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• Hand Washing is about Respect for Patients
  Daniel L Cohen
  Published on: 13 May 2016

• Published on: 13 May 2016

  Hand Washing is about Respect for Patients

  • Daniel L Cohen, Physician, Chief Medical Officer

  The paper by Redelmeier and Shafir resonated strongly with me because I have always believed that there are important factors that motivate some physicians to wash their hands while others behave differently. I agree completely that this is a more complex issue than has been previously noted. I always wash my hands in front of patients and have done so for over 40 years. This has very little to do with the risks of healthc...

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  The paper by Redelmeier and Shafir resonated strongly with me because I have always believed that there are important factors that motivate some physicians to wash their hands while others behave differently. I agree completely that this is a more complex issue than has been previously noted. I always wash my hands in front of patients and have done so for over 40 years. This has very little to do with the risks of healthcare associated infections and much more to do with respect for patients and a commitment to patient-centered care.

  I was a pediatric resident at Boston Children's Hospital in the mid- 1970's and as nonchalant about hand washing as everyone else. Fortunately, I had a wonderful mentor whose example changed me. Professor Charles A. Janeway was a renaissance figure in international pediatrics and an excellent teacher. Though in the twilight of his career Prof Janeway would make rounds once a week with one of the senior residents and ward team, examining a patient or two and then discussing the diagnosis and management of each child.

  One day we presented the case of a toddler with chronic inflammatory arthritis. As Prof Janeway entered the patient's room, he washed his hands, introducing himself to the child's mother, and then sat and talked calmly with her, once holding her hand when she became tearful. He asked if he might examine her child who was sitting in her lap and clinging to her. Before examining the child he washed his hands a second time. After the exam and further discussions with the mother, he washed his hands again, a third time, before leaving the room.

  In a small conference room we began to discuss the case, and one of the students asked Professor Janeway why he washed his hands three times. He slowly looked around at all of us, and said something to the effect of the following.

  "I washed my hands on entering and leaving the room because I did not want to bring any infectious agents into or out of the room. I washed my hands again, the second time before examining this frightened child, because there is something about washing hands that sends a message about caring. It is an honor and privilege to practice medicine and hand washing sends a message about respect. The sound of water flowing and the warmth of hands after washing conveys sensitivity and compassion, and patients find this comforting."

  I never forgot this lesson and have always washed my hands in front of patients, not so much because of my fears of infection transmission, but because of the message it sends to them. It's not all that complicated really.

  Ref: 1. Redelmeier DA, Shafir E. Why even good physicians do not wash their hands. BMJ Qual Saf 2015;24:744-747.

  Conflict of Interest:

  None declared

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  Conflict of Interest:
  None declared.

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