ecugirl

I am so proud of you! I think you reacted in a most professional and calm manner. It is high time that patients are given the message that they are not allowed to treat health care workers as their punching bags; verbally or physically...this type of behavior from "customers" in any other "business" is not tolerated. A nurse in our ER is actually suing a patient for assault and battery...I hope she wins...even if she doesn't she's getting a message across...and she still has her job!!

here are a few I've heard; not necessarily from nurses or at work: - Drinking coffee as a child will stunt your growth - Never have surgery during a full moon...it will cause you to bleed excessively (have had ortho patients check the moon's status when scheduling total joint replacements for fear of this). You want to have surgery when the moon is waxing; not waning - Should never eat or drink dairy products after eating seafood; it will cause the milk to coagulate in your stomach - To cure ringworm: soak a penny in vinegar overnite and then place the penny on the site

Community acquired MRSA (CA-MRSA) is definitely on the rise. It used to be an organism that was isolated in hospitals, but in the last 5 years or so, it is being seen more and more in people that have not been chronically ill or had frequent hospitalizations. Staphylococcus aureus, being a common skin organism anyway, has been evolving and becoming more resistant as the years go on. CA-MRSA is now seen in places where groups of people have close contact with each other, like in prisons, day cares and school football and wrestling teams and in gyms where people may share towels or equipment that has not been cleaned in between use. In fact, a professionsal football player died from it; I think he was with the LA Rams or Raiders...whatever, team is in LA. You may have seen newscasts on Dateline recently about the paraplegic lady who got a resistant staph infection when her foot was cut with a pumice stone while she was getting a pedicure...she died. In Raleigh, NC, there was a woman in the news who had acquired MRSA from an exercise ball at her local gym...she always shaved her legs before she worked out; didn't want to gross anyone out with hairy legs; and in doing so, she created wonderful nicks and openings for bacteria to easily get in. And antibiotics have just been so misused over the years; doctors have prescribed them for colds and ear infections when moms are screaming for them to "give my baby something to make him better!". Studies have shown that by the time a child reaches age 15, he has been on at least 4 courses of antibiotics for something that antibiotics were not necessarily needed. And antibiotics are given to chickens and cattle to make them bigger and have more meat to the bone...so we're getting antibiotics in our food supply that we don't need. All this is beginning to add up.

I've been an Infection Control Practitioner for almost 13 years. When I started this job, I came from being an ANM on an orthopedic surgical floor for 6 years with no experience (other than direct patient care and management) in IC. Most posititions require an RN with a BSN and that you obtain your CIC after 2 years...which, like you said, you have to have at least 2 years of experience in IC before you can sit for the CIC exam. And the exam is expensive so I would definitely try to be in my position as an ICP so that my employer would pay for it. Most ICP positions like someone with some type of management or supervisory experience also...this job requires you to work very closely with Administration, physicians, staff in changing behaviors, teaching, supporting JCAHO, CMS, OSHA, CDC, etc. recommendations and regulations...and trust me, they don't all say the same thing. It's a very exciting and challenging time to be in IC...with the looming of a pandemic flu, bioterrorism, new emerging resistant organisms, new emerging diseases.

There are hospital-based 8 -5 nursing positions that do not require nights, weekends or holidays...down side is that they are ususally 'salaried' positions and so the pay starts less than you make now, no shift differential, and you make the same pay even if you have to work overtime. They are usually in Occupational Health (instead of dealing with cranky physicians, you get to deal with cranky employees who use the office as their personal physician's office), Quality, Education, Infection Control (still have to deal with staff and physicians and with the past SARS and now Avian flu spreading around the world, this is a challenging field), Care Management/Discharge Planning, Utilization Review (may have to do call on weekends), Safety, Information Systems. Keep in mind...there is light at the end of the tunnel in dealing with irate physicians...one of JCAHO's new safety goals is dealing with "disruptive" personnel (really do think their focus is on physicians; they just don't spell it out!). I do hope it will help some; even though there are those that are just beyond help...now Administration will have to show JCAHO followup on complaints about these folks.

I'm from NC and have heard of people eating clay or PI-CA; but not "dirt". I don't know if that's exactly how you spell pica; I spelled it that way because that's how it is pronounced.

A unit secretary I used to work with was named "Vienna Switzerland" and her sister was named "Montana"....both were born in NC.

Oh yes! There was about a 6 month period on my unit where myself (working 7p-7a shift) and another nurse lost 3 DNRs after we assisted them back from the bathroom; once they hit the bed; they were gone. The worst one was a man whose wife had spent every night with him; until the last one. He had felt sooo much better and was sooo alert during the day, that she felt comfortable leaving him alone and of course, he passed away that night. Have you ever noticed that DNRs have a perking up period right before they pass awya? Anyway, that was an awful phone call to have to make in the middle of the night.

I feel your pain! I never have been able to deal with vomiting...I remember one time; after ambulating a college student who had lost one testicle playing LaCrosse; he became nauseous and vomited when he got back to the bed. After making sure he was settled; with his bath basin; I went into his bathroom and threw up! I could hear his mother saying, "Now look what you did to that nurse! Stop it right now!!" Anyway, we got a big laugh out of it; once we both finished and felt better. All the nurses and nursing assistants I work with just don't bother to ask me for help in this situation; even if it's my patient!!

Wouln't it be more professional and appropriate to say "Your primary healthcare workers today will be" ? If they've got to say something, at least, that's what we all are and its not sooo degrading.

Methinks thou doest protest too much. As an Infection Control nurse of almost 15 years, I can tell you from study after study and from personal observations of staff, that staff DO NOT wash their hands nor do they clean equipment from patient to patient. I can't tell you how many times I have watched staff; not just nurses either; come out of a patient room, remove gloves and go straight to the computer to chart...never washing their hands. And I challenge you, whenever you are a patient, be it yourself at your doctor's office or an Urgent Care or Emergency Room OR your child at the pediatrician's...watch and see who washes their hands before touching you or your child...you will be appalled! This is a nationwide effort to respond to JCAHO's Patient Safey Goal of compliance with the CDC Guidelines for Hand Hygiene to ensure staff are washing their hands and involve patients in their care. This should be viewed as a good thing for patient care. At my hospital we have been doing this since 1991 with signs posted in the patient room stating, "Has your healthcare worker washed their hands? ASK THEM!" You shouldn't be so intimidated by this question if you are doing the right thing.

I've been an ICP for almost 12 years now and this has got to be the most frustrating action to get staff to do...maybe because it's the simplest thing to do! One action we've implemented is "thio broth bag handwashing". Our lab prepares 2 bottles of sterile thio broth which we pour into sterile plastic bags (double bagged) and then we take these to the patient care areas and get 5 staff to simulate handwashing in the broth bag. We have gotten nurses, nurses assistants, housekeeping, transporters, physical therapists, social workers and physicians to participate. We just grab whoever is available on the unit at the time. Then we send the 2 bags back to the lab and they culture it for MRSA. We record the names of the participants and send them an email letting them know if their bag grew MRSA. With 5 participants in each bag, it is not punitive and pointing fingers at one person, but if MRSA is found, then you may need to be more diligent with your handwashing. So far we have done this on all our inpatient units, ICU, dialysis and ED and have only cultured MRSA from 1 bag. We are going out to the ancillary departments next and will continue to rotate back thru the nursing units. It has been something different to do and fun for staff; maybe even a little scary, but you should have seen the looks on the faces of the 5 in the bag that did grow MRSA!! It really helped open their eyes.

To determine what you need to do to prevent the transmission of MRSA or VRE, you must understand WHAT it is. MRSA is transmitted no differently that Staph aureus would be...that is, on your unwashed hands or contaminated equipment or clothing. It is a skin organism that sets up house in the patient's nose, armpits, groin, and skin/hair....just like Staph aureus does. VRE lives in the GI tract; just like Enterococcus does.....we just are limited now with what drugs will kill MRSA/VRE. Both are transmitted by contact...you pick it up and hand it over to the next patient....if you don't wash your hands or clean your equipment. The same staff can work with a MRSA/VRE patient as with any patient in the OR; if contact precautions are maintained during the procedure...meaning, you wear gloves and a isolation or cover gown to protect your clothing. MRSA/VRE will not go thru your cover gown worn in a case, so you don't need to wear the isolation gown over it (like the scrub). As with any patient, you would change gloves and wash hands when going from a "dirty" area to a "clean" area on the same patient. The circulator and CRNA or anesthesiologist would also need to wear gloves and an isolation gown also because they will be touching the patient or what the patient has touched. Basically, if you are going to touch the patient or any equipment (I'm talking more about the OR table and linens that are in direct contact with the patient that you might brush up against) used on the patient, you need to wear a "barrier" like gown or gloves. We do recommend that MRSA or VRE patients be scheduled as the last case of the day; if possible and terminally clean the room. It does not have to sit empty for any time because the organism is not airborne. We recommend terminal cleaning because we know that we may not remember all areas/equipment in the OR that we may have touched with our contaminated gloved hands.....but we dont' go so far as washing the walls down....who's touching the walls during a case??? Hope this helps and sorry if I got too "basic" with you....but I've found that most people understand how to prevent the transmission once they understand the organism....from an Infection Control Practitioner