Published Feb 8, 2007
ExCorporateRN
55 Posts
My mental health clinic rotation involves working with meth & crack moms. We sit in a small & poorly ventilated room and it is quite crowded. Yesterday I had the luxury of sitting next to a client who was hacking and coughing. Later that day the RN who runs this group said that there is one patient with TB in our group.
Did some research and see that it is of course, air-bourne and those usually most affected are family, co-workers, healthcare workers who have close/frequent exposure.
Definitely being exposed and getting TB, is a huge concern....but even more long-term is what would happen to me as a nurse in testing positive for TB when I apply for jobs??
What would you do in my situation?
gitterbug
540 Posts
More in-depth testing is done, if found to be positive then meds are given, after some time off to make sure treatment is followed and being successful, a return to work is usually accomplished. If TB is contracted on the job it is compensated by Workers Compensation. Having worked with nurses who have had TB, I can say that they always requested an xray to fully rule out presence of the illness if there was a question. We did attempt to steer them away from patients who were in the rule out phase and even in the active phase of the illness. Hope this helps. Good handwashing, keep environment clean and a small fan may help.
TazziRN, RN
6,487 Posts
Absolutely!!! Most positive results are just conversions and those people need CXRs done instead of PPDs annually. Even someone who's had TB or is being treated for it can get a job.
TrudyRN
1,343 Posts
Certainly. Ditto what Tazzi said.
Does your employer supply you with a HEPA filter mask?
fgoff
256 Posts
I think the chances of this patient having active TB is very slim. They would have been in a neg. pressure room until he has had 3 straight neg sputums (AFB)after starting meds. Before being sent to the floor. Many pts are treated for latent TB(pos skin test no sysmptoms and no history of treatment) on the floors.
If you think you have been exposed to active untreated TB. notify your instructor so you TB skin test can redone. It may be a stacked test one now one in three- four weeks.. All facilities have policies that need to be followed as to which (mostly INH) and when meds are started.
If you show a 10mm TB skin test most likely a chest xray will be ordered next and sputum for AFB sent. You will be started on meds and referred to the local health department for F/U.
Your job should not be effected. Your facility would determine if a worker comp claim is to be filed most of the time it is not needed.
Hope this helps!
elkpark
14,633 Posts
Being exposed to TB is not that big a deal, or uncommon -- there are plenty of public health people who will tell you that nearly everyone who lives in a big city has been exposed at some time or another. The chances you would actually develop active TB are v. slim.
As for employment, I was identified as having been exposed >20 years ago, when I started nursing school (my last job had been running a soup kitchen and working with street folks). My nursing school had no problem with that, I completed the prophylactic treatment regimen without any problems, and it's never been an issue for me in terms of being hired anywhere. Lots of people in healthcare have been exposed -- it's just not a big deal.
There isn't really anything to "do" at this point -- just wait until the next time you have a Mantoux (PPD) test and see if you have a + response. If so, that must be reported to the public health department and they will tell you what to do from that point.
This isn't an employer...it is a nursing school clinical rotation.
Most of these mom's come from the street or from jail. This is an unvoluntary program that they must go through for the county.
This isn't an employer...it is a nursing school clinical rotation. Most of these mom's come from the street or from jail. This is an unvoluntary program that they must go through for the county.
I did understand that from your original post. If, the next time you are tested for TB, your Mantoux test has turned positive, the public health department will provide you with any prophylactic treatment deemed to be necessary/indicated. Unless the "rules" have changed dramatically, they will do that at no cost to you. While there are plenty of people walking around the streets (and participating in involuntary county drug tx programs) with active TB, the chances that you would ever develop active TB are extremely slim unless you are immunosuppressed for some reason. Returning to your original question, having a positive Mantoux (PPD) will not affect your employment opportunities in the future -- it's a v. common situation in healthcare.
Nursing involves working with people with many different serious, communicable diseases. Sometimes we are able to identify them in time to take appropriate precautions, sometimes we don't figure out what they've got until we've already been exposed. That's an unavoidable part of nursing (all the healthcare professions).
chuck1234
629 Posts
My mental health clinic rotation involves working with meth & crack moms. We sit in a small & poorly ventilated room and it is quite crowded. Yesterday I had the luxury of sitting next to a client who was hacking and coughing. Later that day the RN who runs this group said that there is one patient with TB in our group. Did some research and see that it is of course, air-bourne and those usually most affected are family, co-workers, healthcare workers who have close/frequent exposure. Definitely being exposed and getting TB, is a huge concern....but even more long-term is what would happen to me as a nurse in testing positive for TB when I apply for jobs?? What would you do in my situation?
If you had TB, how could you can a job in the health care field!
But if you only exposed to it, you only had a positive PPD result. Most likely than not, your facility might ask you to go for a Chest X-Ray to R/O the active disease! This chest x-ray is going to be Q2 years if PPD result is +. Good luck!