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Nursing, one skin layer at a time

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It’s no unusual occurrence to find my hands peeling every two weeks. The fact that I thought losing the outermost layer of skin was normal is just absurd. It took me working nearly three years at my job to question it. What was it that was making my hands molt, if you will, like clockwork after working consecutive days in a row? Then I started using my investigative skills to see what I did consistently every workday. And it didn’t take me long to figure out the answer.

Alcohol foam. I “foam up” like our infection control campaign tells me to do before and after each and every patient interaction. Add that up in one twelve hour shift and, bam, that’s a lot of foam. I never really questioned why my hands would sometimes get really hot after using the foam consecutive days, or why my  non-medical friends would look at me funny during one of my peeling outbreaks. Or why I had to start explaining to parents as I got near their newborns that no, I did not have leprosy.

Then one day I floated to the NICU, and was introduced to a new product that they use for cleaning their hands at the bedside. This was more of a liquid product, just as effective in its antimicrobial properties, but with more moisturizing agents. I “borrowed” a container of it and brought it back to my management, asking if this was something they could order for me to use. The week after, a box appeared in my manager’s office and I was given full access to that box, a box that made my hands very happy. They haven’t peeled since, and when some of my coworkers ask me why I’m carrying around a small container in my pocket everywhere I go, I ask them if they remember how bad my hands used to be. Everyone remembers, and it seems that since this new antimicrobial alcohol cleanser has graced my presence, other nurses have complained of the same effects on their hands from the alcohol foam.

Then my mind started to wander and images of what the real damage was to my hands (and body) filled my head. If this stuff was soaking into my skin and essentially burning my skin so as to make it flake off, what was it doing to my bloodstream? Was this just an allergic reaction I was having or was I exposing my body to noxious chemicals? I wonder if clinical trials have been done on the effect of this particular alcohol foam on pregnant ladies/small children/etc. I’m in the process of figuring out if said trials have occurred, I’ll get back to you all if I find out anything of interest.

We as nurses sacrifice a lot for our safety and the safety of the patient we care for. Think about how many times you have brought your patient to the Xray department or down for a CT scan- all of those lead gowns don’t have neck protectors. That’s exposure. Or how many times you’ve given an injection to a fighting, flailing patient. That’s risk of needlestick. Or how many times we skip lunch or forget about going to the bathroom because we were too busy caring for the kids on the floor. That’s just bad for our bodies. Or how often I have used all the strength in my legs and my back to shift the weight of the morbidly obese patient so he doesn’t get bedsores. That’s sacrifice.

The profession demands a lot of us. We are expected to be the ultimate caregivers and all the while provide compassion, exude empathy, practice patience, and still maintain a smile. But what about the risk we are putting ourselves in? Nurses don’t often think about that stuff because it’s just what we do. Granted, thank goodness for so many other professionals that put themselves at risk on a daily basis for our protection in our daily lives. But I think nurses deserve some of this credit as well. It took me nearly four years to have this epiphany, and it makes me even more proud of what I do. Sacrificing a little skin off the ol’ hands every now and again is worth it :)

You may want to check out this article on Best Hand Creams for Nurses! (there are lots of recommendations in the comments, too)

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Nicole Lehr

Nicole Lehr is a pediatric nurse. She can be described in three adjectives: content, thankful and fortunate. All credit for the aforementioned description can be given to the love she has for her profession as an RN. She graduated from University of Florida with her Bachelor’s in Nursing and moved to Atlanta to work at the Cardiac Stepdown Unit at Children’s — her dream job.
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One Response to Nursing, one skin layer at a time

  1. anniem

    This is not only a ridiculous way of looking at nursing, but it is not helpful to your patients “ to forego a little skin for the sake of my patients safety”.
    Open skin permits bacteria to enter and be transferred, open skin is painful and detrimental when doing procedures, we are not in the 1800s’-No job should require that a person is put at risk. We are not Angels of Mercy, or the Doctors Right Hand, we are professionals that need to think of ourselves this way, so others will also.

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