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Jan 10 2008

MRSA: Victimization and Shooting the Messenger

Yesterday’s post, where I told the stories of three (+2) victims of MRSA infections, raised ire, blame and excuses from commentators and emailers alike.

Never mind that they were stories of five people who are infected with MRSA, one of whom has basically been left to die. Never mind that the frustration levels of these patients while trying to get treatment are over the top. Never mind that these people are victims of dirty medicine — the kind where guidelines and controls exist, but are ignored in too many places. The negative comments were aimed at me — it’s easier, after all, to shoot the messenger.

From being accused of not knowing what I was talking about, to “clarifying” the two types of MRSA (which I am fully aware of, and have written about), to suggesting that these people should have known to use hygiene to begin with, to telling me I need to get my facts straight, to telling me I should be asking medical professionals about these things (which, by the way, I do several times each week) — to saying that I must be wrong because one nurse practitioner and one hospital administrator claim no one in THEIR hospitals are treated that way — and everyone of these commentators has completely missed the point.

(Oh yes, let me also acknowledge the six people I heard from who wanted to correct my spelling. In fact, I misspelled the word “staph” and corrected it within about 20 minutes of posting, but too late for it to be picked up by Fox News and Reuters. One gentleman made sure I knew I was an uneducated moron, too.)

Here’s the scoop folks — and this has what has raised MY ire:

Everyone of you who tried to put the blame for these stories on the victim’s shoulders (or mine!) are doing nothing but re-victimizing these people. As if it is THEIR fault for being victims to begin with.

For the woman who has spent almost a year in the hospital because the infection she acquired after surgery has left her on life support …. this was reported to me by one of my patient safety colleagues who visited the woman and her husband in the hospital, then observed how she was treated and reported it to the state health department. This woman was a victim of a dirty hospital that caused her to get an infection after surgery, and they have fallen down on their job of taking care of her. Don’t tell me to get my facts straight. Those are the facts. This is one way in which 100,000 people die from hospital-acquired infections each year.

For Maxine, the woman who had surgery last fall, acquired a staph infection, then went home from the surgery with the infection…. to suggest that she should have used better hygiene and then her family wouldn’t have contracted it is just unforgivable. That is not the point! Her son and husband were trying to take care of her. They didn’t understand about MRSA — they only knew their loved one had had surgery and needed caregiving. To suggest that somehow acquiring MRSA is their fault is just revictimizing these victims. Oh — and by the way — even her insurance company has told her she will have to find help out of state because healthcare is so backwards where she is.

As far as Jeff acquiring MRSA in the gym — once again — suggesting that his treatment by the unwashed, non-gloved doctor who laughed at him is somehow his fault for not using good hygiene to begin with? You aren’t serious! First of all — you are right — Jeff should probably have been more careful at the gym, although, he was infected before the recent rash (no pun intended) of news reports, so at that point he was simply uninformed. However — the important part here is that he asked the ER doctor to wash his hands and put on gloves — two things the doctor should have been doing anyway. Basic infection control. Yet — somehow this becomes Jeff’s fault because he didn’t use good hygiene at the gym? You might also be interested to see the several dozen emails I have saved over the past year from people who tell me a provider laughed at them. Simply unforgivable.

There is no room for this “blame the victim and shoot the messenger” mentality. Absolutely, those of you who work in healthcare and work to be sure infections are kept at bay in your own facilities — I’ll give you kudos. But denying that problems exist in other facilities is simply a way to cover up for your dirty colleagues.

In fact — why don’t we place the blame for infection spreading and inappropriate behaviors by those dirty healthcare workers on YOUR shoulders? It’s YOUR fault these infections are spreading because you aren’t holding your healthcare provider peers responsible for doing their jobs to control the infections.

How does that feel?

Wrong?

Bingo. Point made.

Patients — hear what I have to say: Do not assume that just because you go to a hospital to get treated for something that you will come out in better shape than when you went in. Absolutely — take the advice of these people who “know” — make sure everyone who gets near you has followed infection control procedures (as Perrin says — “hygiene, hygiene, hygiene”). Never be afraid to ask someone to wash his hands, use hand sanitizer, and wear gloves. (Those are ANDs, not ORs.) You can find a master list of procedures here.

Remember that there is a good chance that the patient those healthcare workers touched just before you, or the patient who stayed in the same bed as you, or the person who touched the TV remote or telephone just before you, or even the doctor’s tie, may have had an infection that’s just waiting to take over YOUR body. Protect yourself.

And if possible — protect yourself from these holier-than-though blamers who would just as soon revictimize the victims of infections than recognize that they are in a position to influence their peers to make the changes that need to be made.

(And for those of you who track these things — yes — I’ve checked my spelling.)

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Find a follow up to this post: MRSA: Patient Ignored, Left to Die — Redux

8 comments

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  1. TJ

    I do hate the word, “Victim” because it takes away all our power. Do I think these patients that have contracted MRSA deserve the best possilbe care? Absolutely! But I also believe that patients need to become savvy consumers for their own healthcare needs. What you don’t know CAN kill you. My parents generation revered physicians as gods, their professional judgement was never to be questioned but the reality is that only you can protect yourself and only you, the healthcare consumer, can use your power to hold these physicians/facilities accountable. Make sure the physician is board certified in his/her specialty, make sure the facility is accredited or Medicare certified and has met a nationally recognized set of safety standards, ask for rate of infection reports from the hospital or ASC and EDUCATE YOURSELF so you can ask the appropriate questions about procedures, risk management, infection rates, anesthesia complications/risk and get a second opinion if you are not 100 percent satisified with the answers. Ask questions and make educated choices!! Yes, you do have a choice if who and where you go for treatment!!
    Write or call your state legislators, hospital/ASC administrators, state medical boards, DOH, national accrediting bodies, better business bureau and the local media. and report, report, report! If you have a bad experience, don’t assume that things will change on their own. If you have used a physician or facility and received poor care, found sub-standard conditions, acquired an infection………shout it from the rooftop and get the word out so others will be aware that it is not a safe environment to get treated in! Protect yourself as much as possible but if you encounter sub-standard care, don’t just take it, fight back! YOU are your own best patient advocate! AND the next patient may be spared a bad experience.

  2. Wendy

    Bravo, Trisha.

  3. Perrin

    Trisha,
    Do not presume to lecture to me about patient safety and shooting the messenger.

    My own personal history includes a medical injury and deliberate falsification of my chart to make it look like no one knew an injury had occurred. The facts eventually came out during a confidential settlement, which included a signed agreement by me not to pursue criminal negligence charges against the two nurses involved.

    If anyone should be appalled at the dishonesty of the health care profession, it’s me.

    But I try to stay away from the blame game. Situations can be complicated and we don’t always know all the facts. I recognize that for you as a blogger, it can be difficult to convey all the facts and nuances within a single post. The additional information you provide in your most recent post does help clarify the picture somewhat.

    I tried to be polite in my responses to you. I tried to stick to the facts. The other responders were polite and professional as well. Speaking only for myself, my intention was never to “shoot the messenger” or “blame the victim.” Clearly you believe otherwise, and I’m sorry for that.

    I think we could have had some lively, interesting discussions about some of these issues – but not when you react with anger and defensiveness to people who disagree with you or your tactics. So I guess this conversation is over.

  4. Joe Schmoe

    I’ve worked for a large state hospital in nursing for many years, until this year, and I can tell you I have been disgusted by what I have seen. I’ve even known many patients who have died from both secondary MRSA AND Clostridium Difficile (C-DIFF) hospital acquired infections. I shouldn’t leave out VRE (Vacomyicin Resistant Enterococcous); these three are the major hospital acquired infections.

    Many healthcare workers attempt to cut time by cutting corners; and this includes the cleaning staff responsible for disinfecting the rooms after the patients are discharged. Frequently, the cleaning is substandard. A single occupancy room, used as an “isolation” room for an MRSA infected patient, does not get the proper cleaning after the patient is discharged into the community (often times WITH the MRSA infection, out into the public).

    So in addition to nursing and physician staff that don’t follow proper hand washing and sterile field procedures, you have cleaning staff also cutting corners. Part of this has to do with being so overwhelmed by being understaffed for the level of care; they believe that they can work faster if they just cut one little corner, no harm done, right? In their minds anyway, and doctors and nurses alike convince themselves of that. I shudder at the dirty white coats doctors are so fond of wearing, as a symbol of status-the germs I can imagine swimming on those things are enormous. Why change your hospital scrubs every day, or several times a day, if your just going to put a dirty jacket over it? Make sense to anyone?

    Furthermore, let’s talk about inpatient physical therapy rooms. How often are they disinfected? Patients with open wounds and seeping wounds frequent these places, share mats and equipment, with very little to no disinfection in between. What about the wheelchairs shared between patients, with no disinfecting in-between? Or, the sharing of a bathroom in a double patient room. I’m sure these are not good practices. Privacy curtains are not changed between patients, even though they are frequently touched by dirty physician and nurse hands, pulling the curtain back for a patient’s privacy, but also spreading germs… ready for the next patient.

    My best and most disgusting observation is the operating room one. In the OR, many surgeons choose to use cloth drapes over the patient instead of the paper drapes; not much of a problem, except that the surgeons actually STAPLE the cloth drapes DIRECTLY TO THE PATIENT!!! So you get not only disrespect of a human being’s body in lieu of physician preference, but you also get an additional wound here and there from the staples they used, which opens your body up for more entry sites for infection. Sometimes, I have found the staples STILL stapled to the patient on return from recovery; they didn’t even bother taking them out, just ripping the cloth drapes off the patient!! I only touched on a few items I have personally experienced/seen. The more people know, the more empowered they will be. Hopefully, we can make our hospitals and health care safer.
    Cheers.

  1. MRSA: Patients Ignored, Left to Die « Every Patient’s Advocate

    […] MRSA: Patients Ignored, Left to Die (Find an update to this post:  MRSA, Victimization and Shooting the Messenger) […]

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