CurtFletcher.com

"I would rather sit on a pumpkin and have it all to myself, than be crowded on a velvet cushion." – Henry David Thoreau

Ban public scrubs

Scrubs should remain in the hospital at all timesHere is my disclaimer before discussing the issue of health care workers who wear scrubs in public. I have a great deal of respect for all health care professionals.  They perform tasks and have careers in an area that is completely foreign to me.  I have only crunched numbers most of my life as a job and fully understand that to care for a human’s health is very difficult work. The other thing I would like to mention is that I understand that sometimes people are pressed for time, I really do.  As I will mention though this is no excuse for the dangerous behavior of wearing scrubs in public.

I have wanted to blog about this for a long time but recent events have forced my hand to do it now.  I have been noticing an increasing number of hospital workers wearing scrubs in public.  I see this at the grocery store, in office buildings, and even in restaurants from time to time.  I was in Boston on Thursday and at the Charles/Mass. General Hospital stop on the Red Line subway I witnessed at least 5 people exiting the train and 5 people entering the train wearing their scrubs. Yesterday I was at the local 7-Eleven and two people wearing scrubs were there pouring coffee and grabbing donuts.

Will these babies grow up in a "scrubs-free" public?

Why am I so concerned about this?  I have many good friends that work in hospitals in various roles.  I hear stories from time to time about the toxic Armageddon of fluids and vapors that these garments face on a daily basis.  Without getting too graphic scrubs are under constant assault by various projectiles, spatter, viruses, and germs.

After speaking with my friends and searching for this subject on the internet I have seen a few arguments that try to defend this behavior.  The most common is that whether a person wears scrubs or street clothes there is the same chance of germs on each.  I dismiss this out of hand. Scrubs are only worn in certain areas and are in direct contact with patients.  Street clothes are not worn in this way.  The other argument I hear is that they are being worn on the way to work because the person doesn’t have time to change. This one is problematic because hospitals have special laundry ingredients to clean these that are designed specifically to kill germs. If an employee is wearing scrubs on the way into work they more than likely had those same scrubs on on the way home the previous night.

In an age of swine flu, bird flu, SARS, or whatever else is the pandemic du jour is, why wouldn’t hospitals have policies that their employees can not leave work with their scrubs?  This would make it so easy.  (In my web searches unbelievably I found some message boards with doctors who purposely wear their scrubs to bars after they get out of work to try to pick up women.)

Another late disclaimer is that I am certainly not a germaphobe or neat freak at all.  People that know me will confirm that.  I am a person that sees toxic behavior by a growing number of health care professionals to be unacceptable.

A comeback I expect to hear is that scrubs definitely do not carry diseases or germs.  What I would argue is that even if it is all a matter of perception why wouldn’t the hospitals use this tool of perception and not allow this?   Over the last week I have been behind a scrubby in line while buying food at a grocery store, poured coffee at 7-Eleven after a scrubby, and sat next to a scrubby on the subway.  For all I know I am under attack at the microbe level because of a lack of either hospital policy or statewide regulations. It may be time to contact my local legislator!

I look forward to some comments about this, especially if you are a health care professional. Maybe I am not considering something or being too critical.  If so let me know!  Have you noticed scrubs being worn in public?  Does this bother you?

It almost seems like Colin Hay from Men At Work is singing this song to me from an episode of Scrubs!  Notice how even on TV this behavior seems acceptable.

18 Comments »

  lyn wrote @

Bravo Curt! I am so glad that you bring this issue to light. I work in the health care field and I agree with everything you have written. I think that the hospital needs to provide every employee with an area to change from their “outside clothes” to their work clothes. Each floor or unit should provide a locker to protect their personal items. I understand that an argument is any clothing can carry germs, etc. However if your changing out of the dirty scrubs and putting on cleaner clothes, then you may not spread germs to the general public. I think that people need to take responsibility and change their dirty scrubs. I will just leave you with this thought, have you ever had C-Diff? It is spread through contact. Check it out.

  Curt Fletcher wrote @

Someone just emailed me and asked if street clothes and scrubs carry the same risk of carrying germs why don’t doctors operate in street clothes?

  A McArthur wrote @

If you think it should be a law not to wear scrubs in public because of possible contamination, then also outlaw any visitors from coming in and then leaving in the same clothing, any person with an infection should not be allowed out of their homes, aids sufferers should be marked and confined from the public. Really people, stop this insanity, I work with many nurses aids and housekeeping staff and none of us are required to wear scrubs so you wouldn’t even know where we were working. Do you know garbage collectors in most cities just dress in street clothes. What was that friendly dog you just petted rolling around in before he met you. Most of the public who are so aware of sexually transmitted diseases still have unprotected sex but cring in fear of a person wearing scrubs! Wake up, it’s not the scrubs you have to fear but your own ignorance of how germs get transmitted. How many of you wash your hands after every handshake, contact with doors and elevator buttons etc.

  curtfletcher wrote @

A McArthur, I appreciate your comments. What I would say in response to them is this. First of all there is a huge difference between someone visiting someone in street clothes and an emergency room worker wearing scrubs and being exposed to fluids, liquids, and mists at a microbe level. Huge difference. The second point you make is that you work with healthcare professionals who do not have to wear scrubs. Well this is wrong and the fact that it is wrong doesn’t impact my basic argument. I feel for the other groups you mention, people with infections in their homes, aids patients, etc. and would hope they would try to act responsibly in public. The difference here is that hospitals are businesses and organizations that can create policies and regulations for the good of the public and its employees. The individuals you discuss really can not.

The difference between the garbage collectors is that their work is done outside at the beginning. While there are certainly risks there they are already outside and are not exposed to the same level of viruses, germs, etc. that just left the human body. Hospitals are inside and contained for a reason. One of the reasons is to keep various risks within the walls of them.

I do appreciate your points but don’t think they make a difference in black and white argument that wearing scrubs in public endangers all of us. The point isn’t coming up with a list of other behaviors that endanger us. I will cross that bridge when I get to it. Because other risky behaviors exist it doesn’t make wearing scrubs acceptable behavior.

  Curt Fletcher wrote @

Again, I want to stress that I respect health care workers in a big way. The health care workers I know are all in agreement that scrubs should not be worn in public. They mention that they realize firsthand the toxic battles these garments are involved in. If hospitals provide them, which most or all do, why would there be a need to ever wear them outside of the hospital?

Maybe the question should be worded differently…If you are a healthcare worker why would you ever wear your scrubs in public knowing that there is the real issue of public perception? Is it just being lazy and you don’t feel like changing? I don’t say this as an insult I say this because everyone does things to save time in their busy schedules. Again though, this doesn’t make any of it right it is just trying to understand the behavior.

  curtfletcher wrote @

Here is a WSJ article from earlier this year that pretty much agreed with what I am saying…

http://online.wsj.com/article/SB123137245971962641.html

  curtfletcher wrote @

I had to post one more video.

  Postman wrote @

If you google “law scrubs” you will find me.

  Jon wrote @

You mean that there were people at the MGH/Charles stop wearing SCRUBS? Why do you think that is? Maybe because the entire stop is surrounded by MGH.

“Scrubs are only worn in certain areas and are in direct contact with patients.”

Not true. Although scrubs are traditionally associated with surgery, there are lots of other specialties that wear street clothes and white coats. Anyone on Internal Medicine, Pediatrics, etc most likely do not wear scrubs and they spend a lot of time with patients. On the flip side of that, there are a lot of housekeeping people who wear scrubs as well. So it doesnt mean anything.

Scrubs are comfortable. Its like going to work in your PJs. Thats why a lot of people wear them.

Some hospitals use scrubs as a uniform and color code them by what department you are in. Nurses wear dark blue, techs light blue, respiratory brown, radiology grey, etc.

Don’t assume that just because someone has scrubs on they’re at some greater risk of having something gross on them. I’d be more concerned about the family members who stay in the room all day long and probably have much more direct contact than some of the providers.

For the record, after you come out of a surgery, you ditch your surgical scrubs and put on your street clothes (if you’re a doc) or you put on new sterile scrubs. Nobody is going to wear dirty scrubs in public.

“swine flu, bird flu, SARS”

… Doesnt matter what you wear. Anyone seeing these types of patients will be internal medicine docs who don’t wear scrubs anyway. When you go into the room you have to gown up anyway. Particles aren’t going to get stuck in the scrubs and then float off into the air while the person is on the subway.

“I am a person that sees toxic behavior by a growing number of health care professionals to be unacceptable.”

Classic case of someone who is not part of the culture and has no understanding of what is going on making ridiculous comments out of fear and ignorance.

You do “investment” work, correct? I suggest that the folks from your line of work has done much more to damage america as a whole through their faulty practices than someone innocently wearing scrubs on the subway in Boston (which is basically an entire city dedicated to healthcare).

I am not trying to be mean. Its just that your arguments are weak and unfounded.

Finally, I do agree with you that certain douche bags will wear scrubs in bars to (attempt) to hit on women. I’ve personally seen this before and they happened to be dentists. The thing about this is the type of women who are at the bars hitting on the docs are… less than desirable and/or golddiggers. That whole situation is lame (much like the “resident doctor” who was selling Hydroxycut on TV). Buch of losers.

All in all, scrubs in public may be annoying to some but I understand why people do it. I’m not going to go home, change and then do my errands. I’m not going to bring an extra set of clothes to work. Its a uniform and you won’t get sick from being near anyone who wore scrubs. Its like being upset that someone who works a nuclear power plant will give you radiation if you sit next to them. Its just not true.

Take a benzo and chill out.

  curtfletcher wrote @

Jon,

Thanks for the comments. The fact that there were many scrubs outside of MGH doesn’t make it ok. You say nobody is going to wear dirty scrubs in public. My question is why give off that impression then? Why not take the extra few minutes and change? This is mostly about perception and it would be so easy to change the perception.

You mention that family members spend hours with loved ones. I would say that they are not on a payroll of a health organization. In other words the health organization has a responsibility to do whatever it can to not have this stuff in the community.

It would take you under 5 minutes to change. Your final paragraph answered my question. You are lazy. It is ok, we all are to a certain extent. My laziness doesn’t put the general public at risk though like yours does though.

  Hmm wrote @

You clearly have no clue about how germs are transmitted. Even if scrubs get splattered with blood from a Hep C patient for example, the virus does not live long outside the body. HIV lives a shorter time span than Hep C outside the human body conditions.
If you dont lick my scrubs after work, then there are no more chances of you getting SARS from my clothing than from breathing it in from a recently -bathed clean-clothed sick person you might encounter on the street.
Wear a mask in public if you are oh so afraid of catching something. Wash your hands before even touching your face or putting stuff in your mouth after touching any surface on the subway.
Get over yourself and stop spreading nonsense around.

  curtfletcher wrote @

Hmm,

I appreciate your comment but it doesn’t address the point I was trying to make. Why wouldn’t you take the time to change? We may agree this is mainly an issue about perception, so why not take the extra 5 minutes and change your clothes and put on the scrubs at work? Is it laziness or do you want to have a chance to confront people with your scientific theory of how long various illnesses can survive in your world?

Why wouldn’t you wear street clothes to work and change there? I just don’t understand.

  jake wrote @

I agree. Scrubs should not be allowed in public places. Possibly germs aren’t transmitted that way all the time but in reality some last hours and even days. Also do yopu want your doctor and nurses to wear their scrubs on the train at starbucks and everywhere else before they come see you? NO WAY!

It is rude of them to wear these outside their place of work.

  curtfletcher wrote @

Thank you Jake. I agree as well as you probably know. To me the whole argument comes down to if there is a perception thing that the public is concerned about why not spend the extra 5 minutes to keep scrubs contained to medical facilities?

I saw some scrubs being worn just yesterday at the grocery store and at a Dunkin’ Donuts.

That is a really good point about dragging potential germs IN to the hospital from outside. I really never focus on that but that is another risk, another reason why scrubs should always remain in the hospital.

  Margie wrote @

You should work at a hospital to realize how spending a few extra minutes changing wouldnt function.
It would mean that you have to get to work earlier and leave work later, lets say 15 minutes total for both. Now, that means that if you want compliance, they would have to be 15 PAID minutes, which is not going to happen since now punching out and back in for lunch is required… Hospitals would not be saving themselves 30 minutes of unpaid time, but 15. Multiply that by the large number of employees working at a facility. Not an option.
You raise a potential good point, but after 12+ hours of work all you really want to do is get in your car and leave. Think about it.

  curtfletcher wrote @

Margie, thank you for your comments. Now we are getting somewhere. I’m sorry but I disagree with your 15 minutes estimate. 15 minutes is a long time, I think you could do it in 5 minutes. I don’t think it is too much to ask to get to work 5-10 minutes early to change into your work clothes and the same when leaving.

Lunch brings up an interesting point but it would require employees to bring their own lunches or eat in a cafeteria of some sort.

It is so funny that the more comments I get the more it appears that being lazy is a key part of what is driving the scrubs in public conversation. You can’t show up for work 5 minutes early and change there and if you do you must get paid for it???

  Frank wrote @

I thought this was interesting, although maybe a little over the top. I’m working on a project at Boston University right now for a coin sorter that uses a UV-C bulb to kill germs on coins and then puts them in a small tray you can take with you in your car. I would suggest using UV-C light on the scrubs but since UV-C light breaks down DNA (thats how it kills the germs) maaaaaybe not such a good idea to use on people.

But anyways we’ve found that 18% of coins carry germs that can cause infectious disease. I am curious as to what percent of scrubs carry germs. The thing is unless you are making direct contact with the person wearing the scrubs (or their coins!) you aren’t really going to have a problem. Perhaps you are a little too concerned here.

  curtfletcher wrote @

I am not sure about your last statement about direct contact needed. I am under the impression that some serious hardcore germs can leap off from contaminated scrubs, which is why people should take the time and not wear them in public.

I appreciate your comment though. Very interesting work being done with coins.


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