I suspect at least 4 residents have scabies, and....

[Tana13]

I been working at a LTC facility for about 1 year now and I've noticed that the nurses that been there the longest refuse to say its probably scabies. They even won't let me order a skin scraping for testing. I've seen plenty of pt with scabies. So I believe that at least 4 residents have it. And they are suffering. What should I do?

[PeacockMaiden]

Did you talk to the DON or the Administrator about it? I'd do that first. If nothing is done, call the state or county health department and report it. If you do that, I guarantee something will be done about it very quickly. Something needs to be done before other residents and staff become infected.

[Bringonthenight]

Also document every conversation you have when you have brought up your concerns

[chrisrn24]

Are you a nurse or an aide? Why don't YOU call for an order?

[Bringonthenight]

Are you a nurse or an aide? Why don't YOU call for an order?

Good point.

[Blackcat99]

If you are a CNA make anonymous calls or send anonymous letters to the resident's doctor office .

[CapeCodMermaid, RN]

What a bunch of passive aggressive people! Anonymous calls? Anonymous letters? Speak to the charge nurse, supervisor, or DNS. It most likely isn't scabies if only 4 or 5 people have it. Scabies is highly contagious and chances are it would have gone through the floor by now. The treatment for scabies is NOT benign and shouldn't be done unless you're absolutely certain it really is scabies.

[Blackcat99]

When I was a CNA I would sometimes get "the brush off" from the nurses. My opinion was not valued. In fact, when one of my patients didn't look good to me , I told the nurse that the patient needed to be seen by a nurse immediately. As usual, the nurse gave me "the brush off twice". I finally yelled loudly at the nurse and said "You must go and check that patient right this minute". The nurse then walked into that patient's room and called " code blue". So yes if you are a CNA and your opinion is not valued there is nothing wrong with doing something "anonymous". On the other hand, if you are a CNA and your opinion is valued then yes go talk to a supervisor.

[ktwlpn, LPN]

The OP is an LVN.I have been through several scabies outbreaks in LTC and saw my own admin pull the ostrich trick for weeks while residents suffered.You won't often see the typical scabies presentation in the elderly because they are immunocompromised and debilitated. Skin scrapings carry a high rate of false negative results,too. Add in the denial and you have a wildfire before you get your first positive scraping and staff are involved.

Several staff members made anonymous calls to the DOH and that is what finally made our admin take action. One of the docs had told us he had treated several family members,we knew there was an outbreak in the community at the time but still our supervisors, ADON and DON would come to the unit to assess a resident and make statements like " Oh,that's just a scratchmark,look at her fingernails" or "The bath water was too hot,that's why he has that rash" The staff started showing up with intchy rashes on their wrists,the calls were made, the dermatologist came in and did scrapings and we were loaded. The initial treatment on the dementia unit failed because the DON would not listen to us-we were researching feverishly to learn the best way to eradicate it and she was fighting us .On a dementia unit you have people who get in and out of each other's beds, put their dirty clothes in a closet and another resident puts them on,wrap up in the privacy curtains,etc.We (finally) treated the whole floor (including using a toothbrush to apply the treatment around their fingernails after trimming them) and staff were treated ,too. We laundered all of their clothes and privacy curtains ,dealt with the stuffed animals and baby dolls, stripped and scrubbed all beds and that did the trick but what a job it was ....scabies seems to be cyclical and I hope and pray that I am retired before it rears it's ugly head again...

[amoLucia]

Had the attending physician(s) been notified??? That should be done.

It only took ONE pt at my LTC for scabies to be diagnosed. She had a horrendous rash and had been Kwelled in-house several times without improvement so scabies had been initially ruled out. Therefore no precautionary measures were initiated. Turns out, she had atypical Norwegian variant of scabies and was very resistant to treatment when hospitalized.

In all my career, this was the one time I actually contracted something from the residents.

[CapeCodMermaid, RN]

Had the attending physician(s) been notified??? That should be done.

It only took ONE pt at my LTC for scabies to be diagnosed. She had a horrendous rash and had been Kwelled in-house several times without improvement so scabies had been initially ruled out. Therefore no precautionary measures were initiated. Turns out, she had atypical Norwegian variant of scabies and was very resistant to treatment when hospitalized.

In all my career, this was the one time I actually contracted something from the residents.

eeeeeewwwwwww...I've worked in buildings where all it took was one whisper of scabies for all the residents to be treated. The admin at that building told all new staff we had to be treated too. Um, no...the treatment is not something to do unless one has scabies.

[Havin' A Party!, ASN, RN]

From my experience, scrapings are rarely done any more -- which is really the only true way to diagnose.