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Patients testing Covid positive AFTER admission

Disasters   (498 Views | 10 Replies)

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This is a post concerning Covid 19. I work in two hospitals. As we all know patients are now coming to the hospital for non-covid related medical conditions and elective surgeries. Both hospitals I work at are testing admitted patients for Covid 19 and are then sending the patients up to the units (Med Surg, PCU, ICU) pending the test results.  The nurses on these units are wearing only the blue surgical masks, as due to the shortage of N95 masks, those are only being provided to nurse working the Covid/rule out Covid units.  A few days later some of these patients test results come back as Covid positive. This means that nurses have been exposed to these covid positive patients for multiple shifts.  

One of the hospitals I work at will not allow us to bring in our own masks.  My work around this is I've purchased KN95 masks. I wear a blue surgical mask over the KN95 mask. Management does not have an issue with this because I am complying with their policy to wear their blue surgical mask.  Just wanting to help out other nurses as until all nurses working any floor are provided with N95 masks, this is going to be an ongoing issue. 

I obtain my KN95 masks from this website which is FDA approved and the prices are reasonable and they are not price gouging:

www.cleansense.us

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Thanks for this. I'm a new grad and I start my ER residency in September. I was hoping we would be in a better situation by then, but it's not looking too great. I'm not gonna lie, I'm scared. Working in the ER has been a dream of mine, and starting off in the ER as a new grad as part of a residency program is an absolute gift, especially in this economy. I want to stay safe in the best way possible. I would feel most comfortable if I could bring my N95 from home, wear a surgical mask over it, and wear protective glasses/goggles. I just hope they'll let me. What do I do if they don't? There's so much we don't know about this virus, and people recovering from COVID are reporting cardiovascular issues. I'm not trying to cut my life short. But I'm also not trying to trash the BSN and residency spot I worked so hard to earn.

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AI1711 has 4 years experience and specializes in ICU tech.

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I’ve worked as ICU tech in a covid designated ICU since March in NYC, our hospital took highest volume of covid admits across the city. I also float on occasion doing one to ones which meant prolonged exposures. Plenty of patients who were negative who later I was told were positive. I’ve lost count of how many times that happened and I would be in a room with them in just regular surgical/ teddy bear mask, diapering turning .. all over them. I’ve never been sick. Up in our covid ICU I wore n95, blue surgical on top so I could reuse n95. In height of covid I kept my n95 on all shift and replaced surgical mask between rooms. I wore a blue hair bouffant and a visor shield that covered my face - I wipe it with purple wipes between rooms. Sometimes I would wear a blue mask with a fluid shield visor attached over the top of my n95 for quickness because I could just dispose of it between rooms. Yellow gown or maybe blue plastic one too depending on what we had in. Plastic gown either make you sweat like crazy but I like for doing baths, otherwise I used yellow. I feel confident using PPE in this manner. Don’t be scared and try to renew your n95 per shift. I did reuse my n95 for you to a week when we first got caught pants down with this. Use size and type you were fit tested for if possible. I prefer the duck Bill type - they form a seal around my face best. I’ve also travelled subway and uber for months in just surgical mask, as well as talking to known positive family members in just surgical mask. The respiratory therapists and I believe you need to get covered in a significant amount of respiratory particles to get this thing. We think most staff who got sick got it outside of work. So far only one nurse who works our covid ICU tested positive in serology for antibodies and she travelled frequently overseas several times in Jan and Feb. 

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Oh my! I was just saying this in another thread. Hospitals still don't have it together and there's no plan of action. This virus is here to stay.

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scribblz has 13 years experience as a BSN, CNA, LPN and specializes in Med Surg, Tele, Geriatrics, home infusion.

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9 hours ago, caal19 said:

Thanks for this. I'm a new grad and I start my ER residency in September. I was hoping we would be in a better situation by then, but it's not looking too great. I'm not gonna lie, I'm scared. Working in the ER has been a dream of mine, and starting off in the ER as a new grad as part of a residency program is an absolute gift, especially in this economy. I want to stay safe in the best way possible. I would feel most comfortable if I could bring my N95 from home, wear a surgical mask over it, and wear protective glasses/goggles. I just hope they'll let me. What do I do if they don't? There's so much we don't know about this virus, and people recovering from COVID are reporting cardiovascular issues. I'm not trying to cut my life short. But I'm also not trying to trash the BSN and residency spot I worked so hard to earn.

They'll let you use an N-95 regardless of whether they provide it or you bring it. A home made cloth mask they might push back on or make you wear it under your surgical mask, but anything like a face shield, safety goggles or N-95 it's standard practice.

I have a "wine bag" (like you get at the grocery store) one compartment for my face shield, one for a container of Clorox wipes, a few gowns, my N-95 and face shield. I put it on the side of my IV cart. That way when my pager goes off, and I'm flying from one end of the hospital to another; I always have my PPE.

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The website (www.cleansense.us) I get my masks from also sells faceshields.  The masks sell for $14.95 for 10 KN95 masks and I use one mask per shift.

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scribblz has 13 years experience as a BSN, CNA, LPN and specializes in Med Surg, Tele, Geriatrics, home infusion.

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3 hours ago, telenurse2009 said:

The website (www.cleansense.us) I get my masks from also sells faceshields.  The masks sell for $14.95 for 10 KN95 masks and I use one mask per shift.

Good to know, thank you for sharing!

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11 hours ago, AI1711 said:

I’ve worked as ICU tech in a covid designated ICU since March in NYC, our hospital took highest volume of covid admits across the city. I also float on occasion doing one to ones which meant prolonged exposures. Plenty of patients who were negative who later I was told were positive. I’ve lost count of how many times that happened and I would be in a room with them in just regular surgical/ teddy bear mask, diapering turning .. all over them. I’ve never been sick. Up in our covid ICU I wore n95, blue surgical on top so I could reuse n95. In height of covid I kept my n95 on all shift and replaced surgical mask between rooms. I wore a blue hair bouffant and a visor shield that covered my face - I wipe it with purple wipes between rooms. Sometimes I would wear a blue mask with a fluid shield visor attached over the top of my n95 for quickness because I could just dispose of it between rooms. Yellow gown or maybe blue plastic one too depending on what we had in. Plastic gown either make you sweat like crazy but I like for doing baths, otherwise I used yellow. I feel confident using PPE in this manner. Don’t be scared and try to renew your n95 per shift. I did reuse my n95 for you to a week when we first got caught pants down with this. Use size and type you were fit tested for if possible. I prefer the duck Bill type - they form a seal around my face best. I’ve also travelled subway and uber for months in just surgical mask, as well as talking to known positive family members in just surgical mask. The respiratory therapists and I believe you need to get covered in a significant amount of respiratory particles to get this thing. We think most staff who got sick got it outside of work. So far only one nurse who works our covid ICU tested positive in serology for antibodies and she travelled frequently overseas several times in Jan and Feb. 

This is definitely reassuring, thank you. I was a tech before the pandemic and there was a time I spent a whole day in a patient's room and 2hrs before the end of my 12 they told me the patient had the flu. I was so angry. I can't imagine being in that same situation x100 except being told they had COVID. It's infuriating. Have you gotten tested for COVID? You said you've never gotten sick, but I'm wondering if maybe you could've been asymptomatic?

So far I have 1 N95 that properly seals my face (a gift from getting fit tested for the residency). I'm trying to find the same kind (3M small) to buy more of online but obviously it's been very difficult to find. I'm wondering how many reuses I can get out of it 😞

 

10 hours ago, scribblz said:

They'll let you use an N-95 regardless of whether they provide it or you bring it. A home made cloth mask they might push back on or make you wear it under your surgical mask, but anything like a face shield, safety goggles or N-95 it's standard practice.

I have a "wine bag" (like you get at the grocery store) one compartment for my face shield, one for a container of Clorox wipes, a few gowns, my N-95 and face shield. I put it on the side of my IV cart. That way when my pager goes off, and I'm flying from one end of the hospital to another; I always have my PPE.

When I was getting fit tested I asked if they were having staff wear surgical masks or N95s and they said only N95s if it's a confirmed COVID patient. I feel like ER staff at the very least should be allowed and supplied to wear N95s 24/7 because you don't know who's gonna walk in the door with COVID. I'm going to try to wear an N95 as much as possible and hope they don't have a problem with it. In the beginning of the pandemic, I heard of hospitals firing nurses for wearing their own PPE, but after getting clap back I'm not sure if that's a thing anymore. I hope not. Let me protect myself. That's a nice little PPE kit you've got there btw!

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AI1711 has 4 years experience and specializes in ICU tech.

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I didn’t get the antibody test yet.. down to laziness over coordinating an appointment - after my shift I just want to get the hell out of that hospital. My prediction is I will be negative that’s what my gut tells me and from seeing others who worked on my covid unit all over the patients - so far all but one have come out I negative for covid antibodies . As I said the one positive  travelled overseas several times back and forth throughout Jan and Feb. A couple of others working on my unit who got sick with covid got it early on before we became a covid designated ICU And so they never took those patients - they got it outside the hospital. I am OK working with covids with a n95 (preferably duckbill that I can change per shift in size I was fit mask tested for). As I said with the use of brown paper bags and being careful we managed to reuse n95s for a week at a time/4 shifts or so. I did always take my scrubs off before leaving the hospital, bag them up. Leave work shoes at work. Wipe down work phone, personal phone, work ID, lip balm , anything in my pocket with purple wipes or bleach solution on a rag at home. I ruined my iPhones speaker being over zealous Wiping with bleach solution at first... I have a laundry hamper in my vestibule where I throw dirty scrubs, have hand sanitizer available and I walk in with underwear on and straight to shower and wash my hair after every shift. I hate that I can’t use my dry shampoo like I used to but have improvised by buying hair masks and shower gels that have lavender and aromatherapy type benefits to wash the day away. 
 

I will update when I finally do the antibody test. 

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pixierose has 3 years experience as a BSN, RN and specializes in ED, psych.

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I’ve seen this - patients test negative in the ED, but test positive a few days later before their procedure. Meanwhile, nurses/CNA’s/transport/the meal lady/etc have been in their with surgical mask only.

Scary.

I just did my antibody test last week - negative. This after working on a COVID unit. I was so extremely careful, even off the floor. The procedure I took when I got home was specific but hopefully safe enough. I’m still not out in public too much. And I never not got out without a mask. 

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On 6/29/2020 at 5:31 PM, telenurse2009 said:

This means that nurses have been exposed to these covid positive patients for multiple shifts.  

I work with patients who are generally Covid negative until they're not, and sent in for testing and perhaps longer-term hospitalization. In terms of our possible exposure, and what "counts" as exposure, we are referred to a PDF with an information graphic featuring different scenarios of low and high risk exposure depending on who is masked, if the patient is showing symptoms, etc. I'm sure people have seen them.

And that's it.

(Amazingly, no one's been deemed yet to have actually had exposure, which is a load of you know what.)

I'm of two minds about this approach. On one level, it's a joke. Hey folks!, Step right up, and use this infographic to determine your risk! On the other hand, it sort of empowers me, but in terms of testing, I'm on my own, gotta do it on my own time and maybe incur the expense. Also, I can't help but harken back to March and how we'd have these long drawn out meetings featuring very complicated exposure scenarios and what to do (isolate and quarantine) if x, or x and y, or y - so complicated, I shut down my brain during the meetings, it was nearly ridiculous. Point being, at that time, there was little virus circulating and the risk unlike now, was low. And now, now when the risk is high, it's - refer to your emailed PDF with the masking graphic.

I'm glad you're wearing the KN95 underneath your surgical mask. You should always be wearing an N95 or KN95, no matter what. And so should your colleagues.

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