Took Care of a Patient with MRSA Today

dudette10, MSN, RN · Mar 24, 2010

I'm a student, and I was so confused about MRSA and C-Diff for one reason only: MRSA and C-Diff pts--without being cleared of the colonization or infection--are released from hospitals to go home. Visitors are not required to "gown up." In LTC facilities, mobile patients go into the community dining room to eat.

Huh?

Then, I was informed that the precautions are set up to protect both health care workers and the spread of infection to other patients, although not much can be done about community-acquired infections when released. (This explanation still didn't jive with the LTC facility practices or visitor requirements...but whatever.)

Can any nurse who is experienced in infection control confirm the explanation given to me? Thanks.

PAERRN20 · Mar 24, 2010

Relax. You wore gloves to empty the foley. No urine splashed on you. This same patient will probably be out touching the fruit at Walmart next week.

Pepper The Cat, BSN, RN · Mar 24, 2010

He wasn't my patient but I was helping someone out. I rushed in to empty his foley bag and didn't gown up (did not see the sign). I used gloves though. I don't think anything splashed on me, but now I'm super paranoid about catching it.
I don't know where this patient's MRSA is contained. I don't think I'll ever forget to gown up again.
I also don't get a chance to come home and take a shower before my kids rush up and hug me. The thought of getting them sick is terrifying!!!

Don't get too paranoid. Although it is important to follow isolation techniques, don't get too worried about this. You are more likely to get MRSA off a cart at Walmart or a grocery store than at the hospital.

As long as you wash your hands or use the hand sanitizer, you should be fine.

Trust me, You can't let this take over your life like this. I know how worried you are, but you can't let it take over like this. Trust me. I worked thru SARS. Now that was a scary time, and people were really freaking out - and without cause in many cases.

There are pts out there that you will have contact with that can be MRSA +ve and you won't know until a day or two later.

Here's what I recommend. Just tell your kids not to hug you when you are in uniform. Go home after work, change, then hug your kids. That way, you won't have to worry too much.

As a nurse, you are going to be exposed to a lot of different germs - some times you won't be aware until after the exposure has occured. Take precautions with your family, but don't let it overtake your life.

HappyMeNow · Mar 24, 2010

Thank you all so much! I feel a lot better.

One last question before I rest tonight, I remembered that I have a cut inside my nostril. I think it's from dry air and blowing it too much. I don't know if my scab is healed or if it's open, and after knowing that a lot of us carry MRSA in our nares make me think that i'm at high risk of having MRSA entering through the cut in my nose.

Should I have worn a face mask to protect my nose?

PAERRN20 · Mar 24, 2010

Thank you all so much! I feel a lot better.
One last question before I rest tonight, I remembered that I have a cut inside my nostril. I think it's from dry air and blowing it too much. I don't know if my scab is healed or if it's open, and after knowing that a lot of us carry MRSA in our nares make me think that i'm at high risk of having MRSA entering through the cut in my nose.
Should I have worn a face mask to protect my nose?

Generally MRSA calls for a mask. That said, I am an ER nurse and I usually have no clue if the patient is in isolation. Or we find out days later the patient has MRSA. I do not have MRSA. This is were universal precautions comes in. Gloves and good handwashing go a long way to protect yourself. You are just as likely to get MRSA working out at the gym as you are working as a nurse following universal precautions. I hope this puts your mind at ease.

eric909 · Mar 24, 2010

Relax. You wore gloves to empty the foley. No urine splashed on you. This same patient will probably be out touching the fruit at Walmart next week.

LOL so true

JulieCVICURN, BSN, RN · Mar 24, 2010

Generally MRSA calls for a mask.

Not necessarily. We only mask if the MRSA is in the sputum. Otherwise, it's contact precautions only. This is based on info from our ID doc, who is one of the smartest and most careful physicians I have ever worked with. I'm sure if it was necessary for all MRSA, he'd be making us mask.

I take care of at least one patient a week with MRSA. I remember being so scared of it when I was in clinicals in school and not even wanting to go in the room. Now, I'm so used to it that I probably don't give it the healthy respect it deserves. I do still diligently wash my hands and gown up, though.

HappyMeNow · Mar 24, 2010

So... does a cut inside my nose warrant any worries? I am reading that MRSA isn't likely to be trasnported through air, but at the same time it says most of the people who are colonies for MRSA carry them on their nares.

Hoozdo, ADN · Mar 24, 2010

So... does a cut inside my nose warrant any worries? I am reading that MRSA isn't likely to be trasnported through air, but at the same time it says most of the people who are colonies for MRSA carry them on their nares.

No, the cut in your nose does not warrant worry for your exposure.

It WOULD if you did not have gloves on, did not wash your hands, and then picked your nose though!

MRSA can be transmitted via air if the pt has a MRSA respiratory infection. If they are on droplet precautions just add a mask to your gloves and gown.

You will drive yourself nutty if you think of this all the time. I have a personal policy of NEVER touching my face at work. That fact cuts my worries down. If I eat something, I clean the surface of where I am eating with antibacterial wipes and make sure I have clean hands. I don't eat things out of a "communal bag", like potato chips.......never know whose hands have been in there and what they have on their hands. Fellow nurses think I am over conscience about this, but it works for me.

allnurses Guide · Mar 24, 2010

QUOTE=Hoozdo;4196378]. . . . . .You will drive yourself nutty if you think of this all the time. I have a personal policy of NEVER touching my face at work.

I've always done this, too. I haven't been infected with anything. Though I have no way of proving it, I think it has helped.

kaliRN · Mar 24, 2010

Originally posted by HappyMeNow

"So... does a cut inside my nose warrant any worries? I am reading that MRSA isn't likely to be trasnported through air, but at the same time it says most of the people who are colonies for MRSA carry them on their nares."

Just thought I would offer, that MRSA colonized in nares is often procedural protocol for all new admissions (and discharges, since both community and nocosomial MRSA are widespread issues. MRSA is not transmitted "through air" - the number of people positive for MRSA (nares) really reflects this procedure. Just another reason to consider the cut in your nose is not a greater risk, as Hoozdo already identified the resp iso standard for MRSA (and assumedly you did not pick your nose after this contact ).

A stellar RN I worked with once did family teaching on MRSA and raised really valuable common sense points on this that have been addressed here. MRSA is everywhere from gyms to grocery stores. It is identified in hospitals and LTC facilities more often because that's where they are testing for it. Healthcare workers contact MRSA every day, contact isolation precautions are not just designed to protect us - in a healthy individual workplace exposure or even colonization is unlikely to have untoward effects - its more to protect our patients and to eliminate ourselves as modes of transmission.

Now my intent is not to downplay the importance of contact precautions for MRSA, just restating the voices of experience. I do appreciate the feeling of being terrified of "bringing something home" to the kids. I also - never touch my face (or hair) at work. I don't use alcohol-based gel, I wash my hands the "old fashioned" way - every time. I find the extra time it takes is worth the peace of mind. Since I have toddlers, I change out of my scrubs before I come home, it makes me feel better when they run up and hug me.

Best to you with the rest of your education.