Nurse with Shingles caring for patients

[#1Nurss2care]

Hello Fellow Professionals,

I would like to know your opinion about a situation that happened. A nurse came to work knowing that he/she had Shingles. This was not a secret, the nurse told the charge nurse, supervisors, staff on the unit and the employee health department that indeed he/she had Shingles. There was alot a questions regarding whether or not the nurse should go home, to the ER or stay at work and take an assignment with patients. Yes this was an eyebrow raising situation, why was there any questions about the nurse taking an assignment? I am not the criticizer in this situation, but I would have to say that the nurse and the supervisors were putting patients and other staff at risk by allowing the nurse to care for patients knowing that he/she had Shingles. My understanding of Shingles is that when a patient is admitted to the hospital with Shingles they are usually placed in an isolation room alone with a CONTACT PRECAUTION sign on the door. I also understand that Shingles is contagious when the vesicles or whatever are draining. I was told, however that once the vesicles dry and crust over the person is no longer contagious. Now I don't know how many of you have cared for a patient with active Shingles in a semi private room, usually they are alone isolated. The nurse's Shingles were new, which I would think made him/her contagious right? I would like to get you as health professionals opinion regarding this situation. Should that nurse have taken care of patients why or why not?

[kids]

If the lesions were covered there is not reason the nurse couldn't work.

Can shingles be spread to others?

Shingles cannot be passed from one person to another. However, the virus that causes shingles, VZV, can be spread from a person with active shingles to a person who has never had chickenpox through direct contact with the rash. The person exposed would develop chickenpox, not shingles. The virus is not spread through sneezing, coughing or casual contact. A person with shingles can spread the disease when the rash is in the blister-phase. Once the rash has developed crusts, the person is no longer contagious. A person is not infectious before blisters appear or with post-herpetic neuralgia (pain after the rash is gone).

What can be done to prevent the spread of shingles?

The risk of spreading shingles is low if the rash is covered. People with shingles should keep the rash covered, not touch or scratch the rash, and wash their hands often to prevent the spread of VZV. Once the rash has developed crusts, the person is no longer contagious.

http://www.cdc.gov/vaccines/vpd-vac/shingles/dis-faqs.htm

[#1Nurss2care]

I get all that but how would the nurse which patients had chicken pox before. I still think that nurse should not have cared for patient. Because the nurse was still in a contagious state.

[kids]

I get all that but how would the nurse which patients had chicken pox before. I still think that nurse should not have cared for patient. Because the nurse was still in a contagious state.

Did you read the CDC link? Because I'm feeling like you aren't quite grasping the nuances of how it's spread.

Shingles is contagious while the vesicles are open.

The fluid from the vesicles is the infectious agent.

It requires direct contact with the fluid from the vesicles to spread the infection.

If the fluid from the vesicles is contained by a dressing it can not spread the infection.

I can't recall the last time I saw a patient with shingles on isolation, all that is needed is contact precautions.

[rose_njarvis]

Shingles is contracted through direct contact of the lesions, and contigious to an individual who hasn't had the chicken pox. Individuals Are encouraged to refrain from work if open lesions cannot be covered. Once the lesions have crusted over, he/she may resume work. Litchfield, S. (2010). Shingles. AAOHN Journal: Official Journal Of The American Association Of Occupational Health Nurses, 58(6), 228-231. doi:10.3928/08910162-20100526-05

[SopranoKris, MSN, RN, NP]

Keep in mind that shingles are usually isolated to specific locations on the body. Most often on the trunk & back of one side of the body (usually covered by clothing). In some cases, shingles can appear on one side of the face, which is one of the few areas that would be exposed, since it's not covered by clothing. Sounds like your co-worker had shingles that were covered by clothing and, therefore, wouldn't be a risk to contaminate patients.

Unless the lesions are open & the drainage is coming in contact with other people, she shouldn't be a danger to others. I had the shingles back in October and I was told to take extra precaution coming in contact with people who have never had chicken pox (e.g. washing hands after scratching, covering infected area, etc.) My son has never had the chicken pox and I was convinced he'd come down with it when I had the shingles. He never got it, so the precautions worked well. I feel sorry for your co-worker...shingles are extremely painful!!!

[stefRNBSN]

I found this on the CDC though: "People with active herpes zoster lesions should avoid contact with susceptible people in their household and in occupational settings until their lesions dry and crusted." Plus I see from other posts, that their facility won't allow it. Im waiting for an answer from mine as we speak, I do work with immunocompromised dialysis pts.

[JoRNBSN]

I'm a retired nurse and I just found out I had shingles on my abdomen. I had questions also over whether or not I should take care of children in our church's nursery especially since we have some families who did not immunize their children. As many above have stated, it's only by direct contact with the fluid from the vesicles that anyone who hasn't had chicken pox before can come down with chicken pox. I intend to keep the area covered not only with a dressing, but with clothing...As a nurse there should always be proper hand-washing technique anyway, so I don't believe there was anything wrong with the nurse working, and I will be going to care for the children in the nursery.