[Aaron C.]

As a nursing student, I am around these every day and am still very paranoid about taking one home to my 2 year old daughter. And after doing nursing home clinicals my fears were multiplied ten fold. It seems to me that the nurses aides especially are uneducated as to the specifics of these nasty little boogers. From what I hear/read, it seems that they are alot more prevalent on the coasts, and that less precautions are taken.

I had a patient once who had mrsa in his stool. His wife was visiting and when I came into the room he was in the restroom. Well, she had to go and was in there right after him and man, she was in there for at least 15 minutes. I'm no rocket scientist, but that's the last place I would want to be in the room of someone with that in their stools/urine.

What are the odds of her NOT getting it if she does that on a regular basis?

Also what do you think about visitors using patients restrooms? I think they should not.

Figured you all would be the best ones to ask this, as you have worked in many different settings and are very familiar with working with these obstacles every day.

Also do you think that there is an overall lack of understanding of these throughout the health care industry, or do you think that it is not that big of a deal, or what.

I personally, am terrified of MRSA and VRE.

Any thoughts would be appreciated.

[All41]

Personally, I believe that Universal Precautions has been the worst thing to happen to healthcare to date. I say this because I am seeing everything treated at the lowest common denominator (dirty not contaminated) for speed's sake. It is a fact that we must, in order to work in Nursing, trust one another. Well, to a point. If you are going to be a Nurse, MRSA and VRE are some of the least of your worries. Hepatitis C is much worse. I started in Nursing when you were not put in your hospital room until you had a VDRL w/results! Boy, have things changed! The most encouraging thing I can say to you is that after 26yrs. working in surgery and home health, I am disease free to the best of my knowledge. [img]/ubbthreads/images/icons/smile.gif[/img] Just do the best that you can and use precautions. Please understand that when you put on exam gloves that everywhere you put your hands is a place someone wiithout gloves is going to place their hands. Exam gloves are intended to protect everyone before and after. This is the most egregious act I see on a daily basis. Be aware of that one. Finally, NOTHING can replace proper handwashing.
I felt like this as a young mom so I understand where you are coming from. Hang in there!

[MicheleRN]

I do understand your concern about bringing germs home to your family. But, your child will have a stronger immune system for it. I know. I raised two healthy boys and I worked in the worst ICUs.
I do believe that proper hand washing is your best defense.

As to families using the restroom, why not? It is their loved one and someone that they live with anyway. Explain the risks and leave it up to them. Chart it though. If they get sick, they might sue.

MicheleRN

[Aaron C.]

but, if they are in there, where they are most likely to pick it up, they could take it with them outside the room or onto something else. Next thing you know, your whole floor could have it. I think??????

Several times I've been in clinicals and 10 patients out of 20 on the floor have had C diff, all on one side of the hall. It would seem to me that there is a common denominator.

I think visitors not using the restroom of a patient who is in isolation should be a rule. It isn't just their own safety, but for the rest of the patients there too.

[unionnurse]

Best way to avoid transmission is to wash your hands with hot soapy water for a minimum of 30 seconds. Don't wear your work shoes into your home or anywhere else your kid may be. I also agree that Universal Precautions are a joke. You'd be amazed at how many doctors and Respiratory therapists I see going from room to room without washing their hands. One RT wasn't even changing her gloves between patients until I freaked out about it one night. We have several people who need constant reminders. ANd we wonder why VRE spreads like wildfire around the ICU where I work. I also agree that VRE and MRSA are the least of our worries. A colleague got sprayed in the eyes with sputum from an HIV + pt. just a couple of nights ago. The various hepatitis' are also very strong. Scary what we are exposed to isn't it?

[jhf0174]

Both MRSA and VRE are alive, among other things, and growing rapidly here in the midwest. I find it hard to believe that they could be much more prevalent elsewhere! I think a lot of the problem is that they are becoming so common-place that nursing personnel are not showing them proper respect, anymore! I see linens thrown on the floor; hands not washed after gloves are taken off; toilets, bedpans, and urinals not Virexed after use, etc... every week. I am big on gentle reminders...that become more insistent with lack of positive response! Sometimes the problem is ignorance, but sometimes it isn't. As for families using the patient's toilet facilities...they should have been Virexed after the patient's use, each time, whether the patient has MRSA, VRE, Hepatitis, C-Dif, Aids, or whatever. Families do need to be taught about the disease and appropriate precautions, but we as nursing need to be aware that most families are not going to follow precautions the way we think they should. (And that can be pretty hard for me, sometimes!) I have seen MRSA spread through LTC facilities, and known it was from staff. I have had CNAs tell me that when you have 2 MRSA pts in the same room, both with respiratory MRSA & G/Tubes, it doesn't matter if you change gloves between patients! Can you imagine!!!

[agnewRN]

Try not to freak out too much around your patients. Unfortunately you're working around many sick people with compromised immune systems who are probably on or had been on some strong antibiotics. Most people with healthy immune systems can fight off these bugs. Handwashing is still the #1 way to fight these bugs. Cdiff you'll find in many patients who have undergone a course of antibiotic therapy that has probably killed off the majority of the good bacteria in their intestines . Unfortunately most of our antibiotic treatments can do this . GI surgery as well places them at higher risk. You're seeing more of it now because we know more about them now, and know how to detect them better. I suggest reading up on CDC info in regards to this and their recommendations. Also if you get a chance a seminar on infection control could really help. I don't think these bugs are going away, in fact these types of infections are already becoming more commen due to the ability of these bugs to adapt to our current antibiotics. It's like survival of the fittest to them. Hepatitis , HIV is definently scarier.
As for the wife using the bathroom. If this patient were to go home tomorrow he may still have that infection and they would be sharing a Bathroom. I would educate both of them on precautions and stress handwashing. His wife would probably be OK if her immune system is uncompromised. If there is a closer bathroom on the floor she can use, you can offer her the use of it if she would like. As for Nurse aides, just as nurses, they may take shortcuts to finish a task. Gentle but direct reminders may help. They've been through insevicing. I think if you observe more you'll see all type of staff that break good infection control practices.
Hang in there.

[traumaNERD]

UNIVERSAL PRECAUTIONS...PROPER HANDWASHING....

[bluesky]

Don't worry - those gowns are more to protect the other patients from getting the germs than you. People who are sick and have suppressed immune systems are more vulnerable to them.
I do suggest however, since you have kids - do teh following: Get dressed at work, when you get there and when you leave. That way your scrubs go straight into the washer. And leave your sneakers in your locker at work. If you must get dressed at home, take your shoes off immediately and leave your sneakers near the door so that you dont go walking all over the house in them. And make a habit of taking off your scrubs and getting a shower when you get home - don't pick up those kids wearing your scrubs. Also, clean your stethoscope with alcohol after each patient. Maybe even use an alsohol swab on your shoes if you stepped in anything too.
It is a minimal chance of them getting anything, but just stay clean to be sure, in case anyone in your home ever gets sick with cancer, etc.

[1mg.epi]

Shortbus just to update you. MRSA is becoming common in the community now. I do out patient antibiotics and many people come in with it. One person contracted MRSA in a scratch on his knee obtained on a weapons training range for the prison system.

MRSA has joined the ranks of community infections.