I'm so sick of MRSA!!!!!

[FireStarterRN]

MRSA is truly becoming an epidemic. Yesterday I was gowning, gloving and masking all day! I'm so tired of it. I shipped one patient who was septic shock from MRSA whose kidney function was going down the tubes, was on a vasopressor, etc. She had a right elbow MRSA cellulitis. She was having multiple problems including needing dialysis for her acute kidney failure

After I got her out the door I picked up one of my colleague's patients since her other one ended up on a vent. He's been here forever and a day with resp MRSA and we can't find LTC placement for him. Very nice, undemanding fellow whose care is of the complex sub-acute type, with multiple problems. Gown, glove, mask, gown, glove, mask, gown, glove, mask......

Those masks have a disgusting chemical smell, and the gowns are yucky and hot. Ugh, I'm sick of MRSA!!!

[jessiern, BSN, RN]

I think it's a doomed effort. And MRSA is just staph, which everyone has somewhere on their body. It's when it gets where it doesn't belong that we have issues.

And if we use isolation precautions the chance of that happening is reduced.

And it is not just staph. It is a staph infection that has mutated to be resistant to the drugs traditionally used to treat it. The more we prevent the spread the better. If a patients is admitted for a GI bleed, then I think we should do everything possible to prevent that from becoming a 3 week stay for IV vanc because of an infection recieved in the hospital.

And the next step is VRSA, which is starting to pop up. Are we one day going to debate whether it is a big deal or not?

[TigerGalLE, BSN, RN]

How many people are on full precautions because of MRSA in the nares? Ridiculous.

Well if you take that MRSA in the nares and spread it to a patient who is immunocompromised we have a problem.

[SuesquatchRN, BSN, RN]

And if we use isolation precautions the chance of that happening is reduced.

And it is not just staph. It is a staph infection that has mutated to be resistant to the drugs traditionally used to treat it. The more we prevent the spread the better. If a patients is admitted for a GI bleed, then I think we should do everything possible to prevent that from becoming a 3 week stay for IV vanc because of an infection recieved in the hospital.

And the next step is VRSA, which is starting to pop up. Are we one day going to debate whether it is a big deal or not?

It hasn't mutated. Evolution has favored the stronger of the species - the resistant - to survive. It isn't some monster bacteria from The Andromeda Strain.

And obviously we should avoid spreading nosocomial infection. But in most instances of MRSA the gowning etc is wasted effort and more to feel good than do anything concrete.

Hand hygiene, hand hygiene, hand hygiene. Gown and mask when doing dressing changes, period, which has been shown to be quite efficiacious in averting infection, with or without "superbugs."

[Antikigirl, ASN, RN]

Lordie...even if a patient had a wound years ago that had MRSA they are put on precautions and you bunny suit up! Oh believe me I hear you loud and clear!

The thing is I CHOOSE what PPE I use, and according to my own clinical choices! If I know that someone had an infection years ago in a surgical wound that has healed and no more s/sx...oh yeah right...I am not putting on that gown!!!!! I go for universal precautions of glove use and general protection for myself and my patients!

Who designed those gowns anyway!? LOL...I sware that you need to have shoulder pads in a square pattern just to handle the paper like scratch from them every time you turn your head! LOL! Ours are a lovely shade of pale yellow to try to enduce the feeling of cheeryness as you come in looking like some alien biohazard worker cleaning some unknown substance! Oh yes, my patients soooooooo appreciate that when they come to the hospital YEARS after the MRSA was a probelm! No doesn't remind them of isolation, fear, anger or being vulnerable! SHEESH!

These germs, even resistant ones have been around longer than most of us, they still will. Instead of having all the hype and fear make our choises for us...lets get real...case by case basis, choose your ppe well...and reassure patients they aren't lepers but people that have a staph infection that doens't like to die by normal antibiotics and it will be a bit tougher to get it...but we will!

[LiverpoolJane]

I hope all your relatives are well and suffer not harm from carrying MRSA, but can I just mention that your granddaddy and the other family members may have had MRSA for some considerable time, but because it was just sitting on the surface of the skin it was never an issue.

We always assume that only doctors and nurses are capable of passing bacteria from one human being to another, when it is estimated that up to 30% of the population may be colonised with MRSA - and for the vast majority of them they will never know - because it is not causing symptoms. When a person has been found carrying MRSA in all likeyhood it seems reasonable that people who are physically close to that person may well be colonised also.

We need to educate "Joe Public" about MRSA - so they understand the importance of appropriate meassures, especially when visiting realtives in hospital who are at risk - reinforcing the hygiene precautions the staff take.

Can I ask if your family had been screened for MRSA proir to your granddaddy having it in his knee?

Jane

Sue, I agree with you to a point. But I also think that healthcare workers having that opinion may be a small reason why it is as prevalient (sp?) as it is now. We still need to do our best not to pass it to other patients that dont' have it, especially ones with already compromised conditions.

My granddaddy developed MRSA on his knee. The doc told him "oh its no big deal, you don't need to do anything different". Since that time, every member of his house have it, including his 4 year old granddaugther. But, mom and I tried to tell them...but the doc and nurses said... So, basically I think if they had not treated it so casually in his case, then 4 more cases would have been avoided.

[Antikigirl, ASN, RN]

Oh man...this can be a whole topic in itself, but I was asked about infection rates in healthcare facilities by my employer doing a survey...boy did they get an earfull..but not what they expected!

I brought up topics about family and visitors coming in! Purses and coats left on the floor or on pt tables...family using the pt bathrooms and not washing their hands, and the horrid disregard for hygiene by anyone not medical going into their rooms (even our hospital volunteers!). I grossed them out big time!

So when we think of MRSA or any other germ...where we...the RN's and staff are to blame...think of how many purses are put on the floor and perched later on the table or counter where patient items are put? That alone should gross anyone out...and they blame us if for some odd reason a multiresistant form comes around?????

[SuesquatchRN, BSN, RN]

My favorite part of insisting that I gear up in a hazmat suit and end up looking like the Ghostbusters is the incredible condescension of assuming that I neither know nor care about the appropriate precautions for protecting myself and my patients.

[joshuaha]

I could be wrong but I have heard that scientists are frantically working on an MRSA vaccine and it is just around the corner. Wouldn't that be a revolution?!

[MrsCaseyRN]

I think healthcare worker get "desensitized" to MRSA. When we hear it, we are like "yeah ok, yet another pt w/ MRSA". Where I think the general public is very freaked out by it. Not that we should be too casual about it, or that could lead to spreading it to the pts that don't have it, but we need to educate the public.

[TiredMD]

And the next step is VRSA, which is starting to pop up. Are we one day going to debate whether it is a big deal or not?

http://www.journals.uchicago.edu/doi/pdf/10.1086/527392?cookieSet=1

Actually, seven cases ever in the U.S. Five in Michigan, 1 in PA, and I think one in NY.

Once upon a time, staph was susceptible to penicillin. It took less than a decade for the majority of infectious isolates to develop resistance. Now there are fewer and fewer strains that are suscpetible to the later generations of penicillin (eg - methicillin). Eventually we will get over the whole "MRSA" designation and move on with our lives, without the stupid yellow gowns that no one bothers to wear correctly anyway.

[RNsRWe, ASN, RN]

MRSA can be spread through respiratory droplets, and in a case like that, droplet precautions, which include masks, would be indicated.

Ah. I'm not on a respiratory unit. But still, have never once seen a MRSA pt placed on droplet precautions, only contact. Either I've been lucky to avoid thusfar, or someone's missed something.

[Indy, LPN, LVN]

Well, if they have MRSA pneumonia and are on a vent, the one vent line ... dangit I can NOT think of the name of that blue hose-looking thing... Anyway one goes from the pt to the vent and one goes alongside it, from the pt and ends in midair, blowing off the exhale. Which is fine except it blows in my face when I turn the patient. I like masks, even if they smell like old unwashed butt.