COVID Testing and Home Care

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Asked to take a test twice by home care clients. First time employer refused to pay and free test was not available. Since I wanted to work, complied. Now it has occurred to me that I should request the next potential client test to satisfy my need to avoid exposure. Something tells me the agency isn’t going to back me up on this. Are others encountering a one way street in this matter? 

Kitiger, RN

Specializes in Private Duty Pediatrics. Has 43 years experience. 1,639 Posts

A negative test is only for that moment in time. I would be more interested in how well the client complies with the basic mitigation strategies, especially when outside their own home. Do they mask up/social distance/etc.? How likely are they to pick up the virus?

We do not require the family to wear masks in their home when I am there. This is because I see that they are intentional in avoiding COVID when outside their home. I do mask up and I social distance as far as possible from the family members. (Right now, I am only in 2 homes, and I have worked in these two homes for years. As I know them well, I am comfortable with their ways.)

Do you often get new cases?

amoLucia

Specializes in retired LTC. 7,641 Posts

As a homebound pt, I receive many services within my home. Providers have always worn masks, kept safe distances, hand-washed, etc. My contacts were VERY limited, few & far between. Masks for super brief contacts have been physically distressing. 

But now I'm going out daily via ambulance transport for radiation therapy. My circle of contacts has risen exponentially. I wear a mask as soon as the transport arrives at my door, during the ride, during lobby wait-times, during the entire radiation treatment and then back home. With the prolonged mask wearing, I've found the need to use a rescue inhaler several times.

Just with radiation, my immunocompetency is at increased risk. So NOW I, myself, wear a mask when providers visit my home. I'm protecting ME from them and THEM from me during these.

I HAD to covid test the week just before starting rad tx. I do a lot of people-watching during wait-times. It's interesting to see how things have tightened up recently at my rad center this past week.

If I had a problem with any of my contacts/experiences, I would tell them and I would expect compliance (I doubt there'd be little room for me to deviate!).

Kitiger, RN

Specializes in Private Duty Pediatrics. Has 43 years experience. 1,639 Posts

I wear a KN95 mask almost the entire time I am in my client's home, only taking it off 2 or 3 times for 5 minutes (in the kitchen) to drink down a Glucerna.

amoLucia, what is your SpO2 while wearing a mask? Do you perhaps need O2 for your trips for radiation? 

guest1143647

Specializes in Peds. Has 18 years experience. 163 Posts

Home care is so wide open. I fear our exposure is worse than nurses working in LTC and hospitals.

We can't ask the family to get tested regularly,nobody wears masks,not even the nurses,and we are constantly doing aerosol treatments.Plus working with ventliators and trachs. Most of my clients,the rooms are so small that I am constantly within six feet of them.  All of our chairs are literally at the bedside. 

Many of my coworkers are sadly mistaken. They believe we are less at risk than workers in other settings. I am not sure why they believe that.