MRSA please help

[nursex20]

I need everything you know about MRSA.

I was called this week by a coworker and friend who has been sick lately and just learned she is MRSA positive ( a carrier).

She and I worked together on a case that I was on for over a year.

She called as a friend thinking that I might want to know that she tested positive (I did).

She called as a nurse who had lost the rest of her team to ask if I remembered when the diagnosis was made because she heard it from the mom but it was nowhere on the home chart or POC.

She is still on the case and I am with a new baby.

I replied that MRSA was never diagnosed in the time I worked there and it was never on a POC prior to her starting the case. We would certainly have told her.

I called the agency DON and asked why we did not have Lab work included in our home charts and what we were supposed to do to protect ourselves without correct information or protective gear.

I have heard from up my chain of command so far that

"90% of all nurses have colonized MRSA in their noses".

"40 percent of the population are carriers of MRSA, no big deal"

"We are in HIPPA violation for discussing this and should have let the agency handle it by calling us". The original nurse did report to her case manager (whose job it is to keep POC updated).

The DON of agency is saying that just gloves and handwashing are sufficient precaution for trach. colonized MRSA but she has a call in to the CDC to see what is required.

So, from that one phone call I am hearing that in the days since they have known about the first nurse testing positive the primary concern of the agency is to contact CDC and see what they are liable for.

????????

Thanks for the call to warn me and all the other nurses that we might want to get tested.

I have never NOT felt safe in home health simply because I have always known my babies and their histories and work on average of 1-2 years with each case. This really sux though. I am more angry I think that the agency doesn't care more about us in the field. The DON actually asked me if I could afford the HIPPA fine for talking to my co-worker about this since I was no longer on that particular case.

My Doctor fit me in at 9 this morning and ordered chest x-ray, CBC, UA with culture and did a throat culture. I just finished all that and now am worried because the other nurse had her nares cultured but he did my throat. I am getting such mixed information and being made to feel like a bad nurse for being worried about my own health.

The other nurse is on isolation with Hibiclens showers X5days, Doxy, Bactroban swabs to the nares X5 weeks. After the 5 day isolation and Doxy she may return to the outside world and continue meds until reswabbing in 5 weeks or so. Her doctor is certainly not taking it lightly and doesn't think it's ok for her to just be a "carrier".

What experience does anybody have in Hospital and other settings with dealing with MRSA?

I think we are getting swept under the rug here because the agency in question is

a) worried about their own OSHA violations and

b) getting flack from the mom involved because nurses have refused to go back out on the case without masks, gowns and OSHA compliant protective gear as well as family compliance with isolation techniques when baby has

[btraveler]

I am a critical care RN and several months ago ended up with MRSA. It started out like a zit on the back of my neck and then it got infected and the MD called in a boil. I ended up having an I & D on it and it came back positive for MRSA-my doctor stated that 90% of all skin infections are staph infections. So I was treated with bactroban in the nares x 5 days and clindamycin. Several months later I got another skin leasion on my abdomen-I was really frustrated....all along I thought I got it from work, but it turns out I got from the gym I worked out in.

I talked with an infection disease nurse and she stated once you have MRSA it's very common to get it again. She also stated that when someone is under alot of stress, there immune systems are almost as low as what an AIDS pt's immune system is....THAT'S CRAZY AND VERY SCARY!

I too was a carrier of it and using the bactroban cleared me of it. The hospital would not let me return to work until I tested negative: skin and nares.

[ICRN2008, BSN, RN]

MRSA is everywhere, not just in patient care environments. In fact, the Community-Acquired MRSA strains are typically more pathogenic than the hospital-acquired strains because of an additional virulence genes such as pvl. Fortunately, most are still susceptible to bactrim and clindamycin.

http://www.uwlax.edu/urc/JUR-online/PDF/2005/moore.pdf

http://en.wikipedia.org/wiki/Panton-Valentine_leukocidin

Colonization rates are high among a variety of groups, including health care workers, young children, incarcerated persons, residents of LTC facilities and MSM (men who have sex with men). Outbreaks have been described among athletes, prisoners and other groups who have close contact without the benefit of stringent hygeine standards.

It became a joke at my hospital every time we had another admission of a young child for a MRSA abscess in the perineal area "Another butt abscess- not mine!" or "At least I'm not here tomorrow so I don't have to pull out the packing".

I wish to emphasize that "Direct or indirect exposure to an institutional health-care setting in which MRSA is likely to be found and other risk factors typically associated with MRSA colonization are strikingly absent from the recently described cases in which MRSA seems to have been acquired from a community reservoir"

Source: http://www.medscape.com/viewarticle/414383

To make the assumption that having one co-worker who tested MRSA positive means that the rest of his/her collegues need to be informed and tested is not epidemiologically sound. That being said, I empathize with the fact that this situation has caused you so much worry.

[nikhay20]

I have recently developed a MRSA infection that was next to my Left eye. It began as a red bump and turned into a abscess. That thing hurt so bad. I was placed on bactrim. I am a WOCN nurse. (Wound, Ostomy and Continence) I am constantly working with patients who have MRSA in their wounds and follow strict handwashing and infection control. I have had several cases where I see patients who are not diganosed when I intially see them but when I have a follow-up they are now in isolation for MRSA. I have not been able to return to work because my work requires 3 negative cultures and I have not been able to get 3 negatives yet. I have been out of work for a month because of this. I began Bactroban and hoping this will help. I have only been at my job for 3 months. I have been terminated due to their policy because I only have 2 weeks of short term disability. Workers comp was denied of course because I cannot prove it. I am told I can reapply for my job once I have 3 negative cultures. I was wondering if anyone knows of any protection for nurses out there who acquire MRSA. I have found that California association of nurses is acting on this. I live in Pennsylvania and have not been able to find anything for my state. It is very scary to find out that there is no protection for me and that I have lost my job over this.I never in a million years thought I could get terminated for something like this. I am worried about this happening again. I am a healthy 31 year old with no medical history and never thought something like this could happen to me. I just recently got back into direct patient care and its scary out there. Any input would be greatly appreciated. If anyone knows of any cases that were won. I am seeking to appeal my workers comp and seeking an attorney. I can only find articles for protection of patients which is great but what about protection for the healthcare workers?

[bunsterj]

btraveler...how was it determined where you acquired the MRSA? You said you acquired it from the gym and not from work.

Thanks.