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Patient voice

'Some carers don't really know why they wear gloves, they just do'


Tony Nicklinson is paralysed and relies on 24-hour care. In his second article for Nursing Times, he suggests that carers should question the use of gloves

It has been just over a year since the carers have been looking after me without wearing gloves and, as expected, nothing untoward has happened to me or them. Actually, it’s not quite true that they have given up gloves, for one carer puts on a glove when wiping and then drying my bottom. I suppose the company would ordinarily wear gloves for this sort of long-term domestic care, but the truth is that I don’t know. I have asked but, as yet, they haven’t told me.

It may be they don’t really know why they wear gloves, they just do. They probably have some vague notion that it is “hygienic”. Given below are some reasons, although the list probably isn’t exhaustive:

  • Because they can
  • Because they think gloves are cleaner than clean hands
  • Because they don’t want to get their hands dirty
  • Because their competitors do and they don’t want to be different

The central issue is that people don’t appear to ask “why?” before they specify gloves. I believe if they did, gloves would seldom be worn. They could ask questions such as “why do I think wearing gloves is better than not?”, “who benefits?”, “am I trying to stop the worker catching something nasty or vice versa?”, “can I wash my hands instead of wearing gloves?”

I once asked another care provider to justify his glove-wearing and he refused, implying instead that I was a troublemaker and would put my care in doubt if I continued. So much for transparency!

Recently a chiropodist came. She was asked if she would cut my toenails without wearing gloves. She refused and was sent away. She would have been feet away from my en-suite bathroom so what was she worried about?

I recently saw on TV a midwife wearing a glove when giving a patient a scan. Why? I don’t believe that she couldn’t have washed her hands afterwards so was the glove simply a way to avoid having to?

Similarly, I saw a carer preparing food while wearing gloves. Why? Was she avoiding getting food on her hands or avoiding contaminating the food with her hands?

The carer who wears a glove while attending to my bottom obviously doesn’t mind taking risks when wiping his own bottom because he cannot see what he is doing, unlike doing mine; all that happens is that he doesn’t get the glove dirty and he discards it when finished. Why is that not possible without wearing gloves?

The carers who feel they have to wear gloves when giving me a bottle must be pretty incompetent if they think spillage is likely when it is next to impossible. And what does it say about the carers who won’t carry a commode bowl without gloves because it contains faeces or hold a shower without gloves because they are rinsing out said bowl? They are hardly immersing their hands in the stuff, so what’s the problem? Personally, I would be reluctant to employ such a person because their lack of confidence or ability in this aspect of their work could affect other areas.

One can only speculate on the reasons, of course, but I am forced to wonder if the world has gone mad. Have people abandoned common sense in their pursuit of “safety”?

I have shown that wearing gloves for non-clinical use is unnecessary. Someone has to pay for all these gloves and although I don’t know the full cost, I’ll wager it is considerable. At a time when people are protesting about cuts, should we be spending money on something as useless as non-sterile gloves? I don’t think so.

I blame people like Linda Nazarko (in the previous article) for perpetuating the myth that all body fluids are hazardous in all circumstances. Some people drink fresh urine, for goodness sake, so how hazardous is that? Quite obviously there are many situations where gloves are unnecessary when handling body fluids and teachers like Linda should explain what they are.

Linda does make some good points, though, but they appear to go unheeded. Perhaps the nursing profession will try and inject some common sense into the situation but I doubt it because they are as guilty as anybody of promoting the inappropriate use of gloves.

So, stop being delusional and forget reasons like hygiene and modesty and just be honest - admit gloves are worn because you don’t want to get your hands dirty and you are too lazy to wash them. Stop wearing gloves in inappropriate circumstances and wash your hands to save some money.


Readers' comments (27)

  • How insulting and ill informed is this article? I suggest Mr Nicklinson, that it is you that needs to stop being delusional and accept that sometimes gloves ARE worn quite appropriately.

    Oh, and for the record, I always wash my hands and wrists after patient contact, even if I have worn gloves. I also wear gloves for ALL clinical tasks, and the majority of personal ones that you have mentioned.

    I agree that there are many carers and HCAs (I suppose other health care workers and professionals too) who use gloves inappropriately, ie do not change them between patients etc. (Yes I have seen people do this and reprimanded them!) And yes, I agree that when wearing gloves, we should explain to the patient why we are doing so if they ask us, and yes there probably needs to be a lot more IC training for HCAs and carers, but that does NOT mean we should stop wearing gloves!

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  • Linda Nazarko gave entirely appropriate advice in her response to your last article. Your final paragraph is just insulting. Of course, nurses and carers are just an easy target these days and cheap swipes like yours are ten a penny.

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  • A message for the NT moderators, how can an obviously insulting article like this even be allowed onto the site?

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  • nobody ever gets their job 100% right although many do their very best. nurses evaluate and do their best to meet the individual needs of the clients/patients within the scope of their working practices which include following the protocols of their employers and their own knowledge, expertise, professional judgement and some personal preferences, and time constraints as well.

    although it is more respectful and agreeable for a patient, and also from the psychological point of view, if there is skin contact between the carer and themselves for general care such as washing, carrying out care of the most intimate parts, and especially handling body fluids it is essential to wear gloves for protection from potential infection. The carer may have breaks in the skin on their hands which can be so small as to be imperceptible but where germs can collect and enter the system. they also see several patients a day and, although they may be fairly resistant to most common germs, they need to protect not only themselves but also their other clients, some of whom may be far more vulnerable, from risks of cross infection. People all have different levels of tolerance to germs and as these are invisible general principles of hygiene have to be followed for all to avoid potential problems. Lapses in these rules may result in spread of infection which may not have been detected or serious at source but can become a major health hazard to others.

    In response to Mr Nicklinson's statements about urine and faeces: urine is normally sterile but at any one time when carrying out care this cannot be confirmed without microscopic examination that patient's urine is not infected, although its odour can be an indicator. Faeces are very high carriers of different types of germs in large numbers which colonise the gut and notably e-coli which although usually harmless to its host is not necessarily to others.

    As for family members and wives carrying out intimate care and the disposal of body fluids, this is personal choice, those living in the same household are probably more immune to each other's germs and they are usually not dealing with other vulnerable patients whose immune systems may be seriously impaired.

    Correct hand washing procedures are paramount but may also not be a 100% guarantee against the transmission of infection.

    Surely the caring attitudes and skills and competencies of the carer are more important than a dispute over the need for some to wear gloves to comply with their employers regulations or for their own personal preference!

    Sensitivity, understanding and social responsibility are required on both sides of the fence and it is better for all concerned to be cared for by someone who feels respected and valued.

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  • should read at the end ........respected and valued for their skills and the quality of their work.

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  • any illness and physical or mental loss of function is a tragedy and sad waste of a normal, healthy and productive life. but i find this vindication of healthcare personnel who are there to carry out their duties of caring, helping and supporting this client is extremely sad as well.

    Whilst we all like to accommodate the individual needs and wishes of those for whom we care, and aim to understand their physical and psychological needs to the best of our ability, which sometimes involves bending the rules as well, we nevertheless also have to follow certain procedures which have been established for a reason by employers or the nursing and medical organisations for the health and safety, not just of the individual, but for all concerned. nurses and carers should not be coerced or manipulated by their client into changing these rules if they consider this detrimental to themselves and others in any way.

    recipients of care have every right to question the care they receive and the motives behind it as have employees to question employers if a directive is unclear to them or seems unreasonable but flexibility to respect and accept some decisions of the carer and their employer are also necessary, and without which their job would become impossible.

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  • I would also like to add, that while healthcare workers should seek to maintain the dignity of their patients at all times, they ought to be forgiven for not wanting someone elses urine or faeces to end up on their hands. Regardless of the germs issue, it is simply not very pleasant. Please don't label us as unsympathetic or bad at our job just because we don't want your bodily fluids on our skin. I think you raised interesting points in your last article (re: the cost of overuse of gloves and the fact there are some jobs that don't require gloves to be worn at all) but you have gone a bit far this time. Please try and see it from our point of view and then perhaps you would moderate your tone somewhat.

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  • oooh, I remember the days, when gloves didn't really exist, except fo aseptic techniques, and I am here to tell the tale, and so were my patients. I never gave them MRSA or C Diff, they didn't exist. We are victims of being too clean and too many antiobiotics, and it can only get worse. We used to handwash very very well. We need to keep our natural immune system intact. It's not just this topic, but we are so brainwashed these days.

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  • Anonymous | 2-Aug-2011 0:57 am

    that is not the argument of this article.

    I agree with Anonymous | 1-Aug-2011 6:35 pm

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  • I certainly would not like to wipe someone elses bottom without wearing gloves and to suggest that carers should not because we wipe our own bottoms without wearing gloves is just nonsense.

    I do agree that it is not necessary to wear gloves for all procedures but I do because it is my Trust policy for me to wear gloves at all times. I also wash my hands before and after glove wearing most of the time.

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