I have a nurse friend who had surgery several weeks ago, and the wound is still weeping alot and hasn't healed, despite abx. The wound was cultured, and found to be MRSA positive. This nurse is in an OR setting for c-section deliveries, as well as working on the labor delivery floor. This nurse is now taking a MRSA drug (clindamycin, and will progress to vanc if needed), but continues to work-on a clean l/d unit as well as in the OR.
My questions:
1.) I know many health care professionals are MRSA positive, but doesn't having a weeping wound that has saturated your scrubs merit some sick time? It's hard for me to understand why she is putting her patients at risk. (And everything that I've read on MRSA states that it is ok to work, but only if the wound is covered and not weeping.)
2.) How do you disinfect a room after an MRSA patient leaves it? Furthermore, how does one disinfect their home after their MRSA weeping wound culture is negative? (ie Should we make a visit there to see her or not?)
3.) What should the rules be for mandatory sick time for a MRSA positive nurse?
She is not even in the same town or state as I am, so we are not working together. I'm left wondering if she isn't protecting her patients form MRSA, then would her home be "clean" for guests? I'm not sure that a simple discussion with her would work, as she would view it as a confrontation.
The reason I am thinking so deeply about this is that about two years ago, the l/d unit I work on had several post c/s patients return with MRSA infections, and Infection Control mega analyzed the situation and resulted in many many many preventive interventions for all staff. Such as wearing in street clothes, and changing into scrubs at work, as well as a more indepth post op prep.
If anyone has any ideas on this topic, please post.
I'm sure your friend is between a rock and a hard place.
I was discussing the MRSA issue with my manager the other day, cause we admitted a pt who three years ago has a wound with mrsa in it and we had to put her on contact precautions, despite the fact that the wound is totally healed. My manager said we had to do a nasal swab and get a negative result before we could take her off precautions.
I said to my manager, "Suppose they did nasal swabs of all the nurses here. I bet at least half of us would have positive swabs, yet we aren't isolated." She agreed.
The discussion went on and I said if the hospital started requiring that (and it actually looks like we are headed in that direction) that I could collect L&I since I would have gotten MRSA from my job and my manager said there is no way I could prove that and therefore I wouldn't qualify for L&I.9
I imagine your friend is in the same kind of predicament. Her wound is probably mrsa positive; she probably got the mrsa at the hospital, but has no way to prove it so they won't help her out, and she is probably out of sick time.
I mean, what else can a nurse do when she can't be a nurse anymore? The skills really don't translate to the rest of the work world. I always think about this in the context of if I screw up and lose my license. Really, what else could I do with my current skills?
Work in phone triage, case management, be a lecturer, plenty of other aspects of nursing, plus do an inventory of the tasks you perform regularly and you will see that you are qualified to do everything from wrestle grizzly bears to lock horns with crocodiles. Not to mention sit on a flagpole for a very long time without food, rest, or pee breaks. :chuckle
Seriously, we assess, we plan, we act, we re-assess. We manage the unmanageable, we deal with lazy, mouthy, paranoid, arrogant, disrespectful people all day long, we work without supplies, we document, we lift and turn, and communicate with the uncommunicatable, and so on. We know anatomy and physiology, we know norms and needs of each age group. As such, we can run day cares for kids or elders.
Plus, we are intelligent and can learn whole new fields, such as investing in the various financial markets, selling pharmaceuticals, real estate, loans, or medical supplies, or becoming teachers.
We are limited only by our imagination and by our degree of willingness to learn and do something new. I am looking forward to retirement, as I plan to start a 2nd career.
The dressing is not occlusive, and leaks.She noticed after a c-section that the dressing was saturated, as well as part of the scrubs. Not sure about the sick time, as she's been at the job for less than 2 years, and I don't know how much she has accrued or used.
Maybe she got splashed during the section - blood, saline, etc.
Vito Andolini
1,451 Posts
Work in phone triage, case management, be a lecturer, plenty of other aspects of nursing, plus do an inventory of the tasks you perform regularly and you will see that you are qualified to do everything from wrestle grizzly bears to lock horns with crocodiles. Not to mention sit on a flagpole for a very long time without food, rest, or pee breaks. :chuckle
Seriously, we assess, we plan, we act, we re-assess. We manage the unmanageable, we deal with lazy, mouthy, paranoid, arrogant, disrespectful people all day long, we work without supplies, we document, we lift and turn, and communicate with the uncommunicatable, and so on. We know anatomy and physiology, we know norms and needs of each age group. As such, we can run day cares for kids or elders.
Plus, we are intelligent and can learn whole new fields, such as investing in the various financial markets, selling pharmaceuticals, real estate, loans, or medical supplies, or becoming teachers.
We are limited only by our imagination and by our degree of willingness to learn and do something new. I am looking forward to retirement, as I plan to start a 2nd career.