I, like many, obtained my nursing license during a time of turmoil and fear. We did not wear gloves, nor masks, as we dealt with blood, body fluids or airborne infectious pathogens.
We did not wear any protection as we administered chemotherapy agents. Many times, we aerosolized the chemicals into the air to remove air bubbles.
The chemicals covered our hands, absorbed through our skin, absorbed in our lungs as we breathed. We thought we were impermeable to diseases and chemicals. Having grown up on a farm where I wore veterinary gloves to check the positioning of a calf in ureteral, I personally did not like handling fluids without gloves. Yet, there was tremendous pressure to not wear them from my peers. I remember grabbing gloves as I was being called to resuscitate a premature infant that had no heartbeat at delivery. The nurse manager made a snarky comment to me that “real nurses do not wear gloves.”
That same nurse manager contracted human immunodeficiency virus, or HIV, the following year. It was the era of a new virus. One that every day seemed like had some sort of new finding. We were just learning how it was transmitted.
It was thought that only certain types of high-risk behaviors were those who would contract. A fellow nurse’s father had open-heart surgery and required a transfusion. He became HIV+ after the transfusion. He died from AIDS, or acquired immunodeficiency syndrome.
What was this monster that was killing people? What did it mean to us, the care providers, who were exposed to so many things during a shift? It meant that we had to change our thinking, our actions, our practice. The term universal precautions were introduced by the Centers for Disease Control and Prevention.
Healthcare settings were slow to adopt the standards. Nurses tore the fingertips off the gloves to start vascular lines, defeating the purpose of the glove to minimize exposure to body fluids. Two years later after universal precautions were introduced, the CDC introduced another set of guidelines termed Body Substance Isolation. These guidelines advocated avoiding direct physical contact with all moist and potentially infectious body substances. In 1996, both guidelines were modified, and today’s Standard Precautions were introduced.
The 1996 standards outlined what actions should be taken for hand hygiene, wearing of gloves, mask, eye protection/face shield, gowns and management of needles and sharps. Manufacturers and healthcare took note of standard precautions. Gloves were redesigned to allow the wearer to have more sensitivity in touch. Safety shields and needleless systems were developed for fluid management. Slowly healthcare and the public adjusted to understanding the potential hazards and using safety measures.
It was an era of a new virus, yet it took almost 10 years for today’s standards to be enacted. We live in an era of a new virus. Can we afford another 10 years to manage the virus we are combating today? Might we look to the past to inform the present and drive a different outcome for the future?
People polarized when HIV was first identified. The virus lived on moving from person to person. People are polarized now, and the virus lives on moving from person to person. All the virus wants to do is survive and thrive, we are the keepers of its ability to do just that.
Martie L. Moore, MAOM, RN, CPHQ, has been an executive healthcare leader for more than 20 years. She has served on advisory boards for the National Pressure Ulcer Advisory Panel and the American Nurses Association, and she currently serves on the Dean’s Advisory Board at the University of Central Florida College of Nursing and Sigma. She was honored by Saint Martin’s University with an honorary doctorate degree for her service and accomplishments in advancing healthcare.
The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.
