Patient assignments during pregnancy

jeepgirl, LPN, NP · Jan 27, 2005

I wouldn't take a CMV patient if I was pregnant. And, I would try to be nice and give them "clean" patients anyway. When I worked Onc, we always tried to separate clean and dirty to decrease nocomial infection rates. Do you guys try to do that?

kaseysmom, LPN · Jan 27, 2005

In the ideal work place and in the ideal world - pregnant nurses wouldn't be subjected to all of those sorts of infections and diseased patients. However, that's what standard precations/universal precautions and all of those sorts of things were made for (well not specifically..but..you know what I mean). In my opinion, as long as the nurse practices in the CORRECT way (proper hand washing, gloving, gowning, masking, etc) she should stay infection free. Aside from this, some of the infections that were mentioned manifest in open wounds..so the nurse should be vigilent about any open sores that she may have.

When I was in school, we had a pregnant student who was expected to function optimally just as the rest of us were - even until her 8th month of pregnancy. I know that if I were the one pregnant, I would probably prefer to not work with patients who are infected with the above posts infections and such...however, it is no different then not practicing nursing in a safe way (by not gowning or not washing my hands, etc) assuming that i werent pregnant, and taking any infectious diseases home to my child. Just my thought =)

lovingtheunloved, ASN, RN · Jan 27, 2005

a) if you can't handle infectious diseases, don't work in healthcare.

b) pregnancy is not a disability

c) if pregnancy is negatively affecting your ability to do your job, take maternity leave. Don't screw your coworkers.

Sorry if I sound mean, but it's pregnant season where i work, and I get tired of the whole "I'm pregnant, so I can't do anything on the floor, but I can clock in and sit at the desk and suck up all your profit sharing."

DDRN4me · Jan 27, 2005

I think speaking gently with the NM about it is a good idea, but back up what you have to say with facts (assignment sheeets, etc) I know a nurse who contracted CMV and had a very disbled child, so I would steer her clear of that one, but the other infections, with precautions, should be fine. If she gets a doctors note, then your NM will have to justify more staff to replace her decreased workload.

Elenaster · Jan 27, 2005

I'm an ICU nurse and I frequently took MRSA and VRE patients when I was pregnant. In my opinion, I would have rather taken care of those that were identified and in isolation so I would take proper precautions. What I hated (and still do) is finding out a patient was put in contact isolation after turning up positive for VRE and MRSA 2 days AFTER I had taken care of them for 3 or 4 days in a row.

I felt it was more important to take care of myself physically when I was pregnant, meaning I preferred not to take care of those patients that were very large and total care, or extremely confused and physically demanding.

After talking to ID, I really didn't worry too much about contracting an abx resistant infection while I was prego.

medpsychRN · Jan 27, 2005

"So I want to bring this up to my NM because I'm kind of getting tired of it (by the way, prego is lazy and a complainer too). Besides, she does nothing to help anyone else on the unit. She actually gets other people to 'help' her (out of sympathy, I guess) :angryfire . I know I'm not the only one who feels this way, but I'm not sure if others are willing to say something either (you all know how that is). But what I want to know is does she have anything in her defense? Like will she come in with a doctors note. In the past, I've heard NMs say there's no such thing as a light duty. Would I be out of line to suggest that she should get the extra pt, because the acuity of hers end up being lighter? I really hate to complain, as there's so much of that going on on this unit already (and she'll just complain even more after this). But it seems that the squeaky wheel always gets the grease, and I'm feeling rather dry right now."

If you had a broken leg in a cast and technically could work, I can't imagine any hospital giving you the okay to work at your regular pay rate but at a reduced patient load.

Most of us had to work while pregnant and while it's not easy you have an awareness that it's not the staff's fault your pregnant and they can't always give you a break.

I guess I'd tell the manager that I am having difficulty managing the extra load because nurse P is unable to take XYZ patients. I's also ask if the manager could "hire" additional staff to fill the void related to nurse P's condition.

I remember a nurse who claimed she hurt her back and couldn't take any difficult patients. That went on for three weeks and finally the manager sent her to work in the print shop (hospital prints all their own forms). She was there about a week (at a lower pay) and she recovered! Good luck!

saskrn · Jan 27, 2005

i'm sure some may not agree with me, but hear me out.
we have a pregnant nurse on our floor. it's an oncology unit- full of pts that need chemo. many of the others have some kind of infection (mrsa, vre, cmv, whatever). so prego 'can't take' any of the above pts. but for some reason, all those who have been pgregnant in the past did not have such modified assignments. i hope i do not sound cruel. and of course, most of us will not purposely assign her all of these pts (but some may want to at this point b/c she's really taking advantage of this, imho). it's just getting to be a real pain. so of course, i get a chemo pt the other night, a +vre, an (old) cmv+ pt, a line-infected (unspecific) pt., plus two more pts (she actually got one less pt. than i did. and two of my pts. are post bmt, which sually means higher acuity. unfortunately, on this unit, we do not have enough nurses to assign pts by acuity, so it's split down the middle (and i got one left over ).
so i want to bring this up to my nm because i'm kind of getting tired of it (by the way, prego is lazy and a complainer too). besides, she does nothing to help anyone else on the unit. she actually gets other people to 'help' her (out of sympathy, i guess) :angryfire . i know i'm not the only one who feels this way, but i'm not sure if others are willing to say something either (you all know how that is). but what i want to know is does she have anything in her defense? like will she come in with a doctors note. in the past, i've heard nms say there's no such thing as a light duty. would i be out of line to suggest that she should get the extra pt, because the acuity of hers end up being lighter? i really hate to complain, as there's so much of that going on on this unit already (and she'll just complain even more after this). but it seems that the squeaky wheel always gets the grease, and i'm feeling rather dry right now.

i kind of figure that if you can't do your job, you shouldn't be there. i may sound harsh too, but imo, pregnancy is no excuse. if she can't do her job because she's pregnant, than she should try doing a paperwork position (or something more accommodating), etc. her behavior is obviously affecting you, and likely the other staff, so you need to speak with your boss. many should not be burned out, for the sake of one, if you know what i mean.

but, for the sake of political and social correctness, you probably shouldn't refer to her as "prego". :)

Technotart · Jan 27, 2005

The funny thing - you KNOW these patients have these infections!! This is an opportunity to protect yourself!

The patients who dont have them - might have something and you just dont know it yet - to me the risk there is far greater.

We don't deliberately assign PG nurses the CMV babies, BUT we treat every baby as though he has CMV - make sense?

Universal Precautions and then some - if you are pregnant - you can always elect to wear above and beyond what is required of you in terms of protective gear.

Jolie, BSN · Jan 27, 2005

Of course, no one wants to put this nurse or her baby in harm's way, but it sounds like she is taking advantage of everyone's kindness. Unfortunately, that's all too common in nursing, much like the pregnant nurse on ortho who states that she can't lift, or the pregnant nurse on med/surg who insists on taking the patients closest to the nurses' station because of her aching feet and back.

Each institution has policies and procedures which should outline safe and appropriate patient assignments for EVERY nurse, not just pregnant ones. Infection control should be able to spell out the precautions necessary for this nurse to safely care for infectious patients, or ID those to whom she should not be exposed. Ditto the environmental safety officer where chemo is concerned. If the nurse's OB disagrees with hospital ppolicy, let him/her take it up on the nurse's behalf.

A doctor's note is useless in these circumstances, because pregnancy is not a disability caused by work. (At least not usually:) Doctor's notes and light duty come into play when an employee has been injured on the job, and is capable of doing some, but not all of his/her usual responsibilities. In these cases, it is preferable for the employer to gain partial benefit from the employee's work than pay disability for that person to sit home.

If the nurse's pregnancy substantially interferes with her ability to work, then she should apply for FMLA and stay home.

BeenThereDoneThat74, MSN, RN · Jan 27, 2005

when i worked onc, we always tried to separate clean and dirty to decrease nocomial infection rates. do you guys try to do that?

:chuckle :chuckle :chuckle :chuckle :chuckle oh i'm sorry. you were serious, right???

BeenThereDoneThat74, MSN, RN · Jan 27, 2005

but, for the sake of political and social correctness, you probably shouldn't refer to her as "prego". :)

why, is that a bad thing to say?? (i don't call her that, just easier than referring to her as the 'pregnant nurse' for the purposes of this bb).

i'm glad i'm not the only one who feels this way. i've been pregnant myself (and worked to full capacity- not in onc., but in ortho :uhoh21: ), as most of you guys have been. so it's not a 'special circumstance' imho.

i also agree with some of you (as some of the nurses i work with have mentioned) that it's better to know of a confirmed infection, than a possibel (although we should be taking the same precautions for all pts anyway!!!). i truly do not wish ill will on this girl or her baby. i just feel like she's using it a bit to her advantage. most people don't mind taking the chemo pts (i personally don't). but when the acuity changes, that's where the problem begins.

unfortunately, i don't think staffing is going to be adjusted (increased, that is). we are in a terrible situation as far as staffing (we really have very little staff- i mean very little), which of course is lowering our morale.