To have asked her to wash her hands?

[Sistermister]

I went for some routine blood tests today.

As usual in these situations, the nurse asked me to roll up my sleeve and put the tourniquet around my arm. She prodded the vein a few times with her finger and I noticed that she had pretty dirty fingernails. Was about to put the needle in when I said "really sorry to ask but do you mind washing your hands and disinfecting the area?"

She glared at me and said no. Her hands were perfectly clean and that washing them would be more for her protection than mine

WIBU?

The risk to you is low and all that would probably have been achieved by her doing another hand wash is your reassurance. Which is why I think she should have done it.

DD had a blood test today and the nurse didn't wear gloves , I was surprised because DDs eczema was open and bleeding, but like it says it's harder for her to find a vein with gloves on

There's nothing to worry about unless she had open wounds. Even so the chances of contracting anything would be minimal.

I haven't worked in the NHS for 5 yrs but advice then was ok to feel for veins without a glove but glove should really be worn for taking blood. And yes the protecting is more for them than you. As someone taking bloods all day or examining a person and being in contact with bodily fluids Day in and day out they are far more likely to be exposed to a risk than a patient in for a blood test.

YANBU

Thanks for the posts of reassurance. I'll stop worrying now.

When I give blood the staff don't wear gloves. They do disinfect your arm for 30 seconds (timed) and use anti-bacterial gel on their own hands though.

Gloves would be to protect her in case you have any contagious disease, esp blood born. They could also be used if she was contagious and had some cuts etc... on her hands.

Yes washing her hands can make her hands dry and sore. However, she should still washed them JUST BEFORE touxhing a patient and AFTER Taking the blood.
It's common procedure to avoid transmission of disease from one patient to the next.

All that has nothing to do with dirt under the finger nails. This just shouldn't be there regardless.

Re the risk of cellulitis, studies have actually shown that patients are more at risk of infection if you do swab then if you don't.
It's also possible to get cellulitis from a lot of different reasons. Any moneor scratch can lead to cellulitis.

She should have washed her hands after you requested anyway. Part of her role is to put you at ease when undergoing any kind of medical assessment, testing, or treatment. It wouldn't have hurt her at all to do it and it would have satisfied your concerns. So yes I would definitely complain to the practice.

Btw I have never had someone wearing gloves to take blood so clearly experiences are different from one person to the next.

As long as there is no clear wound of the person taking the blood, there will not be any risk of contracting a disease from one person to the next (patient to nurse).
However, the nurse can easily spread any disease (e.g. Flu, DV virus etc...) from touching one patient and touching the next person wo washing her hands in between. That's why there is such a strict routine re hand washing.

Our trust policy is to wear gloves, but I was taught to take without. I prefer without but obviously adhere to trust policy now. The gloves are solely for the protection of the person taking the blood. We no longer swab the area prior to performing venepuncture, this went out a while ago. I know some do swab as habit though.

I either wash or gel my hands before or after any patient contact, I suppose sometimes I'll wash them then call the patient through so they may not always see it.

No excuse for dirty fingernails and nails should be short for this reason.

She should have
A) not had visible dirt under her nails
B) worn gloves
C) not refused to wash her hands as HCPs are taught to wash if asked,

This is a clear breach of the infection control policy, washing hands between handling different patients is critical.

Visible dirt under the fingernails is just disgusting. Seriously, put in a complaint.

I wash my hands usually before calling in each patient, and after each patient. So you might not see me handwashing. I wash my hands up to 50 times a day and whilst I would never have dirty fingernails (that is totally unacceptable!) and wouldn't have an argument with a patient asking me to hand wash, I'd explain that I have washed my hands. I'd apppy gel if asked.

I don't wear gloves for taking blood usually. We don't swab the skin routinely, (donating blood is different to simple venepuncture) and there is no need to routinely cleanse the skin before giving an injection. Most of these procedures are 'no touch' techniques anyway so minimal risk of infection. However I'd always be mindful of a patients concerns and explain my infection control measures if asked.

You weren't unreasonable in the slightest, I work in hospitals around the country and often with the infection prevention teams. They encourage patients to ask staff if they have washed their hands.

So you did the right thing!

I do my DM's blood product infusions. I've been taught to wash my hands in a particular way, put gloves on and use a swab for both needle sites. I think you were right to ask for to at least wash her hands.

most Trusts have signs up encouraging you to ask staff if they've washed their hands.
You were completely right to question her, and you must speak to someone about this.
Yes, it's low risk but it's not no risk. And that's with physically clean hands which hers were not.
Her Infection Control team will be rightly horrified. Please speak to someone, who knows what other invasive procedures she is carrying out without proper hand hygiene.
Fwiw, I wash my hands, tourniquet on, have a good old nudey fingered feel for a vein, then mark if necessary, tourniquet off whilst I alcogel and put gloves on and then do the procedure.

Who would I complain to? And how!

You could go through PALS (patient advocacy liaison service)
If you just call the main desk, they will be able to put you through.
You can give them the department, date etc and they will contact the manager. At the very least she can arrange some training for the staff.
You are no way in the wrong here

That is terrible and you were definitely not unreasonable.

I will be going into hospital for an op soon and I'm stocking up on anti-bac wipes to take in with me to wipe down the table and surfaces by my bed after the cleaner has dragged a rag round the ward from bed to bed. I am the least neurotic person I know but no way do I want to pick up god knows what bug while I'm in there.

Never ever had this done - and had it done tons of times at different sites without gloves ever.

Each time proper wash - gel etc and gloves.

I think you need to ask your docs or wherever it was what their policy is. Sounds very very iffy to me.
I had C section and noticed yellow nicotine stained fingers of the man who helped with the anesthetic. Ie looked un washed.

Rorty very good idea and anti bac gel for yourself too. Never seen such lack luster cleaners than on DD ward last year - there was old chip under bed with hairs when we arrived and when we left cleaners were having good chat and looked like had no energy or desire to clean at all when we were there. No wonder bloody infections go round it was painful to watch.

Hand washing- yes
Gloves- yes, although I snap a finger off for difficult veins
Visible dirt- obviously no
Swab- only if your arm was visibly dirty