"The Bad News Bear"
That's what one of my MRSA patients jokingly called me when I emphasized his responsiblity in keeping his infected wounds covered with bandages. He was a twice-a-day patient in the outpatient department where I worked. Our job was to infuse his IV antibiotic and thoroughly clean his wounds and change the dressings on his community-acquired MRSA skin infections. The degree of his infection was quite dramatic. His abscesses (or furuncles) were on his forearms, chest, underarm, lower legs, and groin. He had recently been released from the hospital after initial treatment which included incision and drainage to free infected pus from the skin lesions.
The deep wound "cavities" resulting from the incision and drainage were cleaned and packed with sterile dressings by the nurses in our department. Infected fluid still seeped from the wounds, sometimes soaking through the thick layers of bandages between dressing changes. Our friendly, outgoing patient seemed relatively unconcerned about his condition. The inconvenience of coming to our department twice daily was his main complaint.
In an effort to expedite his wound care treatment regimen, our patient sometimes removed his soiled dressings before coming in for treatment and would arrive in our department with wound drainage soiling his clothing. Patients with known MRSA infections are cared for in "contact isolation" in the hospital, with healthcare workers donning disposable gowns and gloves to even enter the patient's room, but in the community there are no safeguards. Obviously our patient's unbandaged infected wounds posed a risk for his family, close personal contacts, and anyone in the community who might unwittingly come in contact with this drainage.
Our jovial patient had a nickname for each of the nurses in our department. Calling me the "Bad News Bear" made me optimistic regarding the patient teaching we had provided to him during his treatments. It was reassuring that our patient grasped the important concepts: (1) an understanding of the potential for spreading his infection to others and (2) the potential for serious consequences of inadequate treatment. However, after a few weeks of treatment and without a word of explanation . . . and long before his wounds had healed . . . one day our patient simply stopped coming for treatment!!
Before taking care of this patient, I didn't think as much about my personal risk of picking up a community-acquired MRSA infections. Somehow this was the patient encounter that brought the issue home to me. Now when I go to the grocery store, I grab those disposable cart-handle-wipes that are conveniently situated near the front door and wipe down the cart handle and the "baby seat" before starting to shop . . . just one of a few new little extra tasks I've adopted to avoid picking up any lingering super bugs that might be hanging out on public surfaces, providing a smidgeon more peace of mind for the "Bad News Bear."
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