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Discussion

How do you do lab work on patients while maintaining social distancing?

I draw labs in the morning on my patients (I work overnight), and for me it's usually a very fast process (doesn't take more than 2 minutes). Once in a while, though, you get a 'hard stick' patient and that can take a little while (e.g., more than 5 minutes) as you're looking for decent venous access. You're still nearly face to face with that patient, though. Considering all the labs I do, maybe I already got this corona!

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    • Featured Replies

    • Expert

    What's your definition of nosocomial distancing?

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    "Anybody that wants a test can get a test."

    -Donald J Trump, 3 March 2020

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    What exactly is your question?

    Yes, maybe you are infected. As a nurse, you must understand both the risks and the mitigation strategies. So, what are you asking?

    And why is there an exclamation point at the end of "maybe I already got this corona!"? That is weird.

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    • Guides

    I think all patients should be considered possibly infected with the virus for the purpose of protecting nurses and other workers. The CDC defines close contact as being within about 6 feet of an infected person while not wearing recommended PPE.

    I interpret this to mean that since asymptomatic people can spread the virus the person drawing blood must wear a proper fitting PAPRs, N95, or N100 mask OR wear a surgical mask, and have the patient wear a face mask until the nurse or phlebotomist is no longer in close contact.

    https://www.dir.ca.gov/dosh/coronavirus/Cal-OSHA-Guidance-for-respirator-shortages.pdf

    https://www.CDC.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html?CDC_AA_refVal=https%3A%2F%2Fwww.CDC.gov%2Fcoronavirus%2F2019-ncov%2Finfection-control%2Fcontrol-recommendations.html#minimize

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    • Admin
    11 minutes ago, herring_RN said:

    I think all patients should be considered possibly infected with the virus for the purpose of protecting nurses and other workers.

    My facility recently added a face shield requirement for all staff involved in patient care, whether the patient is COVID+, PUI, negative, or anything. Masks have been required for months.

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    1 hour ago, Rose_Queen said:

    My facility recently added a face shield requirement for all staff involved in patient care, whether the patient is COVID+, PUI, negative, or anything. Masks have been required for months.

    That sounds absolutely horrible.

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    Just now, adventure_rn said:

    That sounds absolutely horrible.

    Why horrible?

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    10 minutes ago, toomuchbaloney said:

    Why horrible?

    The idea of having to wear the shield itself for all patient interaction sounds miserable, especially for hours on end.

    It's great that they have adequate PPE and are acting to protect nurses, but I just feel bad for the nurses who actually have to do it. It's cumbersome enough to wear a mask all shift, let alone having to wear (and don/doff/clean) a face shield. Sounds both uncomfortable and inconvenient. I completely understand the rationale for why they have to do it, it just seems like it would suck.

    TBH, I feel awful for all of the nurses who have to wear extra PPE for long stretches of time. I just wear a surgical mask and my ears and nose hurt after 12 hours. I can't imagine what it's like to have to wear an N-95 for 12 hours straight. My adult ICU friends have told me that it feels as though they're air-hungry and suffocating (on top of simply being hot and claustrophobic).

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    I feel like I don't remember the last time I had a patient interaction without a face shield.

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    By definition we don't 'socially distance' while we practice face-to-face. We use infection prevention and control, aseptic techniques, etc.

    Everyone else calls it social distancing...

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    • Expert

    The hierarchical de facto system of governing these threads continues to make the best power point material for my courses. I mean seriously, you cannot make this kind of whimsical stuff up. I recently revisited T. S Elliot's "The Cocktail Party", and what a masterpiece.

    "It will do you no harm to find yourself ridiculous.
    Resign yourself to be the fool you are...
    ...We must always take risks. That is our destiny...”
    ― T.S. Eliot, The Cocktail Party-

    Without sounding too capricious I say take a risk, draw your morning labs, go test yourself or someone else for COVID today even, but I'd also suggest wearing a mask, with or without eye contact.

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    14 hours ago, adventure_rn said:

    The idea of having to wear the shield itself for all patient interaction sounds miserable, especially for hours on end.

    It's great that they have adequate PPE and are acting to protect nurses, but I just feel bad for the nurses who actually have to do it. It's cumbersome enough to wear a mask all shift, let alone having to wear (and don/doff/clean) a face shield. Sounds both uncomfortable and inconvenient. I completely understand the rationale for why they have to do it, it just seems like it would suck.

    TBH, I feel awful for all of the nurses who have to wear extra PPE for long stretches of time. I just wear a surgical mask and my ears and nose hurt after 12 hours. I can't imagine what it's like to have to wear an N-95 for 12 hours straight. My adult ICU friends have told me that it feels as though they're air-hungry and suffocating (on top of simply being hot and claustrophobic).

    N95, surgical mask, shield. In the ED, every pt, every encounter. Sucks? Yeah, kinda, but after over 2 months of this, not a whole lot of complaining. We use bandaids for nose, have clips so the surgical mask straps don’t cut into ears. A uv disinfector is available to clean shields between encounters.

    Seen too many asymptomatic pts whose labs come back as hmmm, so again everybody covid + until proven otherwise.

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