Mammy1111

I totally agree....once a nurse, always a nurse. I advise family and friends, advocate for them and many others, and read nursing related information and articles all the time. If somebody is in an accident or falls, I'm there! It's in the blood, I swear. So, truthfully, nurses never retire. We just stop getting paychecks.

The problems with MRSA colonized and/or infected Nurses or HCWs. 1. you can spread disease with either condition 2. you don't have infected family members but are constantly exposed to MRSA on your job, yet your employers deny workmans comp for missed work and treatment of MRSA. 3. Ignoring MRSA will not make it go away. You should report your MRSA to your hospital IC department. Refusing to be screened will not help you or your patients. 4. Fight for better prevention of MRSA in your facilities in the form of Active Detection and Isolation. Rapid MRSA screening will allow early or immediate diagnosis of colonization and Isolation and contact precautions can be enacted right away... meaning fewer unprotected exposures for HCWs. If you are a HcW...and need surgery, DEMAND a screening. If you won't do that, then get your doctor to prescribe decolonization (mupirocin in the nares for 5 days and chlorhexidine showers prior to surgery). You still will not know if you are colonized, so the appropriate preoperative antibiotics may not be used. And finally, never ignore precautions and/handwashing.

I am using my knowledge to run my home business educating people on the harmful environmental toxins they have in their homes and the effects it has on their health. Even though I am not actively "nursing" I am still helping people. There is more than one way to be a nurse and the way you have chosen is very honorable.

In 40 years as an RN (not all of them working years) I have reported 2 nurses. One was showing up on the job at midnight, drunk. It wasn't her first time but it was her last time when she came to relieve me. The managers were aware of this and had warned her already. I loved her as a person and I had known her a long time, but I couldnt' pass my assignment off to her when she was in that condition. She was fired. The other was a new grad who was over confident and underqualified. His approach to patients was unprofessional and he was off putting to them. He attempted to tell me what to do and how to do it...as a brand new grad and that was the straw that broke the camels back. I reported him as unsuitable for work in my department and that he needed to sharpen his skills and his approach to patients. I never worked with him again. However, I did read on a later date that his license was withdrawn by the State, so I now know for sure that my instincts about him were correct. He worked hard for his license, but he came on too strong and too confident for an inexperienced nurse. I honestly believed that he would be a danger to patients. We MUST as nurses protect our patients..in is priority. If that involves reporting a coworker who is unsafe, so be it. It is part of our jobs as patient advocates.

The Joint Commission is a membership club with heavy dues. They do inspections and all of the facilities managment teams get in a twit about perfecting things while the inspectors are there. So, all's well while they are being inspected only to return to normal after. In reality, JCAHO does very little to regulate or punish hospitals. The fact that they give warnings to their "members" about the dates they will be there to inspect a facility kind of negates the effectiveness of the organization. Surprise inspections would tell JCAHO what really goes on in their member hospitals, but I have my doubts if they would do much for real change.....ie, recommend safer nursing staff levels.

I'd love to challenge the management to come and work a shift in our shoes, and see them try to flounder through the 12 hours of endless paperwork and crap that they tell us we have to do.It sure would be an eye opener, but of course THAT would never happen.. Actually I did manage to get this to happen a time or two. I worked in a very busy Walk in care at my local hospital years ago. We worked 12 hours shifts and with minimal staff. There was the RN (me), one tech, and a registrar. It was announced that although we were open from 9am to 9pm that after 6pm, I would no longer have a tech. Those last few hours were often times the busiest times we had. So, I told my department head that if there was not going to be a tech to help after 6pm, I was only available from 9am to 6pm. I was a per diem nurse, so I could name my hours. Of course I was the only one to do it, so it didn't change anything, but on a few occasions, the DH couldn't get anyone to cover from 6pm to 9pm. SHE had to cover. I clearly recall one day she came at 6pm all cocky and bossy, and I had all 4 rooms full and several patients in the waiting room. I proceded to give her report. As soon as I finished, she trotted down the hall and demanded help from the ER staff!! The lowly WIC staff nurse couldn't do that, but she could. We were expected to trudge through, no matter how many patients we had. I got my point accross and I never had any more satisfaction about it than when I walked out leaving that bi#@! with a big bunch of patients to care for....even if she used her power to get help! Big time double standard.

That is awesome! I would love to travel all over like that. Maybe someday.

Do nurses ever really retire? Once a nurse, always a nurse!! I'm not talking about money either. I am talking about how we all end up being resources of info for our families and neighbors. I am talking about how we stop at accidents on highways and help out if we can. Volunteering in any number of capacities seems to be a big passtime for nurses who have "finished" their careers. Personally, I have started becoming more politically active and I work on MRSA prevention legislation, and healthcare reform. It is an exciting time for healthcare and rather than whine about the results of our new laws, I figured I ought to pitch in. The options for "retired" nurses are limitless. We may not have specified hours or the big paychecks, but we can still contribute a great deal to healthcare consumers and to our own families, communities and States.

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I certainly hope the hospital is screening for MRSA for the purpose of prevention rather than escaping blame. If patients are screened on hospital admission they can be isolated or cohorted and contact precautions used. They can also use the results in order to treat the colonization preoperatively and to prescribe the appropriate preoperative antibiotic for colonized patients. So that simple screening is cheap but is a very valuable tool for the prevention of new infections and colonizations. I would be absolutely thrilled to hear that my local hospital was screening all new admissions. It would mean they are finally taking MRSA seriously. I think unless a new LTC patient is known MRSA positive, all new residents coming in should be screened too...for the benefit of the patient and everyone surrounding them.

Your question is exactly the problem. Until ALL hospitals adapt a single effective and standard approact to MRSa prevention, MRSA will prevail. My belief is that ADI is the method that will drastically reduce MRSA. That along with decolonization and mandatory reporting of all MRSA for ALL states are the three most important standardized things that hospitals in the US can do to stop MRSA. MRSA precaution recommendations are all over the place. Nobody knows exactly what they are supposed to do. Just watch the VA hospitals in our country. All of their staff knows what to do becasue they have adapted ADI, and decolonizatoin and their rates have dropped over 70% nationwide.

Have your residents been screened or was the one patient diagnosed in a hospital?

Could any of you who work in LTC facilities tell me what perecentage of your residents have either MRSA infection or colonization. I am working with a prevalence test in Maine and trying to find numbers for comparison. Thanks in advance.

A 20 something male who arrested after seizures, a very long code with no response, then a heroic effort of opening the chest, in the ER, and doing manual massage of the heart. My opinion was that it was over about 15 min before opening the chest. A doctor at the nurses station stated.."they started that young man's autopsy in that room", and I agreed.

If you are talking about alcohol breatholizer testing, yes, I have done it as a nurse. It is a simple certification process and simple testing. I did it as an employee health nurse and we did random drug and alcohol testing for DOT requirements where I worked. If you are talking about pulmonary function testing, that is another thing altogether. I have also done that as an industrial nurse.

It seems that you are declaring defeat. During my career, I worked in a busy ER and I know chaos and difficulties. I also know that alone you cannot address ongoing issues and make change. What I was suggesting is that YOU join with your coworkers, come to concensus on what the obstacles are to good consistant IC on your unit or units, and fix them. If everybody is on board from your manager on down to the housekeepers, a lot can be accomplished. I dont' think this is idealistic or unrealistic. There isn't anything that can't be changed. I have read about groups of nurses and others changing what you call "unchangable" to stop unintended infection transmission. I have seen people die of infection to, for example, my own father. My mother and I both were by his side when he died of HA MRSA Pneumonia. He contracted his MRSA during a short hospital stay to rehab with a minor ankle fracture. That is why I am so passionate about positive change in IC and MRSA prevention.

As a group, your nursing staff should write all of the obvious obstructions to effective infection prevention and address them. There is no point in doing IC halfway. A facility will never stop infections that way. And...hospital acquired infections should NEVER be considered part of doing business in a hospital. YOU must make the change. I am an "older" retired nurse. I have found over the years that a big group of nurse's voices is better than one or two. Make the difference. Don't ever look at something as unchangable or insurmountable. With adjustments...consistant practices and enforcement, any hospital can accomplish effective infection control. Your own lives and those of your patients depend on it.

Contact precautions when done properly are never silly. They may save someone's life. YOu must wash your hands in the room before you leave and use dry paper towels if you must touch any surface such as a faucet or door handle. It is as simple as that. Ideally, the sink would be near the door just before you exit, but nothing is ever perfect.

http://www.dirigohealth.maine.gov/Documents/HAI%20MRSA%20Prevalence%20Study%2012%2009%2009%20_2_.pdf This is the MRSA high risk screening test that is being done in Maine starting last week. It is inadequate because it does not address any endemic MRSA, only MRSA on admission, and it does not cover some of the very important risk factors such as surgeries invovling implants. But, it is a start and we can keep working on it. This screening "test" is a result of my legislative proposal for Maine last spring.

I have volunteered at 2 huge flu shot clinics. At the first one, we vaccinated around 4000 kids grades k thru 12 and some babies. Most of them got both vaccines, so we gave out almost 8000 doses. I went back to a smaller clinic where we vaccinated around 2000 (almost 4000 doses) kids and some pregnant women. I have spoken with many of the organizers of these clinics and so far there have been no serious complications from either of the vaccines. Some of the usual things like sore arms but nothing of any significance. We had a few anxious kids pass out, but they recovered quickly and off they went. So, I am convinced that the vaccine is safe. I will get it volunarily when it is available for 60 year old retired nurses. I don't think I fall into any high risk group for H1 N1 yet. I have already had my regular flu shot. One of the things that frightens me is that with flu, a person can become coinfected with bacterial pneumonia or other serious infections. MRSA has been a coninfection that has causes some deaths. So, why take the chance if there is a vaccine available and you will be in contact with many patients who are ill with either one of the flu strains? I don't think it is even legal to 'mandate' the shots so I do not agree with that. But, I do agree that vacination should be fiercely encouraged (by employers and loved ones) for all healthcare workers who will be in constant contact with flu infected people or with family members who are at high risk for flu.

The doctor did not specify CA or nosocimial MRSA. He was addressing patients presenting with SOB, high fever and high WBCs. I felt that his point was the importance of getting it right and getting it quickly rather than where the MRSA came from. And this makes sense. Thank you for the CMO. It appears that coninfections are covered by that order, but only if all providers are aware of this measure. Blood cultures can be negative with MRSA/H1N1 pneumonia, so although important, it seems the sputum gram negative microscopic is the most important thing here when diagnosing the bacterial coinfection....in particular MRSA. Thanks for your response. I learn more all the time about MRSA and it's effects and treatment.

Does anyone know of good articles about H1N1 with compicating MRSA pneumonia? I saw Dr Jain on CNN yesterday and he spoke of this complication that apparently is very deadly. It is not surprising, but the sad thing is that is is effecting children and young adults. He went so far as to recommend that if a flu patient presents with difficulty breathing and a very high WBC, that the doctor should consider starting Vancomycin immediately. This makes sense to me since a patient can go downhill very quickly with MRSA pneumonia. I don't understand why this information or a form of it isn't a widespread warning for anybody with the flu who has persistant difficulty breathing or fevers. CDC needs to get the word out and give warnings that H1N1 complications can include deadly MRSA pneumonia and people should not ignore the warning signs.

Thank you for your response. My next question is, how many new MRSA transmissions have you had because of rooming "dirty" and "clean" patients together. I am not being critical. I know that the standards for LTCs are not as stringent as for acute care facilities. I am however concerned about this practice and how often a "clean" patient becomes "dirty" after being exposed in such a closed and intimate environment as having a roommate with MRSA.

I'm sorry, it is the CNA/NNOC that you may contact. The information came to me from one of their delegates.

YOu may contact the CNOC. They have the information. I was told of this today by a Maine delegate of the CNOC. I am talking about two infections. I am astounded that so much is being done to track and prevent H1N1 and nobody even recognizes MRSA as epidemic. We are trying to avoid an epidemic of H1N1 and everybody is involved at the Federal level and at the State level And yet, MRSA is already epidemic and nobody will recognize it as such and throw the same preventative and efforts at it to control MRSA. So, it was a comparison. Both infections are a threat to healthcare workers and healthcare consumers. We need to fight the same battle against MRSA as we are fighting against H1N1.