Thursday, September 1st, 2011

First We Fire All the Doctors (With Unwashed Hands)

"Changing the message from 'Wash Your Hands to Protect Yourself' to 'Wash Your Hands to Protect Your Patients,' the study found, could motivate some doctors and nurses to wash their hands more frequently."
I guess. Or, you know, they could just start putting doctors who don't wash their hands on a month's unpaid leave. OR! They could forcibly graft a nice hospital-acquired staph infection onto their faces maybe. I don't know: if doctors aren't getting the practice of washing hands between patients, should they even be doctors? Sorry, I know all workplace best practices are hard! But this question of "motivation" seems absurd.

24 Comments / Post A Comment

brianvan (#149)

Has modern parenting affected even medical sanitary standards? "We love you and you're special, whether or not you want to wash your hands before touching a sick person."

Matt (#26)

Missing bike lane rant.

Backslider (#819)

I write pharma copy for a living. For a while I worked on a product intended to treat resistant infections. Here are some insights from my somewhat unique perspective.

1. Money is a great incentive. Insurance companies, including medicare/medicaid are now refusing to pay for hospital-acquired infections. With the hospitals on the hook for these complications, administrators lean heavily on all staff to maintain infection-control standards.

2. It seems to be working. Sales of the drug I mention above–which I will not name for fear of my livelihood–have been in a slow decline for the past few years as a result of reduced infections.

3. Still and all, doctors are dicks. It really is the doctors who resist cleaning up after themselves. They hate being told what to do.

laurel (#4,035)

@Backslider The Doctors-hating-being-told-what-to-do thing reminds me of Atul Gawande's piece in the NYer on the use of checklists in hospitals: "On a sheet of plain paper, he plotted out the steps to take in order to avoid infections when putting a line in. Doctors are supposed to (1) wash their hands with soap, (2) clean the patient’s skin with chlorhexidine antiseptic, (3) put sterile drapes over the entire patient, (4) wear a sterile mask, hat, gown, and gloves, and (5) put a sterile dressing over the catheter site once the line is in. Check, check, check, check, check. These steps are no-brainers; they have been known and taught for years. So it seemed silly to make a checklist just for them. Still, Pronovost asked the nurses in his I.C.U. to observe the doctors for a month as they put lines into patients, and record how often they completed each step. In more than a third of patients, they skipped at least one."

Ham Snadwich (#11,842)

@laurel You're not the boss of me, checklist.

melis (#1,854)

"Wash Your Hands Because You Are a Human Being, Not an Animal, Jesus, Even Raccoons Do It, Fucking Raccoons"

saythatscool (#101)

@melis How To Wash A Raccoon's Fucking Hands.

BadUncle (#153)

"Please do not blow nose on patients."

DMcK (#5,027)

@BadUncle Maybe bedside sneeze guards would help. And a "No Nibbling" sign.

@BadUncle "Patients now equipped with sneeze guards"

roboloki (#1,724)

i propose we just change the name to staff infections.

Tulletilsynet (#333)

All my hand-sanitizing & handwashing amused my doctor pal when I spent time at his hospital recently. You could say it struck him as scrupulous. (His hospital is known for iatrogenic infections.)

Also, perhaps they should consider dressing it down a bit.

Matt (#26)

Missing #DOODY tag.

saythatscool (#101)

@Matt Go wash your ass.

christoball (#4,670)

Man, this is still going on? They drove the first guy to suggest doctors wash their hands to destitution:
Ignaz Semmelweis in Man Without a Country

"Semmelweis observed hospital routines, and began to suspect that doctors were bringing the infection to the patients. He noticed doctors often went directly from dissecting corpses in the morgue to examining mothers in the maternity ward. He suggested as an experiment that the doctors wash their hands before touching the mothers.

What could be more insulting? How dare he make such a suggestion to social superiors?"
-Kurt Vonnegut

whizz_dumb (#10,650)

@christoball Hell yeah, Vonnegut insight wins again. Dude is my hero.

Abe Sauer (#148)

That post (and by extension this one) puts the fault of this on doctors and not hospital support staff (which includes nurses BUT ALSO a ton of other people whose medical education does not extend beyond a 6 month course in bed pan changing etc–there is a massive hierarchy including CNAs etc). So while I'm not saying there are not some doctors out there who do not wash their hands, I would be shocked to know that this is largely a problem amongst doctors, as I've known many and almost to a man they are obsessive about this (especially b/c they worry about infecting their families at home.)

s. (#775)

This is why I don't go to the doctors.

Is "Fire all the doctors" this era's version of "Kill all the lawyers"?

whizz_dumb (#10,650)

@Setec Astrology It's "Pay teachers less, how dare they unionize?" But in this case it's just, "Wash your fucking hands so you can help me live longer and you deserve every cent". Lawyers are still greedy dicks way more often.

lbf (#2,343)

"Wash Your Hands to Protect Yourself (From Lawsuits)"

Post a Comment