What Not To Wear

The Government's new Infection Control Tsarinas yesterday

Reflecting on Gordon Brown's new desire to consign hospital aquired infections to the history books, the Dr Rant Team's very own Mr Salmon brings you his personal take on the recent debate about doctor's clothing.

Mr Salmon attended his general surgery clinic today. The clinic Sister started giggling when she saw what he was wearing, and Mrs Jones, his first patient, was almost dumbstruck. You see, he had followed the latest dikat from the Department of Health, to the letter.

Perhaps an explanation is needed.

Change in medicine happens at varying rates. For example, for Mr Salmon to change how he does an operation requires several steps. It requires a review of previous literature. It then requires the design of a robust clinical trial. Then, an ethical committee must approve the research. The research is then carried out, and sent to a peer-reviewed journal for approval among the medical community. And then, finally, he will change his practice.

This is because Mr Salmon is a surgical doctor.

For other parts of hospital care, the process goes like this. A doctor or nurse in the infection control team thinks up an idea. This idea is typed onto large posters and pinned around the hospital (blue-tak is no longer used is it is an infection risk). Anyone not following these orders faces a disciplinary meeting.

That is because they are part of the infection control team.

Recently, Mr Salmon has been told not to take his briefcase into the operating theatre, as it is an 'infection risk'. There is currently no place in the changing room to put his wallet, phone and medical journals, but he is not allowed to leave them on the desk in the theatre, which is some 30 feet away from any operating. However, parents wearing workboots are allowed to follow their children in when they are being anaesthetised.

Leading by example

Mr Salmon has been asked to remove his watch, as it is an 'infection risk'. The clock in the surgery department has not worked for months, yet staff are not allowed to wear timepieces. Of course, knowing the correct time is not considered as important by the infection control team as it is by medico-legal lawyers.

Mr Salmon has been asked to remove his tie, as it is an 'infection risk'. He is told that it may transfer 'germs' from one patient to another. Mr Salmon thought that having beds 18 inches apart may have more to do with this that his Royal College of Surgeons (of England) tie, which is boil-washed by Mrs Salmon at least once per-week. However, bullying Mr Salmon about his tie is a far easier target for infection control than preventing the ludicrous level of bed occupancy.

Mr Salmon has now been asked to remove his White coat and his long sleeves as they are both an 'infection risk'. The white coat has been a symbol of the medical profession for years, although you are more likely to find a pharmacist wearing one than a doctor in most current hospitals. Mr Salmon found his white coat useful as a junior doctor as he could put his Oxford Handbook of Medicine in one pocket, and his lunch in another. However, the robe designed to prevent blood and shit from splattering over one's suit now seems to be confined to the dustbin, or at least to butchers and greyhound track handlers.

How clean is your hospital?

Bit by bit, Infection Control seems to dictate how Mr Salmon should practice his medicine, and with little more than level 5 evidence to back up their demands. How long is it before Mr Salmon is asked to shave off his beard because it is an 'infection risk'?

And so, he ploughed on through his clinic, seeing patient after patient, many of who questioned Mr Salmon's choice of costume. He thought that a pair of dark brown swimming trunks from the 1970s would be appropriate, as he has little else that seemed to fit with the new rules. Gravity, and the 30+ year change in Mr Salmon's waistline may have been unkind, but rules were rules.

'They're for infection control' he told them all proudly.

Mr Salmon modeling his 'budgie smugglers' before gravity was invented.