The scrub should not be worn out and about: Time to return to old school

Aug 22, 2015 Letters

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DEAR EDITOR,
I refer with some degree of concern, but in profound agreement to the recent assertions by Sister Collene Hicks (Kaieteur News, August 19, 2015) regarding cross infection due to nurses wearing scrubs inside and outside the hospital environment.
Being of Guyanese descent, and a British-trained  Registered Nurse (S.R.N.), Midwife (S.C.M),  and Psychiatric nurse (R.M.N.), I vividly recall the prevailing conditions regarding the wearing of our nursing uniforms while in training in England.  It was forbidden under the threat of training discontinuation to wear uniforms outside of the hospital.  In addition the uniform was protected by an apron which served as a protective agent.
For those nurses who lived outside of the hospital premises they wore a coat or cape supplied by the hospital, but nevertheless they were governed by the same existing rules, and forced to change into uniform once at the hospital and change back into civvies before going home.
During this selfsame period, the hospital was also totally responsible for the laundering of uniforms for all personnel, which was a quintessential part of the steps being taken towards infection control and patient safety. This was all being done way back then when certain bacteria and organisms were not properly identified.
Pray tell me when did the physical image of the Guyanese nursing profession change? From current reports the change was quite dramatic, for gone are the starched striped uniforms and distinctive nursing caps, giving way to coloured and patterned scrubs. Sadly, the professional level is just not there. During my youthful years in Guyanam a nurse was a pleasure to look at in her starched uniform and cap, the latter sometimes visible in a plastic bag hanging over her handle bar.
Currently,  in North America the wearing of scrubs has also given rise to some degree of confusion within the hospital environment, as an array of other ancillary hospital staff  have also adopted that garb, which has caused patients to guess who has arrived to take their temperature and who to clean the toilet.  There should be a call (make that a recall), loud, sustained and clear for the adoption of the traditional known nurses’ uniform.
The voice of Nurse Hicks should not be the sole sound heard in the seeming healthcare wilderness, for it should be a done deal that nurses not be allowed to wear their scrubs, as the majority of scrubs currently worn in health care facilities are equivalent to street clothes in terms of infection control.  It is not what nurses bring into the hospitals but what they bring out, as bacteria and drug-resistant germs could be carried out of the hospital and spread to wherever the scrub-wearing staff goes.
For example, the scrub can contain Clostridium difficile better known as C. diff, a well-known bacteria that wreaks havoc and can cause violent and debilitating diarrhea. Perhaps this bacterium is continent-specific with no travelling privileges.  Hopefully, it is not pointless at this juncture to pose the question as to what part is being played by Infection Control Department of the Georgetown Public Hospital, as I failed to see any mention or reference to this agency in the said article.
Infection control and hospital epidemiology are interconnected to public health, and as a part of infection control, hospital staff should not attend to diseased patients and then walk out of the hospital still clad in the clothes they wore on the ward. Conducted research has shown that scrubs become contaminated quickly and collect bacteria, but not much is known as regards whether going outside the hospital post-contamination can cause transmission to other people.
Experts have cautioned however that the absence of evidence should not be construed as meaning there is no risk. In a study conducted at a hospital in Connecticut, solely to gauge the part clothing plays in the  spread of MRSA (methicillin – resistant staphylococcus aureus), it was found that 70% of the time  the bacteria would be on the clothes of the worker, even in the absence of any actual form of physical contact.
In 2011 the Canadian Medical Journal reported that an Ottawa-based hospital had declared:”Hospital staff are required to don their scrubs and lab coats whenever they enter the hospital, and take them off when they leave, even for a quick trip to the convenience store. This strengthens the quality of patients’ interactions with staff, improves infection control, and ensures that The Ottawa Hospital will continue to portray a professional image.”
“The CMA Journal added:
“Such safety concerns appear justified in the wake of studies that have demonstrated that hospital attire may place patients at risk of infections.
“Over the past decade, research has shown that C. difficile and Methicillin-resistant Staphylococcus aureus (MRSA), two common culprits behind hospital-acquired infections, may be transmitted to patients via lab coats and nurses’ uniforms.”
For the patients’ sake in Guyana, even if a silver bullet has not been found, common sense should prevail, and plainly put, the scrub should not be worn out and about. Returning to old school may be a viable rule.
Yvonne Sam

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