First-semester students taking care of C. diff patients?

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I was under the impression that we as first-semester ADN students would not be "given" a known C. diff or TB patient, something very contagious and serious. Not that we're too good for it but we just don't know anything yet. Now our clinical instructor has indicated that we might indeed be given a C. diff patient. I'm kind of scared because a lady in our class had a child with C. diff and has described it as quite a horrible experience - including that it smelled so bad that the hospital had to clear out the doctors and patients from her child's wing. And that it was constant diarrhea.

I realize C. diff patients are people, too, and need attention in addition to their basic care, but - I'm afraid of what to do as far as spending a lot of time in a room with someone that contagious. I know, I know, wash hands and wear gloves, but it just seems like spending lots of time with someone would up the chances of catching something that contagious and resistant.

What do you guys think? Am I getting too worked up?

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I was caring for a patient who had c.diff during my first clinical. Its all apart of the grand experience. If you do indeed get one, follow the nurses lead, trust me...they don't want it either, so they'll protect themselves. I'd also take the opportunity to learn about c.diff so you are prepared for it. Good luck!

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Students WILL get C.Diff patients and students WILL do AM care. =) =) =) =) =)

Precautions are you best friend ... and washing your hands .. alot.

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Specializes in Pediatric Hem/Onc.

Take a deep breath and relax....because taking care of a C. diff patient isn't a big deal. C diff is spread by spores, so strict handwashing only and contact precautions. So basically....throw on a gown, gloves, and mask (the mask is more to mask the smell and not necessary) for care. Try tucking some peppermint gum into the side of your cheek.

I took care of C. diff patients as an STNA. As long as you remember not to grimace at the smell (and you'll want to, trust me!) and use some common sense, you'll be fine.

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Specializes in Neonatal ICU.

I am in my last semester of nursing school and we are not allowed to take TB or rule-out TB patients. They are also not allowing us to take H1N1 patients either.

As for the C.Diff, use proper contact precautions/common sense and you should be fine. You have gotten some really outstanding advice already.

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Specializes in Orthopedics.

I've worked with many C. diff patients over the years in my normal job. Don't worry about it. As long as you observe standard precautions and make sure you WASH YOUR HANDS (not alcohol based hand rub) after you're done with the pt, you'll be fine. We're allowed to work with all sorts of pts in our clinicals, but not pts with confirmed H1N1 or r/o H1N1.

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What do you do with your stethoscope? Would there probably be one for use with that patient? I guess I'm just having a mental adjustment but I feel like I'm going to walk out of the unit with spores all over me. :imbar

We're supposed to be visiting and spending time with these patients. If I sit down, I am possibly getting spores on my clothes, etc. I mean, I'm just not sure how I'm supposed to "entertain" or play cards with a C. diff patient. Probably way overthinking, want to help the patient but also don't want to spread it around and/or take it home.

I'm trying to research this so I can be informed. I know about the spores and the ineffectiveness of the alcohol hand rubs. But I don't see any specific information about how a student in clinicals specifically would take care of such a patient. We would be spending more time with them than probably a full-fledged nurse so not sure how to "hang out" with them exactly.

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Specializes in IMCU.

The pt's room will probably have a "disposable" stethoscope hanging in it.

There is good information on the CDC's website which might be a bit more useful to you than getting it third hand from allnurses.com

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Specializes in Pediatric/Adolescent, Med-Surg.
What do you do with your stethoscope? Would there probably be one for use with that patient? I guess I'm just having a mental adjustment but I feel like I'm going to walk out of the unit with spores all over me. :imbar

We're supposed to be visiting and spending time with these patients. If I sit down, I am possibly getting spores on my clothes, etc. I mean, I'm just not sure how I'm supposed to "entertain" or play cards with a C. diff patient. Probably way overthinking, want to help the patient but also don't want to spread it around and/or take it home.

I'm trying to research this so I can be informed. I know about the spores and the ineffectiveness of the alcohol hand rubs. But I don't see any specific information about how a student in clinicals specifically would take care of such a patient. We would be spending more time with them than probably a full-fledged nurse so not sure how to "hang out" with them exactly.

You can stand in the room wearing your gown and gloves to talk to the pt. If you are going to be "hanging out" in the room, perhaps take a clean gown and put it down as a seat cover on a chair.

Try not to stress about it too much. As a student nurse you will be expected to take care of pts with C-diff, MRSA, VRE, the flu, and many other infectious diseases. Use your instructor as a resource for how to protect yourself as well as how to care for your patient.

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The pt's room will probably have a "disposable" stethoscope hanging in it.

There is good information on the CDC's website which might be a bit more useful to you than getting it third hand from allnurses.com

That's the thing. I am trying to be more informed so I know exactly what is recommended. I just don't see much on CDC's website about specifically what a nursing student would do. Seems to talk mostly about "real" health care workers. And look at this on CDC's website!

http://www.cdc.gov/ncidod/dhqp/id_CdiffFAQ_newstrain.html

"If an increase in rates or severity is observed, healthcare facilities should reassess compliance with the recommended infection control measures for known cases of C. difficile-associated disease including the following:

  • Perform hand hygiene using an alcohol-based hand rub or soap and water
    o If your institution experiences an outbreak, consider using only soap and water for hand hygiene when caring for patients with C. difficile-associated disease; alcohol-based hand rubs may not be as effective against spore-forming bacteria.
  • Contact precautions
  • Environmental cleaning and disinfection strategies."

WHAT!? Everything else I've read and been told at school says alcohol-based rubs are NOT effective. CDC's website suggests using an alcohol rub and then suggests they "may not be as effective" with spores. They seem to be saying not to use an alcohol rub with an outbreak but otherwise don't worry about it, which I don't get.

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Specializes in IMCU.

I see what you mean. But, as my clinical instructor says....."you are the nurse".

I looked after a C Diff patient and our instructions were clear. Soap and water was to be used to perform hand hygiene. I also wore a gown for most things as it was easy to rub up against a hand rail etc.

You may want to have a little menthol or eucalyptus oil dapped under your nose if smells bother you.

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Specializes in Pediatric/Adolescent, Med-Surg.
That's the thing. I am trying to be more informed so I know exactly what is recommended. I just don't see much on CDC's website about specifically what a nursing student would do. Seems to talk mostly about "real" health care workers. And look at this on CDC's website!

http://www.cdc.gov/ncidod/dhqp/id_CdiffFAQ_newstrain.html

"If an increase in rates or severity is observed, healthcare facilities should reassess compliance with the recommended infection control measures for known cases of C. difficile-associated disease including the following:

  • Perform hand hygiene using an alcohol-based hand rub or soap and water
    o If your institution experiences an outbreak, consider using only soap and water for hand hygiene when caring for patients with C. difficile-associated disease; alcohol-based hand rubs may not be as effective against spore-forming bacteria.
  • Contact precautions
  • Environmental cleaning and disinfection strategies."

WHAT!? Everything else I've read and been told at school says alcohol-based rubs are NOT effective. CDC's website suggests using an alcohol rub and then suggests they "may not be as effective" with spores. They seem to be saying not to use an alcohol rub with an outbreak but otherwise don't worry about it, which I don't get.

Every hospital I've ever worked at had as a policy that when caring for C-diff patients you only used water and soap before and after patient contact to clean your hands. There were typically signs placed on the Purell dispensers in the room telling you not to use with this patient. When in doubt always just use soap and water.

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