I was doing personal care of one of the residents, as the resident was not able to stand up without assistance. I looked out of the door for help and saw the enrolled nurse, who also happens to be the admin manager of the facility. Would you please give me a hand to get xyz, I said to her she came and we both assisted her to stand holding her walker. As I was giving her a wash after assisting with toileting and just about finishing wiping and drying her bottom. “Take your gloves off!” she said in a very authoritative manner but I pretended as if I didn’t hear anything. She again said rudely “take the gloves off” which I felt embarrassed about and I told her why do you want me to take the gloves off. She said, “ those gloves are dirty and you need to remove them now”. I told her there is nothing in the gloves, she keeps saying you just cleaned her which really annoys me and I kept wearing the gloves saying when I did my placement I was told to put them on when doing personal care and she kept arguing with me and went on to give a big lecture saying “we practice different standards here in this facility regarding the hand hygiene”. I straight away told her that I was taught to use the gloves when I did my training and you are asking me to take it off when I am washing her bum or cleaning up. Sorry! I didn’t knew that’s your facility “different standard”, I said, thank you for letting me know and I told her I am not going to stop wearing gloves. Every now and then health organisations around Australia and the world say one must use gloves to protect themselves and the one you provide care to especially in time of COVID-19 pandemic. If that is the standard you follow here in your facility so be it I will not stop wearing gloves I was telling to myself. Recently, they ran the hand hygiene training and stressed staff to follow good hygiene on washing hands, sanitizing and using gloves but as soon as the prices of gloves goes higher in the market they are now saying don’t wear gloves unless need to be….this sounds ridiculous when the government and the health sector highly recommends the use of gloves for the prevention and control of infection in residential and community aged care. Wearing gloves and PPE (Personal Protective Equipment) in essential work practices is the best way to infection prevention and control as when the person has known infectious disease like Methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant enterococci (VRE) and Clostridium difficile or there is a risk of being exposed to blood or body substances, Changing a colostomy bag or urinary drainage bag, Dressing wounds or touching broken skin, Assisting with toileting, Giving mouth or eye care, Oral suctioning Touching equipment or surfaces that may come into contact with blood or body substances, Blood glucose monitoring or You have broken skin Preparing food. Australian guidelines for the prevention and control of infection clearly mentioned Hygiene suggestions for carers of people with incontinence as follows:
- Wear disposable gloves when you are helping the person to clean
- Wash your hands thoroughly with soap and water afterwards, even if you wore disposable gloves.
Incident Reflection – Use of Gloves During Personal Care
While assisting a resident with personal care who was unable to stand without help, I looked out of the room and saw the enrolled nurse, who also holds the role of admin manager at the facility. I asked her for assistance, and together we helped the resident to stand using her walker.
As I was completing the personal hygiene care—wiping and drying the resident after toileting—the enrolled nurse said in a firm tone, “Take your gloves off!” I initially did not respond, continuing with the care to ensure the resident was comfortable and clean. She repeated, more sternly, “Take the gloves off,” which I found abrupt and unnecessary at that moment.
Feeling confused and slightly embarrassed, I asked her why I should remove my gloves during this stage of care. She insisted that the gloves were “dirty” and needed to be taken off. I explained that I was taught during my training to wear gloves when performing personal care to protect both the resident and myself from cross-contamination. She responded that “different standards” are followed at this facility regarding hand hygiene.
I respectfully disagreed and informed her that based on my training and the standard infection prevention protocols—including those emphasized during the recent hand hygiene training—we are advised to wear gloves during personal care, particularly during activities such as assisting with toileting.
I was frustrated by the inconsistency: the facility recently emphasized strict hygiene practices and the proper use of PPE, yet I was now being discouraged from using gloves unless absolutely necessary—possibly due to cost concerns. I understand resource management is important, but safety and compliance with national infection control guidelines must remain the priority.
According to the Australian Guidelines for the Prevention and Control of Infection, carers are advised to:
- Wear disposable gloves when helping a person with personal hygiene.
- Always wash hands thoroughly after glove use.
This guidance exists to prevent the spread of infections, especially in high-risk settings like aged care facilities, where residents may be vulnerable to MRSA, VRE, C. difficile, or other infectious agents.
The following week, I returned to work anticipating a potential issue regarding this interaction, and I remain committed to upholding safe and evidence-based care practices. My intention is not to challenge authority but to prioritize the health and dignity of the residents, alongside maintaining my professional integrity.
Reflective Journal Entry
Date: [Insert date]
Location: [Facility name, if needed]
Situation: Use of gloves during personal care
1. Description
During a recent shift, I was providing personal care to a resident who required full assistance and could not stand up without support. I requested help from the enrolled nurse on duty—who also serves as the admin manager—to help the resident to stand using her walker. Together, we assisted the resident successfully.
As I was finishing the personal care by cleaning and drying the resident’s bottom, the nurse authoritatively instructed me to “take your gloves off.” I did not initially respond, focusing on completing the task hygienically. She repeated the instruction in a more forceful tone, which made me feel uncomfortable. When I asked her the reason, she stated that the gloves were dirty and needed to be removed immediately. I explained that based on my training and best practice guidelines, gloves should be worn throughout personal care tasks involving body fluids to prevent infection and maintain hygiene. She responded that the facility follows “different standards,” which conflicted with my understanding of proper infection control practices.
2. Feelings
I felt surprised and confused by her demand. I also felt embarrassed, as this correction was made abruptly and during a sensitive moment with the resident. Internally, I felt frustrated and defensive, because I believed I was following proper hygiene protocols. I was also concerned about potential risks to both the resident and myself if gloves were removed prematurely.
3. Evaluation
The situation was challenging. On one hand, I was trying to adhere to standard infection control practices, which emphasize the use of PPE during personal care. On the other hand, I was being instructed by a senior staff member to do something that I felt contradicted my training and compromised hygiene. The enrolled nurse’s communication style also made the situation feel confrontational rather than collaborative, which further complicated the interaction.
4. Analysis
This experience highlighted a potential gap between the facility’s internal practices and broader healthcare standards. Australian health guidelines clearly state that carers should wear disposable gloves when helping with toileting or cleaning residents, especially in cases involving exposure to body fluids or infectious risk. The facility had also recently conducted hand hygiene training reinforcing the importance of PPE.
There may be financial considerations influencing decisions around glove usage, but these should not override resident safety or professional standards. The nurse’s insistence on glove removal appeared more focused on institutional policy than on resident well-being or evidence-based practice.
5. Conclusion
This incident made me reflect on the importance of standing by best practices while remaining open to facility-specific policies—provided they align with national health and safety standards. It also emphasized the need for respectful communication among team members, especially when discussing protocols. I realized I need to better understand how to navigate such conflicts professionally and seek clarification through the appropriate channels when needed.
6. Action Plan
- I will review the facility’s infection control and glove usage policy to fully understand their expectations and compare them to national guidelines.
- I plan to raise the concern in a respectful manner, possibly in a team meeting or via written feedback, to ensure safe, consistent care practices are upheld.
- I will also work on improving my communication during challenging interactions, aiming to stay calm while asserting evidence-based practices.
- Lastly, I will document incidents like this in reflective journals or incident reports if appropriate, as a way to track patterns and protect both residents and staff.
No comments:
Post a Comment