Scabies- nurses role

Scrubby · Apr 28, 2008

As far as i'm aware there is no scabies protocol. I don't think it's appropriate for us to diagnose this, it should be done by a doctor otherwise you'd be practising outside your scope.

Titanium888 · Apr 28, 2008

I got your point on that Scrubby.

Any opinion from nurses working in nursing home and has experienced recurrent scabies infestation in their facility and acting on it independently?

It's a hell! 4 months ago, we experienced scabies outbreak and it was a huge disinfestation. I even contacted scabies during that time and got treatment.

Now it's coming back. 6 of our patients has been treated and re-treated. Doctors won't come to assess the skin of the patient in nursing home. They do come in specific day.for check-up The only way of consulting them is calling them up and telling them the type of lesion. And everytime, they'll just ask to treat it with Lyderm. :typing

nyapa, RN · Apr 30, 2008

A nurse cannot diagnose. It is a doctor who determines whether a patient has scabies ... BUT

It is a nurses responsibility to treat the infection within their role, and use at the very least universal precautions, or if bad enough, isolation procedures. And if there are recurrent infections - why? Is there a particular patient who is a source? What about the environment? Is it being treated properly?

Have any of these patients ever had skin scrapings? Have you had a definite diagnosis of scabies?

I work in an acute care hospital where we do give 'lyclear' as a one off treatment without a doctor's order, but then it has to be verified. I guess it is up to individual hospital policies in Australia. Don't know about NZ.

But it can't be ignored. Your manager needs to act now. Saying that it is the doctor's job is not good enough. She should be advocating on behalf of her patients and her staff.

Scabies by compromising the skin can in the worst scenario, lead to other infections, much more serious...

Adit Does your facility actually have a policy on how to deal with scabies? Try and find it, and see if that helps. Imagine if the families of these ppl found out that there were recurrent infections. You may need to point this out, very diplomatically of course!, to your manager....

Titanium888 · Apr 30, 2008

Fumigation of the facility was done months ago. And washing of all the patients' clothes. We don't know why it's recurring. It's really a big problem. I mean to transfer to another facility/hospital now as something is really going on with the management. One year here is enough for me. It's a shame to say that our facility's policy is somewhat loose. And nobody cares.

Well, thank you very much for all your opinions.

nyapa, RN · Apr 30, 2008

Sounds like you are really between a rock and a hard place, when all you are trying to do is care for your patients. Its a shame you have to even consider leaving...

Titanium888 · Apr 30, 2008

Before I was having a second thought of totally leaving since I've already loved my patients (really!). But now I've realized that it's too stressful. It's a shame really. My former charge nurse left because of the ongoing inconsistency and loose management. Plus you can't get the support. It's not only about this scabies. Soooooooo many things.

Well, if I can't join them, I should leave them. I think, open-mindedness is very important for nurses to have.