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You Can Ask? Really?

Posted by Madeline Holler

Have I mentioned I'm not terribly assertive with medical professionals? Well, I'm not. I've got a milllllion opinions and demands and I'm more than willing to share them, just not with the actual nurse or doctor. I just hate the double-takes, exasperation and sometimes mild offense of a reaction I get those times I have womaned-up and asked a question and/or made a request.

So I am at once in awe/totally tense reading about these people, who have the nerve to ask doctors and nurses to do something they should have had the professional sense to already have done: wash their hands.

According to this, repeated studies show that healthcare workers wash up adequately about half the time. (Half!) Some hospitals post a hygiene rate of 20 percent. (Twenty percent!).   

I know! Washing hands! The No. 1 way to cut down on those infections and viruses that are spread around hospitals and medical facilities! But I think we all know they DON'T always wash their hands -- the pediatrician coming in to do a check-up, the nurse readying my kid for another round of shots. I HAVE noticed that the sink sits there dry and unused, but of course I haven't said anything (wouldn't want to cause ill will).

Here's what's supposed to happen: National guidelines say they’re supposed to use alcohol-based hand rubs or soap and warm water for at least 15 seconds before and after every direct contact with a patient, with excretions, or with contaminated surfaces or objects. And just putting on gloves isn't enough, the article says. They're supposed to wash their hands first and THEN put on the gloves, otherwise they contaminate the outside of the glove when putting it on.

In an effort to increase the hygiene rate, some hospitals across the country want you to ask. They've got posters, brochures, buttons, etc. saying "It's OK to ask," and hope to urge you to speak up when you don't see the nurses and doctors wash up before touching you.  

That's exactly what Dalynn Morales did. The 33-year-old cancer patient at Providence St. Vincent Medical Center in Portland, Ore., noticed that a nurse failed to clean her hands before adjusting Morales’ antibiotic line.

“I said, ‘Could you please wash?’” Morales recalled, adding that the nurse quickly complied. “I’m not sure if she felt insulted or not.”

We'll just skip over why we even have to ask, how it's not already automatic to walk into a room and straight to the sink. But now that I know it's OK, I wonder if I will. I'm trying to think how I would ask. Do you say: "Hey, mind washing up?" or "I read that I should be asking you to wash your hands," or ... how do you phrase it without getting them all pissy with you? Come on, give me the script.

Have you ever asked your doctor or nurse to wash their hands? What was the reaction? 


Comments

 

Clean Mommy said:

It could be because they use the hand antiseptic located outside the patient's room and you were not awared of it. I am a health care worker and I use this in between seeing my patients.

January 25, 2008 8:10 PM
 

steffmarcusky said:

I took my son in to the ER due to blood in his stool and severe weight loss (undiagnosed milk allergy), and the doctor went from checking his butt to touching my son's eyes without taking his gloves off (my son still had too much bilirubin - partly due to the milk allergy)! He was more concerned about a little too much yellow in his eyes and not enough with putting POO with blood in his eyes. And my friend who was there with me tried to shush me when I told him he needed to clean his hands before he did that. But he was ok with it - took care of it right away without attitude.

When I saw my pediatrician the next day, I made sure to give her his name, so maybe she could reinforce that you can't do that next time she saw him at the hospital - I don't know. At least that's when she made the connections about the milk allergy. But I can't believe him!

January 25, 2008 8:21 PM
 

Madeline Holler said:

CleanMommy, that's something I hadn't thought of. I'll look next time were at the docs. I'm curious, though, what about opening the door? My doc's office has those lever doorknob things so elbows-only doesn't work. Also, since you're a health care worker, tell us, (1) how would you react if someone asked you to wash your hands and (2) what exactly would you like them to say? Seriously, feed me the words!

Thanks for responding!

Madeline

January 25, 2008 8:22 PM
 

Mike Adamick (Cry It Out!) said:

When my wife had surgery many years ago, her mom asked the doctor to wash his hands, and the look -- wow, I still remember it to this day. It's actually made me afraid to ask myself. A doctor could come in eating Cheetos off a petri dish and I probably wouldn't ask.

January 25, 2008 9:41 PM
 

mistress_scorpio said:

I once spent 3 hours in an emergency room. I was right by the entrance of the room and there was a sink directly across from me. I didn't see one medical professional use the sink, and only about half of them were using the hand sanitizer. And even if they are using hand sanitizer between patients, they are still supposed to wash their hands when coming into contact with any open wounds or bodily fluids.

The current rates of infection in hospitals has brought me to the following conclusion... I don't care if they are offended. I will tell them flat out to wash their hands!

January 25, 2008 10:11 PM
 

pickel said:

I was just thinking about this yesterday...how do doctors not get sick like patients do? Or do we just not see it?

I have never asked a doctor to wash but I have never felt the need to because I always trusted who I saw. Even some Peds offices now have sick and well baby rooms for this reason.

January 25, 2008 10:34 PM
 

Kay said:

I've never asked...but after reading this I probably will (try).

I wanted to say that when my Grandma was in the hospital last month a nurse brought in her tea and then stuck her FINGER in it to test the temperature!!!! My Grandma didn't drink it.

January 26, 2008 12:07 AM
 

Lisa said:

Some doctors wash before they come into the examining room but they touch the door knob. Knobs have more germs than toilet bowls!

January 26, 2008 12:49 AM
 

Abel D. said:

Medical professionals use washing and gloves to protect themselves, not you or me.  Watch next time at the timing of their cleanup activity.

January 26, 2008 3:03 AM
 

RachelZ said:

Once your kid is old enough, make THEM ask. In the meantime, just be polite and say "May I ask if you washed your hands before you came in?"  That opens up the dialogue and if they say "no, oops" you can say "Could you please wash them now?"  No excuses necessary, but if you feel you must (Why? Why do we do this?), then explain that you're one of those "nervous moms."  Those people get away with so much.

Or you could just sniff the doc's hands when he comes in.

January 26, 2008 5:14 PM
 

Sarah H said:

Please ask! I'm an RN and most the MDs and RN/CNA/LPNs I've worked with do not wash their hands in between patients.

January 26, 2008 8:27 PM
 

Clean Mommy said:

Madeline, this article is much more interesting than I thought! Yes, I do have to use my hands to twist the knob and I don't wash my hands before I shake my patient's hand after opening the door...because it's like you shaking another person's hand that you meet...you assume that your hand is relatively clean. Now, this is assuming that my patient and my hands are without any type of wounds/lesions. If I were to do any type of invasive procedure, I would definitely wash and wear gloves and then wash again. It's really for my own protection as well. I would think that when you book an appointment to see your provider at your clinic/hospital, you would have "some" faith. Not everything is sterile in the office unless if it's packaged as sterile. I personally, would probably not be insulted if someone ask me to wash my hands, depending on the tone of the person asking. But I do have to be honest with you and will probably feel a little uncomfortable during the visit since I feel like I'm being scrutinized. If this person doesn't trust my "cootie-free" hands, then why trust my health advice?

January 27, 2008 12:59 AM
 

Dwtintx said:

But CleanMommy, you and every other medical professional is asking us to trust your "cootie-free" hands, yet clearly we shouldn't trust the hands to be "cootie-free".  Yours, obviously, are an exception, but see Sarah H.'s comment.  Also see the study!  This whole thing worries me because handwashing/disinfecting can prevent so many infections, which every medical professional should know.  So why the resistance?  Finally, why would you feel uncomfortable knowing the patient is scrutinizing you?  Shouldn't we, as active and involved patients, scrutinize our caregivers?  I realize that we do not have the training to self-diagnose, but shouldn't we hold our medical professionals to acceptable standards on things we DO know about, like handwashing?  Especially since the medical profession as a group appears not to hold itself to that high standard.

I guess this study dismays me greatly, knowing that handwashing is the easiest way to diminish the risk for any number of infections. It is distressing to think that medical professionals would resent my trying to ensure even this most basic hygiene.    

January 27, 2008 9:29 AM
 

Mom2Two said:

This isn't exactly the same thing...but I'm a vet tech and I always wash my hands between patients.  I quite often wash my hands in the exam room while dealing with a patient.  After taking a rectal temperature, for example, or touching infected ears.  Do I really want to touch my pen or the computer with that on my hands?  The skin on my hands attests to how often I wash (dry, scaly, painful, red).

The only doctor I have seen for most of the past 4 years is my OB and she always heads right to the sink and washes when she comes in the room.

January 27, 2008 2:20 PM

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