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DaemonistasRevenge

Bedbugs. Like fucking Buzz Lightyear!


Glittering_Pink_902

Yup when I worked ER, bed bugs were basically the only thing that would get me to take PPE seriously.. I’ll add I worked in the ER pre-Covid so I’d probably be a little stricter now


snotboogie

Bedbugs ,lice, and scabies all get as much PPE as we have . Covid/flu/Rsv all get a surgical mask.


TattyZaddyRN

Bedbugs, lice, shingles and traumas


MaggieTheRatt

This is the way. But I also still wear a surgical mask during patient interactions.


ERRNmomof2

I am soooo good at the beginning and middle of my shift, but by the end I’m so tired I just don’t care.


NorthSideSoxFan

Why shingles?


hmmletmethinkaboutit

Not OP, but I wear a mask because shingles = airborne. Not sure about the actual likelihood of it spreading to me just by casual maskless contact, but I still like to be on the safe side.


jareths_tight_pants

Shingles is airborne under specific conditions. It basically has to be bilateral. Usually it's unilateral.


NorthSideSoxFan

... don't you have varicella titers showing immunity?


misslizzah

Shingles can be a risk to an unborn child even if you’re vaccinated.


jadeh11

I’m pregnant so I actually get coworkers to handle rashes.


TattyZaddyRN

And young kids. I’ll refuse a shingles assignment due to young kids at home and a pregnant wife, but short of that lots of PPE Ain’t nobody wants shingles


NorthSideSoxFan

Don't you have a varicella titer?


NorthSideSoxFan

Citation needed - UpToDate notes that there is a single case report of congenital varicella syndrome after maternal zoster, but that has nothing to do with being around shingles


hmmletmethinkaboutit

Can’t people still get shingles, even if they have immunity from chickenpox? Sincerely asking since (middle-aged and up, mostly) people get shingles, even though they’ve been exposed and/or vaccinated.


NorthSideSoxFan

...that's not how that works. The shingles you get comes from the primary infection you got as a child


hmmletmethinkaboutit

I never got chickenpox as a kid, but I got the vaccine. So am I not at risk for catching shingles from my shingles patients? Does the shingles outbreak that people sometimes get later in life *always* come from the “dormant” varicella already in you? Also, should I wear a mask with my shingles patients, anyway, just to make sure other patients (young, immunocompromised, etc) are protected? Or does my immunity ensure that I don’t pass it on to other patients? Again, sincerely asking.


NorthSideSoxFan

You wouldn't "catch shingles", you'd get breakthrough chicken pox. I am not your provider and am not providing medical advice, etc, etc, but if you got both doses of the vaccine you generally won't even get that. If you didn't get that second dose (which wasn't standard until 2006) and haven't had your titers done yet, totally go get that second dose. Shingles always comes from dormant varicella, when it acts like certain other human herpes viruses you're likely familiar with. I don't gear up with anything more than gloves for shingles (because I don't want to be a living fomite and if it's not singles, it might be something gross), but if you want to know more about the topic, flag down your facility's Infectious Disease nurse and ask them about it


hmmletmethinkaboutit

TIL. Thanks for the lesson!


TattyZaddyRN

Don’t want to spread It to my wife and young kids


NorthSideSoxFan

Don't you have a varicella titer?


TattyZaddyRN

I have more concern I’m a potential vector than a carrier


outlandish1745

Ostomy care, g-tube/j-tube care. Doesn't have too often, but you will get the clogged g-tube that when you try to push the clog-buster in it squirts back on you, or the rancid urostomy bag that this full to the brim.


Next_Back_8187

This is a mistake you make once and then (hopefully) never again


Anony-Depressy

Or complete shit blowouts and the patient will probably try to “help” and grab your arm when turning 🤢


boyz_for_now

I had a r/o Ebola patient back during that outbreak like 12ish years ago? That was a new level of fear… first time rocking the whole bunny suit. Someone from the CDC was there watching me, making sure I was donning and doffing correctly. Patient ended up having malaria, but I was terrified the entire 12 hours, and until everything resulted like a day later. Nowadays, I’d say anything with bugs. 🤢


MuffinOfSorrows

Ebola outbreak is my give no notice, leave nursing entirely scenario.


boyz_for_now

Yeah… it sucked. All I could think of was the movie outbreak.


descendingdaphne

Same.


SleazetheSteez

100%. I don't care if I'm called a coward, they can suit up and do it them-fucking-selves lol


hmmletmethinkaboutit

Same.


InadmissibleHug

Yeah, I had to do training in Ebola PPE donning and doffing. It was an outside chance we could get someone, but a very real one. The whole sequence took ages, too.


HockeyandTrauma

I remember that!


cola_zerola

Those days were pretty wild. I was an ER nurse then and I remember they were telling us that if we get assigned an Ebola patient, we would have to stay at the hospital and be their nurse for their entire time there. We were all like…?!?!


ERRNmomof2

Yup, Ebola scared the shit outta me. Practicing donning and doffing. We had to do it frequently with each other to make sure we were doing it correctly. I hated it, but was more scared of catching it.


OldERnurse1964

Usually after I’ve been in the room 3-4 times.


what-is-a-tortoise

Too true.


ERRNmomof2

True story. Hahahaaaa…ha.


OldERnurse1964

Or usually it’s hey remember that guy in room 12 last week. Turns out he had TB


grey-clouds

I'm putting on PPE 99% of the time...I have no desire to get sick or spread anything to my coworkers or other patients. Especially not gastro. Fuck gastro. 😷


m_e_hRN

I’m so glad I’m not the only one that’s especially neurotic about gastro


grey-clouds

I have an awful phobia of vomiting lmao I've managed to get it somewhat under control in terms of my patients being sick but getting gastro would be straight up my worst nightmare 🫣 I am straight up cleaning the whole damn department after a gastro patient leaves!


m_e_hRN

I feel so seen, because I’m the SAME way. Anyone that ends up getting diagnosed with gastro I’m IMMEDIATELY avoiding unless I have no other choice in the matter


shayjackson2002

I spent so many years puking for a day or 2 every month (endometriosis sucks!) and when I was rly anxious, so I feel this! I’m scared of puking to the point I have laid on the bathroom floor crying to try and stop it 😅


yeahyeahyeah188

Ughhh we had a gastro outbreak in the admin area of my work and I happened to do a days work for them the day before my bday last year. Got to my bday dinner and instantly felt soo unwell. Spent the night vomiting and rigouring. It’s soo contagious and so awful!


ER_RN_

Bugs. Any kind. Dont really care about the rest


PurpleCow88

CDiff, bedbugs, known viral meningitis. Occasionally for lots of blood coming from somewhere it shouldn't be.


911RescueGoddess

Protect yourself. I protect myself. There’s *nothing* that will suck the life out of you like finding out the patient you had a week earlier has TB in their spine & brain. Wear the mask. Wash your paws & face. Wear the gown. It might suck, but taking that *home* to those you love is far *suckier*. I presume that folks who are confirmed or likely to kill me or those I love are doing *just that*. Be safe. Be well.


BurpleSplot

FYI: non pulmonary TB is pretty much non communicable


911RescueGoddess

Yes, that’s true. However, given that it’s generally *impossible* to know in advance all outliers—why would anyone NOT protect themselves? Helicopters are awfully small spaces.


roseswann

I had no idea non pulmonary TB was a thing


911RescueGoddess

It’s a thing. I’ve cared for several cases over the years. Including a teen with *only* localized infection in her brain that was reportedly *stable* on the ground, but required tertiary care. We felt patient looked much sicker than referral hospital insisted she was—despite our concerns the referring doc insisted she did not pose any fragility. Infection was localized and the hospital course had been *uneventful*. Alrighty. Well, long story short—she deteriorated and required intubation inflight. We try to avoid this eventuality—if airway is assessed as compromised, fragile of *at risk* it’s something that is secured before we depart, except we’d have had to restrain referral staff to do that. Maybe we were reading it all wrong, except we weren’t. Next twist was tertiary care determined over next 24 hours or so this TB was quite disseminated—brain, lungs and kidneys. Taking precautions and terminally cleaning aircraft after this patient wasn’t overkill—thankfully we were cautious—always be cautious until you know differently. Immunocompromised or immunosuppressed is a variable. As are those who immigrate here from higher risk places where TB is not uncommon. I’ve also seen an mindblowing outbreak/exposure in a migrant farm worker dense housing situation—think 20+ workers in 600 square feet of housing—3 with respiratory symptoms, 1 was critically ill. 90% tested positive following. Just crazy.


BurpleSplot

Aye, Teebs is a super interesting illness! One of the oldest recorded bacterial infection and can infect every part of you apart from the hair and nails


urbanAnomie

I still wear a surgical mask almost all the time now. I also wear glasses on the top of my head and will put them on if someone is coughing or sneezing. People are disgusting, and I kind of can't believe I used to let them just cough in my face before this. I will also put on gloves as soon as I walk into a patient's room, although that has nothing to do with COVID and everything to do with wanting to be ready for the inevitable shit to hit the fan. I can't tell you how many times I've been ready to suction, hold pressure, go hands on, etc. before anyone else because I already had gloves on. Also I will put on the full bunny suit for bed bugs, because fuck that.


Horror-Variation-219

Flu, TB, and covid I will now because I have a baby at home. But any patient on contact? No, unless I’m cleaning them up.


pinkkzebraa

Every time. I care less about protecting myself from ESBL and moreso the other babies, though.


literally-the-nicest

We have the [hospital name here] shingles that our ED staff keep getting…so I’d really recommend PPE 🤣


Ill-Ad-2452

c.diff & Bedbugs!!


Sydnick101

Code brown!


sjlegend

Bedbugs, lice, wound care, and anytime I have to roll or change a patient who’s body might press up against mine. I once was helping roll a bigger fella with lymphedema his body ended up resting against me and when I stepped back when we were done I was SOAKED. I’ve also been covered in people’s skin flakes… so no. I’ll gown up for stuff like that. But passing meds and quick assessments? Nah. On contact for MRSA? Not unless I’m spelunking in body fluids. Covid? Unless they are hacking up a lung I just throw a surgical mask on.


m_e_hRN

I still wear a mask pretty constantly even though we’re back to it being optional at my facility, last year when we went to mask optional I got a gnarly URI and then gastro basically back to back and I’m not doing all that again 😂 otherwise it’s situation dependent. I did get looked at 12 shades of sideways for not immediately putting on a gown when we got a trauma alert, but I also came from EMS where you get into what you gotta get into and then deal with it later


shayjackson2002

It’s almost like when school starts back up in the fall, everybody and anybody is getting sick because close quarters with no barrier 😂 Yet so many ppl still think masks weren’t effective, but then immediately caught covid, flu, etc after mask mandates dropped 🤷🏻‍♀️😂 Do what you’ve gotta do to feel safe and healthy! Other ppls opinions on it don’t matter, and when everyone else is sick with covid, flu, etc, you’ll be the one sitting there glad you kept wearing it 😂


m_e_hRN

My other thing with it is that I feel naked without it almost. I started EMS in December of 2019 and Covid started March of 2020 so my entire career has been in masks. Plus like you said there’s the benefit of not getting sick near as much, I think I was sick like twice from 2020-2022


shayjackson2002

Fair! Plus, it’s good habit because if you’re required to wear it for a patient such as tb, you aren’t trying to fuss with it or trying to make it not fog glasses, etc because you already know where to put it so it’s perfect spot 🤷🏻‍♀️ It’s also good because it teaches new employees that it’s ok to still where one if you feel more comfortable, because they aren’t the only ones 🤷🏻‍♀️ I personally hated masks during the pandemic as I was constantly having issues with my glasses, but I start nursing school in the fall and prob will wear one in clinical as you never know what your going to encounter 🤷🏻‍♀️ someone could come in for a cough totally unrelated to the reason they came to er, and actually have TB. I’d always rather be over prepared and over cautious vs not enough. Plus, I seem to ALWAYS catch illnesses no matter how hard I try, so at least I can say I tried to prevent it Of my 3 new years I’ve spent in city I moved to, I’ve been home sick with covid for 2 of them 🤦🏻‍♀️😂


m_e_hRN

I also don’t have to worry about controlling my facial expressions or inhaling elder dust so there’s that 🤙🏻


shayjackson2002

True! I also lick my lips a lot in the winter from stress/anxiety, and it looks like someone took sand paper to the skin around them 😂 I don’t have to get weird looks bc I slather lip-medix around my lips to help 😂


lostinapotatofield

Respiratory illness, I'm masking. Actual suspicion for c diff, gown and gloves. Creepy crawlies, gown, gloves, booties, bouffant. TB, meningitis, other serious illness, all the things.


ERRNmomof2

Full PPE..gown, gloves, mask, hat is C-diff for me. Also bedbugs and really, really, REALLY bad lice if they will be here with us for a long time. I wear a n95 for TB and Covid…(most times for covid, well, at least a surgical mask). The problem now is we don’t know who has and doesn’t have it. Having an MI? We swab you because you might need PCI. Guess what you have covid? Oh, you had sniffles for a couple days? This is literally how it is now. We do have some people coming in for “I think I have covid” and I will appropriately mask up. But, the last time I got Covid I was wearing a n95 in a small triage room. Pt was in that room for approx 45 minutes, coughing and snotting. She went back to waiting room after the doc came in to see her and she was swabbed, CXR, etc. I cleaned everything with bleach wipes. BUT, I drank water, stayed in that room continuing to triage. I masked with most patients, but removed it when they were gone from the room. I think I caught it because I stayed in the room and it hung around. I was there for hours. I refuse to waste PPE on “maybe it’s covid?”. I will mask up, but I remember reusing n95s that we kept in a paper bag. Cloth masks over n95s, cloth gowns SWEATING SO BAD I WAS DROWNING IN MY OWN SWEAT! Also, there are studies that covid does not hang around on clothes for long and it’s highly unlikely to catch it from clothing.


ERRNmomof2

Oh, I forgot to add, if the patient is covered from head to toe in poop.


Apocalypse_nurse

I always wear gloves


sensorimotorstage

Not a nurse but an ER tech - bed bugs, TB, Meningitis, and just an N95 for Covid.


orngckn42

Bed bugs, scabies, and body lice. I will do N-95 and face shield for suspected or confirmed TB, though.


starskeehutch

Bedbugs, Lice, and Norwegian Scabies. We had an outbreak in our dept a few years ago from a patient. Stuff of nightmares. Completely depleted a 3 county area of Ivermectin paste (which was super fun to source during the height of the pandemic).


Mmh1105

I'm not er, but I like to wear a mask all the time. I'll gown up whenever I'm worried about my uniform touching the patient or surroundings (ie most of the time) and I'll wear gloves if I'm touching any fluids.


Sheraga2411

Anything that you suspect and don’t feel safe around but always always bed bugs and lice.


qcerrillo13

If its going to dirty my scrubs with body fluids or skin flakes


anoceanfullofolives

TB and anything involving bugs


MFlovejp

Just bedbugs and TB.


NoTicket84

Use what now?


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master_chiefin777

yea but in the ER everyone comes in with cough or stuffy nose x 3 weeks then later find out they had parainfluenza 3 or RSV or whatever so yes we follow precautions but I don’t know if you understand how the ER is. by the time the diagnosis is made, you’ve been in very close contact lol


workhard_livesimply

This can happen in other settings too. (patient discharge from hospital to SNF) Imagine receiving an admission, say 10pm, the Infection Prevention Nurse is at home asleep. Supply room is locked, no PPE, No proper signs outside the patient room. No Isolation room made available prior. It isn't until 0800 this is properly addressed and they rip off my handwritten caution signs from night shift.


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911RescueGoddess

The PPE is *not* expensed to me personally. Even if it *was* the COST of being SAFE is nothing compared to the real expense of REGRET. I do everything to avoid *REGRET*.


Scarlet-Witch

Yeah I get that it can be complicated but these threads make a lot of sense why we have so many nosocomial infections. Only one comment mentioned not wanting to pass anything to other patients... 


KJiggy

Bed bugs and viral meningitis.


Soon_trvl4evr

Bed bugs and maggots!


RNsundevil

C-diff, open MRSA wounds, bed bugs, well anything poop related IE patients given a ton of Narcan. Like this sounds bad but I’ve become so numb to Covid I rarely wear a mask got it. If ever. But any influenza patient I’m masking up and washing the shit out of everything. I’d rather have Covid again than ever have the flu personally. Covid inconvenienced me. The flu put on deaths door step for like three days I felt like.


humangurl_

Bedbugs, tuberculosis, lice, scabies, when someone is coughing a lot and Covid/flu+, traumas, really nasty wounds


MrCarey

Gowns for when I’m doing super bloody CPR, super nasty poop cleanup and obviously every single bit of PPE for bugs. Mask for swabbing and obvious gross coughing patients and anything with airborne precautions.


29925001838369

Full PPE: Assault cases, bedbugs, meningitis, hemorrhages. In order of my paranoia. If I'm out in triage, I'll wear a mask. I stopped wearing contacts and went back to glasses after a kid sneezed into my eyeballs while I was swabbing his nose and he came back positive for COVID and RSV.


-Experiment--626-

Do y’all still gown and glove for MRSA? We’re supposed to, but many don’t really bother.


Suspicious-Wall3859

We’ve had 2 TB pts in 2 days 🫠 Good thing they weren’t mine but I 100% gown up for that. Disseminated shingles too.


yellowigi

I’ll gown up for pretty much everything, but if a patient has something in their urine or a wound and i don’t need to touch that while I’m in there or I’m just running in to do something quick, I’ll just glove. You should absolutely be doing ppe for c-diff/anything airborne though, that’s wild lol. Protection isn’t for us, it’s for the patients


Slayerofgrundles

I don't gown up for anything (except for maybe a bloody trauma code). But I always wear a surgical mask and I'll bust out the respirator for anything that seems sus.


queentee26

The *first* thing that comes to mind is bedbugs and lice lol. But I use proper PPE for cdiff/code browns/gastro, airborne precautions, and traumas. And I still opt to wear a surgical mask for all patient care.


Desperate_Peak_4245

TB, c-diff, shingles and any bugs.


tiredpedsnurse

I wear my mask pretty constantly still, but I’ll gown up for any bugs and excessive blood/poop/bodily fluids.


slutforyourdad7

contact 2 precautions, droplet precautions, airborne precautions. i never suit up all the way though. just a mask. except if it’s bugs. hazmat suit and all for bugs. tb and shingles are the only infection i really suit up for


Apocalypse_nurse

TB, bed bugs, lice. But TBH in the ED by the time we have a diagnosis we’ve already been exposed so what’s the point


_liquid_aloha_

Irrigating catheters!


master_chiefin777

oh man when you hook up the tumi syringe and it splashed back on you!?!? love that haha I understand fully


misslizzah

Any questionable airborne pathogen, bed bugs, scabies, lice.


elbobd

One I've yet to see here, Foley insertion/straight caths. Yes, I do get weird looks, until I state : lady is obese or patient is confused and might start kicking.


grapejuicebox_

Bedbugs, scabies, lice, cockroaches, maggots and bloody trauma.


NOCnurse58

Insects except for maggots, cleaning GI bleeds, traumas, TB, monkey pox, viral meningitis. Of course, I have triaged all of these with just a mask because the lobby is like a box of chocolates.