I worked night shifts in a nursing home. We had over 100 residents, the majority of them considered high care, in this context that means that they needed help to use the toilet, or wore pads. We would do a number of rounds throughout the shift, and one was solely for pad changes and toileting those on set routines.
We constantly had to argue with management for more gloves to protect our hands when changing pads and toileting people. The brand they used was terribly cheap and would tear often. There were no glove holders in individual rooms, we might be lucky and find a box in a cupboard – day staff were given a box at the start of a morning shift by nursing staff, but usually they’d be almost empty by night shift or someone would hide them for the next day as often nursing staff forgot to collect them. The store cupboards were locked and carers could not get into them. There were inventive hiding places, such as on top of tall cupboards, and in drawers in certain residents rooms where we all knew that soiled pads/beds were more than likely. That is the level that we had to go to to prevent ourselves from changing soiled pads with bare hands – hiding resources from each other. Sometimes we would have to take the gloves from the kitchen that are meant for food preparation.
Nor was there antibacterial hand gel in each room – there were points around each wing with an automatic dispenser, but often they’d be empty or the battery was flat. There were no portable bottles available. I supplied my own. We had multiple MRSA+ and VRE+ residents. If it was a hospital setting, we’d have to gown and glove just to enter those rooms, but in nursing homes that is not something I have ever come across. We also had a HIV+ resident and a number with Hepatitis. Still no gloves or hand hygiene stations within or near those rooms.
If you had no gloves for a shift, you basically had to wash your hands before and after each pad change if you cared in the slightest about infection control. Most did not. I did, but my hands were constantly dry and sore as a result.
I have quite sweaty hands, and when I put on latex gloves they often tear, so I like to use the next size up to give me some leeway. If you consider that in one round I might be changing 30+ pads, and toileting 10-20 people, that is around 80 gloves just for me. If I tore them trying to put smaller gloves on, that could blow out to much more – most boxes contain 100-200 gloves.
If I used gloves properly, like the Hand Hygiene Australia website tells us to do – every time I could potentially come into contact with body fluids – toileting people, brushing their dentures, changing pads, serving meals, feeding people…I alone could use a box in a shift. This was not something senior nursing staff or management were willing to accommodate. I did attempt to supply my own gloves but on $19 per hour it was a financial burden.
One evening I went to the RN in charge and asked him to provide me with some larger gloves because we had looked everywhere and only found half a box of small gloves. He (in all seriousness) made me measure hands with him to justify why I needed bigger gloves, and then handed me six large gloves from the treatment room cupboard. Six. I walked out crying with sheer frustration at the ignorance and complete lack of concern for the health and safety of staff and residents – strangely I’d never seen a nurse searching for gloves when they needed them.