Nurses’ Nails

It’s your first clinical or job as a nurse and you just had a beautiful manicure done a few days prior. Now what? Can nurses wear nail polish? Can nurses wear acrylic nails? What is the appropriate of length of nails for nurses? Likewise, can nurses wear jewelry? As you can see a ton of questions can immediately come to mind when thinking about nail care and hygiene for healthcare team members, especially nurses who likely have the most contact with the patients. These are very important questions and questions that have been discussed for several years with various research studies having been conducted on. Continue reading and we’ll look into each of these a little closer as we learn more about the science behind healthcare team members’ nail care and the policies implemented by most facilities. 

Nurses’ Nails

Work Appropriate Nails

How long should your nails be when working in healthcare? A very common question, especially among women. According to the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) healthcare workers should keep the natural length of nails trimmed to about 0.25 inch in length. In addition, the CDC says that individuals working in an environment with high-risk patients, such as the intensive care unit or the operating room, should not wear artificial nails. The WHO has extended this further by recommending that no team members who have direct patient care wear artificial nails.

Science behind nail hygiene

Over the years several studies have been conducted to determine what is the most appropriate length of nails and if artificial nails could potentially have negative impacts on patients’ health and overall outcomes. It is these studies that have assisted organizations like the CDC and WHO in making their recommendations. Studies have shown that when wearing artificial nails, the bacterial load on the fingernails is increased. It is therefore recommended that no artificial nails be worn by nurses.

Nail polish for nurses 

In addition to the length of nails and can nurses have fake nails, there is also many questions around nail polish. Is that permitted? Is only standard nail polish allowed or can nurses wear gel nails? This can often be a challenging question for healthcare facilities. Some research has shown that there is actually fewer bacteria on freshly polished nails. The key to this though is that freshly polished nails means all nail polish is unchipped. Once chipping of nail polish begins, so does the increase of gram-positive bacteria. Therefore, it really only looks like nail polish is okay to be worn if indeed it is free from any chips. As soon as it begins to chip it should be removed to prevent the growth of bacteria and possible complications it could cause for patients. 

Each healthcare facility may have their own rules and guidelines regarding nurse nail polish and so nurses should always check the individual facility’s policy. If it is allowed, ensure you are following the appropriate guidelines set out by the facility. There are many different designs and nurse nail art now a days and it’s important to ensure that the nurse does not have inappropriate nail art displayed on their hands while at work. Therefore, make sure all nail polish or nail art is truly work appropriate. Remember that patients are in the hospital because they are ill and needing some form of treatment and health care and so the nurses’ nails should not become a distraction to their job or interfere with their ability to appropriately care for their patients.

Can nurses wear jewelry?

There has also been debate over the years regarding the wearing of jewelry, particularly rings, by healthcare staff and if it could potentially increase a patient’s risk of infection. Various studies have been conducted to examine this concern as well and although many suggest the need for further research in this area most studies also show that there is a higher rate of contamination and risk of carrying potential pathogens from one person to another when jewelry is worn.

This is because it can be challenging to thoroughly clean the skin underneath of the ring and any grooves within the ring. Many places, especially surgical settings, will require that jewelry (rings) be removed. Others may allow for a simple wedding band without jewels or stones on it. Aside from the potential concern regarding the thoroughness of hand cleaning around rings, the other large concern with rings is the potential risk that the ring may rip gloves. If indeed the ring does rip a glove it can then further increase the risk of potential contamination which is another reason any rings other than standard wedding bands are often limited in the healthcare setting.

Contamination Prevention

As we can see contamination is absolutely something that can become present when the appropriate nail hygiene is not being done. So, how do we prevent this contamination? What role does the nurse have in ensuring a safe environment for the patient in regards to this possible contamination? First and foremost, the nurse should always follow the healthcare facility’s policy regarding matters of these subjects. In addition, hand washing is the best practice to take.

Depending on the setting there may be specific types of soaps required. For instance, in the surgical setting the healthcare team members will likely be required to use a different type of antimicrobial soap that the nurses on a standard hospital unit use. If this is the case, ensure you are using the appropriate soap. If on a standard nursing unit within the hospital make sure you are taking the appropriate time needed to clean your hands.

According to the CDC, healthcare team members should either use an alcohol-based hand rub or soap and water for at least 20 seconds when cleaning hands. Soap and water should always be used when hands are visibly soiled and nurses should make sure that they clean underneath of any wedding bands they may be wearing. Likewise, paying particular attention to their nails and the area surrounding the nails is a very important step in hand washing. Always remember hands must be washed before and after touching a patient, before performing an aseptic task, after coming into contact with any bodily fluids, and after removing gloves.  

With careful consideration and working together, nurses may still be able to wear nail polish as long as the appropriate hygiene measures are taken and we hold one another accountable.

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Written by
Tabitha Cumpian