If I Didn’t Speak Up…No One Else Will

By Stacy Sutton

I really surprised myself last week, and not in a good way. My significant other had an unexpected hospital stay, and I now have a new appreciation for what it’s like to be a patient.

I’ve worked in the hand hygiene field for nearly two years now, and I understand the importance of healthcare providers cleaning their hands every time they enter or exit a patient’s room, before performing an aseptic procedure, before putting on and after taking off gloves, etc.

I’ve also read industry articles about how patients and their loved ones should speak up when they see a clinician forget to perform hand hygiene. These articles sometimes (but not always) talk about the fact that many patients and families are afraid to speak up because they’re intimidated by physicians and nurses, they feel helpless and vulnerable, etc. I understood this at an intellectual level, but not at a visceral level.

Until now. My significant other – let’s call him Ben – had surgery on an ear and, due to complications, was admitted for observation overnight rather than going home after the operation. I decided to stay with him. The night nurse – we’ll call her Sharon – had just arrived for her shift. She was wonderfully sweet and caring. I kept popping over to the nurse’s station to ask for help with various things for Ben. I noticed that she didn’t clean her hands when she entered or exited the room, or indeed, at any time.

For the next twelve hours, at no time did Sharon ever clean her hands that I saw. In the morning, she put on gloves to clean dried blood off Ben’s ear and she did not sanitize or wash either before or after using gloves. Ben later told me that, during the few early morning hours that I managed to sleep in the uncomfortable reclining chair, Sharon had taken the IV out of the back of his hand. He did not recall that she had gloves on. He did recall that she didn’t sanitize, and that she had placed the sterile dressing on his blanket prior to taping it to his open wound.

It wasn’t just Sharon. After her shift was over, we only worked with the day nurse (“Karla”) for an hour or two, but I never saw her clean her hands either. The surgeon visited twice in the morning, and while he put on gloves to pull a bloody piece of cotton out of Ben’s ear, he didn’t sanitize or wash his hands at any point that I saw.

Three different technicians were in and out of the room while we were there, taking vital signs, delivering food, etc. In stark contrast to the physician and nurses, all three technicians never failed to clean their hands when they were supposed to. In fact, two of them used gloves (sanitizing before and afterwards) to take Ben’s blood pressure and temperature, which seemed almost overly cautious.

And there I was, watching the whole thing save a few hours of sleep. I am not a person who is afraid of confrontation – in fact, I pride myself on being very diplomatic and positive when I’m having these types of conversations with people. But I did not say a word to any of the providers who failed to clean their hands. Even as I saw myself keeping quiet in the moment, I was somewhat mystified by my own behavior and tried to figure it out.

It wasn’t that I was afraid to speak up. Sharon, Karla and the doctor were not scary people – quite the contrary. They were all wonderfully kind and concerned with Ben’s well-being. They were responsive and did everything they could to make him comfortable. We enjoyed chit-chatting and joking around. I think I just didn’t want to turn what was a positive working relationship into a negative one. I didn’t want to be that pain-in-the-rear patient that providers hate working with. I didn’t want to embarrass these sweet, caring people, nor to act like I was more of an expert at their job than they were.

In the meantime, I had noticed that there were no patients on isolation in neighboring rooms, so I convinced myself that Ben wasn’t really at risk. I kept reminding myself how healthy Ben is, and what a good immune system he has. Despite the fact that I frequently write about the statistics – that one in 25 hospital patients in the US contracts an infection in the hospital (largely due to providers not cleaning their hands), and that one in ten of those people will die – I did not speak up when my beloved significant other was in danger.

If I didn’t speak up, then people who are less educated about this issue, who are intimidated by clinicians, or who are non-confrontational, are NEVER going to speak up. It’s time to stop fooling ourselves by depending on patients and their loved ones to be responsible for ensuring healthcare workers clean their hands. Especially when there’s technology – technology that’s always there and never falls asleep – to do it for us.

If you’d like to learn more about how our electronic hand hygiene reminder system has decreased HAIs by an average of over 60% in our last ten consecutive hospital installations, download our free white paper now. Or contact us so we can discuss your hospital’s specific needs.

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