MRSA and poop are making my 1st

  1. clinical unpleasant!!!! I am in the TCU and out of 15 pts, 7 are in iso with MRSA. How contagious is this bacteria? Can I bring it home? Is it normal for a hospital to have a list 30 pages long with MRSA patients? What exactly does this bacteria do to you?

    Also, please tell me about your first experience changing a diaper. Mine was today and I came home and took a 1/2 hour shower and I feel very sad. Will I eventually become numb to it?
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  2. 12 Comments

  3. by   deespoohbear
    Unfortunately, MRSA is being more common and is here to stay. Good news is if you use your universal precautions and common sense you should be okay. I have worked for seven years in an acute care med/surg floor where MRSA is present frequently. I only know of one nurse who contracted MRSA. MRSA can been in several different systems. The most common I have seen is in the urine and wound.

    From Taber's-Staphylococcus aureus-a species commonly present on skin and mucous membranes, especially those of nose and mouth, characterized by production of a golden-yellow pigment. They are gram-positive, coagulase positive anaerobes. Various strains of this species produce toxins including those that cause food-poisoning, staphylococcal scalded skin syndrome, and toxic shock syndrome.

    Humans serve as the predominant reservoir for staphylococci. These bacteria constitute a significant part of the common body flora which are found on the skin surface and in the mouth, nose, and throat. When there is a break in the continuity of the skin the pt becomes suscepitible to infection by staph. The source may even be the pt's own skin. May eventually end up in the bloodstream which can lead to bacterial endocarditis, staph pneumonia, meningitis, or septic shock (Brunner & Sudduth)

    From Brunner & Sudduth's textbook of Med-Surg nursing- MRSA denotes a group of strains of S. auereus that have developed resistance to treatment with semisynthetic penicillins such as methicillin. The strains of MRSA are extremely virulent, often colonizing in patients and health care personnel. Those at high risk for developing MRSA include: elderly pts who are hospitalized or in nursing homes, burn pts, pts with multi-system diseases, pts in ICU with prolonged lengths of stay, pts previously treated with multiple antibiotics and pts with surgical wounds and invasive lines. The major means of transmission within the hospital is person-to-person transmission. (WASH YOUR HANDS!!) Usually treat with Vancomycin.

    If you follow your universal precautions, you should be fine.

    As for changing pts who have soiled themselves, I don't think you ever get used to it. I don't like to use the word diaper for these adults. I find it demeaning. I refer to them as disposable briefs or underpants. When I am changing a person who is incontienent of bladder and/or bowel, I just think that I could be that person one day. Eventually, everyone needs help in one form or the other. I just try to provide the best peri care and nursing care I can to the individual. It is very humiliating to them to know they have know they have no control over their body's basic functions. Treat them with dignity. Hopefully you will never become "numb" to people who need you the most. That way you can remember to treat that person how you would want and expect to be treated. Hope this helps. Hang in there. I think you will find many rewards in the nursing field. Best Wishes.
    Last edit by deespoohbear on Sep 19, '02
  4. by   deespoohbear
    With all the MRSA you have encounter and BM's, have you come across a pt with c. diff? That will be another nasty bug you will encounter, especially in a long term care setting.
  5. by   christianRN
    Deespoohbear provided great info on MRSA, and ditto the incontinence advice as well. I try to be very careful not to show my pts how I feel with my facial expressions, even when something is really gross. As they're lying there, they are usually looking right at my face, so I try to keep talking about something more pleasant to maintain their dignity as much as possible. ADNstudent, it is great that you want to be informed about potentially infectious diseases, for your patients' health and your own!!
  6. by   traumaRUs
    As above posters indicate - you are to be commended for your concern about passing germs to others. I have a son who has been immunocompromised in the past and personally, I always take off my shoes, clothes, etc in the garage before coming into house and I wash my work junk separately. (I keep extra jogging clothes in garage!!)

    C-diff is kinda gross too!!! Best overall thing to do - wash your hands often!!!!
  7. by   mario_ragucci
    This is a great thread and I wish I could say something useful, but most of what I talk about C-diff and MRSA has been here. Take care that you scrub under your nails from time to time to really be clean.

    Can a human body build an immunity to MRSA, that is, can humans produce their own immune response and send killer T-cells after MRSA/C-Diff?

    Lol, some folks said they can smell C-diff poop is different smelling. Lol, I can smell Vivonex poop, but not C-diff.

    Changing a PT ain't no big deal. They got gloves up the ying yang, so you don't hafta get dirty. Plus, if you have comfort baths, its really a snap. Problems arise when its a large PT, and you can't unfold them to klean them up, and your working alone. Then you can stress about hurting yourself with a solo effort to jossle a large person :-( I cleaned my first person in CNA clinicals in Nov01.
  8. by   Gigglesforall
    This summer was the first time I had ever had anything to do with a health-care type position. I'm a PCA at a group home for low functioning physically and mentally disabled clients. On my first day, I almost started crying. The co-worker that was training me in didn't think I was going to come back. She told me it would only get better. When I got home I started bawling because I was so sad, and couldn't imagine myself working there another day if I had to deal with giving supps and changing them all day long. I too took a shower for a half hour. Well, I did go back and now I really enjoy my job. Actually, I have gotten used to the changing. It's not that I enjoy it by any means, but it's just like any other part of the job and it's not a big deal at all anymore. I do think though, that when you work at a group home with 4 clients you get very attatched and close to them so changing them isn't as big of a deal as changing strange people you barely know. I hope you don't get too discouraged, it really will get better!
  9. by   night owl
    deespoohbear,
    That is a great point you brought up about calling disposable briefs "diapers." It is so degrading to use that term for older adults especially right in front of them! I keep trying to stress this point to my coworkers, but to no avail, some of them still don't have a clue! {{{sigh}}}

    adnstudent,
    Remember, always put yourself in their shoes. If they are A&O, they feel as embarrassed if not worse than you do about their unfortunate "accident," but you have to make them feel as though it's really nothing at all. These things do happen and that's what you're there for...to make them feel comfortable with an uncomfortable situation and we're here to comfort YOU with your dilemma. The more times you clean an incontinent pt, the more you won't feel uncomfortable in doing it. Now if I could just get over the vomit thing...:stone
  10. by   Jenny P
    ADN Student, no one has addressed your statement of 30 pages (!!!) of MRSA patients! Yes, that IS excessive! My hospital tracks all MRSA pts. from admission or dx til discharge. Any "new" MRSA pts. and the infection control dept. starts putting up charts and doing formal and informal education re: isolation and handwashing technics. The idea of that many MRSA pts. scares the daylights out of me!

    You have received lots of good advice here; my only advice is to get out of that hospital. MRSA can colonize in the nasal airway and one could end up being a carrier for life.
  11. by   adnstudent
    Thanks deespoohbear!!! Ironic name! Your info helped a great deal. I do remember the basic facts from micro but I still dont understand one thing....if I had a debilitated family member at home, could the bacteria survive a trip home on my scrubs and possibly infect someone at home?
    Thanks for everybodys support. Im hoping the next time wont be so traumatic. As far as the MRSA infections at this particular hospital, it is insane! I was not exaggerating when I said 30 pages with about 15 to 20 patients per page. If this bacteria did colonize in the nares of a nurse, would there be obvious symptoms?
  12. by   Nurse Nikki
    MRSA is a nasty thing!! I am a LPN who is curently going back to school to be a RN. In my microbiology class, we did nasal swabs to see what bacterias would grow. A few of them grew MRSA. As a healthcare provider, you can become a carrier,but the only time this poses a risk is if you become immunocompromised. At my hospital we have at least 3 or 4 at all times on my med/surg floor that holds only 38.
  13. by   CaliNurse
    Originally posted by adnstudent
    clinical unpleasant!!!! I am in the TCU and out of 15 pts, 7 are in iso with MRSA. How contagious is this bacteria? Can I bring it home? Is it normal for a hospital to have a list 30 pages long with MRSA patients? What exactly does this bacteria do to you?

    Also, please tell me about your first experience changing a diaper. Mine was today and I came home and took a 1/2 hour shower and I feel very sad. Will I eventually become numb to it?
    Hello Adnstudent,

    I can tell you about pages of MRSA patients. Usually if you are at a good facility they will keep an ongoing list of all resistant organisms. MRSA, VRE, are two of them. I HOPE this list is an ongoing list. For my unit we have a list of maybe 50 entries which cover the last 4 years. Each time some one is admitted with a resistant organism it is logged onto the list. One patient could be on there a few times. Each system infected is listed separately, example: MRSA of sputum, blood, wound, urine. We even once had someone come in with it in their eye! (Gross!!!) From this you can see how important it is to wash your hands after each contact with a patient or their environment. My biggest challenge of the day is to get everyone to wash their hands BEFORE they leave the patient's room. If you always do this your hands are clean once you leave the room. If you come out and wash at the nurses station you a risking the transmission of this organism to anything you may touch. They other thing to remember is to not lean you body against the bed or equipment. It is a good way to pick up these organisms. I have not ever found the life span for MRSA but I have read that VRE lives 7-10 days on a hard surface. This hard surface could be a simple as your employee badge.

    The reason for the ongoing list ........ so you can check them to see if they have ever been infectious. Our policy directs us to isolate anyone who is even colonized. After 3 negetive cultures we can clear them out of isolation. The list is their to help. I just hope you don't have 30 pages of active inpatient resistant organisms.

    Welcome to nursing! The diapers do get easier. Soon you will look past the poop and think of what happens to skin when it is not clean. That will be your focus. Stool & urine combined with skin makes one heck of a rash. As mentioned prior to my entry
    C-Diff has an unusual smell to it even for poop. When you run into to you will never forget it.

    Good luck in your career,

    Cali

    p.s. If anyone does run into the life span of MRSA I would love to hear from you. I have been told it is "a few" days but I have never seen anything in writting.
  14. by   printsess
    The way to leave it at work is great handwashing with soap & water, and change clothes before you leave work. If your work clothes go home on you, then your coat, seatbelt, etc. get contaminated and stay that way for days. Your street clothes and family get cross contaminated. You protect yourself with these simple measures and you need not worry.

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