I have seen patients with Scabies, Lice, and other known really contagious bugs in regular rooms lately with NO MARKERS to warn staff members!!!!!!!!!!!!!
When I confronted the Charge Nurse on a Pediatric Patient with SEVERE SCABIES, ACTIVE, 2 HOURS S/P ADMISSION TO FLOOR, . . . .
"WHY IS THIS PT NOT IN ISOLATION?". . .
"We don't have the authority to isolate here according to policy and procedure without an Physician Orders, and (HONESTLY) THAT PATIENT DOESN'T HAVE INSURANCE TO COVER THE COST OF AN ISOLATION ROOM AND SUPPLIES!" So his Doc would not sign off on Isolative Measures NOT EVEN CONTACT ISOLATION STATUS!!!!
I was floored. Family coming in and out with sores and scabs, scratching, THIS WAS A NIGHTMARE.
SHOULDN'T ALL NURSES HAVE THE AUTHORITY TO ISOLATE PATIENTS?
Yes, nurses should be able to place patients on isolation. It's not rocket science. If I suspect my patient has anything infectious, just by their history, I just put them on contact isolation assuming they have MRSA or VRE so I don't infect the other patients rather than wait for the swab results. Guilty until proven innocent lol.
At the hospital I work at, the Infection Control department rules over any isolation cases or possible isolation cases. In fact, it's to the point where they can overrule doctors, to a point, because we've had issues with doctors D/C-ing isolation when the patient in question should have remained isolated. If the doctor still has issues with it, they are directed to Infection Control, who usually convinces the doctor with whatever rationale/hospital policies. We can only discontinue isolation once Infection Control clears them.
As a result, we (as nurses) have very specific instructions to immediately isolate anyone who:
- Has diarrhea (and in this case, we are automatically to send 3 separate stool samples to test for C.diff - we don't need a doctor's order for this, or at least no doctors have had an issue with us doing it)
- Has a previous history of MDROs
- Was previously admitted during an outbreak of any kind
- Came directly to us from out of the country
- Has any diagnosis that is or could potentially be contagious (i.e. respiratory infections)
Good Morning, Gil
607 Posts
Yes, nurses should be able to place patients on isolation. It's not rocket science. If I suspect my patient has anything infectious, just by their history, I just put them on contact isolation assuming they have MRSA or VRE so I don't infect the other patients rather than wait for the swab results. Guilty until proven innocent lol.