Thursday, April 9, 2009

Safety, nurses-Hairpiece

Last week, while I was in the hospital with a myocardial infarction, my wife, a nurse, came to visit. Her former nursing instructor accompanied her.

While there, a hospital nurse came to change the bandage covering my femoral cut-down site, where the cardiologist had inserted a catheter and snaked it up my aorta to study the anatomy of my coronary arteries.

The nurse wore no cap, and her long hair hung loosely, blowing freely in the air-conditioned breeze and nearly touching the still raw wound. As she treated my wound, her cell phone rang, and she brought it up to her ear in her still-gloved hand to answer the call, then returned to tend my wound. Oh well, in one ear and into another era.

This sequence of events, which I had witnessed before but thought nothing of it, shocked my aseptic visitors, who had been brought up in an era in which nurses wore caps over hair drawn back in a bun to avoid bacterial transmission. Now I have no idea whether my nurse’s unfettered, flowing locks bore bacteria. I do know, of course, that operating room nurses wear caps to contain and cover their hair. The same goes for nurses doing procedures.

In any event, my wife said, “You’ve got to do a blog on this.” Naturally my first move was to google nurses’ hair and infection. Most of the pieces that popped up concerned hair as a potential source of infection, with staph aureus and fungi, and pointed out good nursing technique dictated keeping one’s hair covered. I also read that nurses’ watches may carry bacteria. No mention was made of cell phones. That may because ubiquitous cell phones are a new fangled development, too modern to mention and too wireless to be a possible source of infection.

I’ve read many hospitals know swab patient’s nasal passages to see if they are carriers of methicillin resistant staphylococcus aureus (MRSA.

Why not do a systematic study based on swabs of nurses’ hair? Hair, after all, is just an extension of the skin, and skin in notorious source of bacterial infection, and as we all know, washing one’s hands has become a fetish as a means of preventing hospital acquired infection.

It might even be simpler to require nurses to wear caps, or to wear their hair pulled back in a bun. But that might offend nurses. The Bible says, “If a woman has long hair, it is a glory to her.” Modern nurses’ unions might rare up and use language that would either curl your hair or make it stand on end.

I end with a verse from Hamlet. If you read Shakespeare , you will generally find there’s nothing new in the world, under the sun, or under a nurse’s cap.

I could a tale unfold whose lightest word

Would harrow up thy soul, freeze thy young blood,

Make thy two eyes , like stars, start from their spheres,

Thy knotted and combined locks to part,

And each partial hair to stand on end,

Like quills from the fretful porcupine

There, dear wife, is your blog.


rlbates said...

I was shocked recently when I watched a cardiology fellow and student put an art-line in my brother-in-law with just gloves, not with sterile technique. I even commented on it as I watched them suture it in with non-sterile needle holder and no sterile draping, etc. "Oh, it's okay. We'll be taking it out in two days." Not the way I was taught in medical school/residency.

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