Sunday, April 8, 2012

Isolation

"The patient is in isolation".....and I groan loudly inside.


This has been going on for 30 years in my professional life. Never any easier or any less aggravating; this need to take off my white coat, find a hook to hold it, don a flimsy yellow gown, put on gloves, and maybe a face mask (depending on whether we're talking respiratory isolation in addition). Then, I go into the patient's room all decked out, find family at the bedside who may or may not be in compliance with the warning sign of the door, and do my work. Then, in reverse, I peel off the costume and pitch all in the trash, wash my hands, and put on my white coat.

Back in the day this might happen once a day and sometimes only every few days depending on the mix of patients on service. Now, up to a third or more of the patients seen in the hospital have the "IN ISOLATION" sign on their hospital room door. Damn it, I think. And then, I feel guilty for cursing the need for all the hoopla.

I suppose it's possible to prove scientifically that what we do to prepare for our interactions with those in isolation actually pays off in terms of preventing transmission of disease to other patients and to prevent ourselves, the presumed healthy, from becoming colonized with bad "beasties". In fact, I feel quite certain that this data exists. I just do what I'm told, cringing with the thought of reprimand if I'm caught out of compliance with the dreaded yellow paper gown.

Microbes are invisible. Yet, they are powerful and in some cases, deadly. It makes great sense to take precaution in hospitals where the risk of cross contamination between patients is so real. I get it. Truly, I do.

But, that doesn't mean I can't despise the process inside and curse and moan in silence for the plague of methicillin resistant staphylococcus aureus (also known as MRSA) which may have once been present in said patient but is years past but forever a "scarlett letter" around their neck. Or, the patient affected by clostridium dificil or multi-resistant enteroccocus, and on and on it goes. "Possible influenza" might be the cause for "in isolation and even though I've been immunized and am at low risk of transmission of disease....my hands and white coat, the humors that surround me, may represent the difference between safety for patients and palpable risk.

 Sigh. I wax mournfully about this annoyance because I can. It takes up so much precious time. If I had a nickel for every yellow gown I've put on, I'd be a rich lady.

But, I'm compliant with orders. Compliant  because it's the right thing to do; even if no one is looking.