Floating and C Diff, MRSA etc.

Our OB gals must wear a lab coat out on the floor when they are floating and they are NOT allowed to go into any isolation rooms.

Granted how many pts do they take care of that test positive the next day for C-Diff/Mrsa etc etc/ Even though the night before they were not in isolation...

Not that the lab coat protects 100%---but it does somewhat I guess protect their scrub top. Once worn the lab coats are not to go back into the "clean" unit.

Does this all occur in the one shift?

I work primarily med surg but when I float to OB I change my scrubs and give myself a sponge bath. OB have showers but they are for OB staff only. I still wear a isolation gown when handling babies.

When OB floats to med surg they do not go into rooms where there is even the possibility of a pt with MRSA, TB, etc. They generally take care of the pt's who are in for COPD, CHF, etc.

So what do you do when it is the postpartum pt that has the MRSA? Heck we get off service with MRSA, VRE etc on our mom/baby unit and one nurse can have thosee isolation pts and healthy mom/babies at the same time.

I used to work at another hospital for 4 years and never once had a MRSA or isolation pt at all on the mom/baby unit then I change hospitals and MRSA is like a common cold here!

Yes, there are those who claim that everyone has MRSA, which I don't agree with !! I have read that C-diff is the new superbug that even 3 or 4 rounds of Vanco might not eliminate. I come from the days when nurses had to have nose cultures prior to working in the nursery and heavy staph shedders were not allowed in there. I am again wondering if the CDC or AWHONN or ACOG or even JCHAO has any guidelines pertaining to maintaining the "clean" status of the maternity floor. We are trying to protect the infants but it is often seen as being insubordinate and that is what we are threatened with is insubordination. Now most of us are not working for the pure joy of it so we end up doing something we feel in the gut as being innately wrong, but we need our job. HELLLLLLLLLOOOOOOOO any management out there care to respond ( or are they banned from this site ?? )

When i worked ob we weren't allowed to take a patient load on med/surg incase we were called back to our floor. But we were NOT allowed to go in a isolation room.

Then i switched hospitals, what is isolation, i had to throw a fit to get gowns and masks for m to go in a room. They said "your a nurse you probably have been exosed already" hello my kids arent and i don't want to bring this crap home. Yeah i think i'm the only one who will wear a mask or gown in a room, they usually just put on gloves, doesn't matter what type of isolation it is, but thats another thread......

I am not a nurse, but in school.

I am a support huc/pct on L&D/mother baby and it is a rule in our hospital that once your out of the building (we have a seperate building for ob/gyn issues) you can't come back the rest of your shift with out showering and a change of scrubs. Most of the time you just don't come back, period. There have only 1 or 2 times that I have seen a nurse come back after a float and that was because there was a epidemic of the stomach bug going around and many nurses called off. I have NEVER seen an aid come back from a float. As a HUC even though I don't do direct patient care when I am HUC'ing, I am NOT allowed to enter the nursery if I have been in the main house. Meaning the nurses have to bring me the charts and then I have to wipe them down before having a nurse come get them.

Most hospitals here in dayton, as a whole, have the rule, "Once your floating, considered yourself floated".

I would definitely try to find that out because it really isn't healthy for new babes and moms.

Oh, there have been a few times that we have had mom's on antepartum that have had VRE or MRSA or C-diff from stints in the main house and they are considered a 1:1. The nurse who has that pt usually just helps with orders or stocks.

I can't believe some of the entries on this blog. As professionals, we need to embrace facts, not react to unfounded concerns. MRSA will not transmit to mother's or babies if you observe the precautions. Gloves, gown and handwashing for MRSA and C. Diff. Do you know how many of your patients in OB (the 'clean' floor) are MRSA carriers too? Depending on your location, maybe 25%. In poorer communities, higher rates exist. Average is 7-10%. So OB is no 'cleaner' than the med surg floors.

Reasonablenurse - where do you get your statistical figures?

Some items that might interest readers of these posts:

"Approximately 32% (89.4 million persons) and 0.8% (2.3 million persons) of the U.S. population is colonized with S. aureus and MRSA respectively."

http://www.cdc.gov/ncidod/dhqp/ar_mr...illanceFS.html

NY Times on MRSA and healthcare workers' clothes:

http://www.nytimes.com/2008/09/23/he...prod=permalink

I'm a tech on Mother/Baby. The nurses rarely float (and if they do it is by choice and usually to Labor and Delivery or NICU) but the techs are not allowed to return to the unit to work with patients once they go to a Medical floor. They're considered "dirty". If our floor needs a tech or a nurse to float to help us out, they cannot go to their floor first otherwise they need to shower. They must change scrubs regardless.

**groan** Floating.

We do not float off our OB unit. I am a casual nurse so I sometimes volunteer on other units, but it has nothing to do with working on my unit and I don't do both on the same day. But we have had MRSA mothers on our unit and last week, we had a pt. with C.diff. She had developed an ileus after a c-section and c.diff after a week on antibiotics. But she had diarrhea for three days before anyone thought to send a stool for c diff toxin. She was hysterical when we told her she could not go home and she had to be in isolation.