Allowing infected staff to work--your thoughts please!

[SteveNNP, MSN, NP]

Hi all,

I need some input/validation here..... Here's the situation. One of our staff members came down with an infection last year and was out of work for several months. She now has a picc line and morphine PCA. She has recently been allowed to come into the unit to work on the schedule for 4 hours every few days, but my problem is that she comes into the patient care areas without scrubbing, lugging her backpack of fluids, and touches pt monitors, computers, phones, etc. She has been repeatedly hospitalized recently for multiple picc infections, and still comes into the unit while hospitalized dragging an IV pole in her pajamas, because she's "bored" and wants to visit. This made me SOOOO mad! I went to the NM, and the visiting was put to a stop for a while, but now she has been cleared through employee health to be back in staffing with a picc, and tpn/morphine. I CANNOT believe that such an infection risk, coupled with alteration in judgement related to narcotic use is taken so lightly in regards to caring for sick preemies! One of the neos is also very concerned, but it seems once employee health clears you, it doesn't matter! We work so hard to keep our infection rate down, only for it to be trumped by her being in the "inner circle" with several senior nurses and management. I have threatened to call infection control the next time she comes in the unit with an infected line, but I'm afraid to rock the boat. I've actually thought about leaving the unit because of this. I've had too many babies get septic to care what she thinks of me. I hate to leave after only a year, but I don't think I can continue to work in an environment where the babies' health is disregarded in favor of "being nice" to a senior nurse who has made herself "invaluable" to the unit.

Sorry for the long post......do you all think I'm overreacting? What should I do?

[Marie_LPN, RN, LPN, RN]

I don't even work in a NICU, but that entire scenario sound horrendous. I don't think you're overreacting at all. It's not like the babies can speak for themselves.

[Jolie, BSN]

All I can say is, "Wow!"

I know that chronic pain is different than acute pain, but I wouldn't work (and wouldn't be allowed to) if I had taken Vicodin for dental pain, let alone a morphine PCA. Add to that the high risk of this RN colonizing her patients with God knows what.

How about a call to Risk Management. Then a call to DHEC. They might care about patient safety.

More than once, you have mentioned working conditions that seem unacceptable to me. I know you want to stay put in your job for awhile, but I'm not sure it's worth it. How far are you from NICUs in Columbia, Charlotte, Asheville, etc?

[Gompers, BSN, RN]

I am shocked as well. That is just wrong. She's on Morphine. I don't care if it's chronic pain or not. It's an IV narcotic. Someone who is on an IV narcotic has no business taking care of patients in an ICU, or any other setting for that matter.

If she's touching ANYTHING on the unit, she needs to scrub up to the elbows each time she visits. If her PICC is in such a place that this is impossible, then she shouldn't be allowed into the unit. Period.

I hate to think that someday one of the babies is going to get the same type of infection she has, and that is what it's going to take to put a stop to this.

I know she's a senior nurse and is friends with management. But this is no time for playing favorites. How invaluable can she be if she's only working for 4 hours at a time, anyways.

There are some people who think that the unit can't go on without them. And with her being sick, maybe she needs some validation in her life. But this is too dangerous, in my opinion.

[LoriAlabamaRN]

RUN... do not walk... to your risk manager! If they do not listen, go as high as you need to. This is an outrage- those poor babies! Noone on IV morphine could possibly make the split second decisions needed to work on a NICU, and the risk of infection is horrifying!

[SteveNNP, MSN, NP]

Hey, thanks for the replies...... my unit has come a long way in the last few months...staffing is normal, our acuity level changed for the better, no more crazy assignments, and a new NM came on board. Our IVH and infection rates are waaay down, but this issue is very troubling to me. But thanks for the input....keep it coming

[greatshakes]

She needs to take a long walk right away from any hospital area. Where the hell is your staff educator and the infection control manager?. She is an accident waiting to happen and friendship with any of the staff shouldn't enter the picture. Would you be allowed to work if you were the one involved? No. I would have thought it would have been dangerous in any area but premmie bubs have enough to contend with, let alone walking disasters.

[Tweety, BSN, RN]

Definately call infection control. I don't know about your hospital but they wield a lot of power in my facility.

Would your coworkers allow an infected patient to just wander in there? I doubt it, and she should be no exception.

If however, her infection has been treated "x" number of weeks/days and has been cleared by employee health and her md to return to work, it's not fair to discriminate just becaue she has been treated for an infection in the past. We all get colds, flu, and infections and return to work when well.

But I do have a problem with someone working while receiving IV morphine.

[dawngloves, BSN, RN]

Employee health cleared her, how about ID? Was her last cx clean?

And she isn't activley getting TPN while at work is she ?? And MSo4??? That is the craziest thing I've heard in a long time! :uhoh21:

[BittyBabyGrower, MSN, RN]

Oh man, no way, no how. If she is colonized with some ick she could be spreading her happy little bugs! I'd have to contact risk management about that, and how do you know she was HONEST with the employee health place! And I can't think of a doc in their right mind that would give her the okay to work in the hospital! Ewww!

[gauge14iv, MSN, APRN, NP]

Not to mention what she could pick up just by being in the hospital environment. Yeah - a HUGE liability risk all the way around.

[GooeyRN, ADN, BSN, CNA, LPN, RN]

I don't understand why she would want to risk getting an infection herself. And she should know better that these babies don't need any extra infections. :trout: