I would prefer not to get into a legal battle

[moosicle]

Currently, I am attending nursing school (still new to the program) and I feel that complicates this issue.

While preparing my immunizations and such for nursing school, I discovered that I have latent TB infection. The city's health department treats all LTBIs, and they put me of INH. Within a few weeks, I lost my appetite and felt nauseous every day and explained this to the responsible nurse at my 1 month appointment. She said that since I had not lost any weight they will wait until my 2 month follow-up and re-evaluate me. I was feeling slightly worse and she had me see the MD. She ordered a blood test (this is my only blood test since baseline). The nurse explained how a blood test is going to be a waste of time (maybe she was trying to be reassuring). So, I assume it is generally their policy not to do LFTs unless there are complications. Well, no one contacted me, so I assumed I am fine. On my 3 month follow up they take me off the meds and do biweekly, sometimes weekly LFTs. My AST and ALT levels around 5x normal the entire time and still are. Last week they said they will start looking into hepatitis on the 26th of January (about 3 months after they detected my elevated enzymes).

Do you think they were negligent for waiting so long?

Also, one of the nurses was VERY accusatory and asked "what have you been doing to hurt your liver?!" and "stop all the drinking" (I don’t know why she thinks I am an alcoholic), and "you can't do any drugs" (implying illicit drugs). I do not look like an alcoholic or drug user, mostly because I am not. I usually come in with my gym bag straight from the gym. I am a vegetarian health nut! I think she crossed the line, but does anyone else think so?

I am not requesting medical or legal advice, but I am curious how nurses feel about this issue because I feel like I am in an odd situation here.

You see, I do not intend to file a frivolous lawsuit and hurt any nurse's or doctor's reputation but I feel the need to do something. I would feel very guilty if my liver does not improve and I think that I must take some legal action. What would you do?

Thanks and sorry it is so long.

[medsurgnurse, RN]

Currently, I am attending nursing school (still new to the program) and I feel that complicates this issue.

While preparing my immunizations and such for nursing school, I discovered that I have latent TB infection. The city's health department treats all LTBIs, and they put me of INH. Within a few weeks, I lost my appetite and felt nauseous every day and explained this to the responsible nurse at my 1 month appointment. She said that since I had not lost any weight they will wait until my 2 month follow-up and re-evaluate me. I was feeling slightly worse and she had me see the MD. She ordered a blood test (this is my only blood test since baseline). The nurse explained how a blood test is going to be a waste of time (maybe she was trying to be reassuring). So, I assume it is generally their policy not to do LFTs unless there are complications. Well, no one contacted me, so I assumed I am fine. On my 3 month follow up they take me off the meds and do biweekly, sometimes weekly LFTs. My AST and ALT levels around 5x normal the entire time and still are. Last week they said they will start looking into hepatitis on the 26th of January (about 3 months after they detected my elevated enzymes).

Do you think they were negligent for waiting so long?

Also, one of the nurses was VERY accusatory and asked "what have you been doing to hurt your liver?!" and "stop all the drinking" (I don't know why she thinks I am an alcoholic), and "you can't do any drugs" (implying illicit drugs). I do not look like an alcoholic or drug user, mostly because I am not. I usually come in with my gym bag straight from the gym. I am a vegetarian health nut! I think she crossed the line, but does anyone else think so?

I am not requesting medical or legal advice, but I am curious how nurses feel about this issue because I feel like I am in an odd situation here.

You see, I do not intend to file a frivolous lawsuit and hurt any nurse's or doctor's reputation but I feel the need to do something. I would feel very guilty if my liver does not improve and I think that I must take some legal action. What would you do?

Thanks and sorry it is so long.

I am not one to answer other poster's health questions. But this was negligent. And the nurse was so far out of line accsuing you of drinking. You must report this behavior to a supervisor. Also it was not the nurses decision to make to decide whether or not you have your labs done; it is the doctors decison to order labs. Second your symptoms were just SCREAMIMG LIVER PROBLEM AND SHE MISSED IT. By the way a lawsuit would not be frivilous if it has merit.

[moosicle]

Thanks for your reply. The only reason I mention the nurse being negligent is because I only saw the nurse until she decided to get the MD involved but I guess the MD must review each case to prescribe INH. See, I don't know the details on how the facility works but I see what you are saying. I really do not feel any one person was particularly negligent but rather the way the system was set up.

Again, thanks for the reply.

[Nurse Ratched, RN]

We aren't in a position to give legal advice or medical advice. I can advise you to check out the CDC website for the standards for latent TB prophylaxis treatment as of 2000 - I believe there may be updates, but the CDC is what is commonly referred to:

http://www.cdc.gov/mmwr/PDF/rr/rr4906.pdf