Ever take care of a patient for a while to later find out...

[wanderingRound]

They had some sort of disease/illness you could have transmitted from them but nobody realized they had the condition until later on?

I had a patient from prison this last week and I took care of him for a total of 6 nights (12 hour shifts) to find out on my last night that the day nurse looked at the results of his sputum culture and saw he has respiratory MRSA. He had really been coughing pretty badly for the past few nights which makes me paranoid about the whole situation. Myself and the CNAs who had been caring for him are frustrated about it and wish we would have known sooner, especially since many of us have small children at home.

The sputum culture was taken from the day of 5/17 and no one realized he had respiratory MRSA until the morning of 5/20 and at that point he was placed in airborne isolation. I know it can take a couple days for cultures to come back, but I'm guessing the results were back for atleast a day without anyone checking the microbiology report to see what type of culture was growing. Could this place the nurses that were caring for him who should have checked the report (and subsequently initiated isolation precautions) under any liability if someone were to be infected with respiratory MRSA and push the case?

[salsa12]

Are you thinking of suing?

[wanderingRound]

No, but I'm one of the nurses who took care of him and could have overlooked the microbiology results which resulted in an extra day(s) he could have been in isolation.

[NurseCherish]

Yep, that happens all of the time, unfortnately.

[wanderingRound]

What happens all the time... getting sued for something like that, or taking care of patients and later finding out they had something nasty?

[mappers]

Our micro department calls us with any positive cultures, so the nurse who has the patient that day would know. Then we are supposed to call the doctors. They'll call us with preliminary results and with final results.

And, since the surveyors are due any day, our IC people are all over the place checking for isolation.

[BellaInBlueScrubsRN]

Was told to move a pt to a neg pressure room as a student. No protection on me or the pt. Later someone put air precaution note on the door. Probable TB.

[salsa12]

Unfortunately, it sometimes takes days to get cultures and/or pathology reports back to even be read. So, the nurse doesn't happen to catch it immediately-what is one more day, I guess? I've taken care of more patients than I can remember who suddenly were put on iso after I had had them while they were not in iso. These are patients that tested positive for MRSA, C-Diff, H1N1, TB...I think I've been exposed at one time or another to all of it. I just try to keep my hands clean and not do anything too unsanitary. There's a lot of folks out in the world who are carriers, too.

[BittyBabyGrower, MSN, RN]

It happens a lot....and the person sitting next to you at the theater could have some crud too, think about that lol You just have to use universal precautions and be aware. You can't isolate everyone until their cultures come back. I'd be more worried about TB than MRSA IMHO.

[Nurse_Hagatha]

Shouldn't the patient have been put on isolation precautions for ruling out MRSA in the sputum?

[wanderingRound]

They were checking sputum because they were trying to figure out why his WBC count was in the 20's, not trying to rule out MRSA.

[GilaRRT]

Shouldn't the patient have been put on isolation precautions for ruling out MRSA in the sputum?

Perhaps is was not initially suspected, and a "routine" sputum C&S was ordered only to find it out after the sensitivity was completed. A Gram stain will ID Gram positive organisms but not the presence of a drug resistant bacteria. This occurs all the time. People are routinely worked up for pneumonia in the ER or upon admit, only to find out that pneumonia, cough, or dyspnea is related to or caused by a really nasty Billy Rey Bug.