OK, I haven't been a nurse forever, but it sure feels like it. Especially when a new resident comes to me complaining about a "rash" she's had for over a year despite multiple trips to her primary care physician, a pharmacy's worth of ointments and pills and anti-itch creams, and now a referral to a dermatologist whom she can't even get in to see until May. She even saw her PCP last Tuesday, and he apparently told her she has to "live with it" till she can get in to the skin doc.
I took one look at it and went She has, literally, at least fifty "spider-bite" lesions in various stages all over her legs, arms, back, and abdomen. Several of them have yellowish exudate and look infected, while others are obviously older and have the characteristic reddish-black craters in the middle..........and if it's not MRSA, I'll eat my nursing cap!! This poor woman is 96 years old, still fairly sharp mentally but she's no bigger than a minute.........what I don't understand is why her PCP hasn't been able to diagnose it when I, a 'mere' nurse, can glance at it and know immediately what it is. I've seen way too much of this stuff not to recognize it; heck, I've had a couple of bouts with MRSA myself. How could an MD NOT catch this??
Luckily, the PCP was receptive to my urgent fax describing my findings ("please schedule an appointment ASAP"), but MRSA is so prevalent in the community now, it blows my mind that a medical doctor can miss it. So now I wonder: is it common for physicians not to recognize this infection? And if so, does this mean that community-based nurses need to start stripping new move-ins down to their skivvies and doing complete skin examinations?
I already know the answer to that last question........but I'm still shocked. And after fifteen years in health care, I'd thought I was pretty much un-shockable.:uhoh21:
Especially when a new resident comes to me complaining about a "rash" she's had for over a year despite multiple trips to her primary care physician, a pharmacy's worth of ointments and pills and anti-itch creams, and now a referral to a dermatologist whom she can't even get in to see until May. She even saw her PCP last Tuesday, and he apparently told her she has to "live with it" till she can get in to the skin doc.
She has, literally, at least fifty "spider-bite" lesions in various stages all over her legs, arms, back, and abdomen. Several of them have yellowish exudate and look infected, while others are obviously older and have the characteristic reddish-black craters in the middle..........and if it's not MRSA, I'll eat my nursing cap!! This poor woman is 96 years old, still fairly sharp mentally but she's no bigger than a minute.........what I don't understand is why her PCP hasn't been able to diagnose it when I, a 'mere' nurse, can glance at it and know immediately what it is. I've seen way too much of this stuff not to recognize it; heck, I've had a couple of bouts with MRSA myself. How could an MD NOT catch this??