Please tell me this isn't happening...negative rubella titer = no job

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Specializes in NICU.

Right now I feel as though my world may come crashing down around me. Because of being immunosuppressed r/t kidney transplant when I was a baby I was only able to get one MMR vaccine. To get into NS I had to get titers drawn to prove I was immune. For rubella it was a very fine line. I was at 9.2 & passing was 9.9....but from 5-9.9 was indeterminate. My school said fine, I passed. The others were all immune. Now, I just got a job as an extern in the NICU (I graduate in December). Well, today I get a call from employee health asking for the actual lab results of the titers. I had only given them my school papers saying positive for all MMR. I'm now wondering if I give them the paper with my results with the ranges that they will say I'm not immune and therefore can't work. I have worked too hard in NS to all the sudden be told you're not immune and can never work. I don't even know what to say, how to feel. I just want to go hide in a hole and not come out. I'm so frustrated. Please tell me, do you think this could be a serious problem and there really is a chance that I may never be able to work as an RN? Any info would be great. Thanks.

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Specializes in CICU.

Can you go ahead and get the immunizations now?

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Specializes in ED, ICU, PACU.

Don't worry. Speaking from experience, once employee health sees your actual titers, they will offer you the MMR. You can sign a form waiving it; but, if you do, you may have to take full responsibility if you are exposed to rubella (unpaid time off of work during the incubation period). I have never heard of anyone not being able to get a job because of low titer results.

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Specializes in NICU.

I can't have any live vaccines including MMR.

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Specializes in Community, OB, Nursery.

I think you will be ok. Many many people refuse HepB, sign the waiver, and no more is said.

Being that you'll be in a NICU you'll have to be extra careful when you're outside work to not get exposed to kids c rubella on the chance you might contract it. But I think you will be ok if you don't get the MMR.

Chin up.

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Is the reason no live vaccines because of your surgery as a child, or because of the ramifications for your tiny patients???

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Specializes in Oncology, Research.

You can definitely sign a MMR waiver. Many people do not get it due to religious objection.

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Specializes in NICU.

I can't have live vaccines because of the immunosuppressive drugs I'm on...and will always be on.

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Specializes in Nursing Professional Development.

While I hope it works out for her ... I think the OP has a legitimate concern. Some employers may not hire her unless she has a positive titer. It's not the risk to her (the nurse) that is the legal problem for the hospital -- it is the risk she poses to patients and their families should she contract the disease and spread it to others.

I don't know if the policy has been tested by a prospective employee, but I know for a fact that my hospital will not allow students to come unless they show proof of immunity -- no exceptions.

My advice for the OP is to talk with the hospital's occupational health nurse, be totally honest, and get new titers drawn if necessary. She might get a positive titer and have nothing to worry about -- or may find out that the hospital is fine with her borderline one. Not knowing and possibly worrying for nothing doesn't help anything. Facing the problem head on will at least give her the correct information so that she can either address any problems or celebrate because there is no problem.

Good luck!

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Specializes in Day Surgery, Agency, Cath Lab, LTC/Psych.

Please don't despair. When I was little I had an allergic reaction to the MMR vaccine and was only given one shot in the series. It didn't become a problem for me until I entered my BSN program and they required titers. Come to find out I don't have immunity against mumps. This was not a problem for my school because I have an allergy to the vaccine. I have gotten 4 nursing jobs and have not had an issue with this. My most recent position is in a staffing agency. I got a lecture from the NP who did my physical exam about it, but what am I supposed to do? You are protected from rubella through herd immunity. However, there is the risk of you spreading it (if you were to get infected) to your newborn patients who haven't been vaccinated yet. I think this risk is very low and shouldn't prevent you from getting the job. I think the hospital would be foolish to let you go because of this.

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Specializes in Diabetes ED, (CDE), CCU, Pulmonary/HIV.

The bigger risk with rubella is not spreading it to newborns, but the possibility of spreading it to women who are in the first trimester of pregnancy. When a woman has rubella during early pregnancy, there is high risk for severe birth defects or fetal death. Many women have elected abortion because of having rubella during early pregnancy.

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Specializes in Ortho, Med surg and L&D.
I can't have any live vaccines including MMR.

Hello,

You didn't go through nursing school for naught, even if you miss on this position.

I would personally advise against taking the NICU position or signing any waivers.

This is from myexperience. My former employer didn't draw MMR, (as of Jan 2006) for pre-employement. Then, myself along with others, contracted mumps from a patient. There was an outbreak among ER staff and staff where the patient was transferred to. The CDC and state were contacted and wel...now most institutions draw for MMR titers and immunity pre-hire and require sufficient levels here.

My immunity is, (knock on wood) healthy. I ended up with a double dose of Mumps! Twice in a row! Just recently I heard from a nurse where I'm doing my internship that he son had them twice too, recently as well within the last few months.

Yet, there were indeed people where I worked and caught the mumps whose titers were low who also refused the attenuated, (right?) virus.

Good luck, there is always a way.

Gen

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