Have you/would you refuse certain patients while pregnant

[dawngloves]

With my last pregnancy I refused patients with shingles and CMV, but usually no one would assign them to me. I worked with a woman that refused everyone with anything infectious. HIV, Hep C, MERSA, VRE, TB, you name it. This made it difficult as many patients in our city hospital had something or ended up with something. But we let her do it and grumbled under our breath about her being overly cautious.

Have you refused patients while pregnant? For what? Were you supported? Lastly, do you think a pregnant nurse should accept assignments of infectious/isolated patients? (excluding varicella and CMV)

[Moogie]

When I was pregnant with my first child, I worked on a floor that sometimes got radiation implant patients. There was a hospital policy that pregnant workers could NOT take care of implant patients; still, one night the charge nurse insisted that I could not refuse the assignment because there had been so many implant patients as of late that she didn't want to risk any additional exposure to herself. She was not pregnant at the time. I got no support from the shift supervisor; she used to administer chemo when she was pregnant. So I took the patient, limited my contact, stayed behind the lead shield---but I also called in the next several shifts because the same charge nurse was on and I did not want to risk any harm to my unborn child. I had already put in my notice, so it was all moot by that point.

My son ended up being fine but, twenty-three years after this happened, the selfishness of that particular charge nurse still makes me very angry. (BTW, this particular nurse always panicked when we had AIDS patients. She was so paranoid and uninformed about AIDS---and homophobic----she was afraid to even touch someone with AIDS and tried to weasel out of any assignments would have required her taking care of anyone with AIDS.) :angryfire

That incident has made me very protective of my pregnant co-workers, even to the point of telling a CNA to not toilet a particular patient because he/she had recently had chemo and I did not want her handling the person's bodily waste. I told her I'd do it myself rather than risk her getting exposed. Just the right thing to do, IMHO.

[ajessrn, BSN, RN]

wow. that was definately wrong to have you take care of a patient with an implant. I think that my coworkers will be supportive about certain patients, such as anyone who has an implant or has had chemo recently, we don't do chemo or radiation treatments on the floor i work on.

I think I am going to have to do some evidence based research to have something in writing to back me up when i decide to get pregnant to protect myself.

So if anyone has read any articles lately or knows a good place to search let me know. I think I will start with the CDC and go from there.

I just almost dread having a nightly discussion about what patients are appropriate for me and which ones won't be, so I am thinking if I do my research and talk to all the charge nurses and my nurse manager about what I have discovered ahead of time, maybe it won't be such an ordeal.

it seems that on this forum and at my workplace there are extremes of opinion from not taking any isolation patients etc...to suck it up and do it. So I think the best thing to do would be to find some scientific research articles about it. Unfortunately I have a feeling nothing will be black and white and it will still be up to whoever is making my assignment so I hope they will be considerate. It won't be forever after all and I will be back to taking C-diff and shingles and everything else.

Even though I am not pregnant yet, it definately concerns me which is why I am trying to plan ahead.

[Spacklehead, MSN, NP]

I worked in the ED and personally requested not to have patients assigned to me who were most likely miscarrying, just because of how it may have affected them seeing me with an obviously pregnant belly.

I think the only other time there was an issue was in the case of a patient that had varicella. The charge nurse instructed me to stay out of that room.

[RNKPCE]

We had one patient when I was about 8 months pregnant that had some psyche problems on top of the medial reason he was on my floor. He without warning would turn around and and swing at people. I am not sure why I was ever assigned him because the charge did the whole assessment that required hands on, she gave the meds, all I did was check on him on rounds.

Have to be careful with combative patients.

Sometimes the patents you have to be the most worried about are the one that you aren't aware are contagious because you may not be wearing PPE.

I had a co-worker once who didn't want to take care of a shingles patient because her son(10 mos old) had not had chicken pox. I said that isn't a reason to not take care of a patient. Besides she had had chicken pox. I felt like saying well my daughter hasn't had H1N1 so I don't want to take care of that patient.

[r0b0tafflicti0n]

Precautions are precautions, but it's kind of amusing (irritating) when pregnant women (or others who are around you when you happen to be pregnant, cough cough) act like pregnancy is a disability. . .

[ajessrn, BSN, RN]

Actually from what I have been reading and from what my co-workers have been telling me it is common for pregnant women and pregnant nurses to avoid people with shingles and chicken pox. Been reading very differing things on this through blogs and through online research. some experts believe if an unborn child is exposed it could cause birth defects and miscarriage, however some experts are not convinced that the risk for this is high.

So I say if you can avoid giving a pregnant nurse a shingles patient that is probably the best practice, and you should.

I do see a problem with a nurse acting like she has a disability when pregnant (if she truly does not have a disability), however I do not see any harm in being cautious if it won't affect the floor and I do not see any harm in her co-workers trying to protect her and support her during pregnancy. Everyone, I mean everyone, has a different opinion on it. From one extreme to the next. Better safe than sorry.

(Not pregnant yet, but when I have small children I plan on changing my clothes before i go home) No sense in exposing them to any of the crazy stuff I work around if I don't have to. PPE is great, but as many have said there are so many people we find out 2 or 3 days later that they do have MRSA or VRE or C-diff etc....