I have extremely dry skin. My hands look red and raw most days while I’m at work, and every winter, if I’m not really attentive to my skin, my knuckles and fingertips will crack, bleed, and generally just cause me no end of pain. It can be miserable. That’s just my skin – but throw in surgical scrubs, hand sanitizers, and a requirement to “gel in and out” and you may as well just peel my skin off because I’m not going to have any left come spring.
When my hands start to get really irritated – a.k.a hand dermatitis – all I want to do is soak them in lotion and never, never, ever get them wet or use any type of hand sanitizers. Keep them away! This is a case where “feel the burn” is definitely bad. Very bad.
Does this sound familiar? Does your skin crack, do your hands bleed, do you get those raised patches of irritated skin on the backs of your hands? It’s a very attractive look, let me tell you.
What’s our natural tendency when our skin starts getting dry? Moisturizers! And lots of them! We’ll slather on lotions and creams until we’ve got a moisture barrier so thick that any water that hits our skin is just going to bead up and fall off. We’re also more likely to avoid hand washing or sanitizers because, well, ow. Soap and water dries skin out further and alcohol-based sanitizers sting and burn when your skin is already cracked and split.
Disclosure: Some links in this post are referral links. That means, at no cost to you, I may earn a commission if you click through the link and make a purchase.
So what’s a nurse supposed to do?
We should only use hospital-approved, water-based lotions while in the hospital.
Bringing in your favorite tub of Dry Skin-B-Gone to slather on at every possible moment isn’t the best solution. Why? Your mega tub of lotion may not be compatible with the antiseptics that your hospital uses, it may have ingredients like petroleum which can weaken your gloves and increase their permeability, and it may have chemicals and other ingredients in it that aren’t approved for use in the perioperative setting. Yes, you want to keep your skin intact and protect yourself from infection, but by using your own lotions while at work, you may be increasing your infection risk due to incompatibility and increased permeability. Check out what the CDC says about gloves and lotion use here: https://www.cdc.gov/oralhealth/infectioncontrol/faq/hand.htm#a4.
Moisturize Often!
Use those hospital-approved moisturizer regularly after hand washing to prevent dryness and minimize skin irritation.
Ditch the Bristle Scrub Brush
According to AORN, the hard bristle brush is no longer necessary when performing a surgical hand scrub. Now you can keep your top layer of skin AND get your hands clean – SCORE!
Use Cooler Water
You also don’t have to wash your hands in scalding hot water. This goes completely against everything we think, I know! But, the 2017 Guidelines actually suggest a water temperature between 70 and 80 degrees. I got out a thermometer and tested the water to see what 70 degree water felt like – it was chilly compared to the hot temperatures I’m used to!
Dry Your Hands Completely
Never put on gloves if your hands aren’t completely dry. Gloves on wet skin increase skin irritation.
Use Your Favorite Lotions On Your Days Off
At the end of your shift, and on your days off, dive into that favorite tub of lotion and baby your skin. Two of my favorites are O’Keeffe’s Working Hands Hand Cream and Burt's Bees Ultimate Care Hand Creme. These creams don’t have a strong scent, so you won’t be walking around smelling like you just left a perfume store, but they are great moisturizers and they do a great job healing dry, broken skin.
So, What’s the Take-Away?
Take good care of your skin. Protecting your skin is your first step in protecting yourself and your patient from infection. On your days off, make use of all of your favorite moisturizers to keep your skin healthy. It’s also just as easy to take care of your skin while you’re at work, it just takes some changes in your normal routine. So change things up! Get in the habit of using the hospital-provided moisturizers. Wash your hands in cooler water, and, please, for the sake of your skin, don’t scrub it off with the bristle brush. 😉
*Source: AORN 2017 Guidelines for PeriOperative Practice*
