Do nurses really need to use so many gloves?

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Alice Suttie CNS works in a surgical hospital in Sydney – but she has some doubts about the extensive use of gloves. Do you agree? We’d especially like to hear from other theatre nurses – but all nurses and midwives too.

I listened to the information being passed on at one of our theatre meetings not so long ago … and it got me thinking. The topic was ACORN Standards relating to double gloving for surgery and the recommendation that green gloves be used under cream or white gloves to make it easier to spot tears or loss of glove integrity. My mind filled with stories from my colleagues who had recently returned from a trip to the Solomon Islands: how little they have compared to our wealthy first world private hospital and our wealthy first world decision-making bodies!

At what point do we, instead of making rules about gloves, actually pause and consider the privilege of having sterile gloves and disposable gloves at all? Is making recommendation standards based on such utter inequality justified – even where efforts are made to get supplies to the poorest nations? Or should standards be based on something that can be achieved in less than ideal circumstances so that there may be a better distribution of funding? If our standards were based on what’s achievable for countries that don’t have first world wealth, would we be able to maintain a standard of practice that has both cost savings and the possibility of better use of resources – a more equitable distribution?

Is it appropriate to make standards based on double gloving and colour coding? In asking if it’s appropriate, I question our actions deeply in terms of the environmental impact. My own hospital is making progress with recycling, but we have yet to begin talking about reducing waste. Do we really need to flood the environment with so many pairs of used gloves? How many nurses have any idea what happens to gloves once they are tossed away to be burnt or added to landfill? How long do they last in the environment? How toxic are the fumes if they are incinerated? What is their impact on the people who live near their disposal sites – on the birds, the animals, the plants and insect life?

I mentioned my thoughts to one doctor in the tearoom and he agreed with my sentiments, noting that he had volunteered on one of the island countries off our coast where a circular has been passed around asking people to please refrain from wearing sterile gloves unless it was absolutely necessary. And here we have standards recommending two pairs, colour-coded!

When our standards are produced, I know the process is rigorous and has various guidelines that need to be adhered to. However, I suspect those guidelines are not inclusive of environmental impact, judging by the ever-increasing number of recommendations steering us away from reusable items (material drapes have been targeted, along with our washable cloth caps, in theatre). I am deeply troubled about this trend as I don’t think it is taking the precarious nature of our time on this planet into account. Healthcare is going to need some very deep rethinking as we move into an increasingly unstable and uncertain future. We cannot continue to make decisions that ignore the situation of other nations or the environment as if we aren’t all connected – because, like it or not, we are.

Previously on Nurse Uncut:

Useful info on hospital sustainability:

3 COMMENTS

  1. Interesting question Alice. I certainly take advantage of our liberal supply of gloves if I consider it will reduce the transfer of microbes that might pose a risk to patients or lower my risk of being personally infected. The growing risk of superbugs is not one to be taken lightly & simple barriers such as gloves seem to be a good idea. However I agree that the waste that comes out of our western hospitals is really unsustainable for our environment. I hope someone out there has some good ideas.

  2. Hi Mark, I hear you, however I think it’s worth remembering that according to current guidelines, gloves are not to be considered an alternative to hand-washing, which remains our first line defence against pathogen transmission. Hand-washing or use of handrub is still required whether one uses gloves or not, thus gloves are a second line defence when there is known or predicted exposure to body fluids or similar. It might be that with thought one may discover times when gloves are not really needed and a simple hand wash will suffice.

  3. As one working in oncology, yes we definitely need gloves. Most patients had chemotherapy and are considered as cytotoxic for average a week until the body has flushed out the chemotherapy. If nurses are aware what previous treatment the patient had prior to surgery, then maybe they can review their policy regarding double gloving, but how many nurses and doctors can truly say they have a full background knowledge of their patients’ past and present medical history. In addition, in surgery, it is very vital that patients are protected from contracting infection by observing the 5 moments of hand hygiene and wearing of gloves whenever an invasive procedure is done or touching, handling body fluids, emptying catheter bags, stoma bag to name a few. Protocols are set up to protect patients and those providing care …nurses and doctors alike.
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