MRSA during preceptorship

[TeresaB930, BSN, RN]

I'm in the 6th quarter of the nursing program, doing my preceptorship. I graduate in 10 days!!

Here is my situation. I was caring for a developmentally disabled patient with pneumonia, who, come to find out on his day of discharge, had a history of MRSA! The patient was not in precautions. I am meticulous about hand washing and glove use, but his MRSA was sputum. My instructor and unit manager said "you're probably alright, if you were good about washing your hands." Hello! This is droplet! I wasn't wearing a mask! The whole thing seems to be being swept under the carpet.

FYI, the patient was in the hospital for 10 days, no nurse, MDs, nor infectious control caught this.

Please....provide me some feedback.

Thanks

[proud2b1]

I imagine any one of us in this field could have a nasal swab done,and find out MRSA is present!!!

[Agnus]

MRSA in suptum is contact precautions not droplet.

[Okami_CCRN, BSN, RN]

to the poster... as a nurse you will be put at risk many times. I myself have had patients who have TB and we do not find out until they were discharged. Its something that comes with the job.

Proud2b1 you're probably right about that any one of us could have MRSA in our noses... creepy but likely

[Agnus]

MRSA calls for contact precautions. It is the organism that determines they type of precautions not where it is located. MRSA in suptum calls for contact precautions.

You can be exposed about town as easily as you can in the hospital. Actually more easily as in the community people are not careful about hand hygiene let alone surface hygiene.

You can come in contact with MRSA any time or place. Shake someone's hand. Unless you are immune compromised you are very very unlikely to be at any risk.

As one poster already pointed out, a swab of anyone's nasal passages of us could reveal MRSA. It does not mean you have MRSA.

[loriangel14, RN]

Many times at work we find out pts are MRSA positive after we have had them for a couple of days. I bet if you swabbed us you would find MRSA.

[imanedrn]

I imagine any one of us in this field could have a nasal swab done,and find out MRSA is present!!!

After taking microbiology and finding out that S. aureus is actually present on our skin and in our nostrils... then working with MRSA patients... I'm convinced I have it in my nares.

[MoonRN]

Many patients have a history of MRSA, but that doesn't mean an active infection is occurring at present.

[queenjean]

Our hospital now puts MRSA pts in droplet and contact if they have MRSA in their sputum.

Thing is, though, we don't always know. I work on the assumption that every one of my pts has it. I don't wear gloves as if everyone is in contact isolation--but I wash the crap out of my hands constantly, I clean all of my personal equipment, and leave my shoes at work.

Honestly, I wouldn't worry about it. I don't have enough fingers to count the times that I came back to work to find a pt who had not been in isolation, but then something funky grew out or was discovered and now they have MRSA, TB, C-diff, whatever.

People are dirty, dirty, dirty. I take my vitamins, get as much healthy sleep as possible, get regular exercise, and wash my hands. I haven't gotten MRSA, TB, or c-diff yet!!!!!!LOL.

[justme1972]

MRSA in suptum is contact precautions not droplet.

That is what I was thinking. I was taking care of a patient in my first semester that had MRSA (and I didn't understand it at the time) but I was told a face mask wasn't necessary b/c he wasn't coughing...just to wear gloves and gown and to wash, not mix laundry, etc.

I hated to go behind the LPN's back (b/c I didn't think this facility was very clean) but I re-ran it by my clinical instructor and she assured me at no time would she ever let her students touch a patient unless it was safe.

I do trust her.