[Spoiler alert: bad words contained within]
Germs are bad, right? We all know that. This sterile thing is important. We like clean, we are in a hospital.
As you know, there are some skin issues around my port so the covering gets changed more than weekly. That is fine. I recently was under the care of a nurse who is not my chemo nurse, but she does have a special title and loads of initials after her name (and no, not Port Authority).
Each nurse has their own little rituals around doing this in as sterile a way as possible. Generally they cover the area around the port with a clean blue cloth like thing. On a tray they lay out a sterile covering and on that is the kit with the sterile dressings, tape, etc. The kit is opened and the nurse dons sterile gloves and begins. First a swab is used on my skin …
And then their pager goes off. Ok, that is not an official part of the ritual but in this particular case, her pager went off. Got the picture? And she reflexively reached for her pager and checked it. Sort of like this:
That is NOT the actual nurse at the actual time. It is a picture found on the internet, and the closest I can find to the real life incident. Close, but not the same.
Quiz time … why is this picture not the same as what happened? In other words, what is this not showing?
In real life, THE NURSE HAD HER FUCKING GLOVES ON.
That would not be a problem if she then removed them, put on new ones, and continued. But as Mr. Bill says …
She did not change gloves. Keep that thought.
One study from the National Institutes of Health (NIH) says this about “orthopedic attending and resident cell phones” …
Of fifty-three cell phones, 83% (forty-four cell phones) had pathogenic [disease causing] bacteria at initial testing, 8% (four cell phones) had pathogenic bacteria after disinfection, and 75% (forty cell phones) had pathogenic bacteria one week later. The mean result (and standard deviation) at initial testing was 3488 ± 2998 relative light units, which reduced after disinfection to 200 ± 123 relative light units, indicating a cleaned surface, but increased one week later to 1825 ± 1699 relative light units, indicating a poorly cleaned surface.
There are many studies such as this. Yes, I know a pager is not a cell phone, but close enough.
We also need to note that it was a reflex on the part of the nurse to look at her pager. I saw what happened, the pager beeped and she instinctively put down the swab, reached down and unlatched the pager, then used both hands to interact with it. She has been doing this for many years. And I have no doubt (although no proof) that she does this wherever she is, in the bathroom, eating a meal, etc. She then snapped it back in its holster, picked up the swab and continued to change my dressing.
I know what you are thinking.
So, Mr. Big-Shot-Advocate-Single-Dad, why did you not say something?
I have not lost my filters yet. My brain was yelling “Are you fucking kidding me?!” but the filters kicked in. Then I reworked it to “What the hell are you thinking? I did not know that KMart sells nursing degrees” but the auxiliary filter kicked in. Then I figured that the cancer will probably kill me anyway, so what are a few germs between friends?
I will soon post more on why I did not say anything, and yes, I was wrong not to, but alas, I did not.
She continued with changing the dressing never realizing that she totally messed up. Literally. Putting my health in danger. Don’t forget that my immune system is currently suppressed.
When my regular chemo-nurse changes the dressing, I am not allowed to look at the area because she does not want me breathing on it for fear of contamination.
I don’t have a stay-put option, you fuck up and I die.
OH MY FREAKING GOODNESS! That is just so not OK.
1. Why does the hospital not have a Vocera system which is hands-free?
2. Which an incredibly problematic medical system where someone like you has not been given the sense that you can say, “Please change your gloves.”
WTF!
Not cool at all. We are audited on a regular basis for hand washing and I’ve found that the audits have made me much more conscious of my hand washing which is a good thing. But central lines are different than regular IVs. They are central, they go into a nice big vein and leave you at risk for sepsis which is why nurses go to the trouble of using a sterile field and gloves to access your port. If it ever happens again, tell him or her, please change your gloves. I wouldn’t be offended, just embarrassed that I hadn’t done better.