I have written before about hand hygiene and the inexplicable difficulty of getting people who are trained in medicine to be attentive to this most basic infection control method. (For BIDMC's latest compliance with this and other clinical safety and quality metrics, you can check our website.)
I am still not pleased with our progress, but this is not just our problem. It appears to pervade medical centers. Here's a true story about a recent example at another place in town.
A friend of mine (let's call her "Mary") was accompanying a friend of hers (let's call him "Sam") to a visit with his doctor's office. Sam has Parkinson's disease and needs help getting around. Sam also needs to be accompanied through his office visit because he takes lots of medications, and the doses and frequency of them are changed from time to time, and he gets confused unless there is someone to help him keep track.
At this visit, several dosages and frequencies were changed, and it became Mary's job to unload and reload Sam's medication dispenser box so he would have the right pills for the right days of the week. As she was moving pills around, and breaking some of them in half, she suddenly realized that she had spent the whole day opening doors for her friend and touching all kinds of surfaces in the hospital and had neglected to wash her hands before handling his medications. Mary blurted out, "Gee, I forgot to wash my hands."
The nurse responded, "Don't worry about it." Now, because of all the medications he already takes, Sam is prohibited from taking any other medications if he catches a cold or gets a sore throat or any such problem. So, for him, a cold is a particularly uncomfortable event. Mary, who therefore was worried about it, temporarily put aside the nurse's comment and looked for a disinfectant dispenser somewhere in the exam room. There was none.
Mary, not being the shy type, made clear to the nurse that she was not pleased with either her comment or this situation. But how many of us would have the nerve to do that? Probably not many. I fear, though, that unless we as patients take it upon ourselves to remind our providers, progress in this arena will be all too slow.
P.S. When Mary told me about this story a few days later, she had a cold . . . .