To the doc that rounded on my patient yesterday... (Tales from the CCU)
added by geena on February 11, 2008 at 11:08 AM
I know you know that our patient was on isolation, because it's very hard to miss: 1) the big red "ISOLATION" sign on his door, 2) the big cart outside of his room containing gowns, gloves, and masks, and 3) me, standing at the patient's bedside wearing said garb. So when you come in ungowned and unmasked and I say, "Um, you do know that this patient is in isolation?" the correct response is not to hold up your gloved hands and say, "It's okay; I'm gloved up."
When told that this patient requires more personal protection equipment than gloves, the other correct answer is not, "I don't have time to bother with that shit. I'm not touching him anyway." Do you want to know how I know that this answer is incorrect? Because when you were bending over ever-so-slightly to listen to the patient's chest using your own stethoscope instead of the dedicated isolation stethoscope, the front of your shirt poofed out just a little, and just enough to brush the side rail. The side rail that has been touched by many many gloved hands probably containing all kinds of millions of organisms that are, you know, resistant to more than quite a few antibiotics.
And the "I don't have time to bother with that shit" comment? I did point out to you that I have to put on the gown, gloves, and mask every time I walk into the room, which was easily 1-2 times an hour, sometimes more often. For 8 hours. So you do not have to tell ME about what a pain it is to bother with it. I am well aware.
You did get one thing right. As you walked out of the room, you very correctly used the alcohol hand gel... and when I told you that the one of the organisms that the patient has does not respond to alcohol gel and that you need to also wash your hands, your snotty reply of "I know that, Geena" was a little unexpected. If you don't even know enough to use proper isolation technique, how am I to know that you know anything else about it?
And finally, when I remind you to clean your stethoscope, your answer of, "I already did that" is not fooling me at all, because I have been watching you closely out of the corner of my eye and I know full well that not only did you not clean your stethoscope, you handled it after washing your hands, thereby contaminating yourself again. Well, it was going to happen regardless. I wish it hadn't happened before you started putting your grubby hands all over the chart, though.
And although the pen that was sitting on the counter right next to you was my favorite pen, I threw it away after you were done "borrowing" it.
Right before I called the epidemiology nurse and told her alllll about you.
Progress Notes
It's okay Geena....doctors have a natural immunity against anything that needs to be put in isolation. ....or at least I think they do....Yeah, they do...it comes with their degree.
added by MyOwnWoman on February 11, 2008 5:09 PM
O M G. Please tell me that this doesn't happen often...
added by Bobby on February 12, 2008 2:45 PM
Oh, it happens quite often, Bobby.
BTW- What's the orgainsim that's resistant to alcohol gel?
added by Beth on February 13, 2008 12:38 PM
C-diff is resistant to alcohol gel. You have to wash your hands with soap and water after tending to a patient with c-diff.
added by geena on February 13, 2008 1:36 PM
I once worked with a nephrologist who came to work one day complaining that his two children had come down with nasty diarrhea. He was one of those I-don't-need-gloves types that frequented our little ICU.
When I told him that he probably brought it home himself after not being careful around his clostridium-difficile infected patient, he did not like it.
added by shrimplate on February 15, 2008 12:15 PM
why is it that some doctors think that all this "isolation stuff" is just nursing silliness? I have heard MD's at a hospital other than the one I work, say this very thing. "Nursing silliness". I mentioned to them that I am one of those silly-type nurses, and they were quite abashed, and quietly harrumphed down the hallway.
added by Silly Nurse on February 18, 2008 3:41 PM
And tell me again why nurses are always being blamed for the spread of organisms a, b and c?
added by Lindsay on February 19, 2008 12:47 AM
I have maintained through the last three years that c-diff is spread around by Doctors. All book smarts (sometimes) and no common sense to speak of....
added by Amber on February 20, 2008 4:58 PM
I guess these organisms only infect humans - so if the doctor is a particularly nasty piece of work it won't infect him - and if he's a great guy and has a very human attitude - he will take precautions
added by Dave on February 27, 2008 12:56 AM
This would be why my mother has had a raging MRSA infection in her abdomen since November '07 after a hernia surgery. The next patient this a-hole touches will be the one who suffers, the people who don't practice good infection control aren't usually the ones getting sick. Unfortunately, it is thier immune vulnerable patients who are next on rounds who become infected with what they carry around with them.
added by Angela on February 28, 2008 7:48 AM
Okay, so this whole isolation thing is killing me! I get isolating for CDiff and RSV and rotavirus, etc. But MRSA is getting a little out of hand. Flame me if you will, but if the patient has it, their family has it, the staff have it, why bother? More patients have MRSA than not? Standard Precautions are said to be ALL THE "ISOLATION" THAT'S TRULY NEEDED. Not to play devil's advocate, but seriously. Besides, you may have thrown that pen away but that doctor touched the chair and you touched the chair to pull yourself closer to the desk. And what about the phone you used? He used it too. Please, educate me.
added by Jennifer on March 4, 2008 10:10 AM
What a joke it was to read this post. Whilst I appreciate nurses like to claim to know everything about medicine without actually getting a medical degree, this 'post' just highlights this fact plainly.
What organisms live on bed rails? seriously. That so fucking LOL. Micro-organisms live on the skin, period and normally in or around the site of a wound not willy fucking nilly on every inch of the skin and surrounding area.
So what he used his own stethoscope, there is NO STUDIES to show that stethoscopes harbour or carry infection and it is hilarious to suggest they do, where would a pathogen get anything that it needs to survive whilst living on a stethoscope. Comedy.
The fact all you could say is "one" of the organisms doesn't respond to alcohol gel instead of being the all so mighty nurse and knowing WHICH organism it was (C.Diff) and the fact that it is THE ONLY organism depending on serotype that isn't killed by alcohol gel and can you tell me dr.nurse why it isn't of course you can't because your probably dreaming up the other nonexistant bacteria that can't be killed by alcohol gel.
Reported to the epidemiology nurse, hilarity what is she going to do, EPIDEMIOLOGY go and look at what that actually means, being a nurse she will probably have a hard enough time understanding the term, never mind doing the job. At best she will look at rates of a specific incident,disease,infection,whatever will she understand the microbiology, physiology or pharmacology of the drugs needed to treat the infection. Don't make me laugh anymore.
added by A whinging nurse on March 29, 2008 3:44 PM
I dunno what that epidemiology nurse did, but last time I saw that doc go into an isolation room, he put "all that shit" on.
I pointed out in the comments above which organism it was that does not respond to alcohol gel.
Bacteria absolutely colonize on bed rails and stethoscopes. Do a little research.
added by geena on March 30, 2008 2:47 AM
Wow! What fun!
added by Pat on April 28, 2008 11:13 PM
What I really meant to say was, where I work we have come to the conclusion that isolation is only for the nurses. Patients who have MRSA in the nares are isolated in the hospital, but when they transfer to our unit (consisting of rehab, hospice, or long-term care, they are not isolated for nares MRSA because they want our section to be more "homelike." Patients in isolation are allowed to be out of their rooms, as well.
added by pat on April 28, 2008 11:17 PM
It ain't for that doctor that isolation is necessary! It's for the rest of the patients that he will infect with C-Diff! Stupid disease spreading rot-brain ass, I hope he dies of a hospital born illness, being ignored by his own doctor, in pain and shitting himself to death.
added by Jess on May 6, 2008 12:56 PM
I am so glad you told him about himself. I am soooooo sick of these damn doctors!!!
added by kasey on May 7, 2008 4:41 AM
So, what brought you to the hospital today?