Wearing masks

NurseCubanitaRN2b, BSN, RN · Jul 19, 2009

I guess I can see your point, though I do my best to make my patients feel like what I have to do for them does not gross me out. With the urine though- it shouldn't be sitting there for HOURS....if a patient/resident is incontinent, they need to be checked frequently.

That is very true. Some of your patient might get offended if you wore a mask, but I believe most are very understanding. When I did LTC I wouldn't wear a mask unless I was sick. But also keep in mind if there is something in the urine or feces, then I would wear a mask. I've heard of MRSA in the urine, and feces, so it's always good to be safe for yourself and your other patients.

NurseCubanitaRN2b, BSN, RN · Jul 19, 2009

No, I hate wearing masks for my isolation patients. I wouldn't put one on if I didn't have to! They don't really do much to combat the smell anyway. Smelling BM is part of the job. So is not leaving people in urine for hours, so they don't smell that way in the first place!

Sometimes the urine is so concentrated that it smells right away as soon as they urinate. I've had patients whose urine was so concentrated that the windows had to be kept open 24/7 because the smell was so bad and we had to think about the patient in the next bed. That patient had to constantly be checked on because of it, and let me tell you I had a tough time with this one because my other patients were getting neglected. That room needed a CNA just for those two patients. But do you think the LTC will agree to that. What's going to be their response, "Well you just have to work a little harder and check on that patient more often". They don't care, it's not them so why should they?

NurseCubanitaRN2b, BSN, RN · Jul 19, 2009

Rather than wearing a mask, you should be reporting the previous shift if they are leaving people laying in urine or feces for hours. If you feel that bad just smelling it, imagine how the patient feels sitting/laying in it!

I worked in LTC on night shift in the past. When we'd start our rounds, we'd first do vital signs because the nurses needed those ASAP and we had them in by 1AM. One aide would do vitals and the other would pass water. Usually I was the first one to show up so I'd be curteous and start those manual vitals and leave the water pass for the aide who came in after me. I'd clock in maybe 10 minutes before start of shift. Sometimes I'd do the water first, but most of the time I would do the vitals. Who ever finished first would then gather the supplies to start diaper changing. We had anywhere from 32-40 patients in our rehab unit at all times, we were mostly full, so that tells you how many patients we had to change. So if your shift starts at 11PM and you don't get to your rounds until 1AM, should you really report to the charge nurse that your patients are soaked? Most of the time, the previous shift would start rounds around 9:30PM, so between the hours of 9:30pm-1AM I believe they will be soaked or soiled in feces. Now us night shift people would start the last rounds around 4:45AM because we had to be finished by 6:30AM in order to do our last rounds of charting. When the day shift would come on at 7AM they'd usually complain about the night before how the patients were always wet. I had to remind them what time we started our last rounds in order to have everything done by 7AM. Most of our patients were on Lasix so you know they were constantly wet. Now when I worked day shift, we'd start rounds at 7AM and we'd have to shower patients according to when they last had a shower. Our unit had a rule that they would have to be showered every other day. So usually I would have 7 patients and usually 5 out of those 7 needed a shower because the previous CNA's wouldn't shower them. Anyway, so after having everyone done by 11AM between the hours of 4:45AM-7AM at the start of shift, I know we're going to find patients soaked with urine or feces. Also, we'd start our last rounds right after lunch which would end at about 1:30PM and finish by 2:30PM. Now between the hours of 1:30PM-3PM, do you think some wont be wet? Plus the PM shift would start their rounds around 4PM because they'd have to do their vitals and pass water. So in reality between 1:30PM-4PM are they going to be wet or soiled? You really can't blame the previous shift. I'd like to think we can, but it is what it is. You're constantly going to find them soiled, suck it up, and get them cleaned up as best as you can. I know everyone here works hard as a CNA. As long as you know you did your job and you document (if your facility allows CNA's to document) that you changed them, then you're covered.

mochabean · Jul 20, 2009

Sorry, Mochabean, I just totally disagree. I've seen and smelled some really, really bad stuff - and never seen a team of health care providers wear masks because of any "intolerable" smell. As Fuzzywuzzy pointed out, masks do very little to eliminate odor, anyway. A dab of metholatum on the upper lip works better. If you can't stand the heat, get out of the kitchen. Do you really think someone is going to complain that they felt embarassed that you were wearing a mask? I'm pretty sure your patients just suffered in silence, just another humiliation to endure.
I used to know a new grad in ICU who expected that she would be wearing a mask whenever something unpleasant assulted her nose. This was immediately nixed not only by the other staff but our manager, as well. It's unprofessional and inappropriate. It non-verbally communicates to the patient, "You're disgusting."
Does it really sound ridiculous? How about:
It you don't like kids, don't be a teacher...
If you don't like blood and guts don't be a paramedic...
If you don't like money, don't be a banker...
If you don't like animals, don't have pets...
Get my point?

No. I don't get your point and your arguement still sounds ridiculous. If you don't like money, don't be a banker? Everybody I know likes money! Can you be more SPECIFIC with your over-generalizations?

You've never seen a team of healthcare providers wear masks due to intolerable smells? Sounds like you don't work on my unit! And masks do eliminate odors, depending on what you add to the inside of the mask to block the overpowering smell, like Vicks or pepperment.

How do you know if someone is suffering if they're suffering in silence? Based on your response, it sounds like you didn't even read my last post. You're making it seem like that healthcare workers are being insensitive morons and going into everybody's room wearing a masks. That's not even the case. You're also not considering individual circumstances. Wear a mask= bad healthcare worker. Booooooooo!

So I'll repeat again: Some smells are TOLERABLE and others are NOT. I work with nurses who've been working for 5-25 years and they even wear masks if they "can't take the heat." Gee, maybe it's even wrong to wear a mask when going to see a patient who has MRSA. We wouldn't want to humiliate them either!

It also sound like you're saying patients are simply suffering because someone is wearing a mask, not because they're lying in stool and in pain. I had a patient who told me she was embarrassed because I was cleaning her up. And guess what? Her stool didn't smell extremely bad and I wasn't even wearing a mask! She said she was embarrassed because she was used to being independent and was now unable to do things for herself. No mention about a mask! But you don't care about that because. . .wear a mask= bad healthcare worker.

Nina,CNA · Jul 20, 2009

does anyone wear masks when changing briefs? i had a conversation with my lpn friend and she said no. i said why should i have to smell something so bad at times.
there are times the bm is soo bad i would gag same with a brief all full of urine for hours. it smells sooooo bad!! i gagged many times and almost threw up!
the facility i worked in did, allow masks. i wish i knew that while working there

i believe that wearing a mask is much better than gagging at the odor in front of the patient. however, everyone is right in saying that a mask alone will not hinder the odor. try putting a bit of vapor rub or peppermint oil in the mask.

please never leave a patient in a soiled brief for hours, just reading that statement hurts my heart :cry: .

pricklypear · Jul 20, 2009

No. I don't get your point and your arguement still sounds ridiculous. If you don't like money, don't be a banker? Everybody I know likes money! Can you be more SPECIFIC with your over-generalizations?
You've never seen a team of healthcare providers wear masks due to intolerable smells? Sounds like you don't work on my unit! And masks do eliminate odors, depending on what you add to the inside of the mask to block the overpowering smell, like Vicks or pepperment.
How do you know if someone is suffering if they're suffering in silence? Based on your response, it sounds like you didn't even read my last post. You're making it seem like that healthcare workers are being insensitive morons and going into everybody's room wearing a masks. That's not even the case. You're also not considering individual circumstances. Wear a mask= bad healthcare worker. Booooooooo!
So I'll repeat again: Some smells are TOLERABLE and others are NOT. I work with nurses who've been working for 5-25 years and they even wear masks if they "can't take the heat." Gee, maybe it's even wrong to wear a mask when going to see a patient who has MRSA. We wouldn't want to humiliate them either!
It also sound like you're saying patients are simply suffering because someone is wearing a mask, not because they're lying in stool and in pain. I had a patient who told me she was embarrassed because I was cleaning her up. And guess what? Her stool didn't smell extremely bad and I wasn't even wearing a mask! She said she was embarrassed because she was used to being independent and was now unable to do things for herself. No mention about a mask! But you don't care about that because. . .wear a mask= bad healthcare worker.

Geez, calm down...no need to get yourself so worked up and defensive. If you feel like you need to wear a mask because you can't deal with odors, be my guest. I still think it's unprofessional, and while it may or may not further embarass patients, it has the potential to do so.

Wearing a mask to see a MRSA patient. Only if the MRSA is in the sputum, or is likely to become air borne in droplet form. And isn't that a totally different situation?

CNAmonica65 · Jul 20, 2009

When i wore my mask it was with patients who harldy even knew their own names and were barely lucid.

If i was a resisent and a CNA put a mask on for me.. i wouldn't be offeneded in the least. Some smells are just to horrible to not use something to cover up the odor.

I don't mind cleaning up a patient it's my job ( when i get a new one ) My job doesn't mean i should be objected to "dealing" with something unpleasant and not making myself sick in the mean time.

Butterfliesnroses · Jul 20, 2009

Um why not put vicks or peppermint oil in your nose (that's what an aide I worked with did that couldn't handle the smells).

Smells don't really bother me. I don't gag and I don't wear a mask, I actually feel like I can't breather when I wear a mask, so don't wear one unless necessary.

I've heard of MRSA in the urine, and feces, so it's always good to be safe for yourself and your other patients.

If the MRSA is in BM and urine, the MRSA would need a portal of entry, meaning you'd have to put some of the BM or urine up your nose or ingest it. The kind of MRSA where you'd want to wear a mask would be if it was in their lungs, nasal passages, etc.

NurseCubanitaRN2b, BSN, RN · Jul 20, 2009

If the MRSA is in BM and urine, the MRSA would need a portal of entry, meaning you'd have to put some of the BM or urine up your nose or ingest it. The kind of MRSA where you'd want to wear a mask would be if it was in their lungs, nasal passages, etc.

In our hospital we had a patient with MRSA in the urine and we were required to wear masks. But I totally agree with what you're saying.

kfarinato · Jul 21, 2009

I had a patient on saturday who was hep c and hiv positive. Physical therapy put a mask on to go in the room, and she kicked them out. Kudos to her. I worked in an operating room for a very long time and masks do not do much to protect you from odors, and honestly with enough fluid they don't protect against much at all.

eddie95603 · Jul 29, 2009

A little dab of tooth past under your nose does wonders :) Its a shame that there are many people out there that are in this line of work for a pay check, not that theye have the compassion for the resident. Guess that is the difference between a good and bad nurse....