Exposed to MRSA resident

Nursing Students Technicians

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The LPN on duty told me at the end of my shift that test results regarding one of our residents was MRSA positive. I have been working with her occasionally over the past few months (including TODAY), and don't know how long she's had it. I always wear gloves while providing care...but I came home from work today and just cried my eyes out. I had no additional protective gear and we are instructed to take gloves off BEFORE leaving the residents room. I'm going to be tested tomorrow. This whole thing has me reconsidering becoming a nurse.

Specializes in Pedi.
I definitely need some sort of wake up call about nursing if it is typical for a serious concern about contagious bacteria to be seen as irrational, as my manager made me feel.

Your level of concern/alarm is simply not warranted. That's what your manager and everyone in this thread is trying to tell you. There is no need to cry your eyes out or quit your job because you may have been exposed to MRSA. We've all been exposed and will all continue to be exposed throughout our careers. I agree that MRSA contained to the urine doesn't necessarily warrant contact precautions. If the patient was restricted to her own private bathroom and she/everyone was instructed on proper hand hygiene, that should be sufficient to prevent the spread. The hospital I worked at generally put all patients with MRSA regardless of where it was isolated on contact precautions but not everywhere does.

Are you sure the patient's specimen was specifically sent to be tested for MRSA? I've never heard of sending off a urine culture specifically as a MRSA culture. Blood or sputum either though MRSA can be present in all of the above. Usually urine cultures are just sent as a culture and sensitivity, the lab tests to see if bacteria are present and then further identifies the species and the drug sensitivities.

Staphylococcus aureus is normal skin flora. It's there on you already. Living peacefully in your skin, hair, throat... It is only a problem when your immune system is low and it overgrows in a wound, in your bladder, in your trachea, etc.

MRSA is Staphylococcus aureus that has developed a resistance to methicillin (a penicillin-type antibiotic) and thus many antibiotics that work the same way as penicillin. It also lives peacefully in your skin, hair, throat, etc... It is also only a problem when your immune system is low and it overgrows in a wound, in your bladder, in your trachea, etc.

If you work in healthcare, you are most likely colonized. It's not really a problem. Don't pick your nose and rub it on stuff. Wash your hands often (you're supposed to anyway).

As a nurse, you will be exposed to germs. I thought that was kind of like universal knowledge. People with normally functioning immune systems will be fine. Patients come in positive for stuff (MRSA, MRSE, VRE, flu, herpes, TB, contagious meningitis) before we know it and put them on precautions, so every patient is a potential exposure whether or not they have a sign on the door.

We aren't all dropping like flies with our MRSA-filled noses...

Thank you for your explanation and advice. Transitioning into healthcare is difficult for me because I have always been so careful with my own health. I have come to my senses after the brief:rolleyes: panic attack.

Your level of concern/alarm is simply not warranted. That's what your manager and everyone in this thread is trying to tell you. There is no need to cry your eyes out or quit your job because you may have been exposed to MRSA. We've all been exposed and will all continue to be exposed throughout our careers. I agree that MRSA contained to the urine doesn't necessarily warrant contact precautions. If the patient was restricted to her own private bathroom and she/everyone was instructed on proper hand hygiene, that should be sufficient to prevent the spread. The hospital I worked at generally put all patients with MRSA regardless of where it was isolated on contact precautions but not everywhere does.

Are you sure the patient's specimen was specifically sent to be tested for MRSA? I've never heard of sending off a urine culture specifically as a MRSA culture. Blood or sputum either though MRSA can be present in all of the above. Usually urine cultures are just sent as a culture and sensitivity, the lab tests to see if bacteria are present and then further identifies the species and the drug sensitivities.

She had a UTI, which I was aware of for a couple weeks now. The antibiotics she was on did not solve the issue, so they sent a sample of her urine to be tested for MRSA (RCA's never informed of this). After __ days, her results came back positive, and then the precautions were taken. All I know about the series of events is what I have been told. And perhaps contact precautions would not need to be implemented in most cases with a UTI, but the resident is at least 85 years old and incontinent with bathroom and dressing assistance typically required.

Me resigning was not so much about being exposed to MRSA as it was not having any idea about her being suspected and currently tested for it, and me providing the care without additional precautions to protect myself because of it. It's not like I said "Oh no, there's a resident with MRSA, I quit". Believe me, I wrote a page and a half resignation letter adressing a number of concerns.

Specializes in Pedi.
Believe me, I wrote a page and a half resignation letter adressing a number of concerns.

This is a generally unwise thing to do. You never want to burn your bridges with a past employer. Resignation letters should simply say that you are resigning, when your last day of employment will be, offer to help with the transition and thank your employer for the opportunity.

Specializes in Emergency Nursing.

What will you do when you have a tubuculosis patient that wasn't tested or put in a negative airflow room for their first 2 days of their hospital stay only to find out they have tested positive for TB? If you think simple ole MRSA is scary just wait until that happens because it will eventually If you decide to stick around healthcare long enough.

This is a generally unwise thing to do.

In most cases, I understand why that would be. I judged the situation, and thought it was very appropriate to explain thoroughly why, after only 4 months of employment, I was resigning. Especially since most of the time I will just smile and say everything is fine when I do not feel it is. That's just how I am.

Anyway, my manager called me into her office when she got the email to discuss it. She thanked me for being open and honest, and that everything I said had valid reasoning. I was also offered to reconsider my resignation if I choose, as well as a manager from a different department offering me a transfer.

It went better than I thought it would.

What will you do when you have a tubuculosis patient that wasn't tested or put in a negative airflow room for their first 2 days of their hospital stay only to find out they have tested positive for TB? If you think simple ole MRSA is scary just wait until that happens because it will eventually If you decide to stick around healthcare long enough.

If I am understand correctly, you are referring to this as something that will most likely happen.

What if a meteor comes barreling toward my house at this very moment and strikes me dead?

Well, there would be nothing I can do about it. I would simply be dead. Just as if a patient with TB was not put on precautions and I was exposed, nothing more could be done on my part. After the exposure had already happened, I would expect the hospital to then use precautions. Which as I have explained before, was not the case at my workplace. No precautions were taken and we were not adequately informed when there was knowledge of her MRSA.

Yeah, I went home and cried when I was exposed to MRSA. Four months into my first healthcare position, which I am taking concurrently with a microbiology course, and just so happened to be studying antibiotic resistance and why it is such a problem in healthcare. Everything is situational.

Specializes in Critical Care.

We aren't all dropping like flies with our MRSA-filled noses...

:roflmao:

the snark. this made me chuckle

Specializes in Neonatal Nurse Practitioner.
:roflmao:

the snark. this made me chuckle

Yes. I've had lots of practice. I just need to remember to sprinkle in some emojis so people don't read my tone as aggressive or rude.

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