Bed Bugs

[84RN]

I did a start of care today, and the referral said "rash" on a wheelchair-bound patient. When I got there, she showed me the areas, and they were definitely bites, and then she had a ziplock baggie with dead bugs inside that she'd picked off of her sheets. I told her she'd need to call an exterminator asap, and called the physician from the home, asking what she could use for the bites, and he said to use Kwell otc, plus some caladryl for the itchy bites.

The house was extremely cluttered, not quite as bad as the tv show Hoarders, but piles of stuff on every possible surface, but there was a pathway. I had to clear off the end of the kitchen table in order to sit and do paperwork with the patient. I kept my bag closed except to get out my bp cuff, thermometer and stethescope, then put them back into the dirty side. Went straight home, put all of my clothes into a hot water wash and showered. My shoes are still by the front door, as is my bag, and I sprayed them with Raid.

How likely is it that I've brought the bed bugs into my house? The reason I'm asking is because I just started to go to bed, and felt something on me, turned on the light and there was a tiny crawling bug on my shoulder, but not sure it was a bed bug. I scared my husband to death because he was already asleep and I yelled and jumped up, looking through the sheets (I'd only been in the bed maybe 5 min at most and hadn't been near it since the morning). I put my pillows in the dryer on high heat, and took another shower and am washing my pillow cases, pj's and clothes I had on after showering this afternoon. I also vacuumed the sheets and bed as well as I could and my desk area and chair where I sat finishing some paperwork from this start earlier this evening.

When I called in report, my clinical manager said that we'd have to have a certificate from an exterminator before entering the home again, but I really don't want to go in there again, even if they say the bugs are gone. The woman has 3 dogs and mulitple birds and the smell is just awful, plus the overwhelming clutter and stuff everywhere. Can I refuse to go into a home for these reasons?

[SummitRN, BSN, RN]

I'd go to a public laundry matt and a fitness center for showers. If you get them in your home, don't think that your work is going to pay the thousands of dollars for repeat exterminator visits that may or may not be successful, or for the things you have to throw away.

The only reason DDT hasn't been relegalized in the USA to kill these invincible pests is that they are not a disease vector.

[caliotter3]

I am surprised that they said they would require the certificate from the exterminator. Of course you can refuse, but the employer may not like that. If all nurses refuse, they would lose the case, and they probably don't want to lose the business. Then, on the other hand, they may discharge the patient anyway. Depends on their need for that case.

[Candyn]

I feel your heart. I found a bed bug in one of my patients and now I am paranoid everytime there is a crawling feeling on my body...the thing about them is they are hard to get rid off;(