Nurses obtaining c.diff

jtjames · Oct 15, 2008

anybody can get c-diff, the spores live for quite sometime. it comes down to contact precautions and handwashing....

Kreskino · Oct 15, 2008

how would she know if she had it?

nlion87 · Oct 15, 2008

Symptoms

Some people who are infected with C. difficile never become sick, though they can still spread the infection. Others have bouts of watery diarrhea, often with nausea and abdominal pain and cramping. And an increasing number of people develop colitis or pseudomembranous colitis-severe inflammations of the colon. Signs and symptoms of these potentially life-threatening illnesses include:

Profuse, watery diarrhea-10 or more bowel movements a day
Fever, often greater than 101 F
Abdominal pain, which may be severe
Blood or pus in the stool
Nausea
Dehydration
Weight loss

Most people develop C. difficile infection during or shortly after a course of antibiotics, but signs and symptoms may not appear for weeks or even months after treatment has stopped

Risk factors

Although more people with no known risk factors-including children-are contracting C. difficile infections, your risk is greatest if you:

Are taking or have recently taken antibiotics.
Are 65 years of age or older. Older adults have a disproportionately high infection rate. They tend to have more health problems than younger people do and so are more likely to be hospitalized and treated with antibiotics.
Have a serious underlying illness or weakened immune system. People with weakened immune systems are especially likely to have recurrent infections.
Are or have recently been hospitalized, especially for an extended period. In general, larger hospitals have higher infection rates than do smaller hospitals.
Live in a nursing home or longterm care facility. Often, the infection spreads when patients are transferred from hospitals to other facilities.
Have had abdominal surgery.
Have a chronic colon disease such as inflammatory bowel disease or colorectal cancer.
Take prescription or over-the-counter antacids. By reducing stomach acid, these drugs may allow C. difficile to pass more easily into the intestine.
Have had a previous C. difficile infection.

Ruby Vee, BSN · Oct 15, 2008

i know i've told this story before, but maybe not on this board.

dh and i are both seasoned nurses with decades of critical care experience. one day, he and a colleague were changing a "fecal incontinence bag" on a patient. dh had his face down, close to "the area" when there was a bag failure, and dh got squirted in the face with liquid stool. he was so distressed that he couldn't bring himself to fill out an incident report. days later, the c. diff culture on the patient came back positive.

a few weeks later, dh began having liquid stools. as is typical for seasoned nurses, he drank gatorade, dragged himself to work and put off any consideration of calling the doctor. it got worse, to the point where he was have 30 stools a day. when he did call the doctor, it was weeks before he brought in a stool culture and c. diff was confirmed. in the meantime, he started missing work. he'd stay home for a few days, get better and go to work for a few days . . . .

management thought he was malingering. he went through three rounds of oral vancomycin (which at that time, cost over $300 a week, with insurance!) and several rounds of flagyl. (flagyl is a nasty drug which makes some people feel like a pile of feces and make some people act like the north end of a south bound mule.) his temperatures got as high as 104. and one night, when he was somewhat delirious and i'd had enough, i dragged him to the hospital.

turns out his c. diff infection, inadequately treated for so long, caused ulcerative colitis.

after the two-week hospitalization for antibiotics, tests, tpn and re-hydration, dh (who was only then my boyfriend and as a result of his behavior during his illness almost became an ex-boyfriend!) went home from the hospital on 240 mg. of prednisone a day. he'd had several rounds of expensive antibiotics pre-hospitalization and missed a total of three months of work. he didn't qualify for disability because he'd keep going back to work when he could. he'd been having 5-30 stools a day for months and was mal-nourished, anemic and dehydrated. he almost died. he's been on and off steroids several times over the years and although he's mostly healthy now, he has to take 12-16 asacol pills a day to stay that way. he still misses work from time to time with uc flare-ups. the 'roid rage episodes almost cost us our relationship. the bills mounted up and didn't get paid and didn't get paid, and i spent most of my savings helping to bail him out. when we got married, we were deeply in debt. we'd mostly bailed ourselves out when i hurt my back and was out of work for 6 months. we're back in the hole again!

yes, nurses can "obtain" c. diff. they can also get c. diff.

StNeotser, ASN, RN · Oct 15, 2008

Wow! That's some story Ruby.

CoffeeRTC, BSN, RN · Oct 15, 2008

Sure...you can pick up anything and everything at work.

Virgo_RN, BSN, RN · Oct 15, 2008

Ruby, that is quite the story. I'm sorry for all that you and your husband have been through. Did the C-Diff cause the UC, then?

racing-mom4, BSN, RN · Oct 15, 2008

Yikes Ruby---what an ordeal!!! Thanks for sharing...

Ruby Vee, BSN · Oct 15, 2008

ruby, that is quite the story. i'm sorry for all that you and your husband have been through. did the c-diff cause the uc, then?

according to his doctor, yes. the c diff caused the ulcerative colitis. oh, the gifts that keep on giving!

AnnemRN · Oct 16, 2008

Ruby,

That is clearly a workers compensation claim if I've ever heard one. If your husband hasn't initiated a claim then he certainly should do so now. Glad to hear he made it through the ordeal.

Ruby Vee, BSN · Oct 17, 2008

ruby,
that is clearly a workers compensation claim if i've ever heard one. if your husband hasn't initiated a claim then he certainly should do so now. glad to hear he made it through the ordeal.

my husband's episode with c. diff was over a decade ago. at the time, he tried to pursue worker's comp, but came up against a brick wall because he had never filled out an incident report when he got the face full of stool. it would have required a lot of energy on his part to fight for his wc, and he didn't have the energy to spare at that time. since we weren't yet married, i couldn't fight for him. so he let it go.