A NURSE WRITES: Let’s talk about our rough hands | Outpost of the Lost Coast
Ignaz Semmelweis, everyone!
It’s time for your monthly column on COVID, and Ignaz Semmelweis isn’t (yet) a weird Lewis-Lusso holiday card, but a true healthcare hero.
Whether you’re still worried about COVID, for a myriad of reasons, or develop a blank, thousand-yard stare when you have to think about it, I hope you’ll still find value in this short trip through history.
Ignaz Semmelweis was a Hungarian physician in the mid-1800s who noticed a problem in two maternity wards at his teaching hospital. Between 1840 and 1846, the maternal mortality rate for the midwifery ward was 36 per 1,000 births, while the death rate for the medical ward was 98 per 1,000 births.
I’ll resist an easy doctor’s joke to continue the story: Semmelweis discovered that doctors sometimes delivered babies after performing autopsies. After the introduction of the hand washing policy (not generally, only after autopsy) the death rate of doctors fell to the same level as that of midwives.
Medical professionals toyed with this idea for a while before finally deciding that regular hand washing was a good idea and making it standard … over a hundred years later, in the 1980s!
This is why I get people who don’t fully embrace the COVID protocols like masking, vaccinations and ventilation. In fact, if you promise to wash your hands regularly, you will be taking the most important step to avoid getting sick in most cases. Unfortunately, most of us are TERRIBLE when it comes to hand hygiene.
Many groups have examined hand hygiene compliance through surveys and observations. Areas that SHOULD have the highest level of compliance for hand hygiene are healthcare and food service. It is not offensive to ask your doctor if they have washed their hands. How about a guy make you a sandwich? If you ask this guy, ask your doctor.
A wise infection preventionist once told me, “Imagine ketchup on everything you touch, and it will make you want to wash your hands regularly.”
“But Michelle, WHY do I have to wash my hands???” So, how do you think we get germs?
Why do some people always have a sore throat or a cold in winter? Is the weather cold? Going out for a minute without a coat? How about wet hair? Forgot to take vitamin C?
No — colds are caused by viruses, not underdressed or “exposed” to the elements with wet hair. The common cold (along with some other nasty viruses) is spread through the stuff that flies out of the nose and mouth of people who have a frequent and sudden urge to sneeze – like when they have a cold.
Some viruses remain viable (live) for hours to days on surfaces. Regular cleaning or disinfection of “high-touch” surfaces is recommended. Touch-sensitive surfaces are just that – we touch them all the time – doorknobs, toilet handles, telephones, keyboards, fridge doors, light switches, worktops, etc.
Viruses land on these surfaces or hang on the hands of those who carry them. If you wipe your nose, shake hands with a colleague you haven’t seen in a while, then grab a cup of coffee in the break room, you’re both completely normal and spreading germs.
I challenged some people during Infection Prevention Week (SO fun!) to “trace the bacillus” or count how many surfaces they touched in the first hour of work. Then I asked them to try to count how many times they touched their faces. There were also surprises. Some studies have shown 23 facial touches per hour! Gee — I’m glad I wear glasses and a mask a lot, because I’m probably going to the areas of my face where I’m likely to leave germs — eyes, nose, or mouth.
You probably won’t be able to train yourself not to touch your face — trust me, I’ve tried. So the next best thing you can do is wash your hands regularly. This will not only keep your hands clean, but also prevent germs from the quality mask you breathe through.
So what are the things that can prevent us from getting sick?
- Number 1: HAND HYGIENE! Wash your hands for at least 20 seconds with soap and water — or use an alcohol-based hand sanitizer — before and after eating, after using the restroom, after caring for or cleaning an animal, child or other dependent, or someone who is sick, before, during, and after preparing food, before touching your face, after blowing your nose, coughing or sneezing, after being in public places, after touching garbage — SO many opportunities!
- Clean and disinfect touch-sensitive surfaces (always read the manufacturer’s instructions for use of these cleaning products!)
- Avoid touching your eyes, nose and mouth
- Avoid close contact with sick people
If it took you a while to embrace preventive health measures, don’t feel bad—it took doctors over a hundred years to finally wash their hands of it. But now that you know, fall is a great time to start. Stay safe and healthy!
Michelle Lewis-Lusso (she/her) is an infection prevention and control nurse at United Indian Health Services, serving more than 11,000 clients and staff in their seven area clinics. Michelle hopes you wash your hands AND don’t come out with wet hair.