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Quot regiones, tot mores

A contribution by an Italian doctor

At the entrance to the hospital two young nurses harnessed with disposable overalls, protective glasses, gloves and a mask stop people to measure the temperature: to me, instinctively showing my employee badge, the measurement is spared.

This is an error of mine, and by those in charge of surveillance: the fact of being a doctor working at the Cardiology clinic does not make me immune from infection, but it is an attitude reflecting cultural and organisational lacks of the Italian health system.

Masks and gloves would be mandatory, but they are uncomfortable and set aside as soon as possible: on the other hand, Why me, we think deep in the heart. We wash our hands thoroughly for 20 seconds, massage our wrists and fingers after each visit, but immediately after we grab the cell phone, which is always between the pocket of the lab coat, the desk surface, and our hands (and others’ hands), becoming a potential vehicle of infection, such as the phonendoscope that nobody protects with some device between one patient and another.

Many years ago, an English study showed that an essential role in the transmission of intra-hospital infections was to be attributed to the tie worn by doctors under the lab coat.

I do not believe there is a rule establishing what the clothing of the hospital staff should be: socks and gowns are often supplied in most ASSTs[1], but the clothes they wear are often the same that they dress in the tram, at home or in the bar.

Even when we have an effective and safe weapon such as vaccination we are reluctant to use it; I know many colleagues who in due course have not been vaccinated against the flu, even though they have advised and practised the flu shot to their patients.

Today I went to another facility, totally undisturbed, but today there is no usual crowding at the acceptance. When I ask for a mask and gloves, the nurse of the surgery replies to me winking that the Health Director has requisitioned the masks because they are not needed if there are no symptoms.

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