I stepped away for a bit. I gave plenty of
notice, trained a new person, and left my job 6 months ago. It was a good
time for me. With a little help from Mr.MoneyMustache, I got some perspective, put things in order, and took some time
for myself.
Sometimes you’re too busy to do the job well.
The days can be long, and I was barely keeping up with new regulations
and standards. Reading that I had planned to do later just wasn’t getting
done, because by the time I got home I did not want to do more work. As a
salaried employee, it’s often required, and I get that, but something was just
missing for me, and I wasn’t enjoying it much anymore. In my time off, I
enjoyed summer vacation with my family, went to a 3-day conference that I would
never have been able to get to if I was still working, and read through a
growing stack of journals and regulations from the comfort of my front porch.
And I picked up a part-time job in the microbiology lab, where I go 2
days a week, and happily punch out after 8 hours. I needed to put my
hands on something real, something that felt like patient care. I also joined the board of my local IC chapter, which I had
long wanted to do. But I’ll be back to infection control soon.
I’m still on staff at my old job, just on the
periphery, supporting the newbie through any crisis. And I have a bit
of a different perspective watching her work. She can get overwhelmed by
the crises. You should know that bombs drop on Infection Control on the
regular (or irregular. Or regularly irregularly). You can’t get
flustered. This, too, shall pass.
The key is being prepared. You need to
leave mental room in your workflow and in your stress level for bombs that will
drop. (Great time mgmt piece, here..Almost all pertinent to IC). You will be plugging along,
preparing docs for meetings, calculating your hand hygiene, doing new employee
orientation every other Monday...and a bomb will drop on your desk.
A kitchen worker has a
positive Hepatitis A test. Are you kidding me? Call Employee
Health, make sure he’s out and under the care of a physician. Just get
him out of the workplace and figure out the rest after. Check your
patients, is anyone sick? Call your board of health, if they haven’t called
you first, about that positive test. Nobody is sick. Good. When did
he work last? Find your guidelines on Hep A--state, local, or CDC.
Who needs to be vaccinated? Anyone? Can pharmacy get vaccine?
Administration wants a huddle about this. NOW.
This is a bomb. It will require you to
stay late, write a lot of things down, call a lot of people, wait for them to
call you back, provide education, and maybe pretend that it’s totally under
control. Which it will be, in 2 or 3 days. So hopefully, your
mandated data reporting isn’t due tomorrow. Or your report to the
hospital board. You’ve got to leave yourself a small buffer. Do not
be a procrastinator in this job, because you don’t know when the next crisis
will hit. Sometimes even a little crisis (like falsely positive Hep A
tests, which happen a lot) takes a couple of days to sort out. A major crisis
(like staff drug diversion with multiple exposed and infected patients), takes
weeks.
When something super major happens, you can be
assured that your state board of health will step in, or a federal authority,
heaven forbid. And you will have support, or you may even be pushed out
of the way. But small bombs are all yours. If you’re new, or in a
small or resource-weak setting, you should have a mentor, or a resource
somewhere. Maybe an ICP from a nearby hospital, someone with a little
more experience under their belt, who can point you towards the right
guidelines and documents. Try to make connections at a local conference.
Just be honest, and say, “Hey, I’m all alone at our 12-bed hospital.
Do you think I could give you a call to talk through something if I get a
tough situation?” Hopefully, that person is flattered that you asked, and
you get a few phone numbers to keep in your pocket.
It can definitely feel like nobody listens to me
when I tell them to wash their hands or document the patient’s stools
carefully. But in a crisis situation, I’ve sat in the C-suite with
everyone looking at me for what to do next. It’s the only time I have a
modicum of authority (IC is tons of responsibility, zero authority). The very
first step in crisis control is to stop the offending issue immediately, and
then head to your office to find your guidelines, review your policy, and make
a phone call. CDC has good resources on the steps of an outbreak
investigation, and plenty of disease-specific resources for illness in
healthcare settings. (And know that you are not the first person to have faced
such an issue before--whether it’s mold in the OR, faulty sterilizers,
hepatitis A in food service staff, or flu amongst the patients.)
No matter
how new you are, you are still the most knowledgeable person in your facility
regarding infection prevention and control. Put on a confident face (and
a decent shirt), and tell what you know, and what you don’t, what your next
steps are, and what you need from them. People are looking to you. And
you’re going to do great.
**Patient
notification is the last step in a crisis, when necessary. Don’t ever
notify anyone of anything until you have every last piece of info, and the
local health department is on board. It’s a very big deal. Do not attempt any
part of patient notification alone.
