Positive TB & New Employment

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OK. New to this. But to sum things up...

I just graduated nursing school in August. My TB test was coming up on being due, so I got it renewed then. It was probably positive. It itched like crazy, swelled up, and in a panic, I iced it like crazy before going in. (Stupid, I know, no lectures - but keep in mind that I hadn't shown a single symptom of any illness in almost 3 years at this point and had a long history of negative tests.)

They originally read it as positive, but I knew I was in a sticky situation, being a new grad. My family is so poor, on the verge of losing everything, and the only way we kept our lights on through school was with my small student loan installments. I knew any delay in employment could mean losing everything, and I started crying. So they kept calling new people over, who read it smaller and smaller, until it was declared negative. Yup. The pity pass.

So it STILL took me this long to find a new job. We are bordering on having to pull my daughter out of her preschool, and our rent has been late for the last 2 months. AND I NEED ANOTHER PPD TEST. I start on the 5th. I have my test Wednesday, read on Friday.

Now, I KNOW I'm healthy - not so much as a sniffle in almost 3 years. Not even a head-cold. Really. So I know a cxr would be negative, absolutely. My question is this - while I can probably secure an x-ray before the 5th, no problem, can they force me to wait months until I'm well established on the prophylactic antibiotics as well? And if the position isn't open then? Can they halt my employment for this? NO ONE at this major corporation can give me a straight answer. And there's been radio silence from my instructors. I know plenty of nurses who converted during their career, and I'm not worried anymore. I could give a CRAP if I croak 20 years from now - as long as my daughter has food tomorrow, you know?

What are the legalities involved? Can they withhold employment? I can't sleep over this... :uhoh3::crying2:

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I'm also a converter. New employment will require a cxr and if it's neg you'll be ok.

They dont test me every year after that dt the skin reaction- red and itch like crazy.

If you find another job explain to them your a converter and they'll just ask you for

a cxr to put in in file.

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Thank you. Like I said before, between Friday and the 5th, a chest x-ray is totally doable. Probably not fun, because I don't have a pcp right now. I'm not on speaking terms with my last one. 3 months of repeated attacks (up to 8 hours at a time) of acute pancreatitis with the insistence that I was completely "fine", begging for more testing, then hanging up on me when I asked for a referral for a GI doc? Yeah... She can bite me.

Hopefully, I can get it done through employee health. But all the same, I just wanted to make sure they won't wait months for me to take the abx in ADDITION to a neg chest x-ray. Considering that I was exposed WHILE in nursing school would just be the icing on the cake of a myriad of issues I hold with the school and the corporation that runs it in general. It would be extraordinarily difficult not to be bitter if it meant I couldn't even be employed...

THANK YOU! Maybe I can sleep now...

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As long as your CXR is negative, then you have nothing to worry about. A positive PPD just means at some point you were exposed to TB that in now way means you have active TB. I have worked with plenty of nurses that had positive PPD's and have to get a CXR yearly, but they don't keep you from working as long as you don't have an active case of TB. Good LUCK.

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I don't think you'll have to go to your PCP for an xray, my understanding is most facilities will "provide" the xray just like they "provide" the PPD.

Good luck and congrats on the job!

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Specializes in Cardiac Care.

Usually if the PPD is positive they send you to an employee health office to get the cxr, if that is negative then you are good to go.

MANY Nurses and nursing student have tested positive... although they say ONCE you test positive you should not get another PPD and you should just the the cxr yearly!

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Specializes in family practice.

Usually when a PPD is positive, you do not need to get another one. A chest X-ray would be required and its good for 3-5yrs (depends on your place of work).

Also most states i have lived in, they send me to the health department (NY, MD and AZ) to get the chest X-ray done and i've never had to pay.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Thank you. Like I said before, between Friday and the 5th, a chest x-ray is totally doable. Probably not fun, because I don't have a pcp right now. I'm not on speaking terms with my last one. 3 months of repeated attacks (up to 8 hours at a time) of acute pancreatitis with the insistence that I was completely "fine", begging for more testing, then hanging up on me when I asked for a referral for a GI doc? Yeah... She can bite me.

Hopefully, I can get it done through employee health. But all the same, I just wanted to make sure they won't wait months for me to take the abx in ADDITION to a neg chest x-ray. Considering that I was exposed WHILE in nursing school would just be the icing on the cake of a myriad of issues I hold with the school and the corporation that runs it in general. It would be extraordinarily difficult not to be bitter if it meant I couldn't even be employed...

THANK YOU! Maybe I can sleep now...

If your test was truly positive 3 years ago.....shame on you for not following up...... I find it unusual that the school did not require a negative TB test for admission to school. Whether or not you are sick does not mean that you aren't contageous and a carrier. Many people are positive converters with never having true "exposure" and just require a chest x-ray. Legally, if you have a communicable disease you can be removed from employment.

http://www.hivatwork.org/tools/pdf_mngrkit/wrkplace/tbhiv.pdf

http://www.cdc.gov/TB/

YOu should seek the advice of a doctor....Good Luck on your new job.

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Specializes in Cardio/Pulmonary.

Mine sometimes reads as positive - depends on who looks at it. the red area gets huge and very itchy, but the thing is, it isn't indurated, so im usually safe.:yeah:

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Trying to fake the results of a PPD? Wow ....

However, that aside, I've been positive since before I started nursing school, long, long ago, and it's never been a problem. Lots of people are; as already noted, it doesn't mean you have TB, just that you've been exposed at some point, which lots and lots of people have been. The point of the follow-up when you first "turn" positive is to make sure you don't have active TB and get you appropriate treatment if you do, which is a good thing. :rolleyes: I had to "turn myself in" to the county public health department, and I did the year of prophylaxis which was the standard at the time, but it didn't affect my nursing school studies at all.

It's never been a problem for me with employment, in >25 years with multiple employers, in five different states.

If you've had a positive PPD in the past, you're not supposed to take any more PPD tests. It can be dangerous. As already noted, employers (in healthcare, anyway, in my experience) provide the CXR at no cost instead, just as they provide the PPD test at no cost. I just went through this process when I started my new job six months ago. No one batted an eye when I told them I was positive. It's a routine thing in healthcare. (And it's been a v. long time since anyone wanted me to have a CXR annually -- it's usually just every several years now, with the weird little questionnaire annually.)

I'm really shocked that anyone would decide a PPD result was negative because the individual started crying (??)

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
OK. New to this. But to sum things up...

I just graduated nursing school in August. My TB test was coming up on being due, so I got it renewed then. It was probably positive. It itched like crazy, swelled up, and in a panic, I iced it like crazy before going in. (Stupid, I know, no lectures - but keep in mind that I hadn't shown a single symptom of any illness in almost 3 years at this point and had a long history of negative tests.)

They originally read it as positive, but I knew I was in a sticky situation, being a new grad. My family is so poor, on the verge of losing everything, and the only way we kept our lights on through school was with my small student loan installments. I knew any delay in employment could mean losing everything, and I started crying. So they kept calling new people over, who read it smaller and smaller, until it was declared negative. Yup. The pity pass.

So it STILL took me this long to find a new job. We are bordering on having to pull my daughter out of her preschool, and our rent has been late for the last 2 months. AND I NEED ANOTHER PPD TEST. I start on the 5th. I have my test Wednesday, read on Friday.

Now, I KNOW I'm healthy - not so much as a sniffle in almost 3 years. Not even a head-cold. Really. So I know a cxr would be negative, absolutely. My question is this - while I can probably secure an x-ray before the 5th, no problem, can they force me to wait months until I'm well established on the prophylactic antibiotics as well? And if the position isn't open then? Can they halt my employment for this? NO ONE at this major corporation can give me a straight answer. And there's been radio silence from my instructors. I know plenty of nurses who converted during their career, and I'm not worried anymore. I could give a CRAP if I croak 20 years from now - as long as my daughter has food tomorrow, you know?

What are the legalities involved? Can they withhold employment? I can't sleep over this... :uhoh3::crying2:

Pity Pass????:eek::eek::eek::eek:

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Specializes in Complex pedi to LTC/SA & now a manager.

Pity pass? Are you sure that qualified professionals were reading your test? Was there an induration? (My site swells & itches and basically turns into a giant hive, BUT there is NO induration. A new MA at my docs' office was going to mark my PPD as positive when the MD corrected her explaining it's not by sight/redness/swelling but by induration.) If you were positive in the past why not skip the PPD and go to CXray? My local health department does the TB screening at low or no cost.

either way like others explained +PPD is only indicative of exposure to the mycobacterium. From the CDC"

Testing for TB Infection

There are two kinds of tests that can be used to help detect TB infection – the TB skin test (TST) and TB blood tests. A positive TB skin test or TB blood test only tells that a person has been infected with TB bacteria. It does not tell whether the person has latent TB infection (LTBI) or has progressed to TB disease. Other tests, such as a chest x-ray and a sample of sputum, are needed to see whether the person has TB disease." http://www.cdc.gov/tb/topic/testing/default.htm

e mycobacterium not indicitive of active or latent infection. From CDC "

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