A day in the life of Infection Control

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    My life as an infection preventionist; the icky dirty truth

    A day in the life of Infection Control

    To start, I'm a spanking new Infection Preventionist of a prominent, 5-star, non-profit 200+ bed SNF located on the water in Seattle. Plucked from the floor a little less than a year ago, I have been thrown into the role of IP... and staff development... and writing ROP policy... and NAC manager... and incident reports... and employee health... essentially immersed in the woes of all nursing home IPs around the country as a "spare part nurse manager."

    But life at the Home isn't so bad. At first glance, I thought I had won the lottery amongst my other floor nurses. I get a free management lunch. I make my own schedule (10-6). I have admin perks and only have to be on call once every 5-6 weeks. I have a company phone. I wear fancy clothes and sit in meetings and write passive aggressive emails.

    So I go to work, day after day, and the months roll on with some days better than others. And as the days go by, everything makes a little more sense, I am filled with more and more anxiety, and I start doing my job. I pore over urine C/S reports and hound nurses for allowing frivolous antibiotic starts. I develop a non-threatening way to remind Housekeeping to not wear gloves in the hallways. I battle with upper admin about hand hygiene (amongst arguments of, its flammable! and, the dementia patients will eat it!) I educate residents, I educate staff, I educate myself. I check under the sheets and find kinks in catheter tubing. I remove foam and other non cleanable surfaces from the mechanical lifts. I kindly educate my docs about how no, we have never done airborne precautions in our nursing home and I kindly educate my staff that no, putting up a handwritten sign for airborne precautions does not mean that the room magically has negative air pressure capabilities. I convince Isabello (my favorite evening shift environmental services buddy) with simplified English to stop mixing bleach into his bucket of quatenary ammonium floor cleaner lest he dies of inhaling toxic substances.

    I also snap at one of my most dependable nurses for running around without a mask on a confirmed flu unit.I also have a nervous breakdown in my car crying for 20 minutes when I find out that Social Services Dept. has moved yet another patient from quarantined unit to unquarantined unit in utter disorganized confusion. I also loudly and perhaps slightly unprofessionally lament in the break room. that I am quitting my job as IP tomorrow and my fellow nurse friends can find me at my new job at the local Walmart in the housewares section organizing pillows.

    Don't get me wrong, I truly love my job. Because I know that preventing infection is the true ETHICS of healthcare. Everything else is just PR and fluff. 5 stars don't mean much if when your loved one enters my facility, and I have a part in making them sicker than before they got here. And we know clinicians that sometimes, our patients don't really "get it." But that we usually do, even though we are tired, overworked, and over stressed humans.

    All human systems easily fall apart. Whatever clinical role you are in, be resilient. As one famous TV doctor once said, "There is no justice in this world, but there is mercy, because we give that to each other." I try to remember these words when I make eye contact and smile to staff in the hallways, when I answer a call light for a resident that really needs to pee and has been waiting for 30 minutes, when I get yelled at by an angry rabid family member, when I feel like it is just TOO MUCH! IP or not, clinicians must know the light in themselves to shine on the light in others.

    Shine on
    Last edit by tnbutterfly on Jun 14
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    6 Comments

  3. by   Have Nurse
    Yes, I understand EXACTLY what you mean!!! Carry on, Comrade!
  4. by   broughden
    Have you looked into Loyola's DNP-ID program?

    Also Im curious about Isabello using quat given how many pathogens are resistant to it, especially C. diff and Staph? It would appear based on clinical data and research, that his instincts to use bleach instead are right. Thought he shouldnt be mixing the two.

    "Commonly used hospital cleaning agents, such as quaternary ammonium-based (and other surfactant-based) detergents, are not sporicidal and may in fact encourage sporulation [7, 10-12]."

    "Mayfield et al. [10] evaluated the effectiveness of 10% sodium hypochlorite, mixed fresh daily, versus that of a quaternary ammonium-based solution in rooms of patients with a positive result of a C. difficile toxin test. In units where CDI rates were high (defined as >3 cases per 1000 patient-days), use of sodium hypochlorite resulted in a substantial reduction in the rate of CDI. Of interest, when the protocol was reversed and quaternary ammonium-based cleaning agents were reintroduced to those units, rates returned to the high baseline level of 8.1 cases per 1000 patient-days [10]. "

    Measures to Control and Prevent Clostridium difficile Infection | Clinical Infectious Diseases | Oxford Academic

    Prospective cluster controlled crossover trial to compare the impact of an improved hydrogen peroxide disinfectant and a quaternary ammonium-based disinfectant on surface contamination and health care outcomes - ScienceDirect
  5. by   ruby_jane
    Yes, yes, 1000X. Just responding as a former public health nurse who had to backtrack and contact trace a TB case through the bronchoscopy suite (no TB precautions in that room) and through a rural community hospital.... Best of luck!!!
  6. by   audreysmagic
    I always love hearing from fellow IPs, especially as a novice IP who's always looking to learn from the experiences of others! (I'm in a freestanding psych facility and also doing staff development and "other duties as assigned," so I feel you especially on wearing multiple hats and trying to learn the world of IP for a less-traditional setting!) Thanks for this!
    Last edit by audreysmagic on May 21 : Reason: typo
  7. by   brownbook
    I love, respect, admire, what you are "trying" to do. Please don't quit. We need you. The world needs you.
  8. by   n.osborne
    My goodness, were you following me around? except my night person is Kurt
    We have to hang in there, our job is like the sign I have hanging in my office "Nobody Notices what I do until I DON'T DO IT"

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