When You're Put in Hospital Isolation

A respiratory infection has you feverish, coughing and wheezing -- severely enough to put you in the hospital. You're placed in a private room, which is fine. As sick as you feel, you only vaguely notice that the nurse checking your vital signs is talking through a mask and face shield. The doctor listening to your lungs wears goggles, and everyone who steps into your room is swathed in a thin yellow gown. When you're wheeled back to your unit from a test, you see two laminated signs affixed to your door. Now you get it -- you're in isolation.

Why Isolation?

Isolation precautions are about "preventing cross-transmission or cross-infection of patients, visitors or staff," says Timothy Landers, an assistant professor at the College of Nursing at The Ohio State University. Patients go on isolation for two basic reasons, says Betsy Todd, a nurse epidemiologist and clinical editor of the American Journal of Nursing. They have something infectious that other patients can easily catch, such as chickenpox or flu, or they have a highly resistant organism like MRSA -- methicillin-resistant Staphylococcus aureus.

The word "isolation" can scare people and "makes it sound like you're in solitary confinement -- and that's not what happens," Todd says. Rather, "our concern is that staff wear gowns and gloves so they don't carry these organisms on their hands to the next person down the row."

[Read: Could Your Hospital Make You Sick? ]

What Isolation Looks Like

Standard precautions, which apply to every patient, mandate that staff members wash or sanitize their hands whenever they enter or leave a patient's room, and use gloves and gowns as needed. Beyond standard precautions, patients with infectious conditions are placed on contact, droplet or airborne precautions, based on Centers for Disease Control and Prevention guidelines.

Carol Wagner, senior vice president for patient safety for the Washington State Hospital Association, estimates that during a bad flu season, "upward of 20 percent" of patients in a hospital could be in isolation.

Contact isolation is used for organisms that can be spread by hand, like C. difficile -- notorious for causing severe diarrheal illness that spreads among patients in hospitals and nursing homes. Staff members garb with gowns as well as gloves, Todd says, because organisms "might also be spread if a nurse leans over a bed and gets it on his or her uniform -- and then they touch their uniform and they touch the next patient."

Rathel "Skip" Nolan, director of infectious diseases at the University of Mississippi School of Medicine and medical director of infection prevention at the University of Mississippi Medical Center, says for people who carry MRSA on their skin yet have no symptoms, it can be hard to understand why they're routinely put on isolation. Staff members have to explain: "Although it's not a problem for you, if we can pick it up on our clothes and lab coats, we may brush up against other patients and give it to them."

Droplet isolation is used "for things that spread through the air by a spray, like coughs or sneezes, but don't go very far," Todd says. Staff members wear masks and eye protection. For bacterial meningitis, patients are kept on droplet isolation until they've been on antibiotics for 24 hours. Flu and pertussis (whooping cough) also call for droplet isolation.

With known or suspected cases of Enterovirus-D68 -- now confirmed in 40 states and the District of Columbia -- both droplet and contact isolation are used. As a parent of a hospitalized child, suspected enterovirus in other patients isn't a major concern, Todd says. However, "if you think that your child has an enterovirus-[infected] roommate, then I would be concerned," she adds, but that's not likely to happen.

[Read: What Parents Need to Know About Enterovirus .]

Airborne isolation is used for infections such as tuberculosis, chickenpox and measles, which are spread by tiny airborne particles that can travel by air currents throughout the hospital unit and onto different floors. However, Todd says, U.S. hospitals have special ventilation that helps prevent these infections from spreading. Patients on airborne isolation must be placed in private rooms, she says. Staff members need protection from breathing the organisms into their lungs. They can use special N95 respirator masks or wear a hood that contains its own air supply.

[Read: Germs That Can Send Your Kids to the Hospital -- and How to Avoid Them .]

What Isolation Feels Like

Isolation is all in a day's work for health care workers, but not patients. "So many patients are placed on isolation precautions and they don't understand, and they don't know what they have," Todd says. "And are they going home with the plague?"

Studies have shown that isolation patients get fewer visits from health care workers, although visits may last longer. "There's good evidence that patients who are on isolation feel more socially isolated, as well as having higher symptoms of anxiety and depression, and they have lower satisfaction scores than patients who are not on isolation," Landers says. "Just keep in mind that sometimes those patients are much sicker than patients who are not on isolation, so it's not [necessarily] the isolation that's causing it."

Kids with conditions like whooping cough may be confused by seeing parents and other visitors in isolation garb, or having to wear masks when they leave the room for tests and procedures. They typically can't visit the hospital playroom, although child life specialists can stop by their rooms with easy-to-clean toys and games.

[Read: 7 Facts About Child Life Specialists .]

Explanations Help

In 2009, the Washington State Hospital Association developed a tool kit with standardized, easy-to-understand isolation signs, brochures and multi-language information sheets to prepare patients for different types of isolation. "It's really letting them know what is happening, instead of a person arriving in all this garb and [patients] not expecting it," Wagner says.

She advises patients to "ask for a sheet that explains the isolation to you. Ask what your visitors can do to help be safe. Observe the isolation precaution signage standards. So if you are in a type of isolation where you need to stay in your room -- then stay in your room." Along with every other infection control expert, she stresses the importance of hand washing or sanitizing -- and reminding health care providers to do so as well.

If you're bringing in children to visit a parent, brother or sister, check with the nurses' station first. "In the case of measles, you would probably be told to stay home." Wagner says. With wounds or other infections, children could visit and be instructed not to touch. "We want families to be together as much as possible," she says.

Nolan says that once patients make the connection between the virus that made them sick and the need for isolation, they usually are "very understanding" and "most of the time, if it's explained to them, they're going [to say] 'I certainly don't want someone to get sick on my account.'"

Lisa Esposito is a Patient Advice reporter at U.S. News. You can follow her on Twitter, connect with her on LinkedIn or email her at lesposito@usnews.com.