Do you actually wear gloves/gowns/masks ?

[Nepenthe Sea]

I am a second-semester nursing student, and just finished my first clinical rotation at a local hopsital. I know that nursing school is different from the real world, and that working nurses will do things differently from what we were taught in school. But I am just wondering if you guys actually use your gloves/gowns/masks when a patient is on special precautions. At the hospital where I was assigned, I had patients with VRE, MRSA and C-diff. All of them were on contact precuations and one also had droplet precautions. NONE of the nurses caring for these patients wore anything besides gloves. My friends that were assigned to a different hospital said that they encountered the same thing, except that alot of the nurses there didn't even wear gloves. Is this pretty common in the real world? I know that Medicaid and/or Medicare has decided that they will no longer reimburse for treatment of hospital-acquired infections, so it seems like everybody would really be using their PPE. I personally have two small children and the last thing I need is to expose them to any of this stuff, so I used the gowns and masks. Do you just quit being afraid after awhile, or are there just alot of careless nurses where I live? Please don't flame me, I'm just asking for an honest answer.

Thanks!

[SuesquatchRN, BSN, RN]

I certainly did in the hospital setting.

[schack]

I am a med/surg/tele. nurse 1 1/2 years out of school. Things are different in the "real" world, but I do use my PPE. I come home to 4 children and I am NOT bringing anything home with me. But having said that... if I have a patient with C-diff I wear gown and gloves for assessments but I may only wear gloves if I am just walking in the room to pass oral meds. Depends on the patient. Is the patient alert oriented, etc. If the patients incontient I wear everything including booties everytime! So it isn't as cut and dry as when your in school. Now respiratory precautions are another thing... I always protect myself and my other patients, I wear the mask!!! Good luck to you.

[TiffyRN, BSN, PhD]

I & my co-workers do wear gloves, gowns & masks when appropriate. Sometimes the same kind of infectious agent will have different precautions d/t the the location of the infection (and that hospital's infectious disease dept's preference). With MRSA infections, I have sometimes needed to wear masks (if the MRSA was in the resp tract & the patient had a trach). Sometimes I have only had to wear gloves if the infection was very localized and the only contact will be possibly to the outside of a dressing of an infected wound.

Where I work now, we routinely gown & glove every kind of isolated infection, adding masks if the infection requires droplet isolation. But we do follow the guidelines set for that particular infection. The only exception I know of is sometimes someone might not gown and glove just to enter the room if they are just poking their head in to relay a message and have no intention of touching anything, but if it requires masking, we always mask.

[PostOpPrincess, BSN, RN]

ABSOLUTELY NO EXCEPTIONS.

The thought of passing on MRSA, or VRSA, VRE to someone else makes me sick to my stomach.

And when my shift was over, I used to undress in the garage before I came into the house too, everything went on super hot in my washing machine and I went straight to the shower.

[morte, LPN, LVN]

it oft depends WHERE the VRE or MRSA is, and what you are going into the room for....

[morte, LPN, LVN]

ABSOLUTELY NO EXCEPTIONS.

The thought of passing on MRSA, or VRSA, VRE to someone else makes me sick to my stomach.

And when my shift was over, I used to undress in the garage before I came into the house too, everything went on super hot in my washing machine and I went straight to the shower.

in my state, the hot water temp for residential use is too low to be of any use....and in all likelyhood would not ammount to much dif. sunlight may be more helpful.....and do you have washable shoes or do you leave them at work?

[TheCommuter, BSN, RN]

While I'd absolutely love to wear more PPE for patients who are on various types of isolation, my workplace purposely understaffs and undersupplies us all the time.

We don't have masks or gowns in stock half of the time. Therefore, the only PPE I can get my hands on are the gloves.

[chicookie, BSN, RN]

Honestly, if I am going in there real quick to ask something and its a contact room, I am not going to gown up. The doctors don't do it, why should I?

if its airborne its a different story. Then yeah I do all of it. But for contact unless I am going in there to mess with the patient then yes I will.

[nerdtonurse?, BSN, RN]

In the real world, I look at actual risk of transmission. If someone's on iso for hx. of MRSA in leg abscess 2 years ago, and the pt's skin is warm, dry and intact, and they are in for something non-invasive, I use standard precautions. If I get a person who has MRSA in the nares, and they're in for something like a lap chole, not coughing, not sneezing, I only go full monty if I'm doing up close personal care -- not for ghosting in at 0300 to clear the history on an IV pump the pt's never touched. I've also had patient who weren't on isolation, but there was something about them that scared me, I PPE. We had a Noro outbreak, and I was told that contact plus standard was enough. I also used my N95 and went in with splatter protection. Of all the "dirty nurses" who worked the outbreak, I alone didn't get sick, so my "extra PPE" that our infection control nurse said wasn't necessary....apparently was.

What's bad is when you have someone in the hospital for a week, they go to the unit where they do nasal swabs on all pts, and you find out the person you've looked after for a week had MRSA. It used to flip me out that I had that period of unknown transmission.

I must be doing something right. My swabs are negative, so as far as I can tell, I'm not one big infected nurse coming down the hall.

[Lacie, BSN, RN]

in my state, the hot water temp for residential use is too low to be of any use....and in all likelyhood would not ammount to much dif. sunlight may be more helpful.....and do you have washable shoes or do you leave them at work?

I do the same, taking off my scrubs in the garage and they go into the washer as mine has a "sanitizer" mode (most newer washers as I bought this one specifically due to the sanitize mode) and into the shower myself before I do anything else. Water is heated much hotter than what my tap can do. I also take my shoes off at work, bag them and they are left in the garage until my next shift. I wear crock brand shoes so it's easy to stick them in a 10% bleach solution also when a blood spill occurs. I've worked in Burn ICU and Dialysis of which strict PPE is utilized - gown, gloves, mask, etc. Even with all the PPE I still would do my end day routine. If CMS came in and you arent following the appropriate guidelines the facility would be heavily cited.

[justiceforjoy]

I would absolutely refuse to work with patients with precautions if my workplace didn't appropriately supply me with protective gear. That's just unacceptable.

To whomever was asking about shoes: Mine stay in my car. They have their own spot -- they don't touch anything outside of that specific spot in my car. They've never seen the inside of my house.

I saw poor precautions being used as well. Droplet precautions = hat, booties, mask with a shield, gown, and gloves. Most often, I only see people using a mask with a gown and gloves. I always feel like a snob when I gown up appropriately, lol I have a small kid at home, too, so there's no chance in heck I'm risking her contracting some infection because of poor work ethics.

I also keep in mind that AROs respond well to hand sanitizer, C.Diff does not. So I always sanitize my hands after removing the gear, then wash my hands as soon as I can get to a sink.