Thursday, March 3, 2016

Operating Room Shoe Covers - Paper vs. Cloth

Operating room footwear was all pretty much the same. Traditional white clinic nursing shoes
modified with the placement of a metallic rivet through the weight bearing area of the portion of the shoe underlying the ball of the foot. I used to wonder, "Why not postion the rivets in the heel?" I guess if the rivets were in the heel, standing on your tippy-toes would break the grounding path for electricity.  We always seemed to standing on our toes reaching for something or to see over a burley surgeon's shoulder.

A Modern elastic paper shoe cover. I bet these would not
work in the Cyclo room. Where is the conductive strap?

The purpose of the metallic rivet was to ground out static electricity to the grounded floor of the operating room. We had one room of the OR suite dedicated solely to the use of Cyclopropane which was highly explosive. I'm thinking about  that for another post "Anesthetics that Go Boom." Cyclo was on it's way out even at the beginning of my career, but it was deemed wise to maintain at least one room  for teaching purposes.

Before entering the "Cyclo Room," (Curious how that sounds like psycho room) we had to step on a gizmo that actually checked our shoes for conductivity. A green light meant it was OK to enter the room and a redlight on the gizmo meant you had better check to make sure the conductive strap from the cloth shoe cover lined up and contacted the rivet in the shoe. An experienced nurse could tell by pedal sensation (I made that one up) if the strap was lined up with the rivet. You knew it when you felt it!

Cloth shoe covers were a true thing of beauty compared to the disposable paper/plastic  ones available today. The manner in which the  saturated deep green color of the shoe cover contrasted on the elegant grey terrazzo floor was a sight to behold. (If interested please see my "Terrific Terrazzo Floors" post)  The cloth shoe covers did not stretch like the one size fits all nobody of today and came in 4 different sizes. We used to hide our own personal sized cloth shoe coverings in unusual places so there would always be a set available that fit. This led to some amusing moments such as "Who hid their shoe coverings in the bottom of the coffee can? The answer was always "That is not a coffee can..That is  my shoe covering can. Keep your grubby hands off them."

One thing about modern health care (other than nurses taking better care of  computers than patients)that really bugs me is the fact that everything that was  made of  substantial material like metal, glass, or cloth is now made of paper or plastic. Somehow it just does not seem right. Whippersnapperrns are missing out on the heft and feel of  things like metal bedpans, glass IV bottles, mercury syphgmomanometers, and cloth surgical drapes, masks, and shoe covers.

OK back on task. Cloth shoe covers had no elastic in them. they were held in place with a drawstring device which worked much better than  constricting elastic because the closure pressure could be varied and did not constrict your foot at the ankle. Overall, a much more elegant way of attaching foot covers to shoes.

Modern paper/plastic shoe covers have another annoying (at least to me) characteristic in that they produce a rustling noise as you walk. They sound a bit like the muffled,  crackly noise of cellophane being handled. To me the disposable shoe covers were reminiscent of a stroll through the woods on a Fall day with the leaves crackling underfoot. Cloth shoe covers were stealthily silent and more suitable for use in the operating room.

All surgeons and nurses were supposed to wear shoes which were encased in the cloth coverings. A few renegade surgeons like Dr. Slambo liked to wear rubber boots in the OR which was  a habit he picked up while serving as a Trauma surgeon in the Army. Every now and then one of the OR supervisors would confront Dr. Slambow about his footwear choice  and he always told them, "I need these boots to wade through your rigid, authoritarian crap, so dummy up."  That would usually be the last time the supervisor attempted to confront Dr. Slambow. He was not one to be trifled with.

Every OR Supervisor seemed to have there own particular gripe. Some complained at length about fingernails while others thought scrub nurses should try to mitigate Bovie smoke with a suction.  Alice, a firey redhead always concentrated on footwear and related problems. She really liked the surgical residents (none of the attendings  listened to her)  to wear rubber bands around their ankles to "catch perineal fallout" so as to avert contaminating the OR with imagined crotch microorganisms. One day she approached one of Dr. Slambow's  residents with her ever present rubber bands and Dr. Slambow unloaded  and screamed  "Alice, he does not need rubber bands on his ankles because today he is wearing underwear."   That seemed to muzzle Alice, at least for a couple of weeks.

One time Alice approached me after along and difficult case with Dr. Slambow and said "Fool sometimes during cases you don't get excited enough when bad things happen." Alice liked to rant and rave and jump around during emergent situations. Dr. Salmbow overheard her criticism of me and quickly put her in pace saying, "Alice that's like saying we did not loose enough blood. You can never be too cool." That kept her off my back for a few days. She really was a nut.

Clinic shoes equipped with grounding rivets and cloth shoe covers were the pinnacle of operating room footwear design. Clean, conductive, comfortable and quiet. Clogs, tennis athletic shoes,  and paper shoe coverings can never duplicate the cloth and Clinics of yesteryear. Too bad some of the finer things are gone forever.


  1. Sometimes I think about sentences that people speak, which in all likelihood have never in all of history been spoken before. "Alice, he does not need rubber bands on his ankles because today he is wearing underwear" is one such sentence.

  2. It's definitely unique and sounds even whackier when taken out of context!

  3. Last year, we got the directive to wear the knee high booties (Surgical Uggs LOL) for all cases that we're scrubbed in on.

    1. I feel sorry for you whippersnapperns when every minutiae of your practice is controlled by committees of busy bodies concocting endless practice directives. Rigid authoritarian supervisors of yesteryear were annoying but eventually left the scene. One of the advantages of being on call was the absence of busy bodies on holidays or in the wee hours of morning.

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