DEAR ABBY: May I add a few thoughts regarding the letter from "Daughter of a Patient," who wrote to stress her concerns about health-care workers and hand-washing? I strongly confirm that health-care workers need to demonstrate frequent and proper hand-washing techniques. Gloves are required while performing invasive procedures such as starting an IV, drawing blood, changing a dressing, etc. But please do not assume that hand-washing did not occur if it was not done in the patient's visual field.

I have been an RN for more than 20 years. I wash my hands before and after patient contact -- always, without fail. Our institution does not allow us to use a patient's bathroom for our routine hygiene (unless our hands become soiled while in contact with that patient). Nurses, physicians and other health-care personnel in direct contact with patients generally use a central hand-washing area, such as in a nurse's station. In this case, patients and their families may never actually observe personnel washing their hands -- even though they have.

However, if a patient or family member actually sees a health-care worker going from one area to the next, one patient to the next and having direct skin contact with that patient, I suggest they report it immediately to the unit manager. A health-care worker is more likely to acquire an infectious disease from the public than the other way around. That's now twice the reason to observe good hand-washing techniques. -- INFORMED AND HYGIENIC RN IN CALIFORNIA

DEAR INFORMED RN: The majority of mail I have received from medical personnel corroborates your statements. Read on:

DEAR ABBY: In response to the letter about hand-washing by medical personnel -- yes, it probably could be better in some cases. I have been an RN for 12 years.

Just because a patient doesn't see me wash my hands, it doesn't mean I haven't done it just before I entered the room. I generally wash my hands at the nurses' station for several reasons. I don't believe a patient's room or bathroom is the most hygienic place for me to wash my hands before I assess the patient.

At my hospital, the soap kept in the nurses' station is a stronger germ killer than what is kept in the patient rooms. Furthermore, I often follow hand-washing with an antibacterial spray or lotion of my own. With the dramatic rise in antibiotic-resistant bacteria these days, such precautions not only protect patients, but also protect me. -- SUSAN KELLY, SCOTTSDALE, ARIZ.

DEAR ABBY: Twenty-five years ago, a group of veterinarians developed and patented a hand-washing device that would give a surgical scrub in 30 seconds. A portable model that could be placed on a cart and moved from room to room was available. Prototype models were proved effective by bacteriologic testing. Though several companies expressed interest, we were never able to bring the device to market.

While there have been tremendous advances in the medical field in the last 25 years, the age-old problem of contaminated hands, first described by Semmelweis in the 19th century, still persists. -- WILLIAM V. LUMB, DVM, PHD, FORT COLLINS, COLO.

DEAR DR. LUMB: Unfortunately, you're right. And hand-washing is still the single most effective method of disease prevention. To quote an old saying, "The more things change, the more they remain the same."

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DEAR ABBY: The letter about nurses and doctors not washing their hands before touching a patient is so true. I got a severe cut on my hand, which required a trip to the emergency room. I was placed in a cubicle next to another patient, with only a drape in between. The doctor examined the person next to me and I heard him say, "Boy! That's some rash you have." When he was finished with him, he parted the curtain, came to me and said, "You need stitches."

I said, "Would you please wash your hands before you touch me?" He did. Abby, why did I have to tell him?

Thank you for the article. I hope everyone reads it -- especially doctors and hospital personnel. -- MADELINE IN NEWARK, N.J.

DEAR MADELINE: People promptly responded to that letter, and some of their letters -- like yours -- were eyebrow-raising. Read on for a sample:

DEAR ABBY: On Nov. 5, 1999, I went into the hospital for an estimated four-day stay for surgery on my lower spine. Four months later I am still bed-bound due to a staph infection.

I was sent home with drainage so bad the dressings were soaked in about half an hour. Nurses come to my home daily to change the bandages. I needed four pints of blood to replace the blood I had lost. I've had to return to the hospital and have the wound opened, flushed and drained twice. The second time it could not be closed with stitches or staples.

One of the nurses who cared for me didn't wear a mask or use rubber gloves, and she constantly sneezed and coughed while changing the dressings. -- ANNE IN PALM SPRINGS, CALIF.

DEAR ABBY: While sitting by my father's hospital bedside, I was handed the phone by a gloved LVN who was in the process of checking the other patient in the room -- a man covered with skin rashes.

Also, my friend recently refused to have her temperature taken by an LVN who had just changed the diaper of her roommate and was still wearing the same pair of gloves!

It makes me wonder what happens to sleeping or unconscious patients who do not have a friend or relative standing guard. -- REPULSED IN SALINAS, CALIF.

DEAR ABBY: Allow me to add my recent experience: In a dermatologist's office, the doctor's assistant put on gloves for a surgical procedure, then ducked out to answer the phone and do a few front-office procedures. Then she returned to the surgery room to assist the doctor -- wearing the same gloves.

In a podiatrist's office, the doctor's assistant smoothed out the paper upon which the surgical instruments were to be placed using her bare, unwashed hands. All the surgical supplies were handled in the same way. After the surgery, another assistant wore gloves while cleaning up the bloody tray -- and then while wearing the same gloves, proceeded to put away the leftover supplies to be used on the next patient. -- HORRIFIED IN CINCINNATI

DEAR READERS: Tomorrow, I'll print what the medical personnel had to say. Stay tuned.

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DEAR ABBY: My husband and I are the parents of three college-age children, all of whom drive their own cars. We are law-abiding citizens who have no trouble with the law. The town we live in has been designated a high-crime area by the county police, so it is not uncommon to see cars pulled over, not only for minor traffic violations, but also for "suspicious" behavior.

My concern as a parent is that most young people don't know how to act if they are stopped by police. Of course, they are expected to answer all questions respectfully. However, do they know that if they reach into their pockets for a license or identification, they might be perceived as reaching for a weapon? Shouldn't they learn this in school as part of a health and safety course?

Recently my children and a few friends were relating experiences of being stopped by the police. I was appalled to hear about some of the encounters these kids have had. My sons and their friends were grabbed from a vehicle, thrown up against the car and searched, just because the driver had started to reach for his wallet. My daughter was yelled at and ridiculed because she began trembling, and then was told she was in "no condition" to drive and must contact a parent.

By the way, we are not part of a minority group, so this was not racial profiling -- and my children dress conservatively. I have always taught them respect for authority, including the police, but I expect that same respect from police in return. -- GAIL FROM BRENTWOOD, N.Y.

DEAR GAIL: I, too, was taught as a child that "the policeman is our friend"; it's a lesson I passed on to my children. While that is still true in most cases today, the availability of illegal weapons has made the job of policing more dangerous than it was a generation or two ago. Call it self-protection or paranoia -- police now fear for their lives when they make routine traffic stops.

I agree that young people should know exactly how to respond if they are pulled over by police. Their parents should instruct them: One's hands should be in plain sight at all times. If there is a need to reach into a pocket or purse, or to open a glove compartment or trunk, the officer should be asked for permission first.

You mentioned that your children's experience was not the result of racial profiling. In many cases it IS. The American Civil Liberties Union has mounted a campaign to bring attention to this problem, and thanks to the activism of people of color who have come forward with their stories, politicians and law enforcement officers are beginning to take notice.

Hundreds of law enforcement agencies have agreed to collect data on the race and ethnicity of the people they stop, which is the first step in dealing with the problem. Bills requiring police to collect data on traffic stops have passed in several states and are on their way to becoming law in others. It's a welcome step in the right direction.

NOT CONFIDENTIAL TO JEANNE PHILLIPS, MY PRECIOUS FIRSTBORN: Happy birthday and many more!

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