COVID and Winter coats

Nurses COVID

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Specializes in Private Duty Pediatrics.

I'm a private duty nurse, home care. I posted this under Specialties/Private Duty, but I think I'll get more traffic here. MODS, is this OK?

Right now, I'm working in two homes, neither of which have COVID. I wear a KN95 mask all shift except when I eat. To eat, I go into another room, wash my hands, briefly remove my mask and quickly eat a piece of fruit and drink a bottle of Glucerna. Then the mask goes back on and I wash my hands.

How should I eat if there is COVID in the home? Same? I can't go outside while I'm responsible for the child. These kids have trachs, vents, and/or they choke easily on excess secretions.

Another question: with COVID in the home in the Winter, since I have to wear a Winter coat when it's cold outside, how do I keep the coat clean? Even if I wear a gown the entire shift - which is what my supervisor says would be required - how can I keep my coat from coronavirus contamination? I don't believe one gown for a 10-hour shift will fully protect me. When the weather was warmer, I figured I could simply throw an old sheet over the car seat, and take it in to wash each day. (We do a load of laundry every day, anyway, the sheet could go in with the work clothes.)

I have extra coats, so I could have a dedicated coat for each home. That way, maybe I could hang the coat up separately, in the basement?

What do you think? Am I being too careful? Not careful enough? 

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.

Those are tough questions and I don't know that there are specific evidence-based answers unfortunately.  I think a lot of common sense precautions would be your go to knowing that what's been driving the spread of infection is respiratory aerosols.

Personally, I would have a pair of work shoes in my trunk and switch to it when I park on the driveway. I would leave my Winter coat outside of the home. I would don a KN95 mask, a face shield, OR cap, gloves, and a washable/fabric gown when I enter the house and while providing care to these patients.  Agree with eating in another room of the house with mask and face shield off.

Before I leave the home at the doorway, I would remove the gown and place it in a plastic bag and throw the gloves away.  Gel my hands with alcohol sanitizer and then remove my face shield while keeping my mask and OR cap on. Then I would put on my Winter coat with the "reassurance" that my gown shielded my clothes from infectious aerosols.  I would open the trunk and put on my regular shoes after throwing my work shoes back in there and drive off.

At home, I would load the contents of the plastic bag of used gowns and OR caps in the washing machine with each daily use.  That's how I would approach this.

BTW, I have my own routine coming in and going home from an ICU shift.

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Specializes in Private Duty Pediatrics.

Thanks for your comments.

You would trust that the gown protected your clothes, but not that the coat would stay clean in the house, right? My agencies would provide me with a gown, but I'm guessing that it would be cheap disposable type. A cloth, washable gown sounds better. Maybe I should try to buy some cloth gowns for my own use. Any suggestions?

I'll ask my agencies about a hair covering - I doubt I can get my hands on OR caps. Since I wash my hair as soon as I get home, maybe a cap isn't needed?

I live where Winter is cold with lots of snow, so I would have to have a coat on to clean the car off enough to get in and put on my cold coat. Ditto for walking through the snow to get to my boots in the cold car.

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.

Oh just get fabric OR caps, there are many CNA's and nurses at work that sew them.  Our hospital started using washable fabric gowns. They are of a shiny nylon material that seem thick enough to prevent bleed through.  They do fill the dirty linen baskets quickly.

Our gowns look like this but not sure if it's exactly the same one: https://directtextilestore.com/Iso-Gowns?campaignid=6497370673&adgroupid=83636415488&creative=382012039879&matchtype=&network=g&device=c&keyword=ISOGOWNUNI&gclid=EAIaIQobChMIpP6xrZqD7QIV3x-tBh1xQgU0EAQYASABEgIip_D_BwE

Sorry, my idea of Winter is rainy days with 50 degree temperatures.

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I think you are overthinking the coat aspect.  I do cover head to toe in a Covid positive room.  My coat is separate in the locker room.  I brought an extra pair of scrubs with me for the ride home.  My dirty scrubs went in a trash bag to be washed in hot water.  I sprayed the bottom of my shoes with Lysol.  I shower as soon as I get home and don’t touch any of my family.

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Specializes in Dialysis.
1 hour ago, LovingLife123 said:

I think you are overthinking the coat aspect.  I do cover head to toe in a Covid positive room.  My coat is separate in the locker room.  I brought an extra pair of scrubs with me for the ride home.  My dirty scrubs went in a trash bag to be washed in hot water.  I sprayed the bottom of my shoes with Lysol.  I shower as soon as I get home and don’t touch any of my family.

If you are in home health/outpatient hospice, you don't get that luxury. You may be walking into a known, or unknown covid environment. Whole different ballgame

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1 minute ago, Hoosier_RN said:

If you are in home health/outpatient hospice, you don't get that luxury. You may be walking into a known, or unknown covid environment. Whole different ballgame

I understand that.  Was just giving some ideas on how to keep the coat separate and have a change of clothes.  Surely, they can keep Lysol in their car and spray their shoes.  Change in the garage, wash scrubs separately.  

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Specializes in Dialysis.
32 minutes ago, LovingLife123 said:

I understand that.  Was just giving some ideas on how to keep the coat separate and have a change of clothes.  Surely, they can keep Lysol in their car and spray their shoes.  Change in the garage, wash scrubs separately.  

But once you've worn that coat into someone's home, you take whatever germs are there with you. The car will then have whatever you bring in it. Depending on temp, coat removal outside the home isn't practical either (well meaning friends used to suggest, while I drove around in -teens to +teens weather).  Lysol in extremes of heat or cold isn't practical either, can in fact be dangerous. No easy answer for this situation

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Specializes in Private Duty Pediatrics.
18 minutes ago, Hoosier_RN said:

But once you've worn that coat into someone's home, you take whatever germs are there with you. The car will then have whatever you bring in it. Depending on temp, coat removal outside the home isn't practical either (well meaning friends used to suggest, while I drove around in -teens to +teens weather).  Lysol in extremes of heat or cold isn't practical either, can in fact be dangerous. No easy answer for this situation

That's where an old sheet over the car seat can help. It would come in to be washed with the work clothes daily. 

I say, "would be" because I haven't gone that far yet. I work with families who are very careful, because of their vulnerable family member. Now, with the cold and the fall surge in COVID, maybe I should step up my game?

50 minutes ago, LovingLife123 said:

I understand that.  Was just giving some ideas on how to keep the coat separate and have a change of clothes.  Surely, they can keep Lysol in their car and spray their shoes.  Change in the garage, wash scrubs separately.  

My shoes (and soon, boots) come off at the door when I get home.

In fact, I change my shoes when I arrive at work, too. The work shoes get washed with disinfecting cleaner (Fantastic, or Lysol-type) the night before and I carry them in. I know it sounds OCD, but I have home shoes, travel shoes (soon to be boots), and work shoes.

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Specializes in Dialysis.
13 minutes ago, Kitiger said:

That's where an old sheet over the car seat can help. It would come in to be washed with the work clothes daily. 

I say, "would be" because I haven't gone that far yet. I work with families who are very careful, because of their vulnerable family member. Now, with the cold and the fall surge in COVID, maybe I should step up my game?

My shoes (and soon, boots) come off at the door when I get home.

In fact, I change my shoes when I arrive at work, too. The work shoes get washed with disinfecting cleaner (Fantastic, or Lysol-type) the night before and I carry them in. I know it sounds OCD, but I have home shoes, travel shoes (soon to be boots), and work shoes.

I haven't done HH in years, and because of current situations, don't think that I'd want to now. Some homes that I went into, the sheet on the seat wouldn't have worked, we were advised to do that. Yes, the homes were that bad. As you know, you run into all types from all walks of life, in all parts of town

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5 hours ago, Hoosier_RN said:

But once you've worn that coat into someone's home, you take whatever germs are there with you. The car will then have whatever you bring in it. Depending on temp, coat removal outside the home isn't practical either (well meaning friends used to suggest, while I drove around in -teens to +teens weather).  Lysol in extremes of heat or cold isn't practical either, can in fact be dangerous. No easy answer for this situation

I don’t agree with that.  If the pt is Covid positive, and lives with other family members, they should be quarantined into one room.  Putting your coat in a different room would work.  Sometimes my coat goes in our report room on our unit.  It’s separate from the pt rooms but still on the same pod.  I don’t see why Lysol is dangerous?  Covid started in the Winter and went throughout the Summer here and I used it.  Why would spraying the bottom of your shoes be dangerous?  I also would sometimes spray my seats with it.  No issues.  Kept it in my nurse bag.

And I’m simply giving some ideas.  I’m not trying to argue.  Just some ways to maybe ease your mind.  

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Specializes in Dialysis.
48 minutes ago, LovingLife123 said:

I don’t agree with that.  If the pt is Covid positive, and lives with other family members, they should be quarantined into one room.  Putting your coat in a different room would work.  Sometimes my coat goes in our report room on our unit.  It’s separate from the pt rooms but still on the same pod.  I don’t see why Lysol is dangerous?  Covid started in the Winter and went throughout the Summer here and I used it.  Why would spraying the bottom of your shoes be dangerous?  I also would sometimes spray my seats with it.  No issues.  Kept it in my nurse bag.

And I’m simply giving some ideas.  I’m not trying to argue.  Just some ways to maybe ease your mind.  

Keeping a pressurized can in extreme temperatures can be dangerous. Says it right on the can. It can explode. Right now in the area where I live, because of covid, no work bags can go into homes, due to risk of germs. The nurse can only carry necessary items (pen, stethoscope, dressings, etc) with them. The last time I did HH, bed bugs were rampant in many homes, and the same rules became necessary to protect staff, so I totally get it from HH management perspective

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