Our hospital’s current policy for avoiding the resulting outbreaks of infection is typical of most: every patient with diarrhea is isolated until we have proven C. difficile is not causing the problem. Each goes into a private room, with boxes of disposable gloves and gowns by the door, which remains closed.

These gowns are thick yellow paper smocks individually wrapped in plastic, with cotton-knit cuffs and ties that wrap around the waist. The gloves are standard-issue vinyl, packed into boxes of S, M and L. Putting on the gloves and gowns takes a couple of minutes (unless the supplies are missing or we are down to the ridiculously tiny size S gloves, in which case the search for replacements can go on quite a while).

Image Credit... Joanna Szachowska

Then you have to take it all off again: the gown is untied and peeled over the gloves, which go off last, optimally sequestered in a bundle of contaminated surfaces all facing inward. The bundle must be stuffed into the red can of contaminated garbage, which is invariably full. Then the hands are washed (with soap and water, as clostridial spores laugh at alcohol-based cleansers). Then it is on to the next patient and, often, the same ritual.

Isolation is an immense nuisance for everyone.

For a nurse rushing in and out of patients’ rooms dozens of times a day, all that dressing and undressing is just not possible. Nurses learn to change their routines to get everything done in fewer visits.

Meanwhile, patients with diarrhea need a lot of nursing care. They may begin to complain they are getting very short shrift in that department and, come to think of it, are not seeing the doctors much either. These patients feel terrible anyway, and they feel even worse feeling terrible all alone.

Any intimation that isolated patients are at risk of substandard medical care will elicit passionate denials from all individuals and institutions involved. But some data argue otherwise.