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Your Home Care Nurse -
Florence Nightingale or
Typhoid Mary?
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Homecare nurses - they come to care for your
medical needs at home so you don't have to leave
home to get care. Home nursing care has kept
many an older person out of the hospital or a
nursing home.
Home care nurses travel from patient to patient,
ministering to people with an enormous variety
of medical needs. Some of the homes they visit
are immaculate, eat-off-the-floor clean. Others
are awesomely dirty. Talk to a visiting nurse
and you'll hear some hair-raising stories.
We don't often think about where the nurse (or
the aide, or the therapist) has been before
visiting our home, and what may be coming in the
front door along with him or her. The best
visiting health professionals give thought to
where they've been, and take proper precautions.
Others bear a strong resemblance to Typhoid
Mary. They contaminate without being aware.
Typhoid Mary, as most people know, wasn't sick
herself. She was a typhoid "carrier," who worked
as a cook and kitchen worker back in the 1800s.
Wherever Mary went, typhoid soon followed.
Eventually she was corralled and the
Mary-induced epidemic ended, but not before many
people became ill. Some died.
An oblivious home care nurse and her medical bag
could be the "Mary" in your home.
Home care professionals are well aware of proper
hand washing techniques, and most observe the
proper protocols before touching a patient: They
wash their hands thoroughly, and dry them on a
clean paper towel.
The bag they carry their paperwork and equipment
is another matter. That bag has been in tens to
hundreds of clean to not-so-clean homes. In a
recent study of the outside of these bags, most
were found to be positive for Gram Negative
Bacteria, E-coli, Pseudomonas, Methicillin
Resistant Staphylococcus aureus (MRSA), and a
long list of other, less familiar nasties.
While you wouldn't expect your home care nurse
to put her shoes on your furniture, your
counters or on your loved-one's bed, without
thinking and for convenience that's exactly
where many nurses will place their bags. So
medical equipment bags are even more likely than
shoes to be contaminated with "bugs" from other
homes.
The Joint Commission on Accreditation of
Healthcare Organizations (JCAHO) recommends that
traveling healthcare professionals carry
newspaper with them. They are instructed to
place a clean piece of newspaper under their bag
before placing it on the floor (always on the
floor, never on any other surface). They should
discard this newspaper in the home as they
leave. In this way, they will be less likely to
transfer organisms from their bags to the homes
of other patients.
This is excellent advice. However, being human,
some home care nurses may still put their bags
where they shouldn't, and clean newspaper is one
more thing nurses have to remember to carry with
them.
The easiest way to be sure your visiting nurse
observes the recommended medical equipment bag
rules is to keep a supply of clean newspaper in
the room where your "patient" will most often be
seen. On the first visit by every nurse,
therapist or aide, simply say cheerfully, "I've
put a pile of clean newspapers over there for
your bag." It's non-confrontational, and right
away the home caregiver will know, a) that you
are very aware of what they are supposed to be
doing; and, b) that you know a little something
about homecare and the dangers of
cross-contamination.
Advocating for an older person with health
problems doesn't have to be an obvious effort on
your part. Little things, like offering
newspaper for medical bags, positions you as
both an ally and a knowledgeable caregiver
yourself. You won't have to say another word. |
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