Question on head lice

[ChefJackie]

You are bathing a patient and you notice movement in hair. It may be an infestation of head lice. What is proper nursing action?

I was thinking-

Examine patients head and genitals for an idea of severity of infestation, if one is present.

Notify Dr for further instructions

Educate patient/patient family on pediculosis treatment, control, and prevention.

Implement Dr's orders

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Any help is greatly appreciated

[nurseprnRN, BSN, RN]

You are bathing a patient and you notice movement in hair. It may be an infestation of head lice. What is proper nursing action?

I was thinking-

Examine patients head and genitals for an idea of severity of infestation, if one is present.

Pubic lice and head lice are generally different species. You can look, but you probably won't find much.

Notify Dr for further instructions

::sigh:: Probably your infection control professional would be better.

​Your nursing department has protocols for instituting isolation for "critters" that you should implement on your own, no physician rx needed.

Educate patient/patient family on pediculosis treatment, control, and prevention.

Implement Dr's orders

::sigh again:: We don't take "orders," we are not in a military hierarchy and nursing us not "under" medicine. Implementing physician prescriptions (you will doubtless get one for a prescription pediculocide) as part of the medical plan of care is one of our legal responsibilities; as such it is not an independent nursing action. If this is for a nursing care plan, remember that.

Document

Any help is greatly appreciated

Answers interspersed in your quote above.

[ChefJackie]

Answers interspersed in your quote above.

Thanks so much for your input. Still a student so excuse my ignorance and thanks again :)

[Esme12, ASN, BSN, RN]

Schools and hospitals still refer to taking and implementing physician orders....

Roles of Nurses in the Implementation of Patient Care Orders

Lice are parasitic insects that can be found on people's heads, and bodies, including the pubic area. Human lice survive by feeding on human blood. Lice found on each area of the body are different from each other. The three types of lice that live on humans are:

• Pediculus humorifice capitis (head louse),
  
• Pediculus humorifice corporis (body louse, clothes louse), and
  
• Pthirus pubis ("crab" louse, pubic louse).
  

http://www.cdc.gov/parasites/lice/

[nurseprnRN, BSN, RN]

Of course they do ... But times change, and because they say that doesn't mean we have to perpetuate it. Words shape attitudes, and this is one traditional attitude whose time is past. :)

If we want to promote the idea of an autonomous, well-educated profession, communicating that by losing the "orders" thing is a liberating way to do it. Doesn't it feel different to say, "I implement parts of the medical plan of care and develop and implement/delegate the nursing plan of care" than to say "I follow doctor's orders"? Sure does to me. :)

[ArrowRN, BSN, RN]

we covered headlice a while back. Far as I know it is something the nurse can manage and does not need doctor intervention. You have to see if it was acquired from the facility (hate the thought of that) or is newly admitted, its probably from home. For latter, just get the family involved because they tend to spread within family and a simple over the counter walgreens lice shampoo and fine tooth comb to remove nits is the treatment. Repeated treatment is necessary. You'd have to let the nurse manager know so that it won't spread throughout the unit. The unit might have procedures for this. Don't touch the patient head without gloves and itch your own head.

[jorge512]

fyi. if someone is directing you to do something is an order. nursing is part of the medical team, part of medicine and part of the multidisciplinary team. if a team is compose of a medical doctor and a nurse the doctor is the one who has the final say, the doctor is the highest license and ultimately the one responsible.