Is this common practice in LTC/Hospitals?

Kris10Noel · Jul 2, 2013

You should be wearing a gown, not a mask with VRE. Always ask your nurse for a report in addition to the aide you are relieving. That's your safest bet!

mvm2 · Jul 2, 2013

I agree ask questions if you don't know. Get to know the residents and if it is not in the report ask about any changes in the residents that you need to be aware of. Sometimes things are simply crazy at LTC and information can fall through the cracks and be forgotten to be shared. Take control of the situation and search out the information if you need to.

Mewsin · Jul 2, 2013

In our facility if someone has MRSA, VRE, CDiff, pretty much anything contagious then there will be everything we need for the patients outside the rooms(gowns, gloves, masks, eyewear, disinfectant), on the doors will be signs saying to wear protective equipment, and inside the rooms there will be a separate garbage bag. If I were in your position though, I would try and take some minutes to read the charts if you are allowed to.

I just went back to work after being in school for 5 months, I went early for my shift and read the charts for the residents I didn't know. It helps a lot. On our care plan it will say what conditions the clients are experiencing.

i_love_patient_care · Jul 2, 2013

If they have anything that you need to use more PPE than standard precautions, there is supposed to be a sign on the door stating to ask the nurse before entering (at least where I live). That being said, if a patient is coughing, or their poo smells like ickiness, I'm going to do what I need to do to feel safe. Nurses I work with know this. If the sign isn't on the door, they need to make sure the oncoming shift is aware. The others are right, you should check the basic info on patients and be given a report.

I always ask for report even if the people leaving don't offer one. Some people don't even know how to give a report, which is a little sad.

MedChica · Jul 3, 2013

I am a CNA at a LTC facility and we have a lot of residents that are total care and wear diapers. A lot of them have chronic medical problems, honestly I have no idea what. I know a lot have MRSA, some with VRE, lots of kidney problems, even an HIV positive.
The other day I was changing a residents diaper and another CNA saw me, ran into the room and told me I should be wearing a mask because the patient had VRE. Honestly the nurses never tell us anything about what these patients have. Is that common practice? I have never had any of them tell me. It is also not in the comminication charts we fill out on the computer every shift either. The only way I know is if there is a separate yellow or red bin for laundry in the room. Is this common in a hospital? I know VRE really isn't an issue for healthy people but I find it unbeliavble no one would communicate anything with us. I definitely use double gloves and sanitizer if I can't wash my hands right away after every patient. Is it like this everywhere? Or only my facility?

In the hospital, they'll go ahead and put the precaution signs and gowns on the door.

At my facility, we put a sign by the room: See Nurse's Station Before Entering.

Although, I've walked into room as a GVN completely unaware that the resident was under contact precautions. Dietary told me after I wandered in there asking if so and so had their tray yet.

Apparently, the resident (a readmit from the hospital) had MRSA and that's why he was eating in his room.

The nurses hadn't said a thing because they were drowning in paperwork and 'tasks'. It takes a little time to set up a room.

I made a beeline back to the hall, grabbed a sheet a paper, wrote 'contact precautions' and slammed it up on the door. I didn't have the PPE ready but at least people knew.

So, I'm very diligent about setting up the precaution rooms. I know what it's like to be totally blindsided with that.

It also helps to write a note by the bio barrels on how to put on and remove PPE. You just can't assume that everyone will remember how. 'Specially if they have to 'gown up'. They don't do it everyday.

funtimes · Jul 4, 2013

If someone has MRSA or VRE there should be something outside the door stating this. Unfortunately exposure to things like this are an occupational hazard. You will undoubtedly come into contact with patients who have MRSA without your knowledge, its a fairly common bacteria these days. This is why I cringe when I see people in scrubs walking around super markets.