The Glove Conundrum

Hi Helen!  Thanks for your comments.  I'm glad someone enjoys my sense of humor.  I'm pretty sure my professors didn't, hehe.  Keep working hard.  You won't be a dead student walking for much longer!

Hi Alissa.  The general consensus I've gotten about peds and gloves is that most (with the exception of hospitals) don't use them.  If they do, they are usually the flavored kind.  It looks like I'll be investing in some flavored gloves if I go into pediatrics. :)  

I think you are absolutely hilarious.  I've read your other blogs and I enjoy your candid humor.  I am in school for OTA and I love your boringme assessment tool, why don't teachers get it before they start teaching?  Keep up the good work.

~dead student walking~

At the outpatient facility I work at, the only time I have ever used (or seen anyone use) gloves is during a serial casting session. There are therapists here who have kids with oral motor processing issues and they use z-vibes, finger swipes, and other tactile inputs with these kids. I have not seen any of them use gloves, although there are several boxes of gloves available to us in the treatment room. Everybody is good with hand washing and hand sanitizer use, but nobody, including myself, uses gloves on a regular basis.

I work in pediatrics as well...as a student I wore gloves constantly, especially when dealing with drool and mucus.  Now that I am practicing, I don't use them quite as often.  If you're helping a child blow their nose, you probably don't need them - teachers and other people teaching in school don't have gloves, and its neccessary there too!  That is where sanitizer comes in handy.  There are also those little incidents where safety overrides the time it takes to don gloves...if we're playing in the rice and beans or doing a beading task and something goes in the mouth...it HAS to come out instantly.

If I am doing something with the oral musculature or on the face, I do use gloves - especially since the flu is rampant right now!  I usually go by the adage "Do unto others as you would have them do unto you..."  I definitely would not want someone sticking their hands in my mouth ungloved, so why do that to children, some of whom are unable to speak up?  

I also agree with the earlier comment that the children don't particularly care for the glove feeling.  We tend to use flavored dental gloves, which the children seek and enjoy.  You get the best sensation if you use gloves that are at least one size smaller than you usually wear.

As for the chronic droolers - it can be kind of gross...but they are also the ones that are again putting their hands and other objects in their mouth through out the day.  They have likely developed a greater immunity to viruses and bacteria likely present in the clinic.  At school there are no gloves - and the exposure there is to far more people.  As a precaution, we tend to Lysol the objects in the room prior to and after their treatment, making it safer for everyone.  Gloving your hands for interaction and non-oral play is removing the personalization that should be present in your session.  You are probably more aware of what you are doing when in that session, which means you aren't likely to rub your eyes, put your hands in your mouth, etc. and contracting the germs is less likely.

Basically, it comes down to personal comfort...I would be uncomfortable if someone were to wear gloves just to play with me/my child, but I would also be uncomfortable if someone went to put their hands in my mouth ungloved.    

Wendy,

I do make liberal use of hand sanitizer.  I'm certainly not suggesting that pediatric therapists should use gloves for all the children they see.  Some don't warrant it.  However, I personally am not comfortable with direct contact with another's fluids, especially when I know there is no need to experience it.

It's true that I'm not doing as much work in the oral motor area as you are.  I understand the need to get an accurate feel for what you're doing and that does explain why many of the people you know and mention also elect not to wear gloves.

My worry is that because many therapists choose not to wear gloves, I will be viewed strangely for electing to wear them.  I don't want to be labeled 'the weird therapist' or 'the germ phobic therapist' or 'the one who can't handle a little drool'.  I can obviously handle it.  I just don't know that I should compromise my comfort parameters when it is such a little thing that doesn't really interfere with my treatment of the children I see.  There's the conundrum.

Thanks for your thoughts.

Andrea,

I work in the Birth-to-three population and I don't wear gloves when I work with my kiddos.  I do carry hand sanitizer in my car and have a small container on my key chain that goes with me into the house.  When I work with a little one who sneezes or drools on me (which is a daily, even hourly some days, event) I pull out my key chain and "clean" my hands.  I do a lot of oral motor and feeding work and feel I need to have my hands glove free so I can feel what I am doing.  The kids are also much more receptive to my warm soft fingers than they would be to cold rubber gloved fingers.  I've been working in pediatrics since I graduated 5 years ago and except for the seasonal cold or two I have been healthy.  I like to be able to feel what I am doing and to connect with the child I'm working with and don't feel I would be able to do that as well if I am gloved.  I am very careful though to use the hand sanitizer before, during, and after my visits as well as wash up thoroughly when I stop to use restrooms and when I get home.  I don't currently know of anyone working in my area of Pediatrics that uses gloves.  I will share, though, that when I worked on the pediatric floor of a local hospital gloves were, of course, manditory.