Friday, March 19, 2010

Have they been isolated from their brains.

I had earlier blogged about the shear stupidity our infection control people exhibit when dealing with patients unfortunate enough to have acquired a drug resistant bacteria (usually acquired in hospital in spite of all the stupid precautions taken).

Case point 1.

One of the urologists was talking about how one of his regular bladder tumour patients has a drug resistant bacteria. This means that when he brings in this unfortunate individual from home to the hospital (where he probably was infected) he has to do him last on the list and usually hoo-haa goes on. The reason this came out is because our urologist had to reschedule the patient two weeks early.

The reason:

The patient wants to fly to Mexico for vacation.


When the patient comes for surgery, he will have to wear a yellow isolation gown, a mask and hat. We will clear the room of all non-essential items and if I want anything during the case I have to ask for it to passed through the door. The same will be done in the recovery room and in the Day Surgery unit. Every area he stops in will have to undergo a thorough cleaning.


He is going to be packed in a plane with about 100 other people in close proximity with the air recirculated.

Case in point 2

I got a call about an inpatient with back pain. The back surgeon had seen him and decided he needed an epidural steroid injection, something I do for a living. I figured the most effective way to get him done would be to just bring him down to the Pain Clinic.

He arrives in a yellow isolation gown, hat and mask. Procedure aborted; we don't want to have to do the major clean up infection control demands after these events. I said I would go up and see him on the ward. I don't really like doing epidurals on the ward but this is a special case.

Later that day I go to see him on the ward. First I find out where his room is. I am expecting to see the familiar pile of yellow isolation gown, gloves and masks along with the infection precaution signs on the door. Nothing there. He is in fact in a four bed room. There is however a pile of yellow gowns outside his bed.

Bewildered I go back to the nursing desk. "Why is Mr. X on isolation precautions?" I ask. He has a UTI says the nurse and until his cultures are clear he has to be isolated. "Is there any risk of transmission to staff or patients?" I ask. "Only if he pees on them" smirked the nurse.

After talking with him and examining him I decided to do the epidural on my next pain clinic.

A couple of days later we phone the unit to have him brought down for his epidural. About 10 minutes later, the unit phones us back. "Do we know he's on isolation?" asks the ward. "Yes we do" we answer.

Nobody likes hospital acquired infections especially drug resistant ones, however one wonders whether all this paranoia does anything other than to keep an army of infection control nurses who work bankers hours at the top of the pay scale busy.

1 comment:

burnttoast said...

How bout this? Someone, I suspect SuperNannyNurse who works for infectious disease, decided anyone on dialysis deserves isolation precautions. So does anyone who has ever had MRSA, C.diff, necrotizing strep, I don't know what else. EVER. As in 15 years before, no recurrance. I wish I owned stock in the companies that make those stupid yellow gowns, etc. The inefficiency is amazing, and the funds for preop nurses are not increased just because stupid rules add 15 minutes onto prep time. (I think with the paperwork burden, and stupid rules, hospital administration is like a ball and chain on the RN's ankle that always gets heavier.) Oh, by the way, our OR personnel must wear their own scrubs to and from work. Tell me that is a good idea! When I suggested to SuperNurseNanny that there needed to be a phone number posted on the hand washing stations so soap/towels could be reloaded when empty (hard to wash up with no stuff) I got the vacant smile, head nod, oh yes. No action.