I worked all day today. Everyday at work is good day, but today, I must say,  freaked me out. I went in to a room, the door was closed, so I went in and closed the door behind me and proceeded with my eval with a female meth addict who told me from the beginning she had “zero interest in therapy”. After educating her and gently persuading her to cooperate, which she did, but resentfully, I completed my evaluation. At the end of the evaluation she thanked me for taking with her and said she would try her hardest in therapy. I know she was in pain, and she was genuine when we finished, I could feel it. This took about 5o minutes. On my out the room, the room-mate in the in the bed next to my patient said, ” most people wear a mask in here”.  My heart started to race and I felt panic. I left, walked out of the room, and saw a rickety bedside table against the wall with some scattered masks, some paper towels wadded up and somebody’s glass of water that had been set down there. I noticed, once again, no sign posted on the wall or door just a shoddy, rickety table against the wall, as if left there by accident. The chart was vague, without contact precautions in the written orders.  I felt angry and sad at the same time. My life is on the line  each time I go to work , I know this. I take all the precautions I can, but when the signs are not clear, and information is left out, and I am not informed after I get clearance to enter the room, I feel disappointed.  I sometimes feel like I risk my life in certain settings. I take methotrexate and steroids for a disease that I caught from a patient in 2008. And believe me, that patient in 2008 could care less if I died right there in front of him, he was madder than hell at the world, having bleeding lesions of syphilis on the brain, dying of AIDS, gaping puss filled wounds on his arms from chronic infections. Now again, I had a sick feeling in my stomach. I asked myself, why don’t I stop this nonsense of russion roulette? I love my career. I love that I can make a difference and help people see that feeling healthy, finding purpose and become independent

Dissappointly again 2 hours later, I walked to an open door where my next patient was lying on the bed, less than 2 feet from the door, reading a magazine, engaging and talking to anybody who walked by his room. He  had MRSA in the sputum but refused to close his door because he said, “Im lonely in here!” . Well, gee, if that isn’t the truest form of misery enjoys company. If he can infect everybody in the building then we will  all be in the same room, in the same boat.  MRSA is rampant in healthcare, a growing problem. But the odd thing is why is it that in the acute care setting, a hospital, the precautions are so much stricter? In a hospital there are bright orange signs posted, masks, gloves, gowns at the door and notes in the orders that this person is infectious, and information given by the nurse when clearance is being given to enter the room. But I have noticed in  some nursing homes, not all, they often forget (?) about contact precautions,  is it viewed no more contagious than a common cold?

I started to feel queasy, my stomach felt in knots and bloated. It took all my strength to hold myself together. Then my last patient of the day, this one with MRSA too, but wearing a mask in the gym, kept talking and talking and talking and she was crying about her home life situation of her on again-off again relationship while I tried to be compassionate but at the same time trying not to vomit from the sick feeling in my abdomen and the fever coming on. When my patient was finished I started to leave the building and rushed to the bathroom to throw-up. I drove home with heater on in my care full blast. I collapsed on the couch and cried, fearful that I had caught something this time that will kill me. Maybe this particular location is too dangerous for me. Maybe I should reconsider this arena when I’m off this methotrexate drug? It is not worth dying for. I was too weak to think and my abdomen was killing me and I vomited again.

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