Nurse, Heal Thy Physical Self and the Skin You’re In
She was one of those nurses that you always wanted to be like when you grew up to be a nurse. She initiatively knew what her patients needed, was compassionate, vigilant, and when she called a doctor—they came running. No questions asked. She was a teacher to the novice, a leader for the unit, and voted Nurse of the Year. As I worked alongside her, she would remind me to wash my hands, every time, every moment. Well before hand hygiene was studied and confirmed as a way to reduce the transmission of infectious disease, she was already promoting this best practice.
Overtime, however, her hands became dry, then cracked, then infected. She had to leave the bedside due to the condition of her skin. I have never forgotten my last conversation with her. I asked her if washing her hands was worth it. Remember, this was before we fully understood hand hygiene. Glove use was becoming more common due to better understanding of HIV transmission. Her answer to me was clear and her voice strong, "Of course. My hands can heal, but they also can hurt. I needed to assure that they did not hurt through transmission of bacteria." She sacrificed her skin health for her practice. But she was wrong about one thing; her hands did not need to hurt her.
The science has advanced, and we now know that skin health can be maintained even in a tough clinical environment. You have to "feed the skin from within and from without." "Feeding from without" means assuring that skin is moisturized on a regular basis. Every nurse out there uses hand moisturizers to try to combat dryness and cracking, but not every moisturizer is the same.
I had to learn that the hard way. My hands were becoming cracked and dry. I would brace myself for stinging and pain when I applied alcohol-based gel. I turned to the evidence to guide me on how to heal my skin from the outside. Some evidence pointed to the benefits of moisturizers or emollients, such as dimethicone or other silicones. Botanical extracts such as safflower seed oil, corn oil, and coconut oil can be beneficial. The evidence also suggested the use of sodium hyaluronate, otherwise known as hyaluronic acid, as well as nutritional components such green tea, clove, soy, and blue green algae, along with additional vitamins, proteins, and amino acids. Additionally, what became clear is application of nutrients to skin promotes resilience or the ability for the skin to respond to adverse conditions. Getting into a pattern of slathering the skin even when not in the clinical setting promotes heathier skin. Reading the labels and understanding what you are applying to your skin is the other action to take.
The second part of taking care of yourself is "feeding the skin from within." Research in the field of wound treatment shows increased protein levels improve healing rates. What we now know is that protein is essential for keeping skin healthy. Yet, as nurses, we do not always have the best nutritional intake, and if we take a moment to eat, we have a tendency to grab low protein foods. A healthy diet supported by protein and Vitamin C intake is essential to keeping you and your skin healthy.
And don't forget hydration—the often infamous catch 22. I've had nurses tell me they do not have time to urinate. I can remember walking through the door of my home and questioning if I went to the bathroom in the last 12 hours. The body—especially skin—needs hydration to be top performing. Not going to the bathroom all day is not a badge of honor for being too busy, it is cheating yourself out of being healthy.
Proper skin care must be part of the fight against HAIs
and caring for patients and ourselves. Join me in giving skin respect and working to make it healthy. It deserves to be considered just as important as the heart, lungs, and brain. It is what holds us together.