# Idiot nurse



## Kamischke (Apr 6, 2011)

Partner and I are at a hospital for a discharge.I take the report and get all the info, ask if the pt has any iso's nurse says no. I asked again to make sure "You said the pt has no isolations, right?" she says correct. Then my partner even asks, does she have any isolations? nurse again, no. I should add that the pt. we were picking up was sharing a room with another pt.

Nurse tells us pt is on o2 via nc but we walk in the room and her cannula is not even on. 

She also tells us the pt is a spanish speaker. What she spoke was definitely not spanish....

So my partner is fiddling around with her nasal cannula, gets it on her, we package her and we're good to go. We get to the elevator and JUSSTTT as we're about to leave, 

nurse: Wait! dont leave yet!
us: Why?..
nurse: She has mrsa!
us: ................. you said she has no iso's.........
nurse: (while on phone) I was told just now!

my partner and i look at each other about to strangle this nurse..... partner had his hands all over the cannula and everything..

so we're in there for about a good 40 minutes because the nurse is making calls, going crazy, gets all the other nurses at the station involved.... and on top of that she tells us to just put the pt back on the bed..
we're like are you serious? isolation means u dont put the freakin pt in a room with another patient..

her response was this..........................

Nurse: She was in there all day, what could 1 more hour do right? haha

all the other nurses ended up taking over and told us to put her in a diff room.. we did and left.
dealt with some horrible nurses but this one had to be the worst.


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## Minnick27 (Apr 6, 2011)

If you've been in healthcare long enough you already have MRSA so there is no need for precautions. At least that's what a nurse had told me. I could not believe she said that


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## Veneficus (Apr 6, 2011)

*Would this be a bad time?*

To tell you 20% of the population (1/5 people) is an asymptomatic carrier of MRSA?

Please control the outrage. 

I am going to have to say that in this case, the nurse had a valid point. 

You will find the higher your education progresses, the less absolute things become.


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## lightsandsirens5 (Apr 6, 2011)

Minnick27 said:


> If you've been in healthcare long enough you already have MRSA so there is no need for precautions. At least that's what a nurse had told me. I could not believe she said that



That is true to a certain extent. I mean, look at it this way, once you had the chicken pox as a kid, you can hang out around kids with chicken pox as much as you want. Except in extremely rare cases, you won't get them again. (I know that isn't the best analogy, but it kind of works to get my point across)

One you have been exposed to MRSA. (I mean truly exposed.) You already got it! I was exposed and "came down" with it while doing disaster relief after Hurricane Ike in Galveston, TX several years back. Now I'm a carrier. Big deal. I do t have any infections now, so I'm good to go as far as not spreading it right now.

Yes we should always take precautions. Regardless of what we have or have not had. But I always get a kick out of the EMS crews I see wearing PAPRs or something while transporting a contact isolation MRSA pt.  

I think I'm mostly right, aren't I vene?


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## Minnick27 (Apr 6, 2011)

Oh I fully agree that we are most likely exposed, but she was saying it as an excuse for no ppe


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## Trevor (Apr 6, 2011)

Just because someone has the "dreaded MRSA" doesnt mean your going to get it if you walk into the room.... Its not gonna jump out and get you... 

What's so special about MRSA? Its resistant to ONE family of antibiotics! Can it be detrimental to granny a couple of rooms down from the patient? SURE. And thats why hospitals use the "idea" of isolation. But you have to educate yourselves about it (on a side note, this is a HUGE DOWNFALL of EMS {lack of education and more importantly "self education"})

So what happens? A patient comes in, is told they have a "super bug" then essentially locked in a room and the only people they see have masks, gloves, and a gown on. They're treated like they have the effin' plague. Thats great for the psychological aspect of healing huh???? (*enter sarcasm here*)


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## Sasha (Apr 6, 2011)

Please. 

I don't even gown up for MRSA patients. And rarely do I glove up for them anymore unless I'm doing something to the area affected by the MRSA or concerning their blood. 

Putting the patient in a room with something you've got to touch to get? So what? The patients shouldn't be touching eachother anyway.

They cohab MRSA, CDiff and VRE patients all the time. It doesn't just float from the infected wound or nares over to the other person.


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## JPINFV (Apr 6, 2011)

Sasha said:


> Putting the patient in a room with something you've got to touch to get? So what? The patients shouldn't be touching eachother anyway.



Err... it depends on where the MRSA is. If it's in the nares, then the patient should be under droplet precautions. Of course thinking about this, shouldn't colonized health care workers be wearing masks themselves and be compelled to be treated?


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## Sasha (Apr 6, 2011)

I've taken a ton of nare mrsa patients and the hospitals never have had them on droplet percautions.


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## Aerin-Sol (Apr 6, 2011)

Why was your partner touching the pt's cannula without gloves on? 

I thought one of the problems with MRSA/VRE/VISA etc was that they do spread easily, which is why hospitals get outbreaks of them. Is that not true?


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## Sasha (Apr 6, 2011)

Aerin-Sol said:


> Why was your partner touching the pt's cannula without gloves on?
> 
> I thought one of the problems with MRSA/VRE/VISA etc was that they do spread easily, which is why hospitals get outbreaks of them. Is that not true?



If they have a MRSA infection in the wound on their heel which is covered and booted, why would you need to gown up?


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## abckidsmom (Apr 6, 2011)

Were you taking the patient to a nursing home?  This would be enough to wreck that plan.  You can't send the pt to a non-isolation bed in a nursing home if they have MRSA.

It's not a big deal for us, but in the sick people it matters.  We gown up so that we don't carry it from room to room and patient to patient to patient on our clothes.


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## rescue99 (Apr 6, 2011)

Kamischke said:


> Partner and I are at a hospital for a discharge.I take the report and get all the info, ask if the pt has any iso's nurse says no. I asked again to make sure "You said the pt has no isolations, right?" she says correct. Then my partner even asks, does she have any isolations? nurse again, no. I should add that the pt. we were picking up was sharing a room with another pt.
> 
> Nurse tells us pt is on o2 via nc but we walk in the room and her cannula is not even on.
> 
> ...



The MRSA is a concern but, she wasn't off base. At least she caught the problem before the patient left the building. What is a concern, is her poor communication skills. 

"Higher education" is the not the answer to everything ailing society. The cure for ignorance cannot be found in text books alone. Education, curriculum, is multi-dementional. If parts of it fail, education is not complete. 

The null curriculum has taken over where societal and covert curriculums once were. Thank parents and students, but don't blame educators and society for the most part. Parents wanted a feel-good education for poor little Johnny and Suzie, and this is what we get. There is a double generation of ignorant lemmings without an independent thought or the education to back it up if he/she attempted to have one. Always remember.....things left out of an education can be as important as what is included.


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## Veneficus (Apr 6, 2011)

JPINFV said:


> Of course thinking about this, shouldn't colonized health care workers be wearing masks themselves and be compelled to be treated?



If you started treating nonpathogenic colonies in healthcare workers everytime they were colonized, I think it reasonable that you would grow some broadly resistant strains in a short time.

As always the trick with masks would first be to establish how much incidence of transmission of infection were reduced as well as the costs of the materials compared to the costs of treatments of those requiring treatment.

People were not meant to be sterile. Infact the complete removal of natural flora is fatal.


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## Kamischke (Apr 6, 2011)

Aerin-Sol said:


> Why was your partner touching the pt's cannula without gloves on?
> 
> I thought one of the problems with MRSA/VRE/VISA etc was that they do spread easily, which is why hospitals get outbreaks of them. Is that not true?



My partner did have gloves on. but the fact that he touched other things after he put on her cannula.. 





abckidsmom said:


> Were you taking the patient to a nursing home?  This would be enough to wreck that plan.  You can't send the pt to a non-isolation bed in a nursing home if they have MRSA.
> 
> It's not a big deal for us, but in the sick people it matters.  We gown up so that we don't carry it from room to room and patient to patient to patient on our clothes.



yeah we were taking her back to a snf so we were stopped and played the waiting game.

And its not the fact that we "might have gotten mrsa" that pissed us off it was just the poorly done job by the nurse and her attittude. Sure bad nurses are dealt with on a daily but this was supposed to be one of the better hospitals that we actually liked going to.
I mean cmon, is it really hard to find that the pt. is not a spanish speaker? Just because they dont speak english doesnt mean u have to automatically label them as a spanish speaker. It sounded nothing like spanish! not to mention the other pt. she was roomed with was a fluent spanish speaker and still couldnt understand a word.


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## WTEngel (Apr 6, 2011)

Get over it. Your attitude comes off as unprofessional and puts you in a bad light.

Mistakes happen. Live and learn, and move on. Calling people idiots and dwelling on it does nothing to serve the patient's interest.


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## Kamischke (Apr 6, 2011)

WTEngel said:


> Get over it. Your attitude comes off as unprofessional and puts you in a bad light.
> 
> Mistakes happen. Live and learn, and move on. Calling people idiots and dwelling on it does nothing to serve the patient's interest.



uhhh thats what i was saying about the nurse's attitude.
i dont think the nurse did ANYTHING to serve the patient's interest. 
and dont worry, im over it, jus thought i'd share in this forum. Isnt that what its for?


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## abckidsmom (Apr 6, 2011)

Kamischke said:


> uhhh thats what i was saying about the nurse's attitude.
> i dont think the nurse did ANYTHING to serve the patient's interest.
> and dont worry, im over it, jus thought i'd share in this forum. Isnt that what its for?



This forum will challenge you, above all other things, to be professional and to have an identifiable reason for every action.  It's not that people don't want to hear it, they just don't want to hear of anything that's even slightly unprofessional.

Regardless of how you acted at the time, if you were thinking these kinds of unprofessional thoughts, they (if they were paying attention) could tell.  And even if they couldn't tell because they were up to their necks in a bad day, it's still up to you to do what you can to stop the escalation of the problem.

Customer service.  That's it.


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## DesertMedic66 (Apr 6, 2011)

Sasha said:


> Please.
> 
> I don't even gown up for MRSA patients. And rarely do I glove up for them anymore unless I'm doing something to the area affected by the MRSA or concerning their blood.
> 
> ...



I agree with the not gowning up for it. But for me gloves are a must for any patient. You will never see me dealing with a patient without wearing gloves. Just a personal preference for me.


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## Sasha (Apr 6, 2011)

I do all the time. I also wash and or sanitize my hands more than my glove happy counterparts. I think the patients are safer in my ungloved but religiously washed hands than the gloved hand of my partner who touches multiple things including the patient with the same gloves.

I had one partner who wore the same gloves from the minute he pulled out the stretcher til we we were putting it back after unloading. That included driving.


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## usalsfyre (Apr 6, 2011)

Sasha said:


> I had one partner who wore the same gloves from the minute he pulled out the stretcher til we we were putting it back after unloading. That included driving.


It takes conscious effort to keep my head from exploding when I see this...


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## DesertMedic66 (Apr 6, 2011)

Sasha said:


> I do all the time. I also wash and or sanitize my hands more than my glove happy counterparts. I think the patients are safer in my ungloved but religiously washed hands than the gloved hand of my partner who touches multiple things including the patient with the same gloves.
> 
> I had one partner who wore the same gloves from the minute he pulled out the stretcher til we we were putting it back after unloading. That included driving.



Ooh ok I understand. I'm the total opposite. As soon as I get out of the rig I have gloves on. If I'm in the back of the rig with my patient then I have gloves on until I clean the gurney and the ambulance. If I'm driving I will take the gloves off. I hate using the sanitizer because it drys my hand outs and I don't use lotion. Washing my hands is fine tho.


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## usalsfyre (Apr 6, 2011)

Gloves are usually in my pocket till I anticipate contact with body fluids, then they go on. When said contact is over, they come off. Which means the majority of the time I am ungloved.


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## JPINFV (Apr 6, 2011)

I'm just curious, do the "gloves for every patient, regardless of which procedures are being done or the actual threat of contact of bodily fluids or respiratory infection" crowd wear gloves when ever they are out of the house? Do they avoid all contact with anyone who isn't a friend or family? Just because the patient is in the ambulance doesn't mean that they are automatically any more or less infective than anyone else.


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## HotelCo (Apr 6, 2011)

My gloves are on during all patient contact, and while cleaning the ambulance before/after a call.


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## HotelCo (Apr 6, 2011)

JPINFV said:


> Do they avoid all contact with anyone who isn't a friend or family?



Why would I be touching strangers? :wacko:


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## DesertMedic66 (Apr 6, 2011)

Exactly. When I'm out in public I'm not touching people. I will only shake hands with friends and family. When I'm on duty I have to touch the patient to do medical aid.


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## JPINFV (Apr 6, 2011)

HotelCo said:


> Why would I be touching strangers? :wacko:



If someone trips, you won't offer them a hand? You never, say, use money when purchasing something? If you're in a business meeting (including things like interviews) you don't offer or accept a handshake ever? The fact is that there are germs around us all the time, especially on some of the most common things. Yet people somehow think that only patients are de facto dirty.


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## DesertMedic66 (Apr 6, 2011)

JPINFV said:


> If someone trips, you won't offer them a hand? You never, say, use money when purchasing something? If you're in a business meeting (including things like interviews) you don't offer or accept a handshake ever? The fact is that there are germs around us all the time, especially on some of the most common things. Yet people somehow think that only patients are de facto dirty.



I've offered to help someone up but they never accept help. I don't have money so I can't buy anything lol. And the interviews I have done have been with fire/EMS people. So I'm either already wearing gloves from a test as are they or I already know them so they are a friend. Small town so I don't have to rub on people to get into an isle at a store.


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## HotelCo (Apr 7, 2011)

JPINFV said:


> If someone trips, you won't offer them a hand? You never, say, use money when purchasing something? If you're in a business meeting (including things like interviews) you don't offer or accept a handshake ever? The fact is that there are germs around us all the time, especially on some of the most common things. Yet people somehow think that only patients are de facto dirty.



If they can't get up, I use my debit card, yes, and I agree. we've had this conversation before. 

I'll ask you: why not wear gloves?


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## JPINFV (Apr 7, 2011)

I agree with wearing gloves for patients you aren't familiar with when you first meet. Once an assessment is done, then I think gloves, like other levels of BSI use should be based on your assessment. After all, when you go to the dentist, when the dentist isn't working in your mouth are gloves always on? Do the receptionist who hands you pens and forms wear gloves? When you go to the doctor and he's listening to your lung sounds, do they always wear gloves? So, if there's no ick or transmittable disease factor, I don't necessarily see the point in wearing gloves to, say, take a blood pressure.

As to "Why not wear gloves?" My issue is that I see the world as an inherently dirty world and that the money in my wallet are inherently more dirty than the majority of my patients who are not exuding bodily fluids nor showing signs and symptoms of infection.


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## DesertMedic66 (Apr 7, 2011)

JPINFV said:


> I agree with wearing gloves for patients you aren't familiar with when you first meet. Once an assessment is done, then I think gloves, like other levels of BSI use should be based on your assessment. After all, when you go to the dentist, when the dentist isn't working in your mouth are gloves always on? Do the receptionist who hands you pens and forms wear gloves? When you go to the doctor and he's listening to your lung sounds, do they always wear gloves? So, if there's no ick or transmittable disease factor, I don't necessarily see the point in wearing gloves to, say, take a blood pressure.
> 
> As to "Why not wear gloves?" My issue is that I see the world as an inherently dirty world and that the money in my wallet are inherently more dirty than the majority of my patients who are not exuding bodily fluids nor showing signs and symptoms of infection.



as soon as i say hi to my dentist he gloves up. and we are friends too lol. my doc always wears gloves as soon as he enters the room. the receptionist does not however thats why there is alot of hand sanitizer in the doctors office. for me i wear gloves no matter what the patient looks like. to me it doesnt matter if there is or isnt bodily fluids. as long as there is any patient contact then i am gloving up and i will glove down when i am done dealing with the patient and after all the cleaning is finished.


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## usalsfyre (Apr 7, 2011)

I've never seen any other health profession wear gloves with the same maniacal obsession as EMS. I've  simply chalked it up to it's much easier to teach "wear gloves all the time" in the limited amount of time available in an EMT-Basic class than it is to teach how to do a real assessment of infectious risk (hence the "scene safe, BSI" dance).


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## CAOX3 (Apr 7, 2011)

I have to admit I don't wear gloves nearly as often as I should, when I started in ems no one wore gloves, stabbings, shootings, and car wrecks it didn't mater.

 I try to keep a pair on me at all times, because if I don't have them I won't attempt to get them  I wash my hands religiously.  Minor complaint I'm not putting gloves on, never have and probably never will, after we load the patient we have sanitizer on the back door I hit that a few times and then after patient care I wash my hands.

Not saying it's right, but bad habits are hard to break.


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## Aidey (Apr 7, 2011)

usalsfyre said:


> I've never seen any other health profession wear gloves with the same maniacal obsession as EMS. I've  simply chalked it up to it's much easier to teach "wear gloves all the time" in the limited amount of time available in an EMT-Basic class than it is to teach how to do a real assessment of infectious risk (hence the "scene safe, BSI" dance).



Dialysis clinics are worse. I could go through a whole box of gloves in a 12 hour shift. I do get your point though. In comparison to MDs and RNs we are significantly more obsessive. I doubt anyone else starts out scenarios with "BSI!!".


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## JPINFV (Apr 7, 2011)

Aidey said:


> Dialysis clinics are worse. I could go through a whole box of gloves in a 12 hour shift. I do get your point though. In comparison to MDs and RNs we are significantly more obsessive. I doubt anyone else starts out scenarios with "BSI!!".



Actually, the only two times I've worn gloves in standardized patient encounters was the pelvic/breast/rectal day (obvious reasons), and the one day I kept sneezing. This isn't an issue with verbalization, just the fact that we aren't expected to wear gloves for the majority of our exams, just to wash our hands or use sanitizer before starting the physical exam.


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## mycrofft (Apr 8, 2011)

*Back to the OP*

If the oxygen issue was wrong, the language issue was wrong, and the iso issue was wrong, I'd be making danged sure that was the right patient!


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## lightsandsirens5 (Apr 8, 2011)

HotelCo said:


> If they can't get up, I use my debit card, yes, and I agree. we've had this conversation before.
> 
> I'll ask you: why not wear gloves?



I'm sorry, I just noticed this....am I the only one who, the first time they read this thought, what the heck? "If they can't get up, I use my debit card......I was like, Huh? What the heck is he talking about....then I read the rest. But at first I was totally thrown off.


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## Aidey (Apr 8, 2011)

No, don't worry, it took me a minute to connect those replies to the right questions too.


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## Handsome Robb (Apr 8, 2011)

^Thats absolutely filthy^ When he asks you to drive do you tell him no? What's the point of a sterile glove if you touch anything and everything with it?

People make mistakes. It sounds like this mistake was made long before this nurse began caring for this pt. Are you so perfect that you have never made a mistake. Like someone else said, what matters is she caught it, and to be honest, she's right. One more hour sharing a room with the other pt would not have made a difference.


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## firetender (Apr 8, 2011)

*All you need is Gloves!*

I left EMS in the mid-1980's when the AIDS scare, which started this whole glove thing, got started.

I was extremely judicious in their use, meaning I ONLY wore them when I was absolutely positive and even then, almost always as a "Crap! almost forgot!"

So what I experienced, having spent a good twelve years un-gloved on every but the very most extreme of calls was a very strong sense of loss. Tactile sensation, the ways in which my hands could "read" a patient, the way that they could convey caring and control at the same time and also make ME feel connected to what I was doing on a live human being meant something to me and I missed it.

(Thinking about it, that sounds like a typical guy talking about his relationship with condoms but I'll let that one alone!)

The point I'm making is that once medicine was personal. Not only for me but for legions of family physicians and country doctors and nurses and practitioners of all kinds. We're ALL losing touch as a tool to bring people closer to wellness.


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