Disappointing?

Senior Nurse – ‘Your favourite person’s here today’

Me – ‘Who’s that’

Senior Nurse – ‘Infection Control’

Me – ‘Okay’

Senior Nurse – ‘Well would you mind wearing a disposable cap over the one you’re wearing because we’re being audited’

Me – ‘Yes I would mind. The evidence indicates no difference in infection rates. There’s lots of it – I’m happy to show it to you if you like’

Senior Nurse – ‘Well it’s policy’

Me – ‘I’m happy to look at the policy if you like’

Senior Nurse – ‘Given you claim to be all about patient safety I find your stance very disappointing’……

Nurse Unit Manager – ‘Is he refusing to comply…. Tut’

My email to Senior Nurse and Nurse Unit Manager:

Apologies for this morning. I can understand your frustration and why you are disappointed with my stance. Please do not let it reflect badly on our working relationship.

Explaining the work being done is very difficult within a short time frame.

Firstly please be reassured that my wearing of a reusable cap places patients at no risk. There have been numerous trials looking at this and all evidence to date indicates no difference in infection rates –  (see here).

I accept there may be a policy somewhere (please do find it as I’m very willing to challenge it) which suggests we should wear disposable caps. I agree that complying with any policy like this may make life easier in the short term.

I might point out how difficult the work is in challenging these policies – a much easier path is to accede to a demand from those in positions of authority – however this may not lead to improvements in patient care. 

I cannot begin to explain the psychological upset of constantly being threatened for choosing a different path – one where we may be accused of being ‘disappointing’ while doing the right thing for our patients.

We are servants to at least 3 different masters (see here).

• our employers
• ourselves, careers and family
• our patients

If serving these masters is not in sync it can lead to significant moral injury.

From someone who’s broken down a door to find a colleague who’d taken her own life, dead in her bath, I’m well aware of the moral injury healthcare frameworks can inflict upon us.

While they may seem trivial, name and role theatre caps are much more than just caps – they represent a collaborative approach from front line staff – one of many initiatives to introduce better work environments for patient care.

Displaying our names and roles on our person is better for communication, team work and ultimately patient outcomes. Within operating theatres reusable name and role caps represent the current best solution for this given badges on tops are readily covered up by sterile and other gowns.

Wearing disposable caps at the insistence of our employer so an infection control audit can be scored in a better way is simply just that.

For more information on the name and role cap initiative please look at this post – (see here) – data collected by an international collaborative team.

I’m very happy to discuss further.

Sincerely