scabies at my facility.

Nurses General Nursing

Published

I have a question for anyone that had a scabies outbreak at work and contracted the little buggers.

We have two confirmed cases of scabies at my facility. The first was a new admission, the second being the roommate who was already a resident at my facility.

We also have at least two, and possibly four confirmed cases amongst the staff. These are CNA's who either did direct care with the infected resident, or helped the staff assigned to that resident.

Well, even tho I'm not on that wing, my S/O is, and helped the staff assigned to the infected resident more than once.

Now, it seems I developed a rash in all the right places for scabies, and so did the S/O. I immediately called the DON, who sent me to Occupational Health for a checkup, and possible tx. The Doc there didn't do a scraping, but examined both of us and agreed it was scabies. Got the script, and I'm literally sitting here coated with Permethrin 5% cream.

My first question is, since I was on the schedule at work today and tomorrow, and was told by the Doc to NOT return to work until Saturday, should I be paid for the time I'm forced to take off d/t inf? I asked the DON, and she said it was something to be expected in our profession, and in fact no, I wouldn't be paid! I've been in health care for 20 years as a CNA, and a few as an LPN, and have NEVER contracted scabies, or anything other than a cold from work. I feel since I contracted this at work, and they have CONFIRMED outbreaks both among staff and residents, it's a pretty safe bet I got it from there. I personally know that's where I got it, because I literally just go between home and work, and don't really socialize anywhere or with anyone else.

They can't use sick days for me, as I delegated not to take them as a benefit, and instead recieve an extra dollar an hour. I'm full time, and the two days off is going to hurt, especially right before the holidays.

Who do I need to talk to, and what do I need to do to get paid?

Second question, is the Permethrin 0.05% spray effective at treating soft furniture? I need to treat my couch, as I fell asleep there several times since I was exposed, and before I got tx. I can't put it in a large bag, and really can't think of anything else to do to it.

As usual ladies and gents, any info is greatly appreciated.

Thanks in advance, and Merry Christmas to all!

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Specializes in Emergency.

Hi,

I hope I can help. I worked a a veterinary technician for 16 years prior to becoming a nurse. For a time I worked for a Veterinary Dermatologist. We saw many cases of scabies (aka sarcoptic mange) in dogs. The manifestations were hair loss, intense itching, and secondary skin infections resulting from the scratching. Occasionally, the owners would have signs of infestation as well.

I would look into workers comp to help you with your time off from work. As long as there is documentation to show where you most likely contracted it from (occ health should help with this).

As far as treatment for your home, you need to do a thorough top to bottom cleaning, not (I am sorry to say) just your couch. Your hairbrushes should be replaced, and your clothes should be washed in hot water (esp your undergarments and socks). If you have animals, they should be bathed and dipped, and watched closely for signs of infestation. Permethrin sprays will help, but you really should bomb your entire home. to prevent the mites relocating to areas that you did not spray. Also, all bedding should be thoroughly treated. You should be able to get info from your local pest control company or veterinarian on what chemicals are effective for your home.

Just out of curiosity, was the pt who originally had the scabies homeless or immunocompromised?

Also at work, scabies should be treated as a contact precaution. At the very least, wear gloves. If you think your clothes will come into contact, wear other protective equipment. The Sarcoptes mite can live on clothing, and be transferred that way, not just skin to skin contact.

Hope this helps!

Amy

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Specializes in Cardiac Telemetry, ED.

You elected not to take sick days in favor of the extra dollar an hour. I don't see why they should have to pay you.

Mites only survive off the person for 48-72 hours. Is there any way you can stay off the couch for three days? Can you bag the cushions and thoroughly vacuum the rest?

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You elected not to take sick days in favor of the extra dollar an hour. I don't see why they should have to pay you.

Mites only survive off the person for 48-72 hours. Is there any way you can stay off the couch for three days? Can you bag the cushions and thoroughly vacuum the rest?

this is not an illness, it is a work exposure "injury" so to speak....he shouldnt have to take sick time for it anyway....the only defense i see the employer having would be HE personally, wasnt exposed at work....the DON's excuse is really dumb.....

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Specializes in Orthopedics/Med-Surg, LDRP.

They can't be forced to pay you since you elected to not have any sick time. Do you have any personal/vacation/non-productive time you can use instead? Other than that, you're kind of at the mercy of the profession. Every once in a while you're going to catch something from the hospital and unfortunately it was scabies. Unfortunately you're probably going to have to take the hit on this one.

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could one of the posters who are relating the lack of sick time to not gettng paid explain the conection of the two things? TIA

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Oye...this touches very close to home. I didn't loose and time from work from my experiences though. I also think this is a kind of "work related injury" and not a I want sick time off thing. Its not like she went into work and asked to get sick. She was exposed. What would happen if say you were bit or cut by a person with a blood borne illness? Would they say "Too bad?" Just because the type of infection or trasmission isn't the typically though of work related illness, I don't think the "you have no sick time" thing applies? I've worked in LTC for over 15 yrs and recently this was the first time I've ever been exposed, so no.....I wouldn't expect to get scabies.

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Thanks for the replies everyone, but I think I need to clarify this a little more.

At my facility, there is a policy that you can elect to not take sick days, vacation days, holidays and personal days, and instead recieve an extra dollar an hour in your pay. I was originally hired to work double shifts on weekends, and one extra shift a week, totalling 40 hours. That being the case, I felt that I wouldn't use vacation days anyway, so elected not to take that package. They were and still are unable to give me that schedule immediately, so I work a regular week of five eight hour days. This decision was based on the significant pay-cut I took when I moved down here from PA.

My absence isn't due to me not being able to work for any other reason than being exposed to scabies in my workplace. After the first resident was found to be infested, staff wasn't told that they needed to take precautions, and several CNA's, including my S/O, contracted them. There is NO WHERE else I could have come in contact with these critters, as I prefer to use my own bathroom at home for anything that requires sitting, and don't have the time or energy to socialize right now outside of work. Also, there are CONFIRMED cases among the staff, the total now being up to 5 confirmed and one probable.

I'm being told to stay home until tomorrow by the DON and the Doc that treated me. It's NOT my choice, although I know the importance of not having contact with anyone until tx is complete.

On a side note, my company also balked at treating my sister, who lives in my home, and I had to have the Doc write "workmans comp" on the script to get the company to even pay for the script. I was told that I should just pay for it and they MIGHT be able to reimburse me at a later date.

Now I really like my DON, and LOVE my workplace. If I have to take the hit and not get paid, fine, but I really feel this wasn't my fault and should be reimbursed. I just feel it's unfair to financially penalize me for something that I wouldn't have contracted had staff been made aware of the condition earlier. My S/O certainly knows to wear gloves and protective gowns when working with a resident on contact precautions, and he wasn't aware the woman had scabies to begin with AFTER she was diagnosed by the Derm guy. To answer the first reply I had, I really don't know anything about the resident, as I'm not a nurse in that wing. My understanding is she came from home and has had this condition for MONTHS w/o seeking tx.

Hope that clarifies things a little. Thanks again for all the replies and advice. I'm bombing the house today and treating the animals.

Again, Merry Christmas, Happy Hannukah, and Seasons Greetings to all!

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Specializes in Operating Room.

This should be considered a workmen's compensation issue because you missed work due to an illness/injury you received from your workplace. We had a similar issue in our hospital due to paint thinner fumes coming through the vents, and several people got very sick(breathing problems, nausea etc) They were paid for their days off-we are union though. Don't know if this makes a difference.

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Specializes in Med-Surg, Wound Care.
After the first resident was found to be infested, staff wasn't told that they needed to take precautions, and several CNA's, including my S/O, contracted them.

This is the key statement. ANY scabies outbreak requires that Occupational Health research and notify all who were in contact with the infected individual. If they chose not to do this, they are liable for the extension of exposure beyond the original contact group.

This is a workmans comp issue, and a State Board of Health violation!

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Specializes in LTC,Hospice/palliative care,acute care.

We've had 2 major outbreaks on our secure dementia units in the past 10 years.We have a policy now to cover not only the residents but the employees as well.First-I don't understand why the doc told you not to go to work.You apply the treatment in the afternoon/evening and shower 12 hours later in the am before work.We were never told to take off.I don't know what your OH doc is thinking..I'd talk to the don about that...Our workmen's comp kicks in after a certain number of days-I have never heard of anyone trying to get it for 1 or 2-that's what sick time is for..In your situation I think since you opted out of bennies you'll have to eat it.The nursing home has had to file a report with the state department of health regarding the outbreak.We also had to aggressively treat the residents,staff and their families numerous times before we were successful.It sounds like your don needs to do some research before everyone gets sent home.Also-wear long sleeves-most of us that contracted the buggers seemed to get it on our wrists and forearms first..As for skin scraping-it is very common to get a false negative result.A normal healthy person may only have 7 to 10 mites on their body and a scraping is just reliable.We learned that the hard way..In LTC when you have a confirmed case then you need to suspect it and treat accordingly..

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Specializes in Cardiac Telemetry, Emergency, SAFE.

As ktwlpn said above, Im not sure why they advised you to stay home from work.

My son had scabies (im guessing he picked it up at school) and proceeded to give it to my daughter and me. The doc wrote prescription for the three of us, but told us it wasnt necessary for my husband to have the cream unless he actually had the rash ( he didnt ). We cleaned this house as it had never been cleaned before, and I was able to go to work the very next day.

I specifically asked him about missing work, and once that cream is on you, there is no reason for you not to be able to go back to work.

Good Luck... ( I do think you should be paid though, if the doctor is telling you to stay home!)

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