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
Inform your chain of command that HIPPA does not apply to every health care information situation in the world. It specifically does not apply to the following: Work Place Exposures, Injuries, Hazardous Material Incidents regulated under the community right to know act (SARA, Title II), and those rights covered under the Federal Whistle Blower Rights Acts. I could list a whole page of what HIPPA does not cover and the liability the average nurse has for preventing care by wrongly using HIPPA.
I did do a little research on the following statements: "90% of all nurses have colonized MRSA in their noses". "40 percent of the population are carriers of MRSA, no big deal" Because you specifically mentioned the Center's for Disease Control I went to their website and drilled own in their publications and discovered that what they define a community carrier as is: "Community acquisition was associated with recent hospitalization, previous antibiotic therapy, nursing home residence, and intravenous drug use." 1: Infect Control Hosp Epidemiol. 1995 Jan;16(1):12-7. http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract
Please note this is a ten year old definition. I cannot find any prospective studies of healthy nurses or of general population of MRSA rates. So the first two statements are not supported at this time.
So what would I do to cover myself professionally and medically?
1. Throw the HIPPA crap back in your manager's face in a professional manner.
2. Another mechanism to move around the HIPPA and notification issues is to give your employer a written release and instruct the employer to notify my co-workers that I have an infectious disease and I want my co-workers notified in order to seek preventive and/or treatment ASAP. I would ask your co-worker who is sick to do this. This will begin to get both of you off of the HIPPA block. Do not rely on your employer to send out the letters you may want to send your own out to your co-workers.
3. File worker's compensation due to exposure of an occupational infectious disease. The cost of the medical surveillance should be covered by your employer. Medical surveillance should have begun before your placement, during and after.
I would be interested in hearing how your employer reacts when you point out this is outside of HIPPA.
Last edit by Sharon on Mar 28, '05