Wednesday, June 6, 2007

He Has What???

I had a very stressful yet educational day that involved diseases. In the middle of my shift we were called to report to one of the floors because of an agitated patient. Upon arrival the nurse was standing far away from the room which is normal when a patient is scarring staff. The nurse gave me the patient’s name and room number and asked me to talk to the patient about leaving the room. As my partner entered the room I noticed a yellow cart that holds all the PPE (personal protective equipment). The seal had been broken and a box of masks was on the floor and that’s when it hit me.

Right before we entered the nurse ran like hell away and I yelled, “Is all this stuff for him or for another room?” The nurse stopped and yelled back, “Oh yea I would definitely wear a gown, gloves, mask and shoe covers.” As she turned the corner she shouted what he had, but all I could make out were these few letters “MRVECDIF.” Not knowing what that was I stopped my partner and we got all the gear on, but we were not prepared for what was next.

When we walked in the entire room was covered in urine, feces, and some sticky stuff and no way can this stuff come from a human. The odor would have been an efficient wallpaper remover. Now I know why I had to wear the shoe coverings. Now in the middle of this mess was a 60 year old that had to weigh 90 pounds. On his stomach were a bandage with a tube an
d that weird sticky stuff was oozing out the sides. There was no way this guy could have been terrorizing the floor. I was coming to the conclusion the reason they did not want to deal with him was because of this “MRVECDIF.”

My partner started to discuss with the old man about staying in the room while I went to find his nurse. After searching the entire floor I had the secretary contact her on her companion phone. The nurse was hiding in an empty room, or in her words looking for supplies (room was not the supply room). I asked her why she wanted us to the floor since the guy posed no threat. She stated he was wondering the floor and what he had was highly contagious and it was visiting hours. I asked her to put the guy in seclusion, soft restraints, or at least a posey vest. The nurse said the doctor refused to do any of the above because the doctor would have to come in on his day off.

I went back to the room and the old guy was just sitting in his bed rubbing feces on the bed. Since there was no threat to others we left and I informed his nurse of what was happening. I also let housekeeping know what room to go to because no one should have to sit in a room like that especially with what ever “MRVECDIFF” is.

10 minutes later we were called back to his room, the nurse stated, “The patient was gearing up for something.” She was crying wolf, but I take all reports of threats seriously. Upon arrival the patient was just sitting there playing with his feces again. I called the nurse and told her she needed to order a sitter because I can not legally do anything to him. The nurse asked if I could stand by until they moved the patient next door to a new room. After 40 minutes of standing around and the patient playing in his feces I went to talk to the other nurse tending to the patient that was supposed to be moved. I asked her when she was moving her patient. She told me that her patient was not the problem patient so she was not moving her patient. I said that’s fine and we left the floor. I found the patient’s nurse and asked again what the patient had and she stopped and said lightening fast what sounded like, “MRVECDIFF.” It was almost like she was trying to hide the illness from us.

10 minutes later I get another call from the nurse yelling at me, she said this patient can not be left alone. I told her to order a sitter because the security department did not have the man power to watch patients, patrol several buildings, watch the parking lot, lock up doors, and respond to emergency calls. I returned to the floor to try and find a solution, but they did not want a solution, they wanted us to baby sit the non threatening guy. This went on for hours and finally they decided to move him into a private room and they wanted us to do it. We are not supposed to, but at this point we were both so mad we did the move ourselves. We just had to wait for our psych doctor to check the guy out.

Now earlier I had asked the guy if he knew where he was, what the date was, and asked him where he hurt. The old guy had all the answers; he was acting that way because he was just a jerk. So the doctor walked in and he was done in less than 5 minutes. The doctor came to the same conclusion I did. Now it was time to move the jerk to his new feces, urine, & sticky stuff free room. We covered a wheel chair with sheets wheeled him into his room. As we did that his nurse appeared out of the wood work and said, “Now grab some soap, a wash cloth and wash him. I told her hell no and walked off, that pushed me over the edge.

Basically the whole day the nurse was trying to dump this sick jerk off on us and the psych ward. When I went down stairs to write my report I wanted to know what the hell my partner and I have been exposed to. When I called back I spoke with the secretary because I was so damn mad at the nurse. The secretary finally deciphered the code after trying to figure out what was scaring the staff. What the nurse was yelling was, “He has “MRSA VRE a
nd C DIFF.” I did not know what it was so I jumped on WEB and after I finished my reading I was slightly upset. It turns out that those things are in the sputum and he defecated and urinated everywhere.

I called our employee heath nurse at home and she said we would be fine as long as we didn’t rub it into any cuts or open sores. Also if we did get infected we would just be under observation and not given antibiotics. I went back to Web MD and it says if you have a drug resistant strain then no antibiotics would work. I called back to the floor and guess what it was a drug resistant strain. Both my partner and I are fine, but not very happy about the fast one the nurse pulled.

Flashlight 1


Jen M. Gorman said...

Holy crap! Literally! Glad to hear there are no ill-effects from you and your partner acting far above and beyond the call of duty.

Judy said...

There are antibiotics that work on MRSA, VRE, and CDif -- but if you're healthy, you don't want to use them. We save those for the folks who are really sick, because we don't want the few remaining antibiotics that work to become useless.

Far above the call of duty, as jen said.

girlvet said...

That is completely ridiculous that the nurse did that. I wish you would have called her supervisor. You have good reason to be upset.

Forgotten Blue Line said...

The sad thing is the Clinical Coordinator (House Supervisor) was there. She sat there and watched and did nothing.

Julie, RN said...

That is a horrible story, sad and shocking, and certainly does not say much about that nurse's ability or willingness to care for her patient.
Personally, I am completely indebted to our security personnel who provide us with brawny manpower when they ASSIST us in heaving a patient from bed to chair and back again, or when they offer a show of force to encourage compliance with hygeine, etc. (ie, convincing a body-fluid encrusted psychotic pt to let us shower him)...
We couldn't get our job done some days, without them.
Thank you for all you do.

The Platypus said...

She wanted you to give him a sponge bath? That's pretty weak, even by floor nursing standards.

shrimplate said...

I have no idea what the fuck that nurse was thinking. It was obviously an abuse of your services.

It seems like all the guy needed was a little freshening up, or a complete hose-down, whatever, and a speech.

Your immune system doesn't care what drugs the bacteria are resistant to, unless you get really sick, and you won't. It'll kill them anyways. But when a patient has methicillin and vancomycin resistant organisms in their junk you don't want a lot of people in and out of the room spreading that crap around.

Especially people who cover the entire hospital. I wouldn't have let you in there at all under those lame circumstances.

poody said...

I will bet that nurse was a youngster too. This is one of the many reasons I no longer work at the hopspital This is sopmething that should have never happened. Poor guy.

Kathryn said...

See, that's funny, "poody," because I was thinking "That nurse must be so burnt-out on the job."

Maybe she's new, maybe she's just seen it all too many times -- who knows? And why assume?

Forgotten Blue Line said...

To clarify the nurse was neither young or old. She also had only 3 patients to watch which is unheard of in our hospital (Normally 1:8 ratio). Also she was only an hour into her shift. She did not want to risk getting sick so she dumped it on security.

The Angry Medic said...

Okay that's weird. Usually nurses in that situation are the really dedicated ones. Ah well, maybe I've just been lucky so far (or you were just unlucky).

And like WHOA! Holy crap (like Jen above said, literally). Glad you survived it - we've just learnt about VRE in Pharmacology and that's scary stuff. Glad WebMD helped you (I write for them too, and I'm glad to see the other parts of the site are useful, because the part I write on just causes bad-humour-induced haemorrhage nowadays).