Dress codes: The dangers of inappropriate footwear

Daniel Sweeney
Member - 23 posts

I honestly had to check my callendar as I thought it was April 1st.
Its not the substantive question of appropriate /safe footwear, which is a serious H&S issue, but the assertion that employers would insist on employees (presumably female ) wearing high heels! As a manager I wouldnt dream of commenting on my male staffs footwear as long as its fit for purpose, but this hang up about 'women in heels' has nothing to do with function, rather form. If my female staff want to wear heels, fine, flats fine, etc. The only issue would be around where their footwear was potentially dangerous to themselves or others.
Is this the sort of thing that happens when you merge the EOC and CRE? . Where are all the employment lawyers?

Kuang Lim
Member - 43 posts

Why don't we ask the shoe manufacturers to take consideration of these issues instead? or does that mean the users can sue the shoe manufacturer for not putting any warning if those shoes are not fit for purpose? What next, the way we walk?

John Robertson
Member - 18 posts

I think that most dress codes are a sign of madness among the management, but there is some confusion about crocs in hospitals. A lot of staff wear this style of shoe because they can go in the washing machine and because hospitals are hot so sandals are good things to wear.

A lot of hospital managers work in vast hierachies with folk-law about the last court case they lost after a falling incident and information passed-down the hierarchy by chinese whispers. So far as I can tell, Crocs have treads: there's no reason to think that they're more slippery on lino than other shoes. If managers are worried, they should vomit on the floor or pee or spill some food, then take various forms of footwear with 2litre bottles of liquid on them for a convenient standard weight, and measure the slip resistance.

Helen Heath asked something more general about the hospitality sector: whether there are guidelines that employers or employees can use in a dispute. I don't see how even government funded quangos can write a guide to management anal-retentiveness and customer snobbery combined. I hope nobody has tried.
John

GLENN RAYBONE
Member - 21 posts

any shoes must be well fitting (so that they cannot slip off such as crocs and clogs) and also so the foot is covered (to prevent from sharps injury and other injury in the event of something being dropped from height on the foot.

For infection control purposes there needs to be a Uniform Policy or some attention paid to uniform and this would include suitable footwear. However, common-sense must also be applied to this, for example I have had staff made to wear tights in the middle of summer which apart from being ridiculous also contributed to a health problem. The managers view was to stick to the Policy, my view was to use common-sense but this is something which seems to be in short supply in certain areas.

Daniel Sweeney
Member - 23 posts

Sorry Glenn, but a uniform per se doesn't necessarily contribute to infection control. Nor does a medic wearing a tie or white coat, in fact very often these status symbols (uniforms?) become disease vectors, transferring patient A's nasties to patient B through fabric to skin contact. Disposable paper gowns/gloves and good general hygene are reasonably useful given the filthy state of our hospitals post contracting out of domestic services. I believe the more intelligent members of the medical trade are in favour of banning these affectations. How much success they have is debatable given the lack of impact of the move by barristers to abandon fancy dress in an attempt to humanise the judicial system.
In general though you are right about the lack of common sense, and some managers do seem to believe that adherence to policy absolves them from the responsibility to actually think!

GLENN RAYBONE
Member - 21 posts

I think you should read some research and get your facts right, unless of course your an expert in infection control and can impart best practice.

Have you some evidence about "filthy state of our hospitals"?

I'd very much welcome evidence to support that uniforms don't contribute to infection control, and likewise I'd supply evidence to the contrary. For example Medics do not wear ties or white coats, and all clinical practitioners are now 'bare below the elbow'.

John Robertson
Member - 18 posts

Glynn

About the filthy state of hospitals: my partner suffered MRSA at Kingston hospital near London. You need only read a newspaper to see reports of similar outbreaks elsewhere.

Crocs and similar brands have straps at the back and covering over most of the toe.

I shall say no more.

John

Daniel Sweeney
Member - 23 posts

Whoops Glenn, I appear to have hit a raw nerve there!
The key to my previous posting was 'per se'. Scrubs contaminated with Staff A (C Diff etc) are likely to act as disease vectors from patient to patient unless changed. Similarly a t-shirt etc etc. Is there a substantive difference between a clean t- shirt (bare below the elbows again!) and a set of scrubs? (green or blue) . I would suggest that its the level of exposure to contaminants/biological or otherwise on the garment that is significant in contact disease tranfer from patient A to B, not the colour or logo on the garment. I dont believe that pathogens show the same level of deference to the trade as some people do, and may piggyback on the 'medical uniform' opportunistically.

The Healthcare Commission has conducted research on the levels of cleanliness in hospitals in England and Wales and has expressed its concerns over information and standards and similar work in Northern Ireland has indicated problems. For example the two main sources of information on this are based on patient perception surveys and self reporting by trusts if I'm not mistaken. Patient environment action teams (PEAT) were managed by NHS estates until relatively recently and oddly enough considered that NHS estates were doing a splendid job. Patient surveys however idicated that there were significant concerns about declining standards.
Methodologically both are questionable as assessment methods
The existing sources of information on cleanliness are contradictory, but the increased prevalence in hospital acquired infections would, I believe, allow an inference to be drawn on the subject. You could be right and there may be no problem with hospital cleanliness, but as one of my colleagues found out in Sweden, the best way into an isolation ward in a Stockholm hospital is to admit you were treated in a UK hospital within the last 6 months. . Lets be honest here, its about identification, status and corporacy which may indeed be legitimate aims, but please dont mask these objectives under clinincal need for uniformity.

Finally I'm not a professional epidemiologist or infection control nurse, rather a Policy Analyst, and one of the main disadvantages of my discipline is that we try to use logic and evidence rather than professional orthodoxy. Its kind of like science without the self ascriptive status!

ellen hamilton
Member - 8 posts

crocs may not look the nicest but as somebody who has to wear them after suffering a badly broken ankle because my normal shoes no longer fit me. now im pregnant it will just get worse so I for one am gratefull that these shoes are on the market.

GLENN RAYBONE
Member - 21 posts

Daniel, the last paragraph sums up nicely, "not a professional epidemiologist or infection control nurse".

I would get actual facts as opposed to reading newspapers and listeing to the television

Daniel Sweeney
Member - 23 posts

Glenn, I'm not at all sure if its the comments on the state of hospials or the process of contracting out that has inspired you to draw this out ad nauseam. This reminds me of my time attempting to teach law students that justice and law were not actually synonomous. My final observation on the matter is to refer you to the reports of the healthcare commission which is neither a print nor broadcast medium. .

David Ireland
Member - 5 posts

With regard to appropriate footwear - which I believe is where this strand started. It basically comes back to risk assessment - if the manager/specialist undertaking the risk assessment understands the risks the person undertaking the role is faced with it is then much easier to decide what sort of footwear is appropriate.
I have been in risk management for many years and have seen a number of injuries which have been caused by inappropriate footwear - nurses wearing open toe shoes and one who dropped an unsheathed needle which went into her unprotected toe, another in catering wearing trainers with next to no grip, another in the estates function moving heavy items who dropped one and broke his toe and wearing shoes with no toe protection, a nurse wearing ballet type shoes who walked into a bed end and broke her toe, etc etc........ The whole principle is that once we had investgated these incidents it was obvious that a) the managers had no control and didn't understand the risks their colleagues faced and b) did not understand the concept of PPE. In catering we have now insisted on non-slip footwear, we currently use shoes for crews, which are excellent. In estates they all have appropriate footwear to suit their tasks - in nursing a bit more difficult to get any standardisation even though there is a uniform policy which says wear 'sensible shoes' what ever they are! Certainly they are not high heels, flip flops or ballet shoes - equally they are not toe steel protected boots.
As a parting shot, I would not be recommending crocs or anythingsimilar for anyone working in hospitality, hospitals or anywhere else. Great for social wear but a) they do not fit well so increase the risk of turning an ankle or b) the ones with holes in provide next to no protection against spills.
I am sure someone will disagree - but we are all entitiled to our opinion.

Helen, I hope you get your problem sorted.

Noel George
Member - 14 posts

I can only say that I still see nurses and care workers of various sorts travelling to and from their work places wearing the uniforms in which they deal with patients and those in their care. Street wear shoes must carry all sorts of foul contaminates.
This can`t be correct practice.

Diane Roberts
Member - 6 posts

My understanding was that Crocs are fine in certain situations, certainly comfortable, but in others are definite no-no's.

Perfect for taking a shower in at a campsite or by a swimming pool, for example, where you don't really want to be walking around barefoot.

Where I work (an electronics company), however, they are banned - the simple reason being that they are no good in situations where you have electrostatic sensitive devices. They create a static charge as you walk around, and I had heard a "folk tale" for want of a better way of putting it, that a nurse wearing crocs had actually damaged a piece of vital equipment in a hospital because of this static discharge. I don't know if this issue has actually been checked or confirmed, but we're not prepared to take the risk that any of our ESDs will blow because of them.

John Robertson
Member - 18 posts

I'm interested to know whether hospitals take Noel George's point into account when assessing risk. For all the good points made about needle stick injuries or loose-fitting mules, the idea of a shoe that obviously goes in the washing machine seems a good rational reason for a nurse to choose it. I promise not to be too florid in any replies.

David Ireland
Member - 5 posts

I can respond to the point about shoe cleanliness. In areas that are sterile such as theatres, staff are required to wear specific theatre shoes, and these are washed. In the hospital I work we have shoe washers for these areas so that the shoes can be kept clean. Visitors in such areas are required to wear disposable overshoes or to change into scrubs and put on theatre specific shoes.
With regard to general areas there is no greater risk from clinical staff wearing outdoor shoes than from the hospital visitors walking the wards visiting their relatives. Hospitals are a workplace and although special attention can be paid to sterile or greater risk areas such as theatres it is impossible to be risk free. This is where good cleaning regimes come into their own and regular high standards of cleaning will help reduce the spread of infection.