Speaking of pregnant nurses...

Kim44 · Feb 5, 2004

I worked oncology while pregnant. I did not administer the chemo, but I cared for these patients. As long as you practice universal precautions with body fluids, there is no harm.

TB patients should be avoided because you can't take the meds to treat it if you become infected.

MRSA and VRE are OK too, with precautions.

CMV needs to be avoided.

LydiaGreen · Feb 5, 2004

Any client requiring a methotrexate injection (used to treat RA and CA). I'm still a student but had to give weekly methotrexate injections to a client while in community placement. I was surprised at how well educated the client was. I had, of course, done a drug study on methotrexate before I gave her the first injection. But, she asked ME if there was a possibility I was pregnant or if I wanted to have anymore children because she was concerned not only about her own health, but that of the people who care for her. An exceptionally wonderful, and self-educated client.

mattsmom81 · Feb 5, 2004

Ya know, we should watch these manager types carefully when they are pregnant...would THEY go into an infectious room as readily as they push us in??? That is if they come to the unit at all ready to pitch in....which is never in my ICU.

We ALWAYS use care in assignments for our pregnant nurses....one slip and two lives effected....there is no reason we can't give a little thought to this and help our mothers to be have a little peace of mind.

ratchit · Feb 9, 2004

Professional nurses use evidence based practice. Which means science decides what is safe and what isn't. Not "why would you take a chance."

I don't claim to be the expert on exactly what diseases are OK to be around and which aren't, but if there's no proof that something is risky, I don't think it's fair to assign all the isolation patients to non-pregnant nurses.

Chemo and CMV are known to be unsafe. I've heard that shingles isn't OK no matter what the mother's immunity status is, but people with more knowledge than I have already covered that. I can see avoiding TB- using precautions should protect you but if you can't take the meds to treat it, it's likely best to avoid it. OBs are a great resource here- but the ID department at your hospital should have good input too.

MRSA and VRE are very prevalent these days and keeping pregnant nurses out of those rooms would cause an unfair extra burden to be added on to their coworkers. Contact precautions have been proven to prevent their transmission.

The other night, 8 of our 12 patients were on contact isolation for something- no way to avoid assigning them to the moms-to-be. But when one coded, we didn't let mom do compressions.

We all help each other out, but saying that pregnant nurses don't go near anything icky just reminds me of the "I'm pregnant so I can't work nights" and "I have kids, I can't work Christmas" threads. I think "no precautions" patients is an unreasonable accomodation to ask for unless there is proof of potential harm.

zambezi, BSN, RN · Feb 9, 2004

The other thing to watch out for is radiation--ie: xray/cath lab...I have to go to cath lab occassionally with an unstable patient or one we are putting in and IABP on...the docs are always really good about asking if there is any chance that I might be pregnant...just to keep in mind if you do any portable CXR in the room or whatever...

NicuGal, MSN, RN · Feb 9, 2004

CMV and chickenpox/shingles are big no-no's in our hospital. Also, since we use nitric oxide, mom's to be can't be in that room, just as a precaution.

We really watch out for each other and if the pg person isn't comfortable taking something we will take it, especially for our high-risk mom's to be :)

Elenaster · Feb 9, 2004

I wish I could avoid taking care of the MRSA/VRE patients, but anymore we have so many in my ICU that it's nearly impossible to avoid. Especially since we don't know that many have MRSA until their screening cultures come back, which is usually 3-5 days after they're collected.

The only patient that I've seen a pregnant nurse successfully refuse to take care of was a young man in strict negative pressure isolation for bacterial meningitis.

I stay far away from the portable x-ray machines, and fortunately I've not had to go to the CT scanner since I've become pregnant. I did have to go to MRI and was embarrassed to ask if I could go in because I really didn't have any idea if MRIs are safe for pregnant women.

The worst patients for me right now....the huge ones. I just can't deal with pulling on patients that weigh over 300lbs. I'm just afraid I'm going to hurt myself or the baby, but since I've been "outed," most of my coworkers have been really good about helping me out.

Because of the nature of my job, I've been forced to tell people that I'm pregnant way before I planned on it. A few weeks ago, before I'd told anyone, I had two patients in contact isolation and both of them weighed more than 300 lbs. I felt like I was in hell, especially since I'm completely nauseated and one of them smelled horrendous, despite the intense scrubbing we gave her.

NicuGal, MSN, RN · Feb 9, 2004

Actually, pregnant women should avoid the MRI scanner if possible, esp when it is on and running...it can potentially damage the bones in the inner ears of the fetus.

Elenaster · Feb 9, 2004

Nicu gal,

I went in to push IV contrast between the two scans. They weren't actively shooting at the time, but the machine is always "on." Will you ask him if this was hazardous? I told the MRI people that I was pregnant and asked if it was okay if I went in there and they said it was fine.

Thanks for the info.

NicuGal, MSN, RN · Feb 9, 2004

You pushed the contrast? We aren't allowed here..that is the techs job!

As long as the magnet isn't "actively" running...you know when it is making all those nutty noises, it is okay :)

mattsmom81 · Feb 9, 2004

Originally posted by ratchit
Professional nurses use evidence based practice. Which means science decides what is safe and what isn't. Not "why would you take a chance."

I think "no precautions" patients is an unreasonable accomodation to ask for unless there is proof of potential harm.

Savvy nurses know nothing is 100%. We use universal precautions and best judgment but there is also a chance something my go awry...something we're not prepared for. We aren't wearing spacesuits into rooms.

As a charge nurse I am protective of my pregnant nurses and will continue to be as much as I possibly can. Sorry if this is deemed not 'professional' to some.

Gompers, BSN, RN · Feb 9, 2004

NicuGal...

We use Nitric Oxide too, and as far as I know we still assign pregnant nurses to those babies. Has there been any news about this being dangerous? I had no idea and would like to bring it to the attention of my manager if there is evidence. However, 99% of the time when we use nitric, I don't see how much of it can be released into the environment. It just goes from the vent to the baby's ETT, and we don't turn on the resuscitation bag's nitric supply unless we are actually going to be bagging the baby. I understand that our ETT's always leak, but most of that would be exhaled air, right? Once we had a cardiac kid on a nasal cannula with nitric though, and there were no pregnant precautions there.

As far as MRI, I agree. In our hospital, though, MRI is located across the campus in another building, and we have to take an ambulence. No pregnant nurses are allowed to do ambulence transports, even short ones like this, so luckily that is covered.