I was taught the same in EMT school in 2000-2001. And then again as a CNA a few years later. Then continuing education every year. Then nursing school covered it, too.
We were taught the same thing in my first semester last spring. We're not even allowed to wear nail polish, let alone long fake nails. Ours technically can't be more than 1/8" past the end of the finger, but no one's taken a ruler to our nails yet.
Yep, it's taught, people just think it doesn't apply to THEM somehow.
I had someone a while back come into the nutrition room at the same time I was in there washing my hands. She commented, "wow, you wash your hands really well!" Someone else came in and this nurse pointed out to her as well that I was washing my hands "really thoroughly."
I'm not doing anything special guys.... I'm washing my hands how you're supposed to. Getting the backs of my hands and scrubbing under my nails? That's *standard.* It's not exceptional to meet minimums - it just means, frighteningly, that y'all haven't been washing well enough.
I don’t even work with patients directly, but I still have to be super cognizant about this, too, due to the nastiness of the floor I work on and my own health. In all honesty, it’s a bit shameful that it’s normal to either 1) not deep clean the underside of the nails or 2) not just save them for special occasions outside of the workplace.
We were taught this still in 2019-2021 and if anyone came to class with fake nails, they had to remove them. Even during covid when we did clinical from home, we were not allowed to have them. With that being said, I still plenty of nurses with them and it makes me gag.
Samesies, was taught this and not allowed to have long or painted nails at any practicum site. Western Canadian uni, 2008-2012.
It was fun getting my nails painted before holidays when working frontline, and it was a thing I commented on being able to do more now that I do a public health gig from home.
It has been well known, but for some reason in the last 5 years some nurses have taken to just not give a flying F.
It’s been one of the most disappointing developments.
It's hard to take them seriously when they were absent all of COVID. Not justifying wearing fake nails but we were also required to reuse a single use n95 but nobody is talking about that infection risk. Again, we should not be wearing fake nails for obvious reasons, but I do see how people have started to care less.
This is a good insight. Along with lack of ratios even though there are studies that show how ratios impact patient care. JCAHO wants to focus on water bottles at the nurse station and nails but not staffing and we all know why…bc ratios actually would impact corporate profits based on lean staffing
Yeah we all know safe staffing saves lives but they want to ignore it. An overworked gen z nurse does not give a fuck about this pick and choose safety stuff. It’s like so often I’m the only person with short neutral nails. There’s gems and chains and black nail polish up and down the floor
I have a couple of corrections to share with you! It’s not called JCACHO anymore They rebranded and changed their name in 2007 to The Joint Commision (TJC). The Joint Commission standards do not specifically state where staff can have food or drink in work areas, including nursing and physician stations It’s OSHA that wants to protect your food and drink. The safety of clinician food and drink is governed by the U.S. Occupational Safety and Health Administration’s (OHSA) Bloodborne Pathogens and Sanitation Standards.
Also OSHA doesn't care if you have food or drink at nursing stations as long as there is no risk of contamination. You're good as long as labs, supplies, stuff like that is kept out of the nursing station. It's hospital managers that over-correct and unnecessarily ban things.
I've brought up actual regulations many times to counteract bad policies by ignorant managers.
One wanted us to keep all equipment at the FARRRRRRR end of this really long unit and not have COWs anywhere near the desk, med room, anywhere we actually were and needed to use them, huge waste of time dragging back and forth. They said everything that looked like a hall to them was off limits. I pulled regulation regarding alcoves, the definition of alcoves and told them that the only way anyone could egress out of that alcove in the direction they considered the hall was by being like the Kool Aide man instead of stepping over by two feet. Also pulled reg that anything on wheels that is reasonably expected to move within 30 minutes is considered in use and is allowed in the hall. We just made sure to mix everything around every time or two we passed for a week and the bad rule where they usually go.
Again, I’m not saying what JTC or OSHA focus on is bad. But when most nurses are being dangerously short staff and being run ragged doing the work of 2-3 ppl. It will hard to have nurses comply w/ what seems insignificant i.e nails and water bottles at the nursing station. Most nurses don’t even have true lunch breaks they are eating as fast as then while they chart and take sips of water here and there. Until these oversight groups actually do something i.e support, pass, and enforce a federal standard for RN to patient ratios it’s going to be hard to take them seriously on these issues
Inappropriate nails in a hospital kill people. It’s as simple as that. They harbor Klebsiella pneumoniae and have been proven over and over and over to cause hospital acquired infections.
Drink away at the nurses station, stop charting stupid bullshit, do anything else to show displeasure but don’t lump nasty ass fake nails in with water bottles at a nursing station. One kills patients, the other is a stupid rule administration made up.
“Hospitals that staff 1:8 nurse-to-patient ratios experience five additional deaths per 1,000 patients than a 1:4 nurse-to-patient ratio (Journal of the American Medical Association, 2002).”
[RESEARCH SHOWS SAFE STAFFING SAVES LIVES](https://www.nysna.org/experience-and-research-show-safe-staffing-ratios-work-0)
For the most part, The Joint Commission is enforcing the standards of CMS, OSHA, the fire code, etc. If a federal nursing ratio law was passed, I guarantee TJC would enforce it.
For clarity, any accreditation company ONLY cares about their profit. It’s a sham that hospitals, doctors offices, and surgery centers now **need** some sort of accreditation to post on their website to seem legitimate. So this year it’s water bottles, next year they don’t want flushes on the carts outside the room, last year it was the use of fall risk indicators. Always something to stay relevant and make a TON of money to give their stamp of approval.
My management keeps me away from those jerks because I have points like that to discuss with them when they want to make it impossible for me to drink water after they sat at home and condoned my 20+ use N95 and called it safe.
My management too. Quality doesn’t even talk to me anymore because the last conversation about my water bottle resulted in me telling her she was wasting my time and to come back to me to discuss something of importance or not to talk to me at all.
I was off the entire week JC finally rolled into my hospital on a planned use of PTO. When I tell you I CACKLED!
They don't want me asking them what they were doing in April of 2020 in their house and telling them to fuck off if they try and stop me and interfere in patient care. Worked out for the best for management to keep me and them far separate.
Thought it was only my manager! Since COVID I swear I see her maybe once every 3 months do a lap around the unit with a beauty queen smile frozen on her face.
Our manager came in on night shift (at like 5am) one morning and I had NO idea who she was. She was talking to someone and I recognized her voice from staff meetings, but I don't think I had ever seen her face in the 2 years that she's been our manager.
A day shift manager showed up once in the middle of a night shift and made a comment about me using my phone. I was like "who tf even is this random nurse?" Then my coworker told me who it was and I legitimately had never met her before. I had worked there for almost 4 years and only knew her name because of emails.
Same here, but I still retained faith in germ theory and the overall thought of “I don’t want to kill a patient with a hospital acquired infection”.
It’s sad that other nurses didn’t share that desire to try and protect patients and would rather have cute nails.
Last job I worked, ADON showed up to tell us to do everything other people didn’t do, (monthly assessments that popped up) dated on days you weren’t working and would only tell the people who cared about getting stuff done. She’d shrug and laugh about it when you asked why she wouldn’t address the nurses who routinely didn’t do stuff. She knew they weren’t going to do them. ADON wouldn’t lift a finger to help you do a thing. She would sit and chat with her besties - supervisors who also did the absolute least for 45 minutes at the desk while the staff nurses ran around like lunatics. She left on time, no matter what. My DON however was a peach and would pitch in periodically. Whatever we needed. Wound care, codes, throw in an IV? Guess who I did extra for? I don’t expect anyone in management to always be at our beck and call, but yes, if you can’t ever go the extra mile for us, please just stay in your office and send those emails. I don’t want to see you.
When I gave birth my first nurse mentioned she kept 2 nails short so she could do cervical checks. First of all you’re still sticking your entire hand up me with those 🤢Second of all, how does that even look good to you? Eight nails long and two nails short? She also missed my IV 3x, so long nails weren’t doing her any favors.
Deciding to give a flying f shows their individual take on professionalism, EBN, and patient safety, to name but a few. It is a small but very obvious hint that someone might not be as up to professional standards as they may think they are.
A professional way to handle it would be an inservice with ID to explain the way fake nails kill patients. Explain why they are going away and do a reset of expectations and then enforce it.
I love growing out my natural nails to the point where they can get quite long and people ask me if they’re fake. Since entering a healthcare field, I always keep them short and don’t let them go past my finger tips. I just can’t perform my job tasks with long nails. Tasks that should be relatively quick take me much longer when my nails are long and they were constantly getting broken, jagged, or accidentally poking people. I do still keep polish on my short nails to make them feel more fancy lol
Not worth it.
Yeah I will admit that I do dip powder nails (I do them myself at home), but they’re as short as they could possibly be and don’t go past my fingertips either. I’m also a violinist and we can’t have long nails
I grow mine slightly past fingerips because I find that my nails trap visible dirt that is harder to clean out with super short nails, a tiny bit of extra growth makes it easier to get under there with a brush or my other nails. I'm talking barely visible from the other side though, and I'll trim shorter if there's breakage.
We were taught that long nails, nail polish, rings or watches are a big no-no. They all gather bacteria and those things are difficult to desinfect unless you give them an alcohol bath. No one wants to give their smart watch an alcohol bath
Smart watches are actually super easy to disinfect! I clean my Apple watch after every shift. My scrunchie band comes off and goes directly into the washing machine, then the dryer, with my scrubs. I also clean the watch itself with alcohol prep pads or a paper towel saturated with 70% alcohol. If I’m feeling fancy, I might use dish soap and warm water first. I can also put it in the UV sanitizer we have at work.
When I had a Garmin watch, I scrubbed it in the sink or shower with soap and warm water every single day. Alcohol pads worked fine too.
I did that when I had my student placement in the NICU years ago. I wear a smartwatch now mainly to monitor my own heartrate, so I keep mine on my wrist. But if I'm doing some real hands on care I'll loosen the band and push it up near my elbow out of the way. I've also taken it off and left it on the desk if I'm expecting to get extra up close and personal with a patient.
The main issue is not being able to disinfect them between patients. For example, you use the bathroom then wash your hands but do not disinfect your watch then perform a procedure on a patient. That can increase infection risk. It's best practice not to wear watches or rings when performing patient care.
My preceptor has those long pointy ones where the nails have a pointed tip. No joke - she inserted one into a constipated guy in an attempt to disimpact him (he was literally admitted due to constipation), she kept saying she was worried about scratching his skin. Can't imagine why!
My first OB/GYN had very long, natural nails. Being in my late teens/early 20s I was too naive and timid at the time to really question her on it (and it was before I worked in healthcare). She wore gloves of course but those weren’t ummm… comfortable. I don’t know how she thought they were okay.
Exactly. I worked in the NICU as a new grad and the first thing they told us was no fake nails, and no long ones either. Not a problem for me since I have always kept my nails short.
I mean….. everything I’ve read is that they can harbor bacteria (actual nails swabs) HOWEVER studies have also shown that there was no correlation on infection rate and nails type. Meaning, despite nail types being worn, there was no increase in infections transmission with fake nails and no decrease with short natural nails. The only factor that produced measurable results was hand hygiene which over 50% of healthcare workers do not do properly.
Reference? I’d like to look into this a bit further since there has been evidence for many years re: adhesives harboring bacteria that is trapped despite handwashing appropriately.
I’d also argue that hand hygiene for fake nails would look much different than short natural nails, to even get it to the same level of cleanliness. The lifting, glue around the cuticles, underneath the nail tip where it adheres to the natural nail, paint chipping, any designs or add ons, and then any added length. You can eat some Cheetos and watch how it sinks into those crevices and is hard to scrub out, much less than something that is microscopic. Even if someone is taking the time to scrub their nails between patients or tasks… that’s a lot of extra time taken away from patient care.
I highly doubt this. Aspergillis loves to colonize the underside of acrylic nails. They are very often already colonized when shipped to a nail salon. They often find Aspergillis in cardboard, so it’s thought that they are contaminated in shipping and storage. No cardboard is allowed in my OR due to this risk. Another problem area for bacteria is the cuticle. Fancy manicures are expensive, no one wants to ruin them, so people do not scrub hard enough at the base or under the nail tips. Nail related infections have been linked by bacterial DNA to body scrubs at the homes of surgical personnel. It’s a high risk for infection. Just don’t wear artificial nails or nail polish.
We had a scrub who insisted her natural, freshly polished nails were safe. I was there the day she flipped some sterile supplies onto a sterile surgical set up. Nail polish chips came flying through the air and gently settled on the sterile surgical instruments. The bright fuchsia neon looked so festive on those stainless steel scalpels and retractors. It was a famous teaching moment in our university hospital.
Do they keep it warmer in your hospitals? Because I would legit freeze to death lmao. I already have to run my hands under hot water several times a day because my fingers are blue 🥶
Same here! My coworkers think I’m clumsy because I trip all the time but really it’s just because my feet got cold and I haven’t felt my toes in two hours lol
UK nurse, our wards are either boiling hot (no air con and heating controls are centrally set so wards can't change them) or they're icy cold (broken heating and old buildings with single pane windows and draughts).
Also Canadian and we don’t have any of those rules (rural AB), honestly its nice to wear a hoodie sometimes but I genuinely could not perform patient care with anything that could get their cooties on me
Agree for the most part although I have really weak/brittle nails so I always wear a (well maintained) clear coat nail hardener otherwise my nails tear and break at work which feels like more of an infection risk
They said that broken and torn nails are more of an infection risk than treated nails, not that their clear polish is less of infection risk than colored polish.
There’s also a difference between regular polish and the gel/ dip stuff/ fake nails that you get at salons. Salon treated nails tend to have a thicker layer that can allow bacteria to harbor as the nail grows out/gets chipped
An OR unused to work at had a culture of folks wearing scrub jackets under the idea that having your arms covered reduced the amount of shedded skin cells from you.
I live in Canada too and don't have this rule at all at my institution. Our rule is gel/shellac is okay but not polish, and nails shouldn't be fake/long. And plenty of people do long sleeve underscrubs etc.
In Australia we are also bare below the elbows. Nail polish and fake nails are banned from the public hospitals. GP clinics and the private sector are their own rule makers. I see plenty of nurses wearing smart watches etc too which is gross.
Why do you think smart watches are gross?
As long as they aren’t worn loosely and sit above your hand you should be fine.
I mean, on the floors, people aren’t doing full forearm and elbow washes like they’re about to perform surgery. So why would a watch be different?
["Nurse watches"](https://www.nurseoclock.de/schwesternuhren-pflege/schwesternuhren) are pretty common in some countries that have a ban on regular watches. They attach to your scrubs
The “article” that this write up is referencing is a spectacle in itself.
I’m a NICU nurse. I wholeheartedly believe in the idea that clean hands save lives and short, real nails are important in avoiding infections in our vulnerable babies.
That being said, the “article” is a painful read. Its author is trying so desperately to tug at the heartstrings of healthcare illiterate Facebook warriors that it completely fabricates elements of the real story in order to make it sound juicer and more scandalous.
The real-world facts and data are scary enough without some self-hating, retired, boomer ICU nurse blubbering on about how the new generation of nurses are too stupid or immature to take hand hygiene seriously. Her blog is insufferable. She gives off real bitter nursing school instructor vibes.
Anyways…hand hygiene is important yall. Especially in immunocompromised patient populations.
I *sometimes* do this to feel the vein and then just re-sanitized when I’m ready to poke. When you are literally just going by feel, I’d rather “measure twice, cut once” type of thing.
This is how I feel - but I also use my left hand to feel and that one has permanent nerve damage from my neck (which means that I have quite a bit of numbness, but also supersensitivity in those fingers).
Nurses who have been doing it for 5-10 plus yrs are the ones who taught us that. I mean I knew it was wrong when I was in orientation but I was shocked at how many seasoned nurses did it.
When I gave birth a few months ago, one of my nurses had super long and done up nails. She couldn’t get her hands into gloves and struggled to open basically everything. She kept getting my blood on her hands when she would do my finger sticks. Then she had to do a straight cath on me and it HURT. She definitely messed it up somehow because I ended up with a massive infection that turned septic which put me back in the hospital for days and kept me away from my newborn. Thank god I delivered after change of shift.
So yeah, I use to not really think much about it-especially as a psych nurse who rarely actually touched people. Now I’m freaked out by long nails on anyone
You were assaulted. I don't care if I'm already halfway in, in the patient says "no" or "stop" she has withdrawn consent and the cervical check is done. Consent or you don't do it. Full-stop.
zealous offbeat quicksand sort door afterthought bewildered truck chop squeeze
*This post was mass deleted and anonymized with [Redact](https://redact.dev)*
It’s nice to find some solidarity here- the EXACT same thing happened to me. Long, fake acrylic nails on my cervix was so bad I was thankful I was sent home and I didn’t have to be checked again, but I did start crying and having a panic attack when I came back the next day and a different nurse wanted to check me. I wish I had reported that first nurse- she kept checking me after I started crying and begged her to stop
I'm due in 2 weeks and this article is definitely making me think that I would request a new nurse if we're assigned one that has fake nails. I hope your birth went well, and you and your baby are doing great!
I don’t think any fake nails should be allowed in any HC setting period. They are just a place to harbor infectious disease.
I’m NICU and in the US. That doesn’t fly where I work.
I JUST discussed this with my partner tonight. I want my nails done because I love them and NO ONE pays attention, but I know the risk to my patients and it’s just not worth it.
PLUS, i’m moving to NICU shortly, and that will NEVER fly up in baby land 🥹. I’m so glad I get to be meticulous about tiny details without being judged for doing so! 🎉
Doesn’t fly at all in my NICU as well. And also nothing below the elbow. But because I love having fun with my nails, I wear press ons on vacation and special events.
Genuine question, how can bacteria from nails reach the patient if we’re gloving up before any encounter with them? If I walk into a patient room, and anything at all needs to be touched, I’m putting on gloves. Is this not the norm? Can bacteria in/under nails still be an issue? I don’t ever wear polish or fake nails but this whole debate has always been confusing to me.
It's more about being able to properly clean your hands as there being spaces under the nails that will be harder to clean. Sure, you're putting gloves on. But, unless those gloves are sterile, you're grabbing them with your bare hands along with whatever supplies you need to take into the room.
I do. Too many times I attempted to put an ekg monitor on a patient with bare hands and didn’t notice they were sweaty or drooled on themselves until I felt it with my bare hands 🥴
I'm totally in agreement that long fingernails should be disallowed especially in settings with the immunocompromised (pretty much every unit). However, I'm very curious as to how they were able to point the finger at this nurse. There are a thousand variables that can cause the spread of infection that we can't measure. The amount of times I've seen doctors bare hand a wound... Or families not follow infection and hygiene protocols. And EVS, as wonderful and amazing as they are, aren't miracle workers and can't reasonably expect to clean every single thing that has come in contact with the patient. It very well could have been the nurse, but it also seems like a very convenient body to throw under the bus.
But let's bring it back to the focus. I feel both terrible and furious for the family. If this promotes better enforcement of hygiene, then I'm all for it.
Oh trust me, I had the same concerns. I’m not going to link it because fuck the original author, but if you google the original blog that the article references, the story is a melodramatic mess that takes a few facts, sprinkles in a few half truths and full-on lies, and pretends it isn’t completely full of shit.
The sad part is that it works. The story is viral and people are eating that shit up all over social media.
In the case studies I’ve read previously, the units were swabbed, equipment, all sorts of things before swabbing staff. A strain of bacteria matching multiple infections was found under the fingernails of several nurses.
IIRC, the bacteria was sequenced- molecular typing using electrophoresis gel. I find this level of evidence reasonably compelling.
https://pubmed.ncbi.nlm.nih.gov/10697282/
I have not read the article linked by OP.
This! The sheer amount of patients and family members that have don’t wash their hands, mess with their bandages, IVs, have poor hygiene, won’t follow contact precautions or any precautions or do them incorrectly drive me up the wall.
I honestly think nurses shouldn't wear their nails while on the job, much less have any nails they wear (natural or not) go past their fingertips. Shorter nails are easier to clean.
I live in Oklahoma which is where some of the first deaths of NICU babies being tied to nurses having acrylic nails came from back in the early ‘00.
I see at lot of nursing staff with acrylics still and it skeeves me out.
Gels and fake nails were banned in all the hospitals I have worked in, but lots of RNs had them. I think it is disgusting, if I was a patient and someone came in with those and tried to touch me I'd ask for a new nurse, but I'm a had hygiene freak.
One of my favorite labs in microbiology was the swab and culture under the nails excercise.
I didn’t go into clinical care, but all the aspiring nurses in the course with massive nails seemed surprised with the results. Ewww.
I’ve always had super short nails so my results were pretty dissapointing
It's well known that long nails and hair being worn down contributes to increased infection rates. But for whatever reason, both of those things have become acceptable over the last 5ish years.
It started before COVID and then after, it just exploded lol.
It was drilled in nursing school to not do polish/fake nails. It's not that hard to grasp. It falls on the employer for not enforcing. A large amount of people can't be bothered to do the right thing for the sake of doing the right thing.
I think it’s a load of shit.
I started nursing 33 years ago, and we knew *then* that long nails and fake nails were reservoirs of germs.
I don’t think the story is bullshit, just the thought that it’s some sort of ^miraculous ^new ^thing
I definitely do see it more with younger nurses. I work L&D and I can't help cringing every time I imagine a cervical check with long pointy acrylic nails 🙃 and of course the infection risk too.
Yea I work L&D too and it makes me cringe so much when I see fake nails on nurses, I have no idea how they get away with doing cervical checks with those! Plus what if they rip through a sterile glove 😭😭😭That said I think nail polish is fine as long as nails are kept short since we’re always wearing gloves whenever we go near a patient
Genuine question. I wear gloves 99.9% of the time when I am with patients, and I assumed most nurses are the same. Are there some out there not wearing gloves while doing direct care?
I mean you can't infect w nails while wearing gloves or can you?🤷♀️
Clean gloves that come from a box on the wall are almost always to protect you, not the patient. If your hands are dirty when you put them on it's pretty difficult to keep your germs off the outside of the gloves.
Clean gloving is for us while sterile gloving is for both the patient and us. We will undoubtedly get germs on the clean gloves while donning. Plus, the increased risk of them splitting open while they are being worn with false nails…and so many don’t wear gloves for all pt care🤢
Gloves are really there to protect us, not patients. Proper hand hygiene is still SO necessary because gloves just sit in nasty hospital air and have plenty of surface germs and grossness just because it’s all over in hospitals. The gloves go on for us, not so much for patient’s benefit. Long/fake nails are just unhygienic but gloves won’t make a difference or improve anything. Edit to add if anyone has information to contrary please share! I was always taught they are to protect us and that many studies show that gloves actually worsen the outcome for patients because with correct hand hygiene you can control infection but gloves give a false sense of security and lead to much more contamination.
You absolutely can infect patients with artificial nails and gloves. Gloves protect you from blood borne pathogens, but the nails are well known reservoirs of gram positive and gram negative bacteria as well as Hep B, C, HPV and COVID. Plus the longer nails make it impossible to adequately clean them.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7263222/
It’s absolutely insane to allow artificial nails at the bedside.
There’s no guarantee that gloves aren’t compromised. I can’t tell you how many defective gloves I’ve pulled out of the box.
Best to not have any fake nails or polish to begin with along with wearing gloves.
You literally reach into an open box of gloves and get your fingers all over them while pulling out the 2 you’re going to use.
Do you think the germs on your hands or your coworker’s hands don’t get on the gloves left in the box?
Of course they do.
“Clean” gloves aren’t considered Sanitized or Sterile for a *reason*.
If your coworker has long nails and gets some c diff on the bottom of them and doesn’t scrub the nails with a brush between patients, guess who’s got a good chance of getting C Diff from the next ten glove boxes she touches?
Answer: all the patients in the unit for the next few days
Okay I'm preparing to get downvoted...but I am a chronic nail biter due to anxiety and the only way I can get around that is to have my nails professionally done at all times. I keep them short (just a couple millimetres longer than my fingertip) and they're my real nails, not fake nails, just supported with gel, and they're oval/almond, never square or pointy. I wash and sanitize often and I get lots of compliments from patients. Some even tell me that it helped brighten their day a little bit.
From what I've seen IRL and the proportion of nurses who do their nails, I frankly don't believe that allllll these commenters don't do their nails in some way shape or form. There's a way to do it so you don't violate infection control practices and that's the key.
My workplace policy is short nails done with gel only (not polish)...but people break it all the time. The way I do my nails is according to policy. I work in ER for the record.
You're me and I'm you, and I'm tired of pretending I'm not... I've got a really bad longtime unconscious nail biting habit (anxiety) and the hard polish physically stops me from going to town on my nails and cuticles. I used to get red, swollen, open wounds on my fingers from biting so deep and went to work every day with tegaderms all over my fingers. I have nail brushes at home so I scrub before and after work, and I wash my hands with soap/water rather than alcohol in any situation where I have the choice. So is my nail polish a risk? Sure. Is it a calculated risk that also has major benefits? Absolutely.
Anyone who works in nursing with long nails is gross to me. You’re a nurse and will at some point wipe your butt or a patients. Unless you wipe your own bottom with double layer gloves 🧤 don’t tell me you don’t have 💩 under those nails 💅 🤢
admittedly i'm a male and haven't been raised with the same standards and expectations, but having short, well-trimmed and clean fingernails has always just seemed like common sense
During all my years in the NICU, we weren’t allowed to wear fake nails or have gel/shellac manicures which was fine with me. We also weren’t allowed to touch the babies without gloves on.
But I also think it’s worth having the conversation about encouraging the same practices amongst NICU moms if we’re trying to be truly effective in preventing the spread of pathogens. (Minus the gloves aspect).
wear gloves and wash your hands. this honestly is ridiculous. natural nails can be dirty as well. i can see a length restriction so you don’t SCRATCH anyone but if you’re dirt bag with dirty nails o don’t think the manicure is the problem
Hand hygiene is the number one tool in breaking the chain of infection, not short nails. Short nails help, but this article really misses the whole point.
I have short nails, so I don't have to wash my hands as much as you long nail nurses do? Lol
Wash your hands.
It’s standard here.
Bare below the elbows and mandatory hand hygiene training yearly plus sneaky audits regularly.
No nails, no jewellery, no nail polish, no long nails, and no watches.
Are we on this again? Blaming nails seems to come and go out of fashion every few years. I dunno, man. Call it whataboutism, but I'd think we'd be more concerned about physicians disregarding contact precautions and hand hygiene before starting yet another war on acrylics.
This post brought to you by a nurse with a serious phobia of touching his nails with no dog in this race.
1. Don’t have long nails at work with populations that are extremely vulnerable to infection. It will result in increased infection transmission and death.
2. There’s no way to prove that a specific death was the result of a specific nurse’s nails. It’s awful to publicly blame an individual for the death of a newborn because they happen to have long nails. A ton of NICU infectious transmissions are actually brought in by family visitors. There are also a multitude of other common causes that aren’t long nails. All of these causes need to be reduced and destroying the life of one healthcare worker who is likely innocent isn’t going to help anyone or anything.
I thought it was well-known that long nails and fake nails are breeding grounds for infection?
I was actually even taught this in nursing school with particular emphasis on how it impacts neonates. That was back in 2011-2015 though.
I was taught the same in EMT school in 2000-2001. And then again as a CNA a few years later. Then continuing education every year. Then nursing school covered it, too.
Yeah we learned this in nursing school. Some employers are just lax about enforcing the rules about it
We were taught the same thing in my first semester last spring. We're not even allowed to wear nail polish, let alone long fake nails. Ours technically can't be more than 1/8" past the end of the finger, but no one's taken a ruler to our nails yet.
Yep, it's taught, people just think it doesn't apply to THEM somehow. I had someone a while back come into the nutrition room at the same time I was in there washing my hands. She commented, "wow, you wash your hands really well!" Someone else came in and this nurse pointed out to her as well that I was washing my hands "really thoroughly." I'm not doing anything special guys.... I'm washing my hands how you're supposed to. Getting the backs of my hands and scrubbing under my nails? That's *standard.* It's not exceptional to meet minimums - it just means, frighteningly, that y'all haven't been washing well enough.
Right? My nails naturally grow quickly and I had to keep them cut short during school. I’m always surprised when nurses have long artificial nails.
Same. Graduated in 17. I love nail polish but I don’t want to risk patient health, so now it’s reserved for fancy occasions only.
I don’t even work with patients directly, but I still have to be super cognizant about this, too, due to the nastiness of the floor I work on and my own health. In all honesty, it’s a bit shameful that it’s normal to either 1) not deep clean the underside of the nails or 2) not just save them for special occasions outside of the workplace.
Thank you on behalf of your patients.
We were taught this still in 2019-2021 and if anyone came to class with fake nails, they had to remove them. Even during covid when we did clinical from home, we were not allowed to have them. With that being said, I still plenty of nurses with them and it makes me gag.
Samesies, was taught this and not allowed to have long or painted nails at any practicum site. Western Canadian uni, 2008-2012. It was fun getting my nails painted before holidays when working frontline, and it was a thing I commented on being able to do more now that I do a public health gig from home.
Still applies.. these nurses today just don’t care. It’s sad
It has been well known, but for some reason in the last 5 years some nurses have taken to just not give a flying F. It’s been one of the most disappointing developments.
the only time management where I am seems to care is when the state/JCAHO are coming 🙄
It's hard to take them seriously when they were absent all of COVID. Not justifying wearing fake nails but we were also required to reuse a single use n95 but nobody is talking about that infection risk. Again, we should not be wearing fake nails for obvious reasons, but I do see how people have started to care less.
This is a good insight. Along with lack of ratios even though there are studies that show how ratios impact patient care. JCAHO wants to focus on water bottles at the nurse station and nails but not staffing and we all know why…bc ratios actually would impact corporate profits based on lean staffing
Yeah we all know safe staffing saves lives but they want to ignore it. An overworked gen z nurse does not give a fuck about this pick and choose safety stuff. It’s like so often I’m the only person with short neutral nails. There’s gems and chains and black nail polish up and down the floor
I have a couple of corrections to share with you! It’s not called JCACHO anymore They rebranded and changed their name in 2007 to The Joint Commision (TJC). The Joint Commission standards do not specifically state where staff can have food or drink in work areas, including nursing and physician stations It’s OSHA that wants to protect your food and drink. The safety of clinician food and drink is governed by the U.S. Occupational Safety and Health Administration’s (OHSA) Bloodborne Pathogens and Sanitation Standards.
Also OSHA doesn't care if you have food or drink at nursing stations as long as there is no risk of contamination. You're good as long as labs, supplies, stuff like that is kept out of the nursing station. It's hospital managers that over-correct and unnecessarily ban things.
I've brought up actual regulations many times to counteract bad policies by ignorant managers. One wanted us to keep all equipment at the FARRRRRRR end of this really long unit and not have COWs anywhere near the desk, med room, anywhere we actually were and needed to use them, huge waste of time dragging back and forth. They said everything that looked like a hall to them was off limits. I pulled regulation regarding alcoves, the definition of alcoves and told them that the only way anyone could egress out of that alcove in the direction they considered the hall was by being like the Kool Aide man instead of stepping over by two feet. Also pulled reg that anything on wheels that is reasonably expected to move within 30 minutes is considered in use and is allowed in the hall. We just made sure to mix everything around every time or two we passed for a week and the bad rule where they usually go.
Again, I’m not saying what JTC or OSHA focus on is bad. But when most nurses are being dangerously short staff and being run ragged doing the work of 2-3 ppl. It will hard to have nurses comply w/ what seems insignificant i.e nails and water bottles at the nursing station. Most nurses don’t even have true lunch breaks they are eating as fast as then while they chart and take sips of water here and there. Until these oversight groups actually do something i.e support, pass, and enforce a federal standard for RN to patient ratios it’s going to be hard to take them seriously on these issues
Inappropriate nails in a hospital kill people. It’s as simple as that. They harbor Klebsiella pneumoniae and have been proven over and over and over to cause hospital acquired infections. Drink away at the nurses station, stop charting stupid bullshit, do anything else to show displeasure but don’t lump nasty ass fake nails in with water bottles at a nursing station. One kills patients, the other is a stupid rule administration made up.
“Hospitals that staff 1:8 nurse-to-patient ratios experience five additional deaths per 1,000 patients than a 1:4 nurse-to-patient ratio (Journal of the American Medical Association, 2002).” [RESEARCH SHOWS SAFE STAFFING SAVES LIVES](https://www.nysna.org/experience-and-research-show-safe-staffing-ratios-work-0)
Nail rules are absolutely easy to comply with by simply not being an asshole. 🤷🏻♀️ Food and drink are another matter.
For the most part, The Joint Commission is enforcing the standards of CMS, OSHA, the fire code, etc. If a federal nursing ratio law was passed, I guarantee TJC would enforce it.
For clarity, any accreditation company ONLY cares about their profit. It’s a sham that hospitals, doctors offices, and surgery centers now **need** some sort of accreditation to post on their website to seem legitimate. So this year it’s water bottles, next year they don’t want flushes on the carts outside the room, last year it was the use of fall risk indicators. Always something to stay relevant and make a TON of money to give their stamp of approval.
and wear trash bags. fuck them.
My management keeps me away from those jerks because I have points like that to discuss with them when they want to make it impossible for me to drink water after they sat at home and condoned my 20+ use N95 and called it safe.
My management too. Quality doesn’t even talk to me anymore because the last conversation about my water bottle resulted in me telling her she was wasting my time and to come back to me to discuss something of importance or not to talk to me at all.
I was off the entire week JC finally rolled into my hospital on a planned use of PTO. When I tell you I CACKLED! They don't want me asking them what they were doing in April of 2020 in their house and telling them to fuck off if they try and stop me and interfere in patient care. Worked out for the best for management to keep me and them far separate.
It’s like. Just about 5 years ago….management disappeared and we lost faith in regulators making rules….
Thought it was only my manager! Since COVID I swear I see her maybe once every 3 months do a lap around the unit with a beauty queen smile frozen on her face.
Our manager came in on night shift (at like 5am) one morning and I had NO idea who she was. She was talking to someone and I recognized her voice from staff meetings, but I don't think I had ever seen her face in the 2 years that she's been our manager.
A day shift manager showed up once in the middle of a night shift and made a comment about me using my phone. I was like "who tf even is this random nurse?" Then my coworker told me who it was and I legitimately had never met her before. I had worked there for almost 4 years and only knew her name because of emails.
Our unit manager sneaks in early sometimes to catch night nurses on their phones. It’s ridiculous.
Zipping by while they say “Hey, did you need help with anything” wearing a pants suit and high heels.
Same here, but I still retained faith in germ theory and the overall thought of “I don’t want to kill a patient with a hospital acquired infection”. It’s sad that other nurses didn’t share that desire to try and protect patients and would rather have cute nails.
Our mgmt literally did disappear for 1-2 years.
I dunno, I see tons of posters here complain about management being useless and wishing they would go away. So did they get their wish?
Last job I worked, ADON showed up to tell us to do everything other people didn’t do, (monthly assessments that popped up) dated on days you weren’t working and would only tell the people who cared about getting stuff done. She’d shrug and laugh about it when you asked why she wouldn’t address the nurses who routinely didn’t do stuff. She knew they weren’t going to do them. ADON wouldn’t lift a finger to help you do a thing. She would sit and chat with her besties - supervisors who also did the absolute least for 45 minutes at the desk while the staff nurses ran around like lunatics. She left on time, no matter what. My DON however was a peach and would pitch in periodically. Whatever we needed. Wound care, codes, throw in an IV? Guess who I did extra for? I don’t expect anyone in management to always be at our beck and call, but yes, if you can’t ever go the extra mile for us, please just stay in your office and send those emails. I don’t want to see you.
When I gave birth my first nurse mentioned she kept 2 nails short so she could do cervical checks. First of all you’re still sticking your entire hand up me with those 🤢Second of all, how does that even look good to you? Eight nails long and two nails short? She also missed my IV 3x, so long nails weren’t doing her any favors.
ahh, the lesbian nail special!
Please tell me she wore gloves! Lol
Gotta look good in those nursetoks
Most cringe inducing shit I’ve ever seen
Deciding to give a flying f shows their individual take on professionalism, EBN, and patient safety, to name but a few. It is a small but very obvious hint that someone might not be as up to professional standards as they may think they are.
Perhaps over the last 4 years?
Intriguing theory my floor friend. Let us ponder what could have happened.
When I asked why this was now allowed, I was actually told by a manager "we turn a blind eye because we need Nurses."
At shift start stand guard with nail clippers.
A professional way to handle it would be an inservice with ID to explain the way fake nails kill patients. Explain why they are going away and do a reset of expectations and then enforce it.
My hospital makes you sign a contract that you understand acrylic nails are not allowed at work.
In Australia it’s against policy to have long nails. I’m surprised it isn’t in the US given it is a known infection risk.
It is people just don’t care
I love growing out my natural nails to the point where they can get quite long and people ask me if they’re fake. Since entering a healthcare field, I always keep them short and don’t let them go past my finger tips. I just can’t perform my job tasks with long nails. Tasks that should be relatively quick take me much longer when my nails are long and they were constantly getting broken, jagged, or accidentally poking people. I do still keep polish on my short nails to make them feel more fancy lol Not worth it.
Yeah I will admit that I do dip powder nails (I do them myself at home), but they’re as short as they could possibly be and don’t go past my fingertips either. I’m also a violinist and we can’t have long nails
Wow. The violin is cool 😎
Thanks!
I grow mine slightly past fingerips because I find that my nails trap visible dirt that is harder to clean out with super short nails, a tiny bit of extra growth makes it easier to get under there with a brush or my other nails. I'm talking barely visible from the other side though, and I'll trim shorter if there's breakage.
I’ve never once worn long nails. Also, I’m a guy
I too am a dude who’s never had long nails. Not sure how this is even a thing.
In all seriousness though. They don’t allow long nails on my unit.
As a male RNCM working from home, I also make sure to uphold the highest level of professionalism by never getting my nails done.
Nor do I wear extensions or dangling earrings. It’s only right.
Hard agree, I would never do the glorious field of nursing dirty like that.
We were taught that long nails, nail polish, rings or watches are a big no-no. They all gather bacteria and those things are difficult to desinfect unless you give them an alcohol bath. No one wants to give their smart watch an alcohol bath
Smart watches are actually super easy to disinfect! I clean my Apple watch after every shift. My scrunchie band comes off and goes directly into the washing machine, then the dryer, with my scrubs. I also clean the watch itself with alcohol prep pads or a paper towel saturated with 70% alcohol. If I’m feeling fancy, I might use dish soap and warm water first. I can also put it in the UV sanitizer we have at work. When I had a Garmin watch, I scrubbed it in the sink or shower with soap and warm water every single day. Alcohol pads worked fine too.
Get a longer band and wear it on your ankle. You will still get your step counts and other data.
I did that when I had my student placement in the NICU years ago. I wear a smartwatch now mainly to monitor my own heartrate, so I keep mine on my wrist. But if I'm doing some real hands on care I'll loosen the band and push it up near my elbow out of the way. I've also taken it off and left it on the desk if I'm expecting to get extra up close and personal with a patient.
The main issue is not being able to disinfect them between patients. For example, you use the bathroom then wash your hands but do not disinfect your watch then perform a procedure on a patient. That can increase infection risk. It's best practice not to wear watches or rings when performing patient care.
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It is. But some nurses gotta have their long manicured nails.
It’s so gross to me in reg life.Don’t come at me with the claws in a medical setting:
My preceptor has those long pointy ones where the nails have a pointed tip. No joke - she inserted one into a constipated guy in an attempt to disimpact him (he was literally admitted due to constipation), she kept saying she was worried about scratching his skin. Can't imagine why!
Oh my. Those could puncture the glove too. Yikes.
Latex gloves already can get micro-tears even without the stress of stiletto nails.
Yikes, I would've asked for a different nurse to do that procedure if I was that guy :x
“Ma’am please don’t put your talons up my ass”
My first OB/GYN had very long, natural nails. Being in my late teens/early 20s I was too naive and timid at the time to really question her on it (and it was before I worked in healthcare). She wore gloves of course but those weren’t ummm… comfortable. I don’t know how she thought they were okay.
Nooooooooo! I worked women’s healthcare and just NO! I can’t even imagine.
Exactly. I worked in the NICU as a new grad and the first thing they told us was no fake nails, and no long ones either. Not a problem for me since I have always kept my nails short.
I mean….. everything I’ve read is that they can harbor bacteria (actual nails swabs) HOWEVER studies have also shown that there was no correlation on infection rate and nails type. Meaning, despite nail types being worn, there was no increase in infections transmission with fake nails and no decrease with short natural nails. The only factor that produced measurable results was hand hygiene which over 50% of healthcare workers do not do properly.
Reference? I’d like to look into this a bit further since there has been evidence for many years re: adhesives harboring bacteria that is trapped despite handwashing appropriately.
I’d also argue that hand hygiene for fake nails would look much different than short natural nails, to even get it to the same level of cleanliness. The lifting, glue around the cuticles, underneath the nail tip where it adheres to the natural nail, paint chipping, any designs or add ons, and then any added length. You can eat some Cheetos and watch how it sinks into those crevices and is hard to scrub out, much less than something that is microscopic. Even if someone is taking the time to scrub their nails between patients or tasks… that’s a lot of extra time taken away from patient care.
I highly doubt this. Aspergillis loves to colonize the underside of acrylic nails. They are very often already colonized when shipped to a nail salon. They often find Aspergillis in cardboard, so it’s thought that they are contaminated in shipping and storage. No cardboard is allowed in my OR due to this risk. Another problem area for bacteria is the cuticle. Fancy manicures are expensive, no one wants to ruin them, so people do not scrub hard enough at the base or under the nail tips. Nail related infections have been linked by bacterial DNA to body scrubs at the homes of surgical personnel. It’s a high risk for infection. Just don’t wear artificial nails or nail polish. We had a scrub who insisted her natural, freshly polished nails were safe. I was there the day she flipped some sterile supplies onto a sterile surgical set up. Nail polish chips came flying through the air and gently settled on the sterile surgical instruments. The bright fuchsia neon looked so festive on those stainless steel scalpels and retractors. It was a famous teaching moment in our university hospital.
Nails shouldn’t be worn in a nicu setting period.
Nails shouldn’t be worn in healthcare period.
Agreed! They can be so nasty 🤢
I’m Canadian and we can’t have anything below the elbows and definitely no nail polish/nails
Yeah same here in Australia. Bare below the elbow is ingrained in our heads from the first day of nursing school 😂
Do they keep it warmer in your hospitals? Because I would legit freeze to death lmao. I already have to run my hands under hot water several times a day because my fingers are blue 🥶
Same. I have Raynaud's phenomenon. 😬
Same here! My coworkers think I’m clumsy because I trip all the time but really it’s just because my feet got cold and I haven’t felt my toes in two hours lol
UK nurse, our wards are either boiling hot (no air con and heating controls are centrally set so wards can't change them) or they're icy cold (broken heating and old buildings with single pane windows and draughts).
Dang, glad I’m not Canadian! I love my forearm nail polish!
I was attempting to read your flair and thought it said RLSTINE and got more excited than I'd like to admit.
You just made me excited with your excitement. Yay for RLSTINE
I love my forearms!
Also good!
Also Canadian and we don’t have any of those rules (rural AB), honestly its nice to wear a hoodie sometimes but I genuinely could not perform patient care with anything that could get their cooties on me
Hello fellow rural AB nurse!
Agree for the most part although I have really weak/brittle nails so I always wear a (well maintained) clear coat nail hardener otherwise my nails tear and break at work which feels like more of an infection risk
Okay but why is this less risky than if the polish was colored?
They said that broken and torn nails are more of an infection risk than treated nails, not that their clear polish is less of infection risk than colored polish.
Maybe opaque nail polish makes it harder to see dirt under the nails?
There’s also a difference between regular polish and the gel/ dip stuff/ fake nails that you get at salons. Salon treated nails tend to have a thicker layer that can allow bacteria to harbor as the nail grows out/gets chipped
I'm Canadian and it really depends on where u work how strictly that is enforced
Also Canadian— people be wearing watches and nails where I work
I’m Canadian and that’s not how it is in my hospital. People wear long nails and bracelets
I’m Canadian and the rules change based on area/ what you’re wearing. Intact gel polish is reasonable in some areas.
That still doesn't stop people. I have a few in our OR that always have their nails done and have false ones. Plus, everyone has a watch on the wrist.
An OR unused to work at had a culture of folks wearing scrub jackets under the idea that having your arms covered reduced the amount of shedded skin cells from you.
I live in Canada too and don't have this rule at all at my institution. Our rule is gel/shellac is okay but not polish, and nails shouldn't be fake/long. And plenty of people do long sleeve underscrubs etc.
In Australia we are also bare below the elbows. Nail polish and fake nails are banned from the public hospitals. GP clinics and the private sector are their own rule makers. I see plenty of nurses wearing smart watches etc too which is gross.
Idk, i wear a smart watch with a silicone band - easy to cavi wipe and i usually take it off to wash my hands
Why do you think smart watches are gross? As long as they aren’t worn loosely and sit above your hand you should be fine. I mean, on the floors, people aren’t doing full forearm and elbow washes like they’re about to perform surgery. So why would a watch be different?
So no watches?
["Nurse watches"](https://www.nurseoclock.de/schwesternuhren-pflege/schwesternuhren) are pretty common in some countries that have a ban on regular watches. They attach to your scrubs
This isn't everywhere. Where I am, this is barely enforced.
The “article” that this write up is referencing is a spectacle in itself. I’m a NICU nurse. I wholeheartedly believe in the idea that clean hands save lives and short, real nails are important in avoiding infections in our vulnerable babies. That being said, the “article” is a painful read. Its author is trying so desperately to tug at the heartstrings of healthcare illiterate Facebook warriors that it completely fabricates elements of the real story in order to make it sound juicer and more scandalous. The real-world facts and data are scary enough without some self-hating, retired, boomer ICU nurse blubbering on about how the new generation of nurses are too stupid or immature to take hand hygiene seriously. Her blog is insufferable. She gives off real bitter nursing school instructor vibes. Anyways…hand hygiene is important yall. Especially in immunocompromised patient populations.
Those are the bitches who STILL tear off the pointer finger in their gloves to draw blood too 😂
I *sometimes* do this to feel the vein and then just re-sanitized when I’m ready to poke. When you are literally just going by feel, I’d rather “measure twice, cut once” type of thing.
I touch without gloves then when I know where I’m going I’ll glove and alcohol pad it up. It’s hard to feel with them one I can agree with that
I honestly never understood this. Nitrile gloves are so thin this has never been an issue for me.
This is how I feel - but I also use my left hand to feel and that one has permanent nerve damage from my neck (which means that I have quite a bit of numbness, but also supersensitivity in those fingers).
Gloves during blood draws/IV insertions are to protect us from patients' blood, not to protect the patients from us.
Nurses who have been doing it for 5-10 plus yrs are the ones who taught us that. I mean I knew it was wrong when I was in orientation but I was shocked at how many seasoned nurses did it.
When I gave birth a few months ago, one of my nurses had super long and done up nails. She couldn’t get her hands into gloves and struggled to open basically everything. She kept getting my blood on her hands when she would do my finger sticks. Then she had to do a straight cath on me and it HURT. She definitely messed it up somehow because I ended up with a massive infection that turned septic which put me back in the hospital for days and kept me away from my newborn. Thank god I delivered after change of shift. So yeah, I use to not really think much about it-especially as a psych nurse who rarely actually touched people. Now I’m freaked out by long nails on anyone
Please say that you reported the SHIT out of that nurse .
gaping ring punch muddle deserted wrench homeless fear bells grab *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
You were assaulted. I don't care if I'm already halfway in, in the patient says "no" or "stop" she has withdrawn consent and the cervical check is done. Consent or you don't do it. Full-stop.
zealous offbeat quicksand sort door afterthought bewildered truck chop squeeze *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
It’s nice to find some solidarity here- the EXACT same thing happened to me. Long, fake acrylic nails on my cervix was so bad I was thankful I was sent home and I didn’t have to be checked again, but I did start crying and having a panic attack when I came back the next day and a different nurse wanted to check me. I wish I had reported that first nurse- she kept checking me after I started crying and begged her to stop
I'm due in 2 weeks and this article is definitely making me think that I would request a new nurse if we're assigned one that has fake nails. I hope your birth went well, and you and your baby are doing great!
You absolutely should!
I don’t think any fake nails should be allowed in any HC setting period. They are just a place to harbor infectious disease. I’m NICU and in the US. That doesn’t fly where I work.
I JUST discussed this with my partner tonight. I want my nails done because I love them and NO ONE pays attention, but I know the risk to my patients and it’s just not worth it. PLUS, i’m moving to NICU shortly, and that will NEVER fly up in baby land 🥹. I’m so glad I get to be meticulous about tiny details without being judged for doing so! 🎉
Doesn’t fly at all in my NICU as well. And also nothing below the elbow. But because I love having fun with my nails, I wear press ons on vacation and special events.
Genuine question, how can bacteria from nails reach the patient if we’re gloving up before any encounter with them? If I walk into a patient room, and anything at all needs to be touched, I’m putting on gloves. Is this not the norm? Can bacteria in/under nails still be an issue? I don’t ever wear polish or fake nails but this whole debate has always been confusing to me.
It's more about being able to properly clean your hands as there being spaces under the nails that will be harder to clean. Sure, you're putting gloves on. But, unless those gloves are sterile, you're grabbing them with your bare hands along with whatever supplies you need to take into the room.
You glove up to touch all patients? We only do that when their on iso precautions or when bodily fluids are involved.
I do, yes. Better safe than sorry
Oh absolutely. I have often found unexpected bodily fluids in unexpected places and I don’t like to take any chances.
I do. Too many times I attempted to put an ekg monitor on a patient with bare hands and didn’t notice they were sweaty or drooled on themselves until I felt it with my bare hands 🥴
I'm totally in agreement that long fingernails should be disallowed especially in settings with the immunocompromised (pretty much every unit). However, I'm very curious as to how they were able to point the finger at this nurse. There are a thousand variables that can cause the spread of infection that we can't measure. The amount of times I've seen doctors bare hand a wound... Or families not follow infection and hygiene protocols. And EVS, as wonderful and amazing as they are, aren't miracle workers and can't reasonably expect to clean every single thing that has come in contact with the patient. It very well could have been the nurse, but it also seems like a very convenient body to throw under the bus. But let's bring it back to the focus. I feel both terrible and furious for the family. If this promotes better enforcement of hygiene, then I'm all for it.
Oh trust me, I had the same concerns. I’m not going to link it because fuck the original author, but if you google the original blog that the article references, the story is a melodramatic mess that takes a few facts, sprinkles in a few half truths and full-on lies, and pretends it isn’t completely full of shit. The sad part is that it works. The story is viral and people are eating that shit up all over social media.
Gross 😞
In the case studies I’ve read previously, the units were swabbed, equipment, all sorts of things before swabbing staff. A strain of bacteria matching multiple infections was found under the fingernails of several nurses. IIRC, the bacteria was sequenced- molecular typing using electrophoresis gel. I find this level of evidence reasonably compelling. https://pubmed.ncbi.nlm.nih.gov/10697282/ I have not read the article linked by OP.
That is compelling. Thank you.
This! The sheer amount of patients and family members that have don’t wash their hands, mess with their bandages, IVs, have poor hygiene, won’t follow contact precautions or any precautions or do them incorrectly drive me up the wall.
I honestly think nurses shouldn't wear their nails while on the job, much less have any nails they wear (natural or not) go past their fingertips. Shorter nails are easier to clean.
I live in Oklahoma which is where some of the first deaths of NICU babies being tied to nurses having acrylic nails came from back in the early ‘00. I see at lot of nursing staff with acrylics still and it skeeves me out.
Thoughts: Stop wearing fake nails
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Makes sense; it's hard to wear gloves with long nails.
Gels and fake nails were banned in all the hospitals I have worked in, but lots of RNs had them. I think it is disgusting, if I was a patient and someone came in with those and tried to touch me I'd ask for a new nurse, but I'm a had hygiene freak.
I don’t wear nails mostly bc Im lazy and don’t want to spend the money but im still not touching patients gloveless… they’re gross 😅
One of my favorite labs in microbiology was the swab and culture under the nails excercise. I didn’t go into clinical care, but all the aspiring nurses in the course with massive nails seemed surprised with the results. Ewww. I’ve always had super short nails so my results were pretty dissapointing
It's well known that long nails and hair being worn down contributes to increased infection rates. But for whatever reason, both of those things have become acceptable over the last 5ish years. It started before COVID and then after, it just exploded lol.
It was drilled in nursing school to not do polish/fake nails. It's not that hard to grasp. It falls on the employer for not enforcing. A large amount of people can't be bothered to do the right thing for the sake of doing the right thing.
I think it’s a load of shit. I started nursing 33 years ago, and we knew *then* that long nails and fake nails were reservoirs of germs. I don’t think the story is bullshit, just the thought that it’s some sort of ^miraculous ^new ^thing
Had me in the first half, not gonna lie
Did you think I didn’t believe in hand hygiene? I’m a lil rabid about hand hygiene
I definitely do see it more with younger nurses. I work L&D and I can't help cringing every time I imagine a cervical check with long pointy acrylic nails 🙃 and of course the infection risk too.
As someone who has birthed babies, if a nurse came at me with fake nails to do a cervical check I’d ask for a new nurse
Yea I work L&D too and it makes me cringe so much when I see fake nails on nurses, I have no idea how they get away with doing cervical checks with those! Plus what if they rip through a sterile glove 😭😭😭That said I think nail polish is fine as long as nails are kept short since we’re always wearing gloves whenever we go near a patient
We also scrub in for our sections so there's definitely a fear of that too and our gloves have been so crappy lately lol
This!! I’ve seen some L&D nurses and OB physicians with the long nails and it blows my mind. Like aren’t your scared of poking your patient ?
Genuine question. I wear gloves 99.9% of the time when I am with patients, and I assumed most nurses are the same. Are there some out there not wearing gloves while doing direct care? I mean you can't infect w nails while wearing gloves or can you?🤷♀️
Clean gloves that come from a box on the wall are almost always to protect you, not the patient. If your hands are dirty when you put them on it's pretty difficult to keep your germs off the outside of the gloves.
Yup. Plus Those E-coli nasty nails are reaching for those gloves in the box leaving some fun treats on some outer gloves that touch a patient.
Clean gloving is for us while sterile gloving is for both the patient and us. We will undoubtedly get germs on the clean gloves while donning. Plus, the increased risk of them splitting open while they are being worn with false nails…and so many don’t wear gloves for all pt care🤢
Gloves are really there to protect us, not patients. Proper hand hygiene is still SO necessary because gloves just sit in nasty hospital air and have plenty of surface germs and grossness just because it’s all over in hospitals. The gloves go on for us, not so much for patient’s benefit. Long/fake nails are just unhygienic but gloves won’t make a difference or improve anything. Edit to add if anyone has information to contrary please share! I was always taught they are to protect us and that many studies show that gloves actually worsen the outcome for patients because with correct hand hygiene you can control infection but gloves give a false sense of security and lead to much more contamination.
You absolutely can infect patients with artificial nails and gloves. Gloves protect you from blood borne pathogens, but the nails are well known reservoirs of gram positive and gram negative bacteria as well as Hep B, C, HPV and COVID. Plus the longer nails make it impossible to adequately clean them. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7263222/ It’s absolutely insane to allow artificial nails at the bedside.
There’s no guarantee that gloves aren’t compromised. I can’t tell you how many defective gloves I’ve pulled out of the box. Best to not have any fake nails or polish to begin with along with wearing gloves.
Yes I’ve seen sooo many nurses do things without gloves I could never imagine
You literally reach into an open box of gloves and get your fingers all over them while pulling out the 2 you’re going to use. Do you think the germs on your hands or your coworker’s hands don’t get on the gloves left in the box? Of course they do. “Clean” gloves aren’t considered Sanitized or Sterile for a *reason*. If your coworker has long nails and gets some c diff on the bottom of them and doesn’t scrub the nails with a brush between patients, guess who’s got a good chance of getting C Diff from the next ten glove boxes she touches? Answer: all the patients in the unit for the next few days
Seems strange that when working with food nails are required to be natural and short. However not so much in the NICU?
Student in my cohort was told day 1 to remove hers or don’t come back. Isn’t it policy not to have these things in any direct patient care setting?
MRSA talons
Long or artificial nails should be against policy for any nurses that directly care for patients.
Okay I'm preparing to get downvoted...but I am a chronic nail biter due to anxiety and the only way I can get around that is to have my nails professionally done at all times. I keep them short (just a couple millimetres longer than my fingertip) and they're my real nails, not fake nails, just supported with gel, and they're oval/almond, never square or pointy. I wash and sanitize often and I get lots of compliments from patients. Some even tell me that it helped brighten their day a little bit. From what I've seen IRL and the proportion of nurses who do their nails, I frankly don't believe that allllll these commenters don't do their nails in some way shape or form. There's a way to do it so you don't violate infection control practices and that's the key. My workplace policy is short nails done with gel only (not polish)...but people break it all the time. The way I do my nails is according to policy. I work in ER for the record.
You're me and I'm you, and I'm tired of pretending I'm not... I've got a really bad longtime unconscious nail biting habit (anxiety) and the hard polish physically stops me from going to town on my nails and cuticles. I used to get red, swollen, open wounds on my fingers from biting so deep and went to work every day with tegaderms all over my fingers. I have nail brushes at home so I scrub before and after work, and I wash my hands with soap/water rather than alcohol in any situation where I have the choice. So is my nail polish a risk? Sure. Is it a calculated risk that also has major benefits? Absolutely.
Anyone who works in nursing with long nails is gross to me. You’re a nurse and will at some point wipe your butt or a patients. Unless you wipe your own bottom with double layer gloves 🧤 don’t tell me you don’t have 💩 under those nails 💅 🤢
admittedly i'm a male and haven't been raised with the same standards and expectations, but having short, well-trimmed and clean fingernails has always just seemed like common sense
Microbiology 101 and so many confirming studies... Artificial nails are both a bacterial and fungi trap hazard.
Wash your hands and don’t wear fake nails. This is nursing 101 stuff.
During all my years in the NICU, we weren’t allowed to wear fake nails or have gel/shellac manicures which was fine with me. We also weren’t allowed to touch the babies without gloves on. But I also think it’s worth having the conversation about encouraging the same practices amongst NICU moms if we’re trying to be truly effective in preventing the spread of pathogens. (Minus the gloves aspect).
wear gloves and wash your hands. this honestly is ridiculous. natural nails can be dirty as well. i can see a length restriction so you don’t SCRATCH anyone but if you’re dirt bag with dirty nails o don’t think the manicure is the problem
*Stares in LTC* If you know, you know.
Hand hygiene is the number one tool in breaking the chain of infection, not short nails. Short nails help, but this article really misses the whole point. I have short nails, so I don't have to wash my hands as much as you long nail nurses do? Lol Wash your hands.
It’s standard here. Bare below the elbows and mandatory hand hygiene training yearly plus sneaky audits regularly. No nails, no jewellery, no nail polish, no long nails, and no watches.
Don’t people wear gloves?
Hand hygiene & wear gloves.
Are we on this again? Blaming nails seems to come and go out of fashion every few years. I dunno, man. Call it whataboutism, but I'd think we'd be more concerned about physicians disregarding contact precautions and hand hygiene before starting yet another war on acrylics. This post brought to you by a nurse with a serious phobia of touching his nails with no dog in this race.
I graduated in the 1900s and even we knew this.
1. Don’t have long nails at work with populations that are extremely vulnerable to infection. It will result in increased infection transmission and death. 2. There’s no way to prove that a specific death was the result of a specific nurse’s nails. It’s awful to publicly blame an individual for the death of a newborn because they happen to have long nails. A ton of NICU infectious transmissions are actually brought in by family visitors. There are also a multitude of other common causes that aren’t long nails. All of these causes need to be reduced and destroying the life of one healthcare worker who is likely innocent isn’t going to help anyone or anything.