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VRE and MRSA

post #1 of 18
Thread Starter 
I work in a long term care facility and there is one resident with VRE and two with MRSA. I obviously use universal percautions with them but feeling the way I do about their sickness. I almost feel afraid to touch them. I don't know if I SHOULD be afraid to touch them or not, which is why I want to learn more about the illness. The one man who has the VRE is constantly wanting to hold someones hand and he always tries to touch my face but I just tell him hands only (gloved). I can tell the other staff members distance themselves from him as well. He was screaming last night and I went in to talk to him and he told me "I just want some companionship". So it is my goal to learn more about VRE and MRSA so I know what I can safely do and not do. Can they be transmitted from him touching my face? Are they airborne or just in body fluids? Can I get them from say sitting on a chair that he has sat on? I just want to know as much as I can.
post #2 of 18
Oh that sounds terrible. I really don't know much about MRSA and haven't heard of VRE. I have nothing to offer but to you and the residents who are sick.
post #3 of 18
Thread Starter 
Quote:
Originally Posted by tayndrewsmama View Post
Oh that sounds terrible. I really don't know much about MRSA and haven't heard of VRE. I have nothing to offer but to you and the residents who are sick.
VRE is:
Quote:
Vancomycin Resistant Enterococc, or VRE, is a superbug bacterium in the gastrointestinal and genital tracts. It can be highly aggressive, especially in post-operative hospital patients, causing urinary tract infections, septicaemia (blood poisoning), endocarditis (heart infection), and wound infections.
post #4 of 18
Everything I read seems to indicate that transmission from hand to hand is a very common vector of colonization. And that people treating people with MRSA and VRE should actually ONLY be treating those patients.

I feel for you and the patients. That would break my heart. But I really don't see what you could do. Perhaps suiting up a therapist/counsellor/clergy person to go sit and chat and hold his hand (gloved) can help. Make up for lack of quality with a bit more quantity.
post #5 of 18
Have you spoken to anyone where you work (i.e. management) about your concerns? It really doesn't make any sense to me that they would have you, or anyone, working with a patient who is ill and not make sure that you are 100% informed about the situation and it's possibilities. Lack of information and understanding is how things like this spread fast. I would be (am?) very concerned about the fact that you shouldn't be treating other patients while working with these ones mentioned.
post #6 of 18
Thread Starter 
Quote:
Originally Posted by tayndrewsmama View Post
Have you spoken to anyone where you work (i.e. management) about your concerns? It really doesn't make any sense to me that they would have you, or anyone, working with a patient who is ill and not make sure that you are 100% informed about the situation and it's possibilities. Lack of information and understanding is how things like this spread fast. I would be (am?) very concerned about the fact that you shouldn't be treating other patients while working with these ones mentioned.
There are a couple of handouts in the staff room about it and I read them and they just made me : . Basically they say use good universal percautions. Gloving up, washing hands. These patients are not confined to their rooms at all either. They freely roam the facility and are able to do things that everyone else can do.
post #7 of 18
Oh no. That is just not good enough. Not your fault - these hospitals need to start being something other than stupid about this stuff.

And the governments need to put in some regulation to force them to not be stupid, since they can't and won't do it themselves.

Really! Letting a guy who has a superbug (two!) walk around and want to touch people in the very places that they are most prone to colonization? What are they thinking!?!

Any expert would totally be horrified.
post #8 of 18
That certainly doesn't sound right at all! I don't think a few handouts laying in a staff room shows that there is any big deal about the situation. And that aside, what the heck does it matter if they are out with everyone else anyway? Seriously, that is not right at all. Is there anyone that you can talk to about this? Maybe there's info on a local health department site about this stuff that you can reference.
post #9 of 18
Thread Starter 
Quote:
Originally Posted by Demeter9 View Post
Oh no. That is just not good enough. Not your fault - these hospitals need to start being something other than stupid about this stuff.

And the governments need to put in some regulation to force them to not be stupid, since they can't and won't do it themselves.

Really! Letting a guy who has a superbug (two!) walk around and want to touch people in the very places that they are most prone to colonization? What are they thinking!?!

Any expert would totally be horrified.
I wonder what I should do about it? All three people are under the care of a doctor, you'd think the doctor would do something about it?
post #10 of 18
Honestly, if I were you, I would look into making an anonymous phone call to the health department. I can see where making a big stink and questioning procedures and doctors could put your job on the line, so I would try to avoid it. Is something like that an option?
post #11 of 18
Quote:
Originally Posted by babygrant View Post
I wonder what I should do about it? All three people are under the care of a doctor, you'd think the doctor would do something about it?
I'm pretty sure that this was on the news not to long ago, with one of those news-exposed shows. 20/20, that sort of thing. It might have been a Canadian specific show....I'll have to go look. A little threat of being a hospital potentially profiled for these offenses.

Doctors are actually the worst offenders about this stuff. They've done some studies on it, and they really are.

This is probably an issue that needs to be addressed on a hospital wide basis, and not just a single doctor basis.


(I have a theory, that on a very primal level people often want to transmit germs to other people. And that one of the urges that they germs impart on people is the urge to touch and not wash etc. There are some studies on how certain parasites make some animals likes cats more prone to grouping up into social groups and have social behaviours - to facilitate transmission. We are just big dna, rna, germ, meme factories looking to share.)
post #12 of 18
post #13 of 18
This is not in Canada, but I found it interesting and extremely frustrating. As someone who was VERY sick last winter with C-difficile, it angers me greatly that there is so much resistance to this idea. It's not just in the inpatient wards. I got this as an outpatient. :

http://www.nursinglink.com/news/arti...ore-screening-
post #14 of 18
VRE and MRSA are mainly transmitted in body fluids and from skin to skin contact (usually people with those touch something on their body and have it on their hands). Where I work, MRSA is mainly in wounds. Wearing gloves should be good enough (ALWAYS practice good handwashing). Unless you are told that the person has respiratory MRSA, you can go in and be in that same room with no mask ect... MRSA and VRE and easy to get when healthcare workers take care of you but don't wash their hands. Remember these people are human and need care. When I go in, I make sure to avoid touching their bedding with my scrubs and if they cough, I turn my head- just in case. When I get home, I strip in the garage then come in and shower right away. So far, so good. I even worked with VRE patients when I was pregnant with no problem.

You have a small amount of MRSA in your nose naturally. Some people get it worse than others and most healthcare workers have it but don't know it (it doesn't cause problems in many). Anyway, think about it.. before these people got to your place of work, they were out in restraurants, grocery stores, movies, parks, malls (trying on clothes) ect.. the difference is.. you didn't KNOW anyone had anything and it didn't bother you then :-) That's why we always wash our hands when we are out and about and before eating!
post #15 of 18
Quote:
Originally Posted by Demeter9 View Post
And that people treating people with MRSA and VRE should actually ONLY be treating those patients.
Quote:
Originally Posted by Demeter9 View Post
Oh no. That is just not good enough. Not your fault - these hospitals need to start being something other than stupid about this stuff.

And the governments need to put in some regulation to force them to not be stupid, since they can't and won't do it themselves.

Really! Letting a guy who has a superbug (two!) walk around and want to touch people in the very places that they are most prone to colonization? What are they thinking!?!

Any expert would totally be horrified.
I was just coming here to see if there were any threads on this. I work in the same environment- nursing home/rehab, and I can tell you that this is standard, normal procedure, most places I've worked in- it's not just the facility that the OP describes. Universal precautions are it. I've never seen someone confined to their rooms. Antibiotics are used like candy.

The budget for nursing care is so tight, we have one LPN for 25+ patients, (less overnight), one nursing assisstant for 10+ patients (again- less overnight). There is NO WAY with the little money that is allocated to this type of facility, that there could be dedicated staff caring JUST for VRE and MRSA patients.

Once in a while we get volunteers who can spend extra time talk one of one with residents, but that is very few and far between. there is simply not money for staff to just sit and talk. All of us who care try and spend extra time talking with those who don't get many visitors, but we all have 90 patients to care for (I mean support staff- not nursing staff), and when we're inspected by the state, they want to see what paperwork you have in the chart, not how much time you've spent chatting and brightening someone's day Sad, huh? That's how well we care for the sick and elderly in the US! :

T&D2005- thanks for that informative response- I think I need to start changing clothes before I get my kids after work, in addition to handwashing.
post #16 of 18
Thread Starter 
Quote:
Originally Posted by T&D2005 View Post
VRE and MRSA are mainly transmitted in body fluids and from skin to skin contact (usually people with those touch something on their body and have it on their hands). Where I work, MRSA is mainly in wounds. Wearing gloves should be good enough (ALWAYS practice good handwashing). Unless you are told that the person has respiratory MRSA, you can go in and be in that same room with no mask ect... MRSA and VRE and easy to get when healthcare workers take care of you but don't wash their hands. Remember these people are human and need care. When I go in, I make sure to avoid touching their bedding with my scrubs and if they cough, I turn my head- just in case. When I get home, I strip in the garage then come in and shower right away. So far, so good. I even worked with VRE patients when I was pregnant with no problem.

You have a small amount of MRSA in your nose naturally. Some people get it worse than others and most healthcare workers have it but don't know it (it doesn't cause problems in many). Anyway, think about it.. before these people got to your place of work, they were out in restraurants, grocery stores, movies, parks, malls (trying on clothes) ect.. the difference is.. you didn't KNOW anyone had anything and it didn't bother you then :-) That's why we always wash our hands when we are out and about and before eating!
The thing with the guy who has VRE. We do "diaper" changes. We touch him with gloved hands, but when we roll him to change him, he always touches us. We have to touch his bed with our legs or arms to roll him over. There's just no going around it.
post #17 of 18
One thing you can do to help protect yourself when in their room is to use a clean pad over the area where your legs will touch- kind of like a drape. You know the pads I'm talking about~ the kind that go under the patients so that you don't have to do a total bed change. I'll ask around for other ideas. You can't prevent him from touching you all the time but maybe you can get someone to distract him? Maybe by holding a towel or something? I know our CNA's work together and one will hold his hand while another flips and changes. Ask your nurses about it too :-) That's why we are there!
post #18 of 18
Thread Starter 
Quote:
Originally Posted by T&D2005 View Post
One thing you can do to help protect yourself when in their room is to use a clean pad over the area where your legs will touch- kind of like a drape. You know the pads I'm talking about~ the kind that go under the patients so that you don't have to do a total bed change. I'll ask around for other ideas. You can't prevent him from touching you all the time but maybe you can get someone to distract him? Maybe by holding a towel or something? I know our CNA's work together and one will hold his hand while another flips and changes. Ask your nurses about it too :-) That's why we are there!
incontinent pad. good idea!!!!
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