Guest guest Posted January 20, 2006 Report Share Posted January 20, 2006 Hey Z'ev, I don't know what California OSHA has to say about PPEs for health care providers, so I can't comment on your decision to not wear a lab coat. Here's what New York, for example, has to say: The State of New York Health Department’s Mandatory Infection Control Training Course has interpreted Federal OSHA PPE requirements (including the use of lab coats) as follows: “Failing to use these techniques not only jeopardizes the health and safety of patients and other health care colleagues but also constitutes unprofessional conduct in the professions of medicine, acupuncture, physical therapy, physician assistant, specialist assistant, chiropractic, dentistry, dental hygiene, pharmacy, podiatry, optometry, ophthalmic dispensing, psychology, social work, massage, occupational therapy, speech pathology, Audiology, nursing (registered professional nurse, licensed practical nurse).” When explaining why health care providers wear lab coats, I typically offer the following scenario: " You are treating a patient who coughs up sputum onto your shirt, blouse, or dress. You continue to work in the clinic or attend classes that day. You don’t remove your garment, since you have no spare clothing, you continue to wear the exposed garment at school, and wear it home. It turns out that the patient is positive for Tuberculosis. The sputum dries on your garment and flakes off everywhere you go. You have just exposed your classmates, car, home, spouse, infants and children to some very hardy Tuberculosis organisms. Maybe antibiotic-resistant TB. You could have bagged your soiled PPE and safely transported it for laundering, thus reducing everyone’s exposure, including your own, if you’d been wearing it. This is a very elementary example of infection control. It’s just one example of what you should be learning in a basic health care degree program. " Since we work in closer proximity to patients, for longer periods of time, than the typical HMO physican or nurse, it's not unreasonable for us to also wear minimal protective clothing, i.e., a lab coat. Another important issue, I suppose, is patient expectations. In the midwest, patients are more conservative, and have certain expectations regarding their health care providers. Here in Minnesota, home of the " world famous Mayo Clinic " , we are fortunate to have a high quality western medical system. Unfortunately for TCM practitioners, patients tend to measure us with the same yardstick, so to speak. One of the reasons our student clinic isn't nearly as busy as it could be is because the carpet is filthy and torn, the walls are dirty, swarms of insects crawl across the floors, and some of the student interns dress like homeless persons, and some like prostitutes (bare shoulders, arms, chests and bellies aren't appropriate in *any* professional setting, even in California...). I recognize that these young ladies have paid a lot of money for their belly rings and gluteal tatoos :-), but is clinic really the place to be showing them off? Lest you think I'm picking on the ladies, the guys are just as bad, in their own way. Would you go to an M.D. who shuffled in to a filthy office, wearing a dirty flannel shirt and torn pants? Maybe, but most patients in *my* community don't. As students, we are powerless to change the " physical plant " ; that's something only the administration can address. However, a lab jacket or coat hides a multitude of sartorial sins, and creates a more professional looking atmosphere, in addition to providing a first line of defense against the transmission of disease. I don't mind if other people chose to practice without minimal PPEs, however, I suspect that the resistance to lab coats has more to do with the fact that lab coats need to be laundered and pressed, or with some distain for things associated with western medicine, than with the other excuses normally given. All of the doctors, nurses, lab technicians, and other health care providers at my HMO wear lab coats. Based on how busy the clinic is, I don't think too many patients are *actually* frightened by or otherwise put off by the lab coats. I'd be *more* uncomfortable being treated by the guy in the wrinkled flannel shirt, torn corduroys, and birkenstocks. If he's that careless about his hygiene and appearance, he's probably just as careless about clinic sanitary conditions. Like it or not, that's how members of the public think. I wasn't trying to convince you that you should wear a lab coat. I think that everyone needs to apply their own professional judgement when reviewing state and federal OSHA requirements. I'm simply pointing out that those of us who *choose* to wear minimal PPEs aren't doing it in order to rain on anyone else's parade. We simply have a different understanding of OSHA requirements and different expectations regarding professional appearance. Best Regards, Rachel H. Peterman, M.S., J.D. Photos Ring in the New Year with Photo Calendars. 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Guest guest Posted January 21, 2006 Report Share Posted January 21, 2006 If this is true for your student clinic, it is abominable. Conditions at PCOM/San Diego's school clinic are nothing like this. I certainly support professional behavior and cleanliness, including reasonable standards. I don't think one has to wear torn dirty clothes in lieu of dressing more casually, please. And I pointed out that lab coats or some other type of professional 'gear' may be appropriate in different settings. I work in a private clinic by myself, seeing ten patients a day. A school clinic with many dozens of patients will have different needs and criteria. On Jan 20, 2006, at 2:01 PM, golden lotus publishing wrote: > One of the reasons our student clinic isn't nearly as busy as it > could be is because the carpet is filthy and torn, the walls are > dirty, swarms of insects crawl across the floors, and some of the > student interns dress like homeless persons, and some like > prostitutes (bare shoulders, arms, chests and bellies aren't > appropriate in *any* professional setting, even in California...). > I recognize that these young ladies have paid a lot of money for > their belly rings and gluteal tatoos :-), but is clinic really the > place to be showing them off? Lest you think I'm picking on the > ladies, the guys are just as bad, in their own way. Would you go > to an M.D. who shuffled in to a filthy office, wearing a dirty > flannel shirt and torn pants? Maybe, but most patients in *my* > community don't. As students, we are powerless to change the > " physical plant " ; that's something only the administration can > address. However, a lab jacket or coat hides a multitude of > sartorial sins, and creates a more > professional looking atmosphere, in addition to providing a first > line of defense against the transmission of disease. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 21, 2006 Report Share Posted January 21, 2006 Interesting, this lab coat discussion... It must be some kind cultural thing?! In Denmark only MDs in hospitals and research facilities wear the lab coats. Almost everyone else: MDs in private practices, CM practitioners, chiropractors, you name it wear semi formal wear: a shirt and a nice pair of pants. Very often we don't even hang our diplomas on the wall of the clinic. In Denmark someone hanging their diplomas on the wall of the entrance of their practice and wearing a lab coat would usually be conceived to be arrogant (read: insecure/ low s.o. - hiding behind lab coat, etc...). But that's in Denmark, so.... Thomas skrev: > If this is true for your student clinic, it is abominable. > Conditions at PCOM/San Diego's school clinic are nothing like this. I > certainly support professional behavior and cleanliness, including > reasonable standards. > > I don't think one has to wear torn dirty clothes in lieu of dressing > more casually, please. And I pointed out that lab coats or some > other type of professional 'gear' may be appropriate in different > settings. I work in a private clinic by myself, seeing ten patients > a day. A school clinic with many dozens of patients will have > different needs and criteria. > > > On Jan 20, 2006, at 2:01 PM, golden lotus publishing wrote: > > >> One of the reasons our student clinic isn't nearly as busy as it >> could be is because the carpet is filthy and torn, the walls are >> dirty, swarms of insects crawl across the floors, and some of the >> student interns dress like homeless persons, and some like >> prostitutes (bare shoulders, arms, chests and bellies aren't >> appropriate in *any* professional setting, even in California...). >> I recognize that these young ladies have paid a lot of money for >> their belly rings and gluteal tatoos :-), but is clinic really the >> place to be showing them off? Lest you think I'm picking on the >> ladies, the guys are just as bad, in their own way. Would you go >> to an M.D. who shuffled in to a filthy office, wearing a dirty >> flannel shirt and torn pants? Maybe, but most patients in *my* >> community don't. As students, we are powerless to change the >> " physical plant " ; that's something only the administration can >> address. However, a lab jacket or coat hides a multitude of >> sartorial sins, and creates a more >> professional looking atmosphere, in addition to providing a first >> line of defense against the transmission of disease. >> > > > > Quote Link to comment Share on other sites More sharing options...
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