Do Doctors know what Isolation precautions mean??

  1. I am a student nurse,and I've had a few situations with isolation precautions and doctors that concern me. 1st situation was a 11 yr. old ped. pt. with osteosarcoma with mets to the chest wall. He had had finished chemo/radiation 1 week ago and was now admitted for fever unknown orgin. Labs showed WBC .4, Platelets 5, etc.. Of course this pt. was on isolation. When the Dr. came in he didn't even wash his hands- NO gown, NO gloves. As a student nurse- I felt this dr. was jeopardizing this pt. and didn't know how to handle the situation, so I said nothing. Now, today I had a pt. with MRSA and Psuedamonas on isolation. A surgeon came in for a quick consult and he did gown/glove, but after he finished with the pt. he asked me (a student nurse) how he was suppossed to take his gown/gloves off and wash his hands without contaminating things! I wanted to ask him- what are you going to do when you do surgery on this pt. in 2 days?!? Any comments/suggestions on this kind of a scenario?
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  2. 12 Comments

  3. by   unknown99
    Most doctors where I work chose to ignore the isolation precautions.Our hospital has made it a standard order now instead of needing a physician order. The docs hate it. But, most of them do not comply with it anyway.
  4. by   Marie_LPN, RN
    Ticks me off how i'd get my butt chewed for that, and they don't. I'm no more immune to carrying something out or in than they are.
  5. by   nekhismom
    OUr docs just tend not to TOUCH the patients if they don't have to, thereby avoiding all isolation precautions altogether. They'd rather just peek at the kid over the edge of the crib or through the isolette than touch the kids.
  6. by   caroladybelle
    The question is not that they know what the isolation precautions are but whether THEY CARE about the precautions.

    And the answer in most cases is a BIG NO!!!!!!!
  7. by   Noney
    Amazingly enough we have a couple of doc's that are very good about isol. precautions and get upset when they see anyone else not following guidelines. I think rationalizing that the problem is only md makes us feel better about nursing, but we all know that some nurses and cna's don't follow the rules very well also.

    Noney
  8. by   fergus51
    They need to be talked to. I find a simple "do you want me to pass you a gown and gloves?" often does wonders. We are living post SARS here, so people tend to be pretty good about following precautions.
  9. by   Jamesdotter
    I see things haven't changed much! In then early 70's, I was working on a post-partum unit that had no running water in the patient rooms (a situation that was later changed). The head nurse put basins of antiseptic soln in the halls for the docs to use during rounds. The basins were as pristine after rounds as they were when she put them out. NO ONE used them.
  10. by   LuLu123NY
    Quote from Christean
    I am a student nurse,and I've had a few situations with isolation precautions and doctors that concern me. 1st situation was a 11 yr. old ped. pt. with osteosarcoma with mets to the chest wall. He had had finished chemo/radiation 1 week ago and was now admitted for fever unknown orgin. Labs showed WBC .4, Platelets 5, etc.. Of course this pt. was on isolation. When the Dr. came in he didn't even wash his hands- NO gown, NO gloves. As a student nurse- I felt this dr. was jeopardizing this pt. and didn't know how to handle the situation, so I said nothing. Now, today I had a pt. with MRSA and Psuedamonas on isolation. A surgeon came in for a quick consult and he did gown/glove, but after he finished with the pt. he asked me (a student nurse) how he was suppossed to take his gown/gloves off and wash his hands without contaminating things! I wanted to ask him- what are you going to do when you do surgery on this pt. in 2 days?!? Any comments/suggestions on this kind of a scenario?
    ** In our hospital, the nurses put a pt on isolation usually before the docs know the labs came back positive, warranting isolation precautions. Often, there are covering docs who did not know the labs came back and per nursing judgement and hosp policy, the pt is on isolation. They usually don't read the isolation notice posted outside the door for kinds of precautions. It is easier for them to ask a nurse then to look up the labs or look in the chart. Since bedside care is not their area of expertise( unless an infection control doc), they tend to ask the nurses what to do. Frankly, I'd rather have them ask us than to assume they know aseptic technique in isolation cases. Nothing more frustrating than to chase a doc who does not follow policy and puts other pts at risk. Get used to contending with egos and stand firm for advocating for pt safety even if it means ruffling feathers. LuLu
  11. by   ProfRN4
    :angryfire :angryfire :angryfire One of the units I work on is always an isolation unit, every patient (transplant). Regerdless of their counts, until the day they leave. This is due to previous questionable cross contamination by staff. Funny thing is, we're the only ones (Nurses and Aides) who have to abide by certain rules: we need to change into uniforms and shoes at work, and we need to cover ourselves with a gown or labcoat when we leave the unit. This ticks me off b/c the MDs, social work, child life, and anyone who floats to the unit obviously doesn't have to abide by this. Everyone needs to gown and glove, which is still a problem with most docyors- most of all SURGERY!! It's a small unit, so we can see what they're (not) doing, and we don't miss them, so we can always remind them before they go in. On regular floors, most don't even wash their hands. It's ridiculous
  12. by   student80
    Some of the doctors at the hospital where I am are exactly the same as described here, however I've seen consultants who tell the patient that they don't want to see their wound etc so they don't over expose it, or simply check that the nurses are currently happy with everything. I was quite impressed by them as he also stated that he could be carrying anything on his clothes! Hope I see more like him in the future!
  13. by   ladylynx
    Quote from Christean
    I am a student nurse,and I've had a few situations with isolation precautions and doctors that concern me. 1st situation was a 11 yr. old ped. pt. with osteosarcoma with mets to the chest wall. He had had finished chemo/radiation 1 week ago and was now admitted for fever unknown orgin. Labs showed WBC .4, Platelets 5, etc.. Of course this pt. was on isolation. When the Dr. came in he didn't even wash his hands- NO gown, NO gloves. As a student nurse- I felt this dr. was jeopardizing this pt. and didn't know how to handle the situation, so I said nothing. Now, today I had a pt. with MRSA and Psuedamonas on isolation. A surgeon came in for a quick consult and he did gown/glove, but after he finished with the pt. he asked me (a student nurse) how he was suppossed to take his gown/gloves off and wash his hands without contaminating things! I wanted to ask him- what are you going to do when you do surgery on this pt. in 2 days?!? Any comments/suggestions on this kind of a scenario?
    In one of the hospitals I worked in, C-Diff was rampant so we started reporting even the Dr.'s that did not follow protocol. I found that in most facilities I have worked in, the Infectious Disease departments are very serious about their jobs and often want to know (we often joke about them being anal). So they are a very good resource for reporting to, even anonymously. When C-Diff showed up with a new Mom, everyone got serious.

    If that doesn't work you always have the famous, "Ethics Compliance hotline".
  14. by   Mammy1111
    My father died this month of HA MRSA pneumonia. In his hospital they did NO SCREENING cultures, inconsistant precautions, Isolation only after MRSA diagnosis..which was 8 days into my fathers second hospitalization. He was given his infection at the same hospital during a 12 day stay for rehab for a minor fracture.
    Doctors comments on Precautions were..."it's a nursing thing". "MRSA happens and there just isn't much you can do about it" "Let's face it. if you have worked in health care you are most likely colonized yourself". All of these comments are incredibly ignorant and irresponsible.
    When they get State mandates, the picture will change. I have written a proposal for just that in the State of Maine.

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