pt with MRSA in sputum ambulating in hallway with no mask - page 4
I am a new grad working at a longterm care TCU. I found one patient with MRSA in sputum walking in the hallway without mask. He even eats at the same table with other patients. I asked the... Read More
May 4, '12Aw, I kind of get why. I work on a burn unit. Ever had to deal with a trach'd pt with copious amounts of sputum which grows MRSA?
May 4, '12I have probably worked with literally thousands of patients with MRSA in various wounds and orifices. I am colonized with MRSA. I still don't see the reason for the chicken little routine in the OP. :shrug:
May 4, '12Quote from unsaint77You said yourself that if you found the pt in the hallway w/o a mask you would take him to his room...nursing programs have specific vocabulary for that and it's called "isolation" and "restraint".OMG Why is that a harmless question posted can irate so many people? Did I ever say anything about isolating this pt? You don't even know about this pt's coughing spells. Please think about why you guys assumed that I wanted to isolate this pt. Why did you assume that this pt had no problem covering mouth? People just love to pounce on others in the same industry because it gives them a false sense of pride. Nurses are one of the worst I realize. BTW, many of you so knowledgeable about MRSA yet none of you ever quoted what CDC said. Hmmm. So, I guess those of you, who were quick to criticize me, know more than the CDC and the MD who ordered the culture?
No, we don't know if the pt is coughing or is able to cover his mouth because you failed to give adequate information and failed to respond the the multitude of questions asking for specific info.
And one poster gave you 2 links to the CDC site with the info you were asking for.
If you have this many issues simply posting on a website, such as failure to give a proper report, failure to have a working knowledge of your facilities policies, failure to comprehend or utilize the report/information given to you by fellow nurses, failure to educate yourself in areas of knowledge that you are finding yourself to be lax, failure to take constructive critisism, etc., I can't even imagine how you function on the floor. There were many posters on here who gave you polite, non-judgemental advice, but you ignored those and only focused on the negative ones. But then again, because the friendly advice did not simply agree with you, you felt those were negative as well.
May 5, '12And further, no one was nasty or irate. Just incredulous that you would get so worked up about something that is just not all that significant to those of us that understand it.
May 5, '12Did I ever say anything about isolating this pt?
Next time, I am going to escort the patient back to the room and have him eat meals in the room. If my supervisor gives me hard time, she just going to have to write me up.As a nurse I think it is reasonable to have the pt eat meals in his room and walk in the hall way with mask on.
You don't even know about this pt's coughing spells.
People just love to pounce on others in the same industry because it gives them a false sense of pride. Nurses are one of the worst I realize
Including questions in your opening post implies a willingness to hear other people's opinions. Disagree with the responses, if necessary, but please don't accuse posters of pouncing on you simply because they gave honest answers to your inquiry.Last edit by rn/writer on May 5, '12
May 5, '12Quote from unsaint77YES. Unless he plans on licking an open wound, I'm perfectly okay with it.So, here is my question to those of you who think MRSA is not a big deal. Would you let your elderly parents or your babies or children sit at a dinner table with someone with mrsa in sputum with no mask?
May 5, '12[h=4]Quote from saint 77actually, no unsaint77...........i gave you 2 cdc references in post #14.omg why is that a harmless question posted can irate so many people? did i ever say anything about isolating this pt? you don't even know about this pt's coughing spells. please think about why you guys assumed that i wanted to isolate this pt. why did you assume that this pt had no problem covering mouth? people just love to pounce on others in the same industry because it gives them a false sense of pride. nurses are one of the worst i realize. btw, many of you so knowledgeable about mrsa yet none of you ever quoted what cdc said. hmmm. so, i guess those of you, who were quick to criticize me, know more than the cdc and the md who ordered the culture?
"the cdc provides information about health care-associated infections. i have provided you links.
cdc - long-term care settings - hai
cdc - prevention tools - hai "
and you did say you would isolate him........and i quote........post #4
"next time, i am going to escort the patient back to the room and have him eat meals in the room. if my supervisor gives me hard time, she just going to have to write me up".
i responded with....and i quote........
making a patient go back to and stay in their room, without an order and just cause, is a form of restraint and can be considered assaultive. that, can get you fired and put your license in jeopardy.
i applaud your dedication and enthusiasm but......i would choose
your battles wisely.
from the cdc website....
it is extremely important to maintain the patients' ability to socialize and have access to rehabilitation opportunities. infected or colonized patients should be permitted to participate in group meals and activities if draining wounds are covered, bodily fluids are contained, and the patients observe good hygienic practices.
cdc - precautions to prevent the spread of mrsa in healthcare settings | mrsa infections (third reference)
so, i guess if you are quick to criticize you need to be sure the resources haven't been made available to you. we assumed this patient wasn't hacking, snorting and spitting down the hallway because you did not infer that in your post. no one has a false sense of pride on this post.....i have seen nothing but informative advice that is standard of practice. hypersensitivity i am seeing.......i am feeling that you are sensitive about your practice as you are a new grad. no one said you were wrong but they did feel you were a bit over zealous.
making a patient to eat alone is isolating them and treating them punitively for an illness and can be considered a form of restraint as you are "restraining"/isolating him to his room without an order and might be a violation of standards of practice. which can be considered assaultive. your supervisor should have handled your question differently ..........however, your complete rejection and mockery of the information that has been given here can be considered aggressive and confrontational.
there are many very smart people here even thought we are "anonymous" and we only seek to educate and help other grow in their chosen profession.
you asked a question....it was answered. peace
May 5, '12I skipped over that sweet little gem about making the poor guy eat alone in his room! That is abuse. Now it that were my grandfather, I'd be at the BON raising cane until the OPs license was revoked!
In short, the people who don't want to eat with him need to eat alone in their rooms, not him. Jeeze.
May 11, '12I've been colonized with MRSA in my nares since 1995 or 96. Sitting in the front row in my micro class in nursing school I was the guinnea pig. I've never been isolated before.
May 12, '12I didn't read all the post but wanted to add something I thought was funny. My son has MRSA. To take him downstairs for a Doppler, the nurse made him wear a mask. Just one little thing, he has a trach and no she didn't cover the trach.
May 13, '12At my hospital, infection precautions are started by the nurse (and infection control is informed by it being placed into the computer that the patient is an infection patient), not by doctor. It is not a doctor order. Once the nurse is aware of it, the patient is informed and isolated, the infection trolley placed by the door, and signs put up.
If it is detected in his sputum, whether it was coincidental or a current infection, the protocol in my hospital is infection precaution now, and for life. Sucks but it's the way it is.
However, I used to work in a long term care facility, and they would not have isolated him unless it was an active infection. After all, 70% of the normal population has MRSA on them!