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First-Year Nursing Student Fears MRSA Exposure at Clinicals

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Stephanie Thibeault, RN, BSN and author responds:

This is an excellent question,and I understand your concern. Multi-drug resistant organisms such as MRSA (methicillin-resistant staphylococcus aureus) and VRE (vancomycin resistant enterococci) are on the rise. Certain highly communicable diseases, such as tuberculosis, are also becoming multi-drug resistant. As a student new to nursing, it is scary to know you are surrounded by potentially deadly organisms all day. When you have a young child at home, the fear of bringing something home is even worse.

With the growing threat of MRSA, VRE and other resistant organisms, are hospitals becoming more dangerous for workers and patients alike? The news headlines would convince you this is so, but the truth is, hospitals are not really any more dangerous now than they were 10, 20, 50 years ago. MRSA is not new, nor are any of the other multi-drug resistant organisms. Keep in mind that:

  • Less than 70 years ago, a paper-cut infected with staph could easily kill a person. There were no antibiotics available yet.

  • Penicillin (the first antibiotic) became available on the open market in 1944--and how wonderful that was! But, by 1945, we had the first case of PRSA (penicillin-resistant staphylococcus aureus); and by 1959, 50% of all staph infections were resistant to penicillin.

  • In 1960, we had a new antibiotic, methicillin, out on the market. Within one year, we had the first documented case of MRSA. Today, close to 50 percent of all staph infections are resistant to methicillin.

In short, we were battling staph and other infectious pathogens long before the advent of antibiotics, and we have been battling multi-drug resistant organisms since 1945.

Before antibiotics were developed, the only viable option for battling infectious bacteria was prevention. At that time, prevention referred to good hygiene, good sanitation and scrupulous hand-washing. Today, these basic steps remain in place, but we also have expanded infection control protocols to keep workers and patients safe. These measures, collectively known as Standard Precautions (or Universal Precautions) have proven to be very effective.

The Centers for Disease Control (CDC) posted an online guide to MRSA infection control. It describes appropriate standard precautions (hand-washing, gloving, gowning, protective eye wear, etc.), contact precautions and isolation precautions. It also provides links to articles on the management of multi-drug resistant organisms in the health-care setting.

Read up on Standard Precautions before you begin caring for your MRSA patient. Once on the unit, you will probably notice an infection-control cart outside your patient’s room—this will have all of the protective gear you need to safely enter the room, care for your patient and exit. As you exit the room, you will be able to take off and dispose of the protective gear. This allows you to move throughout the rest of the unit and to safely go home without transferring MRSA along the way. The key is to follow the protocol--that is what keeps you and your other patients safe. It also keeps your family safe, too!

If you still have concerns, talk with your instructor and/or your preceptor. They will be able to provide guidance and reassurance to help you feel more comfortable.

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