Need advice from nurses please!

  1. Hello I am currently in my nursing program for RN. So now I am starting to work 6 hours a week as a CNA in home health. I am about to work with someone who has Hepatitis C (Can I say this on the boards if not someone tell me) I have to do their bed baths and change sheets and change briefs (CNA duties) So Im scared. Ive never worked in a hospital before or with anyone who had any diseases. I only worked with one elderly lady. Anyways this is my first time working with a disease and Im scared. What are my chances of catching something like this? I have kids and Im just worried. I know this is going to be part of my future career but right now Im scared that I could possibly come into contact and something bad happen? I know Im panicking but please help I need to get over this fear. Can someone tell me what to do and how they overcame this fear in the beginning? And oh one more thing she smokes Im in her home for three hours and Im not a smoker. What would you guys do with a patient that smokes and house smells of cigarettes? Thanks Hope you guys can help!
    Last edit by lizzyberry on Nov 10, '07
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  2. 12 Comments

  3. by   RainDreamer
    As a CNA, I assume you won't be giving injections, right? Hep C is transmitted by direct blood-to-blood contact. Always remember your universal precautions.

    As far as the smoke, that's a tough one. I think I'd just have to tough it out and wash my clothes really good after I left.

    Good luck to you!
  4. by   Djuna
    Hi Lizzyberry

    Hep C is a blood-borne disease so you need to do your standard universal precautions and meticulous hand washing.

    In response to the cigarette issue, that's a hard one. It is the client's home and she has a right to smoke if she so chooses. You could ask her if it would be possible for her not to smoke when you are there for the three hours or if she would mind going outside. Unfortunately cigarette smoke does cling to curtains and couches so I don't know how you would really get away from the smell totally.

    Is there anyway you could transfer to a client who doesn't smoke?
  5. by   lizzyberry
    Quote from Djuna
    Hi Lizzyberry

    Hep C is a blood-borne disease so you need to do your standard universal precautions and meticulous hand washing.

    In response to the cigarette issue, that's a hard one. It is the client's home and she has a right to smoke if she so chooses. You could ask her if it would be possible for her not to smoke when you are there for the three hours or if she would mind going outside. Unfortunately cigarette smoke does cling to curtains and couches so I don't know how you would really get away from the smell totally.

    Is there anyway you could transfer to a client who doesn't smoke?
    Yeah I was thinking that I could ask for a new client but I just started working there and I feel like I would look bad like Im being picky first day on the job. So Im just so stressed right now with NS and my first patient with a disease.
  6. by   nyapa
    It will help if you know how Hepatitis C is transmitted and contracted. Basically it is in the blood of an infected person. So contact between the blood of an infected person, and a wound of your own, is what you should be watching out for.

    It is really not that much of a worry if you make sure you use gloves when ever handling bodily fluids of the person. And ensure your own wounds are covered. Now you should be doing this automatically. Consider that it is rare for a health worker to contract Hep C. You are more likely to pass diarrhoea or the flu to your children.

    Re: the smoking; this is a decision you can only make yourself.
  7. by   Scrubby
    I understand your fears. I work in the OR as a scrub nurse and i'm always pretty cautious about contracting a disease.

    My advice here is if you dealing with wounds, giving any injections or handling bodily fluids with ANYONE then wear two pairs of gloves. People might argue it's a waste of resources etc but i don't care. I'd rather be safe. You might even choose to wear a visor and mask if you know a patient has a blood borne disease to protect your eyes and mouth.

    You have the right to wear personal protective equipment.

    As for the cigarettes well maybe have a mint or something handy for to sort of mask the smell....
  8. by   pagandeva2000
    As everyone else stated, it is a blood borne illness and universal precautions is the key for protection.

    As for the client smoking; you cannot tell a person what to do in their domain. It is the same as if a person that smoked visited your home and you don't smoke. You have the right to tell them to go outside or even to invite them in at all. The same applies to the client, unfortunately for you. Maybe you can ask if you can stay in another room while she is smoking, but you can't ask her to stand outside. Maybe deal with it for a visit or two to see how bad it is, and if you can't hack it, request another case as one becomes available. Good luck in school and remember to glove up!
  9. by   SuesquatchRN
    Bring a change of clothes.

    I can't visit my mom without having to launder everything I brought, including the lhaso apso.
  10. by   RN0707
    - personally i double glove when i have a known diagnosis but it is good practice to treat every pt as if they are positive for everything! that way you are always protecting yourself so treat all blood and body fluids as if they were known to be infectious! use universal precautions/standard precautions with blood and all body fluids, secretions, and excretions regardless of whether or not they contain visible blood! the precations are designed to reduce the risk of transmission of microorganisms from both recognized and unrecognized sources of infection. so always use good hand washing, (get in between the fingers tops of hands etc) gloves, gowns, and masks, whenever touching or exposure to patients' body fluids is anticipated. sometimes nurses get into a bad habit when placing iv's etc ...not using gloves or tearing a finger off especially with the elderly or babies! it's especially easy for me to forget with babies but you never know what someone can be infected with! we recently had a sweet 88 yr old test hiv positive and you would have never known or suspected by looking at them! and with the baby's.. mom can pass hiv hepc etc when they are born so always protect yourself! hep c is more often with needle sticks etc but remember open wounds such as pressure ulcers and you having an open area on your hand with out gloves is a possible transmission! check out the cdc website and it may help calm your fears and will teach you just what precaution is needed for blood droplet etc contact! take a deep breath and never slack when you get more comfortable and you will be safe!
    - as far as the smoking that's a hard one maybe you can tell your work you will only work in nonsmoking homes. it is a known pathogen and if you keep yourself protected any other time why can't you be safe at work. that's why there is no smoking in public places in most areas!

  11. by   Daytonite
    About Hepatitis C:
    Quote from lizzyberry
    And oh one more thing she smokes Im in her home for three hours and Im not a smoker. What would you guys do with a patient that smokes and house smells of cigarettes?
    Go to work?

    Why are you going into nursing if these kinds of things bother you? Did you not think about this before signing up for nursing school?
  12. by   nghtfltguy
    seriously???
    you are seriously worried about gettin hep c from a pt you already know has it?
    don't share needles...

    if that scares you.... well...
    wait until you have had arterial aids infested blood sprayed all over you...
    then... then... you can be scared...
    as for the smoking...
    seriously?
    educate~

    i didn't intend for this post to be offensive....
    just informative...

    if you want to be a nurse...
    you are gonna have to learn how deal w/ disease...
    its part of the job~

    Last edit by nghtfltguy on Nov 11, '07
  13. by   jlcole45
    Lizzy,
    It's OK to be afraid the first time but remember what you are there for, to help someone with their daily basic needs. Use the universal precautions you have learned and treat her with dignity.

    I remember when I was in nursing school in the mid eighties, that's when aides was just gaining momentum and everyone was in a panic, including the hospital staff. I was on my maternity rotation and they had their first pregnant aides patient who was in to deliver. It was horrible how everyone treated her, they left her alone most of the time through the labor, and when they did go in (to take vitals) they suited up like astronauts! I remember going to my instructor because I was so upset that she was being treated this way. Everyone knew that chances were slim and that other then the delivery she was non-contagious but they let there fear get the best of them.

    Good luck and remember she's sick. I doubt she'll be able to go outside to smoke like the others have suggested, if she could then I would think she doesn't need home health services. One other little story...
    I had a home health patient who chewed tobacco and kept her spit cup (an old tin can) right on the kitchen table. It totally grossed me out!!!! I can work a trauma and then go eat dinner, but that really turned my stomach. Yuck.
  14. by   shellsincanada
    Sure this may this woman's home and she can smoke in it BUT it would also be my WORKPLACE and I believe I have a expectation of a smoke free workplace. I have no issues of the smoke smells in the house- just if she is smoking while I am present.

    So if I get cancer can I file for workers comp? I don't smoke and I don't expose myself to second hand smoke ( easy here - no smoking in public places including bars, eating establishments, any place public)

    I do home health ( canada ) and we ask the patient not to smoke for 1 hour before we come. And I am not in there for more then an hour tops. Usually 15 mins to half an hour ( mostly dressing changes, health checks, blood sugars and insulin, med admins etc)

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