The first thing we were taught at university was how to wash our hands; at degree level, this seemed almost comical until the importance of infection control was impressed upon us.
On my first placement, I became somewhat of a ‘sink worshipper’; in moments of uncertainty, I would burn time by making sure my hands were impeccably clean. Then, of course, the red canisters of alcohol hand gel called to me from the end of each bed until my hands had almost no natural flora left! From a hygiene perspective, this may have been impressive but a couple consecutive long days soon took its toll.
I have suffered with eczema since I was a child. Like many, I experienced intermittent red, itchy rashes over my elbows. My GP assured me I would ‘grow out of it’ and sent me away with a prescription for hydrocortisone. In recent years, however, the skin condition has rather annoyingly decided to confine itself to my hands.
And therein lay my problem – with so much ‘wet work’ involved in nursing, how could I maintain the skin integrity of my hands?
Would patients be put off by the dryness?
After some time spent wincing when the alcohol hand gel ate away at the cuts on my dry palms, I began solely to use soap and water until my hands were left red raw. Despairing that my hands now resembled that of an older relative, I decided to do a little research.
Despite my best efforts to moisturise, I was failing to manage my atopic dermatitis by avoiding what I thought at the time was the cause of the irritation. I was reassured that alcohol gels do not cause drying of the skin, unlike soap and water in fact. So while the alcohol did cause my hands to sting, it was not the reason why they initially cracked.
Thereafter began my ‘emollient intervention’. Living the student dream, I developed a cheap yet highly effective way of restoring my hand health; socks.
One pair of old Christmas socks plus mountains of aqueous cream equated to two soft hands virtually overnight. I have stuck to this routine and, besides the inevitable flare up, have managed to maintain a fairly good skin condition. I was also reassured to read that this is not merely the plight of students but even experienced nurses suffer from eczema induced by handwashing.
How then can nurses be supported to moisturise their hands during the busy working day? If patients can use emollients as an alternative to soap, surely there are alternative skin cleaners suitable for nurses?
To date, one of the most valuable life lessons being a student nurse has taught me is that if dry hands is all I have ‘wrong’ with me, I really have nothing to complain about. The joy of being able to reassure someone by holding their hand is worth so much more than having perfect skin any day.
Olivia Millward is a second year adult nursing student at University of Surrey