Coronavirus questions for home care

Published

Specializes in Private Duty Pediatrics.

I work private duty home care. Our city has not yet had any coronavirus cases. These are the questions I have put to my agencies:


What kind of PPE is available if we have a client diagnosed with coronavirus?

How many masks and gloves are available? Any N 95s?

How long do the droplets stay in the air after a cough? Does nebulizing a medication cause it to stay in the air longer?

When a client with coronavirus gets Xopenex per nebulizer, what kind of PPE should we be wearing? We have to be right there with the client - 6 feet away isn't possible when suctioning.

What is the policy for isolation when a client has coronavirus? Keeping the client in their bedroom helps, but I'm referring to the nurses. Do we go home at the end of the shift? What about our families? Do THEY have to then stay at home (self-isolate)?

I normally wash my hands when I get home, grab a clean shirt, wash at least my hands, arms, and face, and put on a clean shirt. Maybe I'll start changing my slacks, too. Is this sufficient for coronavirus?

So, are there any other questions I should be asking?

Up Vote Up Vote ×
Specializes in NICU, PICU, Transport, L&D, Hospice.

Fortunately, home care patients are already isolated within their homes and communities by their health condition...making them less likely to be a risk to you and more likely to be vulnerable because of visitors. COVID 19 patients self quarantined shouldn't need nursing visits.

3
Up Vote Up Vote ×
Specializes in Private Duty Pediatrics.

I work private duty, 8 to 12 hours at a time, with medically fragile kids. They need a nurse or a parent with them at all times.

1
Up Vote Up Vote ×
Specializes in NICU, PICU, Transport, L&D, Hospice.
8 minutes ago, Kitiger said:

I work private duty, 8 to 12 hours at a time, with medically fragile kids. They need a nurse or a parent with them at all times.

Your patient's greatest risk are the people coming into the home to provide care or equipment maintenance...right?

2
Up Vote Up Vote ×

My agency employer has sent all employees two emails to date basically stating that the company "has a plan" and that department heads are hashing out "the plan" and they will keep us informed. Other than that, which is actually nothing, we field nurses, are discussing the matter with our client families, and taking measures to increase infection control on our own in the meantime.

4
Up Vote Up Vote ×
Specializes in Private Duty Pediatrics.
54 minutes ago, toomuchbaloney said:

Your patient's greatest risk are the people coming into the home to provide care or equipment maintenance...right?

Exhausted parents are also an infection risk. In some cases, it's a single parent who MUST sleep sometime.

40 minutes ago, caliotter3 said:

My agency employer has sent all employees two emails to date basically stating that the company "has a plan" and that department heads are hashing out "the plan" and they will keep us informed. Other than that, which is actually nothing, we field nurses, are discussing the matter with our client families, and taking measures to increase infection control on our own in the meantime.

I sent my question list to my two agencies. Let's see if I get any answers . . .

1
Up Vote Up Vote ×

Your supervisor and manager might make an honest effort to answer your questions or steer you to the answers, but chances are high that you might also get their version of beating around the bush. How do they act about day to days matters? Are they like some, who tell you they will tend to a matter and then you never get a response back? That probably predicts how they will act.

2
Up Vote Up Vote ×
Specializes in NICU, PICU, Transport, L&D, Hospice.
7 hours ago, Kitiger said:

Exhausted parents are also an infection risk. In some cases, it's a single parent who MUST sleep sometime.

I sent my question list to my two agencies. Let's see if I get any answers . . .

Yes. Caregivers are the risk for the homebound patient and they are often parents or other family.

1
Up Vote Up Vote ×
Specializes in Private Duty Pediatrics.

The supervisor at one agency told me she was researching it and would get back with me soon.

The supervisor at the other agency said we can make homemade hand sanitizer using alcohol and aloe. She said they have N 95 masks that they will bring out if one of our clients becomes infected with Covid 19. She also said that if one of our clients comes down with it, we are not to go to that house. If the parents cannot take care of their child, they will have to let him/her go to the hospital.

I don't get it. We are to only use the masks if the client is infected but we are not to take care of the client if they are infected. ?

Another thing. The agency cannot tell the client if the nurse has to self-isolate; they can only say that the nurse is unavailable. And they cannot tell the nurse if the client is infected; they can only tell us that we are not needed on that case right now. HIPAA??

That's all I have so far, just more confusion.

1
Up Vote Up Vote ×
42 minutes ago, toomuchbaloney said:

Yes. Caregivers are the risk for the homebound patient and they are often parents or other family.

If I read the question correctly, it was really about our risk as nurses of becoming infected. And what the plan is. Not how the patient is going to get sick. Which of course would be by caregivers. I work 12 hour shifts 3 days a week with my vent patient. He has 7 other nurses, a wife and 2 adult children, and 2 frequent visitors. That's more interaction with people than I get. If he got it from one of the other nurses, or family then I am at risk. I for one would like to know my company's answers to these questions. As it is, they are not exactly compliant with PPE.

- My patient's vent blows right out at me.

- I frequently suction him. Due to PPE compliance issues, I've a few times walked in only to find we had no gloves, and I had to REUSE. ?(I will be buying my own.)

- He refuses Robinul so his secretions squirt out of his mouth all over me.

AND...He DID get me sick. His symptoms started Friday, mine started yesterday. Could be a coincidence, but with the conditions I described, what would you bet on?

1
Up Vote Up Vote ×
Specializes in Private Duty Pediatrics.
3 minutes ago, Orion81RN said:

If I read the question correctly, it was really about our risk as nurses of becoming infected. And what the plan is. Not how the patient is going to get sick. Which of course would be by caregivers.

Exactly

I always have at least some gloves with me, enough to get me through the shift if necessary. Same with hand sanitizer and masks. (I have procedure masks - the ear-loop type). The supervisor at one of my agencies firmly said that these masks are useless against COVID 19. I figure something that keeps most of the spray out is at least helpful. I know that they don't keep it all out.

Is it not reasonable to say that infection is more likely from a spray to the face?

1
Up Vote Up Vote ×
20 minutes ago, Kitiger said:

Another thing. The agency cannot tell the client if the nurse has to self-isolate; they can only say that the nurse is unavailable. And they cannot tell the nurse if the client is infected; they can only tell us that we are not needed on that case right now. HIPAA??

Maybe I should post this under HIPAA, but, I'm curious. On the surface, this makes sense. BUT... HIPAA is based on need to know. Don't I need to know if I were exposed to the virus/disease? Wouldn't the patient need to know if they were exposed to it?

1
Up Vote Up Vote ×
+ Join the Discussion