By Debbie Moore-Black, RN
(Warning: Sensitive topic)
** This is a composite story but based on facts. In 1997/1998 and in 2000. The difference in my story and the truth is several and many babies died from bacteria traced back to nurses fingernails as a contributing factor.
That small cliquish bevy of nurses working their way through orientation in the NICU. Straight out of nursing school.
They were happy and thrilled to be accepted into this specialized nursing unit: the NICU.
Practicing good hygiene, washing your hands up to your elbows with soap each time you entered a babies cubicle, gowning and gloving was standard and mandatory protocol before touching the babies.
These were preemies in the NICU.
Molly and her friends felt privileged and honored to get this job straight out of nursing school.
It was a fast paced NICU with levels 2-4. The higher the level, the higher the babies acuity. They were tiny and frail and had weak immune systems. Most were born prematurely. Others had defects, congenital anomalies and immature lungs. Some babies had to be fed by a feeding tube. Some were on the ventilator.
This was the most sacred unit in the hospital because every nurse that came aboard knew they must always be meticulous in everything they did.
The basic cardinal rules though was to always wash your hands. And keep your fingernails trim.
The new nurses were fashionable. And pretty and smart. But they refused to let a protocol like having short nails bother them.
Management looked the other way when they saw the new grads parade in, with their glossy fingernails, long stiletto type nails.
I guess if they just looked away everything would be ok.
Baby Jessie was a level 2 baby in the NICU. She was born prematurely, hypoglycemic, grossly underweight, and unable to feed without a feeding tube inserted through her nose that landed into her stomach.
She was frail but had big eyes and a hint of fine red hair. She was a beauty.
Her parents, washed their hands, gowned and gloved, held their new baby close to them. Every day they’d come for a visit. Hoping and praying for a progress report.
Each day seemed to be a new accomplishment.
Baby Jessie seemed to be progressing.
Though one day her status was changing.and changing rapidly.
Poor Jessie with her rapid respirations, diarrhea, a rash developed on her abdomen.
Fever developed, lethargy and Jessie was rapidly decelerating.
The sepsis protocol was initiated, stat labs drawn, ABG’s and an LP preformed.
A code blue was called. The code team rushed in. CPR, ventilator as baby Jessie went into asystole rapidly. Rounds of epi, bicarb and the code team couldn’t bring Jessie back.
After what seemed a lifetime, the NICU physicians pronounced her death, and sadly met her devastated parents.
An autopsy was preformed, bacteria was found. Ecoli. It was mandatory to report this to Infection Control and Epidemiology. The CDC was involved.
E. coli was found in Jessie’s bloodstream.
That new bevy of nurses. The fashionable ones, the ones with those long stiletto nails, the bacteria was traced back to their nails upon scraping and microscopic findings.
It was determined that two of these nurses
contributed to the death of this Neonatal premature NICU baby.
Beyond respecting and acknowledging the protocol on wearing short nails, of always washing your hands up to your elbows without fail each time a nurse entered a babies room in the NICU….. because of these nurses that failed to honor this mandatory protocol, a death was pronounced of this small innocent newborn baby.
Years of trying to finally get pregnant, yearning for that new baby, baby room decorated, crib with pink ruffles …..baby showers and happiness …..
Endless tears as baby Jessie lay lifeless in her parent’s arms.
.
.
Do Not Resuscitate 
You are right, it was triggering, even though I never wanted to be nor was a mother. So needless, too. I wonder, did it change anything? I’m from an aviation background and we know safety is built on body count.
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Thanks for high-lighting something that should be deeply engrained in our behavior as nurses-good hand hygiene. I am hoping that COVID re
Indeed many of us of the importance of handwashing. When I worked Ada surveyor for CMS in CA, I would encourage nursing home residents to thank staff when they saw them handwashing & that it was perfectly acceptable to remind “us” when not done.
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Thanks for writing this article. I think it should be given to every nursing school curriculum , college nursing refresher course , and /or new hires. I’m “old school”. We were not allowed to wear long nails, nor polish, much less artificial nails. What’s wrong with this generation and or hospitals / nursing jobs that allow this to continue? Where is the “do no harm” in medicine and why isn’t it being mandated? Long hair falling all over the place is another pet peeve of mine, but unfortunately I’m not in the business anymore to make positive changes. The relaxation of former standards and no enforcements of proper hygiene is causing harm and resistant infections! Please shout this from the hallways, schools and hospitals. I’m supporting you all the way! SJH
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Thank you for this article.
“I guess if they just looked away, everything would be ok.”
What a powerful reminder that the harm still happens no matter how much you deny the actions that caused it.
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I am an RN since 1984. Unfortunately, this article is not new. This has been brought up a few times in the media . I recall the same thing occurred in the Early 1990’s. This makes me sick. In my school, Dalton Jr College, which is now Dalton College in Dalton Ga, it was Mandatory that we comply w the dress code. Hair up off collar, no perfume, nails cut close to the nail bed, moderate makeup, shoes clean polished, underwear not showing under our white uniforms. This sad situation is more sad for the parents too. I blame the RN’s who are too vain & the head RN for not making them go home to remove the nails. I hope the parents sue all involved.
It’s wrong that those babies died.
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