Sunday, January 23, 2005

guess what gross stuff i learned today! OR why nurses are dangerous!

[background information: Since October, I've been going to a support group for GI disorders on WebMD. Some of the folks there have had C. diff. (Clostridium difficile) infections, which are tenacious and evil. One lady is going back for neurosurgery soon and wanted to know how to prevent getting this again.

This problem frequently erupts when people who have been exposed to it go on strong antibiotics, which everyone with GI infections gets.]

[The way C. diff. is spread:] C diff causes spores which are "shed" by the person who has it. These spores can survive up to 70 days in the environment. To catch c diff, you have to ingest it (sounds gross, I know). There are so many ways that it can be transferred in the hospital. And you're at a bigger risk if you're on antibiotics which kill the good bacteria in your gut, allowing the c diff to proliferate and fill the void.

[how to prevent getting it:] The cleanliness of those around you at the hospital and the 'health' of the surfaces in your room is going to be a big determining factor with the C. diff., or with any other opportunistic infections. The very best thing would be to have a 'glove box' posted inside your room door and for the nurses to be instructed that they have to glove up before coming near you. And that would also apply to almost anyone that enters your room - food try handlers, med techs, anyone........

And that's going to prove problematic as you've already thought out. I'd start by talking with your surgeon/doc and see what you can arrange. If necessary, you might purchase the glove box yourself and ask each person to please glove up as they walk in. Your going to be considered a pain and a nut, but what the hell.

If possible bring your own food utensils - wash and use them at every meal. If your food tray is placed on the bed tray, don't touch the tray, itself. Move it using the bed sheet around your hands, or use gloves.

And if you haven't used gloves before, learn the proper way to take them off - use one gloved hand to grab the cuff and pull it down over the hand section so it's inside-out. Ball it in the palm of the gloved hand, and with the un-gloved hand, grab the cuff and roll the glove down off the hand so that the other 'balled glove' is inside. Discard them as a unit. If you have to, when you use the bathroom, 'glove' the handles of the faucet and the toilet (before) each time you use them, and remove and discard each time.

Yeah, you'll use a heck of a lot of gloves, but what the heck if it keeps you 'clean.' If you want to disinfect, that may be problematic, as I don't know too many disinfectants that are reported to kill C. diff., although some on the board might. The cheapest might be a 10% solution of bleach - it's pretty effective in a molecular lab and might work well. The only thing that I know that does work is phenol or phenolic solutions, but they're caustic and dangerous. I don't know how you're going to feel after the operation, but if you can take some steps to protect yourself I'd sure seriously think about it.

[my personal input:] i got my CNA certificate last year, and in NC, at least, we're required to wear gloves whenever dealing with body fluids. your nurses shouldn't be annoyed by being asked to wear gloves even more often. and our hospitals have several sizes of glove boxes in every patient room, next to the door, with a purell dispenser.

if you explain to your caregivers that you have had c.diff, they'll understand your request that they take precautions.

i cared for patients with c.diff as a student, and it is required to glove AND gown if you are entering their rooms. doesn't mean the staff does it; saw the RNs go in to check a gauge in their uniform; they said they weren't touching anything, so they didn't need to.

nurses need to be educated about how c.diff is spread; i didn't know about the spores etc. it's our first responsibility to protect our patients, not expose them to next-door's spores of c.diff!

I got my CNA as a prerequisite for RN, but then had to drop out of school due to GI troubles and financial strain. now working full-time at my job as a medical transcriptionist. been doing this 13 years now, know just enough to be dangerous about so MANY things, thought RN would be less dangerous - guess i was wrong!


Anonymous said...

Wow, all this stuff about how easily c diff is spread in a hospital is scary. I believe sometimes nurses only glove up to protect themselves and not the patient. When I go to the Dr. for my allergy shot, she puts her gloves on and then handles everything coming and going before giving me my shot! OK, her hands are covered but the gloves are no longer sterile when she touches other things in the room. If EVERYONE ALWAYS had gloves on when touching things in that room it would be OK, but I know that is not the case.


MamaBear said...


You CAN get c.diff if you haven't been on antibiotics. that's just a more common cause, especially in otherwise healthy folks.

Rubber (and nonlatex) gloves aren't sterile, they're just a barrier.

Gloves used for surgery ARE sterilized, but when you go to the dr's office, they're using nonsterile gloves. it's usually ok to touch things in the room with them.

If you're getting an injection, tho, they should put them on immediately before and take them off immediately afterward to prevent spreading body fluids.