As a R.N.,L.C.,  whose primary nursing backgroung has been ER (for 12 years,
20 if you count time as EMT and EMT Paramedic) I have worn gloves for any and
all proceedures that have a possibility for contact with ANY body fluids
since the news of AIDS hit the scene. While many of my hospital counterparts
would NOT wear gloves while starting IV's, giving injections etc., I have
always done it. I also wear gloves during consultations when there is any
possibility of contacting any body fluids, mother or baby's. ie when baby is
naked for weight, or I am working hands on with mother and baby feeding and
or pumping. Have never had any negative comments from any patient. Rather I
have had had patients and their families comment about how much better it
makes them feel. I also am very conscouis about changing gloves when I've
touched any potential contaminant (except my pen). And I do try to clean my
pens after, when I'm cleaning the scale etc. I also cover my couch with a
clean sheet and use pillow covers and clean pillow cases for each and every
consult. I simply explain that "we usually end up getting milk or baby poop,
pee or spit up on my couch". Noone has ever complained and they have even
commented about it being a good idea. My office is in my basement and my
consult area is also our family room, (when I'm not working there of course).
I have had mothers hand express milk across the couch, table and floor. I've
had them wipe milk and spit up on the furniture and had babies inadvertently
pee and poop on the furniture and me. One of the great things about working
at home is the quick availability of clean clothes for me when this happens.
My couch and carpet used to get cleaned a lot. I feel a lot better about my
family living in my work area with my new precautions. I think patients
recognize that universal precautions protect them and their babies as well as
the LC or other health care provider. In fact, I've heard a lot of negative
comments about other healthcare workers NOT wearing gloves and how it
BOTHERED the patients that they didn't, but they didn't know what to say! My
skin is dry, and with frequent handwashing my hands tend to crack and peel,
so I always feel I have open areas of skin and would not want to risk getting
any kind of body fluids, even milk, in them. I still manage to get milk
dripped on my hands from time to time, but I feel it's better to take
preacutions and minimize the risks.
Also I have only had one pt whose MD has NOT  told her to bind her breasts if
she asked what to do if she decided to D/C breastfeeding. Binding breasts is
apparently the standard practice in this area. I keep encouraging moms to
epress milk to make themselves comfortable. They will need to express less
and less frequently until they no longer need to do this. For some it may be
a few days, for others a week or longer. I've also had one pt whose MD told
her she HAD to stop breastfeeding and or pumping immediately due to a case of
mastitis. We had already discussed this as an inappropriate treatment, so
when she reiterated her desire to continue pumping and or breastfeeding, he
threatened to refuse to treat her. When she advised him she would seek
another MD, he told her "no other MD would touch her because she had just had
a baby and they would not want to take on someone else's pt". She ended up
going to an ER for treatment, where she was told to continue breastfeeding
and put on an antibiotic. Sadly, 1 week later she ended up stopping and going
back to the same old MD.???