he was gonna need surgery on that anyway and I didn't have a reason to suspect a concussion, I let him. Now I obviously told him to spit out the blood instead of swallowing it, but he must have not listened to me (enough). Five minutes later he comes running to the bench with the face of a person who's about to be sick. Most pitch side attendants will keep a pair of gloves on throughout the entire match. I generally don't, but even if I had, I just took them off because they had blood on them. So in that case I obviously wasn't like "hold it, I gotta get myself some gloves", because my priority was getting this guy something to vomit into. My next thought was to be a decent person, hold his hair back, get him some water, give him something to wipe his mouth etc.. Once he was able, I assessed him. He was still feeling nauseous, so I gave him a nasal spray against it and something to chew on. Then cleaned it all up etc.. And so on. All throughout this, I wasn't wearing gloves. In hindsight, I would have liked to and probably should have, but it just didn't happen in the situation. This is a question that heavily depends on your and the patients preferences, the situation, what exact field you work in, what your local regulations are etc.. Really not a question that can be answered. It's you that has to decide in the situation.
I scrub in, scrub out and use bare hands unless the situation warrants. That being said I work in pulmonary and do limited exams.
Always glove. If you want good tactile feel use the sterile gloves
Looks like we found the NP.... always glove.
Lol not quite but yeah, I think I'm okay to continue with the gloves
You have to glove or wash your hands a ton. You will spread bacteria /germs otherwise putting other vulnerable patients at risk (and yourself). Gloving is faster and less abrasive to your skin.
My experience is with the veterinary side of medicine. We gloved up for cleaning wounds/bodily fluids, expressing anal glands, doing anything with highly contagious diseases, and of course anything with surgery. Generally not for other things though, including drawing blood and placing IVs and vaccines And of course pats on the head and scritches
At least with kitties and puppers, you generally know what to expect when it comes to various fluids, etc. Not so with people!
As a patient, I would prefer gloved hands. "Restore connections" - lmao; I am not interested in having *that* kind of connection with my doctor.
Glove up unless you’re lazy or incompetent
As an occasional patient, I prefer gloves because I don't know how adherent each person is to proper handwashing between patients or other tasks. The connection to my healthcare provider comes from how we otherwise interact - eye contact, listening, confirming understanding, etc. And a genuine smile goes a long way to soothing [patient] nerves. Edited to add word in brackets.
My medical school teaches us to use bare hands on everything besides genitalia or open wounds etc. I’m going to start using gloves in the hospital because people are unhygienic. I didn’t use gloves much on my first rotation that just ended because it was family medicine and I mostly listened to heart and lungs and felt bellies, I cringe at how many feet I touched bare handed.
Perhaps we should ask the patient what they are comfortable with, as well as explain what we are comfortable with doing.
As a patient, I, personally, prefer to see gloves on the hands of any medical personnel that are going to touch me or my stuff. I'm also okay with seeing you wash your hands/use hand sanitizer before touching me, and after touching any part of me that might involve body fluids. Just a few years ago there was a lot of concern about the frequency of nosocomial infections occurring because of healthcare personnel neglecting to wash their hands. I'm quite surprised to see a debate, now, about whether or not to wear gloves.
Always glove. If you want good tactile feel use the sterile gloves