Contact allergy question... again...

[ama3t]

So I posted awhile back. Had a bad allergic reaction to something at work, but I have a previous history of contact allergies. Was out for two weeks. Filed worker's comp but was denied because they determined it "wasn't work related" because the allergies existed before I started, despite the fact that they were controlled until I started because I was using safe products at home.

They changed my gloves and soap, but not my hand sanitizer, and I went back to work. This is despite my dermatologist saying she believed the hand sanitizer was the issue. She even suggested an alternative sanitizer which they did not approve.

After two weeks back at work I am breaking out again. I went back to Occupational Health and basically they said that since risk management determined my issues weren't work related, they were done with me. I did have to call out that night.

Now I'm supposed to go back tonight and don't know what to do, and Occupational Health won't help me anymore so I'm coming to you guys. I need the money, I need to be at work because without Occupational Health saying I don't need to be there I get an occurrence for each absence and am in danger of losing my insurance for not have full time equivalent weeks and losing my job even for getting so many occurrences.

However, my hands are still broken out and somewhat open. Not as bad as when I called out Tuesday, but broken out none the less. My question is I'm not sure where to draw the line on when its acceptable to work and when it isn't. I took a picture and I was hoping you guys would help me. The dark areas are/where open. Some are sort of "scabbed" and some have split today. They aren't actually bleeding but are somewhat open. I need opinions on whether I need to still call out? I'm scheduled to go back to the derm Friday but I'm going to try to move it up to Monday.

http://imgur.com/I6NRZm7

Edit: I feel like the blurry ness of my picture may make this seem like much ado about nothing. So here is a picture (not me) but the same condition I have. It shows how the skin of the broken out areas looks up close. https://www.google.com/search?q=dyshidrotic+eczema&client=firefox-a&hs=oXo&rls=org.mozilla:en-US:official&channel=sb&source=lnms&tbm=isch&sa=X&ei=qPVsU5fFOqWysASq-IBo&ved=0CAgQ_AUoAQ&biw=1252&bih=547#facrc=_&imgdii=_&imgrc=TCKRBNcxV89c2M%253A%3B9B_CxOlGyWIX_M%3Bhttp%253A%252F%252Ffc01.deviantart.net%252Ffs71%252Fi%252F2010%252F193%252F7%252F7%252Fdyshidrosis_picture_set_by_create_a_name_dotcom.jpg%3Bhttp%253A%252F%252Fcreate-a-name-dotcom.deviantart.com%252Fart%252Fdyshidrosis-picture-set-171106143%3B1600%3B1067

[JustBeachyNurse, LPN]

Why not ask your derm for advice? Carry your own hand sanitizer. & don't say anything.

[ama3t]

I'm going back to my derm Monday. Her last recommendation wasn't even approved. What I'm trying to figure out is what to do now since they are broken out and I'm supposed to work.

[Clovery]

This isn't medical advice, just general advice from the "need to work" perspective. Go to work. Go out of your way to only use soap and water. Take extra care and double glove when exposed to fluids. Try to switch days with people so you can have a nice long break for your skin to recover. Maybe get some thin fabric gloves you can wear when you're not in patient rooms to protect your hands when you are charting.

[JustBeachyNurse, LPN]

Is the skin open or active bleeding? Or just irritated right now? Open skin or bleeding, use your judgement but will increase your risk for infection especially as an atopic individual.

Why not carry the recommended hand sanitizer in your pocket without making a big deal. Soap & water is scientifically proven to be more effective than hand sanitizer for most situations.

[Esme12, ASN, BSN, RN]

I'm going back to my derm Monday. Her last recommendation wasn't even approved. What I'm trying to figure out is what to do now since they are broken out and I'm supposed to work.

This is not legal advice....I would call OSHA the employer is obligated to provide you with the means to carry out your job....https://www.osha.gov/as/opa/worker/complain.html

[MunoRN, RN]

The skin on my hands does the same thing a few times a year, i've never thought it to be an allergic reaction, but either way I've never considered not being able to work because of it.

[nurseprnRN, BSN, RN]

Carry your own hand soap/liquid/whatever your derm gave you, use it, and don't tell anyone. Just do it. We told you that last time, still true.

We gave you chapter and verse on handwashing from the CDC, too, as I recall. Did you ever speak to the infection control nurse or physician on this issue? Why are you still focused solely on what somebody in Occ Health "approves"?

You have had a lot of good advice on how to manage this and it doesn't sound like you're following any of it. Am I missing something?

[Esme12, ASN, BSN, RN]

Carry your own hand soap/liquid/whatever your derm gave you, use it, and don't tell anyone. Just do it. We told you that last time, still true.

We gave you chapter and verse on handwashing from the CDC, too, as I recall. Did you ever speak to the infection control nurse or physician on this issue? Why are you still focused solely on what somebody in Occ Health "approves"?

You have had a lot of good advice on how to manage this and it doesn't sound like you're following any of it. Am I missing something?

The facility won't "approve" anything. Sounds to me like they are trying to let her go.

[nrsang97, BSN, RN]

I agree carry your own products. Don't tell anyone and use them. I would go in. Just be extra careful washing your hands. I agree a call to OSHA is a good idea.

[applewhitern, BSN, RN]

I have no skin issues now, but years ago the harsh soaps at work would tear my fingers (esp. the tips) up. They would crack and were quite painful. I never once called out sick because of it. I would do whatever I could to protect and heal them, but I can't imagine jeopardizing my job due to contact dermatitis.